Vaccination
Our teams in Yemen are responding to the increase in measles cases across several governorates (Saada, Amran, Hodeida, Hajjah, Al Bayda, Ibb, Taiz, and Shabwa) by opening new isolation units, extending bed capacity in isolation wards, and supporting case management in health facilities at primary and secondary levels as well as through mobile clinics. In the Ministry of Health’s Al Thawra Hospital in Al-Hudaydah City, MSF is supporting an isolation unit for measles case management. Of 306 suspected measles cases received from mid-July to November last year, 85 patients (35 percent) presented with acute malnutrition. Of all measles patients, only 15 percent had received a measles-containing vaccine before their admission, indicating the low vaccination coverage.
Maternal health
Between August 2021 and August 2022, MSF’s team in Al-Jumhouri Hospital in Taiz governorate assisted 6,739 deliveries, out of which 4,184 were normal deliveries. Almost 29 percent required cesarean sections—an indication of the high number of complex pregnancies arriving at the hospital.
Mental health
Our teams in Yemen provide mental health and psychosocial support through group sessions and individual consultations. MSF’s mental health care aims primarily to reduce people’s symptoms and improve their ability to manage difficult times so they can get on with their lives.
In 2021, three primary health care centers run by MSF in Marib governorate introduced psychosocial support as a key component of medical services and have since become the sole providers of mental health care in the area.
In Al-Gomhouri Hospital in Hajjah City, northwest Yemen, our teams provide a holistic mental health program in collaboration with the Ministry of Health. We receive patients suffering from various mental health disorders with mild to severe symptoms, including anxiety, depressive episodes, post-traumatic stress disorder (PTSD), and behavioral problems. However, most patients arrive with severe conditions such as major depression, psychosis, and bipolar disorder, which require psychiatric treatment in addition to psychological care. These cases amount to 70 to 80 percent of our patients.
People on the move
To ensure people in vulnerable situations are not excluded from medical care, MSF provides primary health care services to migrants from the Horn of Africa, as well as IDPs and a minority group known as Al Muhamasheen, or “the marginalized”—who are usually of African descent and suffer discrimination, poverty, and social exclusion.
Emergency response
MSF teams are delivering emergency medical aid in Sana’a, Sa’ada, Taiz, Amran, Aden, Al-Dhale’, and Hajjah governorates. Activities include surgical care for the wounded, health care services in hospitals, support and medical supplies for local hospitals, mobile clinics, and the distribution of relief items to displaced people.
In early 2022, in response to a dramatic escalation in fighting across several frontlines and a significant increase in airstrikes, our teams in Abs, Mocha, and Sa’ada launched multiple mass casualty interventions.
Although the conflict has reduced in intensity since the UN-brokered truce in April 2022, sporadic clashes continue to break out on frontlines, often resulting in casualties among civilians caught in the crossfire or exposed to unexploded ordnance.
Yemen’s humanitarian crisis is driven by armed conflict, but the consequent deterioration of the economy has also had a direct impact on people’s living conditions, health, and access to essential treatment. As food and fuel prices continue to rise, many families cannot afford to eat or travel to health care facilities.
The availability of health care in Yemen—in particular high-quality, affordable basic medical services at the community level—is diminishing and in some cases non-existent. As we have seen in the health facilities we support, poor access to general medical care means that many people delay seeking treatment or are forced to travel further afield. By the time they reach care, they are often in worse condition and have developed complications.
A large number of people in Yemen remain in dire need of humanitarian assistance and support, amid a marked deterioration in services that leads to increasing gaps in health care. The situation has been compounded by asymmetric restrictions imposed by Yemeni authorities on humanitarian staff and supplies, which have hampered the effective and timely delivery of essential aid. MSF continues to call for a greater, more efficient and more direct international response in Yemen, and calls for the facilitation of access to vulnerable people for MSF and other humanitarian organizations.
In 2022, our teams worked in 12 hospitals and supported 16 other health facilities across 13 governorates, with a focus on inpatient and emergency care. However, given the lack of basic health care in rural areas, the hospital wards MSF supports are often overwhelmed, as people tend to arrive with complications because they were unable to receive care when they needed it. As a result, the facilities we support often operate at well over 100 percent capacity. We therefore provide assistance to basic healthcare centers in several locations across the country, including financial support for health care workers, training, donations of medications, and payment for referrals to facilities run or supported by MSF.
Malnutrition
In Yemen, malnutrition is a persistent risk to children, pregnant women, and people in a heightened state of vulnerability due to medical conditions, with seasonal and annual peaks linked to the lean season between harvests. This pattern was seen before the escalation of the war in late 2014, but it has worsened and become more widespread due to the ongoing conflict, which has exacerbated food insecurity for people living in vulnerable conditions.
In 2022, the malnutrition peak started earlier than other years and did not finish until November. MSF-supported facilities were overwhelmed by the high numbers of patients, with over 10,000 receiving treatment over the course of the year. Our teams launched emergency interventions to address the surge in acute malnutrition cases and compounding health complications, including waterborne diseases, which are particularly dangerous to children under age five, especially if their immune system has been weakened by malnutrition.
Emergency and surgical care
During the year, MSF-supported emergency rooms in Yemen treated hundreds of thousands of patients, many with violence-related injuries incurred during the conflict. Many other people ended up needing emergency care for conditions were initially less serious, but had worsened because the lack of affordable health care in their communities meant they delayed seeking treatment.
Our teams performed thousands of surgical interventions in 2022, not only for violence-related injuries, but also for emergencies such as obstetric complications. They also treated a significant number of road traffic accidents in various locations in Yemen. As a result of limited availability of maternal care, high numbers of women face complications in childbirth and other risks to both mother and child. Often, this is because they receive treatment too late.
Maternal and child care
MSF provides support for maternal and child health care in most governorates in Yemen, where there is an ever-increasing demand for such services. Our teams assisted with deliveries, including cesarean sections, and provided both prenatal and neonatal care. In an effort to reduce the high maternal and infant death rates, we worked with the Ministry of Health in Hodeidah, Hajjah, Ibb, and Taiz governorates to develop emergency referral pathways to accelerate access to care.
Low vaccine coverage and preventable diseases
We have seen a resurgence of preventable diseases, such as cholera, diphtheria, measles, and whooping cough due to low vaccination coverage, poor living conditions, and the collapse of Yemen’s health care system. In response, our teams provide vaccinations, manage disease isolation centers, and carry out health promotion and education activities to encourage people to get vaccinated.
