MSF Projects in Yemen (September 2015)
Crisis Update: September 15, 2015
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.
In Yemen, Doctors Without Borders/Médecins Sans Frontières (MSF) works in Aden, Al-Dhale’, Taiz, Sa’ada, Amran, Hajja, Ibb, and Sana’a. A total of 790 MSF staff are currently working in the country, including 64 international staff.
Yemen: Latest MSF Updates
- MSF Treats a Child Landmine Victim in Aden, Yemen
- Human Toll of Conflict in Yemen
- Houthis Indiscriminately Bomb Aden Neighborhood
- Hundreds Wounded in Attacks on Markets and Residential Areas
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.
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. MSF received 204 war-wounded patients on July 19, 167 on July 25, and 111 July 26. Since the beginning of 2015, MSF has received 5,978 patients in the emergency room and performed more than 3,776 surgical interventions. Since March 19, MSF has received 5,522 war-wounded patients.
MSF has been receiving more patients from Lahj and Abyan governorates recently. The number of victims injured by landmines and unexploded ordnances has been increasing since early August, when MSF received more than 35 victims, mostly children. MSF is also providing mental health care and physiotherapy in the hospital.
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.
Yemen: MSF Treats War-Wounded
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 9,722 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 August, MSF received 20,459 patients in the emergency rooms; performed 1,888 surgeries and 1,597 deliveries; admitted more than 1,900 adult patients to the IPD and 1,949 children to the pediatric ward and neonatal unit; and provided more than 4,423 antenatal and postnatal consultations, and 1,478 gynecological consultations in Amran Governorate.
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 August, MSF received more than 1,784 patients in these health centers and referred nearly 100 of them to Al-Jumhori Hospital in Sa’ada to receive surgical care. MSF is supporting Huth and Khamer with four ambulances.
In Haradh, a total of 212 war-wounded were treated by the MSF team in collaboration with the MoH team from Haradh Hospital. Currently, MSF is not working in Haradh. The MSF team that evacuated Haradh is currently in Hodaida, where they have done a mass casualty training for staff at Al Olafi Hospital. In Al-Jumhori Hospital in Hajja, an MSF team (along with the MoH staff) have received 309 emergency cases, 163 of which were war-wounded. MSF has also donated 720 sessions for the kidney dialysis center at the hospital.
In Beni Hassan, MSF is supporting IDPs with water provision, non-food item distributions, and general medical consultations. 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. Non-food items were distributed to 805 families. 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 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 639 emergency cases, 207 of whom were war-wounded.
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, post-operative care, sterilization, laboratory, infection control, health care waste management, and referrals.
In addition, MSF is supporting Al-Azarik Health Center 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 29,049 patients in the emergency room, with more than 1,681 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 534 deliveries, received 2,366 patients in the emergency room—including 1,260 war wounded—and have seen 34 deaths upon arrival. MSF has also performed 370 surgeries, of which 311 were related to war. Support is also provided to Haydan Hospital in the form of medication and a referral system to Al Jumhori Hospital. An MSF doctor is working in the ER, where 2,030 patients were received from May to September 2015, of which 30 percent were suffering from conflict-related trauma. MSF has also donated 1,080 sessions for the Kidney Dialysis Center at Al-Jumhori 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, 2015, Al-Rawdah Hospital has received a total of 3,821 war-wounded patients, of which 308 died, including 15 women. MSF also plans to provide a hospital-to-hospital referral system starting with two ambulances, to be increased depending on the need.
Given the assessed needs, MSF started setting up an office in Taiz in June 2015 to ensure continued support during this crisis period. MSF also planned to set up a mother and child health care hospital, aiming at a 150-bed capacity for obstetrics and gynecology, and pediatrics focusing on children under five years of age. A building has been identified for the planned hospital. An MSF team consisting of four international staff and eight supporting local staff is on the ground to carry out further needs assessments whenever necessary. MSF is working to get authorization for 150 beds to be sent to Taiz, and to start equipping the hospital. The hospital building that was identified is five kilometers from the center of the city.
MSF has donated medical and surgical materials to Al-Thawra and Al-Qa’idah Hospitals in Ibb Governorate, and is considering one-off donations of food supplies to centralized kitchens of IDPs who are based in seven schools 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.
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 700 injured benefitted 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 2,124 sessions, and is preparing to support this center with materials for three months.
MSF has been holding first-aid and mass-casualty trainings for health staff working in local hospitals in Sana’a. MSF gave donations to local hospitals that received the victims of airstrikes in Sana’a in the second week of September. The main hospitals receiving support are Al-Jumhori, Al-Thawra, the Police Hospital, and Al-Kuwait hospital.
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.
Why are we there?
- Armed conflict
- Massive flow of migrants
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.