The violence, suffering, and death from the terrorist attack on Israel and the Israel-Hamas War weigh on us all. Pediatricians—who are called to care for children and keep them safe and healthy—have been reaching out to the American Academy of Pediatrics expressing anguish, outrage, and a deep desire to help stop the killing, ease the suffering, and protect all children from harm.

We are shaken and pained by what is happening in Israel and Gaza, and we are also alarmed by the increasing acts of violence and intimidation we’ve been witnessing in this country toward Jews, Muslims, and those with ties to Israel or Palestine. Many pediatricians and the families they care for have experienced such incidents.

As antisemitic and anti-Palestinian hate speech have been surging on social media, acts of hate have also been increasing in the United States and around the world. There has been an unprecedented rise in incidents of antisemitism, Islamophobia, and anti-Palestinian racism in this country according to data from the Anti-Defamation League1 and the Council on American-Islamic Relations.2 And reports of violent hate crimes targeting Jews, Muslims, and Arabs have risen steeply across the United States.

As people at home and abroad confront these issues and as world leaders debate how to move forward, one thing is certain: all children affected deserve our unconditional support.

It will always be the mission of the American Academy of Pediatrics (AAP) to advocate for children’s protection, health, and safety, no matter what, no matter where—be it in the United States, Israel, Gaza, the West Bank, Ukraine, South Sudan, Armenia, Syria, Yemen, Myanmar, Ethiopia, Democratic Republic Congo, or other conflict-torn areas that receive less media attention.

As pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, we understand that the profound cost of any war is measured in children’s lives—those lost to violence and those forever changed by it. We know that what happens to these children today and what we do for them will help determine what becomes of this generation tomorrow.

In 2018, the Academy published a policy statement3 and accompanying technical report,4 “The Effects of Armed Conflict on Children,” which began with the following statistic: 1 in 10 children are affected by armed conflict. By 2021, 1 in 6—or about 449 million children worldwide—were living in a conflict zone.5 Africa had the highest overall number of children impacted by conflict (180 million), followed by Asia (152 million), and the Americas (64 million). Today, that figure is tragically even higher.

Our policy details both the acute and long-term effects of armed conflict on child health and well-being and uses a children’s rights-based approach as a framework for the AAP, child health professionals, and national and international partners to respond in the domains of clinical care, systems development, and policy formulation.

Our policy calls on governments to safeguard children and for pediatricians and health organizations to be involved both in preventing and responding to armed conflict. It advocates for integrating core human rights principles set forth in the United Nations Convention on the Rights of the Child (UNCRC) treaty into US policy.

To fulfill these rights, the policy lays out a number of detailed recommendations for mitigating the harms of child conflict both in clinical practice and in social systems serving children. This includes ensuring child health professionals who care for children affected by armed conflict have access to training in trauma-informed care, which involves recognizing and mitigating the harmful effects of these experiences. And it highlights opportunities for public policy advocacy, which include:

  • Ending the participation of children younger than 18 years of age in armed conflict and ensuring all children are protected from torture and deprivation of liberty, including extended or arbitrary detention;

  • Upholding the Geneva Conventions with respect to maintaining the sanctity of safe places for children, ensuring medical and educational neutrality, and allowing children fleeing armed conflict to petition for asylum and be screened for evidence of human trafficking;

  • Ensuring that children are not separated from their families during displacement and resettlement, and in the event of separation, prioritizing family reunification;

  • Protecting children from landmines, unexploded ordnances, small arms, and light weapons through effective clearing efforts and strict control on their sale, ownership, and safe storage;

  • Affording children a voice in creating policy and programs that prevent and mitigate harmful effects of armed conflict; and

  • Providing children affected by armed conflict access to educational opportunities as part of an environment conducive to their reintegration into society.

In examining the entire policy in light of the Israel-Hamas War, we determined it was missing important elements to emphasize the protection of children during war and the Academy’s opposition to religious persecution of any kind. We voted unanimously to add the following to the policy statement:

  • Children should never be harmed because of the religious, cultural, and other beliefs and values of the child and/or their family;

  • Harm to children should never be used as a tool or tactic of war or conflict; and

  • Children should be protected from the direct effects of armed conflicts and their food, housing, health, and other basic needs safeguarded.

With the magnitude of the suffering and so many children hurting at home and abroad, this is a distressing time to work in pediatrics. The pain of our members is palpable; both the urgent desire to do all we can to protect children in Israel and Gaza and the fear and concern we are experiencing as acts of hate proliferate in the United States. Yet our common mission and the outpouring of support and solidarity among our member pediatricians reminds us there is light in the darkness.

We use our platform as the world’s largest pediatric organization to speak out against violence, hate, antisemitism, Islamophobia, and enmity toward Jews, Muslims, Israelis, and Palestinians and to speak up on behalf of all children suffering in armed conflict. We stand with everyone in the pediatric profession in these times of tragedy as we continue our work of healing, protecting, and caring for the world’s children.

2023 AAP Board of Directors2024 AAP Board of Directors
Sandy L. Chung, MD, FAAP Benjamin D. Hoffman, MD, FAAP 
Benjamin D. Hoffman, MD, FAAP Susan J. Kressly, MD, FAAP 
Moira A. Szilagyi, MD, FAAP Sandy L. Chung, MD, FAAP 
Dennis M. Cooley MD, FAAP Margaret C. Fisher, MD, FAAP 
Patricia Flanagan, MD, FAAP Patricia Flanagan, MD, FAAP 
Warren M. Seigel, MD, FAAP Jeffrey Kaczorowski, MD, FAAP 
Margaret C. Fisher, MD, FAAP Patricia Purcell, MD, MBA, FAAP 
Michelle D. Fiscus, MD, FAAP Jeannette “Lia” Gaggino, MD, FAAP 
Jeannette “Lia” Gaggino, MD, FAAP Dennis M. Cooley, MD, FAAP 
Gary W. Floyd, MD, FAAP Susan Buttross, MD, FAAP 
Martha C. Middlemist, MD, FAAP Greg Blaschke, MD, MPH, FAAP 
Yasuko Fukuda, MD, FAAP Yasuko Fukuda, MD, FAAP 
Madeline M. Joseph, MD, FAAP Madeline M. Joseph, MD, FAAP 
Charles G. Macias, MD, FAAP Angela M. Ellison, MD, MSc, FAAP 
Constance S. Houck, MD, FAAP Kristina W. Rosbe, MD, FAAP 
Joelle N. Simpson, MD, FAAP Joelle N. Simpson, MD, FAAP 
2023 AAP Board of Directors2024 AAP Board of Directors
Sandy L. Chung, MD, FAAP Benjamin D. Hoffman, MD, FAAP 
Benjamin D. Hoffman, MD, FAAP Susan J. Kressly, MD, FAAP 
Moira A. Szilagyi, MD, FAAP Sandy L. Chung, MD, FAAP 
Dennis M. Cooley MD, FAAP Margaret C. Fisher, MD, FAAP 
Patricia Flanagan, MD, FAAP Patricia Flanagan, MD, FAAP 
Warren M. Seigel, MD, FAAP Jeffrey Kaczorowski, MD, FAAP 
Margaret C. Fisher, MD, FAAP Patricia Purcell, MD, MBA, FAAP 
Michelle D. Fiscus, MD, FAAP Jeannette “Lia” Gaggino, MD, FAAP 
Jeannette “Lia” Gaggino, MD, FAAP Dennis M. Cooley, MD, FAAP 
Gary W. Floyd, MD, FAAP Susan Buttross, MD, FAAP 
Martha C. Middlemist, MD, FAAP Greg Blaschke, MD, MPH, FAAP 
Yasuko Fukuda, MD, FAAP Yasuko Fukuda, MD, FAAP 
Madeline M. Joseph, MD, FAAP Madeline M. Joseph, MD, FAAP 
Charles G. Macias, MD, FAAP Angela M. Ellison, MD, MSc, FAAP 
Constance S. Houck, MD, FAAP Kristina W. Rosbe, MD, FAAP 
Joelle N. Simpson, MD, FAAP Joelle N. Simpson, MD, FAAP 
1
Anti-Defamation League
. ADL reports unprecedented rise in antisemitic incidents post-Oct 7. Available at: https://www.adl.org/resources/press-release/adl-reports-unprecedented-rise-antisemitic-incidents-post-oct-7. Accessed December 22, 2023
2
Allison
I
;
Council on American-Islamic relations
. CAIR received 1,283 complaints over past month, an ‘unprecedented’ increase in complaints of islamophobia, anti-Arab bias. Available at: https://www.cair.com/press_releases/cair-received-1283-complaints-over-past-month-an-unprecedented-increase-in-complaints-of-islamophobia-anti-arab-bias/. Accessed December 22, 2023
3
Shenoda
S
,
Kadir
A
,
Pitterman
S
,
Goldhagen
J
;
Section on International Child Health
.
The effects of armed conflict on children
.
Pediatrics
.
2018
;
142
(
6
):
e20182585
4
Kadir
A
,
Shenoda
S
,
Goldhagen
J
,
Pitterman
S
;
Section on International Child Health
.
The effects of armed conflict on children
.
Pediatrics
.
2018
;
142
(
6
):
e20182586
5
Save the Children’s Child Rights Resource Centre
. Stop the war on children: the forgotten ones. Available at: https://resourcecentre.savethechildren.net/document/stop-the-war-on-children-the-forgotten-ones/. Accessed December 22, 2023