The BMJ charity appeal Christmas 2017: help MSF bring essential healthcare to millions of people in war torn YemenBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5722 (Published 12 December 2017) Cite this as: BMJ 2017;359:j5722
“Yemen is one of MSF’s biggest missions worldwide, partly because of the medical need and partly because of lack of capacity in the country,” Djoen Besselink, the humanitarian charity’s head of mission in Yemen, told The BMJ by phone from Sana’a, the country’s capital, pausing for the occasional explosion.
More than three million people have fled their homes after two years of brutal fighting between Saudi backed government forces and rebel groups. Some 15 million civilians, half the population, lack healthcare and are facing cholera and malnutrition as the cost of food rises.
Healthcare facilities have been targeted and destroyed, and many healthcare workers have fled. Those who remain have not been paid for more than a year. Add to all that the water shortages, air strikes, sniper attacks, food insecurity, and a fuel blockade and you begin to realise how essential MSF’s work is here.
“Healthcare was bad here before; now it’s really bad,” says Besselink. “After two years of full-on conflict it cannot deal with cholera outbreaks or diphtheria. It can’t even deal with pneumonia and malaria. It’s a massive humanitarian crisis. A healthy health system should be able to deal with cholera. People shouldn’t be dying from pneumonia.”
Besselink adds, “There are fewer and fewer places where the population can go for healthcare, because of security or lack of healthcare workers. A year ago MSF delivered 200 babies a month at one location. Now it’s 800.” MSF treated one in four cases of cholera in last year’s outbreak, he says.
Because it is one of the poorest countries in the Middle East, MSF started a mission in Yemen in the 1980s. “Fighting really escalated in 2015 and since then we scaled up massively,” explained Besselink. “It’s been quite a rollercoaster in the past two years.” Now MSF has some 1600 staff in the country, including 82 from abroad, working in 13 hospitals and supporting 18 more.
“We were hit four times last year by stray bullets. But we’re still here.” Despite the danger, Besselink is proud of MSF’s commitment to neutrality, treating patients on the basis of need, and the trust it’s earnt.
“We are quite accepted here. We’ve been here for so long. People know what we do and that we treat everyone. It’s scary that the front line is 300 metres that way. You just don’t go that way.”
In Yemen this year between January and March MSF saw 97 216 emergency department patients, carried out 5826 surgical interventions, and admitted 2786 children to hospital. Last year it had 460 projects in 72 countries helping the neediest people on the planet. Most staff are volunteers. To help it remain independent MSF relies almost entirely on private donations.
“In the papers you see a lot of political discussion, diplomatic talk, the blockade,” says Besselink. “We want to show the human impact. People’s struggles. People selling their car to pay for healthcare. The fighting that’s become a normal part of life.”
Please help MSF help the people of Yemen
£123 could pay for a blood transfusion for three people
£65 could buy a stretcher to help move an injured person to safety
£54 could provide antibiotics to treat 40 war wounded people
Donate online: www.msf.org.uk/bmj
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Competing interests: None declared.