After more than two years of high-intensity war, the people of Yemen are now facing another battle – a huge cholera outbreak that has affected more than 500,000 people. Dr Melissa McRae, from Melbourne, reflects on her experiences as Medical Coordinator in Yemen
“There are so many challenges at the moment. Médecins Sans Frontières rapidly responded to the need for treatment centres – we are one of the few organisations here with the technical capacity to quickly establish and run these centres. However, a strong community level response is equally, if not more important to bring the outbreak under control. We are covering gaps in the community response, but more needs to be done to ensure that people have access to safe water and sanitation and understand how to protect themselves. The other key challenge is having enough oral rehydration points in many locations to ensure early treatment. The Yemeni context adds another layer of complexity: ongoing fighting, displaced populations and people living in temporary accommodation where hygiene and sanitation standards are not sufficient.
"More needs to be done to ensure that people have access to safe water and sanitation and understand how to protect themselves"
One of the saddest elements of this outbreak is the lack of affordable ‘routine’ healthcare. People present to the cholera treatment centre with a variety of health complaints. Some of these people know they don’t have cholera but are so desperate they attend in the hope of any free medical care. Unfortunately, free medical referral options for patients who do not meet the cholera case definition are non-existent in some places.
Médecins Sans Frontières is stepping in to cover key gaps in the public health system, particularly for the most vulnerable populations including war-wounded civilians, mothers and their children. The private healthcare system does continue to function but prices are inflated and unaffordable for many. In many parts of the country we support existing public hospitals staffed by Ministry of Health teams who are dedicated, well trained and a pleasure to work alongside. Juggling the cholera response while keeping our non-cholera health activities functional has been possible due to a huge amount of flexibility, energy and dedication from our teams.
Recently we have seen a reduction in cases but it is still too early to see which direction the epidemic will take. I hope for the people of Yemen that cases will continue to decrease – they need a break!”