Since the end of March, clashes have sharply intensified in Yemen's Hajjah governorate between Ansar Allah and forces loyal to the Hadi government, which are supported by the Saudi-led coalition. Some of the fiercest fighting is taking place close to Abs, near the Saudi border, where Doctors Without Borders/Médecins Sans Frontières (MSF) supports a rural hospital in collaboration with the Ministry of Public Health.
On August 11, an airstrike in Mustaba district killed at least 10 members of an extended family and injured another 17 family members who were then treated at the MSF-supported Abs Rural Hospital. It was the largest influx of civilians wounded in a single day since we started working at the hospital in 2015. Jaume Rado, MSF head of mission in Yemen, gave the following account below.
“When I spoke to Mariam, the 25-year-old mother of one of the children who died in the attack, I was reminded of the thousands of patients and their families who are affected by this conflict. Every day that MSF spends treating patients is a day spent witnessing the impacts of this war on civilians. Our patients no longer dare to hope that combatants will respect the laws of war, or that there are areas that are safe for those who are not part of the fighting.
It was impossible, speaking to Mariam, not to think of three years ago in August 2016, when my colleagues and their patients were the victims of another airstrike. That strike, by the Saudi-led coalition (SLC), hit the emergency department of Abs Rural Hospital, killing 19 people including one MSF worker and five children. It was the fifth and deadliest strike on an MSF-supported medical service in Yemen since 2015.
"The humanitarian response to the conflict is insufficient and those working to provide this aid are left exposed and unprotected"
Since then, the strikes have continued unabated. On June 11, 2018, a newly constructed MSF cholera treatment centre in Abs was also attacked. As a result we had to rebuild the centre from scratch, and the more than 1.2 million people who rely on the services of Abs Rural Hospital were left with no treatment as a cholera outbreak swept through the population. The mere existence of diseases like cholera and diphtheria, which were previously almost absent in Yemen, signals how deeply the conflict is affecting the health and wellbeing of the Yemeni population.
There is an obvious, reckless disregard for civilian lives among the parties to the conflict in Yemen. It is clear in the open flouting of international humanitarian law, in the bandying about of terms such as "collateral damage," and in the negligence with which strikes on civilian sites are conducted. The number of displaced is 3.65 million and growing, while the capacity of the population to cope with such displacement is diminishing. The humanitarian response to the conflict is insufficient and those working to provide this aid are left exposed and unprotected. Knowing all this, it is impossible to comfort a mother who has lost a child and nine other members of her family, just as it was impossible to comfort our staff and their patients three years ago. There are no answers for them.
Now, there are increasing calls for more funding for the humanitarian response. And more funding is needed. But this is not enough. Humanitarian agencies must be able to bring that aid to those who need it without risk of harm, instead of working in diminishing areas farther and farther from the displaced. In turn, they must also show themselves more willing to do so. All the money that donors can provide will not change the situation if humanitarians' access remains limited. Such funding, without real change from the participants in the conflict, will not end the bloodshed, will not compensate for the thousands of lost Yemeni lives, and will not provide the answers and the solutions that our patients so desperately need.
Three years after the bombing of Abs Rural Hospital there is still only one, simple request we make of all parties to the conflict: respect international humanitarian law, protect civilians. To those who can hold combatants accountable: do not accept "mistakes" or "collateral damage." To the international humanitarian community: it is time to do and say more. History will judge all of us, as Yemenis are already doing.”