- We have put on hold the admission of all patients to Al Sadaqah hospital in Aden following the kidnapping and killing of a patient.
- The latest incident follow a series of threats and security incidents involving patients and staff.
- We are very worried about the deteriorating security situation during an extremely busy period for the hospital.
On the morning of 2 April 2019, a group of armed men threatened guards and medical staff at Médecins Sans Frontières’ (MSF) emergency trauma hospital in Aden, Yemen before entering the building and kidnapping a patient who had been admitted the previous day and was due to undergo surgery. Later the same day, the patient was found dead on a street in the city’s Al Mansoura district.
This incident follows a number of threats and security incidents, involving both patients and staff, which have occurred since the start of the year at our hospital in Aden. It comes at a time when the hospital is particularly busy as a result of escalating violence in Aden.
We are extremely worried by the deteriorating security situation inside Aden and its consequences for our medical activities.Caroline Seguin, MSF’s programme manager for Yemen
“Following this incident, we have no choice but to suspend the admission of patients until further notice,” says Caroline Seguin, MSF’s programme manager for Yemen. “Over recent weeks, the hospital has been functioning at full capacity, particularly the emergency room and intensive care unit, following an escalation of violence in the city.”
“This suspension comes at a critical time for patients and their families from Aden, as well as patients from Hodeidah and Taiz governorates, from where we receive war-wounded in need of urgent surgical care on a daily basis,” says Seguin. “We are extremely worried by the deteriorating security situation inside Aden and its consequences for our medical activities, as incidents like these endanger the lives of both patients and staff.”
MSF teams have been working in Al Sadaqah hospital in Aden since 2012. Since then, they have provided more than 30,000 emergency consultations to patients coming from various regions affected by fighting, including Abyan, Taiz and Hodeidah governorates.
Yemen: Seven years in the life of our trauma hospital in Aden
Médecins Sans Frontières has maintained a constant presence in Yemen since 2007. Following an uprising in 2011, inspired by the Arab Spring revolutions in Tunisia and Egypt, we started working in the south of Yemen. Teams worked in Taiz and Ad Dhale to treat people injured during demonstrations and supported the emergency rooms of Razi hospital in Abyan governorate.
In April 2012, we opened our trauma hospital in Aden. During the war, this facility has remained one of the few functioning hospitals in the city. Dr. Fares has been performing surgeries at the trauma hospital in Aden since 2012, when he joined MSF. He told us the story of this hospital coping with conflict.
MSF opens trauma hospital in Aden
MSF opened its hospital for trauma and emergency surgery inside Al Sadaqah hospital complex in Aden. Since its opening, more than 30,000 emergency consultations have been provided here. At that time, we treated patients with open fractures, burn injuries, or wounded by gunshot and explosives. There was only one operating theatre, a small intensive care unit, no laboratory and no orthopaedic surgeon. We were not specialized, but patients forced us to learn.
Takeover of Sana'a
Ansar Allah troops, allied with former President Ali Abdallah Saleh, took control of Sana’a, the capital of Yemen. That year, we performed 91,000 outpatient consultations and 4,300 surgical interventions in five health facilities across the country.
26 March to 23 July 2015 - An urban war
We saw Aden changing and turning into an urban battlefield, with fighting raging inside the city. During this period, our hospital was one of the very few surgical facilities still functioning in Aden, and teams mainly treated war-wounded people. So, between March and July 2015, we treated more than 2,800 war-wounded at the hospital. Staff and medical supplies were sent by boat from Djibouti to Aden, and later by plane. In July, I remember that an MSF boat was targeted by snipers at the entrance of Aden port, fortunately with no casualties.
25 Mar 2015
The battle for Aden
Ansar Allah forces with the help of Saleh loyalists took over Aden’s airport. The battle for Aden began between them, against southern movement militias, the Yemeni army and forces loyal to current President Abdrabbo Mansour Hadi, elected in 2012.
26 Mar 2015
"The day everything changed"
The Saudi and Emirati-led coalition launched an aerial bombing campaign to push back Ansar Allah forces. On that day, MSF teams in Aden hospital received and treated more than 100 wounded. I remember there was no proper triage to deal with this huge number of injured people, but we started somehow classifying cases depending on the severity of their condition. We worked night and day.
Limited healthcare for people in Aden
Access to healthcare was extremely difficult inside the city because of airstrikes, shelling, road blocks and snipers. We decided to run an advanced emergency post in Crater, a neighbourhood in the south of the city, in order to stabilize war-wounded patients and to improve their chance of survival.
Surgical mobile clinics launched
To respond to increased medical needs, our teams launched outpatient surgical mobile clinics in two neighbourhoods in the south of the city. Admitted patients, emergency consultations and surgical interventions almost tripled in Aden hospital between 2014 and 2015.
01 Jul 2015
Civilians trapped in a city under siege
At that time, fighting between Southern Resistance and Ansar Allah troops led to a large number of victims, including civilians being trapped and shelled in populated areas of Aden. On July 1, there was a bombing on a residential area in Al Mansoura neighbourhood. More than 80 people, among them a lot of women and children, were treated at our hospital.
22 Jul 2015
Aden international airport reopens
The international airport reopened after loyalist forces supporting President Hadi recaptured the city. Ansar Allah forces were pushed back toward the northern neighbourhoods.
Since 2012, the hospital has faced unstable activity levels depending on the political context, moving frontlines and the effectiveness of other medical facilities’ referral systems closer to the frontlines… Surgeons here have developed wide experience with different types of trauma, such as abdominal, thoracic, orthopaedic, and vascular injuries, but also burns and Caesarean sections.
29 Aug 2016
Mass casualties arrive
We experienced a massive influx of wounded after an explosion hit a nearby neighbourhood. Forty-six dead bodies and more than 60 patients were brought to the emergency room within three hours. Even if it was not the first time it happened, it was very difficult to manage such a significant number of wounded patients.
Dealing with antibiotic resistance
We improved infection prevention and control measures inside the hospital and implemented an antibiotic resistance stewardship program in order to improve the quality of care. In 2018, 70 percent of infected patients tested for antibiotic resistance were multidrug-resistant. We receive patients from the frontlines very late, sometimes between 12 and 24 hours after they are injured. Stabilization is not always done properly, so it means that we have to control infections: isolating the patient, analysing the bacteria and selecting the appropriate antibiotic.
MSF increases its response to the cholera epidemic
Teams supported a cholera treatment centre inside the hospital to treat an increasing number of patients affected by cholera, after a massive outbreak swept across Yemen.
Wide range of care
We started implementing internal fixation for patients with fractures, in order to treat post-surgery complicated cases over the long-term. Year after year, we adapted our admissions criteria and admitted various types of patients, for instance those with abdominal or maxillofacial injuries, or eye trauma. If needed, we would call an external surgeon. Our intensive care unit has been working at full capacity, and we admit, for instance, patients who need to be intubated.
Responding to the diphtheria outbreak
Teams rehabilitated an entire floor of Al Sadaqa hospital and trained its staff. We equipped an operating theatre to respond to a diphtheria outbreak, which was eventually handed over.
13 Jun 2018
After months of fighting along the frontlines between Taiz and Hodeidah, a military offensive was eventually launched by the Saudi and Emirati-led coalition-backed forces, loyal to President Hadi, to seize Hodeidah from Ansar Allah troops.
Following the Hodeidah offensive, the capacity of MSF’s Aden hospital increased to 104 beds to respond to an influx of war-wounded. War weapons are causing complex injuries, sometimes with significant internal injuries and severe fractures. Most of the surgery we do is ‘life-saving’: chest and abdominal gunshot wounds, amputations.
MSF opens a surgical hospital in Mocha
In response to the intense fighting along the Hodeidah frontline, our teams opened a field surgical hospital in Mocha. Complicated cases are referred from MSF’s Mocha hospital to MSF’s trauma hospital in Aden for further care. These patients need multiple surgical procedures and specialized care over a longer period of time.
Staggering numbers of patients
In 2018, MSF teams provided more than 6,000 emergency consultations and performed 5,400 surgeries at Aden hospital. Ninety percent of surgeries were violence-related.
During the battle for Aden in 2015, MSF’s hospital was one of a very few surgical facilities still functioning inside the city. Between March and August 2015, our teams treated more than 2,800 war-wounded at the hospital. During this time, MSF teams also ran an advanced emergency post and surgical mobile clinics in the city in order to stabilise the war-wounded and improve their chances of survival.
In 2018, we increased the capacity of Al Sadaqah hospital to 104 beds to respond to an influx of war-wounded following the Hodeidah offensive. During 2018, MSF teams provided more than 6,000 emergency consultations and performed 5,400 surgeries at Al Sadaqah hospital, 90 percent of them violence-related.
In Yemen, MSF teams work in 12 hospitals and provide support to more than 20 health facilities located in 11 governorates: Abyan, Aden, Amran, Hajjah, Hodeidah, Ibb, Lahj, Saada, Sanaa, Shabwah and Taiz.