Yemen: Facing a war that lasts

Yemen has been struggling with a complex humanitarian crisis that has worsened in recent years. Civilians are trapped between a deadly conflict, poverty, and climate change that has led to severe drought and famine. 

The basis of the conflict began in September 2014, when the Ansar Allah movement (also known as Houthis) took control of the country’s capital, Sana’a, and began pushing south towards the country’s second city, Aden. The internal conflict became an international one when a coalition of Arab states launched a military campaign to re-establish the Yemen government in 2015. The conflict has badly fragmented the country, spreading the violence and creating new front-lines as neighboring countries became involved. What started as an internal conflict has expanded into a proxy war between Arab states fighting for dominance in the region, particularly between Iran and Saudi Arabia. 

While attempts have been made to settle a treaty, the results have been largely unsuccessful. In 2018, the UN settled the Stockholm Agreement that provided a ceasefire in Hodeida as well as established a committee to resolve the situation in Taiz. But despite these developments, political instability persisted. In the following years, treaties were signed but rarely maintained, with violence re-emerging. In 2020, the active conflict between the Houthis and the Islamic Revolutionary Guard Corps intensified in some areas, opening up new front lines along the borders of Ma’rib and Sana’a governorates. 

Now in 2022, with the help of the UN, Yemen’s warring parties have participated in a truce over the past six months, the longest period of respite since the conflict began. Yet this peace is incredibly fragile, especially as the deadline is soon coming to an end unless parties agree to renew the truce. While the conflict may have ceased for the moment, the devastating consequences have very much endured. 7.5 million people have been affected by the conflict, with the healthcare infrastructure badly damaged. Drought and displacement has led to famine in many regions, which have been further exacerbated due to the war in Ukraine. The result is one of the world’s largest humanitarian crises, with women and children bearing the brunt of the impact. Over 11.3 million children are in need of life-saving aid, and 6.5 million women and girls will require services to prevent and address gender-based violence.

Health Emergency in Yemen 

The conflict has devastated the health care system in Yemen, leaving a large part of the population without access to basic healthcare. The conflict has left only 50% of health facilities fully operational, the rest lacking much of the necessary medical equipment to properly take care of patients. Shortages in healthcare professionals, equipment and even basic medicines are hindering many facilities from being able to help the civilian population. As of July 2022, 12.6 million people are estimated to be in acute need of health services. The country has become largely dependent on humanitarian actors to sustain health services for the population, which leaves them in a vulnerable position should aid be redirected elsewhere. 

The fragile healthcare system also leaves the country exposed to infectious disease outbreaks like cholera, diphtheria, dengue, malaria and Covid-19. Out of the 7.3 million in acute need, more than 2.2 million children are acutely malnourished and, at the end of 2022, extreme hunger looms for 161,000 people. The situation of malnutrition is exacerbated by the limited access to health services of the most vulnerable, mainly women and children.

Our Humanitarian Intervention in Yemen

In 2007, Doctors of the World began its operation in Yemen to support the populations affected by the ongoing conflict. Our aim was to provide primary healthcare to those in need, including curative consultations, mental and psychosocial support, and sexual and reproductive healthcare. We accomplished this by providing free consultations, medication and treatment, particularly for the most vulnerable groups: women and children. By working with regional ministries of health and local organizations, we were able to inform the civilian populations about our services. In 2022, we supported 20 public health facilities in 6 governorates (Sana’a, Amanat, Lahj, Abyan, Aden, Marib). 

As our mission is to bolster primary healthcare in the country, we have focused our efforts in capacity-building and rehabilitation of healthcare infrastructure, especially when it comes to infectious disease. This action is reflected in the supply of drugs, training, reinforcement of prevention messages, the mobilization of personnel protection kits, technical support for caregivers from the Ministry of Health and the rehabilitation of damaged infrastructure.

Doctors of the World has also worked to improve protection and provide support to survivors of gender-based violence (GBV). We have a two pronged approach: sensitized care and prevention strategies. Healthcare staff receive training on how to provide quality, sensitive care that includes mental health support for survivors of GBV. Prevention takes place at a community level. Doctors of the World works with identified community volunteers to raise awareness of GBV as well as other health issues like COVID-19 or mental health. These sessions empower the community to identify health problems and create community awareness on health issues as well as develop solutions that may mitigate risks like GBV or cholera. 

Results of our intervention in 2022: 

• We provided 288,894 curative consultations including 28,938 antenatal consultations,
• 88,492 people attended health education awareness sessions,
• 1,852 MHPSS consultations were conducted (including group and individual sessions),
• 49,818 children under 5 were screened for malnutrition. 

Sources: 

UNICEF Yemen Humanitarian Situation Report, 31 July 2022 [EN/AR]

Yemen | UANI

Hudaydah Agreement | UNMHA

EMRO | WHO

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