According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), 21.6 million people are currently in need of humanitarian assistance in Yemen. The major problems are food insecurity, malnutrition, lack of access to health services, water and sanitation facilities, and protection needs.
Caritas Poland, a member of Caritas Internationalis, is implementing a project in Aden governorate by providing support to five health centres, in order to provide services to 62,644 vulnerable boys, girls, women and men.
These health centres were totally destroyed during the war and eventually rebuilt from scratch by the project.
Each health centre provides the following services:
- A doctor who provides general consultations for patients.
- Gynaecological services that offer basic emergency obstetric care, including midwives who organise sessions on family planning, follow-up of prenatal and postnatal care, newborn care, and counselling sessions on breastfeeding and nutrition. They even provide consultations at home for pregnant women, fostering a relationship of confidence and trust. Pregnant women receive monthly consultations. Ultrasounds are available at the health centre and costs 1,000 YER (around 0.70 USD). Outside the health centre, ultrasounds costs 8,000 YER (around 5.7 USD).
- A pharmacy that provides medical and non-medical supplies and equipment.
- A laboratory.
- A nutrition service for the prevention of malnutrition.
Before the war, medicines were provided by the Ministry of Health but, since the war began, it has become far more complex. Sometimes, medicines received at the health centres are already expired.
The major challenge is the economic crisis as the government does not have the funds to pay for salaries of staff, medicines, or buy medical material. Everything is in short supply. Through this project, salaries and incentives for health workers are financed.
The most common diseases treated at the health centres include measles, tuberculosis, poliomyelitis, and tetanus.
Pregnant women suffer from anaemia and are at high risk of bleeding during delivery. Unfortunately, because of the war, there are no statistics about maternal and newborn mortality rates, nor other important health statistics that would help medical services to plan better and actually provide preventative support.
One of the major problems at the health centres is that they do not have incubators for babies, and one of the main reasons for newborn baby mortality is asphyxia. There should really be at least 2 incubators at each health centre. Having an incubator is the first step. Then, for each incubator, additional staffing of a nurse and a doctor is needed. The staff that take care of the babies in the incubators have specialist skills and therefore have a different job from those who are taking care of the mothers. These additional costs include the salary of a doctor (around 550 USD per month) and a nurse (around 150 USD per month).
The nearest place to find an incubator for babies is an hour away, and mothers are so poor that they cannot afford to pay for the transport, so they go back home, and their babies die at home.
If a caesarean operation is needed, the health centres do not have the conditions to do this and pregnant woman have to travel to a hospital which is far away. Most of the time, they do not have the financial resources to afford this operation. At the Health Center Kuwait, around 30 babies are delivered each day.
In addition, this project provides pregnant women with “mama kits” which contain products for their babies like pampers, creams, a towel, baby clothes, a dress, sanitary towels, and underwear for the mothers.
Another major challenge is the lack of a blood bank. Moreover, there are frequent shortages of electricity each day which worsens the conditions at the health centres.
Beside the support to provide health and nutrition services, the target health facilities also provide Water Sanitation and Hygienic (WASH) support, including maintenance and rehabilitation of WASH facilities such as water tanks and piping replacement or installation, sanitation networks and toilets, and medical and non-medical waste management system improvement. This component aims to improve access to adequate WASH services and a sufficient quantity of safe water during the provision of life-saving health services delivered by the five target health centres.
“I was gladly surprised to notice that most of the doctors at health centres are women who work very closely with midwives; they are the backbone of this project,” said Marisol Martinez, Caritas Internationalis Emergency Officer, who visited activities in the field.
Patients, and especially pregnant women who come to these clinics, receive something beyond health service. They receive a special kind of attention and support from women health professionals who give them care, attention and protection. They feel they are in a safe and secure place.
“When I asked the doctors how they feel about their job they replied to me that they love their job. Even though the challenges are big they have a mission: to save lives. They like working in a female environment – they are kind to each other [and] they support each other. Their job provides the joy of serving and accompanying pregnant women and bringing life and hope, even in these very tough circumstances,” said Martinez.
The hope of peace in a country at war is exceptional. This is the case today in Yemen – a country destroyed after almost nine years of war and affected by one of the worst humanitarian crises in the world.