Yemen’s humanitarian and food insecurity crisis continues to worsen and malnutrition among children is at an all-time high, but the situation has not yet deteriorated enough to become a famine, experts and observers said.
Almost 14.4 million people in Yemen are food insecure, and almost half of them are in “desperate need of food assistance,” breaking down to one-fifth of Yemen’s population, according to the World Food Program.
Nearly 2.2 million children in the country are acutely malnourished, including 462,000 who suffer from severe acute malnutrition — an increase of 200 percent since 2014, according to UNICEF.
And with already more than half of the hospitals in Yemen destroyed, the health system is now also “on the brink of total collapse,” according to the Disasters Emergency Committee, a coalition of United Kingdom charities.
What’s needed, aid groups say, is increased participation from the international aid community across Yemen, as people’s food and medical needs remain immense and could get worse.
“We are not talking about funding, we are talking about hands,” said Eric Jeunot, the head of the Médecins Sans Frontières mission in Yemen. “We are too few. We cannot do everything and we need support to reach people, to provide direct care to the population.”
A combination of price hikes and halts on food imports, a strained economy and partial shut-down of public institutions means food has become very expensive, or entirely out of reach, for many Yemenis.
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It’s not uncommon to see a child who has not eaten for more than 10 days at one of the 10 hospitals and 15 health centers MSF supports, Jeunot says.
“This is a reality. Millions of people are struggling to get food and we are really concerned that the existing malnutrition situation is deteriorating very, very badly,” Jeunot said in a phone interview. “We are able to deploy some teams in various locations and support the Ministry of Health as much as we can, but we need help.”
MSF, with 1,500 employees and 90 international staff in Yemen, is one of the largest international groups in the field. It has performed 360,000 emergency consultations since the beginning of the war, and more recently observed an uptick in communicable diseases.
Most of the children at MSF clinics are presenting with gastroenteritis or watery diarrhea, acute bronchitis, in addition to some form of malnutrition, according to Jeunot. There have also been 122 confirmed cholera cases, 10 deaths and 72 suspected more, in certain areas, as of the end of November.
Yemen’s crisis is still considered an “emergency” by the World Food Program, and not a famine, despite some calls that the crisis will soon deteriorate into one.
A famine is technically defined as the “absolute inaccessibility of food to an entire population or subgroup of a population, potentially causing death in the short term,” according to a set of standardized tools, known as the Integrated Food Security Phase Classification. The partnership is led by U.N. agencies, the European Commission and some leading international aid agencies, including CARE.
“I would say at this point we don’t necessarily see it as that [a famine],” said Carlos Morazzani, the International Committee of the Red Cross (ICRC) head of delegation in Yemen, speaking on behalf of the DEC last week. “We acknowledge there could be acute malnutrition, however, at the moment we are not endorsing reports from other agencies of starvation and famine.”
In October, the U.N.’s undersecretary-general for humanitarian affairs and emergency relief coordinator, Stephen O’Brien, said that Yemen was “one step away from famine.” He explained that the country’s intensifying conflict required a political settlement and that a humanitarian solution would not be effective in ending the suffering of more than 21.2 million people who need humanitarian assistance.
The country’s internal war between the government and the Houthi rebel movement, which intensified in March 2015, links back to the presidential transition in November 2011. The conflict has also gained outside influence. Last year, Saudi Arabia led a coalition of Middle East countries into the war that has been attacking the rebels. Iran, meanwhile, is backing the Houthis.
The U.N. Office for the Coordination of Humanitarian Affairs has requested $1.63 billion to support humanitarian work in Yemen. So far, it has received nearly 60 percent of that amount this year.
The DEC launched an emergency appeal for Yemen last week, and raised 8 million pounds ($9.9 million) within a few days.
Even before the conflict, Yemen had faced challenges of widespread poverty and food insecurity, notes Sherin Varkey, the deputy representative of UNICEF’s office in Yemen. Now another prime concern is that “health systems are on the verge of collapse,” he said. And less than a third of the country’s population actually has access to medical care.
“Health workers are not being paid for months and the real struggle is for agencies, including UNICEF, to bring in lifesaving supplies,” he explained.
It’s also a question of accessing people in remote areas. While the conflict had led to the deaths of more than 6,500 people as of August, it has not directly impacted access for humanitarian groups, in most cases. There are obvious exceptions. An airstrike hit a MSF hospital this summer, killing one staff member and 10 others. And a ICRC staffer was released in October after a 10-month abduction by the Houthi militia, a Shiite rebel group occupying a portion of the country’s western zone.
As Jeunot explained, MSF still does not have a full perspective of the needs of people in rural areas. It’s not uncommon for people to wait too long to visit health centers or hospitals, or delay visit for their children.
“We want to sound an alert about the situation and say that if it is not tackled now, it is not going to get better,” he said.
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Update on Dec. 23: This piece has been changed to reflect that two staffers are with the International Committee of the Red Cross, not the British Red Cross.