20 million Yemenis lack health care. A new air-bridge scheme won't help them all, but it could help to build trust. Sharmila Devi reports.
Aid workers have welcomed the launch of a unique medical air bridge to transport Yemeni patients abroad for specialised treatment as a confidence-building exercise, even if only a fraction of those in need in the war-torn country will benefit.
WHO, which collaborated with health authorities in Yemen to coordinate the air bridge, said it was a “unique project geared to Yemen's context”, where barely 50% of the health system is functioning.
Médecins Sans Frontières and the International Committee of the Red Cross have also run programmes to fly patients to other countries for treatment, but they have focused on war-wounded patients. The Yemen air bridge aims to serve patients with advanced chronic conditions or who are in need of other specialised care, such as organ transplantations, reconstructive surgeries, and radiotherapy, that is unavailable or inaccessible domestically.
“This has never been done before. Young people, the elderly, those with cancer, for the first time are being taken for treatment paid for by the UN”, Altaf Musani, WHO representative in Yemen, told The Lancet.
Sanaa International Airport, in Yemen's capital, has been closed to civilian passenger flights since 2016 by a Saudi Arabian-led coalition that controls Yemen's airspace. The closure is part of a broader blockade of areas held by Houthi rebels that has led to severe shortages of food and medicine. The Saudi-led coalition, backed by the USA and the UK, has been fighting Houthi rebels for almost 5 years.
The first flight of the medical air bridge took off from Sana'a on Feb 3, 2020, followed by a second flight on Feb 8, carrying a total of 29 patients and their travel companions to Jordan. Most of the patients were women and children affected by one of 12 critical medical conditions, including tumours and lymphomas, for which there is no treatment available in Yemen.
WHO is currently negotiating with the Egyptian Government to take 40 patients and their caregivers from Yemen, although the spread of COVID-19 is expected to cause further delays, said Musani. He would not say how many flights WHO, along with its other UN agencies, planned to operate altogether.
19·7 million Yemenis lack access to adequate health care, while 24 million people—80% of the population—require some form of assistance, according to the UN's last review of humanitarian needs in the country.
“It would be easy to be cynical about the air bridge because it's a lot of work for few patients, but that doesn't mean it shouldn't be done”, Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University, told The Lancet. “It's just as important as a confidence-building measure. Getting the two sides [in the war] to agree on anything is important.”
There are two other international airports in southern Yemen, which are controlled by the Yemeni Government, but it can take more than 20 h to reach them from the north, on roads that go through an active war zone.
Médecins Sans Frontières had been unable to transport any patients by aeroplane to its reconstructive surgery hospital in Amman, Jordan's capital, because the Saudi-led coalition had forbidden it, Caroline Seguin, manager of Médecins Sans Frontières’ programmes in Yemen, told The Lancet.
“The only way we found is to send patients from Sana'a to Seiyun airport by road, crossing front lines and with the risk of being arrested as they are from the other side [that is opposed to the government]”, she said.
“Some patients had to cross front lines to get a passport issued by southern authorities, which does not recognise northern passports, while others were arrested and only released after lengthy negotiations by Médecins Sans Frontières”, she said.
Seguin welcomed the medical air bridge because the humanitarian situation was worsening day by day. “Some people are so poor they are selling land and property just to buy the bus ticket to get to the nearest health facility”, she said. “At least the coalition has agreed to something, even if it is a drop in the ocean.”
A statement from the Norwegian Refugee Council (NRC) said that at least 32 000 Yemenis are estimated to have died while waiting to get specialised medical treatment abroad, according to the Ministry of Health in Sana'a.
In the statement, Mohamed Abdi, the NRC's Yemen director, said “We hope that the recent increase in military escalations in northern Yemen does not put these flights under threat, and this small but significant step helps to build confidence between conflict parties.”