Overview

The population is suffering enormously. Violence and insecurity are affecting them on a daily basis. Access to healthcare, food, water and fuel is problematic. Hospitals are in need of more medical supplies beyond what ICRC & MSF can provide. People are traumatized due to the bombardment and fighting, and their lives are made harder by the economic pressure and increase in prices.

• 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.
• In Taiz a fuel depot was hit on the 25th of May by the bombing, over 200 burned people were transferred to one of the MSF supported hospitals..
• Saada update: city deserted and widely affected by bombings before the truce. During last days of the truce, more people on the streets were getting supplies.
• Around 100 tonnes of medical supplies have been sent by MSF so far.
• We also managed to send in emergency surgical teams.
• Over 1,700 war wounded treated since March 19th by MSF teams (1,110Aden & 251 in The MSF supported Advanced Emergency Post in Crater, Aden, 41 Khamer, 82 Haradh, Amran, 465 Ad-Dhale)
• It remains extremely difficult to move within the country to assess the needs and deploy assistance, due to fighting and airstrikes.
• 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 hopspitals have inadequate provision of diesel to keep their generators running.  Difficult to quantify which hospitals have closed and which remain operational.  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.
• In Aden fighting, attacks on ambulances, snipers and road blocks, make it difficult for patients to come to the hospital. The number of wounded we are receiving has dropped, despite the intensity of fighting. (see Aden below for more details).
• MSF has treated wounded from airstrikes in Amran, Ad-Dhale, Taiz, and Hajjah governorates, and has donated medical supplies to hospitals in Sana’a receiving wounded from airstrikes.

Per-project updates

Aden

Clashes continue in the southern city of Aden where MSF is running its Emergency Surgical Unit. There are continued street battles as well as shelling from the ground, air and sea in some areas. There have been electricity, water and fuel shortages in the city and communications networks are often down.

MSF Emergency Surgical Hospital:

Since March 19th MSF has received more than 1,100 and Injured at the hospital we received more than 550 injured between March 19 and March 31. However, since the beginning of April, the number of patients has decreased to around 10-15 per day, despite the clashes continuing and increasing in some areas, pointing to difficulties in access to the hospital.

Difficulties in accessing the hospital are caused by blockages to roads, movement being very risky due to fighting and snipers, and ambulances having been attacked and hijacked. 7 MoH ambulances have gone missing by the beginning of April. 2 Yemeni Red Crescent volunteers were killed on Friday 3rd April while in an ambulance. Our staff is still finding difficulties going to and from the hospital, and we have some staff who have been living at the hospital.

We are working with all parties to ask them to respect the hospital, ambulances and medical staff, and to allow unhindered access to the hospital for patients. MSF has sent out a number of local communications to express concern over the lack of access for patients to the hospital and to call for respect for ambulances, health workers and patients. We have also been using social media to ask for the respect of ambulances, health workers and medical structures, so patients can access treatment.

Advanced Emergency Post, Crater

The Advanced Emergency Post in Crater, which was started on 20 April and has now received 251 injured, including 64 who were referred to our hospital in Aden.

Activities at the AEP were stopped for 4 days in early May because of heavy clashes and most people moved out of the district during this time.

We still have difficulties to regularly reach the center for pharmacy and logistic supplies support to the team stationed there.

Mobile Clinics

Additionally, in order to provide outpatient care (physio, dressings, medical follow-up) to surgical patients that have difficulty accessing the hospital due to security, mobile clinics have been started in Enma and Ashaab since 19^th May. They are also intended to increase our proximity to IDPs in order to better understand the context and their needs. The first clinic in Enma was on 19^th May and received 14 dressing cases with the second clinic on 21 May received 20 dressing cases.

Ad-Dhale

Since March 19^th Qataba and Al Nasser hospitals have received 465 war wounded patients.

Since early May, there are some issues with access to healthcare especially from more violent areas, especially for wounded cases.   All private hospitals in Ad-Dhale are closed, but not much patients are coming for non-wounded cases. Around 60% of the population is moved outside of Ad-Dhale, but still with the rest of the population we don’t know where they are going for other illnesses,

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

Referrals between Ad-Dhale and other hospitals, including the MSF hospital in Aden, remain extremely difficult.

Sanaa

There are serious shortages of fuel and prices are increasing. People continue to leave the city.  The fuel crisis continues to the extent that some hospitals cannot operate any longer.

Our teams are still alert and monitoring the needs. They are in touch with the MoH and hospitals in the city. We are providing ER and OT supplies as well as dialysis drugs and materials to cover 500 sessions at Al Jumhoori hospital, in Sana'a.

MSF is providing medical support, health education and psychological support to the IDPs from Faj Attan explosion on April 20^th, Nogom explosion on May 11^th and Central Security explosion on May 26^th and to other IDPs from Sa’da too. MSF has provided 58 hygiene kits to 70 families on week 21.

The regular HIV project in Sana'a shifted to a contingency plan of distribution of drugs to make sure that people living with HIV enrolled on the programme in Sana’a have access to ARVs, with stocks available for the coming two months.

Amran

Al-Salam Hospital, Khamer

MSF is running Al-Salam Hospital in Khamer in collaboration with MoH. MSF is actively supporting lifesaving and healthcare services to the patients in 12 departments of the MoH Al-Salam Hospital in the sections of emergency room, intensive care unit, surgical operations, pediatrics and in-patient therapeutic center, hospitalization, neonatal unit, delivery room, antenatal care, blood bank, laboratory, vaccination and the dressing room. MSF is also supporting Huth Health Center with medications, oxygen, logistic equipment, human resource support, electricity and referral system.

Activity at the hospital has increased, and the team has doubled the number of beds for paediatrics and female wards at the hospital. Over the last 2 weeks, the number of ER cases have risen by 100%. Bed occupancy rate is currently 95% for male and 105% for female. Number of malnutrition admissions has increased by 150%. However, patients MSF used to receive from the most vulnerable part of the governorate (Al Ashah, Al Qaflah) are coming in very few numbers to the hospital, and we may need to be more proactive to reach them.

IDP Support, Khamer

There has been a massive influx of IDPs from the north of Amran and Saadah seeking refuge in Khamer, which has been safe, especially after 8^th May. IDPs before this date were mostly among the host community, but since then many new IDPs have been staying at schools and in tents. According to the district authority, more than 2,400 IDP families have arrived in Khamer alone. MSF is seeing more IDPs in Amran governorate as it’s one of a few districts in Amran that was not targeted by airstrikes. IDPs living in tents are in dire need for food and proper shelter.  Their situation gets worse when there is rain.

MSF started providing general consultations in mobile clinics for IDPs in Khamer. 1,235 consultations have been provided so far in 8 locations in Khamer. Additional support has been provided in several IDPs locations, including provision of water, NFIs and hygiene kits for more than 500 IDP families located in 12 locations in Khamer. The IDP support activities also included health promotion among IDPs by 2 CHWs and cleaning the sewage system in the Central Market of Khamer.

As of 20 May, MSF distributed more than 120,000 litres of water in Khamer. MSF handed over this activity to Oxfam on May 21^st.

Haradh Town in Hajjah governorate north of Yemen

MSF is supporting IDPs with water, non-food items distributions (805 kits distributed during 4 days to 805 house holds) and general medical consultations (655 consultations last week)  in the Health Center of Bani Hashim district. ER working 24 hours since May 18^th. MSF also provided emergency and life-saving services for injured in Haradh Hospital.

The team has been supporting Haradh hospital in the emergency room and the OT, and providing fuel and water, although it has been forced to evacuate several times.

Sa’da

MSF is supporting the ER, OT, IPD and maternity departments of Al Jumhuri hospital in Sa'ada town with an international and national medical team. Mass casualty plan has been revised. In the Emergency Room, 269 consultations during last week with 44 cases of war wounded. 17 surgeries performed last week. MSF is also supporting Haidan Health Center with a doctor, referral system and medications and is planning further support for the facility.

MSF is now supporting Haydan Hospital with ER, referral system and medications. The 4-bed ER has been cleaned and equipped. The pharmacy unit was set up and the sterilization unit was installed with autoclave. ER activity started on 17^th May.

The town of Haidan has been targeted by airstrikes. MSF witnessed several airstrikes. One of the airstrikes was 150 meters away from the MSF supported hospital.

Ambulance service started on 18^th May. Referral of patients takes place to Al Jumhori Hospital in Saada which MSF is supporting.

Assessment is also taking place for the IDPs situation in the governorate, and the possibility of setting up advanced stabilization posts.

Taiz

MSF has provided material support, emergency medications and surgical supplies to Al-Jumhori and Al-Rawdah hospitals that have received people affected by violence in the recent and ongoing conflict.  An MSF team is on the ground assessing further support required.

In Taiz, 12 hospitals are closed due to the lack of fuel and the number of wounded people has increased due to the heavy clashes in the area.

Other Areas

The team which evacuated Haradh is currently in Hudeidah, where they are doing a mass casualty training for staff at Al Olafi hospital. We are 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 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.