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Crisis update – 6 August 2015

Overview

In Yemen, MSF is working in Aden, Al-Dhale’, Taiz, Sa’ada, Amran, Hajjah, Ibb and Sana’a.

  • In terms of access for humanitarian aid to Yemen, we have been able to send in staff and supplies by sea and air, but more is needed.
  • 165 tonnes of medical supplies have been sent by MSF so far.
  • We also managed to send in emergency surgical teams.
  • Over 10,500 war wounded treated since 19 March by MSF teams
  • It remains extremely difficult to move within the country to assess the needs and deploy assistance, due to fighting and airstrikes.
  • A fuel blockade is crippling the country.  Huge strain on the general population for moving anywhere, increase in food costs throughout the country, huge increase in water costs, and hospitals have inadequate provision of diesel to keep their generators running.  Sana’a remains without city power consistently since early April.  Populations who do not live in direct proximity to health structures no longer have any means of transport to access healthcare.
  • Large civilian populations remain in towns and villages in Sa’ada and north Amran governorates, near the Saudi border. Many health facilities have been damaged or destroyed, medical staff have fled, and transport is extremely challenging due to high fuel prices and insecurity on the roads.
  • Support has been provided to some 23,000 internally displaced people (IDPs) in Amran and Hajjah governorates. Activities include general medical consultations, water provision and sanitation, and distribution of non-food items and hygiene kits.
  • Out of 20 major medical infrastructures in Taiz governorate, 15 are closed and the remaining hospitals are overloaded. And out of eight urban women and children health centers, six are totally closed and only one is functional but not running fully because of the lack of fuel.
  • On 20 July, in Al-Dhale governorate airstrikes from early morning until mid-day targeted a school, a gas station and a playground. The Emergency Room in the MSF supported hospital received 14 civilians, among them a child dead on arrival to the hospital.

Per-project updates Total of 790 staff working in the country: 64 international staff and 726 Yemeni staff.

Aden

MSF is running an Emergency Surgical Hospital in Sheikh Othman district, in the north of the city. Mass casualties have been frequent in July.  204 war wounded were received on 19 July, 167 on 25 July and 111 the next day. Since the beginning of 2015, MSF received more than 4,767 patients in the emergency room and performed more than 2,760 surgical interventions. Since 19 March, MSF received more than 4,271 war wounded. MSF is also providing mental health care and physiotherapy in the hospital.

In the south of the city, MSF started on 20 April running an advanced emergency post. In the Crater Health Center, MSF staff is working 24/7 providing trauma care, medication and fuel for the power generator. More than 745 wounded patients have been received in the emergency room. Out of these, 215 have been referred to other hospitals for further treatment after initial stabilization. More than 635 wound dressings and patient follow-up consultations have been done in the advanced emergency post.

In May, MSF started outpatient surgical mobile clinics in Enma and later in As-Sha’b district to  provide outpatient care to surgical patients who cannot access MSF hospital. More than 570 war wounded have been provided surgical follow-up consultations and wound dressings.

Amran

MSF has been providing general consultations in mobile clinics for IDPs fleeing from several Yemeni areas. Since late April 2015, more than 5,000 general consultations have been provided. In addition, MSF has provided support in several IDP locations. The support included providing water tanks, non-food items and hygiene kits for more than 500 IDP families located in 20 locations in Khamer. Activities also included health promotion among IDPs and cleaning the sewage system in the central market of Khamer. Support is being given to the MoH in a measles vaccination campaign in Khamer.

In Al-Salam hospital (MoH), MSF is actively supporting life-saving and healthcare services for the patients in various departments. MSF is also supporting the Huth health centre with medication, oxygen, logistic equipment, human resources support, electricity and a referral system.

Since 1 January, MSF has received 20,015 patients in the emergency rooms, performed 1,642 surgeries, 1,343 deliveries, admitted 1,492 adult patients to the IPD and 1,643 children to the paediatric ward and neonatal unit, and provided more than 4,048 antenatal and postnatal consultations, and 1,478 gynaecological consultations in Amran governorate.

MSF is also building a network of advanced medical posts in northern Amran and Sa’ada governorates setting up emergency rooms in local health centres, providing medical supplies and training in emergency care and the management of mass casualties, repairing and improving damaged structures, and running ambulance systems to surgical hospitals in Khameer and Sa’ada city.

In July MSF set-up in North Amran governorate a reference system from three peripheral health centres (Harf Sufyan, Al Ashah, Al Qaflah) to the MSF-supported structures in Huth and Khameer with four ambulances.

Sa’ada

Large civilian populations remain in towns and villages in Sa’ada and north Amran governorates, near the Saudi border, despite daily airstrikes and significant destruction of infrastructure in the region. Many health facilities have been damaged or destroyed, medical staff have fled, and transport is extremely challenging due to high fuel prices and insecurity on the roads, which also receive daily airstrikes.  A need was identified to improve access to lifesaving care for those who live at a distance from the main referral centres. 

Since May, MSF has been supporting the ER, OT and maternity departments of Al Jumhori hospital in Sa'ada city. MSF teams (along with the MoH staff) have performed 359 deliveries, received 1,961 patients in the emergency room, including 869 war wounded, and have seen 34 deaths upon arrival. MSF has also performed 266 surgeries, of which 224 were related to war. Support is also provided to Haydan hospital with a doctor, medication and a referral system to Al Jumhori hospital. Haydan has seen 1,500 patients in its emergency room since May 2015, of which 30% were suffering from conflict-related trauma.

Hajjah

In Haradh, a total of 145 war wounded were treated by the MSF team jointly with the MoH team from Haradh hospital.

In Beni Hassan, MSF is supporting IDPs with water provision, non-food items distributions and general medical consultations in Bani Hassan district. MSF has provided 5,523 general consultations at its mobile clinics and the health centre in the district.

In July, 68 wounded coming from an airstrike in Aahem were stabilised at the Beni Hassan health centre supported by MSF and referred to the Hajjah and Hodeida hospitals. As many of the wounded were referred to Al Jamhoory hospital, a donation for 100 war wounded was made at this hospital.

Since May, MSF has done door-to-door identification of the IDPs in Beni Hassan in order to identify their needs and provide basic services in Al Mangorah, AlKhademah, Bani Kodish and Akasah. Since early July, the community health teams have identified a total of 2,101 families and 8,149 individuals in four locations - Al Khadmah, Al Okashiah, Shab-Al-Dosh and Al Manjorah. Non-food items were distributed to 805 families. By the end of July, the total number of displaced was around 20,000, of which 16,500 were in Beni Hassan and 3,500 in Khamis.

MUAC screening was performed in these IDP sites and showed an alarming rate of malnutrition.

In Abs Hospital, the ER is open with a 24-hour presence of MoH staff supported by MSF staff.

 MSF started supporting the emergency room in Abs hospital on 8 July. So far it has more than 134 emergency cases, with a total of 34 war wounded.

Sana'a

Since 26 March 2015, MSF has focused its support on the main hospitals in Sana’a, especially Al-Gomhoury and Al-Thawra hospitals which are receiving the majority of the wounded people from Sana’a and the rest of the country. More than 700 injured were benefiting from the MSF kits.

Support in Sana’a is not only first-aid dressing items but also surgery and post-surgery materials, along with some blood transfusion and admission required items. MSF also implemented the strategy of putting prepositioned materials in the hospitals in order to be used in case we couldn’t reach the hospital in time with the supplies. Kits for covering 180 war wounded in the emergency room were given to these two hospitals in late July.

MSF donated dialysis session materials to the Kidney Centre at the Al-Jumhori hospital in Sana’a to cover more than 1,500 sessions. MSF is preparing to support this centre with these materials for three months.

HIV Project

Since 2010, an project to provide support to HIV+ patients has running in several locations across the country. In March 2015, the project launched a contingency plan to provide ARV drugs, services and psychological support to patients in the whole country. So far 1,327 HIV patients have received ARV, 775 patients received drugs for opportunistic infections, 546 patients received laboratory reagents, and 202 patients have received mental health support.

Al-Dhale’

MSF provides life-saving healthcare services in the Ministry of Health (MOH) Al-Nasser Hospital in Al-Dhale district, in southwestern Yemen. The support includes emergency room (24/7), surgery, post-operative care, sterilization, laboratory, infection control, health care waste management and referrals.

In addition, MSF is supporting Al-Azarik Health Center in the emergency room, ante-natal care, post-natal care, family planning, normal deliveries, routine vaccination, nutrition and referrals to Al-Nasser Hospital. The number of surgeries performed in Al-Azarik was 287. In Qataba, MSF supports the emergency room (24/7), observation room, laboratory and health care waste management in the MOH Al-Salam Hospital.

In the last few months, MSF expanded its activities by supporting the outpatient department, nutrition and ante-natal care. MSF also provides potable water to 25,000 people through the unique suitable borehole of Qataba town.

MSF is also supporting several health centers in Al-Jaffea and Al-Habilain hospitals with medical supplies and equipment in the governorate.

Since the beginning of the recent crisis in March, 2015, MSF projects in Al-Dhale’ have received 29,049 patients in the emergency room, with more than 1,560 war wounded people among them.

Taiz

Since the beginning of May 2015, MSF has been providing emergency medications and surgical supplies to Al-Jumhori, Al-Thawra, Al-Rawdah, Military and Al-Qa’idah hospitals that have been receiving people affected by violence in the recent and ongoing conflict. During the period, MSF setup and equipped three extra ER rooms at Al-Rawdah hospital to allow extra space for handling mass casualties while continuing supporting the hospital’s ER with supplies and staffing.  MSF has four medical doctors and one nurse working in the emergency room of Al-Rawdah hospital, besides covering the salaries of 27 hospital staff members who are working in the emergency rooms to ensure a 24/7 presence. Since 15 May 2015 Al-Rawdah hospital has received a total of 2,487 war wounded patients, of which 308 died, including 15 women. MSF also plans to provide a hospital-to-hospital referral system with starting with two ambulances, to be increased depending on the need. 

Given the assessed needs, MSF started setting an up office in Taiz in June 2015 to ensure continued support during this crisis period.  MSF also planned to setup a Mother and Child Healthcare hospital, aiming at 100-bed capacity for obstetrics and gynecology and pediatrics focusing on children under five years of age. A building has been identified for the planned hospital. An MSF team consisting of four expats and eight supporting local staff is on the ground to support and carry out further needs assessments whenever necessary.

Ibb

MSF has donated medical and surgical materials to Al-Thawra and Al-Qa’idah hospitals in Ibb Governorate. MSF is also considering one-off donations of food supplies to centralized kitchens of IDPs who are based in seven schools in Al-Qa’idah city in Ibb Governorate. On 01 June 2015, MSF helped the Ministry of Health to evacuate 509,800 vaccine doses meant for routine immunization, from the Governorate Health Office, which is located at the war’s front-line and to relocate them to Ibb cold-chain. However, the donation was a ‘drop in the ocean’ and more support is still needed, especially for those IDPs hosted outside of the schools.”

The team which evacuated Haradh is currently in Hudeidah, where they are doing a mass casualty training for staff at Al Olafi hospital. MSF is also doing water trucking for two IDP camps around 30km South of Haradh, where there are around 3,000 people.

MSF has also been assessing the needs in Saadah governorate and (OCP) plans to start supporting Haydan hospital.

Medical Donations
MSF has made donations of medical supplies to hospitals in Sana’a, Aden, Saadah, Abyan, Taiz and Lahj governorates since the start of the conflict.

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