Yemen is one of, if not the most, fragile country in the world at risk to be decimated by Covid-19, to a large extent because of Houthi mismanagement and a healthcare system already on its knees. Earlier this month, the UN renewed its worst-case scenario saying that the death toll from the virus could exceed the combined toll of war, disease and hunger over the last five years.
Observers have accused the Houthis of leaving thousands of Covid-19 patients in Sanaa and other areas under their control to die of the disease and, despite the international warnings from the UN and WHO, the Houthis continue to ignore the grave consequences of their mismanagement of the coronavirus crisis.
The Houthis — who are aligned with Iran and fighting Yemen’s internationally recognised government and its Saudi coalition — have taken steps to counter the pandemic such as establishing a hotline to report cases and symptoms, yet they have downplayed the effects of the coronavirus and covered up the numbers.
A recent Reuters report accused the Houthi rebels of deliberately underreporting. The four sources Reuters spoke to said Houthi health authorities had not shared additional test results with the World Health Organization (WHO) for at least 50 further patients with Covid-19 symptoms they were aware of at Kuwait hospital in Sanaa. Two of the sources said 20 other patients they had seen with similar symptoms died in that hospital. However, the two sources said authorities in areas under the Saudi-backed government’s control have also not fully disclosed the extent of the pandemic. At least 13 confirmed Covid-19 patients have died at Al Amal hospital in Aden, they said.
“Houthi authorities do not share the results of the tests with doctors and with the WHO when the results are positive,” one of the sources told Reuters.
Earlier in May, WHO suspended staff activity at its hubs in Houthi-held areas of Yemen in a move sources said aimed to pressure the group to be more transparent about suspected coronavirus cases. The WHO has temporarily paused its movements in northern areas due to “credible threats and perceived risks which could have an impact on staff security”, it said in response to a Reuters’ query, adding that operations have not been suspended.
The Saudi-backed government has so far reported 34 cases of the novel coronavirus with seven deaths in territory it controls, while the Houthis, who hold most large urban centres, have recorded just two cases with one death.
The United Nations is operating under the assumption that there is now full-blown transmission in Yemen, it said.
“We are competing for resources and supplies in the global market – and a country’s ‘priority status’ in terms of who receives what for COVID-19 is directly linked to how many cases are in the country and the need – it is the numbers,” it said.
The UN has “systematically for weeks now” advised on case declaration and reporting, but the decision to do so rests with local authorities, the WHO added.
This weekend, the United Nations renewed its warnings of a worst-case scenario, in which thousands of Yemenis are killed by the virus.
“The worst-case scenario – which is the one we’re facing now – means that the death toll from the virus could exceed the combined toll of war, disease and hunger over the last five years [in Yemen],” Lise Grande, the head of the UN’s humanitarian operations in Yemen told CNN.
Back in April, Grande said the WHO may have to cut its work in the country by 80% after the United States decided to stop most of its humanitarian support to Yemen in response to Houthi aid restrictions. Grande acknowledged that the WHO may be forced to “reduce” or “more likely” shut down operations in 189 Yemeni hospitals and 200 medical clinics.
Valerie Peay, Director of the International Observatory for Human Rights, warned of the consequences of underreporting the number of those infected:
“As long as those holding power in Yemen deny or hide the data of those dying from the Coronavirus then they reduce the ability to identify where the pandemic is spreading and hinder any support, either internal or external that could save lives.”
A pandemic amidst a conflict
War-ravaged Yemen is divided between the internationally recognised government temporarily based in the south and the Houthi group that ousted it from power in the capital, Sanaa, in late 2014.
The UN has “systematically for weeks now” advised on case declaration and reporting, but the decision to do so rests with local authorities, the WHO added.
The ongoing conflict has killed more than 100,000 since 2015 and has already caused what the UN says is the world’s worst humanitarian crisis with some 24 million Yemenis reliant on aid and some 10 million facing hunger.
An already shattered healthcare system
The WHO says it fears Covid-19 could rip through Yemen as the population has some of the lowest levels of immunity to disease compared with other countries. Minimal testing capacity has added to concerns. In addition, the ongoing conflict is causing mass displacement and conditions in the refugee camps are unsafe and make it impossible to track and trace the disease.
The five-year war has left its population weakened by hunger and disease and wrecked its health and sanitation systems. Diseases such as cholera are rife and many diseases such as dengue fever share similar symptoms to Covid-19, complicating efforts to estimate the extent of the pandemic.
Between March 2015 and December 2018, hospitals and doctors in Yemen were attacked at least 120 times by the conflict’s warring parties, according to a report that gives the most comprehensive analysis to date of the devastating effect of war on the country’s healthcare system.
The attacks included airstrikes, ground attacks, military occupation, assaults on health workers and other violations such as looting and restrictions on humanitarian aid, according to analysis co-published by Physicians for Human Rights (PHR) and the Yemeni human rights group Mwatana.
“What our report shows is how blatantly international humanitarian law has been ignored in Yemen’s conflict and how in particular attacking healthcare facilities has a long-term and wide-reaching impact,” said Osamah Alfakih, Mwatana’s advocacy director, who co-authored the report.
A vulnerable migrant population
Last week, the Guardian published a report about migrants travelling across the Red Sea hoping to find work in the Gulf states and arriving in Yemen. According to the International Organisation for Migration, as Europe has cracked down on routes over the Mediterranean from Turkey and Libya, the journey to Yemen is now the busiest maritime migration route in the world.
According to the Guardian report, almost none of the new arrivals from mainly Ethiopia and Somalia know that war has raged in Yemen for the last five years, impeding their onward journey, or that torture and rape could await them at the hands of smugglers and traffickers. Now, aid agencies are warning that funding shortfalls and cuts and the spread of coronavirus in the country leaves the migrant population even more vulnerable, as they are unregistered with no access to any healthcare.