CNN watched overstretched doctors and nurses as they tried to give oxygen to Hassan, who had arrived six days earlier but wasn’t putting on any weight, and was struggling to breathe. Just hours later, Hassan died.
“He is just one of many cases,” said Dr. Osman Salah. The ward is full of children suffering from malnutrition, including babies just weeks old.
Every month, this hospital’s pediatric ward takes in more patients than its capacity of 50, sometimes twice as many. Around 12 children die there each month, Salah said. He and his staff are running on empty — they haven’t been paid for more than half a year.
Yemen has stepped up to the precipice of famine, and back again, many times over its six years of war. Now, famine conditions not seen in the country for two years have returned to pockets of the country.
An estimated 47,000 people are likely to be living with “catastrophic” levels of food insecurity — or famine-like conditions — according to an analysis by the Integrated Food Security Phase Classification (IPC), the world’s authority on food security. A further 16 million are living in either “crisis” or “emergency” food security conditions, the analysis shows. That’s more than half of Yemen’s population.
The rapidly deteriorating situation is the result mostly of funding cuts that have battered activities by agencies like the World Food Programme, which is struggling now to meet the most basic of needs for millions of Yemenis, particularly in the country’s north.
But it has also been exacerbated by a mounting fuel crisis. Staff at the hospital in Abs, where baby Hassan lost his life, say they will have to shut in less than three weeks if they don’t receive more funding and fuel to keep their generators going. It’s the same story all over the north.
“If fuel were easily available on the market, the number of cases we are seeing in the hospital would be much higher, because at the moment, there are patients who are staying at home, because of the challenges and expenses of traveling to the hospital,” Dr. Salah said.
As a result, said Dr. Salah, children are simply dying in their homes.
A bitter blockade
Fuel typically comes into the country’s north via the port of Hodeidah, usually bustling with economic activity at the best of times. Even during Yemen’s ongoing civil war, it has been a lively gateway for the conflict economy, where food and other aid that Yemenis rely on arrive.
But the port is now a ghost town. Hundreds of food aid trucks sit parked in a line stretching for miles along a dusty road. A cavernous tank that usually stores some 2,500 metric tons of oil sits empty at the port. It lets off an echoey clang with the softest touch.
Saudi warships have not allowed any oil tankers to berth at Hodeidah since the start of the year, the Houthis say, an assertion backed by the World Food Programme. The practice is starving the north of much-needed fuel. Since 2015, Saudi Arabia has been militarily supporting the internationally recognized Yemeni government, which is now operating in exile from Riyadh.
The Saudi vessels that patrol the waters of Hodeidah have control over which commercial ships can dock and unload their cargo. Some goods are getting through — CNN witnessed aid being loaded on to trucks at the port after being delivered by ship — but not any fuel to deliver them.
CNN obtained documents from the port’s arrival log showing that 14 vessels had been cleared by the UN’s verification and inspection body to carry fuel to the country. The tracking website MarineTraffic.com shows those vessels are now sitting in the Red Sea between the Saudi-Yemen border and Eritrea, unable to unload their fuel.
The UN has previously accused the Houthis of siphoning hundreds of millions of dollars in fuel taxes earmarked to pay civil servants. Nonetheless, the UN has reiterated that agencies still need to operate in the north, where the need is greatest.
Houthi officials tell CNN that they are being fined millions of dollars by the companies that own the ships while they are unable to dock.
Nearly three years ago the UN Security Council criminalized “intentionally using starvation of civilians as a method of warfare,” and demanded that “access to supplies that are necessary for food preparation, including water and fuel” be kept intact in northern Yemen.
The Saudi government did not reply to CNN’s request for comment on the new fuel blockade and a question on whether blocking fuel might constitute a method of warfare.
The World Health Organization, which provides critical funding to hospitals and clinics, says it has been left with no funding at all to secure fuel to carry out its services across Yemen.
“From March 2021, WHO will have to stop distributing fuel to 206 facilities across the country, over 60 percent are hospitals providing services not available at the already fragile primary level. This will lead to the stoppage of life-saving services, such as emergency rooms and intensive care units, including COVID-19 ICUs. Over 9 million people will be affected,” it said in a document, shared with CNN.
The Saudi-backed Yemeni government has repeatedly denied CNN visas to enter the country’s north after coverage last year that exposed Saudi Arabia’s dramatic drop in humanitarian funding for the war. CNN traveled at night by boat from east Africa to reach the Houthi-controlled north, where a Saudi blockade has contributed to widescale suffering and enormous food security challenges.
Saudi Arabia has been targeting Iran-backed Houthis in Yemen since 2015, with the support of the US and other Western allies. It had hoped to stem the Houthis’ spread of power and influence in the country by backing the internationally-recognized government under President Abdu Rabu Mansour Hadi.
The Houthis continue to hit Saudi targets with missiles from within Yemen and drone attacks.
Can Biden turn the war?
The dynamics of the conflict, however, appear to be rapidly changing. In February, US President Joe Biden announced a new Yemen strategy, giving momentum to the search for a ceasefire and eventual political solution.
There are few concrete details yet of his policy, but central to his announcement was the US’ withdrawal of offensive support for Saudi Arabia.
“The US historically has not viewed Yemen as an independent sovereign nation in its own right. The US has treated Yemen as an extension of either the US-Saudi policy or the US-Iranian crisis,” said Munir Saeed, former president of a Yemeni pro-democracy group TAWQ, at a Yemen briefing held by Fair Observer last week.
He welcomed the change in direction, saying the Biden strategy was the first from the US to put Yemen’s interests at its center.
“Dealing with Yemen as a country by itself that has its own problems, and cutting it away from the problems of Saudi-Iranian problems … is very important to lead to peace.”
The Obama administration was supportive of Saudi Arabia’s intervention in Yemen in 2015 and offered the Kingdom arms deals worth more than $115 billion total, more than any other US administration in the history of US-Saudi relations, according to a report by the Center for International Policy.
It later imposed restrictions on the sale of certain arms to Riyadh, including precision-guided munitions, after reports of civilian casualties in several Saudi-led airstrikes. The Trump administration reversed some of those restrictions, though he faced constant challenges in Congress.
As part of his new approach, Biden also appointed a special envoy for Yemen, Tim Lenderking, who is wrapping up a two-week visit to region, trying to engage different parties and give mediation efforts a reboot.
There will be limitations to how much the Biden administration can achieve, and ultimately, a ceasefire will depend on Yemeni actors on the ground.
And the Houthis are showing little appetite of slowing down, still launching missiles and drone attacks on Saudi Arabia, which has been responding with airstrikes. The Houthis said last week they had also seized control of 10 out of 14 districts of the strategic northern city of Marib.
On the back of his Gulf trip, Lenderking told CNN that Saudi Arabia and its allied Yemeni government were ready to agree to a ceasefire, and called on the Houthis to end their cross-border strikes and assault on Marib.
“They are ready to sit down to negotiate an end to the conflict with all relevant parties, including Ansarallah, sometimes referred to as the Houthis, during which access to ports and other issues could be addressed and resolved quickly,” he said, using the group’s formal name, in an emailed response to CNN’s questions.
When asked about US support for Saudi Arabia while the country was blocking fuel deliveries to Hodeidah, Lenderking said the situation was “complex.”
“On fuel, we need to be clear where the problem lies,” he said, pointing to a UN accusation against the Houthis that they had siphoned fuel taxes earmarked to pay Yemeni civil servants to fund its war effort as the main reason the fuel tankers have been barred from docking.
“Instead, Ansarallah diverted them to their war effort, which they continue to fund with revenues from diverted imports and port revenues.”
Lenderking said the US was urging the Yemeni government to work with the UN around the impasse to ensure that aid continues to flow where it’s needed and that a fuel shortage doesn’t worsen the situation.
In Yemen, CNN met with Mohammed Ali Al-Houthi, a senior Houthi leader, who said his group was willing to come to the negotiating table but wanted to see more action from the US first before it put trust in Biden.
“First of all, President Biden was a partner of President Obama, and during that time they declared that they would join the coalition against our country. They also agreed about and gave the green light for the coalition to continue perpetuating the killing in our country,” he said.
“Trust is created by actions not words. Trust must come about by decisions. So far, we have not seen any concrete decisions being made.”
Aid agency’s plead for action now
A political solution, or at least an initial ceasefire, would go a long way in addressing the country’s food security problems.
“Ultimately, until there’s an end to the war, we are doing what we can to save lives. But Yemen needs peace,” said the World Food Programme’s Yemen spokesperson Annabel Symington.
In April last year, the WFP said it was forced to cut every second monthly food aid delivery to 8 million people in Yemen’s north. It’s now hoping to raise $1.9 billion, which will be enough just to avert widescale famine.
The WFP and most agencies don’t know how much money they will get this year, but it isn’t looking good. A pledging conference on March 1 garnered less than half the $3.85 billion the UN estimates it needs just to keep the country fed and running.
Philippe Duamelle, the Yemen representative for UNICEF, is making an urgent plea for donors to step up their pledges, warning that 2.3 million children under the age of 5 in Yemen are projected to suffer acute malnutrition this year, up 16% from 2020.
“The children of Yemen cannot wait, we’ve got to be able to assist them and save them now. The situation has deteriorated significantly, and we need to reverse the trends now,” he said.
But in all humanitarian disasters, there are glimmers of hope. In the district of Harf Soufian, which in January descended into the “catastrophic” famine-like category, another 10-month old baby, just like Hassan Ali, has been fighting for her life.
Zahra sat in her mother’s arms, sucking her fingers, at the Rural Harf Soufian Hospital. All the staff here have been excited by her success story.
When she came to the hospital, her doctor said, she weighed just 5 kilograms, putting her in the bottom 5% for girls by weight, according to WHO growth standards. In just four days, she has put on 400 grams, no mean feat for a baby from a district starved of food.
“She is improving,” said Dr. Adnan Abdul-Rahman, looking through a log of her weight gain.
“The hard thing is getting the children here. But when families can get them here, it makes a difference.”