SANA’A, YEMEN — In Yemen’s Al Sabeen Hospital dozens of cholera patients lie motionless in their beds awaiting treatment for a disease eradicated in most of the world but making an aggressive resurgence in war-torn Yemen. Al Sabeen doctor Mohammed Abdul-Mughni, who had been working in a temporary diarrhea treatment center in the hospital, would usually be making the rounds at the hospital but he succumbed to cholera himself on March 28 after being infected while treating patients in the makeshift ward.
A new cholera epidemic is spreading like wildfire in the Arab world’s poorest country, with as many as 20,000 suspected or confirmed new cases per week. The new wave of cholera comes two years after Yemen witnessed the largest modern outbreak of the disease, which saw more than a million cases before it waned in mid-2018.
“We are taking patients in around the clock; last week we admitted around 1,500 confirmed cholera cases,” a doctor working at Al Sabeen told MintPress News. “The hour that passes without receiving new cholera cases is an exceptional hour.”
Yemen`s Ministry of Public Health and Population told MintPress that since the beginning of this year nearly 172,000 cases of severe acute watery diarrhea and suspected cholera were reported, 351 of which resulted in death. Nearly one-third of those cases were children under the age of five.
Cholera is a severe gastrointestinal disease, transmitted by a bacterium called Vibrio cholerae. It can trigger so much diarrhea and vomiting that patients rapidly become dehydrated. They can lose so much fluid that their internal organs shut down, and in Yemen it is especially deadly owing to the starvation and lack of medical care that has plagued the country since the Saudi-led war began in 2015.
In March, Geert Cappelaere, UNICEF’s regional director for the Middle East and North Africa, and Dr. Ahmed al-Mandhari, WHO regional director for the Eastern Mediterranean, issued a joint statement identifying the sharp increase in the number of reported cholera cases in Yemen since the start of the year.
The rate of new infections in April is slated to surpass those in the first weeks of March, which saw nearly 109,000 suspected cholera cases, 200 of which resulted in death.
The increase is particularly concerning as aid organizations have warned that Yemen’s coming rainy season will likely accelerate the spread of the disease, further exacerbated by the collapse of healthcare in the country as well as the Saudi-led coalition blockade and ongoing airstrikes.
Like Yemen’s many other humanitarian crises, the latest outbreak of cholera can be traced directly to the destruction of the country’s infrastructure, as well as a crippling blockade imposed by the Saudi-led Coalition and supported by the United States.
The continued deliberate attacks on water wells and water treatment facilities in Yemen are causing many in the country to wonder if the U.S.-backed Coalition is intentionally attempting to trigger another massive cholera epidemic. The Coalition’s latest attack was on a municipal water tank in Wahabiya in central Yemen’s Baida province on Wednesday, April 3.
A boy fills a container with water from a well that is allegedly contaminated with cholera bacteria, on the outskirts of Sanaa, Yemen, July 12, 2017. Hani Mohammed | AP
Vaccines in short supply
The cholera ward at Al Sabeen Hospital is also a room of horrors for the doctors working without adequate protection to treat patients. Dr. Abdul-Mughni first realized something was amiss when he began vomiting, his eyes dry and dazed, as the shock of the catastrophe that had befallen him set in.
Like most of Yemen’s health workers, Dr. Abdul-Mughni never received a cholera vaccination. Infection control in Yemen’s health facilities is almost nonexistent owing to a lack of vaccines since the Saudi-imposed blockade on the country began. A single vaccination campaign took place in a few districts in 2018 and covered only 400,000 people.
U.N. officials have confirmed that aid agencies have been largely unable to bring vaccines into Yemen because of the difficulty in delivering them through the blockade. Yemen’s is the 21st century’s worst humanitarian crisis and — when measured by the proportion of the population affected, including healthcare workers — it may well be the worst in a century.
Both the World Health Organization and UNICEF have begun scaling up their response to the cholera epidemic but they say they are facing several challenges, including an increase in fighting, access restrictions, and bureaucratic hurdles to bring life-saving supplies and personnel to Yemen. The two organizations have called on Saudi Arabia to lift all restrictions on humanitarian operations aimed at responding to the spread of the disease.
Water infrastructure in dire straits
Poor sanitary conditions in Yemen make it difficult to keep the number of cholera cases under control. Water chlorination is not a viable solution, summer heat is relentless, rubbish lines the streets, water resources are scarce, and sewers are overflowing in many streets.
In Yemen’s larger cities — including Sana’a, Aden, and Hodeida — where people can often be seen covering their noses due to the offensive odors of sewer gases permeating city streets, sewers have begun overflowing in many areas and old and deteriorating sewer systems threaten to burst at any moment according to officials at the local Water and Sanitation Corporation.
Near Sana’a’s historic Old City, a UNESCO World Heritage site, sewers began overflowing on Al Sayila Road in March as a result of a Saudi airstrike. The overflowing sewers and the environmental pollution they have caused across Yemen is a primary factor in the spread of epidemic and pandemic diseases such as cholera — while the shortage of potable water has driven Yemenis to drink from water sources polluted with feces and urine.
The UN Office for Humanitarian Affairs (OCHA) said in March that the cholera epidemic in Yemen is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements.
Top photo | An elderly woman is treated for suspected cholera infection at a hospital in Sanaa, Yemen, March 28, 2019. Hani Mohammed | AP
Ahmed AbdulKareem is a Yemeni journalist. He covers the war in Yemen for MintPress News as well as local Yemeni media.
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