For more than two years, Yemen has been divided by a violent war. Doctors Without Borders/Médecins Sans Frontières (MSF) has been one of the few agencies providing aid and medical care to people affected by the conflict. On April 25, a gathering of international agencies and major funding organizations gathered in Geneva to discuss the crisis. MSF released the following statement:
Since the armed conflict began escalating across Yemen two years ago, MSF has witnessed thousands of people get injured, maimed and killed. MSF teams have treated more than 60,800 trauma patients, but the Yemeni healthcare system needs to be strengthened, and the transportation of aid supplies needs to be facilitated urgently.
Our patients have been shelled 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.
Millions of people across Yemen are in critical need of aid in order to survive in a country where the economy has largely collapsed, basic services struggle to function, and social safety nets are strained. Many of the patients we treat, and the families of the medical staff with whom we work, have lost their livelihoods and face illness, rising prices and shortages of essentials including food, fuel and electricity. Civil servants, including medical staff, have received no salaries for months. Clean water, decent sanitation and basic hygiene items are often unavailable. Massive numbers of people have had to leave their homes because of the violence, with many families forced to settle in overcrowded, unsafe locations.
Humanitarian aid needs to be scaled up
While faced with ever increasing medical needs, MSF has expanded its operations, reaching a budget of US $70 million last year. Today, we have more than 1,600 international and Yemeni staff working in 12 hospitals and 18 health centres across the country, showing that it is possible to provide direct humanitarian aid in an effective way.
However, there is a lot more to do. Donors need to increase funding immediately and prioritize lifesaving interventions. In such a dynamic and challenging context, they will need to demonstrate greater flexibility than usual in the conditions governing their funding and access to it. Meanwhile, the United Nations has to effectively put in place the Level Three declaration arrangements, which include senior and experienced guidance in emergencies and high insecure settings, strong coordination and practical support to its agencies and NGOs already working in the country.
To avoid total collapse, the healthcare system in Yemen desperately needs to be shored up. In the ten governorates where we work, we have seen how the shortages of functioning health facilities, specialist care, equipment, medical staff and supplies are severely compromising people’s ability to access lifesaving medical care. The injured and patients suffering from chronic diseases are dying by avoidable deaths, while the most vulnerable groups – children, pregnant women and the elderly – are at heightened risk of disease. Resuming the payment of salaries to civil servants, specifically medical staff, is vital to stop the healthcare system collapsing and to prevent the households who rely on those salaries from sliding into destitution.
However, increasing funding for humanitarian aid cannot on its own alleviate the toll taken on the civilian population by the armed conflict. As donor countries gather today to pledge their financial support, they must also commit to stepping up diplomatic efforts to minimize the war’s deadly and destructive impact on the men, women and children caught up in it.
An emergency call for ports and airports
Facilitating humanitarian access to help aid organizations reach the people most in need is essential. Ports and airports must be reopened and international staff must be helped to enter the country. The deliberate obstruction of humanitarian aid by restricting imports, diverting shipments, causing delays at customs, confiscating vital supplies, failing to grant international visas and internal travel authorizations – to name just a few – must end. Essential supplies, including medicines and food staples, must be allowed to enter the country and be transported to where they are most needed.
Finally, we urge all warring parties and their allies to ensure that civilians and civilian infrastructure – including medical facilities and staff – benefit from the protection granted to them under international humanitarian law. Hospitals have repeatedly been hit by shelling, missiles, airstrikes and gunfire for which MSF has launched a social media act of solidarity to stand up for the protection of medical assistance rights, called Not A Target. These attacks include four MSF health facilities in which 26 of our patients and staff lost their lives. Ambulances have been shot at, confiscated or forcibly entered by armed men. Medical staff have been shot at on their way to work, harassed, detained, threatened and forced to work at gunpoint. There is a consistent pattern by all warring parties in the Yemeni conflict of injuring and killing civilians and of deliberately obstructing access to healthcare for those in need. Today we re-emphasize our call on all parties to ensure that civilians and health workers are protected, and that the wounded and sick are able to access medical care.