Bearing Witness: Témoignage as a Tool for Child Advocacy during Armed Conflict.

Children affected by armed conflict suffer devastating physical, emotional, and social harm. War uproots families, forcing many to flee as refugees or internally displaced persons, while others remain trapped in dangerous environments. In these crises, children face disproportionate risks-violence, exploitation, disrupted education, and collapsed healthcare systems. Their unique vulnerabilities require urgent, targeted action to protect their health, rights, and development. Beyond immediate care, the humanitarian principle of témoignage-bearing witness-is essential. Rooted in humanitarian ethics, témoignage means speaking out about injustice, amplifying the voices of those affected, and driving systemic change. It challenges traditional notions of neutrality and calls on humanitarian professionals to ethically advocate for those they serve. Pediatricians and pediatric organizations have a moral duty to ensure that children affected by conflict are seen, heard, and not forgotten. This commentary calls for recognizing children's distinct humanitarian rights and urges global pediatric societies to take action. To guide this effort, the paper introduces a framework of seven pillars of pediatric témoignage: 1. Amplifying children's voices, 2. Advocating for systemic justice, 3. Providing trauma-informed care, 4. Supporting education and psychosocial integration, 5. Advancing training and research, 6. Building professional and community networks, and 7. Creating platforms for policy influence. These pillars offer a shared language and practical strategies for pediatricians to document harm, collaborate with advocacy groups, and speak out in public forums. Through témoignage, pediatricians can help protect children's dignity and rights, ensure their suffering is not normalized, and contribute to a more just and responsive global system for children in conflict.