The Impact of Wartime Child Casualties on Adult Professionals.

Objective: Between 2005 and 2022, more than 315,000 grave violations were verified against children in wartime, including killing, physical maiming, exploitation, and forced displacement. While the resulting harm to children is widely recognized, the profound toll on professionals who witness and respond to these tragedies remains under examined. This article explores the psychological and occupational impacts of exposure to child casualties during wartime on healthcare providers, military personnel, journalists, and mortuary affairs workers. Method: Google Scholar, PsycINFO, PsychNET, and PubMed were searched for literature examining the impact of pediatric death and injury on healthcare professionals, service members, journalists, and mortuary affairs workers in wartime settings. Supplementary searches were conducted to identify supportive evidence from literature addressing impacts in non-conflict contexts. Results: Evidence varied across professions, but impacts examined included moral injury, secondary traumatic stress, heightened emotions, including guilt, anger, helplessness, and grief, as well as professional challenges such as self-questioning, and burnout. Potential mechanisms exacerbating distress include loss of trust in the goodness of the world, cynicism, and hopelessness, personal identification with children, and perceived lack of adequate skills or a sense of professional failure. Conclusions: Findings underscore the urgent need for tailored strategies to sustain the well-being and effectiveness of professionals confronted with child casualties in war. In response, the article highlights promising individual-level and organization-level strategies for building resilience and growth, and promising interventions for professionals requiring clinical care.