Hospital in Yemen’s Taiz warns of collapse in days because of Houthi siege

Dialysis patients face shorter treatment sessions as severe shortages of fuel, medicines, and oxygen threaten hospitals in besieged Yemeni city.

Signs of battles between Yemeni government forces and Iran-backed Houthis west of Taiz on Wednesday [AFP]

Taiz, Yemen – It was approaching 10:30am in the dialysis centre of the Republican Hospital in Taiz when a machine began filtering excess fluids, toxins and salts from the blood of Omar Mukhtar Hammoud.

The 16-year-old suffers from kidney failure and is one of 270 patients who regularly receive dialysis at the centre in the government-held city in southwest Yemen. But with essential medical supplies and fuel running critically low under the renewed Houthi siege , doctors fear they may soon be unable to provide the treatment that keeps their patients alive.

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Dr Essam Mahyoub Dahan, the centre’s director, warned that a complete shutdown could happen within days.

“Because of the siege and the shortage of diesel and medical solutions, we have recently been forced to reduce dialysis sessions from four hours to just two and a half,” Dahan told Al Jazeera. “We know this is not adequate, but we have no choice if we are to keep the centre operating for as long as possible before it shuts down completely.”

Dahan said the centre’s remaining stocks of specialised dialysis solutions were also close to running out.

The supplies, which are expensive, are normally provided by the Yemeni Ministry of Health every three months. But the latest delivery which was due earlier this month failed to arrive because of the Houthi siege on Taiz city. It began in the first week of October after Houthi advances in the Taiz countryside.

The city was previously under complete Houthi siege between 2015 and 2016, in the early years of Yemen’s ongoing war.

Across Taiz governorate, where battles are raging between the Saudi-backed Yemeni government forces and Iranian-allied Houthi fighters, the number of patients at risk is far greater.

In an October 12 statement, the governorate’s health office warned that the continued siege and obstruction of essential supplies could endanger the lives of 1,110 patients with kidney failure. They depend on dialysis services in the governorate’s hospitals, which collectively provide about 210 dialysis sessions a day.

International humanitarian and health organisations have issued similar warnings about the impact of the siege on the already fragile healthcare system in Taiz.

On Thursday, Amnesty International called on the Houthis to immediately reopen vital roads into and around the city, warning that the closure of the main road between Taiz and the southern port city of Aden threatened hundreds of thousands of civilians with losing access to food, water and healthcare.

Fuel: A lifeline for hospitals

Taiz’s hospitals depend heavily on diesel-powered generators because much of the city’s electricity infrastructure was destroyed during the war that began 11 years ago and has not been restored.

The renewed Houthi siege has severely disrupted the entry of fuel, including the diesel needed to run hospital generators and lifesaving medical equipment.

Dr Shaheed al-Ameri, deputy director-general for technical affairs at the Republican Hospital, said the shortages have had a devastating impact on medical services.

“A very large part of this suffering is because of the shortage of diesel,” he told Al Jazeera. “We have no reserve diesel supplies. Our stocks ran out early in the siege and we are now buying it on the black market almost every day, at prices that have reached five times what they were before the siege.”

Al-Ameri warned that the longer the siege continues, the more prices will rise and the further medical services will deteriorate.

The hospital has already suspended operations in some departments, including essential units, he said.

“If this situation continues much longer, we fear we will reach a complete and comprehensive collapse of healthcare services,” he said.

The shortages are not confined to the Republican Hospital. On October 22, the World Health Organization (WHO) warned that critical shortages of fuel, oxygen, medicines and medical supplies were threatening lifesaving healthcare throughout Taiz governorate, with some hospital services already disrupted.

According to the WHO, 42 health facilities in Taiz city had reported severe shortages of essential supplies. Hospitals and ambulances require at least 156,000 litres of fuel a month to continue functioning.

The organisation also warned that diesel shortages threaten to disrupt oxygen production, water pumping, vaccine refrigeration and sanitation services, increasing the risks of disease outbreaks, particularly among displaced families and other vulnerable groups.

The United Nations has separately warned that the restrictions on supplies are bringing Taiz’s health system close to collapse and urged the Houthis to allow humanitarian assistance and essential goods to enter without obstruction.

Oxygen shortages deepen crisis

In its October 12 statement, Taiz’s health office warned that continued restrictions on fuel deliveries could lead to the shutdown of medical oxygen production plants, further endangering patients.

Taysir al-Samei, the health office’s media officer, said that would dramatically worsen the crisis.

“Many medical departments depend on oxygen, particularly operating theatres, inpatient wards, intensive care units and incubators for premature babies,” al-Samei said.

“Most hospitals have already suspended services in some units because of the shortage of diesel and the lack of necessary medical solutions, as well as shortages of medical staff who are struggling to get to work because of the lack of transport,” he added.

He warned that if conditions continued to deteriorate at the same pace, some hospitals could stop providing services in the coming days.

At the Republican Hospital, al-Ameri said that shortages were also affecting diagnostics and treatment. The availability of laboratory reagents had fallen to just 10 to 15 percent of previous levels, he said, while approximately half of the medicines normally available were now out of stock.

Prices for the remaining medicines had doubled, he said, placing them further out of reach for patients already struggling with Yemen’s worsening economic crisis.

The continued fighting and shelling around Taiz have increased the number of wounded people requiring emergency care – placing additional pressure on facilities already struggling with shortages of surgical supplies , anaesthetics and intravenous fluids.

Abdul Badi Abdulwuhab, 53, is another dialysis patient in the Republican Hospital, struggling to cope with the shorter dialysis sessions.

His voice was filled with desperation.

“Because of these measures, I suffer from weakness and I cannot bear the pain,” Abdul Badi told Al Jazeera. “Two and a half hours is not enough to remove all the fluids and toxins from my body.”

Dr Dahan said that the patient’s condition had deteriorated since his sessions were shortened.

“These measures are not effective for many patients,” Dahan said. “The only solution is to end the siege and return things to the way they were.”

由于燃料、药品和氧气严重短缺，被围困的也门城市医院面临困境，透析患者的治疗时间将缩短。

周三，也门政府军与伊朗支持的胡塞武装在塔伊兹以西发生交火迹象 [法新社]

也门塔伊兹——上午 10 点 30 分左右，在塔伊兹共和国医院的透析中心，一台机器开始过滤奥马尔·穆赫塔尔·哈穆德血液中多余的液体、毒素和盐分。

这名16岁的少年患有肾衰竭，他是也门西南部政府控制城市一家透析中心270名定期接受透析治疗的患者之一。但由于胡塞武装再次围困，基本医疗物资和燃料严重短缺，医生们担心他们可能很快就无法为患者提供维持生命的治疗。

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该中心主任埃萨姆·马赫尤布·达汉博士警告说，几天之内可能会发生全面停摆。

“由于围困以及柴油和医疗用品短缺，我们最近被迫将透析疗程从四个小时缩短到两个半小时，”达汉告诉半岛电视台。“我们知道这远远不够，但如果我们想在中心彻底关闭之前尽可能长时间地维持其运转，我们就别无选择。”

达汉表示，该中心剩余的专用透析液也即将用完。

这些物资价格昂贵，通常由也门卫生部每三个月提供一次。但本月初应到的最新一批物资由于胡塞武装围困塔伊兹市而未能送达。围困始于10月初，当时胡塞武装在塔伊兹郊区发动攻势。

在也门持续战争的初期，即 2015 年至 2016 年期间，该市曾被胡塞武装完全围困。

在沙特支持的也门政府军与伊朗支持的胡塞武装在塔伊兹省激战正酣，面临风险的患者人数要多得多。

10月12日，该省卫生部门发表声明警告称，持续的围困和对基本物资的阻挠可能会危及1110名肾衰竭患者的生命。这些患者依赖于该省各医院的透析服务，这些医院每天总共提供约210次透析治疗。

国际人道主义组织和卫生组织也发出了类似的警告，指出围城会对塔伊兹本已脆弱的医疗卫生系统造成影响。

周四，国际特赦组织呼吁胡塞武装立即重新开放通往塔伊兹市及其周边的重要道路，并警告说，塔伊兹与南部港口城市亚丁之间的主要道路关闭，将使数十万平民面临失去食物、水和医疗保健的威胁。

燃料：医院的生命线

塔伊兹的医院严重依赖柴油发电机，因为该市的大部分电力基础设施在11年前开始的战争中被摧毁，至今尚未恢复。

胡塞武装重新发起的围困严重阻碍了燃料的运输，包括医院发电机和救生医疗设备所需的柴油。

共和国医院技术事务副总经理沙希德·阿梅里博士表示，物资短缺对医疗服务造成了毁灭性的影响。

“造成这种困境很大程度上是因为柴油短缺，”他告诉半岛电视台。“我们没有柴油储备。围城初期，我们的库存就耗尽了，现在我们几乎每天都要从黑市购买柴油，价格已经是围城前的五倍了。”

阿梅里警告说，围困持续的时间越长，物价就会上涨得越多，医疗服务也会进一步恶化。

他说，医院已经暂停了部分科室（包括一些重要科室）的运营。

他说：“如果这种情况持续下去，我们担心医疗服务将会彻底崩溃。”

物资短缺并非仅限于共和国医院。10月22日，世界卫生组织（世卫组织）警告称，燃料、氧气、药品和医疗用品的严重短缺正在威胁塔伊兹省的救生医疗服务，部分医院的服务已经中断。

据世界卫生组织称，塔伊兹市42家医疗机构报告基本物资严重短缺。医院和救护车每月至少需要15.6万升燃料才能维持运转。

该组织还警告说，柴油短缺可能会扰乱氧气生产、水泵、疫苗冷藏和卫生服务，增加疾病爆发的风险，尤其是在流离失所的家庭和其他弱势群体中。

联合国另行警告称，物资供应限制正使塔伊兹的医疗系统濒临崩溃，并敦促胡塞武装允许人道主义援助和必需品畅通无阻地进入该地区。

氧气短缺加剧危机

塔伊兹卫生部门在 10 月 12 日的声明中警告说，继续限制燃料供应可能会导致医用氧气生产厂关闭，从而进一步危及患者。

卫生部门媒体官员泰西尔·萨梅伊表示，这将使危机急剧恶化。

“许多医疗部门都依赖氧气，特别是手术室、住院病房、重症监护室和早产儿保温箱，”萨梅伊说。

他还补充说：“由于柴油短缺、缺乏必要的医疗用品，以及医务人员短缺（他们因为缺乏交通工具而难以上班），大多数医院已经暂停了部分科室的服务。”

他警告说，如果情况继续以同样的速度恶化，一些医院可能在未来几天内停止提供服务。

阿梅里在共和医院表示，物资短缺也影响了诊断和治疗。他说，实验室试剂的供应量已降至之前的10%到15%，而通常可用的药品中约有一半现在都已断货。

他说，其余药品的价格翻了一番，这使得那些本已在也门日益恶化的经济危机中挣扎的患者更加难以负担这些药品。

塔伊兹周围持续不断的战斗和炮击导致需要紧急救治的伤员人数增加，给本已面临外科用品、麻醉剂和静脉输液短缺的医疗机构带来了更大的压力。

53 岁的阿卜杜勒·巴迪·阿卜杜勒乌哈卜是共和国医院的另一位透析患者，他难以适应越来越短的透析疗程。

他的声音里充满了绝望。

阿卜杜勒·巴迪告诉半岛电视台：“由于这些措施，我身体虚弱，疼痛难忍。两个半小时根本不足以清除我体内的所有液体和毒素。”

达汉医生表示，自从缩短治疗时间后，患者的病情恶化了。

达汉说：“这些措施对很多病人来说并不奏效。唯一的解决办法是结束围困，恢复正常生活。”