Aid agencies are racing to stop the cholera outbreak in Yemen from getting any worse, as the disease continues to spread through the country while clean water and life-saving supplies remain out of reach.
The World Health Organization said on Tuesday, June 20, that it is trying to stop the spread of cholera from the worst-hit areas to the rest of the country. Already 20 out of 22 governorate are affected, and the WHO estimates 1,200 people have died in the current outbreak.
Sara Tesorieri, the Norwegian Refugee Council’s Advocacy and Policy Advisor in Yemen, told Grasswire that the NRC has pivoted its response in several places, including Sana’a, Hudaydah and Aden, to focus more efforts on combating cholera.
Dr. Nevio Zagaria, the WHO representative in Yemen, said last month the epidemic took the United Nations by surprise, and warned there could be 300,000 cholera cases within six months.
But the disease is spreading even more rapidly: As of June 21, WHO reports 172,000 suspected cholera infections, compared to 23,400 infections reported on May 19.
.@MSF:The poor level of sanitation &lack of safe drinking water is increasing people's vulenrability #Yemen #cholera pic.twitter.com/4JVQQH5vhC
— أطباء بلا حدود-اليمن (@msf_yemen) June 18, 2017
Failing capacity
WHO has said the current cholera outbreak can be traced back to one in October. Cases of the disease spiked in December and then dissipated but never fully went away, and Yemen’s capacity for dealing with a disease like cholera has been ravaged by more than two years of war.
According to the UN Office for the Coordination of Humanitarian Affairs, more than 8 million people in Yemen have no access to clean water or proper sanitation.
Tesorieri said the resurgence of cholera is exponentially worse than it was during the previous outbreak over the winter, due mostly to the deterioration of public services and infrastructure caused by the ongoing conflict.
“I myself have seen overflowing treatment centers where staff are overworked and exhausted, and that is in the cities where such specialized treatment centres have been set up for the humanitarian response; in rural areas there is less spread but also a lot less information about the extent of the outbreak and much less access to treatment,” she said.
Public hospitals, including those run by charities like Médecins Sans Frontières (also called Doctors Without Borders) have been hit and destroyed by Saudi coalition airstrikes. MSF says it clearly identifies hospitals and routinely shares the GPS coordinates of several medical facilities with the Saudi-led coalition, sometimes days before they were hit.
When its hospital in the Hayden district of Saada was hit in October 2015, MSF told Grasswire it received no warning before a pair of airstrikes destroyed the building. Staff and patients inside the hospital managed to escape after the first strike, while the second “flattened the facility.”
Humanitarian funding shortfalls
Even before the current cholera outbreak, NRC Secretary-General Jan Egeland warned that 7 million people in Yemen were at risk of “an entirely preventable famine.”
Yemen imports about 90 percent of its food, about 70 percent through the port at Hudaydah, which the Saudi coalition has periodically blockaded since August 2015.
WHO said Wednesday its health, water, sanitation and hygiene partners need $66.7 million to “scale up the cholera response.” The agency estimates more than 7 million people in Yemen are at risk of cholera.
#Cholera is easy to treat where there is sanitation, water treatment, and a health system. Conflict has destroyed all of these in #Yemen. pic.twitter.com/vnBVGlFB4u
— NRC (@NRC_Norway) June 17, 2017
The overall humanitarian response plan to help people with the most urgent needs requires $2.1 billion, of which only 29.8 percent has been funded, Tesorieri said.
A recent OCHA report estimated that less than one-third of the needed medical supplies are entering the country. On June 20, IRIN reported that Zagaria has requested access to an emergency cholera vaccine stock held by the International Coordinating Group. If the plan goes through, he said the first doses of the vaccine could arrive in Yemen in early July.
In April, a UN pledging conference on April 25 raised $1.1 billion in humanitarian aid funding for Yemen. UN Secretary-General Antonio Guterres said at the conference that he was hopeful the rest of the $2.1 billion appeal will be pledged by the end of the year.
Whether the funds ever reach people in need is another story, and Guterres, as well as charities like the International Committee of the Red Cross, also called for more to be done to facilitate the delivery of aid, medical supplies and food to people inside the country.
Hudaydah port
Hudaydah port remains open – albeit at a reduced capacity – despite concerns that the Saudi coalition would attack it to prevent weapons trafficking.
The Saudis accuse the Houthis of using Hudaydah to smuggle weapons, an accusation the rebel group denies.
#Yemen: #ports are operational, with exception of Balhaf. Coalition operation on #Hudaydah stopped by UN, hoping for third party control pic.twitter.com/v7H9ZnB3b1
— Risk Intelligence (@riskstaff) June 9, 2017
Humanitarian organizations maintain there is no alternative to Hudaydah. In a statement published by the UN, seven aid organizations said Yemen’s commercial importers do not know how they would deliver food if the Red Sea ports were lost.
Tesorieri said things remain slow at Hudaydah, and container ships were still not able to reach it as of two weeks ago. “Only ‘feeder vessels’ bringing containers from transshipment hubs in Saudi Arabia are arriving,” she said.
US Secretary of State Rex Tillerson told the Senate Intelligence Committee on June 13 that he discussed with the Saudis the possibility of turning over Hudaydah to the United Nations or other ways of installing a “secure delivery mechanism” so aid deliveries are not stolen.
A State Department official told Grasswire that the United States remains concerned about the humanitarian crisis in Yemen and the cholera outbreak. “We believe that an enduring solution to Yemen’s conflict will only come through comprehensive peace negotiations under the auspices of the UN. We urge all sides to allow humanitarian assistance to reach all Yemenis,” the official said.
On June 17, Yemeni Foreign Minister Abdel-Malek al-Mekhlafi said the government accepted a UN proposal for the Houthi-controlled port to be turned over to a third party.
In the meantime, the reduced capacity of Hudaydah is having a ripple effect. Tesorieri said the port is struggling to pay its over 3,000 employees any amount of their wages.
The situation is worse for laborers who used to work at the port and the businesses that depended on it. Relatively poor before the conflict began, they’re now destitute and unable to find work.
One man Tesorieri met feeds himself and his family by gathering stray corn grains off the ground where they fell during the unloading of shipments.
The man, who used to work at the port, is one of the few people that security officers allow the privilege of picking corn off the ground.
“They are worried that if too many people find out about it they will get flooded by desperate people who want to search through the dirt to find stray kernels,” Tesorieri said.
