The American airstrikes against a Médecins sans Frontières (MSF) hospital in Kunduz, Afghanistan, earlier this month indicate either a lethal flaw in US intelligence or, in a worst case scenario, a callous disregard for international humanitarian law. (SEE Essential Edge story) The US is not alone in its readiness to risk collateral damage and civilian deaths in the pursuit of an elusive enemy, however. Humanitarian outrages are a daily occurrence in Syria and Iraq, and increasingly in Yemen, all of which have also raised concern within the international community, including organizations such as the World Health Organization and UNICEF. Edward Girardet explores the implications of the relentless bombing of civilian targets by aircraft of the Saudi-led Coalition in its seven-month offensive against Iranian-backed Houthi rebels in Sana’a.
Old man picking his way through rubble in the war-torn town of Taiz, Yemen.

Geneva — The targets are homes, hospitals, clinics, schools, mosques, bazaars and occasionally rebel military positions. Include in that, UNESCO World Heritage buildings. As with the MSF hospital in Kunduz, most of Sana’a’s medical facilities are clearly marked and identified on everyone’s maps, including Google Earth. There is no excuse for primarily Saudi warplanes bombing civilians day and night. The tactic not only violates the Geneva Convention; it is turning the Yemeni capital into a humanitarian nightmare.


For their part, the Saudis claim that they are not targeting civilians. “Our forces are only fighting insurgents,” insists one Saudi Ministry of Defence official.

The United Nations, MSF, the International Red Cross (ICRC) and local medical organizations, have a different story to tell. They estimate that between 3,000 and 5,000 civilians, including women and children, have been killed since the Riyadh Coalition intervened in Yemen last March. Thousands more have been injured. Intense ground fighting coupled with airstrikes and indiscriminate shelling kills an average of 30 people every day and wounds at least 180 more. The result is a humanitarian situation that ICRC President Peter Maurer describes as “nothing short of catastrophic.”

Red Crescent aid workers help with distribution of relief. ICRC Photo.

UNICEF estimates that 10 percent (1.4 million people) of the country’s population has been internally displaced, while 80 percent desperately needs humanitarian assistance. The UN agency further notes that faced with a growing famine, more than half a million children are threatened by severe malnutrition.

Such assessments are broadly corroborated by Yemeni medical workers on-the-ground in Sana’a. “Our hospitals are very badly damaged,” one doctor at the Al Thawra General Modern Teaching Hospital told me in a phone interview this week. “There are very few drugs and essential equipment. People have to pay for what they need but many have no money.” The situation grows worse daily as food, water and fuel shortages become more dire. The hospitals are operating at 5-10 percent capacity with few medical supplies remaining.

Destruction of late 10th century buildings in Old Town of Sana’a. UNESCO photo.

Another doctor working at the Al-Sabeen Hospital for Maternity and Children concurs. “There is no difference between military and civilian places,” she says. A military encampment is only a few hundred meters from her hospital. Nevertheless, she argues, her hospital is clearly visible from the air as a medical facility.

“We never know whether we will see our families alive again when we leave every morning,” she adds. Not only warplanes bomb and rocket this ancient city, famous for its multi-storied buildings in the old town, they say, but naval ships located off the Red Sea coast fire long-distance artillery indiscriminately into densely packed neighborhoods. Both doctors have had their homes severely damaged by the bombardments. They note that Saudi planes often return for second strikes when inhabitants rush out to assist. “People don’t dare to help anymore,” one of the doctors said.

Old Town buildings in Sana’a. UNESCO photo.

Coalition strikes against the Old Town are particularly dismaying. The Saudis began the destruction of Sana’a’s UNESCO world heritage buildings last June, only two days before UN-brokered peace talks were to take place in Geneva. Those talks still haven’t managed to halt the fighting. Located in a 2,200 metre-high mountain valley, Sana’a was founded more than 2,500 years ago.
Since the outbreak of fighting, Al Thawra hospital has performed over 2,000 complicated surgeries and dealt with more than 12,000 injured. “No time is quiet. They can bomb at any moment,” one of the doctors said. “We don’t know which areas are safe.” During the air strikes, medical personnel have to transfer patients from one part of the hospital to another safer section. This often means moving patients who are in intensive care. Some of them risk dying in the process. Many staff no longer come to work because it is too dangerous or there is no transportation. Sometimes, too, families will not allow female doctors or nurses to leave home.

According to the doctors, numerous displaced people are now staying in schools, but the Saudis bomb these buildings as well. Most children have not been able to go to class for months. Medical supplies are running out and hospital generators often don’t work because of fuel shortages. Petrol now costs US$100-150 per 20 litres.

Internally displaced woman and child in a Yemeni refugee camp.

None of the hospital staff are paid so they have little or no money to buy food or water. At the same time, most shops are closed or whatever is being sold is too expensive. “We now rely on charity to survive,” said one doctor. “We have nothing now.”

MSF and the ICRC are trying to respond to the crisis. MSF operates an emergency hospital in Aden and is providing medical support, mainly blood sacks, to the Al-Sabeen Hospital, which was temporarily evacuated in September because of heavy bombing. It is also operating at other locations. Two ICRC volunteers were recently killed in the attacks. Despite that, the ICRC is furnishing some relief, primarily in the form of fuel to the hospitals.

Edward Girardet is a Geneva-based journalist and author who has covered conflicts and humanitarian crises in Asia, Africa and elsewhere. He is also co-editor of The Essential Edge as well as a Journalist in Residence with the Geneva Centre for Security Policy.