Her infant son, weakened by hunger, needed a better-equipped hospital in the capital, Sana’a, roughly 30 miles away. But Hanan Saleh could no longer afford even the $30 taxi fare.
Before, she depended on a Western aid organization, Save the Children, for funds, drawn from money donated by the United States, to cover the travel costs, said employees of the organization and hospital officials. But last year, the United States slashed its funding to United Nations groups and others such as Save the Children.
So Saleh had to raise money to treat her son, Mohammed, in Sana’a until those funds ran out, too. Her last option was a small hospital in this northern Yemen market town, a 15-minute walk from their home. The staff tried to build up his skeletal, malnourished nine-month-old body.
“He died two months ago,” Saleh recalled in November, breaking down in tears.
Aid cuts by the Trump administration and other Western countries, intended to prevent Yemen’s Houthis from diverting or blocking funds, are worsening the country’s humanitarian crisis, already considered the most severe in the world.
Last year’s pledges totaling $1.61 billion were less than half of 2019’s funding, and hundreds of millions of dollars committed by donors have not yet been paid, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA) for Yemen. At least 15 of the UN’s 41 major programs have been scaled back or closed, and additional programs could shutter in the months to come, if more funds are not received, UN officials say.
Aid groups fear the crisis would get even worse if the Trump administration, in its waning days, goes ahead with plans to designate the Houthis as a foreign terrorist organization.
It would prevent numerous Western aid organizations, concerned about prosecution for perceived support of the group, from operating in Houthi-controlled areas, where most Yemenis live. It could also prompt retaliatory measures by the group against aid groups, further undermining efforts to assist millions of Yemenis.
The reduction in funding comes at a time when “Yemen is now in imminent danger of the worst famine the world has seen for decades,” UN Secretary-General Antonio Guterres warned in a recent statement, adding that “in the absence of immediate action, millions of lives may be lost.”
Aidan O’Leary, head of the UN’s humanitarian office in Yemen, said the lack of funding could result in emergency food aid being suspended for five million people and basic health care for nine million people, including more than half a million malnourished children.
An economy in free fall, a locust infestation and devastating floods, as well as the spread of the coronavirus have compounded the humanitarian woes, aid workers said.
Today, more than 24 million Yemenis, roughly 80 percent of the population, require humanitarian assistance, including more than 12 million children, says the UN Children’s Fund (UNICEF). Half of all medical facilities are destroyed or not operational, according to Oxfam. Cholera, dengue and other diseases have shattered the immune systems of millions, leaving them more vulnerable to the coronavirus.
In March, the Trump administration suspended at least $73 million in aid after accusing the Houthis of diverting and disrupting aid. Other Western donors followed suit. In October, a UNICEF study found that acute malnutrition rates among children under the age of five in some parts of Yemen were the highest ever recorded.
An acting spokesperson for USAID, the US government’s donor arm, defended its aid giving, saying the United States remains Yemen’s largest donor, despite the cutbacks. The US government “remains committed to providing assistance to Yemen’s most vulnerable communities,” said Pooja Jhunjhunwala, the acting spokesperson.
According to UN data, the US contribution in 2020 of $530 million was about 60 percent of its 2019 contribution. Jhunjhunwala said US government data, which goes by fiscal year rather than calendar year, shows there was a 15 percent decrease in fiscal year 2020 from the previous fiscal year.
The Raydah hospital is far less equipped than a full-fledged hospital but receives patients from across the region.
Save the Children, an American charity that receives US government funds, once paid for most salaries, medicines, nutritional supplements, hygiene equipment and first aid service.
“These things have stopped since March,” said Abdullah Saleh Altam, the hospital’s general manager. “As a result, the situation here has deteriorated in the past few months.”
Today, he said, patients with chronic diseases cannot find basic medicines for respiratory illnesses, diarrhea and malnutrition.
“Even those who were financially okay have started showing signs of malnutrition,” Altam said. “It’s not only children but also pregnant and breastfeeding women, too.”
In 2019, Save the Children reached 1.2 million adults and children across north Yemen, including the area where the Raydah hospital is located. Last year, the funding cuts forced the charity to reduce food support to 21,000 households.
The reduction in aid “has left them in an uncertain fate,” said Anna Pantelia, a spokesperson for Save the Children, referring to the 1.2 million people they once reached.
Kareema al-Maakhathi, a nurse at the Raydah hospital who is under contract with Save the Children, said there are many people unable to even afford the trip to the hospital.
“In the past, we would cover, not only the transportation, but also traveling costs” to Raydah hospital or even from as far away as Sana’a, Maakhathi said. “However, three months ago, we were forced to stop.”
“In October, six or seven children died because their families couldn’t afford taking them to the hospital,” Altam added. “All were under the age of five.”
“Recently, we were forced to turn away parents whose children needed the food when we ran out of supplies,” he said.
Dying at home
Several months ago, 18-year-old Hind al-Qarreh brought her twin girls to Raydah hospital. Enas and Eman, 10 months old, suffered from severe malnutrition and diarrhea. Enas was worse off: She weighed about six pounds. “She was literally skin on bones,” recalled Mansoor Matar, a medical assistant who runs the nutrition department at the hospital.
Her case was so severe that he advised Qarreh to take her infant to a larger hospital in the provincial capital. But the family could not afford it, and funds from Save the Children were no longer available.
So Matar and other hospital employees raised money to pay for medicine and nutritional supplements. He made follow-up visits to the family’s home.
“Now, Enas is 5.4kg,” said Qarreh, or nearly 12 pounds.
But countless infants don’t survive. This is especially so in remote areas where even getting to a small facility has become financially prohibitive.
Fatima Alwadei, a nurse in the Almadan clinic, about 100 miles north of the Raydah hospital, said she has told many parents that funding for transportation to larger hospitals has ended.
“So, they go back home,” Alwadei said. “Frankly, many children I know of have died at home as a result.”
Saleh, the mother who initially couldn’t afford the taxi fare to Sana’a, came close to saving her son Muhammed, she said.
In May, after she learned about the funding cutbacks, she and her husband begged for money from relatives, friends and neighbors. They raised $1,700 and took Mohammed to the main hospital in Sana’a.
Their money, used for blood transfusions and other medical needs, lasted one month. Against their doctor’s advice, they headed back to their village because “we had no more money or means to get money,” Saleh said.
That’s when they started bringing Muhammed again and again, whenever he was ill, to the Raydah hospital, until he died.
“I am so heartbroken because I felt helpless and wasn’t able to do anything,” his mother said, wiping the tears away from her face.
This article was first published in The Washington Post.