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Yemen: Attacks on Health October 2018 Newsletter

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Summary June – Sept 2018

Since early June, a military offensive in al-Hudaydah has displaced 470,000 people, representing more than half of the city’s population. Failed September peace talks escalated tensions. In the days following the collapse of talks, government forces backed by the Saudi-Emirati-led coalition attemped to retake the city of al-Hudaydah, causing more than 701 deaths.

Attacks exacerbated the lack of sanitation, clean water, and food as health conditions further deteriorated. Suspected cholera cases increased for the 13th consecutive week: 154,527 cases have been reported so far in 2018. Seven million people were on the brink of starvation. As the Yemeni Rial depreciated and prices rose, an additional two million people may face starvation and 3.5 million others could face food shortages.

In August, the UN Group of Eminent Experts (GEE) on Yemen issued a report analyzing the main patterns of violations of international human rights law, international humanitarian law, and international criminal law committed by all parties to the conflict from September 2014 to June 2018. The GEE’s report noted that the Saudi-Emirati-led coalition air strikes have caused the most direct civilian casualties by hitting civilian areas, including medical facilities. In September, the UN Human Rights Council renewed the GEE’s mandate. 

This fact sheet draws upon data from the UN Office for the Coordination of Humanitarian Affairs, World Health Organization, UN Children’s Emergency Fund (UNICEF), media, and independent reporting.

What is an “attack” on health care?

PHR defines attacks on health care and personnel as an action by a state or non-state party to a conflict that disrupts the indiscriminate delivery of care to all wounded and sick, regardless of combatant status. This includes:

  • Attacks on hospitals, health clinics, ambulances, or other facilities via air/ground strikes;
  • Shelling or any military activity causing physical damage to facilities or service disruption;
  • Killing, kidnapping, or other bodily harm inflicted on health care professionals;
  • Pressure, intimidation, or punishment of personnel for treating all wounded and sick without discrimination.

Attacks on health infrastructure

Most health centers remained nonfunctional, adding stress to a struggling system. Airstrikes and artillery attacks increased insecurity for medical personnel, often in repeated patterns. Moreover, seven health facilities in three al-Hudaydah districts (al-Mina, Bayt al-Faqiah, at-Tuhayat) closed temporarily due to security concerns in July. Displaced staff also affected medical services in Jabal Ra’s District and at a nursery of al-Salkhana Hospital in al-Hali District. From June to September, PHR verified 11 attacks on medical facilities. 

  • June 11: A Saudi-Emirati-led coalition bombing destroyed a Doctors Without Borders clinic in Abs.
  • June 16: Yemen’s largest hospital, al-Thawra Hospital in al-Hudaydah, was damaged.
  • July 5: Mortar shells hit al-Hais Hospital in al-Hudaydah.
  • July 26: Mortar shells damaged Zobaid Hospital.
  • July 28: Mortar shells damaged the water network of al-Thawra Hospital in Taizz. 
  • Late July: An attack in al-Hudaydah put the Health Laboratory, the Central Pharmacy, the Tahrir Health Center, and the Emergency Delivery Center out of service.
  • August 21: An attack on al-Thawra Hospital in Taizz caused structural damage, multiple deaths, and injuries.
  • August 8: Armed militants terrorized patients and health workers in al-Jamhouri Hospital in Taizz.
  • August 16: Mortar shells again damaged al-Thawra Hospital in Taizz; three civilians were injured.
  • Late August: al-Amal Medical Center in ad-Dhale’e was affected by attacks.
  • September 29: Mortar shells damaged the Aziz Medical Clinic in at-Tuhayat sub-district in al-Hudaydah.

Health consequences

Cholera is widespread, affecting 22 out of 23 governorates and 305 out of 333 districts in Yemen. A recent increase in cases near Sanaa and al-Hudaydah indicated a possible third epidemic, and ongoing indiscriminate attacks that affect water supplies only increase this likelihood: in July, a main water station in al-Mina District was attacked. A day later, a UNICEF-supported sanitation center in Zabid District was also attacked.

  • From July to September, 43,700 suspected cholera cases were registered in Yemen. Rates rose for a 13th consecutive week in September: 9,425 cases and 15 deaths were reported in one week alone.
  • From April 2017 to August 2018, Yemen reported 1,170,389 cholera cases and 2,427 associated deaths.
  • In June, 1,850 diphtheria cases and 98 associated deaths were registered in 20 governorates. 
  • Recent damages to reproductive health facilities affected 90,000 women in al-Hudaydah. 
  • In August, Taizz governorate registered over 1,500 dengue cases and more than 15 casualties.

Access to humanitarian aid

Al-Hudaydah and al-Saleef ports remain open, yet ongoing conflicts continue to impact humanitarian aid. After the collapse of the peace agreements in early September, attacks closed the only open road that connects al-Hudaydah to the capital of Sanaa, as well as the rest of the country.

  • In August, more than 1.4 million people – an increase of 200,000 since February – resided in highly constrained areas where checkpoints and attacks on humitarian personnel are routine.
  • In June, the UN World Food Programme (WFP) reached 7.5 million people with emergency cash and food vouchers. However, the Famine Early Warning System Network warned that catastrophic symptoms resulting from lack of nutrition are imminent.
  • In September, a mortar shell in al-Hudaydah hit a WFP warehouse that stored supplies to assist 19,200 people. The WFP has warned that ongoing clashes could jeopardize 46,000 tons of wheat expected to arrive in al-Hudaydah by the end of the month.

Recommendations

  • All countries providing arms to any party to the conflict should ensure these are not used to attack civilian objects, including hospitals and other health infrastructure. 
  • The United States must implement reporting and certification provisions of Section 1290 for the recently enacted FY2019 National Defense Authorization Act, providing a forthright and complete assessment of whether Saudi Arabia and the United Arab Emirates meet conditions to receive continued U.S. military support.
  • UN member states must provide political support and adequate financial resources so that the UN Group of Eminent Experts can continue investigating all alleged violations of human rights and humanitarian law, as well as identify those responsible.

Read the full newsletter here

Read PHR’s Attacks on Health May 2018 Newsletter here 
Read PHR’s Attacks on Health February 2018 Newsletter here

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