Yemen: Health Care Under Siege

Mohammed Sanabani/MSF

As a nearly two-year-old war continues to devastate Taiz, Yemen's third most populous city, a deepening medical and humanitarian crisis is putting patients' lives at risk, according to a report released today by Doctors Without Borders/Médecins Sans Frontières (MSF), which provides medical care on both sides of the city's front lines.

Parties to the conflict are destroying Taiz's health system through airstrikes and shelling and by compromising the protected and neutral status of medical facilities, the report found. At the same time, they are strangling it by actively preventing medical supplies from getting through and by failing to prioritize paying the salaries of medical staff.

Residents are falling victim to shelling, airstrikes, crossfire, landmines, and snipers, while many patients with serious conditions cannot access treatment.

"The desperate situation in Taiz exemplifies what is happening in Yemen as a whole," said Karline Kleijer, MSF's emergency manager for Yemen. "The warring parties in Taiz regularly demonstrate a lack of respect for the protection of civilians, health facilities, health care workers, and patients. Our patients on both sides of the front lines report being injured by shelling while preparing lunch in their kitchens, wounded by airstrikes while walking to their fields, maimed by landmines while herding their livestock, and shot at by snipers in the streets outside their homes."

The conflict escalated in March 2015 when Ansar Allah (Houthi) forces allied with former President Ali Abdullah Saleh ousted President Abed-Rabbo Mansour Hadi's government in Sanaa and continued advancing south, and the Saudi-led coalition started its aerial campaign in Hadi's support. MSF has treated over 55,000 war-wounded patients in Yemen to date, including more than 10,700 from Taiz.

Once Yemen’s cultural hub, Taiz’s population has shrunk to just one-third of its pre-war size. Yet it is still a densely populated urban war zone where 200,000 people live amid constant heavy artillery shelling, daily airstrikes, and armed clashes. The so-called Resistance—a myriad of different groups united not in their loyalty to Saudi-backed President Abed-Rabbo Mansour Hadi but in their opposition to the Ansar Allah (Houthi) and former President Ali Abdullah Saleh-allied forces—hold the city center surrounded by Houthi/Saleh forces.

Streets in the city center now known as the "enclave" are controlled by different armed groups who frequently clash among themselves. Shells are launched into and out of the city center while the movement of people and goods in and out is severely restricted and tightly controlled.

Hospitals have been repeatedly hit by shelling and gunfire, one clinic has been hit by an airstrike, and ambulances have been shot at, confiscated, or intruded on by armed men. Medical personnel have been shot at on their way to work, harassed, detained, threatened and forced to work at gunpoint. Many health workers take great personal risks.

MSF works on both sides of the front lines in Taiz, running a trauma center for war-wounded and other injured as well as a mother and child hospital in the Al-Houban neighborhood. MSF also supports departments in four hospitals inside the city center, at Al Thawra, Al Jomhori, Yemeni Swedish, and Al Rawda hospitals—two of them for emergency treatment of the wounded and the others supporting maternal and pediatric health care.

Today, there are no public hospitals in Taiz city or its surroundings that are fully open and functioning. Four of the five public hospitals are partially open, but none are able to provide the same level of services as before the conflict. Of the 31 private hospitals in the area, 15 are closed and five are only partly open, offering specialized services with limited capacity.

In Taiz city, MSF employs more than 375 Yemeni staff and pays incentives to almost 200 Ministry of Health staff, but on its own MSF cannot meet the growing medical needs of people surviving in a violent and difficult environment.

At the same time, people's living conditions have deteriorated and the price of essentials, including food and water, has soared. This has had a major effect on the city's residents, particularly the most vulnerable, such as pregnant women, young children, and people with chronic diseases. MSF's report describes the collapse of health services in Taiz and the consequences for its population, as witnessed by MSF teams providing health care on both sides of the front lines.

MSF is urgently asking all parties to the conflict in Taiz to respect international humanitarian law, ensure the protection and neutrality of medical structures and personnel, facilitate the delivery of medical and humanitarian aid, and allow the wounded and sick to safely access medical care. These issues must also be addressed throughout Yemen, in all 10 of the governorates where MSF is providing medical care.

Download the report here.

MSF medical team at AL-Nasr hospital in Al-Dhale governorate south of Yemen providing medical assistance to patient in the ER, the patient was injured due to road traffic accident.
Mohammed Sanabani/MSF