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The Conflict in Yemen: A Humanitarian Catastrophe

June 12, 2015

Where Yemen will rank in terms of all-time disasters will be a matter for debate. What is far less debatable, however, is whether Yemen is on the verge of becoming a humanitarian catastrophe. As the departing ICRC Yemen delegation head, Cédric Schweizer, stated at the CSIS event Yemen’s Crisis on May 21, the continued Saudi-led military campaign in Yemen has pushed an already highly fragile, fragmented country to "the edge of a big humanitarian crisis" that seemingly has no end or solution in sight.

The United Nations Office for the Coordination of Humanitarian Affairs’ (UNOCHA) current estimates suggest that at least 2,228 people have been killed and another 9,755 injured in Yemen since mid-March. Likewise, the International Organization on Migration reports that the conflict has produced more than 1 million internally displaced persons (IDPs) and nearly 30,000 refugees, with neighboring Djibouti and Somalia serving as the principal recipients.  For context, this is within a total population of over 24 million.

Yet those figures only represent the tip of the iceberg. Taken in a broader context, the current situation is significantly more alarming. To begin with, casualty estimates reported by UNOCHA only reflect the number of deaths or injuries formally recorded in health care facilities. Since many of the wounded and dead are never brought to such facilities, actual figures are believed to be significantly higher.

Furthermore, these estimates only reflect additional casualties, IDPs, and refugees since the start of the Saudi-led campaign in late March. The figures don’t take into account Yemen’s tremendous pre-existing vulnerabilities—including the nearly 16 million people who were previously in need of humanitarian assistance, the 40% of the population that was food insecure, the 1 million children under 5 that were acutely malnourished, the 13.4 million people who lacked access to safe drinking water, or the more than 330,000 IDPs already living in the country—whose severity have only worsened as sustained airstrikes, an ongoing Saudi naval blockade, and a widening internal war involving multiple armed factions have disrupted international aid and ground the commercial system to a halt.

Yemen’s health care system has been particularly impacted by the conflict and blockade. Shipments of desperately needed fuel and medical supplies have either been slowed—due to a rigorous inspection regimen imposed by the Saudis on all incoming cargo vessels—or halted entirely. With widespread lack of electricity, most hospitals and clinics rely solely on generators to power their facilities; generators that are increasingly unable to run as already scarce fuel reserves dwindle. This has caused nearly all of the country’s hospitals, both public and private, to either partially or entirely close, resulting in more than 15 million Yemenis not having access to even basic health services. Power cuts, fuel shortages, and violence have also disrupted much of Yemen’s vaccine cold chain, resulting in the suspension of several childhood vaccination programs and dramatically increasing the risk of communicable diseases—including dengue fever, measles, and even polio—spreading unfettered throughout the country.

There has also been extensive targeting of health care workers and facilities by armed combatants. To date, there have been at least 53 separate instances of health care facilities being attacked or destroyed as a result of the conflict. On top of this, many hospitals and health facilities are currently under-staffed, as medical personnel either can’t reach work—due to the disruption of public transportation—or are simply not reporting to work due to safety concerns.

What sets the humanitarian disaster in Yemen apart is the sheer degree of chaos, armed conflict, and fragmentation in a country that was already teetering on collapse. Houthi rebels are vying for control of territory with Al Qaeda in the Arabian Peninsula (AQAP) and Islamic State (IS) affiliates, while continued airstrikes bombard much of the country. As a result, virtually no area of Yemen is safe from attack. As Schweizer noted, “Today, all the population [of Yemen] is at risk. It’s not just a particular region or a particular population. It’s all the population.”

International NGOs operating in the country—such as Médecins Sans Frontières (MSF), International Committee of the Red Cross (ICRC), and World Food Program—struggle to operate under these conditions. Many NGOs have been forced to draw down their international staff and rely instead on domestic personnel. They face increasing threats of kidnapping and difficulties gathering accurate data about what’s actually happening on the ground. Reportedly, the Saudis have no regular communications with ICRC or MSF.

The question then becomes, what can we expect to unfold moving forward?  It is likely the situation will continue to worsen into the foreseeable future. Unless the Saudis and the Houthis are able to arrive at a long-term ceasefire—an unlikely prospect as no real incentives are in place for either side to suspend hostilities—health systems will continue to worsen and communicable diseases begin to appear, causing additional illness and death from what should be preventable or treatable conditions.  Moreover, protracted and acute chaos in Yemen may present new opportunities for AQAP and IS affiliates to exploit.

Addressing the humanitarian crisis will require several concrete actions. First, the current inspection regimen imposed by the Saudis on cargo vessels entering Yemen should be eased. Until fuel and medical supplies are able to flow faster and smoother into the country, individuals won’t receive the health and humanitarian assistance they desperately need. Second, it is important that the reach of international NGOs is expanded. Lack of capacity from humanitarian organizations is significantly hindering accurate regional assessments and delivery of vital aid to vulnerable populations. Finally, pressures should intensify upon the Saudis to open direct lines of communication with NGOs like MSF and ICRC operating in Yemen to ensure aid workers aren’t inadvertently caught in the crossfire.

However, these actions are merely short term fixes. Any long-term solution to the humanitarian crisis will require a cessation of hostilities, lifting the naval blockade, and allowing normal commercial activities—specifically the import of fuel and medical supplies—to resume. Unless such a solution can be reached, and soon, Yemen will face the increasingly likely risk of devolving into a total humanitarian catasrophe, from which it may never recover. 

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Contact H. Andrew Schwartz
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Related
Global Health, Global Health Policy Center, Health Security, Health and Security

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