Crisis in Yemen

Indiscriminate bombings and chronic shortages of supplies and staff have led to the closure of more than half of Yemen's health facilities.

Recent outbreaks of diseases such as cholera and diphtheria and an upsurge in fighting have exacerbated the already dire humanitarian situation in Yemen. More than three million people have been displaced since the war started more than three years ago. With an estimated 20 million in need of humanitarian assistance, our activities in Yemen are among our most extensive worldwide. We work in 13 hospitals and health centres in 12 governorates and support 20 public health facilities across the country.

 

Malnutrition: No famine yet, but a continuing crisis

Since the beginning of 2018, MSF hospitals and our supported health facilities have treated around 3,300 cases of malnutrition in Yemen. MSF teams are working across 12 governorates in the country. MSF, as other with NGOs and UN agencies, cannot have a global view on the nutritional status of all the population in the country, partly because insecurity and access constraints do not allow to conduct large-scale surveys. As a result, there is not enough quality data available to declare a there is a famine in Yemen.

But malnutrition, especially among children, remains a serious concern. Caroline Seguin, MSF's operations desk manager for Yemen, describes what our teams are seeing on the ground:

"Concerning malnutrition, we mostly see young children with severe acute malnutrition, often because they’ve been weaned from the breast too quickly or due to pre-existing conditions that cause malnutrition. We treat these children with highly nutritious therapeutic foods and use drugs to treat the pre-existing illnesses responsible for the malnutrition. But, there are places where rates of severe acute malnutrition are increasing. According to data collected in our hospital in Khamer, this is the case in Amran governorate. For example, twice as many children suffering with malnutrition were admitted in September 2018 compared to the same month last year. But the situation differs across the country." 

"What we are seeing is a general deterioration in people’s living conditions. The population have very limited access to health centres, because they’ve either been destroyed in the fighting or deserted by their medical staff who’ve received no wages since August 2016. We see civilians trapped by the massive airstrikes, particularly in the north of the country, and others who have been wounded or displaced by the fighting on the ground. According to information obtained by the Yemen Data Project— a data collection system independent of the parties to the conflict — nearly a third of the airstrikes carried out since March 2015 have targeted non-military sites. There have also been more bombings of civilian vehicles in 2018 compared to last year."

"The economic situation is clearly worsening. Purchasing power has collapsed, wheat flour costs almost 80% more than before the war and the price of fuel has risen by 130%. Yemen’s social dynamics enable some of the most vulnerable to receive support from their communities, which mitigates the effects of food shortages for at least some families. But Yemenis are also dying because they have no money to pay for the transport to reach the only too few health care facilities still open in the country. These are some of the obstacles facing the people of Yemen. MSF is doing what it can to assist them, despite the hugely challenging security constraints and problems of access."

 

MSF suspends activities after attack in Ad Dhale

The MSF staff house in Ad Dhale governorate, southern Yemen, was targeted with explosives on Monday evening, October 1, 2018. Fortunately, nobody was harmed. This was the second attack against the MSF house in less than a week.

MSF strongly condemns the attacks on our compound and staff. Due to the severity of these attacks and the clear lack of safety for the team working there, the organization has been forced to withdraw its staff from Ad Dhale and suspend its medical programs until further notice.

MSF is one of the few medical organizations delivering humanitarian assistance to the community in Ad Dhale. These attacks will deprive thousands of Yemenis of much needed humanitarian and medical assistance. Targeting the civilian population and humanitarian actors is prohibited under international humanitarian law at all times and deprives the population of humanitarian assistance.

MSF calls on all warring parties, armed groups and individuals to respect and ensure the protection of humanitarian and health workers in Yemen. MSF has been working in Ad Dhale since 2011 providing free medical care to the people of Ad Dhale, Qatabah, Al Azariq and Damt districts.

MSF remains committed to supporting the Yemeni people and currently operates 15 hospitals and health centres in Yemen and provides support to more than 16 hospitals or health centres across 12 governorates.

'What we see most are bullet wounds': MSF staff and patients describe the impact of Yemen's war

Haydan village lies just a few kilometres from the frontline in Saada governorate, a mountainous region with almost no medical facilities. The endless barrage of airstrikes makes transport here extremely challenging. 

In March 2017, Doctors Without Borders/Médecins Sans Frontières (MSF) teams returned to the hospital in Haydan that had been bombed and destroyed by Saudi warplanes in October 2015. MSF teams provide healthcare to isolated communities in Haydan as well as the remote surrounding area.

Timeline of the Conflict

This timeline was created in order to present the key events since the escalation of the conflict in March 2015, as well as the development of MSF efforts to improve access to health care for the population. As the health care system collapses to a critical state, MSF is continuing to expand its activities.

 

'Our presence is important': A Canadian nurse on how MSF provides a lifeline to people trapped by conflict in Yemen

Mariko Miller understands the effect that repeated exposure to patient trauma can have on healthcare workers. As an experienced Vancouver nurse, she is aware of the importance of preventing emotional burnout among medical staff.

So one of the things she found most remarkable about working at the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the city of Taiz in Yemen — where she recently spent three months helping provide medical care to people affected by the country’s recent conflict — was the attitude of her Yemeni colleagues.

“The kindness among our staff was really incredible,” she says. “Just watching some of the doctors I worked with, and the way they treated patients, was something I found really inspiring. The levels of empathy were so high, and people were so careful to be caring. I’ve worked in ERs in Canada, and I know it can be hard for people to sustain that and to not burn out, so to see people in a place exposed to so much trauma still manage to hold on to that fundamental empathy was really remarkable.”

“The impact of our presence is really tangible,” she continues. “I don’t know how many times, just walking into the hospital, I would meet people thanking me and us for being there. Often an older lady just wanted to kiss me on my forehead to say thanks to MSF.” The lack of most available alternatives for free good quality care has made MSF’s medical programs lifelines for many people. “We were able to stabilize traumas, and admit the pediatric and neonatal emergency cases and patients who otherwise had limited access to services. The conflict has put that out of reach for so many,” Miller says.

 

MSF activities in Yemen

MSF works in 13 hospitals and health centers in Yemen and provides support to more than 20 hospitals or health centres across 11 Yemeni governorates: Taiz, Aden, Al-Dhale’, Saada, Amran, Hajjah, Ibb, Sana’a, Abyan, Shabwa and Lahj; with approximately 1,827 National staff and 93 International staff , making it among MSF´s largest missions in the world in terms of personnel.  For more details about the activities please check the online map.

Medical figures From March 2015 to December 2017:

  • War and violence wounded treated in MSF facilities: 72,29
  • Emergency room patients received in MSF facilities & MSF supported facilities: 718,802
  • Surgical interventions performed by MSF: 54,313
  • Children admitted to pediatric ward (non-violence cases): 23,411
  • Deliveries: 43,890
  • General consultations for internal displaced people: 205,240
  • Malaria cases treated: 10,291
  • Malnutrition cases treated: 9,515
  • Patients admitted to MSF Cholera Treatment Centres: 107,966

 

Yemen: 'On an average day in Taiz, we hear around five explosions per minute'

Arunn Jegan is a project coordinator who has worked with MSF since 2016. “I’ve just arrived in Taiz, Yemen," he writes, "where we support multiple hospitals on both sides of the front line. Although I read in the media before coming here how dire the humanitarian situation is, in my first week I really realize how desperate the situation is and how many challenges the population face on a daily basis. On January 24, the day of my arrival in Taiz, violence escalated along all the front lines around Taiz city. The last few days have been extremely heavy. Sadly, this is the daily life of people here. Over the last three days, we have treated more than 117 war wounded and the number continues to grow as we speak.'

 

Conflict and blockade preventing humanitarian access to Yemen

On November 6, 2017, the military coalition led by Saudi Arabia imposed a complete blockade of Yemen, where the coalition is fighting against Iranian-backed Houthi rebel forces. The blockade has had a significant impact on the ability of Doctors Without Borders/Médecins Sans Frontières (MSF) to continue delivering emergency medical care and humanitarian assistance to alleviate the suffering the conflict is causing to the people of Yemen.  

 

Yemen in figures

  • Population: 27.4 million (OCHA)
  • An estimated 22.2 million in need of humanitarian or protection support (OCHA)
  • 17 million people food insecure (OCHA)
  • 14.8 million people in need of basic healthcare (OCHA)
  • An estimated 4.5 million children and pregnant or lactating women are acutely malnourished (OCHA)
  • 2.9 million of IDPs and returnees (OCHA)
  • 1,900 out of 3,507 health facilities in 16 governorates are either non-functional or partially functioning (WHO)
  • 9,245 conflict-related civilians deaths and 52,807 injuries (WHO – 12/17) 

 

 

Humanitarian crisis in Yemen needs to stop: MSF speaks out for more financial and diplomatic help

For more than three years, Yemen has been divided by a violent war. Doctors Without Borders/Médecins Sans Frontières (MSF) has been one of the few agencies providing aid and medical care to people affected by the conflict. On April 25, 2017, a gathering of international agencies and major funding organizations gathered in Geneva to discuss the crisis. MSF released the following statement:

Taiz: Healthcare Under Siege

The medical-humanitarian situation in Taiz, Yemen’s third most populous city, is extremely dire and only seems likely to further deteriorate. Shelling, airstrikes, crossfire, landmines and snipers are consistently injuring, maiming and killing local residents, while access to lifesaving healthcare has become increasingly limited.

Video: A Canadian nurse on coming under fire in Yemen

In the video above, Canadian Doctors Without Borders/Médecins Sans Frontières (MSF) nurse Céline Langlois describes getting caught in the crossfire of the ongoing violent conflict in Yemen.