What children hurt in conflict zones actually need - and how Save the Children helps

When Chouchou*, at just one year old, was struck by a stray bullet during political violence in the Kasai region of the Democratic Republic of Congo, her leg had to be amputated. Her grandmother Deba* fled with her to Angola for surgery, and then back home to DRC in 2018.

For the next six years, Chouchou stayed home. She had never been to school. She couldn’t move around on her own. With no money for mobility aids, no prosthetic leg, and no support, she simply sat outside her hut while other children walked past on their way to class.

The injury happened in a moment. The consequences lasted years.

This is the part of conflict that rarely makes headlines: not the explosion, but everything that comes after it. Not the emergency, but the long, complicated and often invisible road that children like Chouchou must travel to reclaim any part of their childhood.

The immediate needs: staying alive

When a child is injured by an explosion, survival is the first priority—yet in conflict zones, it is far from guaranteed.

Children’s bodies respond differently to blast injuries. According to Save the Children’s Children and Blast Injuries report, published in 2025 with the Centre for Paediatric Blast Injury Studies at Imperial College London:

• 65–70% of children injured in blasts sustain injuries to multiple parts of their body at the same time.
• Children are twice as likely as adults to suffer serious internal bleeding from a torso injury.
• Approximately 56% of child blast patients require surgery — double the rate for other types of childhood injuries.

In functioning health systems, these injuries are survivable. In conflict zones—where hospitals are attacked, staff flee, and supplies run out—they often are not.

This is why Save the Children operates emergency health units in active conflict zones: to deliver lifesaving care where children are being hurt, even as the wider health system collapses.

What recovery actually involves

Most people imagine bandages, surgery and medicine. But recovery from a blast injury—especially for a child—is long, complex and far from guaranteed.

A child who loses a limb needs a prosthetic—and because they are still growing, they may outgrow it every single year. Over a childhood, this can mean dozens of replacements, each requiring specialist fitting, adjustment and rehabilitation.

Save the Children’s research shows prosthetics range from USD $4,000 to $75,000 depending on type. For children, cumulative lifetime costs are several times higher than for adults, simply because they grow.

Then there is pain. Not only the acute pain of injury, but long-term, chronic pain that can persist for months or years. Around 1 in 5 children globally lives with chronic pain, and those who have experienced major trauma are at even higher risk. Pain affects everything—sleep, learning, play and social connection.

And the psychological toll is immense. Many children experience nightmares, flashbacks, anxiety, withdrawal and difficulty concentrating. Nour*, Ali’s younger brother, lives with pain from a spinal fracture and still longs to return to school. Their mother, displaced and separated from their father, manages their care alone.

Without sustained psychosocial support, these invisible wounds can shape a child’s entire life.

The funding gap nobody talks about

In 2023, of roughly USD $1 billion in global mine action funding:

• Just 6% went to victim assistance — the care and rehabilitation survivors desperately need.
• Just 1% went to risk education — teaching children to recognise and avoid unexploded weapons.

Children account for 43% of global civilian casualties from landmines and unexploded ordnance — yet funding for their recovery remains a fraction of what is needed.

How Save the Children helps — from the moment of injury to years down the line

Save the Children’s support follows the child — from emergency care, to rehabilitation, to long-term recovery.

In 2019, we established the Paediatric Blast Injury Partnership with Imperial College London. This grew into the world’s first dedicated research centre for blast injuries in children.

The partnership created the world’s first field manual on treating blast injuries in children, developed at the request of doctors in Syria. It is now available in nine languages and used in Syria, the occupied Palestinian territory, Ukraine, Ethiopia, Somalia and Yemen.

Our teams provide prosthetic limbs, wheelchairs, crutches and mobility aids. We deliver psychosocial support — including safe spaces — and help children return to school.

Ali* received a walking stick, then later a motorised wheelchair so he could reach school on time. Chouchou* received school supplies, crutches, and eventually a prosthetic leg — and now plays confidently with her classmates and dreams of becoming a tailor.

The work is far from finished

Nour still needs specialist rehabilitation. Many children like Chouchou waited years before receiving the prosthetics and care they needed. And for every child reached, many more receive no long-term support at all.

The systems required to help children recover are chronically underfunded. Specialist knowledge is still not standard in most conflict zones. Save the Children is working to change that — but we cannot do it alone.

How your support helps

A monthly gift helps fund emergency care, prosthetics, rehabilitation, psychosocial support and education for children injured in conflict. Children like Chouchou and Ali need support not just today, but for years to come.

*Names have been changed to protect identities. 

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