What really happens to children caught in conflict

It started with a football.

Ali*, 13, and his younger brother Nour*, 9, were playing in the courtyard of their home in Khartoum, Sudan, in April 2023, when the ball rolled into the street. They ran after it – the way children everywhere run after footballs – and a shell landed nearby.

In an instant, Ali lost his leg. Nour suffered severe abdominal injuries and a spinal fracture that left him unable to walk. Their mother, the family's sole caregiver, spent the months that followed travelling from city to city – Khartoum, Madani, Al-Faw, finally Gedaref – searching for medical care as hospitals were attacked and doctors fled. Nour's treatment was interrupted multiple times. He lived with a medical catheter for more than 18 months.

"We have lost everything except hope," their mother says. "I just want my children to recover."

Ali and Nour's story is not unusual.

The scale of what is happening

Between 2020 and 2024, almost 50,000 children were killed or injured in conflict – the equivalent of 200 passenger planes full of children. In 2024 alone, nearly 12,000 children were killed or injured – the highest annual toll ever recorded.

More than 60% of those deaths and injuries were caused by explosive weapons: bombs, landmines, shells, airstrikes and the remnants of war that remain buried in farmland and playgrounds long after fighting stops.

The countries where children faced the greatest danger in 2024 were the occupied Palestinian territory, Sudan, Myanmar, Ukraine and Syria. But the crisis is not confined to any one place. In Afghanistan, children account for up to 80% of blast-related deaths and injuries. In Somalia, nearly 4,000 children were killed or injured between 2020 and 2024. In Lebanon, at least two children were being killed every day in the first five weeks of the Lebanon–Israel war escalation in 2024.

Why explosions hit children harder

When an explosion happens near a child, the consequences are not the same as they would be for an adult. This is not just a question of being in the wrong place. It is a question of biology.

Children's bodies are still growing. Their skulls are thinner, their skin is more delicate, their bones are softer. Research by the Centre for Paediatric Blast Injury Studies at Imperial College London – co‑founded by Save the Children – has found that 80% of child blast patients experience penetrating injuries to the head, compared to 31% of adult blast patients. Children under seven are almost twice as likely to suffer life‑limiting brain trauma as older children.

Children are also more likely than adults to need amputations. And because they are still growing, a child who loses a limb may need their prosthetic replaced every single year – sometimes more frequently. One example is Chouchou*, who lost her leg at one year old when a stray bullet struck her knee during political violence in the Kasai region of the Democratic Republic of Congo. She is now walking again with a prosthetic limb, but will likely need dozens of replacements as she grows.

Burns affect children differently too, impacting a larger proportion of their bodies. Children under two have thinner skin, meaning burns penetrate more deeply and spread more rapidly, causing faster loss of heat and fluid – with serious consequences for survival.

None of this is reflected in the way conflicts are fought, the way international law is applied in practice, or the way funding for recovery is allocated.

The injury is not the end of the story

What happens to a child after a blast injury is often harder to understand than the injury itself – and harder to see.

Ali spent two years getting to school on a walking stick, until the distances became too much and the swelling in his hands too painful. Save the Children gave him a motor wheelchair. He can reach school on time now. "I believe things will get better," he says.

Nour still can't walk. He needs specialist care that his family, displaced and separated from their father, cannot easily access. "Sometimes I feel pain in my back and legs," he says. "I miss school, but I want to go back and learn again."

These are not edge cases. They are the pattern. When a child survives a blast, they face years – often a lifetime – of physical rehabilitation, psychological recovery and disrupted education. Many children continue to struggle long after war ends, grappling with fear, nightmares and anxiety. Without sustained support, those invisible wounds can be just as damaging as the physical ones.

Yet in 2023, only 6% of global mine action funding went to victim assistance, and just 1% went to risk education.

What Save the Children is doing

Save the Children responds to blast injuries at every stage – from the moment a child is hurt to the years of recovery that follow.

We run emergency health units in conflict zones. We co‑founded the Centre for Paediatric Blast Injury Studies at Imperial College London, the world’s first research hub dedicated to understanding the unique needs of children injured by explosions. We also produced the world’s first field manual on treating blast injuries in children, now used across Syria, Ukraine, Gaza, Somalia, Yemen and beyond.

We provide prosthetic limbs, wheelchairs, crutches and mobility aids. We offer psychosocial support so children can begin processing what they have been through. And we help children return to school – because education, even in crisis, protects children.

Chouchou’s headteacher carried her to school on her back for six months before Save the Children and partners provided her with mobility aids and eventually a prosthetic leg. Now she goes to school herself. She plays, learns and dreams of becoming a tailor.

This is what recovery looks like – not a single moment, but a series of steps made possible by people who refuse to accept that a child's future should be decided by a bomb.

What you can do

Children like Ali, Nour and Chouchou need support not just in the immediate aftermath of injury, but for years to come. A monthly gift helps fund emergency care, rehabilitation and long-term recovery – so that surviving is only the beginning.

*Names have been changed to protect identities. 

Frequently asked questions