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The struggle of low income patients in Yemen

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The struggle of low income patient in YemenMohammed Qasim, of Hodeidah, Yemen and a father of eight children was diagnosed with renal failure in July. He had to undergo surgical intervention which he could not afford.14 December 2017, Sana’a, Yemen - Mohammed Qasim of Hodeidah Governorate in Yemen was diagnosed with renal failure in July 2017. In order to be able to receive dialysis sessions, he had to undergo a surgical intervention to create an arteriovenous fistula for dialysis access.

The governorate of Hodeidah where Qasim has been living with his family for the past 23 years is one of the poorest governorates in Yemen. The majority of its residents work in trade, farming or fishing. The living conditions of thousands of people have worsened because of the war in Yemen.

Qasim is a father who supports his wife and eight children. Even before the war, his living conditions were humble. He was working on a motorcycle -- a means of public transportation in Yemen -- earning 1,500 ($4) a day. After being diagnosed with renal failure, Qasim’s elder son, who is now 20, started working on his father’s motorcycle. As Qasim puts it, his son earns “barely enough money to keep the family from starving.”

When he found out that he needed surgery, Qasim knew that he would not be able to afford it with what little money his son was earning. The public hospitals were unable to provide the surgery due to shortages in medical staff, medicines and medical supplies, and private hospitals charged 150,000 YR (US$400) for the operation, an amount beyond Qasim’s capacity.

“The stress I felt thinking how I would afford the medical costs was massive. I was thinking of how I could get the money, and who would be there for my family if I died,” says Qasim.

“Luckily, the doctor I went to referred me to Al-Thawra hospital where he told me I could get the surgery for free. I only had to pay registration fees of 10,000 YR (US$35),” adds Qasim.

Al-Thawra hospital is the main public hospital in Hodeidah that receives nearly 1500 patients a day. The hospital itself has been facing a lot challenges to keep its doors open for the poorest patients in the governorate due to lack of operational cost and shortage of fuel needed to run generators.

Qasim was one of 100 patients who received surgery with minimal fees at Al-Thawra hospital, thanks to support from WHO and World Bank. On a monthly basis, WHO provides the hospital with enough medicines and supplies for 100 surgical interventions. In addition, WHO is supporting a national vascular surgeon at the hospital with financial incentives to provide injured patients with life-saving emergency trauma care services. The surgeon is also conducting an on-the-job training program on vascular trauma emergency care for 15 professional medical staff.

This support is part an Emergency Health and Nutrition Project (EHNP), a partnership project between the World Bank, WHO and UNICEF.

As part of the project, WHO also provides fuel and water supply to the hospital to enable it to run its activities and operations. In total, the Emergency Health and Nutrition Project supports 65 hospitals in all Yemen’s 22 governorates.

EHNP aims to support the health system in Yemen to be able to continue providing healthcare to people. The EHNP receives grants from IDA, the World Bank's fund for the world's poorest countries including Yemen.

Key health-related statistics

Total population (000s) 25 235
Total health expenditure (% of general government expenditure) 3.9
Primary health care units and centres (per 10 000 population) 1.5
Life expectancy 65.7

Source: Country statistical profiles 2017

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