WHO EMRO - Yemen site-information resources

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The protracted conflict in Yemen continues to have a profound impact on communities facing humanitarian crises and long-term health challenges. Yemen’s health care system is stretched to breaking point. Crumbling infrastructure, overcrowded households, poor physical conditions, lack of hygiene facilities and often insurmountable obstacles to access to medical care are the norm in many areas. Yet at the same time, Yemen faces some of the highest disease outbreak levels in the world.

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Since the start of 2024, Yemen has reported over 11 300 suspected cases of dengue and 890 000 suspected cases of malaria. Poverty and dire living conditions compound the risks to the health and well-being of millions of Yemenis, trapped in a seemingly never-ending vicious cycle.

Recent heavy rainfall in Yemen’s eastern governorates saw torrents flowing through the streets, damaging roads, sweeping away dozens of vehicles, damaging agricultural land, power grids and water sources, and bringing death in their wake.

As the planet warms and rain patterns change, emerging diseases pose a growing a threat. Strategies urgently need adaptation to combat emerging diseases and protect the people of Yemen.

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In May, with support from the Central Emergency Response Fund, the Ministry of Public Health and Population and WHO launched a campaign to combat mosquito-borne diseases in 6 of Yemen’s governorates. The campaign included awareness-raising activities conducted by community health volunteers, indoor fogging, residual spraying, larval source management and control of breeding spots, including the disposal of used tyres which provide a fertile breeding ground for mosquitoes.

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Community health volunteers knock on doors to ensure that health information reaches the households that need it most.

Extreme weather events like floods disrupt normal water storage and increase the number of breeding sites for mosquitoes in and around human habitation, leading to outbreaks of mosquito-borne diseases in densely populated areas.

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Sources of clean water are scarce. Many households use barrels and other large containers to collect water for drinking and washing. A few days’ worth of water is usually stored before the next refill, increasing the risk of water- and vector-borne illnesses.

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Providing basic information about safe water storage and disposal saves lives.

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Inside cities, graveyards serve as a repository of memories and are an intrinsic part of Yemen’s rich cultural heritage. Surrounded by residential buildings, they are also an ideal mosquito habitat. The graveyards have open water tanks from which families take water to pour on the graves of deceased family members as a sign of respect. The stagnant water in these tanks offers a breeding ground for mosquitoes and other disease-causing organisms, including bacteria, viruses and parasites.

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Health teams use residual spraying with a long-lasting insecticide to prevent mosquito egg-laying and larvae development, a simple step that reduces disease transmission and helps control mosquito populations from spreading in cities.

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While it does not stop mosquito bites, it plays a crucial role in breaking the cycle of disease transmission.

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Waleed Mohammed, a man in his sixties, visits his mother’s grave to pray and pay his respects. He collects water from the graveyard tanks in a yellow barrel and carries it to where his mother lies.

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Pouring water and chanting prayers asking God for peace and mercy for his mother’s soul “is the least I can do to thank her” he says.

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Situation update, 17 August 2022

Intense rains and devastating floods are continuing across Yemen affecting shelters, livelihoods and water sources of approximately 35 000 households, mostly in displacement sites and settlements.

Heavy rainfall is expected to continue until 20 August, likely causing further displacement of households especially in lowlands of Al Hodeidah, Al Mahwit, Hadramawt, Hajjah, Lahj, Raymah, Sa’dah, Sana’a, Shabwah and Ta’iz governorates.

The districts of Ma’rib City and Ma’rib (Al Wadi) and Abs currently have the highest concentration of affected families. OCHA and sub-national clusters are coordinating with partners to mobilize a response given floods continue to pose a serious threat to displaced populations.

Situation report, Issue 1, August 2022

Yemen annual report 2020

14 November 2021 – The Yemen Emergency Human Capital Project is the successor to the Yemen Emergency Health and Nutrition Project and it will be implemented in Yemen by WHO, UNICEF and UNOPS with the fund and support of World Bank. The Yemen Emergency Human Capital Project approval date is 30 June 2021, and the expected closing date is 30 June 2024.

The project's development objective is to provide essential health, nutrition, water, and sanitation services to the population of Yemen. The project will protect and preserve the human capital of Yemen by continuing to support the provision of essential services; support core public health and population-based interventions, as well as restoring water supply and sanitation services, including response to emergencies and disease outbreaks; and build national and local capacities/institutions for health, nutrition and WASH service delivery and system management in Yemen.

The project components and the responsible implementing agency are outlined below.

Component 1: Improving Access to Healthcare, Nutrition, and Public Health Services. This component aims to continue to ensure the delivery of Minimum Service Package (MSP) services and strengthen the integration of the primary, secondary, and tertiary healthcare and community levels through four subcomponents described below.

Subcomponent 1.1: Improving Access to MSP Services at Primary Healthcare Level (implemented by UNICEF).

Subcomponent 1.2: Improving Access to Essential Preventive and Curative Nutrition Services (implemented by UNICEF).

Subcomponent 1.3: Improving Access to the MSP at Secondary and Tertiary Healthcare Levels (implemented by WHO).

Subcomponent 1.4: Sustaining the National Health System Preparedness and Public Health Programs (implemented by WHO).

Component 2: Improving Access to Water Supply and Sanitation (WSS) and Strengthening Local Systems (implemented by UNOPS).

Component 3: Project Support, Management, Evaluation and Administration (implemented by UNICEF, WHO, and UNOPS).

The environmental and social documents applicable to the project are described below.

Environmental and social commitment plan

The environmental and social commitment plan sets out material measures and actions that need to be carried out throughout the entire project cycle to comply with the World Bank's environmental and social standards.

Environmental and social commitment plan
Updated 20 July 2023 | Updated 1 August 2022 | Updated 3 July 2023
Arabic (updated October 2023)

Environmental and social management framework

The environmental and social management framework assists implementation of the Project inside Yemen through the development of necessary plans in accordance with the World Bank’s Environmental and Social Framework and proposes a clear delineation of responsibilities in compliance with the project's Environmental and Social Commitment Plan.

In addition to describing the rules, regulations, and guidelines applicable for the project, the framework outlines the procedures to identify and mitigate the environmental and social risks and impacts associated with the project's activities during the various implementation stages.

Environmental and social management framework
Updated July 2023 | updated 1 August 2022 | Updated 3 July 2023
Arabic (updated October 2023)

Medical waste management plan

The medical waste management plan overall objective is to prevent and/or mitigate the negative impacts of infection and medical waste on human health and the environment. The plan includes advocacy for good practices in infection control and medical waste management and is to be used by health, sanitary and cleaning workers who manage medical waste in project-supported health care facilities. The plan also includes good practices and procedures for waste segregation, storage, transportation, treatment, and disposal.

Medical waste management plan

Updated 20 July 2023 | updated 1 August 2022 | Updated 3 July 2023

Arabic (updated October 2023)

Labor management procedures

The labor management procedures have been prepared in line with the requirements of the World Bank’s Environmental and Social Standard ESS2, Labor and Working Conditions. The procedures detail the types of project worker as well as the applicable labor rules and regulations.

The procedures outline the key labor risks, mitigation measures and occupational health and safety requirements, as well as key administrative controls, applicable for the Yemen COVID-19 Response Project that need to be applied so that the workers will be protected from any adverse impacts resulting from activities implementation.

Labor management procedures
Updated 20 July 2023 | updated 1 August 2022 | Updated 3 July 2023
Arabic (updated October 2023)

Stakeholder engagement plan

As per the Word Bank's Environmental and Social Standard ESS10, Stakeholders Engagement and Information Disclosure, the implementing agencies should provide stakeholders with timely, relevant, understandable, and accessible information, and consult with them in a culturally appropriate manner, which is free of manipulation, interference, coercion, discrimination, and intimidation.

The stakeholder engagement plan, jointly prepared by WHO, UNICEF and UNOPS, defines a roadmap for stakeholder engagement, including public information disclosure and consultation of safeguard instruments, throughout the entire project cycle. The plan outlines the ways in which the project team will communicate with stakeholders and includes a mechanism by which people can raise concerns, provide feedback, or make complaints about project and any activities related to the project.

Stakeholder engagement plan
Updated August 2024 | Updated 20 July 2023 | updated 1 August 2022
Arabic (updated October 2023)

Environmental and social management plan for diesel fuel supply

Environmental and social management plans consist of the set of mitigation, monitoring and institutional measures to be taken during implementation and operation of an activity to eliminate adverse environmental and social risks and impacts, offsets them, or reduce them to acceptable levels. The environmental and social management plan of the project comprises the following document:

Environmental and social management plan for diesel fuel supply
Updated February 2024
Arabic (February 2024)

Updated 20 July 2023 | Updated 30 April 2022 | Updated 3 July
Arabic

Environmental and social management plan for maintainance of mental health facilities

The environmental and social management plan for maintenance of mental health facilities has 4 components: 1) improving access to health, nutrition, and public health services; 2) improving access to water supply and sanitation and strengthen

Launched in 2017, the Yemen Emergency Health and Nutrition Project aims to contribute to the provision of basic health, essential nutrition, and water and sanitation services across Yemen in all 333 districts and 22 governorates. The project is jointly implemented by WHO and UNICEF, leveraging each organizations’ comparative advantage and areas of expertise along with partnership and support of the World Bank.

The project aims to support the national health system through financing health and nutrition services and assists in maintaining the existing health system capacity through support and engagement of public health facilities and communities.

The project has 3 main components:

Improving Access to Health, Nutrition, Public Health and Water and Sanitation Services.
Project Support, Management, Evaluation and Administration.
Contingent Emergency Response.

For adequate implementation of the project activities following the environmental and social safeguards requirements, the following documents have been developed and published. Both documents are applicable to any activities financed by the project to ensure adequate protection for the personnel, environment and communities from any adverse impact resulted from the implemented activities.

Environmental and Social Management Framework

The objective of the Environmental and Social Management Framework is to provide guidance to implementers to ensure the environmental and social assessment process is carried out in compliance with national legislation and World Bank's safeguard policies. The framework sets out the principles, rules, guidelines and procedures to screen, assess, manage and monitor the mitigation measure of environmental and social risks associated with the project activities, subprojects and should provide guidance for development of intervention checklists or simplified site-specific environmental and social management plans, and according to the potential impact significance of each proposed subproject.

The framework establishes clear directives and methodologies for the evaluation of subprojects to be financed, and ensure that the activities are environmentally and socially sound and sustainable. It is also in compliance with the environmental and social laws and legislation of Yemen, and the guidelines of WHO and UNICEF as implementing agencies.

Environmental and Social Management Framework| Arabic

Medical Waste Management Plan

The objective of the Medical Waste Management Plan is to prevent and/or mitigate the negative impacts of medical waste on human health and the environment. The plan includes advocacy for good practices in medical waste management and is to be used by health, sanitary and cleaning workers who manage medical waste in the supported facilities or activities.

All health facilities and health services supported through the World Bank should have appropriate procedures and capacities in place to manage medical waste, therefore, this plan includes good practices and procedures for the waste packaging, storage, segregation, transportation, treatment and disposal.

Medical Waste Management Plan | Arabic

Environmental and social management plans

For subprojects that involve civil work activities and implemented under the Emergency Health and Nutrition Project, the environmental and social management plan will be prepared for each subproject to ensure the associated environmental and social risks are properly identified and managed.

An environmental and social management plan consists of the set of mitigation, monitoring and institutional measures to be taken during implementation and operation of an activity to eliminate adverse environmental and social risks and impacts, offsets them, or reduce them to acceptable levels. It also defines the activities summary, level of responsibilities, communication summary, reporting and monitoring requirements, as well as the grievance mechanism requirements.

Environmental and social management plan of waste treatment units installation

Rehabilitation of Rainwater Channel Bajil Hospital | Arabic

WASH maintenance Al-Thawrah Hospital Sana'a | Arabic

Rehabilitation of Aden Central Public Health Laboratory | Arabic

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Dengue is a mosquito-borne viral disease transmitted by female mosquitoes mainly of the species Aedes aegypti. It remains endemic in the urban and semi-urban setting in the coastal areas of Yemen on the Red Sea and the Arabian Sea. Data collected in 2019 and 2020 showed that dengue was reported in 204 districts, including rural areas.

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Early in 2020, once-in-a-generation flooding devastated Yemen’s southern communities, including Aden governorate that was among the most affected. In addition to loss of life displacement and damage, it has resulted in further spread of diseases transmitted by mosquitoes such as dengue fever, malaria and chikungunya.

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The campaign included indoor and outdoor fogging, vector surveillance, environmental management of all mosquitoes breeding sources. The campaign ensured direct protection to 430 000 people and indirectly to the 1.7 million total population of the city.

In September, health authorities launched a dengue control campaign covering eight districts in Aden city with the support of the World Health Organization (WHO) and the King Salman Humanitarian Aid and Relief Centre (KSrelief).

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The campaign included indoor and outdoor fogging, vector surveillance, environmental management of all mosquitoes breeding sources. The campaign ensured direct protection to 430 000 people and indirectly to the 1.7 million total population of the city.

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Increasing the community awareness of dengue control and prevention is essential to reduce the risk of transmission. Leaflets were distributed to the population, including children, to raise their awareness of dengue.

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In addition to Aden, the dengue fever control campaign also covered Ateq district, Shabwa governorate. Two training workshops on integrated community case management were also organized, respectively in Al-Khokha district (Al Hudaydah governorate) and Al-Azariq district (Al-Dhalea governorate).

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“This campaign is part of the support provided by the KSrelief to combat vector-borne diseases. The support also includes training and capacity-building for the malaria control programme to ensure the continuity of malaria and dengue fever control and prevention,” said Dr Abdulla Ameen, disease and vector control specialist at WHO.

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The campaign is part of a WHO-KSrelief project to enhance national response for malaria and dengue vector control and prevention in Yemen, through strengthening surveillance, diagnosis and treatment. The project, signed in March 2020, aims to serve more than 7 million people.

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The Yemen COVID-19 Response Project is being implemented in the Republic of Yemen by WHO with the support and finance of World Bank since 4th of April 2020. The project aims to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.

Within this context, Additional Financing is a new grant by the World Bank approved in June 2021 to support the costs of expanding activities under the Yemen COVID-19 Response Project. In addition, it will support access to COVID-19 vaccines and help ensure effective vaccine deployment in the country through vaccination system strengthening.

The environmental and social documents of the Yemen COVID-19 Response Project have been updated to include the new activities supported by the Additional Financing to comply with the project requirements.