Hundreds of children younger than five have been wounded in the latest round of fighting in Mogadishu, Somalia's capital, accounting for almost half of all trauma cases in May, according to the UN World Health Organization (WHO).
In a press statement issued on 31 May, WHO said recent data showed that the main causes of death among under-fives were burns, chest injuries and internal haemorrhaging caused by blast injuries, shrapnel and bullets.
"Of the 1,590 reported weapons-related injuries in May alone, 735 cases, or 46 percent, were children under the age of five, compared to only 3.5 percent in April," the agency said.
Marthe Everard, WHO's representative for Somalia, said: "This is the highest number of injured children that has been reported since the beginning of this year."
Fighting between government troops, backed by the African Union Mission in Somalia, and Al-Shabab has intensified in Mogadishu in recent weeks, with government troops trying to dislodge the insurgents from several parts of the city that had been under their control.
In the past week, the fighting has been mostly around Bakara, the largest open-air market in Somalia, with government troops seeking to oust Al-Shabab from the area.
Ahmed Dini of Peaceline, a Somali civil society group that monitors the welfare of children in the country, told IRIN the numbers would be even higher "if you take into consideration that many families are unable to access hospitals and are therefore keeping wounded children at home, taking care of them as best they can.
"Unfortunately, in every instance in Mogadishu, be it displacement, poverty or violence, children are more often than not the most affected," Dini said.
He said civil society groups had, on several occasions, appealed to the warring sides to stop shelling populated areas and to minimize civilian casualties.
"We are also asking them to allow access to those who cannot reach hospitals," Dini said. "We have reports of children dying because they could not [obtain medical care].”
According to WHO, health workers in Mogadishu are "stretched very thin" to treat the high number of war-wounded; in many cases, they lack proper equipment and means to cover all cases.
"Service delivery is hampered by accessibility issues, poor infrastructure and an insufficient number of health facilities," Everard said in the WHO statement. "Wherever health facilities are operating, they often lack very basic and essential medicines, supplies and equipment, operational and logistical support."
Abdirizaq Hassan Ali, head of Mogadishu's Benadir Children's hospital, told IRIN on 31 May that since the beginning of the month, more and more wounded children had been taken to the hospital.
"We are receiving on average 20 to 30 wounded children daily," Ali said.
Previously, he added, the hospital admitted about 10 war-wounded children daily.
Dini said the difference between the latest fighting and past conflict was that "this is more sustained and without let-up. Previously, we have had intense fighting but it would fizzle out after a few days, but now both sides are digging in."
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions