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Home health clinics step in to plug critical health gaps in conflict-ridden Yemen

05 Jul 2016
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With health care services severely diminished, home-based clinics like Faten’s act as essential alternatives for people in need of medical attention.


With health facilities dwindling, home-based clinics like Faten Dhanri's (pictured here) provide essential assistance to people in need. Credit: OCHA/Afif Abu Aser
 

Twenty-five year old Faten Dhanri returned to her village in Haydan District in northern Yemen after leaving her job as a midwife in the district capital. Six months ago, she set up a health clinic in her house, which now provides basic health services including nutrition, immunization and reproductive health services to more than 3,000 village residents.

“She was not receiving her salary anymore, so she came back home,” said her 30-year old husband Fahd Qasem. “In January, UNICEF approached us to start a home health clinic in our one-room house. UNICEF provides medical supplies and Faten is the health worker. The rest of the family helps to manage.”

Over 21 million people need humanitarian assistance in Yemen, where a brutal armed conflict has caused the already fragile health care system to all but break down in some parts of the country. Less than 30 per cent of life-saving medicines and medical supplies are entering Yemen due to restrictions and other challenges to commercial importation. According to WHO, 25 per cent of all health facilities have shut down. Many of those still functioning are operating at minimum level and are in desperate need of staff, medicines and medical supplies.

With health care services severely diminished, home-based clinics like Faten’s act as essential alternatives for people in need of medical attention. More than 40 clinics have been set up in northern Yemen since May of last year, some of which are located in caves where people have taken refuge from conflict and airstrikes. They are all managed by local residents, including some former health workers, who receive a small payment for their work.
“The model has worked successfully, although it cannot handle more serious cases and larger health facilities do not have the capacity to take referrals,” said Ali Mogli, Director of Health in Haydan District.

Faten treats 8 to 10 patients every day. Most cases are children suffering from diarrhea and respiratory infections – two of the biggest killers of children – and women with ante-natal issues. She refers complicated cases to larger health facilities, but these are often out of reach of families whose livelihoods have been devastated by years of war.

Health care system on life support

Across Yemen, health facilities, medical personnel and patients have come under increasing attack over the course of the conflict. Haydan Health Centre – where Faten sends some of her patients – was hit by an airstrike last October. OCHA is following up with humanitarian partners to rehabilitate the facility and to deliver badly needed medical supplies.

“We have two doctors and a car for referrals, but we lack medical supplies and funds to pay staff,” said Ali Dhager, the Health Centre’s director. “In most cases, we only make the diagnosis and ask patients to look for medicine elsewhere.”

Though the situation in Yemen is worsening, humanitarian funding is not keeping up. As of June 2016, less than one quarter of the US$182 million needed for humanitarian response had been pledged, and just 18 per cent of the $32 million required for health needs had been received.

“The health care system is itself on life support,” said Jamie McGoldrick, the UN Humanitarian Coordinator in Yemen. “Overall access to health care services for 14.1 million people has been disrupted and people are dying of preventable diseases because of the limited availability of even the most basic medical supplies.”