This is the first in a two-part series examining the escalating humanitarian crisis in Yemen.
The first wave of COVID-19 placed tremendous strain on health-care systems in many developed countries, killing hundreds of thousands of people in the span of just a few months. And in the developing world, the virus is wreaking havoc in Brazil and India.
However, the world’s worst outbreak may be yet to come if the virus takes hold and spreads rapidly in war-torn Yemen, where the battered population is enduring severe food insecurity and a crippled health-care system.
Worst humanitarian crisis in the world
Before the onset of the global pandemic, what was the humanitarian situation in Yemen?
“Over five years of conflict has destroyed lives and livelihoods, wreaked havoc on health systems and pushed millions to the brink of famine,” Julie Marshall, Canadian spokesperson for the World Food Programme, replied.
“Even before COVID-19, millions of Yemenis were hanging by a thread and extremely vulnerable to shocks. The co-ordinated humanitarian response has prevented catastrophe in Yemen, but we must be careful. If we don’t get the access we need, vital funding or if our operations stopped or slowed down, the situation would deteriorate very quickly.”
According to the WFP, more than 20 million people in Yemen face food insecurity, and half of them are acutely food insecure.
“I would describe the pre-COVID-19 situation in Yemen as dire,” Brittany Lambert, women’s rights policy and advocacy specialist for Oxfam Canada, said. “It was already the world’s worst humanitarian crisis.”
“The situation in Yemen was dire prior to the COVID-19 pandemic,” Bill Chambers, president and CEO of Save the Children Canada, agreed. Chambers pointed out that “80 per cent of the population was — and still is — depending on humanitarian assistance.”
According to Save the Children, the conflict in Yemen has displaced two million children. And Chambers said the violence has decimated the health-care system, leaving only half of the country’s health facilities functional.
“Families have experienced more than five years of war, widespread displacement, a crippled economy, near-famine conditions, severe floods and multiple health crises — including several outbreaks of cholera and epidemics of dengue fever and diphtheria,” Ramzi Saliba, program manager with CARE Canada, said, echoing the other non-governmental organizations.
Airstrikes
“Key infrastructure such as hospitals, schools and water plants have been routinely hit by airstrikes,” Chambers said. “The water structure is operating at less than five per cent efficiency, and increases in fuel prices impact families’ ability to buy water from food trucks; therefore (they are) turning to dirty water.”
According to Oxfam, the destruction of water and sanitation systems has left 17.8 million Yemenis without access to clean water and sanitation. “Waste is piling up in the streets and in the settlements for displaced people,” undermining efforts to control outbreaks of cholera, Lambert said.
“The impact of the conflict has been devastating,” Saliba agreed. “All parties to the conflict in Yemen have been targeting civilian infrastructure and basic services, including roads, hospitals, schools, markets and water infrastructure since the war started.”
The destruction of water infrastructure is especially devastating during the pandemic. “It’s hard for vulnerable Yemeni families to implement COVID-19 prevention measures when they have such poor access to clean water to wash their hands,” Chambers explained.
Blockades
Are naval blockades causing food insecurity?
“Yes, 90 per cent of Yemen’s food supply is imported, so there is a strong link between blockades and food insecurity,” Lambert replied.
“Yemen has been experiencing reoccurring temporary blockades of its ports throughout the conflict period,” she explained. “They are usually lifted after sustained requests from the humanitarian community, but there are no guarantees that they won’t be imposed again in future or that they won’t become permanent. In addition, bureaucratic obstacles placed in the way of major food and fuel importers can create de facto blockades.”
Similarly, the CARE Canada representative said naval blockades and attacks on the ports of Hodeidah, Saleef and Ras Issa on Yemen’s west coast are contributing to food insecurity — as is the pandemic.
Malnutrition
Malnutrition is pervasive in the war-torn country. “In Yemen, the malnutrition rates among women and children are among the highest in the world, with more than one million women and two million children in need of treatment for acute malnutrition,” WFP’s Marshall said. And she warned that approximately 360,000 are at risk of death if they don’t receive urgent assistance.
As a result of malnutrition, stunting among children is widespread. “Around 50 per cent of all children in Yemen are stunted — a figure that has increased by around one per cent per year since the start of the conflict,” Marshall said.
“Yemen has the largest number of children in need of humanitarian aid globally, and children are dying from malnutrition,” Lambert revealed. “Twenty million Yemenis — some 70 per cent of the population — are going hungry, marking a 13 per cent increase on last year. Nearly 10 million of them are one step away from famine.”
Faced with increasing food insecurity, “the only solution for many families is to reduce the amount of food they eat, or feed what little they have to their children in priority before themselves,” Lambert said of the negative coping strategy adopted by many Yemenis. “They also skip meals and end up buying poor quality food.”
Child marriage is another negative coping mechanism. “Some families have pushed their daughters into early marriage so that they can use the dowry they are paid for essential food,” Lambert said. “Girls as young as eight or 10 years old are being married off to reduce the number of family members to feed, but also as a source of income in order to feed the rest of the family and pay off debts,” she added.
“People suffering from malnutrition face a greater risk when it comes to COVID-19,” Salib stated. “Pregnant and breastfeeding women are one of the groups that are hardest hit by food insecurity, as they need the greatest dietary diversity, including iron, calcium and folic acid. Because of the effects of malnutrition, they simply might not have a strong enough immune system and the coping mechanisms needed to fight off the virus.”
Marshall warns that “any deterioration of the fragile health system may leave malnourished mothers and children unable to access the nutritional support they need, pushing many more children in Yemen into acute malnutrition because of COVID-19.”
Challenges
How difficult is it for WFP to get humanitarian assistance to those in need in Yemen?
“Getting humanitarian assistance to over 12 million people each month is a huge logistical challenge for WFP,” Marshall concedes. “We are dealing with ongoing conflict, shifting front lines and balancing available resources with the unprecedented need.”
The COVID-19 pandemic is also complicating the WFP’s work by disrupting the humanitarian supply chain. “Any shocks to the supply chain will have a severe impact on the humanitarian response as well as the local food markets.”
For example, Marshall noted that “prices of imported foods have already increased significantly since the start of 2020 — by over 25 per cent in the case of sugar.” And she explained that imports continue to decline due to “Yemen’s weak economic situation — depleted foreign currency reserves — and compounded by a reduction of global trade flows as a result of COVID-19.”
Water borne diseases
How pervasive are water-borne diseases in Yemen?
“More than two-thirds of Yemenis currently need support to meet their basic hygiene needs, a situation that has been exacerbated not only by COVID-19 but also by recent devastating flooding and a subsequent rise in water — and mosquito-borne diseases like cholera and malaria,” Saliba said.
“Cholera cases are caused by the lack of access to safe water, which was identified as one of the biggest challenges for both men and women, according to CARE’s assessment,” the CARE Canada staffer said. “CARE is continuing our prevention programming for water-borne diseases — ensuring people have safe water, conducting hygiene awareness campaigns, distributing hygiene kits — programming which is also highly effective in reducing the spread of COVID-19.”
“The number of people in Yemen suspected to have had cholera in 2019 was the second largest ever recorded in a country in a single year, surpassed only by the numbers in Yemen in 2017,” Lambert noted. “The year 2020 has been bad for water-borne diseases so far, because of severe flooding this spring. This has led to surges in illnesses such as cholera, dengue and malaria.”
In addition, Lambert said the lack of access to safe water is major problem in internally displaced persons camps, where one-third of the country’s population lives. “For this reason, one of our top priorities at Oxfam is to provide clean water and sanitation, to help prevent and contain the disease,” she said.
For example, Oxfam repairs water systems, disinfects water storage using chlorine, provides households with water purification equipment, distributes hygiene materials, builds latrines and constructs solid waste management facilities.
According to Save the Children, children are especially hard hit by water-borne diseases in Yemen. “Almost 1.2 million children fell sick with cholera, diphtheria or dengue fever over the last three years,” Chambers said. “In 2019, the number of cholera cases amongst children doubled compared with last year.”
Handwashing
Chambers stated that “the vulnerability of Yemeni families to these other epidemics makes the spread of COVID-19 in Yemen particularly concerning.” And without access to clean water, frequent handwashing, which is essential in reducing the transmission of the virus, simply is not possible for much of the population.
According to CARE Canada, only 40 per cent of IDPs in Yemen have access to soap and handwashing. “Just half of Yemenis have access to sufficient water quantities and up to 65 per cent of Yemenis lack adequate hygiene items,” Saliba said. “When we take these figures and add the COVID-19 backdrop, knowing how essential water and sanitation are to combat the pandemic, the situation jumps to an even more heightened level of risk.
“We are ensuring in all our ongoing programs — including food distributions, water and sanitation interventions — that we integrate COVID-19 prevention and awareness-raising activities around what people need to do to protect themselves and what happens if they get sick.
“There is clearly a need for increased, sustainable and long-term funding for Yemen. However, an inclusive political peace above all is required — this message must not be lost amid the global focus on COVID-19.” https://www.thewhig.com
Picture- KHALED ABDULLAH / REUTERS