Armed conflict escalated into a full-scale war in Yemen in 2015, exacerbating already massive medical and humanitarian needs and severely restricting access to healthcare.
The Houthis continued to advance in 2015, taking over the presidential palace in Sanaa in January. President Hadi fled to Aden, and a Saudi-led coalition supporting his government began airstrikes to recover lost territory, including the port of Aden. Meanwhile, the war allowed Al Qaida and Islamic State (IS) group fighters to reinforce their presence in the country. By year’s end, the United Nations estimated that 2,800 people had been killed and some 2.5 million were internally displaced. The healthcare system has been decimated: medical staff have fled the country, facilities have been destroyed and medical supplies cut. To read more about the situation in Yemen, see here.
MSF managed to maintain its operations in Aden when it was divided by a frontline. In other areas it also scaled up its activities during 2015 as much as security allowed, despite an attack that destroyed the hospital it supports in Haydan, Sa’ada governorate, on 26 October and another on its tented clinic in Al-Houban, Taiz governorate, on 2 December, which wounded nine. A fuel blockade hampered the delivery of aid, while fighting, shifting frontlines and airstrikes restricted the movement of people and humanitarian organisations.
Sa’ada governorate was one of the worst-affected areas. From March, there were daily airstrikes targeting many civilian areas, including healthcare facilities, and access to medical care was almost impossible in some districts. In April, MSF started supporting Haydan hospital’s emergency room and maternity services, but had to suspend activities following an airstrike in October. They could only resume in December, using an undamaged part of the building. In May, a team started working in Al Jomhouri hospital in Sa’ada city, providing emergency, inpatient and intensive care, and maternity and mental health services for a population of about 700,000 people. Over 6,110 patients were attended to in the emergency room, and over 2,900 surgeries were performed. In November, another team began to support the Shiara hospital in Razeh district. In 2015, more than 100 births were assisted every week and over 1,000 emergency room consultations were performed. Staff also assisted in Majz and Nushur hospitals towards the end of the year.
Intense conflict broke out in Ad Dhale governorate in April but had subsided by August, when the frontline moved towards Ibb. People were trapped in the conflict areas and there were many deaths resulting from war injuries. MSF expanded its support in Ministry of Health hospitals and basic healthcare clinics such as Al Salaam and Al-Azariq, providing outpatient and emergency consultations, surgery, inpatient care and reproductive healthcare. The teams carried out more than 60,000 outpatient and emergency consultations, performed over 700 surgical procedures and made around 1,000 referrals.
There was intense fighting in Aden between March and July. In Sheikh Othman district of Aden city, MSF continued to run the emergency trauma centre, comprising an emergency room, two operating theatres, an intensive care unit and an inpatient ward. Mental health and physiotherapy consultations were also provided. Bed capacity was increased from 45 to 74 to accommodate the surge in needs, including several mass casualty incidents involving over 100 wounded each time. Many of the patients were children wounded by landmines and unexploded ordnance. Overall, teams carried out 7,778 emergency consultations and 4,300 violence-related surgical interventions. During the peak of the conflict, emergency healthcare was available in three health clinics in districts where medical access was very limited.
Taiz city, with an estimated population of around 600,000, was the scene of intense fighting as of July. Some residents were trapped in an enclave under siege, and a blockade on medical supplies began in August, which has had a major impact on healthcare access. MSF donated medical supplies to hospitals on both sides of the frontline. On the Al-Houban side, MSF provided assistance to the military hospital, Yemeni International and Al-Risalah, and inside the enclave, MSF supported Al-Thawra and Al-Rawda hospitals. Altogether, MSF provided more than 15,400 emergency room consultations, 6,800 consultations for people with war wounds, 1,100 surgical interventions and 10,900 wound dressings. Relief items such as blankets, food and jerry cans were also distributed to displaced people in the city.
In November, MSF opened a mother and child hospital in the Al-Houban neighbourhood, providing emergency services and reproductive healthcare, and an outpatient department for children under the age of 10. Some 7,800 outpatient consultations and 7,500 emergency room consultations were completed.
MSF continued its project at Al-Salam hospital, providing emergency, maternity, inpatient and outpatient services and assisting in the laboratory and blood bank. As access to medical care in other healthcare facilities decreased, MSF scaled up its activities in Amran hospital, carrying out 3,000 surgical interventions and 28,200 emergency consultations. More than 5,500 patients were admitted to hospital and over 2,900 babies were delivered. MSF supported the health centre in Huth, completing 9,300 emergency consultations, and provided drug donations and training to three facilities in the north of the governorate. As displacement increased, MSF launched mobile clinics and helped with water and sanitation activities in Khamir and Huth.
In May, MSF opened a project supporting Beni Hassan health centre, and offering medical aid to 15,000 internally displaced people through mobile clinics. The team provided outpatient consultations, and distributed relief items and up to 240,000 litres of water per day. In July, the programme moved to Abs hospital, a more comprehensive facility in Abs district, to provide a greater range of services, including emergency and maternal healthcare and surgery. Since August, MSF has supported Al Jamoorhi hospital in Hajjah city by responding to emergencies, treating war injuries, performing surgery and assisting in the inpatient department. Over 4,550 patients were received in the emergency room.
MSF continued its HIV programme at Al Gumhuri hospital in Sana’a city, providing antiretroviral treatment to 770 people.
Two cyclones hit the southeast coast of Yemen in November. MSF set up a mobile clinic in Mukalla to assist families who had lost their homes, and made donations to the local hospital and blood bank. Around 300 consultations were undertaken. Blankets, jerry cans and washing kits were distributed to 200 displaced families. About 50 kilometres away on the west coast, in the district of Borom Mayfa, the team set up 14 water tanks to provide water for over 400 displaced families.
Husni Mansoor – MSF nurse supervisor, working in Aden
“Our biggest fear is that the fighting will surround the hospital. Many times, when the clashes intensify, we go down to the basement. But this creates a different problem. Before we save ourselves, we move the patients who are in beds near the windows to a safe place. This has happened many times. We hear the sound of gunshots and shelling or airstrikes and we move all the patients to safe areas before finding a safe place for ourselves. Windows at the hospital have been broken more than once and bullets have entered, but no one has been hurt inside the hospital.”