Saturday, August 8, 2020

Yemen's Multilayered War: The Failing Healthcare Infrastructure

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Anant Jani

Article Title

Yemen's Multilayered War: The Failing Healthcare Infrastructure

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Global Views 360

Publication Date

August 8, 2020

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Air strike Al-Thawra hospital, Hodeida on August 2, 2018

Air strike Al-Thawra hospital, Hodeida on August 2, 2018 | Photo credit: ABDO HYDER/AFP/Getty Images | Source: Felton Davis via Flickr

This is the 6th and last part of a short explainer article series on the current crisis in Yemen. To read the earlier parts of the series click on the link.

To read the 1st part of the series click on the link.

To read the 2nd part of the series click on the link.

To read the 3rd part of the series click on the link.

To read the 4th part of the series click on the link.

To read the 5th part of the series click on the link.

The civil war in Yemen, more so after 2015 has taken a toll on the civic infrastructure of the already fragile and poor country. Among these, the healthcare infrastructure of the country was one of the worst affected.

Apart from the physical damage to the hospitals and clinics due to the aerial bombings by the Saudi Arabia led coalition, the naval blockades exacerbated the dire situation. In June 2015 itself, aid agencies warned of the humanitarian risks brought by the US and UK-backed Saudi blockades.

The humanitarian situation aggravated further as there was a consistent famine since 2016 and Yemen was dependent on foreign aid for feeding almost 80% of its population.  According to UNICEF reports, over 3.3 million children and pregnant or lactating women suffer from acute malnutrition.

In 2017, the World Food Programme estimated that an additional 3.2 million people would be pushed into hunger. If left untreated, 150,000 malnourished children could die within the coming months.

Save the Children, the international charity and aid agency, estimated that 85,000 children under the age of five have starved to death in between 2015 to 2018.

Major healthcare operatives are dying due to the active bombing and conflict in Yemen, including personnel from MSF and United Nations Office for Coordination of Humanitarian Affairs (OCHO).

The MSF (or Doctors Without Borders), who have been in Yemen since 2007, have reported that fears of stigmatization are causing people to stay away from hospitals, with misinformation and lack of medical services only compounding the healthcare issue during the pandemic.

As of 24th July, the country reports 1640 confirmed infections and 458 related deaths.  Al Jazeera reported that “Cemeteries in Aden are overflowing with graves, suggesting that the number of people killed by the new coronavirus is higher than the official count.” Yemen and its related aid agencies also suffer from lack of PPEs and adequate information about the pandemic.

As of April 2020, there are 800,000 internally displaced persons in just one province of Yemen Marib. The number of verified civilian deaths stands at 7,700.

The United Nations has been continually asking for donations, but has failed to collect as much as it requires. While it collected $4 billion last year, it has only received $700 million, halfway into 2020.

The UN urged for $2.4 billion this year to fight the humanitarian crises and the Coronavirus. As of 2nd June, 29 countries and the European Commission pledged a total of $1.35 billion to support humanitarian efforts in Yemen, just over half of the amount needed to sustain programs through the end of this year.

In April 2020, the Saudi deputy defence minister, Prince Khalid bin Salman, said Saudi Arabia “will contribute $500m to the UN humanitarian relief program for Yemen in 2020, and an additional $25m to help combat the pandemic. It is up to Houthis to put the health and safety of the Yemeni people above all else.”

There are 41 major UN programmes in Yemen, and it is estimated that more than 30 of them will close due to lack of funds. The UN stated, “Due to the COVID-19 suppression measures, all integrated outreach activities, which include the Expanded Programme on Immunization, Integrated Management of Childhood Illness, Maternal and Newborn Health,and nutrition activities, were suspended.”

Most of Yemen's 3,500 medical facilities have been damaged or destroyed in air strikes, and only half are thought to be fully functioning. Officials warn that monetary relief may not be enough to assist in the war against the pandemic alongside the Civil War. A solution to the war must be found soon, before the pandemic eviscerates more of the healthcare infrastructure.

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February 4, 2021 4:54 PM

The story of reconciliation and development in the genocide hit Rwanda

The genocide and civil war had rendered hundreds of thousand of people homeless and in utter misery. If the Tutsi’s were the primary victims of genocide, the Hutu’s too suffer in the ensuing civil war when Paul Kagame led Rwandan Patriotic Front defeated the government forces and took over Rwanda.

When the genocide stopped by August 1994, the the suspected perpetrators of crime were hounded by the new government forces. Thousands of Hutus left the country and sought refuge in the neighbouring countries. The legal system of Rwanda was in shambles and the vengeance was taking precedence over the quest of justice. Over a hundred thousand suspected genocidaires were put in prison but could not be properly tried due to a strained judicial system.  

Things however started to change from the year 2000, when Paul Kagame became Rwanda’s President. The biggest challenge for him was to rebuild a society that is economically and socially stable. The socio-economic transformation of Rwanda under Kagame is an inspiring story of reconciliation based on acceptance, repentance and forgiveness, the very foundation on which the edifice of Rwanda's reconciliation is standing firmly today.

The first step towards reconciliation started in 2002 when Rwanda introduced the community-based dispute resolution mechanism, Gacaca to try the genocide related crimes. Gacaca was traditionally used in Rwanda to resolve minor disputes. In its new incarnation, the objectives included not only delivering justice, but also strengthening reconciliation, and revealing the truth about the genocide.  

In the Gacaca court the local community elected the judges who then tried the defendants  in front of members of the local community. These community members  were asked to share whatever they knewabout the the role of defendant during the genocide. Gacaca courts functioned extensively during 2005 to 2012 and processed almost two million cases in this duration.

Though Gacaca courts were criticised by many human right organisations for putting speed over fairness in trial, it undoubtedly resulted in giving the opportunity for some genocide survivors to learn what had happened to their relatives. It helped many families of survivors and perpetrators living side by side with peace and contentment in many reconciliation villages, after the ‘perpetrators’ confessed their crimes and expressed repentance.

Taking inspiration from The Truth and Reconciliation Commission” of South Africa, Rwanda established a “National Unity and Reconciliation Commission” in 1999 with an objective to reconcile and unite the Rwandan citizens. This process used four specific tools. (1) Ingandos - to bring normal activities to a standstill in order to reflect on, and find solutions to national challenges, (2) Organising reconciliation summits, (3) Creation of a leadership academy for developing a new set of grassroot leaders, and (4) Frequent exchanges and consultations at inter-community level.

All these efforts along with that of many non-governmental organisations helped to greatly heal the deep wound of sectarian violence in Rwanda. According to the report published by the National Unity and Reconciliation Commission of Rwanda in 2016, over 92% of Rwandans feel that reconciliation is happening.  

Alongside the reconciliation process, the government of Rwanda started spending on health, education and other civic infrastructure which has paid a good dividend in last two decades.

Government expenditure on healthcare facilities per person has gone up sixfold from just $21 in 1995 to $125 in 2014) which contributed to the increase in Life expectancy at birth by 32 years between 1990 and 2016 while  reducing the infant mortality by half since 2000.

The focus on the education sector resulted in almost three quarters of girls and two-thirds of boys now completing primary schooling while literacy rates of adult males and females increased to 75% and 68% respectively.

Rwanda now ranks 6th out 149 countries in the global gender gap index and a high proportion of front-line political positions, including 61% of the parliamentary seats are occupied by women. Rwandan women possess the right to inherit property and can also pass citizenship to their children.

The newfound peace, stability and reconciliation in Rwanda gave a boost to the country’s economy which saw per capita GDP growth from $200 to almost $800 between 1994 and 2017. In 2018 the GDP grew at  8.6% and the county rated the second-best place to do business in Africa.

Rwanda today is a shining example that a country with a long and painful history of violent sectarianism, can achieve great success, if it takes every section of the population along on a path of peace, unity and reconciliation.

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