Yemen. Women and children die as war limits access to medical care | Doctors Without Borders

AMSTERDAM/BARCELONA/NEW YORK, April 24, 2019—the the war in Yemen is preventing women and children from receiving life-saving medical care in time, contributing to a growing number of deaths, the international medical humanitarian organization Médecins Sans Frontières (MSF) said in a report today, Complicated delivery.

Pregnant women, newborns and children, among the most vulnerable people in Yemeni society, are arriving increasingly late at medical facilities. At MSF’s Taiz Houban Mother and Child Hospital, the number of children and newborns who died on arrival rose from 52 in 2016 to 72 in 2017 and 103 in 2018. The most Common causes of newborn deaths were prematurity, birth asphyxia and serious infections. .

“Last month, in our emergency room, we had 10 cases of dead children,” said Rachel Fletcher, MSF hospital manager in Taiz Houban. “Of these 10 deaths, four were clearly the result of a journey of several days to get here. If they had lived closer to the MSF hospital or had been able to afford transport or medicine to simple lung infection, it would not have led to such a serious result.”

The report focuses on mothers and children in two hospitals where MSF works in war-torn areas: Houban suburb of Taiz city (Taiz Houban) and Abs district in Hajjah governorate. After more than four years of war, an economic crisis has made treatment unaffordable, many hospitals are no longer functioning and patients have to cross conflict zones to seek treatment.

Before the conflict escalated in 2015, the city of Taiz, with around 615,000 inhabitants, had five public hospitals. As of March 2019, no public hospitals in Taiz city or the surrounding governorate were fully functioning. Three of the hospitals in downtown Taiz remain partially open, with the support of MSF and other international humanitarian organizations. However, these hospitals do not offer the same level of services as before and are not easily accessible.

Across Yemen, many patients now have to cross front lines, cross no-man’s land or negotiate their way through multiple checkpoints to reach a functioning hospital. In Houban, what was once a 10-minute journey to a hospital in central Taiz can now take six hours as patients have to circumvent an active frontline. In Abs, patients are sometimes prevented from traveling due to airstrikes and clashes.

Medical staff face the same difficulties in accessing hospitals as their patients. Just this week, another MSF-supported hospital in the city of Taiz was forced to temporarily suspend its activities due to new violent clashes. The violence has led to the closure of the only remaining public hospital in the area providing maternal health care and now prevents humanitarian medical personnel from traveling to and from the hospital.

Traditionally, Yemeni women give birth at home with the help of birth attendants rather than in hospitals. When complications arose, access to care was a much simpler process before the outbreak of conflict. But now medical complications during pregnancy have become much more dangerous.

At the MSF hospital in Taiz Houban, 70% of women who arrive suffer life-threatening complications such as obstructed labour, prolonged labour, eclampsia, uterine rupture or postpartum bleeding. Without community health clinics providing prenatal care, complicated pregnancies go undetected until the time of delivery.

“Primary health care services are not fully functioning and haven’t been for a long time,” Fletcher said. “Most often they are not staffed by medical professionals and if they are, the staff are usually not trained in the management of the cases presented. Without sufficient capacity and confidence in these services within the community, women wait until the last minute to make the dangerous journey to receive care.”

In MSF facilities in Taiz Houban and Abs, a total of 36 women died from complications during childbirth from 2016 to 2018.

MSF calls on all warring parties to ensure the protection of health workers and other civilians, to allow the wounded and sick to access care and to ease the restrictions imposed on humanitarian organisations. MSF is also calling on international aid organizations to step up their humanitarian response, increasing the number of experienced staff in areas where the needs are greatest and ensuring the supervision, quality and speed of aid.

MSF has stepped up its work in Yemen since the escalation of the conflict in 2015. Today, MSF runs 12 hospitals and health centers across the country and provides support to more than 20 hospitals or health facilities in 11 governorates: Abyan , Aden, Amran, Hajjah, Hodeidah, Ibb, Lahj, Saada, Sana’a, Shabwah and Taiz. From March 2015 to December 2018, MSF teams performed 81,102 surgeries in the country, treated 119,113 patients injured in war and violence, delivered 68,702 newborns and cared for more than 116 687 suspected cholera patients. In 2019, MSF has 2,200 international and local staff in Yemen and offers incentive bonuses to 700 Ministry of Health staff across the country.