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In a dedicated ward of the Al-Nasser Hospital, babies are treated for malnutrition—they’re just two of the estimated 1.8 million acutely malnourished children under age five. Yemen’s depleted health ministry relies on humanitarian organizations to provide medical care.

The World Has Left Yemen to Die

Exclusive photos give a rare look inside the country, where civil war has trapped civilians in a life of violence and disease.

This story appears in the August 2018 issue of National Geographic magazine.

The young woman was carried into the hospital at 9:30 a.m. Twenty minutes earlier she had been hanging laundry when a bomb fell in her courtyard on the outskirts of Taizz, an ancient city in southwest Yemen. A man covered in blood, her cousin, cried as the doctors rushed her to the trauma center.

“Both legs?” he asked when the doctor returned and gestured to show where they would amputate. One leg was shredded; the other had a protruding bone. Both, the doctor confirmed. She was put in an ambulance and taken to another hospital. Then there was silence. The nurses scrubbed blood off the floor and waited for the next patient.

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A father holds his baby at the Mother and Child Hospital after the child was treated for a respiratory infection. Doctors and nurses have fled Yemen, leaving hospitals stretched thin. “A lot of my colleagues have already left or are trying to travel to the Gulf states to find a better life,” says one Yemeni doctor working in Sanaa.

The outskirts of rebel-controlled Taizz have endured some of the country's heaviest fighting. For those displaced in this area, home might be a makeshift shelter or rented room.

 

That night, Matteo Bastianelli, an Italian photographer who’d watched the scene, wrote in his diary about life in Taizz after three years under siege: “Doctors wait, with the thunder of airplanes in their ears and the dust in their eyes, living with the fear that something terrible and irreparable could happen at any moment."

Once known by the Romans as Arabia Felix, “Fortunate Arabia,” Yemen was a strategic port at the entrance to the Red Sea, made rich by spices and scents. Today it’s one of the poorest countries in the world. Until 1990 north and south Yemen were governed separately, and this divide continues to fuel conflict. In late 2014 separatist Houthi rebels seized the capital of Sanaa in an attempted coup. Fearing a regional shake-up, neighboring Saudi Arabia intervened on behalf of President Abdrabbuh Mansour Hadi’s former government. With support from the U.S., the U.K., and nearly a dozen Arab states, a Saudi-led coalition launched an air campaign to help Yemen’s government keep its grasp on large swaths of the country.

EUROPE

ASIA

AFRICA

YEMEN

CHOLERA CRISIS

Since April 2017, more than a million suspected cholera cases have been reported in Yemen.

An international blockade and reliance on imported medical supplies have made it difficult to contain and treat the outbreak.

Cholera infection rate

April 2017–March 2018

Low

High

SAUDI ARABIA

Sadah

Sayun

Sanaa

YEMEN

Al Hudaydah

Al Mukalla

Taizz

Ad Dali

100 mi

Aden

100 km

North and south Yemen were governed separately until the country unified in 1990. Tensions between political factions erupted in 2014, creating what the UN deems the world’s worst humanitarian disaster.

Area under control or influence

As of May 2018

Houthi rebels (supported by Iran)

Al Qaeda in the Arabian Peninsula and tribal allies

Hadi government and other forces (supported by the Saudi-led coalition and allies)

Former North-South divide

SAUDI ARABIA

Sadah

Sayun

Sanaa

YEMEN

Al Hudaydah

Al Mukalla

Taizz

Ad Dali

100 mi

Aden

100 km

CLARE TRAINOR, NGM STAFF

SOURCES: RISK INTELLIGENCE; WHO; EUROPEAN COMMISSION, JOINT RESEARCH CENTRE

CHOLERA CRISIS

Since April 2017, more than a million

suspected cholera cases have been

reported in Yemen. An international

blockade and reliance on imported

medical supplies have made it difficult

to contain and treat the outbreak.

Cholera infection rate

April 2017–March 2018

EUROPE

OMAN

ASIA

AFRICA

Low

High

YEMEN

SAUDI ARABIA

North and south Yemen were governed separately until the country unified in 1990. Tensions between political factions erupted in 2014, creating what the UN deems the world’s worst humanitarian disaster.

Sadah

Sayun

Hajjah

Amran

Marib

YEMEN

50 mi

Sanaa

50 km

Arabian

Sea

Al Hudaydah

Red

Dhamar

Al Mukalla

Sea

Ibb

Area under control or influence

As of May 2018

Ad Dali

Taizz

Houthi rebels (supported by Iran)

Al Qaeda in the Arabian Peninsula and tribal allies

Aden

Bab el Mandeb

Africa

Hadi government and other forces (supported by the Saudi-led coalition and allies)

CLARE TRAINOR, NGM STAFF. SOURCES: RISK INTELLIGENCE; WHO; EUROPEAN COMMISSION, JOINT RESEARCH CENTRE

After three years of fighting, the numbers are stunning: In a nation of nearly 29 million, 22 million Yemenis are in need of humanitarian assistance, according to the UN. Two million have been displaced. At least 10,000 are dead. With the economy and health care system in shambles, Yemenis make desperate decisions to find medical treatment. Some take dangerous cross-country journeys to hospitals run by humanitarian groups; others spend their savings at private clinics. More than half of Yemen’s hospitals are closed or partly functioning, and sometimes administrators must choose between buying medical supplies and fuel for generators. Infectious diseases such as cholera and diphtheria are rampant, reflecting the lack of treated water and other basic government services.

In Ad Dali life goes on despite four years of civil war.

Before 2015 the recently built, five-story white stone building on the outskirts of Taizz was slated to be a hotel. Less than two miles behind a battlefront, it’s now a maternity hospital and trauma center run by Doctors Without Borders. Behind the concrete barrier, malnourished babies are fed, cholera patients recover, and war victims are bandaged: young boys hit with shrapnel while playing in their yards, the hospital’s own night watchman, hit by a shell while shopping.

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Long lines to refill canisters are a common sight at gas stations. Since 2015 fuel prices have more than doubled and the country has lost more than 40 percent of its GDP. “The economic disaster is even worse than the killing,” says Radhya Almutawakel, co-founder of the Mwatana Organization for Human Rights, in Sanaa. “People are dying behind closed doors.”

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Hundreds of schools like this one in Ad Dali have been destroyed by air strikes. Currently two million school-age children are not enrolled in school.

Doctors and other health workers at public hospitals haven’t been paid since 2016. Humanitarian groups are supporting the health ministry with salaries and supplies. But a Saudi-led coalition blockade on the country’s airports and ports in an attempt to stop supplies from reaching the rebels has arbitrarily delayed or diverted aid shipments, says Kristine Beckerle, with Human Rights Watch, adding that both sides “are weaponizing aid.”

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A man walks through Ad Dali, a southern city that has been fought over by Houthi rebels and the Yemeni government since the war began. In the background, a Kalashnikov monument honors the commander who fought off the Houthi.

Since 2017 the country has seen more than a million suspected cholera cases—the worst outbreak in modern history. One NGO ordered a shipment of medication in July 2017. It didn’t arrive until April.

Two boys play among the ruins of a school destroyed by a Saudi-led coalition air strike in Ad Dali. Since the war began, 2,500 schools have been bombed, closed, used for military purposes, or turned into shelters.

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A cloud hovers over mountainous northern Yemen. North and south Yemen were unified in 1990, but the historical distinction still sparks conflict. Today the UN has declared Yemen the world’s worst humanitarian disaster.

Many of Yemen’s doctors have moved to private hospitals or fled the country, leaving a shortage of medical professionals. Those who stay behind train their neighbors to treat wounds in case of an emergency overnight, when it’s too dangerous to travel.The private clinics cost more than even a middle-class civilian can afford. If you are dying, one elderly man told Bastianelli, you have to pay to be pronounced dead. The other option is to drive across the front lines to one of the country’s two open airports. Few can afford the cost of fuel—or the risk. “They’re locked in Yemen. No country is giving them asylum or making a humanitarian corridor,” says Bastianelli. “They count the days and wait to die.”