The Yemen conflict is one of the biggest humanitarian crises in the world, with at least 80% of the country’s population affected. The international coalition led by Saudi Arabia has launched more than 18,000 air attacks since March 2015. One third of strikes hit civilian targets including markets, homes and hospitals.
Mines, which had almost disappeared from conflicts, are again being deployed in large numbers in Yemen.The 2018 Landmine Monitor reports that Houthi forces used anti-personnel and anti-tank mines, mainly on the country’s west coast, close to the port of Al-Hudaydah. Yemen is now one of the countries most heavily contaminated with explosive remnants of war and mines in the world.
A total of 70,000 casualties, including (United Nations figures):
At least 6,000 civilians killed
And 10,500 civilians injured
HI’s Head of Mission in Yemen
HI works with local medical teams in six hospitals and two rehabilitation centres in Sana'a, in the north of the country. Maud Bellon, HI's head of mission in Yemen, describes the disastrous situation, including overcrowded health facilities and the trauma suffered by patients.
Unacceptably large numbers of mine and bombing casualties continue to arrive in the six hospitals and two rehabilitation centres where HI works in Sana’a. HI has treated some 800 casualties of mines*, improvised explosive devices and explosive remnants of war including cluster munition remnants* since late 2015. The organisation has also treated 1,800 bombing casualties in three years. In total, HI has treated 2,500 victims of all kinds of explosive weapons.
* The use of anti-personnel mines and cluster munitions is banned under international law.
Eighty HI staff members have been working in eight hospitals and two rehabilitation centres since 2015.
HI is preparing to lead rehabilitation and psychological support activities in the governorates of Aden, Hodeidah and Hajjah.
Its teams will work closely as possible with the communities. HI will cover the cost of transportation to the hospital.
Yasser was doing his homework with his father on the flat roof of their home in Taiz when a missile exploded nearby. When the 12-year-old woke from a coma in hospital the next day, he discovered that his father had been killed, his home flattened, and his right leg amputated.
"We helped him feel less isolated. We gave him elbow crutches – which made it easier to walk than his original auxiliary crutches - and put him in a group with children his own age, who were in the same situation and learning to walk again. The prospect of being fitted with a prosthesis restored his hope of being a child like any other."
After a month of convalescence, his mother travelled with him to Sana’a, where HI gave him rehabilitation care.
HI's psychologist, Sana, recalls the first time she met Yasser: "Yasser had lost his interest in life. He didn’t want to talk or see anyone. We had to restore his confidence and his will to live."
HI’s operations manager in the Middle East
Widespread bombing and an armed group that resorts to the use of mines, the poor man's weapon, is the disastrous scenario played out repeatedly. Not only in the conflict in Yemen, but in places such as Iraq and Syria, where civilians have been caught up in the fighting.
<p><img alt="Pénurie" src="/sn_uploads/ca/Penurie-placeholder.JPG" style="margin: 5px; float: left; width: 120px; height: 102px;" />Le Yémen est dépendant des importations. Celles-ci sont gravement perturbées par les combats et le blocus imposé en 2017 par la coalition internationale menée par l’Arabie saoudite : avant le conflit, le pays importait 90 % des produits alimentaires de base ; ils ne sont aujourd’hui plus disponibles.</p>
Quand ils sont sur le marché, ces biens sont inabordables à cause de l’inflation vertigineuse de ces derniers mois. Le prix de l’essence a, par exemple, triplé en trois ans. Selon l’ONG Care, au 31 octobre le prix d’un kilo de riz représente 65 % du revenu quotidien d’une personne. L'accès aux services, en particulier pour les personnes venant de régions éloignées, est devenu impossible en raison de leur coût et de celui du transport.
La plupart des salaires ne sont plus payés. Les enseignants, le personnel médical, le personnel administratif n'ont plus les moyens de subvenir à leurs besoins ; la plupart d'entre eux refusent de travailler volontairement de sorte que les services s'écroulent. Les services souffrent également des combats et de la destruction des infrastructures publiques : 50 % des établissements de santé ne peuvent plus fonctionner.
Yemen depends on imports. Fighting and the blockade imposed in 2017 by the international coalition led by Saudi Arabia have severely disrupted these supplies. Before the conflict, the country imported 90% of its basic foodstuffs. Today, almost nothing gets through.
When supplies do reach the market, months of rocketing inflation means they are impossible to afford. The price of petrol has tripled in three years. According to the NGO Care, on 31 October, one kilo of rice cost 65% of the average daily income. People, especially from rural areas, are unable to access services due to their cost and the price of transportation.
COLLAPSE OF SERVICES
Most wages are no longer paid. Teachers, medical staff and administrative personnel no longer have the means to support themselves. Since most refuse to work without pay, services collapse.Services have also been affected by fighting and the destruction of public infrastructure: 50% of health facilities are no longer in operation.
In response to the Yemen conflict, HI has set up an emergency rehabilitation service in Sana'a. One of HI's physiotherapists, Aiman al-Mutawak, explains what makes rehabilitation in conflict situations unique.
HI begins the patient’s rehabilitation care the day after their operation. We supply them with technical aids, such as crutches, so they can walk without help. This restores some of their mobility and dignity. They can go to the bathroom alone, without needing someone to take them. Psychologically, it makes a big difference.
Physiotherapists start with basic hands-on treatment. They perform gentle exercises, massage the scar to prevent stiffness and provide practical advice to patients and their families on how to clean the stump and move without pain, which exercises to do in order to restore their mobility, how to prepare the stump for a prosthesis, etc. Caregivers play a decisive role.
Post-operative care almost did not exist in Sana'a. We set up an emergency rehabilitation service and trained more than 500 medical staff. Patients would lie in hospital without moving, in the same position, for days or weeks and then return home. They risked muscular contraction, which can cause problems bending an affected leg - and therefore walking again - or using an arm to drink, eat or do other routine tasks.
Our physiotherapists tell the patient why they need to do their rehabilitation exercises, such as bending their leg to climb stairs, or doing routine tasks with their arm such as washing, drinking and dressing. Patients need to understand the risk of disability if rehabilitation exercises are not done properly..
Rehabilitation exercises are always associated with everyday tasks to make sure patients do them at home. They are discharged rapidly from crowded hospitals where new patients arrive daily. We give them as much information as possible in a short space of time to make it more likely they do the exercises at home.
As a member of several NGO coalitions working in Yemen or involved in humanitarian action on this crisis, HI regularly draws the attention of policymakers to the humanitarian disaster in the country.
HI calls on governments and the international community to put pressure on belligerent parties to :