When Mohsen al-Matari’s wife went into labour, she was advised to seek an emergency caesarean section. But the closest hospital in western Yemen turned her away, with staff saying they weren’t equipped for the procedure. “Go to the capital,” they told her.
“I didn’t have enough money to take her to Sana’a,” said Matari, who lives 30km west of the city. “I was forced to take her to a midwife in our village.”
The Mataris were lucky to have someone so close who could help; the midwife delivered a healthy baby. Across the country, other Yemenis who need medical attention are less fortunate. An acute shortage of medication, supplies and staff is compounding damage by airstrikes, and forcing Yemen’s doctors to turn away patients in dire need of treatment.
Before Houthi rebels took over Sana’a earlier this year, forcing President Abd-Rabbu Mansour Hadi from power, 8.6 million of Yemen’s 25.2 million people had no access to adequate healthcare.
Since a coalition led by Saudi Arabia began trying to oust the Houthis by pummelling the country with airstrikes in March, more than 5,000 people have been killed, including 2,300 civilians. Last month, the World Health Organisation warned that Yemen’s healthcare system was on the brink of collapse, estimating that 23% of the country’s medical facilities were no longer functional.
The September 26th hospital in Bani Matar, where the Mataris sought treatment, was bombed three times last month. The coalition was apparently targeting the building next door.
A guard at the hospital – the name of which is a reference to the day in 1962 when Yemen’s last monarch was deposed – was killed in one of the strikes, and 10 staff members wounded. The doors and windows were blown out, hospital director Mohammed Abduladheem Zaid said. Patients were left to fend for themselves as doctors abandoned their surgeries and sought shelter.
After the bombings, “the emergency room, x-ray department, and maternity wards stopped work completely until patients broke into the hospital”, Zaid said. “They forced the staff to return to work because [the patients] couldn’t find another solution.”
It is not the only hospital that has been hit. Al-Thawra general hospital in Sana’a, Yemen’s largest medical facility, suffered significant damage after a May airstrike apparently aimed at a Houthi weapons cache in nearby Noqoum mountain. In Aden, one of the city’s largest hospitals, named the Republic, also lies shattered and empty, its first floor badly damaged by shelling.
Many doctors are doing their best to treat patients in bomb-damaged buildings, but there is often little they can do if they do not have the right medication.
In April, the UN security council slapped an arms embargo on the Houthi rebels, but the strict import restrictions have in practice meant that precious little food, water or medical supplies have made it in. With local markets tapped out, hospitals now rely on aid organisations to stock their medicine cabinets, but this has not been sufficient to keep treatment steady.
Standing outside the gates of Sana’a’s general military hospital, a frustrated 62-year-old, Mohammed Ali, had just been rebuffed for a second time. “I was told that Al-Thawrah hospital has stopped dialysis for a week, and here at the military hospital they told me they ran out of dialysis solution and today is the last day [they’ll be offering dialysis treatment].” Ali was unsure where to turn to next for dialysis for his wife, who has acute kidney failure.
Anwar Mughalis, chairman of the board at Al-Thawrah, said his hospital was running a bare minimum of services and was regularly turning away patients.
“We’ve run out of many medical instruments and medications like dialysis solution, artificial valves [for heart surgery] and stents,” he said. “It’s impossible to get them from the local market because companies can’t import them.”
Until last week, Mughalis was able to perform dialysis thanks to solution salvaged from closed hospitals, but that supply too has dried up.
“Even those solutions have run out, and now I can only take cases of patients who are facing death,” he said.
His cardiac unit has nearly ground to a halt as well, with 120 patients awaiting urgent heart surgery.
Mughalis blames the blockade. “Commercial ships are not allowed to come to Yemen, so the companies cannot provide medicines and medical equipment. Only the international organisations are allowed to import them, but [they] cannot import everything we had before the war.”
Many medications also require careful temperature-controlled transport, simply not an option amid the chaos in Yemen, he noted.
At September 26th hospital, they are out of medications to treat high blood pressure, diabetes, and psychiatric conditions.
Hassan Boucenine, head of mission for Médecins Sans Frontières in Yemen, echoed doctors’ complaints.
“Because of the embargo, the market cannot cover the needs of the hospitals and patients and the ministry of health has extreme difficulty in importing goods,” Boucenine said. MSF brings in most of its medical supplies from abroad; 400 tons have arrived since March.
“Our supply is mostly for emergency, but also we bring medications and tools for a large variety of services in the hospitals we are supporting,” Boucenine said.
Adnan Hizam, a spokesman for the International Committee of the Red Cross, said the organisation was also importing supplies and medication for local hospitals, as well providing some budgetary support.
While hospitals can’t seem to get drugs into the country, they have the opposite problem with staff. Nearly all foreigners, including medical personnel, have left Yemen.
Mughalis said he had lost 400 staff members since the bombing began in March, including a lot of foreign expertise. “Nurses and doctors, including anaesthesiologists, heart and kidney specialists have left … This has caused a lot of confusion.”
Local staffers have left too, joining the 2.3 million Yemenis displaced by the fighting. Hospitals have attempted to compensate by increasing doctors’ shifts from eight hours to as long as 24 hours. Those working long hours bunk in the quarters formerly occupied by foreign doctors. Medical students have even been drafted early to help keep hospitals running.
Although the Houthis recently agreed to the terms of a UN-brokered peace deal, the bombs keep falling and no clear end is in sight. In the meantime, Yemeni civilians trudge from hospital to hospital in search of help, while others are left to fend for themselves. Some, like the Mataris, get lucky. Others do not.