Yemen conflict: doctors warn of crisis as medical supplies run low

http://www.theguardian.com/world/2015/jun/02/yemen-conflict-healthcare-crisis-medical-supplies-run-low

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Two months of war have devastated Yemen’s health sector, aggravating a humanitarian crisis by depriving millions of urgent medical care and threatening outbreaks of diseases like polio and measles, according to doctors and aid organisations.

Medicines, vaccines and basic medical supplies are running desperately low, while hospitals are scaling back services or closing, they say. Increasingly, they note, medical facilities are being attacked by warring militias and bombed by a Saudi Arabian-led coalition, which launched an air war against Shia insurgents, known as Houthis, in late March. “Yemen’s health system is nearing collapse,” said Marie-Elisabeth Ingres, who heads Yemen operations for Médecins sans Frontières.

We are quite sure that people are left to die in their homes because they aren’t able to receive treatment

The nation of more than 25 million people already struggled with grinding poverty and lack of access to basic healthcare before the start of the air campaign, which has fuelled fighting on the ground between Houthis and forces aligned with Yemen’s now exiled president, Abd-Rabbu Mansour Hadi. In February, Shia militants toppled Hadi’s government in assaults that continue throughout the country. Saudi Arabia accuses the Houthis of being proxies of its enemy, Shia Iran – a charge denied by the militant group.

Though aid workers are unable to obtain precise data because of the fighting, Ingres noted that the crisis has produced an unspecified, but probably increasing, number of preventable deaths. This includes a four-year-old boy in a northern province who was unable to receive medical treatment for tonsillitis, Ingres said. “We are quite sure people are left to die in their homes because they aren’t able to receive treatment,” she said.

Since late March 2,000 people have been killed and 8,000 wounded. During that period, the number of people who require urgent medical care has surged to 8.6 million, the World Health Organisation said in a statement released last week. But such care is increasingly scarce because of an inability to access even basics, like obstetrical support during childbirth, the statement said. The WHO also notes that a national programme to fight tuberculosis has been suspended and that “infectious diseases such as malaria and dengue fever are spreading. Outbreaks of polio and measles are also serious risks.”

Sadeq al-Jabri, head of the kidney dialysis department at the military hospital in the capital, Sana’a, said that the medical facility can hardly perform basic services. The hospital now focuses on emergency cases and increasingly turns away people because of limited supplies of everything from oxygen and insulin to medicines for kidney dialysis and chemotherapy, he said.

“We’re facing an especially acute shortage of medicines for patients who suffer from kidney dialysis,” he said. “We’re no longer able to treat people adequately.”

Nasser al-Shirahi, 55, was one of the patients turned away by the military hospital. Doctors at the medical facility told the retired freelance construction worker, who has been on dialysis for two years, that they lacked the medicine to treat him. “We’re suffering so much because of this, and we’re afraid our father might die,” said al-Shirahi’s 25-year-old son, Ameen.

A major problem for medical facilities is a severe shortage of fuel for generators and transport. The Saudi-led coalition has imposed an air and sea blockade of Yemen, which doctors and aid organisations say is choking off vital medical supplies as well as food and fuel. Coalition officials say they allow supplies to come in after determining ships and aircraft are not carrying weapons for rebel fighters.

The fighting has damaged electricity plants and power lines that feed most urban centres, depriving communities of power for days. A severe shortage of diesel fuel means that backup generators cannot power medical centres, causing large quantities of vaccines to spoil in affected refrigeration facilities, doctors say. They also say the petrol shortage makes it difficult for medical staff and patients to get to hospitals.

Mareb al-Mahweeti, a vascular surgeon at the military hospital in Sana’a, said the lack of transport is forcing doctors to take drastic measures. “Because this is delaying their ability to reach hospitals, we’ve increasingly had to amputate arms and legs because these people are arriving with bullet and shrapnel wounds that have gone untreated for so long,” he said.

Since the Saudi bombing campaign began, he has performed 10 amputations on war-wounded patients, which he described as last-resort measures. “We could have saved their limbs if they had received treatment sooner,” he said.

Ali al-Mudhwahi, a senior adviser at the health ministry, said that a rising number of hospitals across Yemen have been forced to close because of the fighting. This is partly a result of attacks on medical facilities by fighters on both sides of the war. In the southern city of Taiz, he said, militias fighting the Houthis had “looted” hospitals for medical supplies to treat their own fighters. In the northern province of Saada, a Houthi stronghold, medical facilities had been “systematically” targeted by coalition airstrikes, he said.

Brigadier General Ahmad Asseri, spokesman of the Saudi-led coalition, declined to comment on allegations that coalition aircraft are hitting hospitals; he would only address such claims from officials in the exiled Hadi government that operates in Saudi Arabia.

“We do not comment on rebel and gangster declarations,” he said, referring to officials linked to the Houthi-dominated authority in Sana’a.

Houthi fighters are widely accused in Yemen of carrying out indiscriminate attacks in civilian areas, most notably in the southern city of Aden, which has been ravaged by fighting.

Last month the UN humanitarian coordinator for Yemen, Johannes Van Der Klaauw, accused the Saudi-run coalition of violating international law with “indiscriminate bombing of populated areas”.

This article appeared in Guardian Weekly, which incorporates material from the Washington Post