Barran Press
Yemen's Health Minister Warns of Crumbling Healthcare System Amidst War and Global Crises
In a video interview with "Barran Press," Yemen's Minister of Public Health and Population, Dr. Qasim Buhaibeh, has sounded the alarm about the dire state of the country's healthcare system, warning of imminent threats due to dwindling international funding and shrinking government resources. The Houthis' blockade of oil exports through Yemeni ports has severely impacted the internationally recognized government's finances, further exacerbating the crisis.
These challenges come amidst the ongoing war's devastating consequences, compounded by the effects of climate change, including heavy rains and floods, and global pandemics that continue to plague the war-torn nation.
In the interview, Minister Buhaibeh delves into the state of Yemen's healthcare system after a decade of relentless war and the impact of the recent storm that hit the country. He sheds light on the consequences of declining funding from international organizations and the potential impact on healthcare services. He outlines the government's strategies to mitigate these effects and discusses plans for managing available international funding.
The minister also addresses the ministry's plans and vision for developing the healthcare sector, ensuring the sustainability of services, combating emerging diseases and outbreaks, and addressing the resurgence of previously eradicated diseases due to the Houthis' actions, which have been internationally condemned as terrorist activities.
Buhaibeh further highlights the ministry's role in addressing the healthcare needs of displaced populations and treating wounded soldiers. He also discusses the role of international and regional interventions in supporting Yemen's healthcare sector.
Q: To begin, can you paint a picture of the state of the health sector in Yemen after 10 years of ongoing war?
Minister: The health sector has undoubtedly been one of the most severely affected sectors by the Houthi insurgency and the destruction of state institutions. Health indicators like child and maternal mortality rates, immunization coverage, and nutrition levels have significantly declined from pre-war levels. This is a direct result of decreased funding and operational capacity for the sector. Only about 50% of health facilities are operational, most of which rely on external support. Government funding has dwindled due to low revenue and stalled salaries for healthcare workers. Adding to this, the Houthis have further hampered progress by restricting immunization campaigns and national health initiatives. The health sector is now heavily reliant on foreign aid, which is increasingly vulnerable to global crises and funding cuts.
Q: What are the repercussions of the recent weather events on public health and the health sector?
Minister: Beyond the direct damage caused by the rains and floods to health facilities and infrastructure, these events have created a breeding ground for diseases like diarrhea, cholera, and mosquito-borne illnesses such as malaria and dengue fever.
Q: Reports suggest a decline in international funding for the health sector. What are the reasons behind this, and what are the potential consequences for health institutions and citizens?
Minister: Yes, there has been a drastic decline in humanitarian funding, exceeding 70% for some key projects supporting the health sector in Yemen. This will inevitably lead to the closure of over 1,000 health facilities. Unfortunately, this is expected as other humanitarian crises in the region and around the world are drawing away funding and attention from donors. This will undoubtedly have a severe negative impact on the health sector, as there are no local alternatives. It will further exacerbate existing problems within the health sector in Yemen.
Q: What plans does the Ministry of Health have to secure alternative funding to cover the funding gap and save the health facilities at risk of closure?
Minister: The Ministry of Health has proactively raised this critical issue with the government, proposing solutions such as increased international efforts by the Ministry of Planning to secure external resources, and requesting increased government spending on healthcare.
Q: What are the ministry's plans for managing international interventions in the health sector to ensure sustainability and a safe exit strategy?
Minister: The ministry is actively seeking solutions and alternatives, proposing to the government alternative funding models for the health sector and focusing on long-term solutions.
Q: Does the ministry have any plans to develop the health sector?
Minister: The ministry has a vision and plans for development, including strengthening administrative structures, expanding health financing, updating healthcare models, focusing on preventive and community-based care, and promoting community participation. However, the lack of funding has forced us to postpone many of these plans and focus on ensuring the continuity of basic services rather than their development.
Q: Has the decline in government revenue and the halt of oil exports impacted the health sector and the ministry's plans? If so, what are the effects?
Minister: Undoubtedly, this has had a negative and significant impact. While 2022 saw some recovery in government finances, leading to a slight improvement in the health sector and the resumption of stalled projects like the rehabilitation of the central Dhamar hospital and the Socotra hospital, the recent halt in oil exports has reversed these gains. The primary concern now is ensuring the continuity of salaries and operational budgets.
Q: What are the key health sectors and services that require urgent international funding or intervention?
A: Firstly, primary healthcare services like immunization, nutrition, maternal and child health, and disease surveillance and control programs like malaria, tuberculosis, HIV/AIDS, and dengue are the backbone of the health sector. These are all vital programs that rely entirely on international funding. A decline in this funding would lead to serious health disasters, with the spread of preventable diseases and increased mortality among the most vulnerable groups in society. The government is currently unable to cover these funding gaps.
Secondly, secondary healthcare services in hospitals and specialized centers benefit from international support in providing fuel, equipment, training, and qualification.
Q: How do you view the health situation in IDP camps, the existing needs, and the Ministry's role in meeting these needs?
A: IDP camps are among the most vulnerable communities and are susceptible to complications due to poor health and nutritional conditions. The Ministry is working to direct health interventions to these camps. Provincial health offices are also prioritizing the provision of health services for them. However, the large increase in IDPs, especially in some governorates like Marib, makes the needs far greater than the scope of interventions and requires more extensive intervention.
Q: What about the health situation in Taiz under the siege imposed on it since 2015?
A: Taiz is undoubtedly one of the most populous governorates and is most exposed to the siege and pressure on services, whether population-related, livelihood-related, or service-related. It needs support from all parties. The Ministry of Health prioritizes Taiz in allocating available resources. Despite the siege, Taiz has some of the best health indicators. A significant part of this success is attributed to its people, their struggle, and their remarkable ability to overcome difficult circumstances. For example, the best heart and kidney transplant center was recently established in Taiz, achieving top national figures despite the war and siege the governorate faces.
Q: UN human rights reports have accused the Houthis of preventing vaccinations and immunization campaigns in areas under their control. What are the consequences of this, and how can it be addressed?
A: Yemen previously achieved high vaccination coverage rates and declared itself polio-free in 2009. Unfortunately, due to the Houthi militia's policy and obstruction of home-based vaccination campaigns, these diseases, including polio, have returned. Yemen has become one of the few regions still recording polio cases in areas under Houthi control. Meanwhile, in areas under the legitimate government, we have conducted several precautionary campaigns, and no polio cases have been reported for two years. However, the danger remains.
Q: What is behind the Jordanian requirements for children entering the country with their families?
A: Due to the continued registration of polio cases in areas under Houthi control, Jordan recently announced a vaccination requirement for children entering from Yemen. This is a precautionary measure on their part.
Q: "Bran Press" recently published a report on the Houthi project to establish "National Pharmacies" in local hospitals. How do you interpret this?
A: This is an old project of the Ministry of Health from the beginning of the millennium, known as the "Drug Fund." It was an experiment in self-financing and management of financial resources, with its own advantages and disadvantages. It was previously stopped, and they may have reactivated it under a new name for an old project.
Q: What about the Houthis' control over pharmaceutical companies and harassment of the private sector in general? What is the Ministry's stance on this?
A: They have a clear approach of confiscating national capital, including the pharmaceutical industry, in favor of the Houthi group's own sectarian sector and capital.
Q: You mentioned a government initiative to support national pharmaceutical industries in late 2023. Tell us about this initiative and how far you have progressed in this area?
A: We have several factories established in different regions of Yemen. The Ministry's approach is to support and facilitate them.
Q: Recently, there has been a surge in cases of acute watery diarrhea and cholera. What are the effects of this outbreak, and what efforts are being made to address it?
Minister: Yes, Yemen has witnessed a significant increase in cholera cases this year. The Ministry is working tirelessly to combat it. Unfortunately, the floods exacerbate the situation. However, we are working closely and extensively with our partners to confront the crisis. We have a cholera vaccination campaign planned for October in the most affected areas.
Q: The World Health Organization recently raised the alarm about monkeypox and declared it a public health emergency, causing global concern. What precautionary measures has the Ministry taken to address it? Do you believe it will become a pandemic like COVID-19 and other global outbreaks?
Minister: Yes, due to the spread of monkeypox cases outside of Africa, a public health emergency of international concern was declared. There is a significant effort underway to address this. As a member of the World Health Organization's Executive Board, Yemen's Emergency Committee is closely monitoring the situation.
Currently, the situation requires continuous monitoring, surveillance, and strengthening national capacities for surveillance, monitoring, and diagnosis.
Q: Tell us about the Ministry's efforts in overseeing hospitals and addressing errors and violations in this area.
Minister: The Ministry, through its health offices and private facilities, is working to ensure effective monitoring and oversight. Recently, we established the Medical Council in the temporary capital of Aden. This council is responsible for regulating and overseeing the quality of healthcare professionals in the health sector, addressing any violations or negligence, and protecting patients' rights and safety.
Q: How does the Ministry assess the health situation in Marib?
Minister: Marib is a governorate that bears a heavy burden on the health sector due to the ongoing Houthi aggression and the displacement of millions of people. This has placed a significant strain on the governorate's health sector, demanding a high level of service provision despite limited resources. However, thanks to the significant efforts of both local and central authorities, as well as humanitarian interventions, there has been an expansion and improvement in health services, although not to the desired level due to the reasons mentioned above.
However, we see a continuous improvement and hope for a better future.
Q: What role does the Ministry play in addressing the issue of wounded soldiers and resistance fighters?
Minister: The Ministry of Health plays a supporting role to the military medical services responsible for treating wounded soldiers. Ministry of Health hospitals provide their services to the army, security forces, and all citizens equally.
Q: What is the role of international organizations in supporting the health sector, and is it meeting expectations?
Minister: In light of the weak government support, UN and humanitarian aid have played a significant role in meeting essential needs, especially with sufficient funding available. However, this support is steadily declining.
Q: What about the role of the King Salman Center and the Saudi Program for the Reconstruction of Yemen in supporting the health sector?
Minister: Undoubtedly, Saudi Arabia is the primary supporter of Yemen in general and the health sector in particular, through the King Salman Center for Relief and Humanitarian Action and its urgent and ongoing interventions in various sectors, including health, exceeding $800 million since 2014. The Saudi Program for the Development and Reconstruction of Yemen also contributes significantly to supporting the health sector. It has built and rehabilitated a number of major hospitals, such as the Saudi Hospital in Hajjah, Al-Salam Hospital in Saada, Prince Mohammed bin Salman Hospital in Aden, and currently, the King Salman Medical City in Al-Ghaydah is being equipped. Additionally, the University Hospital and Cancer Hospital in Mukalla, Hadramaut, the University Hospital and Medical Colleges in Taiz, and many other past, present, and future health projects are underway.
Q: A final message?
Minister: Thank you for your kind hospitality and interest in the health sector and its challenges.