Why are we there?
- Armed conflict
Yemen: Latest MSF Updates
- Yemen: Escalating Conflict, Escalating Needs
- Saudi-Led Airstrike on Abs Hospital Cannot be Justified as Unintentional Error
- BBC: Yemen Conflict: Terror of Life Under Siege in Taiz
- On First Day of Ceasefire, Hospitals Receive 76 Wounded and 21 Dead in Taiz
- Detailed Documentation of Two Attacks on MSF Medical Facilities
- Foreign Correspondent: The War on Children
- Dialysis Treatment at a Breaking Point
Crisis Update: January 2017
MSF works in 12 hospitals and health centers in Yemen and provides support to more than 30 hospitals or health centers in 11 Yemeni governorates (Taiz, Aden, Al-Dhale’, Saada, Amran, Hajjah, Ibb, Sana’a, Hodaida, Abyan, and Lahj). There are nearly 1,600 MSF staff members in Yemen, including 82 international staff, making it one of MSF´s largest missions in the world in terms of personnel.
MSF resumed working in Hajjah and Abs hospital in November 2016. MSF supported Al-Jamhouri hospital in Saada city with medications, incentives for their Ministry of Health (MoH) staff, and logistic support until December 2016, and is supporting the Shiara hospital in Razeh district with advanced care (emergency room and maternity).
A growing number of cases of acute watery diarrhea and suspected cholera have been reported by the Yemeni Ministry of Health. MSF supports Al-Sabeen Hospital in Sana’a and Al-Sadaqa Hospital and Al-Jumhori Hospital in Aden, as well as other health facilities in Taiz Governorate, to help with the response. MSF provides these health facilities with medical supplies and staff training, in addition to logistical support with the aim of preventing the spread of the disease, isolating patients with symptoms, managing cases, and capacity building. In addition to this direct support, MSF teams are continuously monitoring the situation in anticipation of any increase in cases, in addition to providing precautionary measures in MSF facilities in Aden, Al-Dhale, Amran, Ibb, and Taiz.
MSF urges the international community to support Yemen’s fragile health system to cope with any needs.
MSF teams reported and treated cases of malnutrition throughout 2016, as well as prior to March 2015. Ongoing conflict and deteriorating economic conditions jeopardize access to sufficient food and medical care. From January to September 2016, MSF treated 775 children suffering from malnutrition in Amran and 2,880 in Taiz.
Medical Figures, March 2015-November 2016
- 56,202 war-wounded patients treated
- 28,796 surgeries performed in MSF facilities.
- 176,847 medical consultations provided for displaced people in MSF mobile clinics
- 23,489 deliveries in MSF facilities
- 396,032 patients treated in emergency rooms
- 2,416 tonnes of medical supplies sent to Yemen
MSF withdrew its teams from Al-Jumhori, Haydan, and Shiara hospitals on August 18 due to security concerns following the bombing of Abs Hospital on August 15. Yemeni MSF staff returned to Haydan in November 2016. MSF continues to support the hospital with medications and a referral system but international staff have not returned. This is the only time MSF has evacuated its staff in Yemen after a bombing. The support to the hospitals never stopped, though, in the form of medications, incentives, and a referral system. MSF is currently supporting Shiara hospital with advanced care, and will resume its presence with international staff in February 2017 in Haydan.
Before the withdrawal of staff, MSF treated patients with injuries from landmines, unexploded ordinance, and other war injuries, in addition to injuries caused by traffic accidents. MSF provided treatment in the maternity, surgical, and inpatient departments, as well as mental and physiotheraphy support. MSF also provides assistance in the emergency room and maternity department of Shiara Hospital, which was hit by a rocket in January 2016.
The Haydan Health Center, which was hit in an airstrike on October 26, 2015, was rebuilt and has resumed activities. MSF also supports the emergency rooms and referral systems in Noshoor and Yasnim health centers.
MSF withdrew its staff from Abs hospital and Al-Gamhouri hospital in Hajjah town on August 18, 2016, because it considered them unsafe for both patients and staff. This is the only time MSF has evacuated its staff in Yemen after a bombing. As Abs Hospital is run by the MoH, a minimum of medical activities continued despite the level of destruction of the facility, with the remote support of MSF, and both national and international personnel resumed the intervention in late November.
In Abs Hospital, MSF currently manages emergency cases in the ER, the pediatric ward, the maternity ward, and emergency surgery with post-operative care, with mental health support for both patients and caretakers. In addition, MSF opened an inpatient therapeutic food center (ITFC) within the hospital in early December. MSF refers complicated cases to the specialized hospitals in Hajjah, Sanaa, and Hudaydah.
The population served by the project lives in displaced sites all around the Abs District. Through a system of mobile clinics, MSF teams provided basic medical care to people while monitoring the nutritional situation. Mental health services were also provided through outreach activities for the population in and around the IDP camps. This mobile clinic program will resume in late January.
In Hajjah town, MSF has been supporting the main public referral hospital in the governorate in the ER with surgical services and in the ICU and post-operation wards since August 2015, and the maternity services since July 2016. MSF also supports a referral system to bring patients to Al-Jamhouri Hospital in Sana’a.
The situation North Amran Governorate is relatively calm; as a result people are fleeing conflict to settle in this area. MSF provides general consultations to displaced people with mobile clinics.
MSF supports Al-Salam Hospital and Huth Health Center with health care provision; donations of medications, oxygen, logistical equipment, and electricity; and with human resources and a referral system. MSF also provides medical supplies, trains personnel in emergency care, repairs and improves damaged structures, and runs ambulance and reference systems in a number of health structures in Amran Governorate. In January, MSF treated nearly 150 patients with scabies, and, when medical teams treated around 2,000 more in May, decided to conduct a mass treatment campaign in Khamer and Huth.
MSF continues to support the emergency room in Al-Kuwait Hospital in Sana’a. In addition, MSF is donating emergency supplies to Al-Jumhouri and Al-Thawra hospitals. MSF supports war-wounded patients in Al-Jumhouri and Al-Thawra hospitals in Sana’a and also distributes war-wounded supply kits in the surrounding districts. MSF also supports Al Sabeen Mother and Child Hospital.
MSF´s support to the Ministry of Health´s HIV program in Sana'a continues as normal, with 97 percent of the program’s 1,752 patients from Sana'a and several other governorates receiving lifesaving antiretroviral treatment despite the tensions and violence in the city. MSF provides blood testing kits to the National Blood Bank in Sana’a as well.
From October 2016 to the end of December 2016, MSF supported dialysis treatment centers in Sana’a, such as Hajja, Mahweet, and Taiz, by assisting around 650 patients with kidney failure. These patients were at risk of death, as the dialysis treatment centers were badly affected by lack of supplies and had reduced their sessions per patient from three to two. MSF brought in 240 tons of medical supplies for this effort alone. In December 2016 ICRC took over management of two of the centers. MSF is looking into the possibility of supporting three new centers.
In light of the escalating needs, MSF has progressively increased its mental health and psychosocial support activities across Yemen. Psychosocial support teams are composed of clinical psychologists and counselors who treat victims of violence and their families, paying special attention to war-wounded and/or internally displaced persons. In 2016, MSF provided 5,700 individual and family sessions to over 2,700 patients and their relatives. Group interventions for sensitive populations, mental health support, educational resources, and recreational activities for the children hospitalized are all included in the psychosocial care package. Furthermore, regular trainings are provided to medical staff in order to improve the referral system and the understanding of psychological effects of exposure to violence. Mental health teams are also actively involved in mass casualty contingency planning and implementation in all the projects.
MSF began medical and humanitarian operations in Ibb Governorate, Yemen's most densely population region, in mid-2015.
MSF supports the emergency room department of Ibb Governorate’s largest central hospital, which is the most important referral medical structure in the region and has a catchment population of two and a half million people. MSF's aim is to implement free access to good quality emergency health care and improve the hospital’s capacity to clinically manage large influxes of wounded. The emergency room receives more than 1,000 patients per week, of which around 15 percent are victims of violent trauma and 17 percent are other critical cases. MSF provides regular financial and material support to support departments of the Hospital.
Simultaneously, in the southern border with Taiz Governorate, close to one of the war's front lines, MSF rehabilitated and is now provides health care in a general hospital in Thee Sufal District. MSF is implementing free access to good quality emergency health care, improving the hospital’s mass casualty management, and providing lifesaving surgeries as well as inpatient hospitalization for the most severe medical conditions. On average, MSF teams offer 250 consultations in the Emergency Room and perform 80 surgeries per week. The catchment population of this medical structure is estimated to be 500,000 inhabitants. MSF also provides regular monthly donations to the maternity department, in addition to water, fuel and other support to the entire hospital.
The situation in Taiz remains extremely critical, with some of the heaviest fighting in the country.
MSF runs lifesaving medical activities on both sides of the frontlines in Taiz, Yemen’s third largest city, where most hospitals have closed due to the conflict. In the Al Houban neighborhood, MSF runs a mother and child hospital where 458 deliveries were recorded in November 2016 and over 2,500 severely malnourished children were admitted to the therapeutic feeding clinics supported by MSF. MSF runs a trauma center for war-wounded and trauma cases and covers referrals. In the city center, MSF supports Al Jomhouri Hospital with maternity services, Yemeni Swedish Hospital with pediatrics, Al Thawra Hospital with medical and surgical emergencies, and Al Rawdah Hospital with emergency room services for war-wounded patients. Most of the wounded come from the city center, where many civilians are caught in the middle of intense fighting, struggling for food and survival. The patients MSF sees in Taiz mainly suffer from injuries caused by airstrikes, blasts, shellings, gunshots, snipers, and, more recently, landmines. Movement in and out of the city remains restricted and dangerous for civilians and humanitarian actors. MSF also provides medications to the emergency room and emergency operating theater supplies to Khalifa Hospital in Al-Turba.
Al Dhale Governorate is located on the old border between northern and southern Yemen and, besides being affected by the current conflict, is also affected by ongoing tensions over the old border. The governorate has front lines on three sides between pro-Hadi forces and pro-Houthi forces (Hamak, Taiz, Moreis/Damt).These areas saw intense fighting in August in the form of armed clashes, snipers, shelling, and rockets. Shelling along the frontline hit civilian houses and cars. There was an increase in civilian casualties as armed actors targeted villages. MSF works in partnership with the hospital in Al Dhale and district health centers in Al Azariq and Qatabah, running emergency rooms, outpatient consultations, surgeries, inpatient services, patient referrals, pediatrics, nutrition programs, and maternity services. After an increase in war-wounded patients, MSF also began supporting the emergency room of the health center in Damth.
Aden is currently controlled by southern resistance forces, backed by the military coalition led by Saudi Arabia. MSF runs an emergency surgical hospital in Sheikh Othman District in the north of the city. The hospital provides free medical care in an emergency room, a hospitalization ward, and an operating theater, and provides mental health and physiotherapy consultations. MSF is still seeing victims of landmines and unexploded ordinance coming from Aden, Taiz, Lahj, and Al-Dhale’. A medical doctor and nurse conduct weekly visits to Aden Central Prison to provide primary health care services. An average of 50 consultations are provided every week.
MSF provides on-job- training to Ministry of Health doctors and nurses in this hospital as well. An official training program supported by the David Nott Foundation, validated by the Royal College of Surgeons of England, ran for three days in early July 2016. Around 40 surgeons attended the course.
MSF also provided 700 blood screening test kits to the national blood bank in Aden to restart their blood donation activities.
MSF has been supporting Ibn Khaldoun Hospital in Lahj with regular donations of medical supplies since December 2015 and Al-Razi Hospital in Abyan since February 2016. The support includes medications for emergency rooms and emergency operating theater supplies for Lawadar Hospital and Al-Razi Hospital.
This is an excerpt from MSF's 2015 International Activity Report:
Armed conflict escalated into a full-scale war in Yemen in 2015, exacerbating already massive medical and humanitarian needs and severely restricting access to healthcare.
The Houthis continued to advance in 2015, taking over the presidential palace in Sanaa in January. President Hadi fled to Aden, and a Saudi-led coalition supporting his government began airstrikes to recover lost territory, including the port of Aden. Meanwhile, the war allowed Al Qaida and Islamic State (IS) group fighters to reinforce their presence in the country. By year’s end, the United Nations estimated that 2,800 people had been killed and some 2.5 million were internally displaced. The healthcare system has been decimated: medical staff have fled the country, facilities have been destroyed and medical supplies cut. To read more about the situation in Yemen, see here.
MSF managed to maintain its operations in Aden when it was divided by a frontline. In other areas it also scaled up its activities during 2015 as much as security allowed, despite an attack that destroyed the hospital it supports in Haydan, Sa’ada governorate, on 26 October and another on its tented clinic in Al-Houban, Taiz governorate, on 2 December, which wounded nine. A fuel blockade hampered the delivery of aid, while fighting, shifting frontlines and airstrikes restricted the movement of people and humanitarian organizations.
Sa’ada governorate was one of the worst-affected areas. From March, there were daily airstrikes targeting many civilian areas, including healthcare facilities, and access to medical care was almost impossible in some districts. In April, MSF started supporting Haydan hospital’s emergency room and maternity services, but had to suspend activities following an airstrike in October. They could only resume in December, using an undamaged part of the building. In May, a team started working in Al Jomhouri hospital in Sa’ada city, providing emergency, inpatient and intensive care, and maternity and mental health services for a population of about 700,000 people. Over 6,110 patients were attended to in the emergency room, and over 2,900 surgeries were performed. In November, another team began to support the Shiara hospital in Razeh district. In 2015, more than 100 births were assisted every week and over 1,000 emergency room consultations were performed. Staff also assisted in Majz and Nushur hospitals towards the end of the year.
Intense conflict broke out in Ad Dhale governorate in April but had subsided by August, when the frontline moved towards Ibb. People were trapped in the conflict areas and there were many deaths resulting from war injuries. MSF expanded its support in Ministry of Health hospitals and basic healthcare clinics such as Al Salaam and Al-Azariq, providing outpatient and emergency consultations, surgery, inpatient care and reproductive healthcare. The teams carried out more than 60,000 outpatient and emergency consultations, performed over 700 surgical procedures and made around 1,000 referrals.
There was intense fighting in Aden between March and July. In Sheikh Othman district of Aden city, MSF continued to run the emergency trauma centre, comprising an emergency room, two operating theatres, an intensive care unit and an inpatient ward. Mental health and physiotherapy consultations were also provided. Bed capacity was increased from 45 to 74 to accommodate the surge in needs, including several mass casualty incidents involving over 100 wounded each time. Many of the patients were children wounded by landmines and unexploded ordnance. Overall, teams carried out 7,778 emergency consultations and 4,300 violence-related surgical interventions. During the peak of the conflict, emergency healthcare was available in three health clinics in districts where medical access was very limited.
Taiz city, with an estimated population of around 600,000, was the scene of intense fighting as of July. Some residents were trapped in an enclave under siege, and a blockade on medical supplies began in August, which has had a major impact on healthcare access. MSF donated medical supplies to hospitals on both sides of the frontline. On the Al-Houban side, MSF provided assistance to the military hospital, Yemeni International and Al-Risalah, and inside the enclave, MSF supported Al-Thawra and Al-Rawda hospitals. Altogether, MSF provided more than 15,400 emergency room consultations, 6,800 consultations for people with war wounds, 1,100 surgical interventions and 10,900 wound dressings. Relief items such as blankets, food and jerry cans were also distributed to displaced people in the city.
In November, MSF opened a mother and child hospital in the Al-Houban neighbourhood, providing emergency services and reproductive healthcare, and an outpatient department for children under the age of 10. Some 7,800 outpatient consultations and 7,500 emergency room consultations were completed.
MSF continued its project at Al-Salam hospital, providing emergency, maternity, inpatient and outpatient services and assisting in the laboratory and blood bank. As access to medical care in other healthcare facilities decreased, MSF scaled up its activities in Amran hospital, carrying out 3,000 surgical interventions and 28,200 emergency consultations. More than 5,500 patients were admitted to hospital and over 2,900 babies were delivered. MSF supported the health centre in Huth, completing 9,300 emergency consultations, and provided drug donations and training to three facilities in the north of the governorate. As displacement increased, MSF launched mobile clinics and helped with water and sanitation activities in Khamir and Huth.
In May, MSF opened a project supporting Beni Hassan health center, and offering medical aid to 15,000 internally displaced people through mobile clinics. The team provided outpatient consultations, and distributed relief items and up to 240,000 liters of water per day. In July, the programme moved to Abs hospital, a more comprehensive facility in Abs district, to provide a greater range of services, including emergency and maternal healthcare and surgery. Since August, MSF has supported Al Jamoorhi hospital in Hajjah city by responding to emergencies, treating war injuries, performing surgery and assisting in the inpatient department. Over 4,550 patients were received in the emergency room.
MSF continued its HIV programme at Al Gumhuri hospital in Sana’a city, providing antiretroviral treatment to 770 people.
Two cyclones hit the southeast coast of Yemen in November. MSF set up a mobile clinic in Mukalla to assist families who had lost their homes, and made donations to the local hospital and blood bank. Around 300 consultations were undertaken. Blankets, jerry cans and washing kits were distributed to 200 displaced families. About 50 kilometres away on the west coast, in the district of Borom Mayfa, the team set up 14 water tanks to provide water for over 400 displaced families.
Training is part of MSF's regular activities in the hospital in the form of on-the-job training for MoH doctors and nurses. MSF has one doctor and two nurses at a time in the hospital. Started in February 2016, the program has trained 14 doctors and nurses so far.
Support for Other Hospitals
MSF has supported Ibn Khaldoun Hospital in Lahj with regular donations of medical supplies since December 2015 and Al-Razi hospital in Abyan since February 2016. This support includes medications for the emergency rooms and emergency operating theater supplies for Lawadar Hospital Abyan and Al-Razi Hospital in Abyan.
MSF provided 700 screening test kits to the national blood bank in Aden to restart their blood donation activities.
At the end of 2015, MSF had 551 staff in Yemen. MSF has worked in the country since 1994.
Husni Mansoor – MSF nurse supervisor, working in Aden
“Our biggest fear is that the fighting will surround the hospital. Many times, when the clashes intensify, we go down to the basement. But this creates a different problem. Before we save ourselves, we move the patients who are in beds near the windows to a safe place. This has happened many times. We hear the sound of gunshots and shelling or airstrikes and we move all the patients to safe areas before finding a safe place for ourselves. Windows at the hospital have been broken more than once and bullets have entered, but no one has been hurt inside the hospital.”