The scrubby hospital room in a former al-Qaeda stronghold in Yemen is filled by the tortured cries of a baby whose wizened face is drawn taught across his skull.
Mohamed is nearly three months old, but looks simultaneously like a premature newborn and a grandfather. Hunger has ravaged his tiny frame and given him a bulbous head: all tell tale signs of acute starvation.
He had just arrived at the hospital in Mukalla, south Yemen, after his mother had completed an arduous journey in the heat of summer from a remote village in Hajar. Behind her five other women, with equally skeletal children, sit cross legged waiting for treatment.
The tiny babies are among 500,000 children under the age of five who are so severely malnourished they are fighting for their lives. A further 1.8 million children are also starving, according to United Nations children’s agency, Unicef. The number of malnourished children increases every day.
“My husband doesn’t have a job. He works day by day to try to get money to feed his kids, but it is not regular,” Hanan, a mother of three said, clutching the skeletal bundle.
She appeared embarrassed to admit she struggles to feed her family, and talked quietly of trying to find baby milk to feed Mohamed.
“We just came in today. We can’t stop his diarrhoea,” she added, trailing off.
Abha Abdalla, director of the hospital, said it has had a flood of new cases since al-Qaeda was ousted from Mukalla by Gulf backed Yemeni forces in 2016. With the militants – and thus the battleground – corralled into the hills around central provinces like Ma’rib and Al Bayda, many families here in Hadramawt province have finally felt it safe enough to move around.
“Starvation definitely increased under al-Qaeda, because the area suffered massively from deteriorating economic conditions and a lack of aid during that period,” said Dr Abdalla, who like many women was forced to give up work and go into hiding under the previous regime.
“Now we are seeing a rise in cases coming to us because people can finally get here. People were reluctant to get treatment because of the difficulty of movement when al-Qaeda was in control.”
The hospital, one of the main medical centres for women and children in the area, is struggling to treat the flood of cases because it has six beds. The centre, which has limped through three years of war, was hit by Cyclone Chapala in 2015, which destroyed the children’s ward.
“We are trying our best, but until very recently we could only take in 11 malnutrition cases a month,” she added.
Yemen, the Gulf’s poorest country, has been in the grip of a devastating civil conflict since 2015, when Saudi Arabia and its allies launched a bombing campaign and ground invasion to reinstate the recognised government, which had been ousted by Iranian backed Houthis.
Amid a total breakdown in security, al-Qaeda flourished, conquering a swathe of territory from near the border with Oman down to the southern port city of Aden.
Although the militants have been largely pushed back by UAE-trained and backed Yemeni forces, the battle against the militants continues.
There is also no sign of an end to the war with the Houthis, a conflict which has killed well over 10,000 people. Neither side of the conflict has much hope for UN hosted peace talks due on 6 September.
The fighting has sparked the largest humanitarian crisis in the world, according to the UN. The appalling statistics speak for themselves.
More than 8.4 million people are on the verge of famine. An additional 18 million are going hungry as they lack access to food.
Three-quarters of the population – 22 million people – require humanitarian aid. Among that number are more than 11 million children, which Unicef says is almost every child in the country.
The famine has been partly blamed on the destruction of Yemen’s already poor infrastructure. The World Health Organisation has accused the US backed Saudi coalition of targeting water supplies and hospitals, a charge it has denied. The coalition has, however, blocked sea ports and airports, fearing they could be used by Houthis for weapons deliveries.
The Houthis, meanwhile, have been accused of intercepting and halting aid drops, as well as laying siege to pro government areas further north. The Gulf coalition says it has destroyed infrastructure by laying landmines and other explosive devices.
The conflict has decimated Yemen’s health system: nearly half of the country’s hospitals are not working and many medical professionals have not received salaries.
Yemenis like Hanan, who are trapped in rural areas, are often unable to reach health centres when their children become ill: a lot of the malnutrition cases stem from disease.
Yemen has witnessed the world’s worst outbreak of cholera which, since 2016, has claimed more than 2,300 lives.
The UN warned this week the country was on the cusp of a third wave of cholera, particularly in the most war affected places, such as Hodeida, a town on the country’s east coast that is the frontline of the latest battle. Lise Grande, the UN’s humanitarian coordinator on Yemen, said the Red Sea port town was “one airstrike away from an unstoppable epidemic”.
Despite the challenges, there are local initiatives supported by international agencies trying to move mobile clinics around the country, according to Dr Khalil Bamatraf.
A young female medic in Mukalla, Dr Bamatraf was forced to don a niqab and work in segregated hospitals under al-Qaeda. She was repeatedly threatened by militants for being critical of the group.
Two years on, and with limited funds, she tries to access the sick and starving in the most rural areas of Hadramawt, places like Hajar and Addis al-Sharqia, where the nearest hospital can be a five-hour journey away.
Dr Bamatraf described how some families she met were so desperate for food they lived off emergency medical pouches handed out for minors.
“We had given pouches with nutrients to feed the children, but instead of feeding the children they used it as the main meal for themselves,” she told The Independent.
“I found an old woman in a village with five disabled children, they each had severe malnutrition. One of them just starved to death.”
She said the year of al-Qaeda had had a hidden impact on civilians, as it set aid deliveries back years and trapped people inside villages.
“Al-Qaeda had a full database of everyone in Mukalla, so it was impossible to do anything or to fight them. Under their rule we didn’t have budgets from international organisations. We hope now we can procure drugs, equipment and supplies and treat the cases,” she added.
Back at the women’s clinic, and accompanied by Emirati officials, Dr Abdalla talked about her plans to expand the centre. She hopes to build a new wing to service the province.
She attends to one woman, Hadija, whose one year old baby girl is so thin she looks half that age and cannot sit up.
“Thanks to funding ... we are now able to give people 50 or 100 per cent discounts on treatment. Many patients can come here. The only problem is space,” she said.
“But things are looking up.”
Read the first piece in Bel Trew’s series, One Week in Yemen, here: Inside the UAE’s war on al-Qaeda in Yemen; the second piece, here: Mukalla: Life after al-Qaeda in Yemen and the third dispatch, here: Yemen’s hidden menace, the decades-long struggle ahead to clear the country of landmines
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