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Elizabeth Bratton explores the toll coronavirus is going to take on Yemen: a country that has endured years of war, disease and famine. While various nations are resuming life as "normal", the infection rate in Yemen seems to show no signs of stopping, despite still being underreported. A lack of awareness, a collapsing healthcare system, and social stigma makes it difficult for Yemenis to approach hospitals and other care facilities. There are fears that Trump's decision to withdraw funding from WHO may exacerbate the economic aftermath of the pandemic.
While many countries are celebrating the easing of lockdown, there are still nations that are yet to bear the full brunt of the COVID-19 pandemic. One of those is Yemen: a Middle Eastern country with a population of 28.5 million.
Yemen has endured almost six years of civil war, alongside numerous deadly diseases such as: cholera, malaria, and dengue fever. 80% of the population is in need of humanitarian aid, while the majority of citizens rely on aid to survive, although the combination of the aforementioned issues has led to the closure of essential malnutrition centres and hospitals. Additionally, half of the country’s health facilities are “dysfunctional”, while almost a quarter of the country’s districts are completely deprived of doctors.
These factors ultimately leave Yemen in one of the most vulnerable positions in the world. Jean-Nicolas Beuze, Representative for the United Nations Refugee Agency in Yemen, worries that COVID-19 “could be the straw that breaks the camel’s back”, as the country’s healthcare services have already been overwhelmed by conflict. Patients have reportedly been turned away from care facilities, due to a lack of oxygen and PPE supplies. The Yemeni population generally have very low immune systems, while many are only eating once a day.
Currently, only 214 Yemeni deaths have officially been reported, although the World Health Organization fears these statistics will be far higher. As of the end of May 2020, less than 3,000 Yemenis had been tested for the virus: as a percentage, this is less than 0.01% of citizens, meaning thousands of cases are likely going unnoticed.
Throughout May, Aden suffered deaths at a rate five times faster than is normal for the port city. Charity Save The Children stated that local authorities had reported a daily death toll of around 50 a day, while, still, no quarantine measures remain in place for those suffering from the virus. Some reports warn that the COVID-19 could result in a death toll higher than that caused by war, disease, and famine combined over the past few years. The civil war has already left over 100,000 dead.
On Monday the 15th of May, Yemen reported its highest daily COVID-19 infection and death count since its first case in April. The UN Office for the Coordination of Humanitarian Affairs stated that the fatality rate for Yemenis is just below a quarter, making it approximately four times higher than the global average. Many doctors are finding themselves under constant pressure, as many staff lack the training to deal with such a catastrophe, and others are simply absent. Mark Schakal, deputy operations manager for Yemen at Médecins sans Frontières, told TIME magazine that healthcare staff are having to prioritise patients “based on age and chances of survival”.
Both the Saudi-endorsed Yemeni government, and the rebel Houthi group have been accused of mismanaging and underreporting the severity of the situation, although some believe that the Houthis have been more culpable. Citizens describe how thousands of COVID-19 patients have been left to die in areas such as Sana’a, while infection statistics have been distorted, and the effects of coronavirus have been “downplayed”. One source also told Reuters that the Houthi authorities are intentionally refusing to inform WHO about patients who test positive for the virus. However, a hotline has recently been created, reportedly to enable citizens to report symptoms or cases.
Almost half of deaths within government-controlled areas can be attributed to Yemen’s largest province: Hadramouth. Doctors recall that isolation measures have led to a general avoidance of hospitals, as even the sick are reluctant to be separated from their loved ones. Families of the deceased have often expressed a lack of faith in the public healthcare symptoms, while many are uninformed about coronavirus symptoms. Dr. Alabed Bamousa recalls: “Patients stay at home till they are dying,” proceeding to emphasise: “The real number of cases is five times larger than the reported figures.”
In April, Lise Grande - head of the UN’s humanitarian operations in Yemen - expressed concerns that WHO may have to reduce its work in the country by 80%, after the US decided to withdraw funding. This could potentially lead to the closure of 189 hospitals and 200 primary care facilities. As a result, at least 250,000 children suffering from malnourishment will lose access to medical care, while almost 150 camps for displaced Yemenis will suffer cuts.
The full effects of the pandemic are not yet clear, although Dr. Hamdan Bajary, head of ICU at the Al-Thawrah General Medical Hospital in Sana'a, believes “Yemen is going to be deleted from maps all over the world.”
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