Catastrophic circumstances

In June Medicines San Frontiers/Doctors Without Borders (MSF) started supporting the Covid-19 treatment centre at the Shaikh Zayyed Hospital in rebel-held Sana’a, the capital of war, disease and famine ravaged Yemen. However, Roger Gutierres, MSF’s head of emergency programmes in Yemen, tells Gulf Today on the phone from Sana’a, that the hospital is “receiving very few” mildly or moderately ill patients. “Yemenis in general do not seek treatment in hospitals. There are rumours about the quality of care. They prefer to stay at home and self-medicate and rely on pharmacies” until they become critically ill.

As a result the seven beds allocated to diagnosis (triage) and the 20 beds provided for treatment are not fully occupied while the six beds in the intensive care unit “have been full almost the whole time” that MSF has been working at this hospital, he states. Some patients at Shaikh Zayyed Hospital “come from governorates as far as Taiz and Ad-Dhale in search of essential care that may be inaccessible in their areas.” MSF is also tackling Covid-19 at the Kuwait Hospital in Sana’a.

Gutierres has been in Yemen for 10 months on this, his second tour of service there. The first was before Covid-19 added to the trials and tribulations of Yemen’s 28 million people. MSF has three international and 20 local staff at the Shaikh Zayyed Hospital and has the support of 150 staff from the local Ministry of Health. MSF-Spain works in the north, he says while MSF-France and Belgium are based in Aden, the temporary capital of the government headed by Abed Rabbo Mansour Hadi and the south and cooperate with the Health Ministry there.

Yemen’s health system, poor before the war, has collapsed during five years of conflict. Yemeni doctors and nurses have not been paid for several years. There are shortages of clothing to protect health workers, medications, and oxygen cylinders which must be replaced every few hours. The intensive care unit has several ventilators for the most critical but more are needed to upgrade and expand the intensive care unit. Gutierres argues the situation has improved since airports reopened to humanitarian flights. The World Health Organisation and other UN agencies provide most essential supplies but more are required as need grows. “People need to continue sending supplies,” he states and points out that trauma cases, mothers and babies, and diseases other than Covid-19 also demand care.

Muthanna, infection prevention and control supervisor for Covid-19, started in Shaikh Zayyed hospital in March this year. A nurse, he is in charge of making certain the staff use protective equipment and observe sanitary practices. Having initially been frightened by the coronavirus, Muthanna came to terms with dealing with it in order to help provide proper treatment for victims.

He is quoted in an MSF press release as saying, “In the wards of this hospital, we see patients who are terrified, for their loved ones and for themselves. I saw one patient who had asked a nurse to sit with him and help him write his will in case something bad happened to him. Sometimes people are their own worst enemy, causing themselves harm with negative thoughts when instead they should stay optimistic, strong and determined and keep in their minds that they can overcome this disease and recover.” MSF has pointed out that since Yemen has limited testing capabilities for Covid-19, “the virus is spreading across the country untraced.”

MSF works at 13 health centres in a dozen governorates, from Sa’ada in the north to Aden in the south, Shabwah in the east and Hodeida in the west. MSF had to tackle cholera and diphtheria outbreaks before Covid-19 erupted.  These diseases have not gone away.

Founded in 1971 in Paris by journalists and doctors, MSF is a worldwide organisation with more than 67,000 staff members from more than 150 countries. It began with 300 doctors seeking to deliver emergency medicine during the war and famine in Biafra, Nigeria. In 1999 MSF was awarded the Nobel Peace Prize.

Yemeni authorities report 1,380 cases of the virus, 364 deaths, and 630 recoveries although the true rates of infection and death are certainly higher because hundreds of thousands of Yemenis do not or cannot access treatment. The first case was identified on April 10 in a man at the port of Mukalla in Hadhdramout governorate. A limited outbreak in Aden, another Port city, followed and the disease soon spread across the country where already poorly maintained and ill-supplied health facilities have been devastated by warfare, poverty and disease.

The situation has worsened over the past six months due to a reduction in humanitarian aid.  An emergency appeal raised only $1.35 billion (Dhs5b) of $2.4b (Dhs8.8b) needed to maintain the necessary level of food and medical aid and sanitation and potable water programmes provided by UN agencies until the end of this year. The World Food Programme said nearly 10 million Yemenis face acute food shortages and urgent action is required to head off famine.

During this time of plague, war and want, Yemeni families have been delivered another harsh blow. Oxfam has announced that cash transfers from expatriate members have declined by 80 per cent during the first four months of this year due to job losses in the Gulf and elsewhere. In 2019, Yemenis sent $431 million (Dhs1.6b) home each month. Oxfam also reported, “Borders and supply route closures have led to food shortages and food price hikes in the country which imports 90 per cent of its food.”

Oxfam estimated, “Up to 12,000 people per day could die from hunger linked to the social and economic impacts of the pandemic before the end of the year, perhaps more than [that] will die each day from the disease.”