Sexual abuse of children as young as six by aid workers and United Nations peacekeepers has continued unchecked despite repeated promises to stamp it out, according to a 12-month investigation.
More than half of the children interviewed in three countries, Ivory Coast, South Sudan and Haiti, knew of cases of forced sex with aid staff or peacekeepers.
The assaults were often in return for the very food or protection supposed to be provided to the vulnerable in a crisis.
Similar allegations have dogged UN missions since the organisation sent peacekeepers to Cambodia in the 1990s. However, today's report, from Save The Children, is the first to point the finger at civilian aid staff, including those working for British charities, as well as soldiers.
Its findings suggest a continuing lack of action despite promises to tackle alleged abuse made at a conference of UN officials and aid agencies in December 2006.
Six months after that meeting's stern commitments, 12-year-old "Elizabeth" claimed that she was walking to tend her mother's fields past the camp of a battalion of UN peacekeepers in northwestern Ivory Coast.
"There were men there who called my little brother over and gave him biscuits," she haltingly told The Daily Telegraph last week in a village close to the town of Man.
"I refused to go, but one man came to me and held me by my dress and took me into the bush far from the road. His friends came, there were 10 of them. They held me down and raped me one by one. I could not flee. They were big men.
Afterwards I ran to my village, I was crying all night and vomiting. Even today I have medical problems. I can never forget that thing, it is stuck in my mind and I keep seeing it happen over and over like a film."
Too fearful to leave the security of her village, she has dropped out of school. Even now, almost a year later, she says she freezes with fear whenever she sees a white UN or aid agency vehicle.
Elizabeth's case is not unique among the 341 children interviewed.
A third claimed that they knew of someone in their community who had been sexually attacked by a peacekeeper or an aid worker.
More than half claimed to know of cases where penniless children, some as young as six, were forced into sexual acts in return for money or food.
The overwhelming majority of those interviewed said that they would not report a case of abuse themselves and had never heard of others doing so, despite commitments from all humanitarian agencies that allegations would be dealt with sensitively but firmly.
Heather Kerr, Save The Children's country director in Ivory Coast, said: "Even one prosecution would show that local authorities will act, and that would be a big step forward."
A spokesman for the UN's Department of Peacekeeping Operations in New York said: "The abuse of children by those who are sent to help is a significant and painful issue and one that we have begun to address. We are doing everything we can to train and monitor our civilian staff."
Save The Children itself is not immune. There were 15 allegations of misconduct towards children made against its staff in 2007, three of which were proven and led to dismissal. Oxfam reported 12 allegations of exploitation or abuse in 2007, leading to three staff being sacked.
They and other British-based agencies including Plan International, ActionAid and Care said that they supported the Save The Children report's call for a global watchdog to police sex abuse by aid staff.
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