As of Thursday, Yemen remains one of the only countries with no reported cases of coronavirus, the pandemic that has infected over half a million people worldwide and resulted in over 20,000 associated deaths. Experts have warned that Yemen’s health care sector is already strained beyond its limits, and will be unable to cope should the deadly virus pierce its borders.

The health sector in Yemen has deteriorated dramatically due to more than five years of war. Coalition airstrikes have hit countless hospitals and clinics, the Houthis have siphoned millions from humanitarian funds for their war effort and doctors and nurses across the country have received their salaries only sporadically, if at all. Moreover, the country is already struggling to cope with a range of existing diseases, including a cholera epidemic that has resulted in an estimated 2.3 million suspected cases since 2017.

Throughout March, as countries around the world take stronger measures to prevent the spread of coronavirus, Yemeni authorities have begun enacting a number of their own actions. The Yemeni government suspended flights and closed land points midway through the month. The Ministry of Education suspended schooling until the end of May, while the Ministry of Health ordered the closure of qat markets in all governorates. Moreover, the Ministry of Endowments ordered a halt to all prayer and other gatherings in mosques until further notice.

Given the variety of actors with influence on the ground across Yemen, the preventative steps taken have varied considerably. Whereas the Houthis maintain a highly centralized structure of governance in areas under their control, in nominally government-controlled territory some governorate-level authorities, in addition to southern separatists, hold considerable influence in shaping policies. Below are some of the main steps taken by authorities across Yemen to prevent and/or prepare for the spread of coronavirus into Yemen.

In Aden, the seat of the internationally-recognized government, the local authority and the Ministry of Health have taken a number of precautionary steps to confront the danger posed by a potential outbreak of the virus. They transformed Al-Amal Hospital for Cancer Treatment in Buraiqa district into a quarantine facility should any suspected cases arise.

The quarantine facility is equipped with an initial capacity of 120 beds, which can be increased if necessary, including ten beds for intensive care rooms. Another hall is prepared as a spare quarantine. On March 10, a training course on dealing with coronavirus was held, organized by the Ministry of Health with support from the World Health Organization (WHO). About 80 doctors and health workers participated.

A Saudi plane carrying medical supplies relating to preparedness and response to coronavirus arrived at Aden International Airport on Monday, a move that came at the request of the WHO for greater contributions to prepare for the potential outbreak of the virus.

Health emergency operations; Ministry of Public Health - Aden:

02-358259

02-358260

In Marib, the local authority formed an emergency committee and approved an emergency preventive and remedial action plan to confront the virus. As a result, a number of measures have been taken, among them preparing quarantine facilities, enhancing health preparedness and expanding awareness campaigns and community awareness-raising programs in all areas, including IDP camps and other population centers. This includes raising awareness about the symptoms of the virus, how to deal with suspected cases and ways to prevent the spread of infections if any suspected cases are recorded.

The emergency committee also approved the closure of public swimming pools and gardens for five days in order to perform necessary sterilizations as part of precautionary measures. Among the other measures that the local authority said it would take are health oversight and inspections, the promotion of public and private hygiene and the reduction of crowds in public and private hospitals and markets. It also decided to prevent the smoking of all types of shisha in public places.

The local authority met with humanitarian partners to discuss and coordinate cooperation and partnership in implementing the plan of action to confront the transmission of the virus and to strengthen measures to protect society in the governorate.

Health emergency operations; Ministry of Health - Marib:

06-302223

06-303664

In Taiz, the local authority has also formed an emergency committee to take precautionary measures to face the virus and implement the instructions of the national government. The governorate committee has approved the closure of parks, clubs and halls, as well as placed restrictions on markets in the city of Taiz and other areas in the liberated districts.

The emergency committee is forming a plan for a number of exceptional procedures, as well as following up the necessary preparations, including the construction of quarantine facilities, providing equipment for sterilization and equipping the work teams in the quarantines, hospitals and medical centers in various districts throughout Taiz.

In partnership with local civil society activists, the committee is also setting up a mechanism to monitor the body temperatures of all individuals entering the city of Taiz, which is one of the most populous urban centers in Yemen.

Health emergency operations; Ministry of Health - Taiz:

04-273087

In Mukalla, coastal Hadhramawt, the local authority has similarly established a committee, which has taken precautionary measures in the sea ports of Mukalla and Al-Shahr and Al-Rayyan International Airport. The committee formed an urgent response and epidemiological surveillance team to monitor and follow up with citizens coming to the districts through air, land and sea ports.

The local authority banned the entry of qat into the governorate. It also closed all stadiums, halls and sports sites until further notice. The committee additionally directed officials to intensify the efforts of field medical teams and enhance awareness programs on the risks and methods of prevention and infection of coronavirus among citizens through various media outlets, and by partnering with influential community figures.

Health emergency operations; Ministry of Health - Hadhramawt:

05-303498

05-409898

In Seiyun, central Hadhramawt, an emergency committee has approved a number of precautionary measures. These include reducing the administrative staff of all public service bodies by at least 25 percent, with the exception of emergency facilities in health, electricity and water. It also includes preventing gatherings of citizens in parks, malls, qat markets, wedding halls and in religious and social events.

The committee is also forming sub-emergency committees in various districts to take precautionary measures and partner with civil society organizations to launch training programs, provide further assistance to health facilities and raise awareness campaigns through the various media outlets to broadcast health tips and advice and educate community members about coronavirus.

Health emergency operations; Ministry of Health - Hadhramawt:

05-303498

05-409898

In Al-Mahrah, the local authority formed an emergency committee to oversee health procedures, monitor preparations at Al-Ghaydah Hospital and assess the necessary requirements. It also directed authorities to intensify the work of health teams in border crossings and security checkpoints and provide them with health professionals and devices for examining expatriates. It called on the media outlets to play their role in educating society about the dangers of the pandemic and its symptoms, how it is transmitted and how to prevent it.

Health emergency operations; Ministry of Health - Al Mahra:

06-611360

06-611361

In Shabwa, the local authority took a number of precautionary measures, including preparing a quarantine facility in the governorate, studying the establishment of two other centers and raising awareness of health teams working in the face of the pandemic. It called on international organizations working in the governorate to contribute to strengthening the efforts made by the local authority to confront the virus. Moreover, a joint committee was formed to coordinate the efforts of international and local civil society organizations in the governorate and its emergency committee.

Health emergency operations; Ministry of Health - Shabwa:

05-201005

05-201008

The Houthis

The Houthi-run Ministry of Education has also suspended studies and closed schools until further notice. The ministry announced that 18 hospitals would be prepared with the necessary health supplies and training for health personnel in various governorates to confront the virus. The ministry called on international organizations to assume their responsibility to quickly prepare and equip these hospitals and quarantine centers.

The Houthis announced a set of precautionary decisions, including most notably: 

• - Reducing the number of employees in the public sector by 80 percent, with the exception of the ministries of health, interior and defense, as well as security and intelligence services under their control; and limited gatherings to no more than eight people.
• - Limiting public and private hospitals to receiving emergency cases and emergency operations; Visits to patients in all public and private hospitals are restricted to close relatives only, as with prison visits.
• - Requiring banks, exchange shops, transport buses and other businesses to provide the necessary sterilizers and disinfectants to customers.
• - Relocating qat markets to new areas; regulating all markets, malls, shops and stores to reduce congestion, and asking citizens to reduce their movements.
• - Preparing plans to implement rapid quarantines of any street or area in case any suspected cases are reported.

One of the most controversial measures taken by the Houthis has been to prevent travelers coming from Saudi Arabia or government-held areas of Yemen, and banning them from entering areas under Houthi control. This resulted in large numbers of Yemenis being stuck in Dhamar and Al-Baydha governorates, unable to travel home. The Houthi authorities in Rada’a city in Al-Baydha detained many of the travelers under the pretext of precautionary measures against coronavirus.

However, this so-called quarantine lacks even rudimentary medical services or accommodations, let alone proper procedures to prevent the spread of the disease. The Houthi official responsible for humanitarian affairs, Abdul Mohsen Tawoos, acknowledged the situation the travelers are facing as a tragedy, but he held Lise Grande, the United Nations Humanitarian Coordinator in Yemen, and all international organizations responsible for any failure to provide the necessary services to the travelers.

Health emergency operations; Ministry of Health - Sanaa:

+967-1- 250888

Challenges

Despite all of the above measures, the underlying challenges Yemen faces are the lack of uniformity between the procedures undertaken by the various warring parties and the difficulties of implementation by local authorities on the ground. In a positive sign, Abdulrab Al-Salami, minister of state in the Yemeni government, called this week for a joint government-Houthi initiative to tackle the country’s coronavirus prevention strategy, sponsored by the WHO.

Beyond lack of coordination at the national level, a number of challenges are present. These include the shortage of masks, sterilization equipment and other medical resources; the dire conditions in prisons, which lack even basic sanitation and could serve to rapidly spread the disease; and the fact that some qat markets remain open and group chewing continues in certain areas. Additionally, travelers from outside Yemen, especially East Africans migrating to the Gulf, continue to enter Yemen and travel through various governorates without proper monitoring and examination. On top of all this, there are fears that tens of thousands of public employees will not receive their salaries, and that countless private sector employees will be put temporarily out of work as public life grinds to a halt amid the campaign to remain indoors.