Ahmed Nagi, a Yemeni man in his fifties, had worked for more than 30 years as a porter in the Al-Turbah market in Taiz province, until his life took a dramatic turn. By helping shoppers carry goods from stalls to their vehicles, he earned enough to support his family of seven. However, two years ago he was diagnosed with severe liver complications, which left him unable to continue working. Today, Nagi can barely walk with the help of a cane, which he uses whenever he leaves the house. Because he can no longer work, he cannot even afford the medicine he needs to treat his illness.
“The doctors, who were not liver specialists, told me that my liver was not functioning properly, but they were not sure if this was the main cause of the problem. The condition has left me almost unable to walk, and sometimes I cannot move at all,” said Nagi.
“Some generous people provided me with medicine for several months, but I did not recover and my health is deteriorating every day,” he added. Coming from a low-income family, Nagi could only receive treatment at the local hospital. Doctors told him that for a diagnosis and specialized treatment, he would have to go to a medical center in Sanaa or Aden. For a man who survives on the help of others and to feed his family, meeting the costs of travel and treatment in another province is almost impossible. “Traveling to Aden or Sanaa costs a lot of money, and I am unemployed. I pray every day for someone to help me recover,” he said.
According to the World Health Organization (WHO), Yemen faces a severe shortage of qualified health personnel. About 18 percent of the country’s districts do not have a single doctor. Many of the most skilled health professionals have left the country for years, seeking better working and living conditions. Yemenis who can afford it travel to Egypt, Jordan, India and other countries for medical treatment. Those who cannot afford it are forced to seek help within the country, despite the fact that nearly twelve years of war and the emigration of professionals have severely damaged Yemen’s health system.
LOSE SIGHT IN ONE EYE, RISK OF LOSSING THE OTHER ALSO
Taha Nabil, 45, from Al-Shimayateen district in Taiz province, has been suffering from cataracts in his right eye for a long time. Like Nagi, he was unable to find proper treatment near his home. Since there was no ophthalmologist in his area, he saved up money to undergo surgery in Taiz city. However, he too fell victim to the lack of qualified specialists. “I thought the surgery would be simple and I did not hesitate to do it, but later I regretted it. Before the surgery, my vision was only blurry, and after the surgery, I completely lost my vision in my right eye,” Nabil told Al Jazeera.
After the unsuccessful surgery, he continues to search for an ophthalmologist who can restore his sight. But finding a qualified specialist, as well as securing the approximately $4 needed for treatment, remains almost impossible.
“I don’t know any Yemeni ophthalmologists who can really help me, and proper treatment is extremely expensive. Before 2015, there were doctors who could treat this problem, but many of them have left the country, leaving patients without the necessary healthcare,” he said. Because he cannot afford specialized treatment, Nabil has been forced to adapt to daily life seeing only with his left eye. “Ophthalmologists have warned me that even the vision in my left eye will deteriorate if I don’t get proper treatment. Unfortunately, this is beyond my means,” he concluded.
ESCAPE OF HEALTH PROFESSIONALS
The impact of the exodus of doctors and health workers on Yemen’s health system has been devastating. According to the World Bank, Yemen now has just 0.1 doctors for every 1.000 people, far below the Regional average of 1.1 doctors. By comparison, the global average is 1.9 doctors per 1,000 people, while the Arab average is 1.2. In other fragile and conflict-affected Regions, the average is around 0.5 doctors per 1.000 people.
Driven by years of war and a severe lack of funding, the collapse of Yemen’s health system has left at least 20 million Yemenis, nearly half the country’s population, without access to basic health services. At least half of the country’s health facilities are not functioning at all, critically limiting the country’s ability to respond to recurring outbreaks of diseases such as cholera and diphtheria. Dr. Ismail al-Hamoudi, deputy director of the Public Health and Population Office in Taiz province, said that the acute shortage of specialized medical personnel has severely limited access to essential health services for thousands of residents.
“About 41 percent of the medical staff in Taiz have been displaced or have completely left the country. This has created an enormous amount of pressure on the doctors and nurses who remain and are trying to keep the health services functioning,” al-Hamoudi told Al Jazeera.
Dr. Abdulkareem Mubarak, deputy director of the National Program at the Ministry of Health in Aden, said the exodus of qualified health professionals is the main reason behind Yemen’s severe shortage of medical personnel. “There are many factors that are pushing our qualified professionals to leave the country, but among the most important are low incomes and irregular payments. Current salaries do not allow doctors and other health workers to provide for their families,” Mubarak told Al Jazeera. In addition, the lack of basic medical supplies, malfunctioning equipment and frequent power outages have created great frustration among health workers, who often feel unable to perform their duties properly in such difficult conditions.
“Although the ministry does not have the financial means to offer salaries high enough to convince qualified professionals to stay in Yemen, it is trying to find alternative solutions. This includes working with humanitarian organizations to provide financial incentives for medical personnel who continue to work in the country,” Mubarak said.
RECRUITMENT OF FOREIGN DOCTORS
As an emergency measure to fill the shortages in critical and specialized medical services, hospitals in Yemen have begun recruiting foreign doctors, including from Syria. “Hiring foreign doctors is not the final solution, because it is very expensive, but it helps fill the gaps and at the same time enables the transfer of knowledge and experience from foreign doctors to their Yemeni colleagues,” Mubarak said. On June 12, two Syrian doctors, Samer Ahmed Hassan and his wife, Dr. Samaher al-Mousa, were killed after they were caught in the crossfire when a gunman opened fire on guards at the Aden governor’s residence.
However, despite the insecurity in the country, Syrian doctors continue to arrive in Yemen and work in public and private hospitals across the country. Dr. Ahmed, a Syrian orthopedist working in Taiz province who asked to use a pseudonym for security reasons, said that the lack of doctors in Yemen was one of the main reasons that prompted him to leave Syria and go there three years ago.
“I had heard about the alarming shortage of medical personnel in Yemen and I was ready to come and help provide healthcare to the Yemenis who need it so much,” he told Al Jazeera. While the arrival of foreign doctors has helped ease the pressure on Yemeni health professionals, it has not been enough to significantly reduce the cost of medical treatment. As a result, doctors continue to work at an incredibly intensive pace. Dr. Ahmed said he performs about ten major surgeries each month, more than double the number of surgeries a surgeon usually performs. Despite the instability and risks that continue to exist in Yemen, Dr. Ahmed says he has no intention of following the example of hundreds of other Syrian doctors who have chosen to seek work in Europe or the Gulf countries.
Meanwhile, Taha Nabil, who lost his sight in his right eye, said he had heard of a Syrian ophthalmologist who could treat his problem. However, the ongoing shortage of specialists means the cost of the surgery is far higher than he can afford. “It seems there are Syrian ophthalmologists who can help me, but I just can’t afford the cost of the surgery,” Nabil said. (Al Jazeera)