In response to the physical and verbal offences that take place in health facilities or against the medical mission and ambulances in Yemen, Medecins Sans Frontieres (MSF) is discussing this issue in a seminar in cooperation with the Ministry of Public Health and Population. MSF will follow the seminar with regional round sessions in specific governorates in an attempt to solve this humanitarian concern resulting in the denial of access to healthcare to a large number of people.

The consequences of those attacks against healthcare personnel or facilities are dramatic for the patients: the quality of care is impacted and the access to health care services is shrinking:

MSF interviews the Minister of Public Health and Population Dr Ahmed Al-Ansi.

MSF: From your point of view, how do you see the situation in Yemen in regard of the respect of medical healthcare and the security situation?

Minister This is one of the most difficult questions to answer. I believe that medical practitioners suffer while performing their duty for many reasons. The first of which is the absence of awareness amongst people regarding the respecting medical facilities and practitioners. The second is not applying the law, if there is any, on health facilities violators. Besides this, the huge number of people in one area makes it difficult to control people’s behaviors in hospitals. You can see that in large residential areas, violations are more than areas where the number of people is small. Respect is not expected from a specific segment of the society rather from all members of the society. As a doctor and a lecturer, I believe that people need awareness and education through the media. When I was a doctor treating people during the revolution, I worked with ICRC to produce a declaration that attacking health facilities is not but a war crime.

MSF: How can lack of respect of medical practitioners and facilities affect people?

Minister: This has definitely negative impact on people. Say for example, a group of people brought a patient. The doctor will do his best to check the case and see what measures should be taken. However, if the accompanies of the patient insisted that their patient is treated first and at once, this will by no means affect the other patients in the hospital who have emergency cases. When the doctor is insulted verbally or physically, this will affect his spirits that he will not feel comfortable anymore doing his job. Respect is the number one element needed between patients/their relatives and the doctors. During the revolution, when I was working in the Military Hospital, the manager of the hospital who was at the time was a military official. I asked him to treat people in the hospital based on medical ethics not to apply the rules of military inside the hospital. I asked him to treat people inside the hospital based on humanitarian consciousness.

MSF: What are your recommendations regarding increasing the level of awareness among people?

Minister: This can be achieved through media education and organizing seminar to increase their awareness. It can also be done through organizing workshops for health practitioners on how to work as a team, to make medical ethics the guidance for them inside the hospital and to forget their different backgrounds. Hospitals are neutral places and should not be disturbed.

ADEN & Abyan Governorates

• Surgical activity- Aden Emergency Surgical Unit (ESU)
In April 2012, MSF opened an independently run emergency surgical centre in Al Wehdah Hospital.
The hospital is treating the victims of violence from Aden city and it also provides emergency surgical services to the population of Abyan, regardless of the cause of the trauma, if they can not be treated locally.
Patients are referred from Jaar Al Razi Hospital. From August 2011 until July 2012, the medical team had to work in very difficult conditions from the Jaar post office, transformed into a medical post, after the bombing of Al Razi hospital.
• Lawdar Hospital.
• Shoqra health center
• Al Nasser hospital in Ad-Dhali governorate
• Habilain Hospital in Lahj governorate

An ambulance service is active 24hrs/ 7 days to transfer patients from Abyan to Aden.

• Emergency & Maternity Support to Abyan
o Lawdar
o Jaar

• Polyclinics support
In response to the influx of displaced population in Aden city fleeing the conflict in Abyan, MSF supported 3 polyclinics in Aden with supply of drugs, supervision and improvement in hygiene / sterilization and waste management. The cooperation ended in April 2012.

AL-DHALI Governorate : MSF supports the vulnerable community in Al-Dhale’ in Al Naser Hospital. It is also providing primary health care services to the population of Al Azareq district as it provides consultations for 2000 people a month. MSF is currently identifying the needs and considering opening a new health care center within the governorate.

By the end of October 2012, MSF activities in Radfan district, in Lahj governorate, performed more than 400 operations during 2012. Activities in the health structure of Al Hosn carried out around 18,400 consultations and assisted 132 births.

Sanaá governorate: HIV project will re start its activities from January 2013. The aim of this project is to reduce stigma and discrimination and provide access and quality of care to people with HIV / AIDS in Sanaá Yemen. The project would be a 3 years project and

could be eventually extended to some other areas if the Sana’a one reaches its objectives in the coming months.

Hajjah governorate: During 2012, MSF continued managing a hospital close to Al Mazraq town, which was built by the Organization of the Islamic Conference and the Qatar Red Crescent Society. The hospital provided primary and secondary health care, emergency assistance and surgery to the displaced population living around the town and to local population. In 2012, MSF carried out more than 23,300 consultations, performed around 310 operations and cared for more than 2,600 inpatients. Moreover, more than 3,300 women received ante-natal health care and more MSF teams assisted around 940 births.

Some of the displaced people living in IDP camps around Al Mazraq town decided to return to Sa’ada after the ceasefire agreement in 2010. However, others chose to stay in the area. At the end of 2012, MSF started to reduce some activities in Al Mazraq hospital because the situation in the area was no longer an acute emergency as when the camps were established. After 3 years and half of providing aid to the IDPs, MSF will hand over the structure of Al Mazraq to OIC (Organization Islamic Conference who built it) end of June 2013.

AMRAN Governorate: MSF support to the Ministry of Health’s Al Salam Hospital in Khamer and to the Huth Heath Centre started in 2010 in response to populations fleeing the conflict in Sadaa governorate.

After the return of most of the displaced population in 2011, the support continued to answer the medical and surgical emergencies in a very unstable area in which clashes and violence are frequent. Al Salam Hospital is the only comprehensive health facility in the northern districts of the governorate providing high quality, free of charge medical and surgical care.

- Khamer Al Salam Hospital
In the course of 2012, MSF in collaboration with the Ministry of Health has opened two new services: a paediatric ward and an intensive care unit. The maternity and the nursery have been reorganised to properly respond to the most complicated cases, while the support to family planning and ante natal care has been on-going.
MSF is also supporting the emergency room, operation theatre with a team of surgeons and anaesthetists and the inpatient department (IPD) for male and female. The nutrition activities have been stopped and handed over to the Ministry of Health, but MSF will keep on treating cases of secondary malnutrition only in the new paediatric ward.

- Outreach activities in the valleys
The population in Osman and Akhraf valleys have a limited access to health care due to the remoteness of the locations and the limited financial resources of the families. MSF started in 2011 to screen and treat malaria and malnutrition cases. The most complicated ones are referred to Al Salam Hospital.
In 2012, MSF has increased its activities in the valleys extending the services to remote villages and is planning to add ante natal consultations. Paediatric cases and pregnant women with complicated delivery are referred to Al Salam Hospital, giving the opportunity to patients living in remote locations to have access to quality health care.

- Huth Health Centre
The health centre provided a comprehensive range of activities that were supported by MSF. Due to a serious security incident in September 2012, MSF decided to scale down its support to the emergency room, IPD and maternity; negotiations are ongoing to restart the support.
Emergency surgical cases as well as paediatric and gyno-obstetric cases are referred to Al Salam Hospital.

AMMAN Project – Jordan

Since 2006, MSF has been running a project of reconstructive surgery in Amman (Jordan) for Iraqi victims of violence. Patients from Palestine and Syria are also treated in this MSF hospital.
Since 2010, Yemeni patients are now treated in Amman. The number of patients coming from Yemen has steadily increased to reach the number of 104 by the end of 2012.

Patients are members of the security forces, victims of 2011 clashes or civilian affected by violence across the country.

In order to ensure its independence, MSF does not accept funding from any government, religious committee or international agency for its programmes in the Middle East, relying solely on private donations from the general public around the world to carry out its work.
As an international medical humanitarian organization, MSF strives to provide free medical assistance to communities affected by natural disasters, armed conflicts and disease outbreaks, as well as those suffering from a lack of access to healthcare. MSF offers neutral and impartial assistance regardless of race, religion, gender or political affiliation. MSF is an independent, non-profit organization founded in 1971. Today, it is a worldwide movement working in 65 countries around the world. It has been working in Yemen since 2007.