NEW YORK — Hunger and COVID-19 are both spreading across Yemen, but one worrying indicator — hospital admissions — is not keeping pace, according to Caroline Ducarme, head of the Médecins Sans Frontières mission in the country.
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Fear of contracting COVID-19 in hospitals and the perceived stigma of catching and spreading the disease are keeping people at home, even if they require medical care, Ducarme said. Only half of the 20 beds reserved for patients with moderate COVID-19 symptoms are currently occupied in one new MSF-supported coronavirus treatment center at Sheikh Zayed Hospital in Sanaa.
“It's something that we are seeing not only in the COVID centers, but also in the health facilities and hospitals in the whole country. It's quite concerning for us, the decreasing numbers of patients arriving at the hospitals,” Ducarme said.
Another hospital MSF supports with intensive services for malnourished children typically has a 100% bed occupancy rate. Bed occupancy rates are now below 50%.
"This is not because there's less malnutrition. This is because we don't see [the children] anymore, because they stay at home and they don't come,” Ducarme said.
“I don’t think we are in a very good situation, and unfortunately world leaders are closing their eyes.”— Sultana Begum, advocacy manager for Yemen, Norwegian Refugee Council
There were 1,585 confirmed coronavirus cases in Yemen as of Saturday, but actual numbers are likely far higher, given the country’s minimal testing and severely reduced health care capacity. People infected with COVID-19 are waiting until they are very sick before showing up at health care facilities, according to Ducarme, and the vast majority of mild and moderate cases of the disease are going undetected.
“What we're seeing is not representative of what's out there, that's for sure. We don't see most of them [critical-care COVID-19 patients], very likely. But we also see more people coming from outside Sanaa, from other governorates, where the response is even more challenging and limited,” Ducarme said.
"There's no large-scale surveys that can be done, or it's very complex here to do that. So having a full understanding of what exactly is happening in the communities is a challenge,” Ducarme continued.
Yemen was already considered the world’s worst humanitarian disaster before the pandemic, as ongoing conflict has made about 24 million people reliant on humanitarian aid. Aid and health care workers in May described the pandemic as a “perfect storm” for catastrophe.
Now, COVID-19 is exacerbating and accelerating all of Yemen’s pre-pandemic problems of high unemployment, inflation, food insecurity, and violence, according to Sultana Begum, advocacy manager for the Norwegian Refugee Council in Yemen.
But growing funding restraints for some international relief organizations, including the United Nations Office for the Coordination of Humanitarian Affairs, are making it harder to match people’s demand for lifesaving aid, Begum said in a phone interview. Some of NRC’s in-person work, like training sessions, has been cut during the pandemic, but it continues to provide food, cash, and emergency health kits.
“COVID is coming on top of many things. What we are really concerned about is if we are going to see a reversal of gains by humanitarian aid in Yemen. Eighteen months ago, we were talking about famine warnings, and millions of people were pulled back from the brink of famine,” Begum said. “With aid drying up, COVID, and all these other factors, I don’t think we are in a very good situation, and unfortunately world leaders are closing their eyes.”
A new NRC survey of 450 households in Yemen found 1 in 4 vulnerable families have lost all their income since the pandemic reached the country in April. Almost half of the respondents said they lost at least half of their income, and 94% of families reported food as a top concern, according to the survey, which was released Wednesday.
The World Food Programme this week also released new data on hunger in Yemen, estimating that 1.2 million more people in the southern areas of Yemen will face acute food insecurity by the end of the year. Acute food insecurity will increase from the current rates of 25% of the population to 40% in areas the WFP surveyed.
Social-distancing measures have loosened in Yemen over the last few weeks, with many people unable to stay home and work remotely. Ducarme said she worries that people’s movement will continue to increase toward the end of the month as Eid al-Adha approaches.
“We really hope that the people will remain cautious. But unfortunately, that's not exactly what we're seeing here. It's very difficult to predict,” Ducarme said. “We are all a little bit in the dark about numbers and trends. It’s hard to say exactly where we are on the curve, but we do know that it's not over. And that you can expect that we'll likely see waves of the epidemic, like elsewhere.”