Yemen’s civil war, now in its fourth year, shows no signs of abating and is driving residents of the Middle East’s poorest country deeper into misery.
Already struggling to control communicable disease and chronic malnutrition before the conflict broke out in March 2015, Yemen today has arguably become the world’s worst humanitarian disaster, with more than 75 percent of the population of 29.3 million people in need of aid, a quarter of the population living on the brink of famine and an estimated 3.3 million children and nursing mothers acutely malnourished.
The country endured the world’s largest cholera outbreak in recent memory last year, and the outbreak is accelerating once again. Roughly 10,000 suspected cases of cholera per week were being reported countrywide in September 2018, nearly double the average weekly cases from January to August. Fighting in and around the country’s main port city of al-Hudaydah has worsened existing shortages of food, fuel and medicines—most of which are imported—while a sharp drop in the value of the Yemeni Rial has pushed the cost of those critical commodities that are available beyond the reach of many.
In this challenging environment, International Medical Corps serves areas of Yemen with some of the most pressing humanitarian needs, even though widespread damage to existing infrastructure has restricted access to many areas. More than half of Yemen’s health facilities no longer function, and with the government unable to support it, the country’s health system is on the verge of collapse. With no sign of an end to the violence, humanitarian conditions in Yemen are expected only to deteriorate further.
children and pregnant or nursing women are acutely malnourished
Every ten minutes
a child under five in Yemen dies of preventable causes
of Yemen’s population lacks clean water, sanitation and hygiene services, increasing the risk of infectious diseases
Frequently Asked Questions
Why are hunger and malnutrition major issues in Yemen?
Yemen is the poorest country in the Middle East. Historically, it has endured long years of weak, often divided governments that have been unable to provide a secure, politically stable environment or basic social services, such as healthcare, for their people. In addition, Yemen grows little of its own food, relying chiefly on imports. But the cost of this food is simply out of reach for many Yemenis—especially in rural areas, where bread and rice are the mainstays, supplemented occasionally with vegetables and very rarely with meat. Even in the best of times, poor roads, clogged ports, little government authority, weak purchasing power and only nascent distribution systems combine to make delivering imported food to rural areas a challenge.
Why don’t we hear more about Yemen if conditions are so desperate?
Yemen lies at the outer fringes of the Middle East region. It is remote, sharing land borders with only two countries: Saudi Arabia to the north and the Sultanate of Oman to the east. It is accessible by air via just one commercial carrier or by sea from Djibouti. Consequently, Yemen is both very hard for journalists to reach and extremely dangerous for them to tell the story of Yemen’s tragedy. And unlike Syria, where another Middle East civil war rages on, few of Yemen’s citizens can afford the journey to safety in Europe or elsewhere in the West. Although Yemen’s population of more than 29 million is larger than Syria’s pre-war figure of 22 million, fewer than 200,000 Yemenis are officially listed as refugees, compared to about 5.6 million Syrians.
Why is Yemen vulnerable to cholera and why was the outbreak there so virulent?
Cholera is endemic to Yemen, but it has been able to take hold in recent years because of the ongoing conflict. More than half of Yemen’s population of 29.3 million now lacks access to proper healthcare and to clean water, sanitation and hygiene services, which leaves Yemenis vulnerable to communicable disease. And as the conflict wanes on, the ever deepening economic crisis has caused many more people go hungry—and malnourished children, women and men are much more susceptible to illness. In addition, Yemen’s civil war has further eroded the already limited capacity of the country’s healthcare system to respond to public health emergencies.
Ongoing Civil War
War with no end in sight has divided the country, claimed many thousands of lives, left many more thousands wounded. The war has also severely disrupted the flow of goods, including fuel, food and medical supplies, all of which are imported
Fewer than half the country’s health facilities still function and over 16 million people lack access to basic health care
Civil war, the presence of well-armed militant group, and stifling bureaucratic demands all limit access for humanitarian organizations
Health Care, Nutrition and Food Security
Working in six of Yemen’s 23 governorates (Sana’a, Taizz, Aden, Lahj, Ibb and al-Dhalea) International Medical Corps supports primary health care centers, secondary care hospitals, mobile clinics as well as stabilization centers for treatment of malnutrition. In response to this emergency, we provide treatment for Severe and Acute Malnutrition (SAM) and Moderate and Acute Malnutrition (MAM) cases at community-level health facilities and with mobile clinics in Sana’a, Taizz, Lahj and Aden governorates. We offer training, essential drugs and nutrition commodities needed to operate outpatient therapeutic programs. In a country that has long struggled with food shortages and chronic malnutrition, the effects of civil war and an on-again-off-again blockade of major ports has exacerbated conditions to a point where nearly a quarter of Yemen’s 27 million people face the threat of famine.
On average, International Medical Corps reaches over 13,000 individuals per month with health and nutrition education, 80% of them female. In Taizz, we are implementing emergency livelihoods and livelihoods restoration programs to rebuild livestock herds lost by vulnerable households during the conflict. Also in Taizz Governorate, a program is underway in two districts to provide tens of thousands of goats and sheep to families forced to sell or slaughter their own animals in order to eat.
International Medical Corps also treats children under 5 in our outpatient and inpatient nutrition programs, as well as pregnant or nursing women in our supplementary feeding programs. In addition, we provide thousands of food-insecure households that included acutely malnourished children with monthly vouchers as part of our food assistance programs designed to improve household food consumption and dietary diversity.
In an attempt to address the causes of malnutrition, we supported some of the most food insecure communities in Taizz and Lahj Governorates by distributing food and providing income-generating work.
Cholera and Diphtheria
At the peak of Yemen’s cholera outbreak, International Medical Corps supported a string of 80 treatment centers and oral rehydration points in six governorates–Sana’a, Taizz, Ibb, Aden, Lahj and Al-Dhalea. As the epidemic declined in intensity many of these treatment centers have been turned over to local health authorities or other NGOs. We have retained a small number of these facilities protectively to respond swiftly to meet any resurgence of the disease that might accompany the onset of Yemen’s raining season later in the year.
International Medical Corps also responded to a diphtheria outbreak, in the country, providing essential drugs, supplies and equipment needed to fight the disease, engaging in educational messaging about the disease and participating in a large-scale vaccination campaign to protect residents in areas where diphtheria was prevalent.
International Medical Corps supports health facilities, including hospitals, smaller clinics and cholera treatment and rehydration stations in six governorates by trucking in regular supplies of chlorinated water that are tested regularly for possible impurities. We have also rehabilitated handwashing points and installed latrines in several health facilities and installed new water tanks to boost storage capacity at health facilities in Lahj Governorate.
We also conduct hygiene promotional activities in three governorates designed to prevent and control the spread of cholera and reduce the risk of other diarrheal diseases and distribute hygiene kits to households located in areas with high rates of cholera.