By: Kevin Watkins
In an overcrowded nutrition clinic at Alsalkhana hospital in Hodeidah, one of Yemen’s largest cities, around 30 anxious mothers wait with resigned patience to have their children weighed and measured.
The first thing you notice about Ayesha*, aged seven months, is her stick-thin legs and distended tummy. She weighs just 3.5kg – the average weight of a newborn baby in the UK. When the doctor measures her upper-arm circumference, the tape goes deep into the red zone, indicating dangerous malnutrition.
This is not Ayesha’s first brush with starvation. Two months ago, she spent five days in the hospital’s emergency stabilisation centre for severely malnourished children. Her life was saved – just. Now she is back in Save the Children’s emergency feeding programme, along with two of her sisters, aged two and three years old. “I just don’t have the money to feed them or buy medicines; what can I do?” her mother, Amina*, asks me.
Sometimes the war in Yemen kills very visibly. Over 5,000 children have lost their lives or have been wounded by military action since 2015. Some have been the victims of bombs, some of which were manufactured in the UK, that have hit schools, homes and public places. Others have been caught in indiscriminate crossfire across the jigsaw of frontlines that define Yemen’s war. That war pitches the Houthis, who control the capital, Sana’a, against groups backed by a Saudi-led coalition of nations.
It’s not just bombs, bullets and artillery shells that threaten Yemen’s children. This is a conflict that also kills by stealth. Economic strangulation is being used by the Saudi-led coalition as a weapon of war, targeting jobs, infrastructure, food markets and the provision of basic services. Nobody is there to count the bodies of the victims. But for every child buried beneath the rubble of a building hit by a “smart bomb”, there are dozens of children – like Ayesha – threatened by the starvation that has accompanied the economic assault.
The UN has described Yemen as “the world’s worst humanitarian disaster”. Almost two-thirds of the population need emergency support. The food system is collapsing, pushing the country to the brink of famine. Over 400,000 children are at imminent risk of starvation. Unlike Ayesha, most of them will never see a health clinic or receive treatment. Many of those who survive will be affected by stunting and poor health for the rest of their lives.
Economic collapse has been the catalyst for economic crisis. Jobs, economic infrastructure and basic services have been systematically targeted by acts of war. Coalition airstrikes have targeted warehouses, factories and – critically – transport infrastructure. The economic assault has trapped millions of Yemenis in a vicious spiral of rising food and fuel prices, unemployment and declining wages.
The road from Sana’a to the port of Hodeidah, one of Yemen’s main arteries, bears the scars of economic warfare. Making the journey last week, I counted three bridges destroyed by Saudi airstrikes. The port itself is a ghost town. Saudi bombs have destroyed the five cranes that once unloaded ships carrying 80% of Yemen’s imports, along with grain storage silos. Over 20,000 people have lost their jobs. One of them is Ayesha’s father, which is why a family with five children is now living on less than $3 (£2) a day.
Economic collapse has been compounded by the collapse of the banking system. In 2016, Saudi authorities transferred the central bank from Sana’a to the southern city of Aden, which is controlled by its allies. The move effectively pulled the plug on public financing in northern governates under Houthi control, leaving more than 1.5 million health workers, teachers and water and sanitation workers without pay; and schools, hospitals and other basic services without budgets.
You can see the consequences at the general hospital in Amran. This is the main referral hospital, serving a population of over a million people. It has no antibiotics, no anaesthetics, and no drugs for obstetric emergencies. The hospital covers its costs by charging patients, who have to purchase their own drugs from private providers. Try imagining your nearest teaching hospital in the UK operating without the medicines you can get prescribed by any GP.
Kevin Watkins is chief executive of Save the Children UK. Previously he was executive director of the Overseas Development Institute.