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Yemen

Yemen: Crisis Update - April 2016

Overview

The situation in Taiz remains critical, with some of the heaviest and most sustained fighting in the country. An increase in fighting in March resulted in the treatment of over 1,000 war wounded alone. Access in and out of the city remains restricted and dangerous for civilians and humanitarian actors.

The last devastating Saudi-led coalition airstrikes MSF witnessed were in Hajja on 16 March, when a local market was hit by two airstrikes killing at least 107, and injuring at least 44 people, according to local sources. MSF received the injured in its Abs hospital.

The number of injured due of airstrikes has decreased significantly since mid-March. However, MSF is receiving an increasing number of victims of landmines and unexploded ordnance.

MSF is witnessing another emergency related to chronic disease patients. As the embargo still hinders importation of medications, these patients are struggling to find their treatments in the market, and many are dying.

On 9th January 2016, the MSF-supported Shiara hospital in Razeh, Saada Province, near the border with Saudi Arabia, was hit by a projectile, killing six and injuring seven. This follows two other such incidents affecting MSF health facilities in Yemen: one in Haydan, Saada province on 26 October 2015, and another on a MSF tented clinic in Houban, Taiz governorate, on 2 December 2015. MSF has called for an independent investigation into the Razeh incident by the International Humanitarian Fact-Finding Commission.

Recent figures

Main figures for MSF (Between March 2015 & March 2016)

We received more than 37,000 war wounded since March 2015 More than 15,000 surgeries were performed in MSF facilities. More than 49,000 medical consultations were provided for displaced people in MSF mobile clinics. More than 10,000 women have given birth in MSF facilities. More than 144,000 patients have been seen in the emergency room. More than 1,100 tonnes of medical supplies have been sent to Yemen Operational information

MSF is carrying out activities in 11 hospitals and health centres, and is providing support to another 18 hospitals or health centres in eight governorates: Aden, Al-Dhale’, Taiz, Saada, Amran, Hajjah, Ibb and Sana’a governorates.

A total of 2,102 MSF staff are currently working in Yemen – 97 international staff and 2,005 Yemeni staff – making it among MSF´s largest missions in the world in terms of personnel.

Aden

Aden is currently dominated by Southern Resistance Forces, backed by the military coalition led by Saudi Arabia.

MSF is running an Emergency Surgical Hospital in Sheikh Othman district, in the north of the city. The hospital provides free medical care in an emergency room, a hospitalization ward and an operating theatre, and provides mental health and physiotherapy consultations.

A medical doctor and nurse conduct weekly visit so Aden Central Prison to provide primary healthcare services. An average of 50 consultations is provided every week.

Training

Training is part of our regular activities in this hospital in which MSF provide on- job- training to MoH doctors and nurses. We have one doctor and two nurses at a time. We started this activity in February and we trained 14 doctors and nurses so far.

Support for other hospitals

MSF has been supporting Ibn Khaldoun Hospital in Lahj with regular donations of medical supplies since December 2015 and Al-Razi hospital in Abyan since February 2016. The support includes medications to the emergency room and emergency OT supplies to Lawadar Hospital Abyan and Al-Razi Hospital in Abyan.

Blood bank

MSF provided blood 700 screening test kits to the national blood bank in Aden to restart their blood donation activities.

Amran

The situation North Amran governorate is relatively calm; as a result people are fleeing conflict to settle in this area. MSF has been providing general consultations to displaced people with mobile clinics.

MSF is supporting Al-Salam hospital and Huth health centre in healthcare provision, donations of medication, oxygen, logistical equipment, electricity, human resources and a referral system. MSF is providing medical supplies, training personnel in emergency care, repairing and improving damaged structures, and running ambulance and reference systems in a number of health structures in Amran Governorate.

Saada

MSF-supported Al Jumhori hospital, Saada city, continued its activity in providing life-saving health services to patients in the emergency room, maternity and operational theatre (OT) and in the inpatient department. After stabilizing patients with complicated conditions, MSF refer them to Al-Jumhori Hospital in Sana’a where MSF covers all the costs of the treatment. In addition, MSF is providing assistance in the Emergency Room and in the maternity department of Razeh Hospital, as well as organising referrals from here to Al-Jumhori reference hospital in Saada city.

The Haydan Health Centre, which was struck in an airstrike on 26 October 2015, has resumed some activities. MSF repaired the staff accommodation room and re-opened an emergency room there in late December.

Hajjah

Though the security situation in Hajjah city has been relatively calm, war wounded people continue to arrive to at the MSF-supported Al-Jamoorhi hospital from the front line area.

In the displaced persons (IDP) camps of Abs district MSF is supplying drinking water to 16,000 people, installing bladders and regularly supplying water to meet minimum humanitarian standards in the camps. Through a system of mobile clinics, MSF teams are also providing basic medical care to people as well as monitoring the nutritional situation.

In Abs Hospital MSF is supporting the Emergency Cases in the ER , the pediàtric ward, the maternity and the emergency surgery with post operative care MSF also refer the some complicated cases tot he specialized hospitals in Hajjah and Hodida.

In 2016, a higher number of patients reach the Abs hospital, a referral System with Hayran and Mustaba has been put in place to guarantee that severe cases reached the hospital. MSF is facilitating the transport for these patients.

Following the floods in Hajjah governorate in mid-April, MSF distributed NFI kits to 184 families.

Hodaida

A distribution providing essential household items (soap, blankets, cooking utensils, for example) was carried out by MSF team in Hajja in mid-April to 250 families in Hodaida governorate after floods swept their items in their homes.

Saana

MSF continues supporting the emergency room in Al-Kuwait hospital in Sana’a. In addition, MSF is supporting Jumhori and Al-Thawra hospitals, the three main hospitals in Sana’a. MSF is supporting war wounded patients in Al-Jumhori and Al-Thawra hospitals, in Sana’a and also distribute war wounded kits in the districts surrounding Sanaa like Arhab, Hamdan, Jihnanah districts.

MSF´s support to the Ministry of Health´s HIV programme in Saana continues as normal, with 97% of the programme´s 1300 patients receiving their life-saving anti-retroviral treatment despite the tensions and violence in the city.

MSF is providing regularly blood testing kits to the National Blood Bank in Sana’a since September 2015.

Al-Dhale

In Al Dhale governorate, MSF´s support continues to the hospitals in Al Dhale, Qataba and to health centre in Al Azariq. MSF activities in Al Dhale include running emergency room, outpatient consultations, surgeries, inpatient services, patient referrals, observation room, pediatrics, nutrition program, maternity and reproductive health, spread over the three sites. In January alone, a total of 5,000 outpatient and emergency room consultations were carried out by the MSF teams.

Taiz

Situation in Taiz remains critical, with some of the heaviest and most continued fighting in the country. MSF runs and supports hospitals in Taiz which have been receiving thousands of war wounded over the last months. An increase in fighting in March resulted in the treatment of over 1000 war wounded alone. Most of the wounded are coming from within the city where many civilians are caught in the middle of the intense fighting. Patients MSF sees in Taiz are mainly suffering from injuries due to airstrikes, blasts, shellings, gun shots, snipers and recently landmines. Access in and out of the city remains restricted and dangerous for civilians and humanitarian actors.

In November 2015 MSF opened the Mother and Child Hospital in Al-Houban area of Taiz. Services include emergency room, OPD under 5 years, maternity, reproductive health, operation theatre for cesarean sections, pediatrics, nutrition programs and patient referrals. MSF is providing at least 300 general consultations to mothers and children on daily basis in the hospital.

MSF is also providing medications to the emergency room and emergency OT supplies to Khalifa Hospital in Al-Turba in Taiz.

Ibb

MSF has initiated in mid-2015 its medical and humanitarian operations in the Ibb Governorate, which in turn is the most densely populated region in the country and bordering two of the active war front lines.

Since the first days of 2016, is supporting the Emergency Room Department of Ibb Governorate’s largest central hospital, which is the most important referral medical structure in the region and with a catchment population of two and a half million inhabitants. The objective is to increment free access good quality emergency health care in general and to improve the hospital’s capacity to clinically manage a large influx of wounded (mass casualty management) in particular.

Accordingly, our staff is seeing 600 to 850 patients per week in the Emergency Room, out of which between 15% to 20% is violent trauma.

Simultaneously, in the southern border with the Taiz Governorate, close to one of the country’s violent war front lines, MSF rehabilitated and is supporting a general hospital – dysfunctional until then – incrementing the free access to good quality emergency health care, improving the hospital’s mass casualty management (as above), provide lifesaving surgeries as well as inpatients hospitalization for the most severe medical conditions. The catchment population of this medical structure is estimated to be five hundred thousand inhabitants.

On average MSF medical teams provide per month around 600 Emergency Room consultations, 120 life-saving related surgeries and more than 100 severe medical cases’ hospitalizations. Violent and accidental trauma represents more than 50% of the cases seen in this medical structure.