Yemen: Going behind the front lines of a hidden war

The entrance to the operating theater and intensive care unit at MSF's trauma hospital in Aden.
Yemen 2018 © Agnes Varraine-Leca/MSF
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There is an invisible war being fought in Yemen. Most people know only about the war in the headlines: the armed conflict between the forces of the Saudi-led coalition and the Ansar Allah group that has killed and injured thousands of people and uprooted more than three million forced to flee the fighting. That conflict has decimated the country’s health system, now ill equipped to treat the growing numbers of war-wounded patients and others with urgent medical needs. Which brings us to the other war underway to fight drug-resistant bacteria. 

More than 60 percent of patients admitted to the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the Yemeni port city of Aden suffer from antibiotic-resistant bacteria (ABR). These infections require complex diagnostics and prolonged treatment, further straining an already battered health system. 

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MSF Aden trauma hospital
Hamoud, 40, underwent surgery at MSF’s hospital in Mocha, Yemen, after he was shot in the leg by a sniper. After the surgery he was referred to the hospital in Aden to recover in traction. He is originally from Sharab district in Taiz governorate, where he lives with his wife and four daughters. “Once I’ll be discharged from Aden hospital I will go back to my family in Sharab,” he said.
Yemen 2018 © Agnes Varraine-Leca

When our teams in Yemen saw patients who weren't improving from standard antibiotic treatments, they changed their protocols and set up a microbiology lab to begin testing for ABR. At first, results were sent to MSF experts outside Yemen for interpretation and diagnosis. Proper diagnoses enable responsible use of the correct antibiotics—and more effective treatment. 

A staff member and a patient walk in the hallway of the Aden hospital in Yemen. Physical therapy is an essential part of the care patients receive at the hospital as they recover from complex and often life-changing injuries.
Yemen 2018 © Agnes Varraine-Leca

Within two years, the microbiology and antibiotic stewardship programs in Yemen, now completely run by Yemeni staff, are among MSF’s most advanced in the world. The project in Aden has shown that the processes and protocols needed to combat the spread of ABR can be successfully implemented in even the most unstable conditions. But the fight is far from over, and urgent action is still needed to halt the public health crisis of antibiotic resistance on the front lines of war and beyond. 

MSF bio lab at MSF’s Aden hospital
Waddah, 15, has developed a drug-resistant infection so is receiving care in the isolation department at MSF’s Aden hospital.
Yemen 2018 © Ehab Zawati/MSF