Yemen: A Canadian field worker on the impact of war on mother and child health in Taiz
The ongoing conflict in Yemen, with indiscriminate bombings, shelling and shortages of supplies and staff, have led to the closure of many of the country's health facilities. More than three million people have been displaced since the war started more than four years ago.
With an estimated 20 million in need of humanitarian assistance, Doctors Without Borders/Médecins Sans Frontières (MSF)’s activities in Yemen are among our most extensive worldwide. Ivy Bojmic, a Canadian MSF field worker, describes the impact she has seen in Taiz, where MSF provides care to a city divided by conflict.
By Ivy Bojmic
Saeeda strokes her four-year-old grandson Murad’s head gently in the small isolation unit of Doctors Without Borders/Médecins Sans Frontières (MSF)’s Mother and Child Hospital (MCH) in Taiz, Houban, in Yemen. “He began vomiting and his eyes began swelling,” she says. “We live in a tent in the mountains. We’re displaced.” Saeeda says she is the sole caregiver for Murad and his brothers.
Saeeda arrived at the hospital after carrying Murad across rugged mountain terrain, leaving her other three young grandsons in the care of a neighbour. It was an hours-long trek through the cold night, but bringing Murad to the MSF hospital — which provides free medical care in an area where many of the existing health infrastructure is not functioning — was her only option.
“When he became sick in the night, my neighbour told me to go to another clinic in [a nearby region] but I said no, I will come to MCH," Saeeda says. "Medicine is very expensive. It’s not possible to get. I have no money.” The hospital has already played a significant role in Murad's health: he has come before to receive blood transfusions for sickle cell anemia. Now, he has been diagnosed with measles.
Yemen conflict: a devastating impact on civilians
Since its beginning in March 2015, the escalation of conflict in Yemen has caused hardship for citizens across the country, devastating parts of what was already the poorest country in the Middle East. Accessing life’s daily essentials has become an ongoing challenge.
“So many people are poor. They are coming from outside [the hospital’s catchment area] and from far away. Some of the patients are already dead when they arrive. They don’t have any money,” says Saleem, an Emergency Room (ER) Nurse at MCH. He explains that MCH is therefore considered a lifeline in the surrounding community and beyond, providing free, quality medical care for mothers and for children under the age of five.
Lubna, a 20-year-old mother, and Lubna’s 15-year-old cousin, Meetha, recently arrived at the hospital. Lubna wipes the sweat from her brow and looks lovingly at her crying nine-month-old twins, a girl named Hasna and a boy named Bakil. “They were born at MCH,” she smiles. Admitted eight days ago, the twins, too, have been diagnosed with measles. “I noticed they were feverish and had difficulty breathing.”
Lubna explains that her family is also displaced and lives in the mountains. “We were from Taiz City but we moved because of the war. I came to MCH because of its good reputation.” To make the journey, she and Meetha paid their neighbour some meagre savings for fuel to drive them through the winding roads.
Shelling, snipers and resurgent diseases
The effects of the war on health facilities and public vaccination programs has been detrimental for children, contributing to a deadly resurgence of vaccine-preventable diseases.
Imagine your current town or city of residence. Now imagine an active conflict zone — including shelling and snipers — slicing it in half. Access to healthcare is challenging, if not impossible, for people living near the front line, which divides Taiz City and nearby Taiz al Houban. Vital resources are nearly impossible to access for those trapped on the other side.
Before the conflict, Taiz governorate had nine functioning public hospitals, five of which were located in Taiz City, serving some 615,000 people. However, as of March 2019, no public hospital was fully functioning in the region.
“Many different cases we receive include infectious diseases — for example, measles, cholera, chicken pox,” Saleem explains. “These are all vaccine-preventable diseases. We are receiving a lot of measles cases. Families are not able to get vaccines. The war is an important part of this.”
Mother and child care urgently needed
Since opening in the fall of 2015, the demand for MCH’s services has been high and has increased each year:
- Newborn deliveries increased from 4,100 in 2016 to 8,443 in 2018.
- In 2018 alone, MCH saw 6,915 inpatient admissions and admitted 1,432 malnourished children to its therapeutic feeding programme.
- Again in 2018, MSF referred 3,322 patients to local private health facilities because of a lack of capacity to provide the care required.
“When we look at our statistics, we would have to build five mother-and-child hospitals in Taiz governorate to provide enough care and coverage for the people of the governorate, but that is not possible,” says Rachel Fletcher, Hospital Director.
For now, the future of Yemen’s children seems uncertain. But one thing is undeniable: without any access to MCH, the high mortality rates already witnessed by MSF in Taiz would sharply increase.
Ivy Bojmic is an MSF field worker from Toronto, who recently returned from an assignment as a finance and HR administrator in Taiz, Yemen.