The Impact of War on Child Health in the Countries of the Former Yugoslavia (1995)

Michel Duprat, M.D.

Health Advisor

United Nations Children's Fund, Former Yugoslavia

Zagreb, Croatia

Thomas Hammarberg

Vice Chair

United Nations Committee on the Rights of the Child—Geneva

Stockholm, Sweden

Birt Harvey, M.D.

Former President, American Academy of Pediatrics

Professor and Associate Chair

Department of Pediatrics

Stanford University School of Medicine

Palo Alto, California, USA

Thomas McDermott

United Nations Children's Fund Special Representative for the Former Yugoslavia

Zagreb, Croatia

Sergio Nordio, M.D.

Director, Scientific Pediatric Institute

University of Trieste

Trieste, Italy

Eugeen Verhellen, J.D.

Professor, University of Ghent; and Director, Center for Children's Rights Ghent, Belgium

Dr. Milos Banicevic

Director

Institute for Health Protection of Mother and Child

Belgrade

Dr. Ilir Begolli

Deputy Director

Institute of Public Health

Pristina

Dr. Ismet Ceric

Chief

Psychiatry Department

Kosevo Hospital

Sarajevo

Dr. Ivan Fattorini

Director

Children's Hospital

Zagreb

Dr. Josip Grguric

Chief of Pediatrics

Children's Hospital

Zagreb

Dr. Veronica Ispanovic

Chief

Department of Research and Training

Institute of Mental Health

Belgrade

Dr. Liljana Ivanoska

Ministry of Health

Skopje

Dr. Sead Jamakosmanovic

Chief of Public Health

Tuzla

Dr. Anica Mikus Kos

Child Psychiatrist

The Counseling Center for Children, Adolescents and Parents

Llubljana

Dr. Aleksandar Krstic

Head

Pediatric Department

Faculty of Medicine

Novi Sad

Dr. Ciril Krzisnik

Director

University Pediatric Clinic

Llubljana

Dr. Marijana Kuhar

President

Slovene Pediatric Association

Llubljana

Dr. Faruk Kulenovic

Chief of Traumatologic Center

Kosevo Hospital

Sarajevo

Dr. Branislav Lolic

Chief

Children's Hospital

Banja Luka

Dr. Veselin Radonjic

Director

Institute of Public Health

Belgrade

Dr. Zvonko Soce

Chief

Maternity Department

General Hospital

Mostar

Dr. Nikola Sofianov

Head

Department of Neurology

University Hospital

Skopje

Dr. Dusart Strbac

Head

Pediatric Department

Hospital of Knin

Knin

Dr. Ninaslava Vucak

Chief

Pediatric Intensive Care

Regional Hospital

Zenica

National Academy of Sciences (NAS)

James Wyngaarden, Foreign Secretary; Mary Ellen Avery (member)

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters.

Institute of Medicine (IOM)

Mary Ellen Avery, Robert Haggerty, Birt Harvey, Samuel Katz, Elena O. Nightingale, Jane G. Schaller, and James Wyngaarden (members)

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research and education.

National Research Council (NRC)

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

In a typical year, the academy complex has more than 9,000 scientists and other professional participants volunteering in the work of nearly 950 committees. The work of many of these committees is related to the health and development of children throughout the world. Past and current examples of these committees include the Panel on the Mental Health of Children and Adolescents, Children's Vaccine Initiative, the Board on Children and Families, and the Steering Committee of the National Forum on the Future of Children and Families.

International Pediatric Association (IPA)

Robert Haggerty, Executive Director

The International Pediatric Association is an organization of 140 national pediatric societies, eight regional pediatric societies (such as the Union of National European Pediatric Societies and Associations), and seven international subspecialty pediatric societies. It pursues the ambitious goal of improving the health of children everywhere in the world through education, a triennial world congress (the next one is in Cairo in September 1995), regional workshops, and a journal entitled International Child Health:A Digest of Current Information.

Union of National European Pediatric Societies and Associations (UNEPSA)

Eberhardt Schmidt, Secretary General

The Union of National European Pediatric Societies and Associations was founded as a federation of pediatric societies in 1975, and was designed to build a bridge between East and West in Europe in the interest of child health through conferences and mutual personal contacts across the Iron

Curtain. This concept proved to be successful because by 1989 25 member societies had joined UNEPSA. With the opening of European borders and the independence of new European states, 34 national societies now constitute UNEPSA, which has now transformed itself to a Forum for Planning and Development of European Pediatrics. This is achieved in annual conferences on various pediatric standards in close cooperation with activities of the European community which encloses 17 states on the way to harmonize pediatric training and standards. UNEPSA is affiliated with the International Pediatric Association.

The American Academy of Pediatrics (AAP)

Dr. Birt Harvey, Former President

The American Academy of Pediatrics is an organization whose members consist of U.S. pediatricians and pediatric medical and surgical specialists. Its 46,000 members dedicate their efforts and resources to the health, safety, and well-being of infants, children, and adolescents. The goals of the Academy include advocacy for children, access to health care, research and service to children, public education, professional education, and representation for pediatricians.

Since a major goal is professional education, the Academy offers continuing education courses, biannual scientific meetings, seminars, and publications and statements from committees and section. The Academy also publishes the monthly journal Pediatrics and Pediatrics in Review as well as periodic manuals on such topics as infectious diseases, school health, hospital care, and nutrition.

Although the primary focus of the Academy is on children in the United States, it is concerned with the health and well-being of children throughout the world. To further this objective, the Academy has a Committee on International Child Health and a Subcommittee on Human Rights that recommend Academy involvement in projects and activities in other nations. Pediatrics is published monthly in overseas editions in Italian, Spanish, Arabic, and Portuguese. English language editions of Pediatrics are also published in India and Japan. Pediatrics in Review and a manual on infectious diseases are translated into Spanish and are disseminated throughout Latin America.

Adopted by the General Assembly of the United Nations on 20 November 1989

Unofficial Summary of Main Provisions

PREAMBLE

The preamble recalls the basic principles of the United Nations and specific provisions of certain relevant human rights treaties and proclamations. It reaffirms the fact that children, because of their vulnerability, need special care and protection, and it places special emphasis on the primary caring and protective responsibilities of the family. It also reaffirms the need for legal and other protection of the child before and after birth, the importance of respect for the cultural values of the child's community, and the vital role of international cooperation in securing children's rights.

DEFINITION OF A CHILD (ARTICLE 1)

A child is recognized as a person under 18 years of age, unless national laws recognize the age of majority earlier.

NONDISCRIMINATION (ARTICLE 2)

All rights apply to all children without exception. It is the state 's obligation to protect children from any form of discrimination and to take positive action to promote their rights.

BEST INTEREST OF THE CHILD (ARTICLE 3)

All actions concerning the child shall take full account of his or her best interests. The state shall provide the child with adequate care when parents, or others charged with that responsibility, fail to do so.

IMPLEMENTATION OF RIGHTS (ARTICLE 4)

The state must do all that it can to implement the rights contained in the Convention.

PARENTAL GUIDANCE AND THE CHILD'S EVOLVING CAPACITIES (ARTICLE 5)

The state must respect the rights and responsibilities of parents and the extended family to provide guidance for the child which is appropriate to her or his evolving capacities.

SURVIVAL AND DEVELOPMENT (ARTICLE 6)

Every child has the inherent right to life, and the state has an obligation to ensure the child's survival and development.

NAME AND NATIONALITY (ARTICLE 7)

The child has the right to a name at birth. The child also has the right to acquire a nationality and, as far as possible, to know his or her parents and be cared for by them.

PRESERVATION OF IDENTITY (ARTICLE 8)

The state has an obligation to protect, and, if necessary, reestablish basic aspects of the child's identity. This includes name, nationality, and family ties.

SEPARATION FROM PARENTS (ARTICLE 9)

The child has a right to live with his or her parents unless this is deemed to be incompatible with the child's best interests. The child also has the right to maintain contact with both parents if separated from one or both.

FAMILY REUNIFICATION (ARTICLE 10)

Children and their parents have the right to leave any country and to enter their own country for purposes of reunion or the maintenance of the child-parent relationship.

ILLICIT TRANSFER AND NONRETURN (ARTICLE 11)

The state has an obligation to prevent and remedy the kidnapping or retention of children abroad by a parent or third party.

THE CHILD'S OPINION (ARTICLE 12)

The child has the right to express his or her opinion freely and to have that opinion taken into account in any matter or procedure affecting the child.

FREEDOM OF EXPRESSION (ARTICLE 13)

The child has the right to express his or her views, obtain information, and make ideas or information known, regardless of frontiers.

FREEDOM OF THOUGHT, CONSCIENCE, AND RELIGION (ARTICLE 14)

The state shall respect the child's right to freedom of thought, conscience, and religion, subject to appropriate parental guidance.

FREEDOM OF ASSOCIATION (ARTICLE 15)

Children have a right to meet with others and to join or form associations.

PROTECTION OF PRIVACY (ARTICLE 16)

Children have the right to protection from interference with privacy, family, home, and correspondence and from libel or slander.

ACCESS TO APPROPRIATE INFORMATION (ARTICLE 17)

The state shall ensure the accessibility to children of information and material from a diversity of sources, and it shall encourage the mass media to disseminate information that is of social and cultural benefit to the child and to take steps to protect him or her from harmful materials.

PARENTAL RESPONSIBILITIES (ARTICLE 18)

Parents have joint primary responsibility for raising the child, and the state shall support them in this. The state shall provide appropriate assistance to parents in child-raising.

PROTECTION FROM ABUSE AND NEGLECT (ARTICLE 19)

The state shall protect the child from all forms of maltreatment by parents or others responsible for the care of the child and establish appropriate social programs for the prevention of abuse and the treatment of victims.

PROTECTION OF A CHILD WITHOUT FAMILY (ARTICLE 20)

The state is obliged to provide special protection for a child deprived of the family environment and to ensure that appropriate alternative family care or institutional placement is available in such cases. Efforts to meet this obligation shall pay due regard to the child 's cultural background.

ADOPTION (ARTICLE 21)

In countries where adoption is recognized and/or allowed, it shall only be carried out in the best interests of the child, and then only with the authorization of competent authorities and safeguards for the child.

REFUGEE CHILDREN (ARTICLE 22)

Special protection shall be granted to a refugee child or to a child seeking refugee status. It is the state's obligation to cooperate with competent organizations that provide such protection and assistance.

DISABLED CHILDREN (ARTICLE 23)

A disabled child has the right to special care, education, and training to help him or her enjoy a full and decent life in dignity and to achieve the greatest degree of self-reliance and social integration possible.

HEALTH AND HEALTH SERVICES (ARTICLE 24)

The child has a right to the highest standards of health and medical care attainable. States shall place special emphasis on the provision of primary and preventive health care, public health education, and the reduction of infant mortality. They shall encourage international co-operation in this regard and strive to see that no child is deprived of access to effective health services.

PERIODIC REVIEW OF PLACEMENT (ARTICLE 25)

A child who is placed by the state for reasons of care, protection, or treatment is entitled to have that placement evaluated regularly.

SOCIAL SECURITY (ARTICLE 26)

The child has the right to benefit from social security including social insurance.

STANDARD OF LIVING (ARTICLE 27)

Every child has the right to a standard of living adequate for his or her physical, mental, spiritual, moral, and social development. Parents have the primary responsibility to ensure that the child has an adequate standard of living. The state's duty is to ensure that this responsibility can be fulfilled, and is. State responsibility can include material assistance to parents and their children.

EDUCATION (ARTICLE 28)

The child has a right to education, and the state's duty is to ensure that primary education is free and compulsory, to encourage different forms of secondary education accessible to every child, and to make higher education available to all on the basis of capacity. School discipline shall be consistent with the child's rights and dignity. The state shall engage in international co-operation to implement this right.

AIMS OF EDUCATION (ARTICLE 29)

Education shall aim at developing the child's personality, talents, and mental and physical abilities to the fullest extent. Education shall prepare the child for an active adult life in a free society and foster respect for the child's parents, his or her own cultural identity, language and values, and the cultural backgrounds and values of others.

CHILDREN OF MINORITY OR INDIGENOUS POPULATIONS (ARTICLE 30)

Children of minority communities and indigenous populations have the right to enjoy their own clture and to practice their own religion and language.

LEISURE, RECREATION, AND CULTURAL ACTIVITIES (ARTICLE 31)

The child has the right to leisure, play, and participation in cultural and artistic activities.

CHILD LABOR (ARTICLE 32)

The child has the right to be protected from work that threatens his or her health, education, or development. The state shall set minimum ages for employment and regulate working conditions.

DRUG ABUSE (ARTICLE 33)

Children have the right to protection from the use of narcotic and psychotropic drugs and from being involved in their production or distribution.

SEXUAL EXPLOITATION (ARTICLE 34)

The state shall protect children from sexual exploitation and abuse, including prostitution and involvement in pornography.

SALE, TRAFFICKING, AND ABDUCTION (ARTICLE 35)

It is the state's obligation to make every effort to prevent the sale, trafficking, and abduction of children.

OTHER FORMS OF EXPLOITATION (ARTICLE 36)

The child has the right to protection from all forms of exploitation prejudicial to any aspects of the child's welfare not covered in Articles 32, 33, 34, and 35.

TORTURE AND DEPRIVATION OF LIBERTY (ARTICLE 37)

No child shall be subjected to torture, cruel treatment or punishment, unlawful arrest, or deprivation of liberty. Both capital punishment and life

imprisonment without the possibility of release are prohibited for offenses committed by persons under 18 years of age. Any child deprived of liberty shall be separated from adults unless it is considered in the child's best interests not to do so. A child who is detained shall have legal and other assistance as well as contact with the family.

ARMED CONFLICTS (ARTICLE 38)

State Parties to the Convention shall take all feasible measures to ensure that children under 15 years of age have no direct part in hostilities. No child under 15 years of age shall be recruited into the armed forces. States shall also ensure the protection and care of children who are affected by armed conflict as described in relevant international law.

REHABILITATIVE CARE (ARTICLE 39)

The state has an obligation to ensure that child victims of armed conflicts, torture, neglect, maltreatment, or exploitation receive appropriate treatment for their recovery and social reintegration.

ADMINISTRATION OF JUVENILE JUSTICE (ARTICLE 40)

A child in conflict with the law has the right to treatment that promotes the child's sense of dignity and worth, takes the child's age into account, and aims at his or her reintegration into society. The child is entitled to basic guarantees as well as legal or other assistance for his or her defense. Judicial proceedings and institutional placements shall be avoided whenever possible.

RESPECT FOR HIGHER STANDARDS (ARTICLE 41)

Wherever standards set in applicable national and international law relevant to the rights of the child are higher than those in this Convention, the higher standards shall always apply.

IMPLEMENTATION AND ENTRY INTO FORCE (ARTICLES 42–54)

The provisions of Articles 42 to 54 notably foresee:

1. The state's obligation to make the rights contained in this Convention widely known to both adults and children.

2. The setting up of a Committee on the Rights of the Child composed of 10 experts, which will consider reports that State Parties to the Convention are to submit 2 years after ratification and every 5 years thereafter. The Convention enters into force—and the Committee would therefore be set up—once 20 countries have ratified it.

3. State Parties to the Convention are to make their reports widely available to the general public.

4. The Committee may propose that special studies be undertaken on specific issues relating to the rights of the child, and may make its evaluations known to each State Party concerned as well as to the U.N. General Assembly.

5. In order to “foster the effective implementation of the Convention and to encourage international cooperation,” the specialized agencies of the United Nations—such as the International Labour Organization, World Health Organization, and United Nations Educational, Scientific, and Cultural Organization— and the United Nations Children's Fund would be able to attend the meetings of the Committee. Together with any other body recognized as “competent,” including nongovernmental organizations in consultative status with the United Nations and U.N. organs such as the United Nations High Commissioner for Refugees, they can submit pertinent information to the Committee and be asked to advise on the optional implementation of the Convention.