Yemen: First bombs, soon a coronavirus epidemic
At a time when the world is scrambling to respond to COVID-19 and ensure that hospitals can treat all patients, Yemen has entered the sixth year of a war that has all but decimated its healthcare system.
The new threats of the virus will complicate an already disastrous and entirely man-made humanitarian crisis. The multiparty war that has ravaged Yemen the past five years has not spared hospitals or health workers the violence and destruction.
Mwatana for Human Rights, the organisation I founded in in 2007, documented 120 attacks on health facilities and medical personnel by all parties to the conflict in Yemen between 2015 and 2018. They resulted in the death of 96 civilians and health workers and wounded hundreds of others.
In a report released in March by Mwatana for Human Rights and US-based organisation Physicians for Human Rights, we illustrate how these attacks were carried out and how they have contributed to the disastrous humanitarian situation in Yemen. This is just a snapshot, with the actual number of attacks on health facilities likely being much higher.
The Saudi and Emirati-led coalition, the Houthi armed group, and the internationally recognised government of Yemen have all contributed to the collapse of the healthcare system. They have launched aerial or ground attacks on known, occupied medical facilities, looted medical supplies, and assaulted medical personnel, among other violations.
What I saw when I visited hospitals in the city of Taiz and the capital Sanaa in 2015 was heartbreaking. The Republican Public Hospital in Taiz was empty, like a ghost house. It was in an area that soon became the site of armed clashes between Houthi and forces loyal to the late Yemeni President Ali Abdullah Saleh on one side and "public resistance" forces affiliated with the government of Yemen on the other.
In addition to being caught in the crossfire, hospitals across Taiz were suffering from shortages of oxygen to perform basic operations due to the siege imposed by Houthi and Saleh forces.
In Sanaa, the hospitals I visited were not equipped to treat the large numbers of people injured in Saudi/UAE-led coalition air attacks. I still remember the scene of wounded people filling the hallways of understaffed hospitals. I will never forget the overwhelmed doctors and nurses, unable to respond adequately and feeling helpless due to the lack of essential medical equipment.
By the end of 2016, just one year into the war, more than half of Yemen's health facilities closed and those that remained operational lacked specialists, essential equipment, and medicines.
The few remaining and barely functional medical centres were often occupied and militarised by parties to the conflict, thereby weaponising and co-opting access to healthcare. These acts violated the medical principle of non-discriminatory healthcare provision and exposed many of these structures to the risk of losing their protected status under the laws of armed conflict.
All parties to the conflict have threatened, injured, abducted, detained, and killed health workers. This hostile environment led almost all foreign medical professionals, who comprised approximately 25 percent of the health workforce before the escalation of the conflict, to flee the country, putting further strain on the healthcare system.
Today, Yemen is facing a tremendous shortage of medical professionals, with only 10 health workers per 10,000 people - less than half of the minimum ratio recommended by the World Health Organization to provide the most basic health coverage to a population of this size.
The destruction of health facilities and the shortage of medical professionals have all contributed to a catastrophic situation for civilians in Yemen. This explains why Yemenis suffered an outbreak of an easily preventable disease, cholera.
Parties to the conflict in Yemen must cease attacking and weaponising healthcare across the country and should immediately conduct investigations into attacks to ensure accountability for crimes committed, and offer redress to victims.
In Yemen, our worst fears will likely become a reality: another epidemic. While novel to the entire world, the disease may be particularly deadly to countries in conflict like Yemen. A friend of mine who lives in Sanaa told me: "If Coronavirus arrives in Yemen, we should just dig our graves and wait quietly for death."
The spread of coronavirus anywhere is a threat to everyone. While countries shore up their own health systems to battle coronavirus, they must not ignore the plight of Yemenis who are already under attack.
People with kidney failure at a hospital in the Red Sea port city of Hodeidah, Yemen [Reuters/Abduljabbar Zeyad]