Al-Monitor.com: As health system collapses, disease kills more Yemenis

SANAA, Yemen — In Al-Gumhouri Teaching Hospital in Sanaa, a security guard in a hallway has covered his mouth and nose with a face mask and refuses to shake hands with patrons asking his permission to visit patients in the hospital. The guard told one of the visitors, “Sorry, we are taking precautions because of the virus.”

He was referring to the swine flu virus (H1N1), which has been infecting residents of one of the poorest countries in the Middle East amid a devastating civil war that has attracted regional intervention and has been ongoing for 11 months. This new killer came on the scene in mid-January, and as of the beginning of February had killed 20 people and infected 26 others, according to statements Al-Monitor obtained from the Yemeni Ministry of Health.

Tamim al-Shami, spokesman for the Ministry of Health told Al-Monitor, “Sixteen people in the capital, Sanaa, have succumbed to the virus.” The first cases of people being infected with H1N1 were reported in 2009 in the United States and Mexico. At the time, the World Health Organization declared a state of emergency, fearing a global pandemic. Patients typically present with extremely high fevers and pneumonia.

By early February, local authorities in the oil-rich province of Hadramout, on the Arabian Sea nearly 500 miles from Sanaa, had recorded 30 cases of H1N1, four of them fatal. According to health officials, Seiyun General Hospital had treated 15 cases. The town of Seiyun lies in the middle of a desert valley some 223 miles from Hadramout's provincial capital. Authorities were asked to quickly provide treatments, protective wear and money for medical staff.

Last year, Doctors Without Borders (MSF) said that more than 15 million people needed lifesaving health assistance in Yemen. Medical services in the country had been deteriorating even before the outbreak of the current conflict. The civil war and a blockade by the intervening Saudi-led Arab coalition have greatly exacerbated the suffering.

The land, sea and air blockade by the Saudi coalition, which is fighting the Houthi rebel group Ansar Allah, has led to a shortage of more than 200 essential medicines, according to Shami. He said the essential medicines desperately needed by patients are “insulin for diabetes, pills for patients with heart and blood pressure disorders, cancer medications and kidney solutions.”

Since the Saudi-led coalition launched military operations March 26, 2015 — at the request of former President Abed Rabbo Mansour Hadi after the Houthis overran Sanaa and overthrew his government — the import and manufacture of medicines have decreased, the three biggest importers of medicine told Al-Monitor.

An administrative employee at the Pharmacare International Manufacturing Company in Sanaa told Al-Monitor, “The blockade on Yemen has prevented the importation of raw materials to make medicines. But this is not the only problem. Access to US dollars [to pay for the medicines] amid the current economic situation is extremely difficult.” The price of the US dollar on the black market in Sanaa has reached 250 Yemeni riyals, a record 35 riyals above the price set by Yemen's Central Bank, a sign of one of the main downsides of the tensions plaguing the country.

The same employee, who spoke on condition of anonymity, added, “All the parties deal with us cautiously because we import raw materials to make medicines, and we can turn these materials into explosives as well. To import these materials, we must obtain a license from the Yemeni National Security [Bureau] and seven government institutions, as well as communicate with the Arab coalition leadership. Due to these obstacles impeding their import, these materials are unavailable.”

Health care facilities in Yemen have also been affected, directly and indirectly, by coalition raids. Shami told Al-Monitor that 345 hospitals and clinics had been damaged in airstrikes. The attacks have not been limited to local health care facilities. Even MSF facilities have been hit despite being protected by international humanitarian law. MFS was hit by three airstrikes in less than three months. 

Taiz, Yemen’s third-largest city, with 3 million people, is experiencing extremely difficult health conditions due to a blockade imposed by the Houthis. The city is witnessing heavy fighting pitting Houthi rebels backed by military forces loyal to former President Ali Abdullah Saleh against Popular Resistance forces loyal to the Hadi government. The latter are attempting to retake the city, which the Houthis have controlled since last spring.

The local Mwatana Organization for Human Rights has reported that Taiz is being deprived of basic services because of the blockade, noting that the rebels had “prevented the entry of basic necessities such as water, food and medicine through the crossing points they control in the major ports.” This has led to the drastic deterioration of health conditions. Some patients have died because of a lack of oxygen.

Sohail al-Thobhani, general manager of Al-Rawda Specialist Hospital, which is treating victims of the war in Taiz, told Al-Monitor, “The health situation has greatly deteriorated. The UN delegation that visited Taiz on Jan. 22 noticed this.” Thobhani warned of impending disaster because of the accumulation of garbage and the absence of government, stressing that the Houthis' blockade is almost entirely responsible for declining health conditions, which he described as catastrophic.

The persistence of this dangerous humanitarian situation, which the United Nations considers to be one of the worst, is heavily affecting poor Yemenis and will lead to further economic deterioration, which in turn will have negative repercussions on basic needs, such as health and food. The UN reported in December that some 21 million Yemenis, about 80% of the population, were in need of help.