ABSTRACT:
Children living in protracted conflict zones experience sustained exposure to violence, displacement, loss, and instability, placing them at significant risk for long-term mental health consequences. These “invisible wounds” often remain underrecognized and undertreated due to disrupted health systems, limited mental health infrastructure, stigma, and competing survival priorities within humanitarian settings. This presentation examines pediatric mental health needs in protracted conflict zones through a public health and humanitarian lens, emphasizing equity, inclusion, and sustainability consistent with the theme of Health Without Borders. Drawing on trauma-informed and developmentally appropriate frameworks, the session explores common psychosocial manifestations observed among conflict-affected children, including anxiety, behavioral dysregulation, somatic complaints, sleep disturbances, emotional withdrawal, and impaired developmental trajectories. Particular attention is given to the interconnected mental health needs of children, families, and healthcare providers, recognizing caregiver distress, collective trauma, and moral injury as compounding risk factors. Structural determinants, such as forced displacement, family separation, poverty, disrupted education, and attacks on healthcare infrastructure, are examined as drivers of persistent mental health inequities. The presentation highlights evidence-informed, culturally responsive strategies that can be integrated into emergency, primary, and humanitarian care settings, even in resource-constrained environments. These include early psychosocial screening, family-centered communication, child-friendly spaces, play- and arts-based interventions, humor and routine as protective factors, and support for family reunification and community cohesion. Strategies to support the mental well-being of frontline healthcare workers are also discussed as essential to sustaining pediatric care delivery. The session concludes with a call to action for interdisciplinary collaboration, community engagement, and policy advocacy to strengthen sustainable pediatric mental health services in conflict-affected settings. Addressing the invisible wounds of war in children is not only a humanitarian imperative but a critical investment in global health equity and future resilience.