Fieldset
Yemen diary, part two: Entitlement

In part two of her diary from Yemen, Dr Georgina Woolveridge writes about the patients at the hospital in Al Udayn, Yemen...

Click here to read part one of Georgina's diary.

They never came back.

It’s been a month since I met that skeletal bundle and begged his family to stay. Despite my best hopes, and fastidious checking of our Emergency Room register, they didn’t return.

With no forwarding phone number, I can’t be sure he made it to six months, or to 4 kg, or to his burial plot.

For me, this is the face of war.  No combat boots, no blast injuries or camouflage gear.  The soldiers, the bombs, the traumatic, immediate devastation is so far from the overwhelming truth I’ve found here in Yemen, and last year too, in Iraq.  

The true face of war

War doesn’t look like a running soldier, laden with artillery shells.  It’s the face of a five-month-old child, emaciated, aged exponentially in a cruel twist of irony as he dies slowly and prematurely from malnutrition.  

It’s the withdrawal of humanitarian organisations in rural areas as fighting parties threaten advance, then retreat. The agencies telling starving families the gaping hole won’t only be in their stomachs, but in the provision of international aid.

Conflict is the pain on the face of a husband as he begs us to try and revive his cold, pale wife.  She was alive two hours ago, birthing their fourth child at home in a frenzy of life, until she began bleeding out on the floor. 

The road was short but pockmarked from the waves of war. They couldn’t afford access to a health centre for the birth, there were likely no options for family planning.  

Conflict killed her no doubt, but the stray bullet was poverty, she’d been dead at least an hour before we met.

Outside the system

Combat is the daily struggle for a child born with countless possible congenital conditions, a child that doesn’t have a place in the system.  Not even in our system.

Maybe the hole in his heart was a by-product of suspended national vaccination campaigns that saw his mother contract rubella during pregnancy.  Maybe it’s a result of off-the-cuff prescriptions she got from a pharmaceutical system that’s completely deregulated.

[Read next: Yemen - Giving hope to the people caught in the crossfire]

He was treated with off-label medication to reduce the growing arterial pressures in his lungs, but was discharged from hospital prematurely when the bed was needed and their money ran out.  

As MSF we covered his care when he came to us again with a bowel obstruction, but the chronic condition was beyond our scope.

Fear the rain

War on civilians smells like chlorine.  As airstrikes damage hospitals, water and sanitation infrastructure, millions of people become more vulnerable to waterborne disease.  

With worsening states of malnutrition, and little ongoing treatment for medical disease predating the conflict, the cholera outbreak of 2016 surges on until this day.  Our local colleagues learned early to fear the rain for the spike of cholera that often follows, many having watched loved ones die with limited access to aid.  

While chlorine effectively kills many waterborne pathogens, health education and supplies seem to spread slower than disease.

You can hear the airstrikes in the vocabulary of colleagues. Many flown-in humanitarians would be naïve to believe they know more about trauma and war wounds than their Yemeni colleagues.  The management of these injuries is second nature now, a drill most healthcare workers here have run for years.

I wanted so dearly for that malnourished baby to return, to provide that chance of life the system was trying to deny him. 

I wanted hope, for myself and for the future of the Yemeni people. Maybe I thought I was entitled to it, when in fact it is 28 million Yemenis who are entitled.

To basic human rights. To healthcare.  To an existence free from conflict.

 

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Top image was taken in Al Salakhana hospital, Yemen, in 2019.