Yemen: Crisis update – 15 September 2015
13,376 war wounded have been treated by MSF teams since 19 March. 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.
MSF Emergency surgical hospital in Aden has started receiving an increased number of landmine & unexploded ordinance (UXO) victims, especially children (more than 35 cases since the second week of August)
We have been able to send in 390 tonnes of medical supplies and staff (including emergency medical teams) by sea and air, but more is needed.
A fuel blockade is still crippling the country. The standard price for fuel is 150YR/litre but it’s price on the black market varies between 450YR and 750YR. This places a huge strain on the general population for moving anywhere, and has caused an increase in food and water costs throughout the country, 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.
It remains extremely difficult to move within the country to assess the needs and deploy assistance, due to fighting and air-strikes.
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.
The situation in Taiz is tense with air-strikes and ground fighting between Houthis and southern resistance is heavier than ever. The frontlines are changing every day. MSF has not been able to supply its supported hospital of Al-Rawdah or hospitals on both. MSF is unable to get authorization to give medical supply to these hospitals. Health structures are under fire. Out of 20 major medical infrastructures in Taiz governorate, 16 are closed and the remaining hospitals are overloaded. And out of eight urban women and children health centres, six are totally closed and only one is functional but not running fully because of the lack of fuel.
In September, the Saudi led coalition targeted several locations in the capital Sana’a, one of which was the Central Security that is opposite to Al-Sabeen Hospital. The hospital was evacuated soon as the premises were affected. The patients were sent to other hospitals in the city. The main Blood Bank in Sana’a is located in Al-Sabeen Hospital. MSF donated 3,000 blood bags
MSF is running an Emergency Surgical Hospital in Sheikh Othman district, in the north of the city. Mass casualties due to fierce fighting, air raids and shelling have been frequent in July. Since the Southern Resistance forces supported by the Saudi-led coalition regained control of the town and the frontline moved northwards. 204 war wounded were received on 19 July, 167 on 25 July and 111 the next day. Since the beginning of 2015, MSF received 5,978 patients in the emergency room and performed more than 3,776 surgical interventions. Since 19 March, MSF received 5,522 war wounded. MSF is also providing mental health care and physiotherapy in the hospital. MSF has been receiving more patients from Lahj and Abyan governorates recently. Victims of landmines and unexploded ordnances have been increasing since early August MSF received more than 35 victims, mostly children.
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 1,232 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. 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 could not access MSF hospital. More than 1,220 war wounded have been provided surgical follow-up consultations and wound dressings.
MSF has been providing general consultations in mobile clinics for IDPs fleeing from several Yemeni areas. Since mid May 2015, more than 9,722 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 July.
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 until the end of August , MSF has received 20,459 patients in the emergency rooms, performed 1,888 surgeries, 1,597 deliveries, admitted more than 1,900 adult patients to the IPD and 1,949 children to the paediatric ward and neonatal unit, and provided more than 4,423 antenatal and postnatal consultations, and 1,478 gynaecological consultations in Amran governorate.
MSF has built 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. MSF is supporting the emergency rooms in Harf Sufyan, Al Ashah, Al Qaflah health centres. In August MSF received more than 1,784 patients in these health centers and referred nearly 100 of them to Al-Jumhori hospital in Sa’ada to recieve surgical care. MSF is supporting Huth and Khameer with four ambulances.
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 & MoH staff have performed 534 deliveries, received 2,366 patients in the emergency room, including 1,260 war wounded, and have seen 34 deaths upon arrival. MSF has also performed 370 surgeries, of which 311 were related to war. Support is also provided to Haydan hospital with medication and a referral system to Al Jumhori hospital. An MSF doctor is working in the ER where 2,030 patients were received between May and September 2015, of which 30% were suffering from conflict-related trauma. MSF has also donated 1,080 sessions for the Kidney Dialysis center at Al-Jumhori Hospital.
In Haradh, a total of 212 war wounded were treated by the MSF team jointly with the MoH team from Haradh hospital. Currently MSF is not working in Haradh. MSF team which evacuated Haradh is currently in Hodaida, where they have done a mass casualty training for staff at Al Olafi hospital. In Al-Jumhori Hospital in Hajja, MSF team (along with the MoH staff) have received 309 emergency cases, 163 of them were war wounded. MSF has also donated 720 sessions for the Kidney Dialysis center at the hospital.
In Beni Hassan, MSF is supporting IDPs with water provision (216,000 a day), 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. MSF received 123 emergency cases in Bani Hassan Center. Since early July, MSF 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 August, 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 in July and in August and showed an alarming increasing emergency rate of malnutrition.
In Abs Hospital, the ER is open with 24/7 presence of MoH staff supported by MSF staff. MSF started supporting the emergency room in Abs hospital on 8 July. So far it has received 639 emergency cases, 207 of whom war wounded
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 2,124 sessions. MSF is preparing to support this centre with these materials for three months.
MSF has been holding first aid and mass-casualty trainings for health staff working in local hospitals in Sana’a. MSF gave donations to local hospitals that received the victims of airstrikes in Sana’a in the second week of September. The main hospitals receiving the support are Al-Jumhori, Al-Thawra, the Police Hospital and Al-Kuwait hospital.
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. By the end of August 1,327 HIV patients have received ARV, 775 patients received drugs for opportunistic infections, 650 patients received laboratory reagents, and 300 patients have received mental health support.
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.. 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 1,681 war wounded people among them.
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 3,821 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 150-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 international staff and eight supporting local staff is on the ground to and carry out further needs assessments whenever necessary. MSF is working to get authorization for 150 beds to be sent to Taiz and to start equipping the hospitial. The hospital building that was identified is 5 km away from the center of the city.
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 1 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.”
Yareem Hospital support: MSF has supported Yareem Hospital with kits enough for 40 patients.
MSF has made donations of medical supplies to hospitals in Sana’a, Aden, Saadah, Abyan, Taiz and Lahj, Marib, Al-Baydha governorates since the start of the conflict.
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