Yemen: A "War Against Civilians"

Narciso Contreras/MSF

Teresa Sancristóval, the head of the Doctors Without Borders/Médecins Sans Frontières (MSF) emergency unit, recently returned from Yemen and gave the following account of the medical and humanitarian crisis.

It's not that Yemen was in a peaceful situation before, but it is clear that since March, the level of violence has radically increased in the country. We have seen mass casualties from bombings, such as in the internally displaced persons camp in Harad, or in markets, schools and other places where a lot of civilians are concentrated. When I was in Saada, one day we received a family of 27 members of which only two were alive after three bombs hit their houses.

We have a lot of amputations, and we have very severe cases. From about 10,000 injured patients, about 5,000 have needed surgery. These figures are extremely high, even for MSF, which is an organization that is used to working in conflict.

Especially in Aden, the situation has been extremely difficult, where the population feels it's almost impossible to go out of their houses. Snipers are shooting from the roofs of the hospitals. Ambulances are unable to cross front lines. Some days ago, 250 people were injured in Aden by a land attack and 80 people were injured in Sana'a through bombing.

The impact of this conflict is much wider than only the bombing or the shooting. The situation is growing worse every week. The blockade is having an enormous impact on the population and you can see it on different levels. Yemen is predicted to be the first country in the world to have a capital without water, and water scarcity has an enormous impact. In Yemen, water has to be pumped out with electricity, and the lack of fuel makes it impossible to pump water in most places. The price of water has doubled since the last month, and many families already spent one-third of their incomes on water. It makes it very difficult for a family to cope with the most basic needs.

The conflict is having an enormous impact on access to health care, because of violence and the lack of transportation. The other day we received a kid in the hospital with a respiratory infection. The parents detected it on time, but it took them two days to bring the kid to the hospital because there was no means of transportation. The child's condition degenerated enormously and it was impossible to save the child. It was a totally avoidable death because it would have been treatable earlier.

In some moments, I felt that the conflict in Yemen is much more of a war against civilians than a war against armed groups. One of the days I was in the hospital in Saada, we heard 100 bombs. When you are in a city and they are bombing it 100 times a day, it is impossible to go out for anything. People cannot let their kids go out to the street because they don't know when it's going to happen. And if people cannot go to work, if they cannot go to the school, the situation is only going to deteriorate. For the MSF teams, you end up being exhausted, not knowing when the ambulance can be transferred to another place because the level of bombing is extremely difficult to handle.

Hospitals are lacking supplies. In the city of Taiz, out of 21 hospitals, only 15 are running and many of them have been bombed directly or affected by nearby bombing and insecurity. Some hospitals have stopped functioning because they cannot run without electricity, water, and supplies. In the beginning of the crisis we realized that there was not enough oxygen available for emergency rooms. We went to the factory where they produce oxygen but they did not have the fuel they needed. We had to get fuel for them from the black market.

The crisis is affecting chronic patients who need to be supplied drugs and medical care to live. In the last month we lost 11 dialysis patients because there were not enough fluids continue their treatment. These patients have kidney failure if they don't receive their treatment. We are trying to supply them and doing whatever we can, but it is not easy to get supplies into the country.

We have a lot of diabetic patients who are unable to refrigerate their insulin, which they need to survive.

For our HIV patients, we managed to bring in drugs from the Global Fund, but it was extremely difficult because many of the patients are in cities on the front lines. We are quite satisfied that 90 percent of these patients are receiving their supplies.

The lack of vaccination is going to be an extremely difficult issue, making Yemen more vulnerable to outbreaks. We are starting to see malnutrition in new places and higher malnutrition figures in areas where it was already a problem. So if there are malnourished kids with measles, the combination will be very lethal, and the capacity for a humanitarian response will be extremely limited.

The presence of international aid organizations in the country is very low, especially in the most difficult areas. The International Committee of the Red Cross and MSF are covering quite a number of places in the front-line areas, but we are unable to meet most of the medical and humanitarian needs.

Not all the needs are on the front lines. There are 1.2 million displaced people with very little aid, sometimes in places where the temperature reaches 52 degrees Celsius, or 125 degrees Fahrenheit. There is a need for nutritional support in the camps. There are a lot of things that can be done.

We call on all the parties to avoid targeting civilians, to avoid combat in the very populated areas and to ensure that the population has access to basic goods. We ask that once aid arrives in the country, it is distributed according to the needs of the population, and we ask donors and aid organizations to come and try to alleviate the suffering of the people.

Learn More About MSF's Work in Yemen

Displaced from the heavy fighting in Haradh bordertown and Sa'bah governorate are seen in Al Manjoorah temporary settlement at the outskirts of Beni Hassan, in Hajjah province, Northwest of Yemen.
Narciso Contreras/MSF