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

Publisher

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 4:39 PM

US Sanctions versus Iran’s fight against COVID-19 pandemic

Iran is the hardest-hit country by the coronavirus pandemic in the middle east. The contagion was first detected on 19 February 2020 in the holy city of Qom, and thereafter spread quickly across the country. As of 18th June 2020, it had over 9000 coronavirus related fatalities. The virus attacked all the 31 provinces of the country not discriminating between the common man and the people at high places including the members of the Parliament, religious leaders and senior ministers. The crisis touched most parts of the country, but it most severely impacted working and the poor class. 

The Iranian government has been criticized for its response towards the pandemic. The health care policy, which has been politicized, has preferred denial and misinformation as a response to the crisis the pandemic brought with it. Questions have also been raised about the role of US sanctions in crippling Iran’s economy, public health facilities and public health facilities. All these factors, when combined, have disabled Tehran (the capital of Iran) from providing the best response to the pandemic. 

What do the sanction laws say?

According to the Office of Foreign Assets Control, the US has “consistently maintained broad exceptions and authorizations to support humanitarian transactions with Iran.” The first significant sanctions were imposed in 1995 by Bill Clinton, and in 2001 exemptions for medical goods and medicine first came into effect. These sanctions have periodically widened the scope of products for exemption, and by 2012, the exclusions included agricultural products and most foods. After the world powers, including the US, reached a deal with Iran on its nuclear programme in 2015, the sanctions were lowered against Iran. This approach was abandoned after Trump withdrew the US from the deal and sought to force Iran’s leaders to change their anti-US policy. .

The US sanctions are enforced through a wide array of instruments. Financial sanctions prohibit US banks from transacting with Iran, which limits Iran’s access to dollar-denominated transactions. Secondary sanctions measures also target non-US entities that have dealings with Iran, thus at a risk of facing prosecution in the US. These sanctions make transactions with Iran lengthy and complicated, and even impossible in some cases

There are some exemptions from sanctions for humanitarian assistance (sale of agricultural commodities, food, medicine and agricultural services). Despite these exemptions, sanctions have severely impaired Iran’s ability to be able to finance humanitarian imports. Given the volume of complexity and due diligence involved, most banks are reluctant to deal with Iran. This makes it difficult to find a way to pay for purchases difficult for Iran. Also many items require additional authorization because the US considers them as “dual-use” (the things might also be used for defence- for example, the sort of oxygen generators that are needed in life support machines used to treat coronavirus cases). Lastly, the sanctions on Iran’s oil exports led to a decline in revenue, further weakening Iran’s currency, which has left the country vulnerable and with fewer resources to pay for non-sanctioned items as well. 

All these put together have directly caused shortages of medical equipment and impacted Iran’s health sector negatively. This has also impacted the capability of Iranian healthcare sector to effectively manage the COVID-19 situation.

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