With medical teams working across Yemen, we at Médecins Sans Frontières (MSF) witness on a daily basis the reality of the humanitarian crisis facing its people. In the more than two years since the armed conflict escalated, thousands of people have been injured, maimed and killed. Our teams have treated more than 60,800 trauma patients, including war wounded and other violence related injuries. Our patients have been shelled while preparing lunch in their kitchens, wounded by airstrikes while walking to their fields, maimed by landmines while herding their livestock, and shot at by snipers in the streets outside their homes.
Millions of people across Yemen are in critical need of aid in order to survive in a country where the economy has largely collapsed, basic services struggle to function, and social safety nets are strained. Many of the patients we treat, and the families of the medical staff with whom we work, have lost their livelihoods and face illness, rising prices, and shortages of essentials including food, fuel, and electricity. Civil servants, including medical staff, have received no salaries for months. Clean water, decent sanitation and basic hygiene items are often unavailable. Massive numbers of people have had to leave their homes because of the violence, with many families forced to settle in overcrowded, unsafe locations.
Faced with ever increasing medical needs, we have expanded our operations, reaching a budget of US$70 million last year. Today, MSF has more than 1,600 international and Yemeni staff working in 12 hospitals and 18 health centres across the country, showing that it is possible to provide direct humanitarian aid in an effective way.
Humanitarian aid needs to be scaled up – urgently. Donors need to increase funding immediately and prioritise lifesaving interventions. In such a dynamic and challenging context, they will need to demonstrate greater flexibility than usual in the conditions governing their funding. Meanwhile, the United Nations has to effectively put in place the Level 3 declaration arrangements, with senior and experienced guidance in emergencies and highly insecure settings, strong coordination, and practical support to its agencies and NGOs already working in the country.
To avoid total collapse, the healthcare system in Yemen desperately needs to be shored up. In the 10 governorates where we work, we have seen how the shortages of functioning health facilities, specialist care, equipment, medical staff and supplies are severely compromising people’s ability to access lifesaving medical care. The injured and patients suffering from chronic diseases are dying avoidable deaths, while the most vulnerable groups – children, pregnant women and the elderly – are at heightened risk of disease. Resuming the payment of salaries to civil servants, specifically medical staff, is vital to stop the healthcare system collapsing, and to prevent the households who rely on those salaries from sliding into destitution.
However, increasing funding for humanitarian aid cannot on its own alleviate the toll taken on the civilian population by the armed conflict. As donor countries gather today to pledge their financial support, they must also commit to stepping up diplomatic efforts to minimise the war’s deadly and destructive impact on the men, women and children caught up in it.
Facilitating humanitarian access to help aid organisations reach the people most in need is essential. Ports and airports must be reopened and international staff must be helped to enter the country. The deliberate obstruction of humanitarian aid by restricting imports, diverting shipments, causing delays at customs, confiscating vital supplies, failing to grant international visas and internal travel authorisations – to name just a few – must end. Essential supplies, including medicines and food staples, must be allowed to enter the country and be transported to where they are most needed.
Finally, we urge all warring parties and their allies to ensure that civilians and civilian infrastructure – including medical facilities and staff – benefit from the protection granted to them under international humanitarian law. Hospitals have repeatedly been hit by shelling, missiles, airstrikes and gunfire. This includes four MSF health facilities in attacks in which 26 of our patients and staff lost their lives. Ambulances have been shot at, confiscated or forcibly entered by armed men. Medical staff have been shot at on their way to work, harassed, detained, threatened and forced to work at gunpoint. There is a consistent pattern by all warring parties in the Yemeni conflict of injuring and killing civilians, and of deliberately obstructing access to healthcare for those in need. Today we re-emphasise our call on all parties to ensure that civilians and health workers are protected, and that the wounded and sick are able to access medical care.