Around the world, a stunning one in five children are growing up in a war zone today. Neither their governments, nor humanitarian-aid groups, nor their families can guarantee the basic elements of survival, much less anything like a happy childhood. That’s according to a bleak accounting by human-rights researchers that reveals that in many regions, it’s not soldiers who suffer the most on the front lines, but the estimated 420 million children who live in conflict-affected areas—about a fifth of all youth. The total count, drawn from an international database, represents an increase of 30 million between 2016 and 2017. The humanitarian group Save the Children (STC) estimates that conflict now impacts children at the highest rate in a generation.

Today’s war-zone children grapple with everyday violence that would be unthinkable in more peaceful and privileged societies. STC found that based on a United Nations index of “grave violations against children,” the number of incidents of “being killed, maimed, recruited by armed groups or abducted, sexual violence, attacks on schools and denial of humanitarian aid” jumped from roughly 10,000 in 2010 to 25,000 in 2017. Often, children are “specifically targeted”— perhaps to maximize the political spectacle of carnage, or to test the rules of combat by deliberately placing children in the cross fire—or deliberately starved under siege.

About 30 percent of kids in Africa and 40 percent in the Middle East are living in conflict zones today, while Asia has the highest number of children in conflict zones, 195 million. Beyond the front lines, countless children have been displaced, often living as refugees abroad indefinitely. The rise in the number of children in conflict zones is driven partially by an expansion in populations affected by conflict, but also by increasing violence by non-state actors as war shifts from traditional international fighting to informal clashes. Overall, since 1990, according to Bernice Romero, senior director of public policy and advocacy at STC, “conflict is happening in more populated areas, including the urbanization of war, the rise of non-state actors, the increasing number of conflicts, and conflicts becoming longer and more drawn out.”

Child deaths in conflict reached nearly 10,700 in 2017, a rise of about 6 percent from the previous year. In many cases, children are the “collateral damage” of warfare. For example, roughly one in three of those children were killed by improvised explosives or unexploded devices, like landmines, that are triggered inadvertently. But many children were slaughtered directly on the front lines. About 8,000 boys and girls were “recruited” into or otherwise used in combat. Many have been “sacrificed” as suicide bombers. The use of children as weapons has ticked up about 3 percent overall in 2016—including a near quadrupling of children as tools of warfare in the long-running sectarian conflict of the Central African Republic.

Young survivors grow up in a world hostile to childhood. Asmaa, a Syrian child refugee whose family escaped to Lebanon after losing her mother to the war, testified in the report on how exposure to war shapes children’s behavior: “My 11-year-old brother used to cover his ears when the shelling was happening. He thought that if he closed his ears, he would not hear the shelling anymore. He stopped eating.’”

Other documented abuses against children include more than 1,400 attacks on schools, more than 950 documented sexual assaults, and more than 2,550 verified cases of abduction (and those are only the numbers that have been verified). And even after the war technically ceases, survivors struggle with social and economic collapse, including “the breakdown of markets and essential public services, such as healthcare, water and sanitation; and pervasive insecurity.” Children are especially vulnerable to malnutrition and disease outbreaks, and to the oppression and abuse of child marriage and child-labor trafficking.

The report denounces not only the direct combatants in war but also the governments that are indirectly responsible for human-rights violations against children, through their failure to intervene through political pressure, or in some cases, their complicity in conflict. The report explicitly points to the need for accountability from the Western countries that orchestrate proxy wars by facilitating arms sales or providing back-up military assistance.

The US and UK governments, for example, have faced public criticism over lucrative arms deals with Saudi Arabia, which fuel its devastating assault on Yemen. Aid itself has often become weaponized: Although the Geneva Conventions mandate that states either provide for the basic needs of civilians or, failing that, allow intervention by outside humanitarian-aid organizations, in many conflict zones, particularly communities in Yemen and Syria, children and families have suffered long-term deprivation of food and medicine as the political impasse between warring factions has blocked aid convoys from entering.

Amid this near-total impunity among state and non-state perpetrators of conflict, human-rights advocates are calling for international justice: Accountability might come through institutions like the International Criminal Court or other human-rights tribunals, or in domestic courts, through criminal cases brought under laws of universal jurisdiction. But for the children of war, justice will always come too late, if it ever happens at all. For refugee children—who make up one in every 200 children worldwide and a third of the world’s migrant children—even after they escape to safer territory, the wounds of war continue to reverberate through other social ills, including family violence and psychological distress that endure as intergenerational trauma. Both child refugees and conflict survivors face elevated risk of mental distress, yet suffer greater barriers to mental-health care, typically because of logistical, social, or language barriers to services, along with lack of culturally appropriate services.

In the aftermath of conflict, advocates call for a child-centered recovery process, which is focused on providing children not just safety and shelter but also socially supportive environments and stable educational access—for many refugee kids, such basic provisions are what they most need for rehabilitation, rather than intensive psychotherapy. Ideally, their recovery would also play a role in shaping their futures. Romero says via e-mail that in post-conflict communities, “civil society voices—including those of children—must be prioritized in monitoring and advocating for child rights and peace-building.” Initiatives like youth parliaments, for example, are designed to provide young people a public platform, “to highlight their points of view and promote their advocacy.”

Today, however, the youngest victims of war do not have a voice in Congress; the sites of their suffering lie a world away from Capitol Hill and insular diplomatic summits. But unlike the politicians, those children can’t just turn away from the conflicts that the “international community” regards as mere geopolitical inconveniences, because war is where they live.