Explosive weapons have become a leading cause of child casualties in modern conflict. These weapons cause severe injuries, lifelong disabilities, and profound developmental harm in addition to death. Despite this vulnerability, health systems and humanitarian responses frequently fail to meet their distinct needs. This article argues for stronger protections for children in conflict, child-centred proportionality assessments, as well as sustained investment in victim assistance, research and rehabilitation for children affected by blast injuries.
Introduction
In modern conflict, explosive weapons have become a defining threat to children’s survival and well-being, with their use now being a leading cause of child casualties. In recent years, the severity of injuries among children has been unprecedented. Between 2020–2025, nearly 50,000 children were killed or injured, with over 60 percent of verified child deaths and injuries caused by explosive weapons.1 These numbers represent only a fraction of the true scale, as many casualties are never officially recorded.
Blast injuries reshape the trajectory of a child’s life by interrupting education, isolating children from their communities, and placing enormous strain on families navigating life-altering injuries often in settings where services are limited or non-existent. The psychological toll is profound, with children experiencing nightmares, regression, anxiety, and lasting fear.2 The nature of contemporary conflict multiplies long-term costs, inflicting irreparable harm on children, infrastructure and social systems.
Across conflicts from Ukraine to Gaza, Sudan to Syria, children are disproportionately harmed by explosive weapons with wide area effects, in ways that current policies, military practices, and humanitarian responses still fail to fully address.
Children’s distinct vulnerabilities
Most health responses to the impacts of explosive weapons in conflict remain designed for adults, overlooking children’s distinct needs despite the unequivocal evidence that children are not simply smaller civilians. They are physiologically, psychologically and socially distinct, and they are far less able to withstand the effects of explosive violence.
Children have a lower threshold for harm and sustain more severe injuries than adults. Many children arrive at hospitals with shrapnel wounds, traumatic amputations, severe burns, fractures, and complex injuries. Their smaller bodies and developing organs mean the same blast that an adult might survive is far more likely to kill a child or cause catastrophic trauma. It is estimated that 65–70 percent of injured children sustain wounds to multiple parts of their bodies 3 and that children under seven are almost twice as likely to suffer life-threatening head injuries.4
By early 2025, the number of children killed in Gaza since the escalation began in October 2023 had surpassed 20,000 – around 2 percent of Gaza’s child population and one third of all fatalities.5 On average, one child has been killed every hour over nearly two years of war, the majority by explosive weapons.6 As of July 2025, over 40,500 children were estimated to be injured. 7 Gaza is now home to the largest cohort of child amputees in modern history,8 with operations often performed without anaesthesia or sterile conditions. Dr. Ghassan Abu-Sittah, a surgeon treating children in Gaza, observed after weeks of operating under siege conditions, that “Gaza is redefining war injuries. I saw many babies who suffered amputations before learning to walk.”
The curiosity of young children and their proximity to the ground result in high numbers of eye injuries from mines, many of which are remnants of past conflicts and located in civilian-populated areas. Damage to the eye in infancy, for example, not only causes visual impairment but also prevents normal eye development, leading to additional visual defects over time.9
Burns from explosive weapons are also more severe in children, affecting a much larger proportion of the body than in adults.10 Because children face greater risks from burns and penetrative injuries, they are at higher risk of death and serious injury when caught in the path of an explosion. A study in Kharkiv, Ukraine, found over one-third of injured children sustained severe or critical trauma, with 41 percent discharged with disabilities.11 Younger children, including infants and toddlers, were especially prone to head injuries and burns, likely because of their smaller body size and their closer exposure to heat and blast effects near the ground. This pattern is consistent with evidence from Afghanistan, Syria and Iraq.
In many conflicts, health systems are frequently overwhelmed or destroyed. The consequences are stark: injuries that would be survivable and manageable in a functioning health system become life-altering or fatal. Medical blockades and destroyed infrastructure mean many children cannot access surgery. In Sudan, more than 80 percent of hospitals are no longer functioning, and those still open lack basic supplies like blood bags, oxygen and fuel.12
Injuries from explosive blasts often result in amputations, blindness or severe scarring, and very few children have access to prosthetics or rehabilitation. Limb injuries and limb loss further restrict children’s daily lives, limiting movement, play and access to school, particularly in rural or conflict-affected settings. Long-term rehabilitation for limb injuries is often unavailable, compounding social exclusion and unmanaged pain.
Children with major physical trauma commonly report long-term, chronic pain, which significantly affects their quality of life. Despite evidence that unmanaged pain in children has devastating consequences, pain is frequently under-assessed and under-treated, including by healthcare professionals and caregivers.13
Prosthetic limbs are therefore vital to children’s access to education, healthcare and play, and to their physical, psychological and social development. However, existing paediatric prosthetics are largely scaled-down adult models and lack design features that support a fulfilling childhood, with limited direct input from children themselves.14 Nadin*, 13, from Yemen was forced to drop out of school due to severe injuries from a shelling incident. The attack occurred at a house near the frontlines during a wedding party that she was attending with friends and family, where several people were injured. Nadin says, “When I woke up from surgery and found out my leg was gone, I cried a lot. I was in shock and kept screaming, ‘Give me back my leg, why did you take it?”15
But the threat does not end when the fighting stops. Children injured by explosive weapons face lifelong medical and psychosocial needs, and over the course of childhood and adolescence may require dozens of assistive devices and years of rehabilitation, making the total cost several times higher than for adults injured later in life.
Explosive remnants of war and their long-term impact on children
Explosive remnants of war, including landmines and unexploded ordnance, continue to kill and injure children long after conflicts subside. Children are particularly vulnerable due to their curiosity, their tendency to play outdoors, and their limited understanding of risk. Globally, they make up 43 percent of all casualties from unexploded ordnance.16
In Syria, for example, brothers Osama*, 6, and Yousef*, 10, returned to their home near Idlib to start repairs to their destroyed home after the end of 14 years of conflict. After pitching a tent with their father for shelter, a landmine exploded as the boys played outside. The two brothers were seriously wounded, each losing a leg, while their other brother, 8-year-old Khaled*, was killed.17
Their story is not isolated—it reflects a broader pattern in which the remnants of war continue to maim and kill, undermining recovery and trapping communities in cycles of fear and displacement, and devastating livelihoods. Farmland becomes unusable, infrastructure remains unsafe, and humanitarian access is restricted. Entire communities are prevented from rebuilding, prolonging dependence on aid and delaying economic recovery.
Today, a quarter of Ukraine is contaminated with landmines and unexploded ordnance, making it one of the most heavily mined countries in the world,18 where one in every ten landmine casualties is a child. Children face daily risks simply by walking to school or playing outside.
Mitigating the risks to children of explosive remnants of war in UkraineIn Ukraine, one innovative response is helping to mitigate the dangers of explosive remnants of war: a demining dog named Chivas.19 Trained to detect explosive materials, Chivas participates in mine safety education sessions for children, using simple, engaging signals - such as crossing his paws to indicate danger - to teach life-saving behaviours. The presence of the dog transforms what could be a frightening topic into an accessible and memorable learning experience. Children report feeling calmer, more engaged, and better able to retain critical safety messages. Mine awareness programmes have reached tens of thousands of children, equipping them with the knowledge needed to identify a deadly threat that children in Ukraine are exposed to every time they go out and play. This kind of child-centred approach should not be seen as a luxury, but rather as essential. Yet, such efforts remain underfunded relative to the scale of the threat. |
In addition to innovative responses to risk mitigation, equally important is the need in scaling up mine clearance, expanding risk education, and restoring safe access to schools, healthcare, and livelihoods. Without these efforts, the end of active hostilities will not mark the end of danger for children.
Where policy and practice fail children
Disproportionate harm to children from the use of explosive weapons in conflict is driven by their developmental stage, dependence on adults, and need for specialised services, making them far less able to withstand the effects of war. While these vulnerabilities are recognised in international humanitarian law, they are rarely reflected in practice, due in part to policy and practice that continues to treat civilians as a homogeneous group, failing to account for children’s distinct vulnerabilities.20
A proportionality assessment that deems a level of civilian harm “acceptable” based on adult thresholds is both legally and morally flawed. If the same blast is significantly more likely to kill or permanently disable a child, or if many children are likely present near the location of an attack, then failing to account for this difference undermines the very purpose of civilian protection.
Addressing this gap means recognising children as a reference point for assessing harm, not the exception. It requires integrating age-differentiated data into military planning, ensuring that weapons use accounts for children’s higher vulnerability.
Strengthening the protection of children also demands investment in paediatric medical capacity, from emergency care to long-term rehabilitation. It further necessitates sustained funding for victim assistance, research, and child-focused recovery programmes.
A child who loses a limb loses more than mobility—they lose access to education, independence, and opportunity. A child who grows up under constant bombardment loses not only a sense of safety, but the foundations of healthy development. A community contaminated by unexploded ordnance loses its ability to rebuild, trapping families in cycles of poverty and risk.
These impacts on children are predictable and preventable, and yet they are increasingly forgotten. Until children are placed at the centre of how wars are fought, regulated, and responded to, explosive weapons will continue to define not only the violence of conflict, but the shape of childhood itself.
Names marked * in this publication have been changed to protect identities.