A little girl with cholera in Yemen [IMAGE: AA-Turkey]
Yemen is a place we don’t hear a lot about in the U.S. News, but we should. The humanitarian crisis there intensifies and becomes more multi-faceted on a daily basis, and there seems to me to be something we can all do about it. But in the words of Dav Pilkey, before I tell you that story, I have to tell you this story:
Chapter 1: “How Yemen Got to Where it Currently is (extremely abridged version)”
Until fairly recently, the Yemeni government worked well with the U.S. and many Western countries on counter-terrorism initiatives. This ended when the government was overthrown by a rebel group known as the Houthi. The sitting president fled to Saudi Arabia, whose government formed an international coalition to retake Yemen from the Houthi. Check out this excellent 3-minute synopsis from Al-Jazeera for details. The two take-homes here are: a.) the Houthi were not prepared to manage infrastructure, and waste, sewage, and water maintenance fell apart leading to widespread famine and disease; and b.) the Saudi Arabian coalition has established a blockade of the Northern ports and land to the south, preventing the entry of food, medical supplies, and fuel. Civilians, most notably small children, are disproportionately bearing the impact of these two broad themes. While famine and lack of fuel to power clinics, hospitals, and infrastructural plants are profoundly contributing to the humanitarian crisis, there are two particular topics that I’d like to focus on, found in Chapters 2 and 3:
Chapter 2: “To Die of Cholera is to Die of Dehydration and Thirst”
While many diseases have emerged and grown to epidemic levels in Yemen, none has been more prominent than cholera. I have written about cholera many times because it is such an infuriating illness. The disease symptoms are caused almost entirely by a bacterial toxin rather than bacteria themselves. This means that once the toxin is no longer present, the symptoms abate and patients can recover. Cholera is marked by intense, voluminous (up to 20 liters per day) diarrhea. For perspective, the “8 glasses of water” we are urged to drink each day to maintain healthy hydration total about 2 liters. Losing up to 20 rapidly dries a person out, and patients ultimately die from dehydration. Putting those two facts together, the treatment strategy for cholera emerges: aggressively rehydrate patients until the toxin passes, after which they will recover. Rehydration in Western countries is relatively easy and uncomplicated. Rehydration in a place without hospital infrastructure or potable water is staggeringly difficult. Cholera deaths are maddening, because the disease is so eminently treatable under regular circumstances. Nearly 1 million Yemeni civilians have been afflicted with cholera since the epidemic began; meanwhile, medical supplies including those for rehydration are caught up in the Saudi blockade.
Chapter 3: “To Die of Diphtheria is to Die of Suffocation”
In the past three weeks a new and equally frustrating disease has appeared in Yemen: diphtheria. Diphtheria is a bacterial illness that causes tissue death (i.e., necrosis) in the throat. Tissue necrosis happens so rapidly that the decaying material builds up and ultimately blocks the trachea. Diphtheria patients die by asphyxiation; in other words, they suffocate. Diphtheria deaths are just as maddening as cholera deaths to me, because it is such an awful – and unnecessary- way to die. Diphtheria is readily prevented by a simple, affordable routine vaccination. Many routine immunization doses have been provided to prevent disease in Yemen. Guess what they’re caught up in? Hint: they’re probably in the crate next to the rehydration supplies.
Now that we’re all caught up, I did say that there seems to be a simple, straightforward measure we can all take to address this. It won’t cost any money (though supporting Oxfam and MSF are ALWAYS a good move). It won’t even cost an hour of your time. It will take ~5 minutes. The blockade is maintained by Saudi Arabia, a nation with which the U.S. has extensive ties and provides intelligence and logistics to its coalition. Bipartisan efforts in the U.S. Senate led by Chris Murphy and Rand Paul intended to cease this assistance to Saudi Arabia were thwarted. I suggest that these efforts need to be revisited given the scale of the crisis. Yes, I understand that these relationships are extremely complex. Yes, I know there are a hundred moving pieces. However, removing blockades in the name of humanitarian aid is absurdly low-hanging fruit when it comes to compromise. This would not take much diplomacy, and we certainly have the means for it. We only need the will to do it. Make noise. Contact your members of Congress. Say something along the lines of, “Hello, this is X, calling from Y. I am gravely concerned about the humanitarian crisis in Yemen, which is being exacerbated by the blockade of food, water, medicine, and other relief supplies by Saudi Arabia. I am urging you to please introduce or support measures that will pressure Saudi Arabia to allow passage of these supplies and the necessary aid workers into Yemen. Innocent civilians are dying, and the United States must not abide this. Thank you for taking my call.”
Attacking hospitals is a war crime. Blocking medical supplies directed at sick and starving children? That is not far off.
#yemen #cholera #diphtheria #Houthi #SaudiArabia #MSF #OxFam