MSF Projects in Yemen (August 2015)
Crisis Update: August 6, 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, MSF works in Aden, Al-Dhale’, Taiz, Sa’ada, Amran, Hajja, Ibb, and Sana’a. To date, MSF has brought 105 tons of humanitarian aid supplies to the facilities it runs and supports in Yemen, and has received more than 10,500 war-wounded patients since March 19, 2015.
Yemen: Latest MSF Updates
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- Yemen: "We Don't Know Where to Go"
- Yemen: An Update from an MSF Doctor in Khameer
- "We Have to Forget About Our Pain": Working Through the Conflict in Yemen
- A Day at MSF's Hospital in Aden, Yemen
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 runs an Emergency Surgical Hospital in Sheikh Othman District, in the north of the city. Mass casualties were frequent in July. Two-hundred-four war-wounded patients were received on July 19, 167 on July 25, and 111 July 26. Since the beginning of 2015, MSF has received more than 4,767 patients in the emergency room and performed more than 2,760 surgical interventions. Since March 19, MSF has received more than 4,271 war-wounded patients. 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 work 24/7 to providing trauma care, medication, and fuel for the power generator. More than 745 wounded patients have been received in the emergency room. Of these, 215 were referred to other hospitals for further treatment after initial stabilization. More than 635 wound dressings and patient follow-up consultations have been performed in the advanced emergency post.
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 cannot access MSF hospitals. More than 570 war-wounded patients have received surgical follow-up consultations and wound dressings.
Yemen: MSF Treats War-Wounded
MSF is providing general consultations in mobile clinics for internally displaced people (IDPs) fleeing from several areas. Since late April 2015, more than 5,000 general consultations have been provided. MSF has also provided support in several IDP locations, including providing water tanks, non-food items, and hygiene kits for more than 500 IDP families located in 20 locations in Khamer. Activities also include health promotion among IDPs and cleaning the sewage system in the central market of Khamer. MSF is also supporting the Ministry of Health (MoH) in a measles vaccination campaign in Khamer.
In the MoH's Al-Salam Hospital, MSF is supporting lifesaving health care services for patients in various departments. MSF is also supporting the Huth Health Center with medications, oxygen, logistics equipment, human resources support, electricity, and a referral system.
Since January 1, MSF has received 20,015 patients in the emergency rooms, performed 1,642 surgeries, assisted 1,343 deliveries, admitted 1,492 adult patients to the inpatient department (IPD) and 1,643 children to the pediatric ward and neonatal unit, and provided more than 4,048 antenatal and postnatal consultations and 1,478 gynecological consultations in Amran Governorate.
MSF is also building 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, In North Amran Governorate, MSF set up a reference system from three peripheral health centers (Harf Sufyan, Al Ashah, and Al Qaflah) to the MSF-supported structures in Huth and Khamer, with four ambulances.
In Haradh, a total of 145 war-wounded patients were treated by the MSF team in collaboration with the MoH team from Haradh Hospital.
In Beni Hassan, MSF supports IDPs with water, non-food items distributions, and general medical consultations. MSF has provided 5,523 general consultations at its mobile clinics and the health center in the district.
In July, 68 patients wounded in an airstrike in Aahem were stabilized at the Beni Hassan health cent supported by MSF and referred to the Hajjah and Hodeida hospitals. A donation of supplies for 100 war-wounded was made to Al Jamhoory Hospital.
Since May, MSF has gone door-to-door in Beni Hassan in order to identify the needs of IDPs and provide basic services in Al Mangorah, Al Khademah, Bani Kodish, and Akasah. Since early July, community health teams have identified a total of 2,101 families and 8,149 individual IDPs in four locations: Al Khademah, Al Okashiah, Shab-Al-Dosh, and Al Manjorah. Non-food items were distributed to 805 families. By the end of July, the total number of displaced was around 20,000, of which 16,500 were in Beni Hassan and 3,500 in Khamis.
Mid-upper-arm-circumference screening was performed in these IDP sites and showed an alarming rate of malnutrition.
In Abs Hospital, a 24-hour emergency room staffed by the MoH and supported by MSF has received more than 134 emergency cases, with a total of 34 war-wounded.
MSF provides lifesaving health care services in the MoH's Al-Nasser Hospital in southwestern Yemen's Al-Dhale' District. This support includes a 24/7 emergency room, surgery, post-operative care, sterilization, laboratory, infection control, health care waste management, and referrals.
In addition, MSF supports Al-Azarik Health Center in the emergency room, antenatal care and postnatal care, family planning, normal deliveries, routine vaccination, nutrition, and referrals to Al-Nasser Hospital. The number of surgeries performed in Al-Azarik was 287. In Qataba, MSF supports the 24/7 emergency room, observation room, laboratory, and health care waste management in the MoH's 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.
Since the beginning of the crisis in Yemen, MSF projects in Al-Dhale’ have received 29,049 patients in the emergency room, with more than 1,560 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 emergency room, operating theater, and maternity departments of Al Jumhori Hospital in Sa'ada City. MSF teams (along with MoH staff) have performed 359 deliveries; received 1,961 patients in the emergency room, including 869 war wounded; and seen 34 deaths upon arrival. MSF has also performed 266 surgeries, of which 224 were related to war. Support is also provided to Haydan Hospital with a doctor, medication, and a referral system to Al Jumhori Hospital. Haydan has seen 1,500 patients in its emergency room since May 2015, of which 30 percent suffered from conflict-related trauma.
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. 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 emergency room with supplies and staffing. Four MSF medical doctors and one nurse work in the emergency room of Al-Rawdah Hospital, and MSF covers the salaries of 27 hospital staff members working in the emergency rooms to ensure a 24/7 presence. Since May 15, 2015, Al-Rawdah Hospital has received a total of 2,487 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 an up office in Taiz in June 2015 to ensure continued support. MSF also plans to set up a mother and child health care hospital, aiming at 100-bed capacity for obstetrics/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 and eight national staff is on the ground to support and carry out further needs assessments whenever necessary.
MSF 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 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, to the Ibb cold-chain. However, more support is still needed, especially for 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 wounded patients from Sana’a and the rest of the country. More than 700 injured patients benefitted from MSF kits.
MSF also provides support with surgery and post-surgery materials, along with blood transfusion and admission-required items. MSF also prepositioned materials in the hospitals for emergency use. Kits for covering 180 war-wounded patients in the emergency room were supplied to these two hospitals in late July.
MSF donated dialysis materials to the Kidney Center at Al-Jumhori Hospital to cover more than 1,500 sessions. MSF is preparing to support this center with materials for three months.
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. So far, 1,327 HIV patients have received ARVs, 775 patients received drugs for opportunistic infections, 546 patients received laboratory reagents, and 202 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 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.