Yemen’s conflict – now in its eighth year - has created what the UN says is one of the world’s worst humanitarian crises. This in a country already ravaged by political upheavals, economic instability, and a fragile healthcare system.

The conflict has devastated the country, and Hodeidah, an important port city considered to be Yemen’s economic backbone, has not been spared. As one of the key entry points where most food commodities and medical aid enter Yemen, the results are felt countrywide.

Despite Hodeidah’s importance, it has suffered from a significant decline in healthcare services due to the limited number of functioning health facilities. This left Al-Thawrah Hospital as the main medical services provider in a city often threatened by disease and epidemics, but the hospital simply could not cope with demand. But now, with support from the World Bank's International Development Association (IDA), and in partnership with the United Nations Development Programme (UNDP) and the Social Fund for Development (SFD), a new medical centre for infectious diseases has been built with crucial input from doctors to determine its needs.

Yemen’s humanitarian crisis has continued to worsen over the years with Hodeidah suffering from high rates of hunger and severe acute malnutrition. The persistently high unemployment rate poses a challenge for both individuals and society, exacerbating an already difficult situation for many. Even basic services such as electricity are unreliable with regular blackouts leaving the governorate sweltering in scorching summer heatwaves. This is coupled with the COVID-19 pandemic and outbreaks of diseases such as diphtheria, dengue, malaria, tetanus, tuberculosis, SARS, and pneumonia.

Easing pressure on the public hospital

The absence of a specialised medical centre to control infectious diseases in Hodeidah has had huge ramifications. Medical statistics issued by Al-Thawrah Hospital show that between November 2019 and March 2020, the hospital had over 5,200 infectious disease cases, with more than 50 deaths. Sadly, children were the most vulnerable with a death rate of 70 per cent. With no dedicated centre, the infectious patients were housed in the main hospital, resulting in overcrowding and adding to the risk of further outbreaks – a situation only made worse by COVID-19.

The new centre is of “great importance since it reduces overcrowding in the hospital and helps accommodate more patients,” says Yaman Fattah, the Health Projects Officer at SFD in Hodeidah. She explains that there was previously an ‘unviable’ medical centre being used and that it was ‘rehabilitated and equipped based on the latest healthcare standards and regulations.’

Dr. Ahmed Mujam, Vice President of the Al-Thawrah Hospital, agrees that overcrowding was previously an issue since the hospital receives patients from four governorates – Al-Mahwit, Hajjah, Hodeidah, and Raymah. He says there have been times when the hospital ran out of beds, leaving it unable to admit patients needing care. “We resorted to emptying other medical departments to admit patients,” he recalls. “Even corridors were packed with patients because there were not any beds left.”

Well-equipped centre for treatment

The new centre has been equipped with modern medical oxygen systems as well as an air purification and decontamination system to reduce the transmission of infections. Expected to receive around 120 patients daily, it will provide emergency medical and pharmacy services, and it has its own mortuary.

The centre’s focus is on quick diagnosis – another tool in the fight against infectious diseases and essential in curbing the spread of COVID-19. Professor Dr. Muhammad Al-Kamrani, the Scientific Medical and Epidemiological Advisor at the Centre for Tropical Medicine and Infectious Diseases at the hospital, says: “The centre facilitates the diagnosis and treatment of infectious and epidemic diseases since it enables us to take an evidence-based, therapeutic approach to diagnoses. This will contribute to reducing the mortality rate associated with infectious and epidemic diseases.” 

But opening a centre to specifically handle infectious diseases is not enough. Prevention and the raising of community awareness is essential to the fight as well. Using an outbreak of diphtheria that began at the end of 2017 as an example, Dr. Al-Kamrani explains how treatment and prevention are key to the fight against infectious diseases. Cases in the city peaked at a recorded 319 in 2019 but with the intervention of medical immunisation campaigns, it dropped to 167 in 2020 with fewer people dying from these diseases today. “The mortality rate associated with infectious diseases has dropped by 47 per cent compared to other diseases, which is a huge figure,” says Dr. Al-Kamrani. “The new centre will help us control the transmission of infections and contribute to saving patients’ lives.”

Al-Kamrani explained that 26 of the health staff working at the centre were trained in partnership with academic and medical authorities to help control infectious diseases. The centre relies on upon an effective treatment guide and a model treatment plan of managing patients from admission to discharge.

Additionally, the protection of medical professionals when treating infectious diseases is key – something that COVID-19 has highlighted. The centre is equipped with modern preventive means and has a specialised Isolation Unit that helps protect doctors from exposure.

A ray of hope

Azhar Ismail, the mother of three-year-old Ismail, was impressed with the level of healthcare provided at the centre. She did not expect it to be fully-equipped and adequately staffed.

“I brought my son, Ismail, to the centre. He was in extremely poor health condition; he was suffering from sore throat and high fever, and I lost all hope of his recovery. With the efforts of the medical staff at the centre, my son recovered after 12 days of his admittance at the centre,” she says.

The centre includes a reception, an emergency department, a vector-borne diseases unit (for malaria, dengue, and chikungunya), an in-patient unit, an intensive care unit, an isolation unit, a diagnostic radiology unit, a biological unit, a blood and biochemistry laboratory, an operating room, and a nurses’ shift room.

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Funded and supported by the World Bank’s International Development Association, the Yemen Emergency Crisis Response Project (YECRP) was implemented by the Social Fund for Development (SFD) and the Public Works Project (PWP) in partnership with UNDP Yemen. The US$400 million project provided economic stimuli in the form of large cash-for-work projects, support to small businesses, and labour-intensive repairs of socio-economic assets, benefiting vulnerable local households and communities across Yemen.