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Cancer patients in Yemen face the compounded pain of disease and conflict
Maryam and Jamila receive treatment at a WHO-supported oncology centre in Aden
20 September 2020 – The pain of cancer patients in Yemen is being compounded by the additional burden of conflict, displacement, widespread poverty and hunger.
Jamila, a 40-year-old woman, is currently displaced due to the ongoing conflict. To add insult to injury, she has cancer.
“It’s difficult to find medicines nowadays, and the available ones are very costly. Being without income, I cannot afford them”, said Jamila, who has received free of charge cancer medicine provided by a WHO-supported cancer centre.
The ongoing conflict in Yemen has turned an already vulnerable country into the world’s largest man-made humanitarian crisis, taking away what its people need the most, including the fundamental needs, like health care. In 2020, more than 19.7 million people need health care services in Yemen while only half of Yemen’s facilities are still functioning. There are also about a total of 1.5 million currently displaced people, suffering from already existing vulnerabilities.
As the economy collapses and imports are restricted, medicines and equipment that are readily available in other countries are scarce in Yemen. As a result, treatment is available at only a fifth of Yemen’s health facilities.
Maryam, 60 years old, receives treatment at a WHO-supported oncology centre. “I have to travel for 350 km only to receive treatment. The transportation cost has skyrocketed, let alone accommodation.”
Approximately 35 000 Yemenis currently have cancer, and more than 11 000 are newly diagnosed with the disease every year. In 2016, many cancer clinics closed due to a lack of staff, medicines and equipment, creating long waiting times and forcing people to travel many miles for vital treatment. As a result, thousands face a death sentence through lack of access to medical care.
“There are so many things that people around the world take for granted, while they are beyond our reach in Yemen. As we struggle to get the most basic needs, our right to health and life is compromised,” said Maryam, who fears that her children would one day be unable to secure her treatment.
“In Yemen today, we are dealing with the real threat that patients face imminent and painful death unless we continue to receive the support that will enable us to save their lives,” stressed Dr Abdulwahab Al Nehmi, WHO Noncommunicable Diseases Officer.
WHO and partners, including the King Salman Center for Humanitarian Aid and Relief and Kuwait, are working to prioritize the procurement and delivery of supplies to cover the life-saving treatment needs for patients living with chronic, life-threatening conditions, including cancer. WHO has supported the national oncology centre with various life-saving anti-cancer medicines and chemotherapy medications, helping to save the lives of thousands of patients, and providing painkillers, such as morphine and fentanyl, to improve the quality of life for patients at advanced stages of the disease. WHO has also facilitated workshops on the early diagnosis of breast cancer, and mental health and psychosocial support for cancer patients. Thanks to the generous support of the donors, all cancer centres are currently open and providing cancer care across the country.
“Without WHO support with the cost of my treatment, I would have stayed home, waiting for death to relieve my pain,” said Maryam.
Dengue fever control campaign in Aden
14 September 2020 – A dengue fever control campaign that will cover the 8 districts of Aden city was launched on 13 September by the Ministry of Public Health and Population, with the support of the World Health Organization (WHO) and the King Salman Humanitarian Aid and Relief Centre (KSRelief).
The 4-day campaign will include indoor and outdoor fogging, community awareness activités, vector surveillance and environmental management of all mosquitoes breeding sources, providing direct protection to 430 000 people and indirectly to the 1.7 million total population of Aden city.
The campaign represents the second round of dengue control response in the city this year. A first round was conducted in May with the support of WHO.
Dengue is a mosquito-borne viral disease transmitted by female mosquitoes mainly of the species Aedes aegypti. It is endemic in the urban and semi-urban setting in the coastal areas of Yemen on the Red Sea and Arabian Sea. However, data collected in 2019 and 2020 showed that dengue was reported in 204 districts, including rural areas.
Early in 2020, once-in-a-generation flooding devasted southern communities in Yemen, including in Aden, resulting in the emergence of outbreaks, including dengue fever, malaria and chikungunya, all transmitted by mosquitos.
About the WHO-KSRelief malaria control and prevention project
In March 2020, WHO and KSRelief signed an agreement to support national response for malaria and dengue vector control and prevention in Yemen. An 18-month multidimensionnel projet has been built on 4 pillars:
- strengthening malaria diagnosis and treatment at public health facilities and community level;
- maintaining effective coverage of all populations at risk of malaria and dengue through implementation of suitable vector control interventions;
- strengthening surveillance activities, epidemic preparedness and response for malaria and other mosquito-borne diseases;
- strengthening national capacity to ensure the continuity of malaria control and prevention and to address the ongoing emergency and humanitarian crisis.
The 18-month project will serve more than 7 million beneficiaries.
Polio outbreak in Saada governorate
6 September 2020 – Fourteen cases of vaccine-derived poliovirus type 1 (cVDPV1) have been detected in several districts in Saada governorate, in the north-west of Yemen.
The cases – children aged from 8 to 156 months – had onset of paralysis ranging from 31 January to 18 June 2020, with one other case from June 2019 also confirmed retrospectively.
The 14 cases are clustered in an area with very low routine immunization levels that has been inaccessible to the polio programme since late 2018 for various reasons, including the restrictions due to the current COVID-19 pandemic, and has been a source of growing concern for those reasons.
Health authorities in Yemen, supported by the polio programme staff, and the regional teams of WHO and UNICEF, are working hard to mount an outbreak response rapidly.
Contacts of affected children are being traced, and every effort is being made to ensure more children have access to essential immunization.
Vaccination is the only way to protect children from polio, and the oral polio vaccine (OPV) is the best know tool for that. It is the tool used by the WHO’s polio programme to eradicate polio and protect populations from type 1 polioviruses, in Yemen and worldwide.
Note on the vaccine-derived poliovirus
Vaccine-derived poliovirus type 1 is a strain of poliovirus that emerges and paralyses children in communities where not enough children have received OPV. The term “vaccine-derived poliovirus” can be misleading: while the vaccine-derived strains can cause outbreaks of polio, these outbreaks are stopped by achieving high vaccination coverage by the same vaccines. For this reason, an outbreak of VDPV acts as an urgent warning signal that immunity levels in that area are dangerously low.
Fighting for the rights of renal failure patients in Yemen
Osama, 28, receives treatment in Al Sadqqah Hospital in Aden
31 August 2020 – Over 5 years of hostilities in Yemen have resulted in a massive setback to an already weak health care system and led to a dramatic collapse of health care services provided to the population. More than 17.9 million people out of the total population of 30 million require health care services in 2020, while only half of the health facilities are fully functioning.
The dialysis centre also face a severe shortfall of essential supplies such as medication and fuel to run hospital equipment, as well as a lack of funds to pay health care workers regularly.
Dheya has been working as a nurse in Al Sadqqah Hospital's dialysis centre in Aden for the last 6 years. She has witnessed the torment of kidney failure patients, and the decreasing capacity of the hospital to treat the patients properly.
"Without dialysis consumables and supplies, the suffering of these patients is unbearable. But because of the lack of medical supplies, we often had no other choices than to reduce the duration or the frequency of the dialysis sessions,” said Dheya.
"Limited access to dialysis sessions and treatment put the lives of these vulnerable patients at higher risk, not to mention the suffering they go and their families through because of the lack of treatment," said Dr Abdulwahab Al-Nehmi, Noncommunicable Disease Officer at the WHO country office in Yemen.
A partnership between WHO, KSrelief and the Government of Kuwait has helped support patients suffering from renal failure in Yemen through the provision of access to healthcare. Between September 2019 and May 2020, up to 110 340 dialysis sessions were delivered to more than 4300 patients with chronic kidney failure.
KSrelief has covered up to 80% of the total cost of the dialysis sessions in all 21 centres across the country. WHO has provided up to US$ 24 million worth in supplies to cover the life-saving treatment needs of patients living with chronic, life-threatening conditions (cancer, kidney failure and noncommunicable diseases, including diabetes).
Osama is 28 years old. He is one of the patients receiving dialysis treatment at Al-Sadaqa hospital. "Being a dialysis patient is very challenging. Receiving treatment is also a challenge, but those dialysis sessions have made a positive difference in my life. I am gradually feeling better, and I can feel that my health is improving," he said.
"As a health worker, witnessing my patients' health condition stabilize and improve through treatment is what gives me the energy to continue my mission despite the hardship," says Dheya.
Despite the long-standing efforts of WHO and partners in coordination with health authorities, significant gaps remain due to funding shortages to the humanitarian response in Yemen under the throes of the collapse of public institutions. Continued support is still needed to save the lives of the most vulnerable, including renal failure patients.
