LONDON: Save the Children warned on Monday that more than five months into the Middle East conflict, children across the region continue to pay the highest price, with many killed, injured, displaced or cut off from healthcare, education and protection.

Compounding the crisis, the London-based charity said, is disruption caused by the conflict in the Strait of Hormuz, a critical global shipping route, and the Bab Al-Mandab Strait, which connects the Red Sea and the Gulf of Aden, slowing the delivery of humanitarian assistance.

“Children are directly impacted by blocked routes and restricted maritime traffic,” said Ahmad Alhendawi, Save the Children’s regional director for the Middle East, North Africa and Eastern Europe.

“Disruption is delaying humanitarian supplies and driving up the cost of food, fuel, and medicine. These waterways must remain open and safe for civilian and humanitarian traffic.”

Both waterways have become flashpoints in the wider conflict. Iran has kept the Strait of Hormuz closed to traffic, saying it will not reopen until the US lifts its blockade of Iranian ports.

Shippers rerouting through the Red Sea face a second threat after Yemen’s Houthis declared a blockade on Saudi-linked shipping on July 20 and began firing on tankers, cutting traffic through the Bab Al-Mandab by about 30 percent, Reuters reported.

Alhendawi called for an immediate halt to the fighting.

“Children are paying the price daily for this dangerous escalation which must end now,” he said. “The international community must pressure all parties to immediately de-escalate, act responsibly towards children, cease all military operations, and pursue peaceful resolutions to their disputes.”

“Scholars and clinicians working in conflict and occupation contexts have long noted that the damage to children is not simply emotional,” said Dr. Jeeda Alhakim, a specialist counseling psychologist at City, University of London. “It reshapes how they understand the world and their place within it.”

That damage, she said, is broader than any single diagnosis.

“This goes beyond what a diagnosis like (post-traumatic stress disorder) can capture,” Alhakim told Arab News. “PTSD focuses on specific traumatic events, but for children in conflict zones there is rarely a single incident.

“Instead, there is a continuous accumulation of exposures to threat, loss, displacement, and powerlessness that affects every aspect of daily life.

“One of the things that happens when a child grows up under ongoing threat is that their nervous system adapts,” Alhakim said. 

“They become hypervigilant, constantly scanning for danger, struggling to feel safe even when there is no immediate risk.

“When that state becomes permanent, it takes a serious toll on a child’s ability to concentrate, sleep, form relationships, and develop normally.”

The effects may also be passed to future generations.

“There is growing evidence that trauma affects us biologically, influencing how stress response systems develop and potentially how certain genes are expressed,” Alhakim said.

“Children may arrive in the world already carrying something of what their parents and grandparents endured.”

Lebanon-based child psychologist Dr. Rim Ajjour said repeated displacement leaves many children feeling they are never truly safe.

“This accumulation of traumatic events and the repetitive displacement leaves children in a (constant) state of fear, where they feel that their safety is not guaranteed.”

In her clinical work, Ajjour told Arab News, that fear surfaces as constant worry, difficulty concentrating and a sense of being “always on edge,” driven by children’s lack of control over their own safety.

In Lebanon, where Israeli shelling and house demolitions continue in the south, children make up an estimated 35 percent of the more than 375,000 people still internally displaced.

In Gaza, more than 800,000 Palestinian children have been displaced, with over 7,000 unaccompanied or separated from their families, according to the Site Management Cluster.

In both Lebanon and Gaza, schools have been repurposed as shelters, leaving many displaced children without access to education.

Losing a familiar home compounds that instability, Ajjour said, because children are moved into places they must share with strangers.

“Their home is not their home anymore,” she said, leaving them with a “sense of instability.”

Being cut off from school, she added, “can have a massive effect on their well-being.”

“Children who have achieved specific milestones in terms of walking, speaking, toilet training are even showing regression in those achievements.”

Despite a fragile ceasefire in force in Gaza since Oct. 10, 2025, rights groups warn that children continue to be killed, and essential civilian infrastructure remains under attack.

Israeli strikes on the enclave on Sunday killed four children, according to media reports. One was the fetus of a pregnant woman found beneath the rubble.

In the occupied West Bank, Israeli military operations and settler attacks have also intensified. On Friday, Israeli settlers reportedly shot a 10-year-old child in the back during an attack on a village near Ramallah.

“Growing up under these conditions does not only produce fear and symptoms,” Alhakim said. “It produces a particular way of understanding the world, a clear-eyed awareness of power, history, and injustice that develops earlier than it would under other circumstances.

“This is not pathology. For many of these children, it is an accurate reading of the reality they inhabit.”