Before the current pandemic, Yemen was the world’s worst humanitarian crisis (Karasapan, 2020). The country is involved in unending civil war since 2015, subjected to famine, acute food insecurity, locust attacks, and disease, with 80% of its population dependent on humanitarian assistance, and now COVID-19 (ibid).
There is a 25% fatality rate for confirmed COVID-19 cases in Yemen (UN News, 2020). However, lack of testing and an incapacitated health care system means the reported cases are underestimated (Human Rights Watch, 2020). As of May 2020, there were 2,678 COVID-19 tests recorded – insignificant given Yemen’s population of 28 million (Kasaparan, 2020). The civil war also presents a political hurdle to COVID-19 mitigation and response as both sides have accused the other of spreading the virus (Human Rights Watch, 2020). The death toll due to the pandemic is estimated to exceed the deaths due to war, famine, and other diseases combined (Karasapan, 2020).
Yemen is also currently experiencing the world’s largest recorded outbreak of cholera (United Hands Relief & Development, 2020a). Recent flooding is raising concerns that the cholera epidemic will worsen (Human Rights Watch, 2020). All 333 districts in Yemen report cholera cases, with 110,000 cases reported as of April 2020 (Karasapan, 2020).
The health system, wrecked primarily by the civil war, cannot respond effectively to the impacts of COVID-19. Less than 50% of health facilities are functional, and these lack essential staff, equipment, and medicines (The World Bank, 2020a, pg 9). Only two centers are equipped with isolation facilities and treatment for COVID-19 patients, each with the capacity of only 40 patients (The World Bank, 2020a, pg 10).
More than 20 million Yemeni are food insecure and 10 million are at risk of famine (The World Bank, 2020b). The on-going conflict has led to severe disruptions to food production and distribution, while significant population displacement has reduced purchasing power for any products still reliably reaching markets (ibid). Recent locust swarms have also devastated crops and the food supply (The World Bank, 2020a).
Displaced and malnourished populations are at an increased risk of succumbing to COVID-19 and other diseases, since many of them live in overcrowded temporary shelters with lack of water, sanitation, and medical aid (UNHCR, 2020). Both international and local aid agencies are rallying to gather and distribute food, health, and medical supplies to the vulnerable and run clinics (United Hands Relief & Development, 2020a and 2020b).
Fulfilment of aid pledges from international bodies has fallen from US$2.6 billion in 2019 to US$800 million in 2020, with only 27% of Yemen Humanitarian Fund pledges realized (Human Rights Watch, 2020). CARE International’s Programme Director expressed concern over the fact that UN humanitarian and refugee response plans for existing crises collectively were only 13% funded by the end of April (CARE, 2020).
The scale of the crisis in Yemen is incomprehensible. Will internationally coordinated support be urgently mustered to prevent the spread of COVID-19 amongst other calamities that the country is already facing?
A contributor and member of the Public Health Pathways team
3 July 2020