Why are we there?
- Armed conflict
- Massive flow of migrants
Yemen: Latest MSF Updates
- MSF-Supported Hospital Bombed in Northern Yemen
- Yemen: Nine Wounded in Saudi-Led Coalition Airstrike on MSF Clinic in Taiz
- Aiding People Affected by Cyclones in Hadhramaut Province
- "The Situation is Devastating"
- Air Raids Continue, Haydan "Flattened" After Hospital is Destroyed
MSF Projects in Yemen (December 2015)
Crisis Update: December 23, 2015
In Yemen, Doctors Without Borders/Médecins Sans Frontières (MSF) has a total of 2,102 staff working in the country: 97 international staff and 2,005 Yemeni staff. Currently, MSF is working in Aden, Al-Dhale’, Taiz, Saada, Amran, Hajjah, Ibb and Sana’a, managing and providing urgent support to various hospitals and health centers.
The conflict in Yemen currently has the country divided between the Houthi movement, supported by former president Saleh, which controls the north of the country (including the capital Sana’a) and continues its southward advance, and an anti-Houthi coalition based mainly in the South. President Hadi of the transitional government fled to Saudi Arabia in March.
A coalition of mainly Gulf states led by Saudi Arabia started airstrikes against the Houthi on March 26, with the declared aim of stopping the advance of the Houthi and to reinstate President Hadi. The Houthi are seen by Saudi Arabia as a proxy group for Iran. Other countries participating in this Saudi-led coalition against the Houthi are Qatar, Bahrain, Kuwait, UAE, Egypt, Jordan, Morocco, and Sudan. Other countries, including the USA, are providing logistics and intelligence support.
While the political struggle unfolds, civilians are caught in the crossfire. MSF is responding to the needs of civilians affected by violence. It remains extremely difficult to move within the country to evaluate needs and provide assistance, due to the fighting and the airstrikes.
Access to Healthcare
On December 2nd, the MSF tented clinic in Houban, Taiz governorate was bombed by the Saudi-led coalition, killing one person and injuring eight others. The MSF facility in Haydan, Saada governorate was bombed on Oct. 26th. This hospital was the only remaining operational facility in the district, covering a population of nearly 20,000 people.
MSF is running another health facility in Saada governorate, the Al-Jumhori hospital, in the main city of Sa’ada.
MSF trucks are still unable to to deliver essential medical aid to two hospitals in a besieged enclave of the city of Taiz, in southern Yemen even after two months of negotiations with the Houthis. The situation in Taiz is still tense, and airstrikes, snippers and ground fighting between Houthis and Taiz resistance is heavier than ever. There are reports that the Saudi-led coalition is deploying ground troops to Taiz to control it, however large civilian populations remain in towns and villages in Taiz where the fighting is tense.
Out of 20 major medical infrastructures in Taiz governorate, 14 are closed and the remaining hospitals are overwhelmed. Out of eight urban women and children health centers, six are completely closed and only one is functional, but remains unable to run at full capacity due to the lack of fuel. MSF has started a new mother and child project in one of the hospitals, which now also contains an OPD/Emergency room, reproductive health and nutrition activities.
Large civilian populations also remain in towns in Saada and north Amran governorates, near the Saudi border. Many health facilities have been damaged or destroyed, medical staff have fled, and transport is extremely challenging due to high fuel prices and insecurity on the roads.
The MSF Emergency surgical hospital in Aden is still treating victims of violence, including war wounded referred from the frontline north of Aden, and patients wounded during clashes among armed groups or violent crimes.
A fuel blockade is still crippling the country. Fuel is readily available on the black market, but at up to fives times the regular price. It is extremely difficult for the general population to move anywhere, food and water costs continue to increase, and hospitals have inadequate provisions of diesel to keep generators running. Sana’a remains without city power, and populations not living in direct proximity to health structures do not have the means to access healthcare.
MSF is running an emergency surgical hospital in Sheikh Othman District, in the north of the city. Mass casualties due to fierce fighting, air raids, and shelling were frequent in July since the Southern Resistance forces supported by the Saudi-led coalition regained control of the town and the front line moved northwards. This year, MSF has performed more than 5,148 surgical interventions. Since 19th March, MSF has received 7074 war wounded of whom 438 were women, 419 were children under 12 years old, and 624 were children between the ages of 12 and 18 years. MSF is also providing mental health care and physiotherapy in the hospital. Recently. MSF has received an increasing number of patients from Lahj and Abyan governorates. MSF has treated more than 80 victims of landmines and unexploded ordnances since early August, and this number is increasing daily.
In Lahj, MSF supported Ibn Khaldoun hospital in August with medical supplies in order to restart its emergency services, and continued this donation in December.
On April 20, MSF started running an advanced emergency post in the south of the city. In the Crater Health Center, MSF staff is working 24/7 to provide trauma care, medication, and fuel for the power generator. More than 1,232 wounded patients have been received in the emergency room. Of these, 215 have been referred to other hospitals for further treatment after initial stabilization. In May, MSF started outpatient surgical mobile clinics in Enma and later in As-Sha’b District to provide outpatient care to surgical patients who could not access MSF hospitals. More than 1,220 war-wounded patients have received surgical follow-up consultations and wound dressings.
In December, MSF donated medical supplies to the Emergency Center in, Mu'alla district, the General Clinic in Towahi district, and Health Centers in Sheikh Othman, Bureiqa, Dar Saad and Al-Mimdara districts.
MSF has been providing general consultations in mobile clinics for internally displaced people (IDPs) fleeing from several Yemeni areas. Since mid-May 2015, more than 17,821 general consultations have been provided. In addition, MSF is providing support in several IDP locations, including water tanks, non-food items, and hygiene kits for more than 500 IDP families located in 20 locations in Khamer. Activities also included health promotion among IDPs and cleaning the sewage system in the central market of Khamer. Support is being given to the Ministry of Health (MoH) in a measles vaccination campaign in Khamer in July.
In the Al-Salam hospital (MoH), MSF is actively supporting lifesaving health care services for patients in various departments. MSF is also supporting the Huth Health Center with medication, oxygen, logistic equipment, human resources support, electricity, and a referral system. From January 1 to the end of November, MSF received 34,649 patients in the emergency rooms, of which over 1,017 were war wounded; performed 2,750 surgeries and 2,575 deliveries; admitted more than 3,224 adult patients to the IPD and 2,497 children to the pediatric ward and neonatal unit; and provided more than 5,505 antenatal and postnatal consultations, More than 450 children with severe acute malnutrition were admitted and treated in Al-Salam hospital.
MSF has built a network of advanced medical posts in northern Amran and Sa’ada governorates, setting up emergency rooms in local health centers, providing medical supplies and training in emergency care and the management of mass casualties, repairing and improving damaged structures, and running ambulance systems to surgical hospitals in Khamer and Sa’ada city. In July, MSF set up a reference system from three peripheral health centers in northern Amran Governorate. MSF is supporting the emergency rooms in Harf Sufyan, Al Ashah, and Al Qaflah health centers. In November, MSF received more than 6,898 patients in these health centers and referred more than 348 of them to Al-Jumhori Hospital in Sa’ada to receive surgical care. MSF is supporting Huth and Khamer with four ambulances.
In Hajjah, Al-Jamoorhi hospital, a total of 3772 patients arrived into the Emergency Room, from August to the end of November, 1991 trauma patients, 1003 medical patients, 428 pediatric patients, and 572 war wounded. In addition, MSF donated 1020 sessions, for 30 patients, to the Kidney Dialysis Center in the hospital.
In Beni Hassan, MSF supplied 16,000 IDPs with drinking water, distributed non-food item (NFIs) for 805 families in June, as well 30 NFI kits in November. MSF has provided 5,523 general consultations at its mobile clinics and the health center in the district. MSF received 123 emergency cases in Beni Hassan Center. Since early July, MSF community health teams have identified a total of 2,101 families and 8,149 individuals in four locations: Al Khadmah, Al Okashiah, Shab-Al-Dosh, and Al Manjorah. By the end of August, the total number of displaced people was around 20,000, of which 16,500 were in Beni Hassan and 3,500 in Khamis. Mid-upper-arm circumference screenings performed in these IDP sites in July and August showed an alarming increase in emergency rates of malnutrition.
In July, following an airstrike on Aahem market, 68 wounded civilians were stabilised at the Beni Hassan health center, supported by MSF, and referred to the Hajjah and Hodeida hospitals.
In Abs Hospital, the ER is open with 24/7 presence of MoH staff supported by MSF staff. MSF started supporting the emergency room in Abs Hospital on July 8. So far it has received 2926 emergency cases, 208 of whom were war-wounded. In November 2015, MSF started to support the maternity and the OT which is run by an international team.
MSF provides lifesaving health care services in the MoH Al-Nasser Hospital in Al-Dhale' district, in southwestern Yemen. The support includes a 24/7 emergency room, surgery, in-patient care, post-operative care, sterilization, laboratory, infection control, health care waste management, and referrals. MSF admitted 1793 inpatients and performed 531 surgical procedures. Following security incidents, activities in Al Dhale hospital were suspended for four weeks in October and resumed in November.
In addition, MSF is supporting the Jalal Health Health Center, Al-Azarik, in the emergency room, antenatal care, postnatal care, family planning, normal deliveries, routine vaccination, nutrition, and referrals to Al-Nasser Hospital.
In Qataba, MSF supports the 24/7 emergency room, observation room, laboratory, and health care waste management in the MoH Al-Salam Hospital. In the last few months, MSF expanded its activities by supporting the outpatient department, nutrition, and antenatal care. MSF also provides potable water to 25,000 people through the unique suitable borehole of Qataba town. MSF is also supporting several health centers in Al-Jaffea and Al-Habilain hospitals with medical supplies and equipment in the governorate.
Since the beginning of the crisis in March 2015, MSF projects in Al-Dhale’ have received 55,917 patients in the emergency room, with more than 2,319 war-wounded people among them.
Large civilian populations remain in towns and villages in Sa’ada and north Amran governorates, near the Saudi border, despite daily airstrikes and significant destruction of infrastructure in the region. Many health facilities have been damaged or destroyed, medical staff have fled, and transport is extremely challenging due to high fuel prices and insecurity on the roads, which also receive daily airstrikes. A need was identified to improve access to lifesaving care for those who live at a distance from the main referral centers.
Since May, MSF has been supporting the ER, OT, and maternity departments of Al-Jumhori Hospital in Sa'ada City. MSF teams and MoH staff have performed 1728 deliveries, received 6,186 patients in the emergency room—including 2,046 war wounded—and have seen 34 deaths upon arrival. MSF has also performed 1284 surgeries, of which 1055 were trauma. 1393 patients were admitted to the in-patient department. MSF has also donated 1,811 sessions for the Kidney Dialysis Center at Al-Jumhori Hospital. In November 72 patients were under dialysis treatment.
MSF was also providing support to Haydan Hospital in the form of medication and a referral system to Al Jumhori Hospital, until the center it was destroyed in a Saudi-led coalition airstrike on October 26th. An MSF doctor was working in the ER, where more than 3200 patients received treatment from May to October 2015, of which 30 percent were suffering from conflict-related trauma.
In November 2015, MSF started the Emergency Room of Shiara hospital in Razeh district, and the referral System from Razeh to Saada Al Jamhoory Hospital.
Since the beginning of May 2015, MSF has been providing emergency medications and surgical supplies to Al-Jumhori, Al-Thawra, Al-Rawdah, Military, and Al-Qa’idah hospitals, which have been receiving people affected by violence in the recent and ongoing conflict. During this period, MSF set up and equipped three extra ER rooms at Al-Rawdah Hospital to allow extra space for handling mass casualties while continuing to support the hospital’s ER with supplies and staffing.
MSF has four medical doctors and one nurse working in the emergency room of Al-Rawdah Hospital, in addition to covering the salaries of 27 hospital staff members who are working in the emergency rooms to ensure a 24/7 presence. Since May 15 to the end of November, 2015, Al-Rawdah Hospital has received a total of 12,800 war-wounded patients, of which 4,549 were war wounded patients including 15 women.
On 25 October, despite weeks of intense negotiations with Houthi officials, MSF was blocked from delivering stocks of essential medical supplies to two hospitals in a besieged enclave of the city of Taiz, in southern Yemen. MSF’s trucks were stopped at Houthi’s checkpoints and denied access to the area. The hospitals in this besieged area are seeing large number of patients with war wounds. We have not been able to deliver essential medical supplies since August 24th. Supplies include; chest tubes, anaesthetic drugs, IV fluid, sutures and antibiotics – to assist lifesaving surgery.
In November MSF opened a new hospital in Taiz to provide Mother and Child Healthcare services, with a planned 100-bed capacity for obstetrics and gynecology and pediatrics focusing on children under five years of age. The hospital opened on November 7th and provides antenatal and postnatal Care, family planning, and has an emergency room, ambulatory therapeutic feeding center (ATFC), and outpatient department. By mid-December 2015, the facility treated 5,295 outpatients, 995 antenatal, three postnatal, and 80 patients in the ATFC. MSF current employs a total of 110 Yemini staff in Taiz.
In late October MSF teams started a malnutrition screening for 2269 children in the besieged area in Taiz. Some pockets of children in specific parts of the neighborhood had high malnutrition rates, but the overall the situation in the area was not alarming. MSF also distributed food and non-food items (including floor, sugar, oil, buckets, mosquito nets, blankets) to 273 displaced families in one of Taiz neighborhoods, in November 2015.
MSF has donated medical and surgical materials to Al-Thawra and Al-Qa’idah Hospitals in Ibb Governorate, and also donated food supplies to centralized kitchens of IDPs who are based in eight schools housing 179 families, in Al-Qa’idah City. On June 1, 2015, MSF helped the MoH to evacuate 509,800 vaccine doses meant for routine immunization from the Governorate Health Office—which is located at the war’s front line—and relocate them to the Ibb cold chain. However, the donation was a "drop in the ocean" and more support is still needed, especially for those IDPs hosted outside of the schools.
In September, MSF donated 40 kits for war wounded patients to Yareem Hospital and Al Thawra Hospital.
Since March 26, 2015, MSF has focused its support on the main hospitals in Sana’a, especially Al-Gomhoury and Al-Thawra hospitals, which are receiving the majority of the wounded people from Sana’a and the rest of the country. More than 1426 injured benefited from MSF kits.
MSF also provides surgery and post-surgery materials, along with items for blood transfusion and admission. MSF also placed prepositioned materials in hospitals for emergency use. Kits for covering 180 war-wounded patients in the emergency room were given to two hospitals in late July. MSF donated dialysis session materials to the kidney center at the Al-Jumhori Hospital in Sana’a to cover more than 4,022 sessions, and is preparing to support this center with materials for three months.
MSF has been holding first-aid and mass-casualty trainings for more than 130 health staff working in local hospitals in Sana’a.
In October, MSF expat ortho surgeon, anesthesia doctor were working in the hospital to support the OT medical team in October. MSF gave donations, including 3000 blood bags, to local hospitals that received the victims of airstrikes in Sana’a in the second week of September. Hospitals receiving support include Al-Jumhori, Al-Thawra, the Police Hospital, the teaching hospital, Omarah hospital, Mohamed Al Durrah Hospital, Sheikh Zayed maternity hospital.,
Two cyclones in one week hit the southeast coast of Yemen in early November, causing major damage - hundreds of families lost their homes. In Moukalla, the main city in Hadramout, torrents of water spilled into the city, destroying houses, bridges and infrastructure.
MSF has set up a mobile clinic in Mukalla city. A doctor and a nurse provided more than 300 consultations. MSF also identified water needs, providing 430 families with water.
In Boroom-Mayfaa district, MSF set up water tanks and provided water trucking to 230 displaced families. Drinking water and hygiene kits were also distributed. On November 20, MSF assisted a further 170 displaced families with food and non-food items, including blankets, jerry cans, kitchen sets and hygiene kits. The team also distributed mosquito nets and provided more than 100,000 liters of water to IDPs.
Mental Health activities
In November, MSF began mental health activities in Abs, Saada and Al Jamhoory hospital in Sanaa. 205 people have attended individual counselling sessions, and 2,610 people participated in the psychological and social educational group sessions.
MSF has run a project to provide support to HIV positive patients in several locations across Yemen since 2010. In March 2015, the project launched a contingency plan to provide antiretroviral (ARV) drugs, services, and psychological support to patients in the whole country. By the end of August, 1,327 HIV patients have received ARVs, 775 patients received drugs for opportunistic infections, 650 patients received laboratory reagents, and 300 patients received mental health support.
This is an excerpt from MSF's 2014 International Activity Report:
High levels of poverty and unemployment combined with continuous insecurity make it difficult for Yemenis to access health care.
Basic health care and lifesaving surgical care is provided by Doctors Without Borders/Médecins Sans Frontières (MSF) in Al Azaraq and Qataba’a districts of Ad Dhale governorate. More than 47,000 outpatient consultations took place in 2014. Emergency surgery for victims of violence is available in Al Naser General Hospital, Ad Dhale city. The team performed around 300 surgical procedures here between June and September, when they were evacuated because of insecurity.
MSF teams in Amran continued to support Al-Salam Hospital, providing emergency, maternity, inpatient and outpatient services, and assisting in the laboratory and blood bank. More than 2,300 surgical interventions and 25,300 emergency consultations were carried out, 5,200 patients were admitted to the hospital, and over 2,500 babies were delivered during the year. To assist the communities in the remote Osman and Akhraf valleys, MSF supported the reopening of Heithah health unit in April, but insecurity caused the suspension and then complete cessation of activity in November.
MSF’s emergency surgical unit in Aden re-established networks of medical referrals from Abyan, Ad Dhale, Lahj, and Shabwah—places frequently affected by violence and increased surgical needs. More than 2,000 emergency consultations, 1,600 surgical procedures, and 5,600 physiotherapy sessions were completed. A weekly clinic in Aden central prison recorded more than 1,600 consultations. Support to Lawdar and Jaar hospitals in Abyan was stopped because MSF was seeing fewer victims of violence from these areas, and the networks were re-established and strengthened so patients could be referred to the MSF emergency hospital in Aden.
Rapid Emergency Response
MSF set up a team to provide rapid medical aid following violence and other emergencies. Medical supplies were donated to clinics and hospitals, relief items were distributed to people forced to leave their homes by conflict, and direct care was offered to victims of violence and the displaced. Medical items were donated to 38 health facilities in five governorates, including the capital Sana’a, and hundreds of displaced people received direct emergency support.
Reducing HIV Stigma
Lack of knowledge about HIV/AIDS among health care providers has been the main cause of stigma and discrimination in Yemen. MSF trained staff in seven hospitals as part of its work with the National AIDS Programme and its advocacy resulted in a dramatic increase in the number of people getting tested for HIV, including pregnant women, and in the number of HIV-positive patients admitted to Al Gumhuri Hospital in Sana’a.
MSF closed the mental health program for migrants in detention that had opened in 2013. The number of new arrivals had stabilized, and there were organizations ready to take over running the project.
At the end of 2014, MSF had 562 staff in Yemen. MSF has worked in the country since 1994.
Mohamed, from Shabwah
My nephew was shot during gunfire in Shabwah. There was no hospital … nothing in the area. The only place we could bring him was here [MSF hospital in Aden]. We sincerely thank MSF for the unconditional medical care they offered to him and to everybody in this hospital.