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While the COVID-19 pandemic has reached nearly every corner of the globe, one country stands out, for now, as unmarked by the virus. Wrecked by five years of brutal war, Yemen is already home to the world’s worst humanitarian crisis. There are currently no reported cases in the country, which is very fortunate: The coronavirus’s spread in the country would be particularly catastrophic.
Despite that potential disaster scenario, the Trump administration announced on Friday that it is cutting $70 million worth of aid to northern Yemen, where the country’s humanitarian crisis is the most acute. International organizations say this funding could have gone to health programs that Yemenis desperately need. The country’s medical facilities have been routinely attacked during the war between the country’s Saudi-backed government and Iran-aligned Houthi rebels. According to Yemeni government statistics, there are only 700 ICU beds and 500 ventilators in the country for a population of about 30 million.
“It’s a very big problem as the U.S. was one of the biggest donors,” says Caroline Seguin, Doctors Without Borders deputy program manager for the Middle East. For example, in northern Yemen, there is now no funding to open a COVID-19 treatment center, she said: “If you don’t have any money to pay doctors’ salaries, it will be very difficult to open any center that treats the coronavirus.”
The official reason for the U.S. cutting is that the Houthis, who control northern Yemen, have been siphoning off food supplies and other aid intended for the Yemeni populace. The move also fits into a strategy employed by the Saudi coalition in its war against the Houthis: limiting the rebels’ resources in order to pressure them into political concessions. Yemeni civilians have suffered as a result, but despite the outcry from human rights groups, the U.S. and U.K. have continued to provide military and logistical support to the Saudi coalition.
Meanwhile, fighting between the Houthis and the Saudi coalition has kicked up a notch over the past few days despite United Nations Secretary-General António Guterres’ recent call for a global cease-fire so the world can work together to fight COVID-19. The Houthis fired two ballistic missiles at the Saudi capital, Riyadh, over the weekend. Saudi Arabia responded by bombing the Yemeni capital, Sanaa, which the Houthis control. The pattern of fighting is consistent with Houthi-Saudi sparring over the past few years as negotiations consistently break down between the two warring sides. While these most recent attacks may only be posturing before the two sides begin negotiations yet again, less promising for a cease-fire is the increase in deadly fighting between the Houthis and Saudi-supported government forces along the border of Houthi territory in Yemen, eastward of the capital.
“The truth is that even if the fighting were to stop, a COVID-19 outbreak would be catastrophic for millions of very poor, very hungry, and vulnerable people in Yemen, but if it does not stop, it will be far worse,” said Peter Salisbury, Yemen senior analyst at International Crisis Group.
Additionally, it’s unclear if the country’s beleaguered health system would be able to keep track of COVID-19 even if it had arrived. COVID-19 isn’t the only health crisis Yemen faces. In 2017, the country went through the worst cholera outbreak in modern history, with about 1.2 million cases, and Yemen often seems to be on the brink of a resurgence, while also fighting outbreaks of dengue fever and typhoid.
“It would be very lucky to have no cases in Yemen, for sure,” said Seguin.
According to the World Health Organization, it has distributed about 1,000 COVID-19 testing kits to medical facilities across Yemen. So far, only suspected cases who have symptoms and a history of exposure are being tested. “It’s nowhere nearly enough where you could test every suspected case that walks into a hospital,” said Christine Cool, WHO spokesperson in Yemen. Because Yemen hasn’t announced any cases yet, it’s not considered a priority country for receiving more coronavirus-related supplies from WHO.
Still, at the time of a pandemic, Yemen’s isolation may have turned into a strange blessing. Even before COVID-19, Yemen was relatively cut off. Houthi-controlled Yemen received no commercial air travel, and Sanaa’s airport had only been functioning for the past few months. While the Saudi blockade on Houthi territory has led to humanitarian catastrophe, it may have had the unintended consequences of helping keep the coronavirus at bay. Now the Houthis are enforcing a quarantine for any Yemeni entering their territory from government-controlled Yemen, even if the person is just returning home. The conditions of the quarantine are reportedly grim.
Even in the rest of the country, nominally under control of Yemen’s internationally recognized government, there were few international commercial flights a day from neighboring countries on the national carrier, Yemenia, and only into two cities, Aden and Seiyoun. These flights were suspended in mid-March, though it is certainly possible that Yemenis traveling home from Cairo, for example, could have brought COVID-19 into the country. In preparation for the virus’s arrival, Yemen’s government has tried to take steps to enforce social distancing by suspending gatherings for Friday prayers and closing markets that sell qat, the mild narcotic that is widely consumed in Yemen, though local reports show that these efforts have not always been obeyed.
There is one part of Yemen, however, that did receive international travelers prior to the flight suspension: the island Socotra, south of the mainland in the Indian Ocean. Over the past few months, a few dozen tourists, mostly from Europe, have been flying from Cairo to the island each week. So far, there have been no known cases of COVID-19 in Socotra, but given that medical care is quite limited on the far-removed island of 60,000, it could swiftly turn into a coronavirus nightmare if there are cases. There also are no testing kits on Socotra, according to WHO. Swabs would have to be sent to Aden.
I was one of those visitors in early February. I recall being required to complete a medical form upon arrival, attesting that I hadn’t visited China recently. Little did Socotra authorities know that it would have been wiser to ask if I had come from Europe.
Correction, April 3, 2020: This piece originally stated that Yemen is the most populous country in the Arabian peninsula. That is Saudi Arabia.