Emergency area outside Aden hospital.

Global Geneva seeks to provide personal insights based on first-hand experiences into humanitarian and conflict situations around the world. 

Senseless violence, lawlessness, resilient people tired of conflict, and a country in chaos: these were my impressions of Yemen before I arrived. It was visceral. And then there was Taiz City: the last bastion of hope for peace. Many Yemenis repeated the same thing: “If Taiz falls, so does the future.

Haydan Hospital, March 2016, after 5 months of air strikes. (Photo: Atsuhiko Ochiai)

Taiz, the third largest city in Yemen, is divided by a frontline. People living there are exposed to violence on a daily basis. The constant sound of shelling and gunfire crackling during the days and blaring through the nights has become the norm. I remember at one point in January this year, we were hearing what felt like five explosions every minute for a period of two weeks.

For those living in Taiz, there’s the day-to day fear of being killed by stray gunfire or shelling. There’s the fear of family members never returning home from work. Freedom of movement is far more restricted than what it was before the war.. How do you go to the market to buy food if the road is dotted with checkpoints, and at any point, a stray bullet or missile might hit you? How do you send your children to school, if there is a real and constant threat they might not come back home?

You can imagine that living in these conditions is incredibly tough for the locals. The devastating psychological impact on people there will last long after this war is over.

Displaced from the heavy fighting in Haradh bordertown and Sa’bah governorate are seen in Al Manjoorah temporary settlement at the outskirts of Beni Hassan, in Hajjah province, Northwest of Yemen. (Photo:Narciso Contreras/MSF)

A potential for future outbreaks

MSF has been supporting three hospitals in Taiz city for almost two years, focusing on the main emergency priorities including medical care for people injured from the war and paediatric and maternal healthcare. In war, surgery is an enormous part of our work, but there is also a real need for quality medical services for children and pregnant women.

Emergency entrance of Thi As-Sufal District local hospital, Ibb governorate. The sign reads “The hospital needs to be a neutral and peaceful place, thank you for your cooperation”. (Photo: MSF)

In Taiz city, we had on average, 2,000 maternal health consultations per month – these were women who would otherwise not have had access to care. Staff were seeing malnourished children, and many with advanced respiratory infections. They also treated children for common illnesses that were amplified because of the lack of provisions available.

Unfortunately, there is no infrastructure supporting waste management in Taiz. The situation is equally dire in terms of access to clean water and sanitation facilities. Last year, this contributed to the rise of cholera and the fear is that there is potential for future outbreaks as the seasons change.

What struck me most was seeing our staff interact with patients.

Very broadly, we have seen a collapse of the secondary and tertiary healthcare systems in Yemen. We have spoken out openly about this over, and over again. Over the last two years, public hospital staff have been paid little to no salaries. So  many are leaving to find other paying jobs outside the medical field.

Yemen, gouvernorat d’Amran, Khamer, mars 2018. Vue générale de la ville de Khamer.
Yemen, governorate of Amran, Khamer, in March, 2018. Overview of the city of Khamer. (Agnes Varraine-Leca/MSF)

Other sectors face similar challenges. This has meant that professionals in Yemen are now working in different fields. Teachers, for example, don’t have jobs anymore because the education system is defunct. Some have come to work with MSF taking on various administration and logistic roles.

I remember going through one of the hospitals with a former teacher, now an MSF logistician. As we were walking through the emergency ward, he recognized some of the patients as former students. He was quite shocked to see them in such a precarious state. He remembered them being fit and healthy and was worried about their health now.

Everyone has a story in Yemen about how their life has changed because of the war. In most situations, in most communities, you would expect to see a broken people. Year after year of being forgotten, not being able to access healthcare services, and not being able to afford food, you would feel broken…

But the people keep doing their best to alleviate their misfortune, even though war and the fear of death is a daily reality for them. In Yemen, people are still hopeful for a stronger future.

Arunn Jegan, MSF project coordinator, who worked twice in Yemen.

MSF works in 13 hospitals and health centres in Yemen and provides support to more than 20 hospitals or clinics across 12 Yemeni governorates: Taiz, Aden, Al-Dhale’, Saada, Amran, Hajjah, Ibb, Sana’a, Hodaida, Abyan, Shabwa and Lahj,. With nearly 1,600 staff, this makes it among MSF´s largest missions in the world in terms of personnel.