War has erupted again in the north of Yemen in the past eight weeks. Andrés Romero, head of mission in Sana’a, describes the evolution of MSF activities in the current context.
How have MSF’s activities evolved in North Yemen?
Médecins Sans Frontières (MSF) has worked in Saada governorate in northern Yemen since September 2007, providing medical care to the population affected by the conflict between government forces and the Al Houthi group.
MSF supports two Ministry of Health hospitals, in Shara’a (Razeh district) and in Al-Talh (Saher district). In both hospitals, our teams provide free medical services carrying out primary healthcare and emergency consultations, inpatient hospital treatments and obstetrics and gynaecology. In Al-Talh, emergency surgery is also performed.
Local anaesthetic being administered prior to a surgical procedure at Al-Talh hospital. August 2009
Photo by Arnaud Drouart/MSF
In the surrounding towns around Razeh and Al-Talh, MSF supports Ministry of Health structures by providing consultations and hospital referrals.
Since what is being described as the Sixth War started on August 11, 2009, MSF has also started providing assistance to displaced populations in Mandabah area, north of Saada governorate. A water supply system has been created to provide drinking water for around 250 families.
During the past two months of intense fighting, running all these activities has become increasingly complex, despite the authorisations that we have from both sides. We have had to temporarily cease surgical activities in Al-Talh and have reduced the support we provide to primary healthcare structures. We have also had to delay the planned start of medical activities in Mandabah area.
However in Razeh, consultations and hospital treatments are continuing and our teams perform around 560 emergency consultations per month. An MSF surgical team will soon reinforce the team at this hospital.
How would you describe the main needs of the people in Saada governorate today?
The continuous fighting has forced large numbers of people to flee repeatedly within the governorate or towards neighbouring governorates. It has been difficult to obtain precise figures for the overall number of displaced persons because rescue teams and humanitarian agency staff have experienced difficulties reaching all areas of the governorate. However, according to UN figures, about 60,000 displaced people have so far been registered in Saada, Amran and Hajja governorates.
Families are still on the move, travelling from one location to another in fear for their safety. For example, in the north of the governorate some families were displaced from Dahyan towards Jesnem, then from Jesmen towards Baqim, and then from Baqim towards Mandabah. But even in Mandabah, finding a safe place has proved extremely difficult because clashes have erupted there and families have been scattered again.
In Mandabah, our teams have assessed the situation of about 3,000 people, mostly living in precarious conditions, with poor access to water and lacking basic items such as blankets, cooking equipment, etc. Food has also become a serious concern because supply difficulties have caused food prices to rise at four times the normal rate. Because other aid agencies are focusing on the distribution of food and non-food items, the objective for MSF is to provide medical care for the population of this area.
Healthcare access in the governorate is definitely an issue, as most of the health structures are not functioning and those that remain are very hard for the population to access. It remains difficult to estimate the number of civilian casualties.
Between August 11 and September 22, 2009, MSF carried out 195 surgical operations at Al-Talh hospital, of which 135 were for war-related cases. Since then, surgical activities at the hospital have been interrupted. MSF is working with the Yemeni Minister of Health to restart these activities as soon as possible.
How has MSF continued its activities in such difficult security conditions?
It has been a daily challenge. We have faced numerous problems, namely insecurity and lack of communication. Land and wireless telephones have been unreliable, roads linking Saada governorate with the rest of the country have been blocked and MSF's Yemeni staff have often been working in hospitals without contact with their families.
MSF adapted to the situation by sending medical supplies and human resources (notably a surgical team) through Saudi Arabia, and monitoring how the situation changes.
It is worth mentioning that all the parties involved in this conflict understand MSF's principles of neutrality and impartiality. As a result, in Razeh and Al -Talh, we have managed to treat any person in medical need – including war wounded cases – regardless of their political affiliation.
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Between January and July 2009, in Saada governorate, MSF teams carried out 30,000 consultations of which 8,000 were for emergencies, and treated 1,450 people as hospital inpatients. MSF also performed 720 surgical operations, about 100 of them for war injured.