Malnutrition, displacement and attacks on water supplies could spark a new wave of the disease

• Save the Children’s health centres report 170 per cent spike in suspected cases.
• Malnutrition, displacement and attacks on water supplies could spark a new wave of the disease nationwide.
• 100,000 severely malnourished children at risk in Hodeidah.
• Case studies, photos and b-roll available for download
• Spokespeople available in London, Amman and Sanaa

Suspected cholera cases have almost tripled in Yemen’s coastal Hodeidah region since fighting escalated in June.

Health facilities supported by Save the Children across the governorate recorded a 170 per cent increase in the number of suspected cholera cases, from 497 in June to 1,342 in August.

The spike is in line with national data that also shows a steady increase of suspected cholera cases across Yemen. 30 per cent of all suspected cases are children under five years old, according to the World Health Organization.  

The rise in suspected cases in Hodeidah follows a dramatic increase in fighting between the Houthis and forces backed by the Saudi- and Emirati-led Coalition since June.

Between 26 and 28 July, airstrikes resulted in the damage of a sanitation facility and water station that supplies Hodeidah with most of its water. After this incident, suspected cholera cases almost doubled between July (732) and August (1,342) in Save the Children-supported health centres.

In a recent UN survey of more than 2,000 respondents across Yemen, more than half (56 per cent) cited water supply damage as the most common form of infrastructure damage. In Hodeidah governorate this jumped to 62 per cent of respondents.

As battles have intensified around Hodeidah’s port city in September, Save the Children is warning of a humanitarian catastrophe should the ground fighting reach densely populated areas or if the city should be besieged.

Hodeidah governorate is also home to nearly 100,000 severely malnourished children – more than a quarter of Yemen’s total. Severely malnourished children are much more likely to contract and die from diarrhoeal diseases like cholera than well-nourished children.

In addition, over half a million people have been displaced from their homes in Hodeidah since June, forced to live in host communities in cramped conditions and with little access to clean water and sanitation. Yemen’s rainy season which runs from April to August is further compounding the crisis.

Speaking from Sanaa, Tamer Kirolos, Save the Children’s Yemen Country Director, said:

“Children in Yemen are experiencing severe hardships that no child should endure, facing multiple threats from bombs and bullets to disease and extreme hunger. It’s unacceptable that they’re dying from entirely preventable causes. 

“Treating cholera is straightforward providing children can get the rehydration and antibiotics they need, and hospitals and clinics are adequately equipped. But nearly four years of conflict has led to a near-total collapse of the health system in Yemen. The warring parties have repeatedly attacked medical facilities, making some of them unusable or inaccessible. If this continues many more children could die of cholera and other preventable diseases. 

“There are no aboveground water sources in Yemen so the vast majority of communities depend entirely on wells and water trucks to meet their daily needs. Even in towns and cities water systems are in a state of disrepair or damaged from the fighting. Limited availability often results in poor hygiene practices and sanitation, heightening the risk of further cholera outbreaks.

“The solution is simple. The fighting must stop and the parties to the conflict need to find a political solution. In the meantime, Save the Children will continue to distribute medicines and support clinics to reach the most vulnerable children before it’s too late.”

Speaking from Hodeidah, Dr Mariam Aldogani, Save the Children’s Hodeidah Field Manager, said:

“The situation in Hodeidah has become unbearable because of the conflict. I’m seeing more and more children coming in with suspected cholera. I met one mother of two who has acute diarrhoea and she told me her whole family is affected because they don’t have access to clean water any more. They all drink from an open well and don’t even have enough money to buy cooking gas needed to boil the contaminated water they collect. Her husband hasn’t been paid a salary since last year. She knows she’s putting her children’s health at risk. But what can she do when they cry from thirst? So they just drink, and hope for the best.”    

22-year-old *Salwa and her two-year-old son *Aseel live with 13 family members in their house in Hodeidah. Both mother, who is four months pregnant, and son are suffering from cholera. When *Salwa got sick, she couldn’t afford the $4 bus fare to the hospital. After three days, her father managed to rent a motorbike and brought his daughter in critical condition to a Save the Children health clinic. Both mother and son are being treated now, but *Salwa continues to worry about the fate of her unborn child and whether she’ll be able to reach a hospital in time to give birth safely.

*Salwa told Save the Children:

“Two days after I got sick, my two-year-old son got sick and joined me in the hospital. For sure, I infected him with cholera. We drink water from a well near our house. We collect the water from the well more than three times a day.

“Our life before the war was prosperous but after the war our life changed because there is a lack of fuel. Before the war I used to work in the farms but after the war work opportunities finished.

“I am four months pregnant. When I got sick with cholera I felt worried that I’d lose my baby, especially with the current bad situation. I always think about giving birth in such a bad situation.”

Cholera is an infectious disease transmitted through contaminated food or water. Access to clean water is crucial for bringing a cholera outbreak under control. But Yemen is the most water-scarce country in the Arab world. Even before the war began experts feared Yemen could become the first country in the world to run out of usable water. Nearly four years of conflict have only made matters worse.

Visit our Yemen Crisis Appeal page here.

For free-to-use multimedia content including stills, GVs and case studies click here.

SPOKESPEOPLE AVAILABLE IN SANAA, AMMAN AND LONDON

To arrange an interview please contact:

Bhanu Bhatnagar in Amman

B.Bhatnagar@savethechildren.org.uk

+962 79 145 2375 (SMS and calls)

+44 7467 096788 (WhatsApp only)

24-hour press officer in London:

Media@savethechildren.org.uk

+44 7831 650 409

NOTES TO EDITORS

• Hodeidah is the epicentre of Yemen’s cholera outbreak with a cumulative total of more than 23,000 suspected cases so far this year, 7,000 of them children under five years old, according to the World Health Organization (WHO). 
• Other parts of Yemen are also reporting an increase in cholera. Suspected cholera cases nearly doubled in Save the Children-supported health facilities in Ibb governorate between June (383) and August (746) this year.
• According to the WHO’s epidemiological bulletin on cholera in Yemen for week 36 (Sept 3-9), the cumulative suspected cholera cases from 1 January to 9 September this year, is 154,527 with 197 associated deaths. The cumulative suspected cholera cases from 27 April 2017 to 9 September 2018 is, 1,176,963 with 2,435 associated deaths.
• One in four children under five years in Hodeidah governorate are malnourished. One in 20 suffer from severe acute malnutrition – the deadliest form of extreme hunger. Hodeaidah has a Global Acute Malnutrition (GAM) rate of 25.2% and a Severe Acute Malnutrition (SAM) rate of 5%.
• Severely malnourished children (SAM) are 12 times more likely to die from diarrhoeal diseases like cholera than well-nourished children. For more see here.
• In 2017 Yemen witnessed the worst recorded cholera outbreaksince records began with well over one million suspected cases, 600,000 of them children.
• During last year’s cholera outbreak, Save the Children supported 15 Diarrheal Treatment Centres (DTCs) and Oral Rehydration Therapy points across Yemen. As cases decreased after the second wave, Save the Children closed these DTCs but continued to monitor the situation very closely. With the renewed increase of cholera cases this year, Save the Children has reopened several DTCs, including three in Hodeidah governorate.
• The number of people lacking adequate access to healthcare increased from 8.8 million before the escalation of the conflict in March 2015 to 16.4 million in 2018, of whom 9.3 million are in acute need of assistance to health care. For more see here.
• As of 24 September this year, more than 78,400 households have been displaced from their homes in Hodeidah since June. With an average household size of seven individuals, that’s a total of 548,800 people displaced since June.
• The humanitarian crisis in Yemen is widely acknowledged as the worst in the world. According to UNICEF, 22.2 million people – including 11.3 million children – are in need of humanitarian assistance. Sixty per cent of the country’s population is hungry, including 8.4 million acutely food insecure people who do not know where their next meal will come from, half of them children under 18 years. An estimated 400,000 children under the age of five are suffering from severe acute malnutrition.
• Save the Children has over 50 years of experience working in Yemen. Operational in the country since 1963, the charity was the first international aid group in Yemen. We work nationally and locally to promote and protect children’s rights, with programmes in education, protection, health, nutrition, water, livelihoods, and food security. For more see here. 
• Save the Children stand side by side with children in the toughest places to be a child. We do whatever it takes to make sure they survive, get protection when they’re in danger, and have the chance to learn. Together, we fight for children every single day. Because every child should be able to make their mark on their world, and help to build a better future.

2018 ESTIMATED SEVERE ACUTE MALNUTRITION (SAM) CASELOAD BY GOVERNORATE