Yemen's Civil War Returns              09/25 06:25

   

   ADEN, Yemen (AP) -- Tarek al-Salami, aged 7, sat in a diaper, looking frail. 
Normally, the malnutrition and diarrhea that weakened his tiny frame would have 
been treated within a few days, but nothing is normal in 
https://apnews.com/hub/yemen anymore.

   Tarek's father carried him on foot from the southwestern city of Mokha as 
https://apnews.com/article/yemen-houthis-iran-war-red-sea-battle-e32ed78eb9b5286
42d043d4303192927 this month, bringing a return to civil war. The boy reached a 
hospital two days later in the government-held city of Aden, 270 kilometers 
(170 miles) away but it said it had no beds. Like others, it was overwhelmed by 
the wounded. They finally found a therapeutic feeding center.

   The boy arrived in "acute crisis" after the delay in care, according to the 
center's director, Dr. Arwa Atef, and he only began walking again on Wednesday, 
over a week later.

   "I swear to God, when I look at him, my heart breaks," said his father, 
Mohammed al-Salami. "He looks almost lifeless."

   This is how the already fragile health system in the Arab world's poorest 
nation is collapsing, caught in a new front of the https://apnews.com/hub/iran. 
The Associated Press spoke with patients, medical workers and aid groups in 
Yemen as medicines run short and some workers flee. A few facilities have been 
overtaken by the fighting.

   Some health centers are turning pregnant women and others in need away to 
focus on trauma patients. Vulnerable children are filling incubators and 
sharing beds. Millions of people are affected by the fighting backed by two of 
the Middle East's biggest powers as Iran-backed Houthis advance against 
https://apnews.com/article/yemen-saudi-arabia-houthis-missiles-d19776cf1a68b45d2
8b1402f3a47b8cd supported by Saudi Arabia. Over 130,000 have fled their homes.

   The feeding center where Tarek and other children are recovering is 
struggling to cope with a rise in patients in a country where many already were 
hungry, Atef said.

   "We can't keep up with the situation," she said.

   Overwhelmed hospitals focus on the wounded 

   Most hospitals and primary health centers affected by the escalation in 
fighting closed for the first 48 hours before resuming services, the United 
Nations said. But the Houthis have seized the Red Sea coast, including key 
ports for aid.

   "The areas with some of the highest health needs are increasingly difficult 
to reach," the World Health Organization said Friday.

   Less than 10% of the affected health centers are fully equipped with the 
trauma services that wounded people need, WHO has said. With resources thin, a 
painful triage is underway.

   Fewer facilities are handling the pregnancy-related emergencies that were 
killing three Yemeni women every day even before the escalation, said Francesco 
Galtieri with the United Nations Population Fund. That's one of the highest 
rates in the Arab world.

   "Around 2,000 pregnant women are on the move," with over 200 expected to 
deliver in the next week or so, he said.

   Maternity wards have been converted into emergency rooms in some hospitals 
close to the fighting, said Hashem Osseiran, an International Committee of the 
Red Cross spokesperson, adding that many lack enough anesthesia drugs, oxygen 
supplies and sterile surgical gloves.

   At a hospital treating mothers and children in the government-held city of 
Marib, Dr. Ahmed Modhesh said they are seeing more emergency maternity cases as 
other city hospitals focus on the wounded.

   But his facility, Martyr Mohamed Hayel hospital, lacks intensive care 
specialists and doesn't have enough generators to keep all departments running 
if the power goes out.

   A midwife said the number of childbirths the hospital is handling has 
basically doubled to about 80. One woman with an ectopic pregnancy arrived 
bleeding heavily, yet the under-resourced staff were still able to perform an 
emergency procedure to save her life, the midwife said. She spoke on condition 
of anonymity because she wasn't authorized to speak with the media.

   Yemen's healthcare was in trouble before the fighting 

   Even before the escalation, hospitals in Yemen relied on limited government 
support and citizen donations. Some were not able to fully pay staff.

   Now, "we are in a very dangerous situation," said Fahd al-Nazari, manager of 
the health office in Taiz province, which has received most of the newly 
displaced. "Within a day or two, or a week at most, we might have to close down 
(some facilities). In fact, some hospitals are already closed."

   Three of the province's 17 hospitals are no longer under government control. 
Hospitals across Taiz had received around 635 casualties, including 112 bodies, 
as of Thursday after the Houthis captured Mokha, al-Nazari said. They included 
civilians and combatants.

   "We're exhausted receiving wounded people under these circumstances," 
al-Nazari said.

   Medical supplies and fuel are running short after key supply routes between 
Mokha and Taiz were largely cut off, forcing convoys onto mountainous roads 
unsuitable for large trucks. Even before the escalation, public hospitals in 
the province had just one MRI machine available.

   At the Yemeni-Swedish Maternity and Children's Hospital in Taiz, incubators 
were full and two or three children were sharing beds in the emergency room, 
general manager Sami al-Sharabi said.

   "I'm scared that the conflict would reach the hospital," he said. "Any 
explosive that could hit us would destroy the hospital, as some parts of the 
building are already weak."

   Even hospitals in Aden, where Yemen's government is based, struggle to cope. 
Doctors Without Borders said more than 60 wounded people had been admitted to 
Al-Gamhouria hospital in a week. Many needed urgent surgery or blood 
transfusions.

   Fighters are also seeking emergency treatment 

   At a private hospital treating rebels in the Houthi-held city of Sanaa, two 
medical officials last week said it was overwhelmed with hundreds of wounded. 
The officials spoke on condition of anonymity because of security concerns.

   It was not clear how many Houthi fighters have been killed or wounded 
overall. Few aid agencies operate in rebel-controlled areas, as the group has 
detained and harassed dozens of humanitarian workers. Experts say the Houthis 
have struggled to pay salaries to civil servants, including public sector 
doctors and diverted most tax revenues to their military wing.

   The ICRC, one of the few global agencies still able to operate in Sanaa, 
last week said it delivered 22 tons of badly needed medical supplies to support 
"overwhelmed" hospitals.

   There is also little information about casualties among government forces, 
though one government-allied group has said over 1,500 of its fighters were 
wounded.

   Some medical workers have fled the conflict, making it harder to find care.

   In Mokha, Doctors Without Borders said its small team was still working 
"despite the severe shortage of health professionals." The charity's deputy 
coordinator of operations in Yemen, Emmanuel Massart, said three other 
hospitals there had closed for days before resuming services.

   Resupplying remains a major challenge because of closed roads, Massart said.

   "We should not forget about Yemen," he said. It "remains one of the worst 
humanitarian crises in the world."