“I am very satisfied with the medical outreach team’s activities. It saves us, as patients, a lot of effort, money, and time trying to find transport when we have emergencies. It saves lives.” — Amt Al-Razaq Ahmed Mohammed Oaydan, 38, displaced from Al Hudaydah
Yemen currently holds the unenviable title—the epicenter of the world's worst humanitarian crisis, with nearly half its population on the brink of famine, hundreds of thousands affected by cholera, and more than 20 million people in need of humanitarian assistance and protection.
Protracted conflict has severely affected the country's healthcare system since 2015. Essential medication and equipment have been in short supply throughout the war; barely half the nation’s public health facilities are fully functional; and for three years, healthcare workers went unpaid. As a result, many workers have been forced to quit healthcare and, even now, in a time of great need, facilities are losing staff as the nation is gripped by COVID-19.
Even proximity to a functioning health facility does not guarantee access to a specific service. About 40% of the population lives more than a two-hour drive from full emergency obstetric, surgical and antenatal care. In terms of walkability, 45% of Yemenis live more than 30 minutes away from the nearest operational primary healthcare facility, and 68% live more than a 60-minute walk from the nearest hospital.
A lack of healthcare services
The district of Nawjed in Socotra Governorate on an island off Yemen’s southern coast contains clusters of small, remote villages with a combined population of 18,000. Bedlihi, which is home to the major healthcare center, is considered the second most densely populated after Hadibu District, and comprised of 15 tribes (each consisting of between 100-300 people).
Serving a small population size and changing needs, its local healthcare facility lacks services providing emergency, obstetric, gynecological, and child nutrition care, and laboratories and suffers from severe staffing shortages that interfere with preventative care and routine diagnoses. In fact, after malaria, the most common disease in the region, was eliminated, only to be quickly replaced by diarrhea, dengue fever, typhoid, and acute malnutrition.
“There is only one healthcare facility in our entire region, and for many years a single doctor was responsible for running it and treating all the patients,” said local resident Ali Sa’ad Jumaan. “I hope this facility will be able to provide more services, particularly for pregnant women. They have to travel to Hadibu for urgent care and some of them end up dying on the way.”
The power of partnerships
Fortunately, the Yemen Emergency Health and Nutrition Project (EHNP) is now providing basic health, nutrition, water, sanitation and hygiene services to the country’s most remote and historically underserved areas, thanks to partnerships between the International Development Association (IDA)—the World Bank fund for the world’s poorest countries—and the United Nations Children’s Fund (UNICEF) and Yemen’s Ministry of Public Health and Population and Governorates’ Health Offices.
Under the EHNP, IDA and UNICEF support service delivery for primary healthcare, including: child care; nutrition; general services and trauma care; the treatment of common, communicable diseases; basic laboratory services; reproductive, maternal, and newborn health; mental health and psychosocial support; and environmental health services.
Nawjed’s clinic recently began monitoring child nutrition, administering vaccines to pregnant women and children, and sending ambulances to transport pregnant women, the sick and the elderly to the clinic. The obstetrics emergency unit now sees at least 20 cases a day and has become more effective.
Say’un, at a glance
Over 600km away in Hadramaut Governorate, the EHNP has made it possible to offer free healthcare services to pregnant women, children, and patients with routine healthcare needs, as well as nutrition, reproductive health, and immunization services.
An internally displaced person, and recently widowed, 50-year-old Safia Ali Hassan was struggling to meet her family’s needs and began to view healthcare as a luxury. She had been scraping to get by since the shooting of her eldest son, who helped pay for food and other household items. She experienced extreme anxiety whenever one of her other children fell sick.
The free medical services of a community outreach team have alleviated her family’s suffering. She no longer has to travel a long distance for healthcare or pay for transport and treatment. She wants the service to continue. “It gives us some of the essential care we need and receives many patients from other families like mine,” said Safia.
Community outreach activities in the city of Sa’yun take place each week, with teams of specialists visiting to fill in the region’s health gaps. Residents can now be seen by immunization, reproductive health, and/or child health specialists and a dietician.
According to a 25-year-old nurse, Ali Omar Ahmed Taeib, “the support we have received has made a big difference in the services our facility provides. We are now close to 90% functionality.”
The EHNP has made great progress when it comes to improving community health services. Still, there is still a long way to go before sustained health development reaches all Yemenis.
By April 2021, the ENHP program had made it possible for:
- 537,193 births to be attended by skilled health personnel
- 1.25 million pregnant women to receive antenatal care
- 2.6 million Yemenis to receive oral cholera vaccine
- 37,482 health workers to receive targeted health training
- 4,246 health facilities to be equipped and ready to support and treat patients
- 1,964 health facilities to receive direct support, including regular supplies and equipment, as well as issuing per diems to health workers to carry out community visits
- 7.6 million children to be vaccinated against preventable diseases
- 1.3 million women to receive basic nutrition services.