Yemen: Crisis update – 23 December 2015
- 20,539 war wounded treated since March 19th by MSF teams
- More than790 tonnes of medical supplies have been sent by MSF so far.
- It remains extremely difficult to move within the country to assess the needs and deploy assistance, due to fighting and airstrikes.
- MSF is “managing” 11 Hospital/health centres, we also support regularly 18 health centers (HC), and provide urgent support to other HC to respond to specific needs or emergencies.
- MSF tented clinic in Houban, Taiz governorate was bombed by Saudi-led coalition on December, 2nd, that resulted the killing of one person and injured 8 other civilians.
- MSF facility in Haydan, Saada governorate was bombed on Oct. 26th. The Haydan hospital was the only remaining operational facility in the district, covering a population of nearly 20,000 people MSF is running another health facility in Saada governorate, the Al-Jumhori hospital in the main city of Sa’ada.
- MSF trucks are still unable to to deliver essential medical aid to two hospitals in a besieged enclave of the city of Taiz, in southern Yemen even after two months of negotiations with Houthis. The situation in Taiz is still tense with airstrikes, snipers and ground fighting between Houthis and Taiz resistance is being heavier than ever. News says that the Saudi-led coalition is deploying ground troops to Taiz to control it.
- Large civilian populations remain in towns and villages in Taiz where fighting is tense. Out of 20 major medical infrastructures in Taiz governorate, 14 are closed and the remaining hospitals are overloaded. 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. MSF started a project a new mother and child in one of the hospital, after we transferred a regular building into a hospital that contains; OPD/Emergency room, Reproductive Health activities and Nutrition, gradually increasing activities.
- Large civilian populations also remain in towns in Saada and north Amran governorates, near the Saudi border. Many health facilities have been damaged or destroyed, medical staff has fled, and transport is extremely challenging due to high fuel prices and insecurity on the roads.
- MSF Emergency surgical hospital in Aden is still treating victims of violence: war wounded referred from the frontline north of Aden, patients wounded during clashes among armed groups or in violent crimes and received 80 landmines & UXO victims since the second week of August until late November.
- A fuel blockade is still crippling the country. It’s worth mentioning that fuel is 24/7 available in the black market. The standard price for 20 litres of fuel is 3000YR but its price in the black market varies between 9000YR and 15000YR. 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 & have no longer any means of transport to access healthcare.
Total of 2,102 staff working in the country: 97 international staff and 2,005 Yemeni staff. In Yemen, MSF is working in Aden, Al-Dhale’, Taiz, Saada, Amran, Hajjah, Ibb and Sana’a governorates.
MSF is running an Emergency Surgical Hospital in Sheikh Othman district, in the north of the city. The Southern Resistance forces were supported by the Saudi-led coalition to gain control of the town. The frontline moved northwards. Since the beginning of 2015, MSF and performed more than 5,148 surgical interventions. Since 19th March, MSF received 7074 war wounded of whom 438 were women, 419 were children under 12 years old and 624 were children between 12 & 18 years old. 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 80 victims, mostly children, the number is increasing everyday
In Lahj, MSF supported Ibn Khaldoun hospital in August with medical supply to restart the emergency services. Mid-December, MSF started providing the hospital with medical supply donations.
In December, MSF donated drugs to the polyclinic located in Crater district, the Emergency Center in, Mu'alla district and the General Clinic in Towahi district. MSF also provided with medications the polyclinics in Sheikh Othman, Bureiqa, Dar Saad and Al-Mimdara districts.
As the situation in North Amran governorate is relatively calm, many people fleeing from several Yemen in areas are taking refuge there. MSF has been providing general consultations in mobile clinics for IDPs.
Since mid-May 2015, more than 17,821, 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 was given to the MoH in a measles vaccination campaign in Khamer in July.
In Al-Salam hospital Ministery of Health (MoH), MSF is actively supporting life-saving and healthcare services and also supporting the Huth health centre with medication, oxygen, logistic equipment, , electricity, human resources and a referral system. Since 1 January until the end of November, MSF has received 34,649 patients in the emergency rooms (more than 1,017 are war wounded), performed 2,750 surgeries, 2,575 deliveries, admitted 3,224 adult patients to the IPD and 2,497 children to the paediatric ward and neonatal unit, and provided 5,505 antenatal and postnatal consultations. More than 450 children with severe acute malnutrition were admitted/ treated in Al-Salam hospital.
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 Khamer and Sa’ada city. In July, MSF set-up in North Amran governorate, a reference system from three peripheral health centres. MSF is also supporting the emergency rooms in Harf Sufyan, Al Ashah, Al Qaflah health centres with medications and cover the costs of referring the patients to its hospitals (Al-Salam, Al-Jumhori or Huth health center) according to the patients’ conditions. MSF provides logistic support to these centers when necessary. In August, MSF received 6,898 patients in these health centers and referred more than 348 of them to Al-Jumhori hospital in Sa’ada to receive surgical care. MSF is supporting Huth and Khameer with 4 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 like Shiara Medical center, in September 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 mid-May, MSF have been supporting the ER, OT and maternity departments of Al Jumhori hospital in Saada city. MSF team Works along with the MOH staff.
Since mid-May, a total of 6186 patients have been admitted in the Emergency room, 2046 of them being war wounded. 1284 surgical procedures were performed, 1055 being were trauma. In the maternity services 1728 deliveries have been performed. 1393 patients were admitted in the in-patient department. MSF has also donated 1772 sessions for the Kidney Dialysis center at Al-Jumhori Hospital in Saada. In November 72 patients were under dialysis treatment.
MSF started supporting Haydan health center since mid-May 2015, unfortunately this centre was destroyed in a Saudi-led coalition airstrike on October 26th. The health center was providing medication and a referral system to Al-Jumhori hospital. An MSF doctor was working in the ER where more than 3200 patients received treatment in the center between May and October 2015, of which 30% were suffering from conflict-related trauma.
In November 2015, MSF started the Emergency Room of Shiara hospital in Razeh district, and the referral System from Razeh to Saada Al Jamhoory Hospital.
In Hajjah city, in Al-Jamoorhi hospital, since the opening of the program in August until the end of November a total of 3772 patients arrived into the Emergency Room, 1991 of them being trauma cases, 1003 were medical cases, 428 pediatric cases, 572 of them were war wounded. MSF donated 1020 sessions for 30 patients to the Kidney Dialysis Center in the hospital.
From May to July in Bani Hassan district, MSF has provided 5,523 general consultations at its mobile clinics and the health centre in the district.
MSF is supplying drinking water to 16,000 people in Beni Hassan area, by installing bladders and regularly supplying water to meet minimum humanitarian standards in IDP camps in Alkhadima, Okeishia, Bidah, Monjoura, Sheba Dosh, Shebatulmal,and Al Mehsam. A minimum of 15 to 20 litres per person per day is distributed through a water trucking system. MSF plans to adjust the quantity of water supply to cover the needs of the recent arrivals of IDPs.
MSF, also-did a Non-food Items (NFIs) distribution for 805 families in June 2015 as well as 30 NFI kit distribution in Nov,2015 to newly arrived families in Beni Kodish & Akasha and Beni Hassan (Al bidah) and Shebatulmal.
In July, following an airstrike on Aahem market, 68 civilians wounded were stabilised at the Beni Hassan health centre supported by MSF and referred to the Hajjah and Hodeida hospitals. Then, MSF moved from Beni Hassam Health center to Abs hopsital in July to extend its suport to the IDPs and the general population.
In Abs hospital, since the opening of the program in July a total of 2926 emergency cases were seen in the ER, 130 of them were admitted in the hospital and 317 were referred to Hajjah and Hodeida hospitals. 208 of them were war wounded. In November 2015, MSF started to support the maternity and the OT which is run by an international team.
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 1426 injured benefited 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.
Since October, MSF has been supporting the ER of Al-Kuwait hospital by regular drugs supply and kits for mass-casualty. MSF also provided mass casualty training for more than 130 medical staff in the hospital. In October, MSF expat ortho surgeon, anesthesia doctor were working in the hospital to support the OT medical team in October. MSF expat ER nurse and special emergency doctor worked in October in the hospital for the re-organization of the emergency set up in the hospital and set the mass-casualty plan for the hospital. MSF donated 3000 blood bags to the National Blood Bank that was affeced by an airstrike that hit the Centeral Security, 200 meter away from the Hospital.
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. In Sanaa, in September, kits for covering 50 war wounded in ER, Ot and IPD were given to each of the 5 following hospitals in Sanaa: Yemeni German Hospital, 22nd of May Teaching Hospital, Omarah hospital, Mohamed Al Durrah Hospital, Sheikh Zayed maternity hospital. MSF donated dialysis session materials to the Kidney Centre at the Al-Jumhori hospital in Sana’a to cover more than 4022 sessions. 152 patients are benefiting from these donations.
MSF is also supporting Al Sabeen mother and child hospital in Sanaa with medical supplies and logistical support.
In Al Dhale governorate MSF is supporting health facilities in Al Dhale, Qatabah and Al Azarik.
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, in patient care, sterilization, infection control, health care waste management and referrals. Furthermore, MSF admitted 1793 inpatients and performed 531 surgical procedures. Following security incidents, activities in Al Dhale hospital were suspended for four weeks in October and resumed in November.
In addition, MSF is supporting Thee Jalal Health Center (Al-Azarik district) in the emergency room, OPD, obstetric care, nutrition and referrals to Al-Nasser Hospital.
In Qatabba, MSF supports the emergency room (24/7), observation room, the outpatient department nutrition, and stabilisation and referrals of war wounded brought in from the governorate border frontlines in the MOH Al-Salam Health Clinic (PHC).
Until the end of November 2015, MSF has treated 55917 patients through emergency and outpatient services. Amongst them, 2319 presenting with violence related injuries.
Since the beginning of May 2015 till August 2015, MSF had been providing emergency medications and surgical supplies – before the besiege of the Taiz city intensified - to Al-Jumhouri, Al-Thawrah, Al-Rawdah, Military and Al-Qa’idah hospitals that have been receiving people affected by violence in the recent and ongoing conflict. Moreover, MSF setup and equipped three extra ER rooms at Al-Rawdah hospital to allow extra space for handling mass casualties. Since 15th May 2015 Al-Rawdah hospital has received a total of 12,800 ER consultations till mid-November 2015, of which 4,549 were war wounded patients including 15 women. From mid-August 2015, MSF increased the incentive support to cover a total of 150 hospital staff till end of November 2015 before reducing the support to only ER. In October MSF started to support the Al Resalah hospital in Taiz with incentives for 32 staff and provision of supplies. From 01 November 2015, MSF started also to support the Emergency Room (ER) in Al-Thawrah Teaching Hospital with incentives for 32 staff and the hospital saw a total of 1,003 ER consultations with a total of 758 were violence-related. MSF has doctors and nurses working in 4 hospitals in Taiz and is covering the salaries of about 214 medical staff who work in the Emergency Room and surgery. MSF provides a hospital-to-hospital referral system using two ambulances as a start.
In 25 October, Despite weeks of intense negotiations with Houthi officials, MSF was blocked from delivering stocks of essential medical supplies to two hospitals in a besieged enclave of the city of Taiz, in southern Yemen. MSF’s trucks have been stopped at Houthi’s checkpoints and denied access to the area. The hospitals in this besieged area are seeing large number of patients with war wounds. We have been prevented from delivering essential medical supplies since August 24th. Supplies include; chest tubes, anaesthetic drugs, IV fluid, sutures and antibiotics – to help staff provide lifesaving surgery.
In November MSF opened a new hospital in Taiz to provide Mother and Child Healthcare services, with a planned 100-bed capacity for obstetrics and gynecology and pediatrics focusing on children under five years of age. We received our first patient on November 7th. At the moment the emergency room (ER), Antenatal Care (ANC), Postnatal Care (PNC), Family planning (FP), Ambulatory Therapeutic Feeding Centre (ATFC) and Outpatient Department (OPD) are up and running. By mid-December 2015, the facility treated 5,295 patients in the OPD, 995 ANC, 3 PNC, and 80 ATFC and did 92 dressings in the ER. MSF current employs a total of 110 MSF national staff in Taiz.
In late October MSF teams started a malnutrition screening for 2269 children in the besieged area in Taiz. Some pockets of children in specific parts of the neighborhood had high malnutrition rates, but the overall the situation in the area we screened was not alarming. MSF also did distributions of food and non-food items (including floor, sugar, oil, buckets, mosquito nets, blankets, etc) to 273 displaced families in one of Taiz neighborhoods in November 2015.
MSF has donated medical and surgical materials to Al-Thawra and Al-Qa’idah hospitals in Ibb Governorate. In July 2015, MSF is also did a one-off donations of food supplies to centralized kitchens of IDPs who are based in eight schools hosting a total of 179 households in Al-Qa’idah city of Ibb Governorate. In September, MSF donated to Yareem Hospital and Al Thawra Hospital, kit for 40 wounded were given to each hospital.
Medical Donations: 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. Beside the 400 tonnes MSF brought into the country, MSF did purchase another 21 tons of Medical supply locally. Dialysis supply counts for 14 tons and 3650 liters of oxygen was given to various hospital.
MSF took over the management of the ER in Al Thawara referral hospital along with a Distribution of NFI for displaced people.
Two cyclones in one week hit the southeast coast of Yemen early November and did major damage. Hundreds of families have lost their homes in Hadramaut. In Moukalla, the main city of the governorate, small houses have not withstood the tornado, torrents of water spilled into the city and destroyed bridges and infrastructures.
MSF has set up a mobile clinic in Mukalla city. A doctor and a nurse provided more than 300 consultations. MSF has also identified water needs. MSF also provided 430 families with water tanks.
Water tanks were set up in Boroom-Mayfaa district and provided water trucking 230 displaced families. Drinking water was also distributed, in addition to hygiene kits. On November 20, MSF assisted further 170 internally displaced families with food and non-food items, namely blankets, jerry cans, kitchen sets and hygiene kits. The team distributed as well mosquito nets and provided more than 100 000 liters of water to internally displaced persons.
MENTAL HEALTH ACTIVITIES
In November, MSF started mental health activities in Abs, Saada and Sanaa - Al Jamhoory hospital. The Mental Health activities provided individual and group sessions. 205 people attended individual counselling sessions and 2610 people in psychological and social education group’s sessions.
Since 2010, a 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.
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