Iran Medical Council Journal of Iranian Medical Council 2645-338X 9 3 2026 07 01 Children in Armed Conflict: Lessons from Iran on Cultural and Health‑System Resilience 550 552 246495 10.18502/jimc.v9i3.21813 EN Azadeh Kiumarsi Pediatric Hematologist Oncologist, Children’s Medical Center Hospital, Department of Pediatric Hematology & Oncology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mina Govahi Department of Pediatrics, School of Medicine, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahshid Manuchehri Department of Pediatrics, School of Medicine, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Zeinab Afzali Department of Pediatrics, School of Medicine, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Tahereh Rostami Hematologic Malignancies Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2026 05 20 Children constitute one of the most vulnerable groups in situations of armed conflict, yet the manifestations of this vulnerability are profoundly shaped by context. Global analyses of child well‑being during war consistently describe recurring harms, including forced displacement, interruption of education and basic health care, deterioration in nutrition, increased vulnerability to vaccine‑preventable diseases, and profound psychological trauma such as post‑traumatic stress disorder, depression, and anxiety (1-3). These consequences arise not merely from exposure to violence but from the collapse of social, cultural, educational, and health‑system protective structures. In this letter, the experience described in Iran’s recent imposed war is used to reflect on how cultural, religious, family‑centered, community‑based, and health‑system factors may have shaped children’s health outcomes during conflict.<br>According to the narrative available, the imposed war began with the martyrdom of more than 160 school‑aged children, and within one month the documented toll had increased to 216 children under 18 years and 17 children under 5 years, including newborns of 3 and 20 days of age. These tragedies emphasize that children were not shielded from lethal violence. Global findings demonstrate that exposure to life‑threatening events, loss of caregivers, and sudden bereavement are major determinants of child morbidity in war zones (4,5). Despite these losses, the Iranian context described diverges from patterns commonly reported in other modern conflicts. Reports from the period indicate that Iran did not experience large‑scale forced displacement, mass refugee flows, or widespread collapse of child health services. Rather, an absence of compulsory migration and even some instances of reverse migration, in which families returned to their home communities despite insecurity have been reported in Iran. This report, raise important questions about how families perceive risk, the cultural meaning of home, and the role of religious duty in decisions to stay or return. Comparative research suggests that large‑scale forced displacement is one of the primary mechanisms by which conflict magnifies harm to children (3). Refugee and internally displaced populations often face overcrowding, food insecurity, inadequate shelter, and deteriorating sanitation, elevating the risk of infectious diseases. Displacement also disrupts education and separates children from extended kin networks, increasing vulnerability to exploitation. In contexts where families remain embedded in their communities, protective structures, including extended kin support and local health facilities, are more likely to persist. https://www.jimc.ir/article_246495_ca4f9d11b9da4f38a57046858f4b5877.pdf