James Appleyard: 'Physicians have a duty to protect the world's children'

Violence is a leading public health problem. As a profession, we need to have a fundamental rethink on the role we physicians can play both to mitigate the effects of the epidemic of violence and to develop strategies to prevent violence in the longer term.

The World Medical Association was founded in 1947 after the turbulence, terror and torture of the Second World War, to unite physicians worldwide in a shared mission founded on traditional Hippocratic principles. Later, after wide consultation, the Declaration of Tokyo was forged. This states that doctors shall not "countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures". More recently, the Declaration of Ottawa on the Right of a Child to Health Care encouraged physicians to "eradicate all forms of child abuse".

After the end of the Cold War, the expected "peace dividend" never materialised. Expenditure on arms decreased in the early 1990s, but the savings were not allocated to children's needs. A decade of ethnic conflict and civil wars around the world ensued, characterised by deliberate violence against children on a vast scale.

During these conflicts, children have been maimed, killed, uprooted, orphaned, exploited and sexually abused. They have been abducted and recruited as soldiers. During conflicts, a country's food production is compromised and malnutrition ensues.

As a profession we need to do more. We must also tackle the root causes of child abuse, and instil in societies non-violent means of resolving disputes.