After three years of conflict, the situation in Yemen has gone from bad to worse and is now the world’s greatest humanitarian tragedy. At the end of 2017, 22.2 million people (75% of the population) needed either aid or humanitarian protection. Unfortunately, over the past 18 months the situation has deteriorated and 11.3 million people — one million more than in June 2017 — now face a critical situation. Furthermore, 17.8 million people suffer from malnutrition and food insecurity and, if in late 2017 8.4 million people found themselves in dire circumstances, in October 2018 this number soared, reaching 14 million and prompting Mark Lowcock, the United Nations’ (UN) Under-Sub-Secretary General for Humanitarian Affairs and Emergency Relief, to warn of the imminent danger of famine in the country.
Clashes and bombings rage on in different areas of Yemen, affecting the civil population, despite diplomatic efforts to reach a ceasefire. In this complicated environment, access for humanitarian organisations continues to be a serious challenge, and is further compounded by the blockade the Saudi coalition imposed on the main entry points to the country a year ago.
The collapse of the economy, public institutions and social services, and the destruction of the population’s livelihoods, has pushed communities to the limit of their capacity for resilience and survival.
One consequence of this widespread crisis has been the alarming rise of undernutrition, the deterioration of the population’s health and an increasing risk of epidemics outbreaks, particularly among the most vulnerable such as minors and the elderly.
In 2017, cholera, diphtheria, malaria and other neglected tropical diseases such as rabies and leishmaniasis reappeared with renewed force. The country has had to endure one of the most extensive outbreaks of cholera in recent decades and one that continues in 2018; between April 2017 and September 2018, more than 2,500 people died and 1.2 million possible cases of cholera were identified. In terms of the spread of the disease, 224 of Yemen’s 333 districts have reported possible cases.
With regard to diphtheria, between August and December 2017, 333 possible cases were reported along with 35 deaths in 20 of Yemen’s 23 provinces. Those most affected are children aged between 5 and 14, who make up half of suspected cases, while over 90% of deaths have occurred among children under 15, and the risk of new cases continues to be high given that 60% of children in this age group are not vaccinated against diphtheria.
The risk of malaria has also significantly increased, and over 40% of three million displaced people have settled in zones where malaria is endemic. Without doubt, the lack of water and sanitation will also increase the rate of malaria and dengue fever.
Finally, there has also been a rise in neglected tropical diseases, among them rabies and leishmaniasis, which are both spreading, above all in settlements where displaced people reside.
This situation is also further complicated by a deteriorating health care system on the brink of collapse at the present time, with only 50% of health establishments in operation, and the ones that are running only doing so precariously owing to a shortage in medicines, equipment and staff. This is compounded by attacks on hospitals, the electricity grid, the water supply system and roads, causing the majority of the population to have limited access to the scarce health services available.
Despite a weak and fragmented information base, with desynchronised and incomplete data, health indicators offer enough alarms on the population’s health situation for the international community to act accordingly to the humanitarian crises occurring in the country and to demand that conflicting parties end violations of international humanitarian law.