Health care needs in Yemen remain high after seven years of brutal war. Since 2016, Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing urgently needed health care services at the General Rural Hospital of Dhi As Sufal in Ibb governorate, near one of the country's front lines.
"The medical need at the district level is great; the Dhi As Sufal area in particular has become home to most of the displaced people fleeing frontlines in both Taiz and Al-Hudaydah governorates,” said Dr. Iman, medical activity manager at the MSF-supported General Rural Hospital in Dhi As Sufal.
"Most cases we are admitting to the intensive care unit are surgical cases due to bullet wounds, accidental cases with chest and abdomen injuries, severe burns, thalassemia [an inherited blood disorder], tetanus, lower respiratory tract infection, and neglected diseases like snakebites and dog bites," said Dr. Adwa'a, the MSF intensive care unit supervisor at the hospital. "Some medical cases arrive late and the teams do everything they can to save their lives, but when you see a patient's smile after getting better this motivates us to do it, knowing the extent of the people's need for such services, especially amid all of these harsh conditions—war, poverty, and weak economic stability.”
In addition to treating adult patients, the hospital has a robust pediatric unit. "The medical needs for newborns are huge in Yemen," said Mohammed, a neonatal nurse at the General Rural Hospital of Dhi As Sufal. "This hospital is located in a remote area and there are no newborn care services available in the area, which is why MSF provides these services to take care of newborns. Often new babies are underweight and suffer from infections that occur during delivery, as well as birth asphyxia.”
Over its five years of operation at the hospital, MSF admitted more than 52,590 patients to the emergency room. Every week, an average of 290 patients arrive in the emergency room, and 85 surgeries are carried out. MSF also provides physiotherapy and mental health care to patients admitted to the hospital. Below are a selection of testimonies from patients and medical staff who faced a variety of medical challenges in harrowing conditions.
Caring for the wounded
Salah, MSF patient at the General Rural Hospital of Dhi As Sufal
Salah, 24 years of age, was in a motorcycle accident. MSF doctors at the General Rural Hospital of Dhi As Sufal treated him and were able to save his leg.
"I had a motor accident and I was admitted to a number of hospitals in the city that decided to have my feet amputated. Then I was transferred to the MSF hospital here and surgeries were performed—the doctors provided me the necessary care so my feet began to improve, thank God. The doctors told me that there was not a need for any amputation. I am very happy with this and the treatment I got here."
Dr. Raoof, OT supervisor for MSF at the General Rural Hospital of Dhi As Sufal
"In the operations theater, we receive all cases that need emergency lifesaving surgical intervention. These include injury cases from gunshot wounds—either in the abdomen or the extremities— and cases of internal bleeding in the abdomen or chest after car accidents, major arterial injuries and fractures—whether after explosives, gunfire, or traffic accidents—that threaten a patient's life or limbs. We also treat cases of acute abdominal infections [and inflammation]. In addition, we intervene with emergency Caesarean sections with all causes that threaten the life of the mother or fetus." –Dr. Raoof, operating theater supervisor at the General Rural Hospital of Dhi As Sufal
One of our patients, [Ghamdan], injured his foot and it was in a state of rot from the thigh to the middle of the leg. He had a defect in kidney function due to toxins in his body and his condition was difficult. We did the cleaning work and he was admitted to the intensive care unit, after that the vital signs began to appear on his foot, and a skin transplant was done for his leg. Now he started to walk on it easily."
Ghamdan, MSF patient at the General Rural Hospital of Dhi As Sufal
Ghamdan fell down while at work on a farm, and developed an infection in his foot that started to swell. He was treated by Dr. Raoof and other MSF staff at the General Rural Hospital of Dhi As Sufal.
"I went to a number of hospitals at the beginning and doctors told me that the foot tissue had died, and this required amputation. But after I came to the MSF hospital here, the doctors told me that they would do their best to avoid amputation. Thank God, after the operations, the foot tissues improved and came back to life, big thanks to the doctors here."
Sadeq, physiotherapist at the General Rural Hospital of Dhi As Sufal
"We focus on reducing the amount of time patients have to stay in the hospital, preventing any complications that may occur during treatment, and generally supporting patients after they receive operations. We do sessions with patients with fractures and burns, respiratory infections, and patients in the pediatric department as well. At first, patients may not realize the importance of the physiotherapy sessions, but after one session they see the difference and you find them asking about the physiotherapist for treatment."
Addressing children’s needs
Ali, father of Yunes, a six-year-old patient at the General Rural Hospital of Dhi As Sufal
Yunes Ali, six years of age, had a traffic accident. His father brought him to the hospital at the General Rural Hospital of Dhi As Sufal to receive care from MSF staff.
"Doctors performed surgeries on [Yunes]—skin transplants, and the colostomy closure operation. He was admitted to the inpatient department for over two months. Now his health is getting improved and I see his smile again."
Dr. Omar Ba'ashan, pediatric doctor for MSF at the General Rural Hospital of Dhi As Sufal
"Health awareness in the region is almost non-existent, and maternity health services are weak, in addition to the harsh economic situation and long distances to access hospitals. We see children who are underweight, suffering from birth asphyxia, preeclampsia, chest infections, tetanus, burn cases, and other health conditions. The medical team in this department is dedicated [and] works day and night to provide the best care for all children."
Osama Al-Mujahid, ambulance driver
Osama Al-Mujahid works as an ambulance driver for MSF in Dhi As-Sufal, where he lives with his family, after he was forced to leave his house in Taiz four years ago due to ongoing violence in the area.
"We always transfer patients between MSF hospitals or other hospitals. Most patients that we transfer experienced accidents or gunshots. Some are children, with injuries. The case that impacted me the most emotionally was a young girl—when a shell fell next to her and she fell into a borehole and injured her backbone. I felt very sad for her."
Mental health support sessions for adults and children
Afrah Al-Dumaini, MSF psychologist at the General Rural Hospital of Dhi As Sufal
Afrah Al-Dumaini works with children and adults who benefit from mental health sessions offered at the hospital.
"We offer psychological support and mental health sessions for children and adults, mostly to address fears, depression, and tensions as a result of mass injuries, burns, violent incidents, or even before and after surgeries. The medical team diagnoses patients that need psychological support and refers them to us in the mental health department, or we reach out during our rounds and identify patients. We try to break the barriers of fear and anxiety through a number of activities and games that vary from one patient to another. We notice the impact of improved psychological states of the patients on their health and their rapid response to treatment. We also continue to follow up with patients even after they are discharged from the hospital."
Basma, MSF patient at the General Rural Hospital of Dhi As Sufal.
Basma, seven years of age, was psychologically traumatized after a fire accident that happened while she was playing in her neighborhood where she was living with her family after they forced to leave due to the violent conflict in Taiz. She spent four weeks recovering at the General Rural Hospital of Dhi As Sufal and continues to get physiotherapy there.
"[Basma] experienced dread and nightmares and we do private sessions with her in order to relieve stress through playing and drawing. We notice that she loves to play and draw, and now she eats well, has less anxiety, and her health and psychological status is improved.
Playing is a very useful way for children to help them express their feelings and emotions. We try to continuously educate parents and caregivers to make sure that patients live with relatives or friends to take care of them. [We also raise awareness and provide] advice to the family on how to deal with the patient and how they take into account the psychological situation they suffer after the accident they experienced." —Hind Al Marani, MSF psychologist at the General Rural Hospital of Dhi As Sufal.