COVID-19 Devastates an Already War-Torn Yemen on Brink of Collapse

“The authorities didn’t believe coronavirus existed at all in Yemen, even though the virus was spreading exponentially, and deaths cases were surging,” said Dr. Madhi Mahdi Abdel Qawi, head of the intensive care unit at the Aden German International Hospital in the Lajih governate in northern Yemen.

Dr. Abdel Qawi was among the first to officially learn, in early April 2020, that he contracted COVID-19. He spent ten days in a coma before recovering and is now back at work at the hospital.

The Soufan Center’s reporting team heard from displaced persons, healthcare workers, and humanitarian organizations in Aden and Lahij about prevention efforts related to Yemen’s COVID-19 outbreak, using Truepic’s image verification platform to record select interviews and help ensure the accuracy and veracity of reporting. The Team also visited a cemetery in Aden where COVID-19 victims were buried. The interviews took place at the end of June 2020.

Umayma Al-Khader, a civilian activist in Lahij who was also previously infected with the virus, said “lack of awareness and denial [of the virus] led to an exponential spread of COVID-19.”

The Soufan Center’s reporting team visited the Radwan cemetery in Aden and spoke to a gravedigger who was burying the dead. He suggested “around 800 deaths” occurred during Ramadan which he attributed to COVID-19. While exact figures are unknown, one Facebook group, COVID19 victims in Yemen, is documenting the deaths attributed to COVID-19 across Yemen and points to a far higher death toll, which seems more likely given the lack of testing and the Houthis downplaying the significance of the virus.

The UN’s head of humanitarian operations in Yemen, Lise Grande, says that Yemen is facing a worst-case scenario. The death toll from the pandemic, in her view, could “exceed the combined toll of war, disease, and hunger over the last five years (in Yemen)” – a staggering figure.  A UN-commissioned report from the University of Denver estimates that there could ultimately be over 230,000 deaths during the duration of the COVID crisis.

The World’s Worst Humanitarian Disaster

The five year-long Saudi-led war in Yemen has decimated the country’s economy, healthcare infrastructure, and contributed to widespread malnutrition and massive cholera outbreaks. Over 112,000 people have died due to the conflict and the UN reports that 24 million people require some form of humanitarian assistance and 14.3 million are in acute need.

The conflict in Yemen has its roots in the Arab-Spring overthrow of Ali Abdullah Saleh, who then handed over power to Abdrabbuh Mansour Hadi. Amid chronic instability, the Houthi rebels took control of northern Saada and then the capital, Sana’a, in 2014. The conflict assumed a regional dimension when the Iran-backed Houthi militias took on the Saudi- and UAE-backed and internationally-recognized Hadi government for control of the country. Over time, the conflict has expanded to including multiple politically warring factions within the country, including the Southern Transitional Council, which wants the secession of southern Yemen, in Aden. Affiliates of Al-Qaeda and the Islamic State are also active in Yemen and regularly carry out attacks, including suicide bombings.

Saudi Arabia and its coalition are under increasing international pressure to end their involvement in the conflict, as Germany, Denmark, the Netherlands, Finland, Norway, and Austria have stopped selling arms to Riyadh after years of bombing innocent civilians. Yemen’s economy is also suffering because of the global oil crash and COVID-19. The Houthis currently control the capital Sana’a and the northwest of the country, while Hadi supporters control Marib, al-Jawf, northern Hadramawt, al-Mahra, Shebwa, Abyan and Taiz city. In April, the two sides agreed to a cease-fire, which quickly fell apart.  The ongoing conflict restrictsshipments of food and fuel from entering the country. For humanitarian organizations, the fighting makes the import of aid supplies exceptionally difficult.

Taken together, these political and socio-economic conditions already facing Yemenis put them in an even more compromised and dangerous position as COVID-19 spreads across the country.

COVID-19 Ravages Through Yemen 

As of 21 July, the Yemeni government has reported 1,629 cases, 456 deaths, and 741 recoveries from the virus. These figures fail to take into account the lack of testing across the country, including in the northern Houthi territories, which have largely failed to acknowledge COVID-19 cases.

Many specialist doctors have long fled from the conflict prior to the COVID-19 outbreak. In May, the UN reported that the country had just 675 intensive-care beds and 309 ventilators for a population of over 28 million.

“Yemen could fall off the cliff without financial support,” said the UN’s head of emergency response, Mark Lowcock, underscoring the fragility of the situation.

The reality in Aden and Lahij – the southern part of the country where fighting continues – is that aid agencies, already overwhelmed by the scale of Yemen’s war, health, and poverty crisis, are struggling to meaningfully address the COVID-19 crisis. Since the middle of April, 31 of 41 critical UN programs have reduced or closed due to a lack of funding.

Action Contre La Faim (Action against Hunger/ACF) is among the most active humanitarian agencies in southern Yemen. They are providing training to hospital staff, distributing information to the public, and providing essential services related to COVID-19, but they warned that more services were required to support the Yemeni people.

“Abyan and neighboring areas lack testing facilities…those living in remote areas face significant difficulties in getting tested, because they have to travel long distances and incur the expenses,” said Dr. Rana Abdullah, program manager for health and nutrition at ACF.

Some parts of the south have no access to humanitarian assistance at all. Dr. Abdullah noted that ACF has not been able to provide aid to Khaber Al Marakasha, located outside of Aden, since September 2019 because of the deteriorating security situation.

Health workers said they were forced to provide advice and services over WhatsApp given their inability to travel to rural areas because of security concerns and the risk of contracting the virus. According to the Economist, approximately 55 of Yemen’s 333 districts are without any doctors.

COVID-19 has also compounded the crisis for the country’s displaced persons, many of whom already suffer from or remain at risk of cholera, food shortages, and lack of basic education and health care. Ibrahim Awad Suleiman is the designated camp leader of a displaced persons camp in Aden, which has approximately 240 families. He told us that, since the state of the pandemic, food delivery had ceased.

Residents of Aden detailed their fears as the number of patients overwhelmed hospitals and doctors were unable to provide general care. “We have no access to face masks, soap, detergents, or any other hygiene products at all. You can see trash everywhere, at the gates and all around,” he said.

Another Aden resident said: “My close friend’s father had high blood pressure, so he went to the hospital to get checked out, but the medical staff panicked, and the hospital didn’t admit him.” He later passed away.

At the same time, prices of basic medical necessities in Yemen are spiraling. Sarah Chauvin, a humanitarian worker from Medicine du Monde, said “normally you buy a thermometer for 50 dollars, but now prices for one are nearly 600 dollars.”

The COVID-19 crisis has compounded the situation, especially as remittances to Yemen – largely coming from the Gulf states – have decreased by 80 percent over the first four months of 2020 as a result of job losses.

Five years of conflict in Yemen has effectively shattered its healthcare system, while the country experiences a cholera outbreak and the instability caused by millions of displaced persons. The COVID-19 crisis not only risks killing hundreds of thousands of Yemenis, but secondary impacts are likely to intensify as the virus spreads, including malnutrition rates among children and overall food insecurity, which already impacts more than 20 million people.

Reporting from Yemen by Qais Al Shaer and Naguib Saeed, Writing by James Blake