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Dengue and malaria update
Updated: 18 November 2019, Yemen – Over 4 years of conflict in Yemen have resulted in the displacement of over 2 million people, destroyed infrastructure and taken systems to the brink of collapse. Yemen, like the majority of countries in conflict, has sustained massive damage to its infrastructure. The successive onslaught of heavy rains, resulting in flash floods and inadequate drainage have turned harmless puddles into active mosquito breeding sites. These larvae are given space and time to turn into adult mosquitos who then infect people.
“Containing these diseases has been a challenge given the operational environment and scale of this conflict, but WHO remains commited to the people of Yemen. These vector control measures along with sustained community involvement can improve vector control efforts substantially. We will continue working with local health authorities to fight all diseases that serve as a threat to public health in Yemen,” said Altaf Musani, WHO Representative in Yemen.
In Yemen, malaria and dengue are endemic, while for dengue the number of suspected cases (as of 18 Nov 2019) is at 29 509. WHO, with the support of health authorities in Yemen, have been fighting dengue and malaria for years. In the first 2 weeks of November alone, we have continued to provide response kits enough to treat 15 000 people, deployed technical teams to investigate suspect cases, provided diagnostics and laboratory support for vector-borne diseases, IV solutions, and built the capacity of health care staff in health facilities to treat these diseases. In communities, WHO along with support from local health authorities, has continued to educate communities and conducted mass spray campaigns to kill these mosquitos.
Malaria and dengue are known as vector-borne diseases that are transmitted to humans by infected mosquitoes. These vector-borne diseases affect many countries across the globe, including Yemen. An estimated 70% of the world’s malaria burden is located in 11 countries — 10 of which are in Africa and 1 in India. As for dengue, an estimated 390 million infections are recorded every year, worldwide.
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WHO remains vigilant in the detection, prevention and control of communicable diseases in Yemen
13 November 2019 – In a non-permissive environment replete with operational and security challenges, the expansion of the national electronic disease early warning system (eDEWS) in Yemen to identify and quickly control infectious disease outbreaks is nothing short of a miracle.
Even in the middle of active conflict, WHO, through its Emergency Health and Nutrition Project (EHNP) partnership the World Bank, successfully revamped and expanded Yemen’s existing eDEWs system, transitioning it from a paper-based system into a centralized, electronic reporting system.
New sentinel sites are added each year to cover more areas across the country and protect people from deadly outbreaks. In this way, WHO and partners are able to better monitor the occurrence of disease outbreaks and quickly respond to them before they place already vulnerable people at even greater risk.
Across Yemen today, there are 1991 active sentinel sites that are detecting and electronically reporting on 28 different highly pathogenic diseases such as cholera, dengue, viral haemorrhagic fever, measles, pertussis and acute flaccid paralysis. This is a significant increase from 400 sites that existed in 2015 at the start of the crisis, reporting on only 16 diseases.
Today, more than 90% of all sentinel sites provide reports that are both accurate and timely, strengthening infectious disease prevention in communities, and protecting the country’s fragile health system. In 2019, 78 011 disease alerts, were received through the eDEWS system that were verified and investigated by the eDEWS coordinators and district rapid response teams to early detect and contain any potential outbreak.
The establishment of eDEWS is a critical component of a much larger effort by WHO, UNICEF and the World Bank to operationalize the humanitarian development nexus—ensuring acute health needs are met while simultaneously safeguarding the protection of Yemen’s health system.
ECHO and WHO partnership meets critical trauma needs in Yemen
6 November 2019 – The conflict in Yemen continues to intensify, sparking multiple frontlines across the country. Since 2015, an estimated 70 000 men, women and children have either lost their lives or suffered serious injuries as a result of the conflict. These injuries threaten to debilitate thousands physically and financially — especially those who do not have immediate access to trauma care.
The injection of 5 million euros from the European Civil Protection and Humanitarian Aid Operations (ECHO) is dedicated to supporting trauma care, emergency medical services and surgical mobile teams in Yemen, while strengthening the hospital referral system in country. With the support of the Milan-based nongovernmental organization EMERGENCY — WHO and ECHO are working to provide effective and timely trauma support in Yemen.
“The conflict in Yemen is a harsh reality that continues to evolve and escalate and EMERGENCY, and WHO, with the support of its partner ECHO, are working to strengthen access to life-saving specialized surgical care for the conflict-affected population. The opening of a surgical centre for war victims in Hajjah will allow reaching out to a large population in need of war surgery,” said Emanuele Nannini, EMERGENCY's Deputy Director of Operations in Milan.
This lifeline of funding aims to target over 30 000 beneficiaries, support over 40 surgical team specialists and provide incentives to almost 300 health workers.
Trauma cases add to the health burden in Yemen
“Yemen is a crisis of epic proportions. Only 50% of hospitals are functioning. In the remaining half, health staff and capacities are overstretched. The European Union is supporting emergency health services in Yemen so that victims of violence can get rapid access to quality care,” said Christos Stylianides, EU Commissioner for Humanitarian Aid & Crisis Management. “As the conflict rages on, we need to do our utmost to reduce loss of life and lessen the suffering inflicted on the Yemeni people.”
Though many deaths have occurred due to noncommunicable and communicable diseases, a large number of deaths also happen outside of the health system, like conflict-related trauma. Trauma patients are part of the reason why hospital resources are so overstretched.
Bed occupancy, prescription of medicines and other health needs of trauma patients add an additional burden on facilities that are also overwhelmed with patients suffering from non-war injuries or diseases. Conflict-related injuries have consequences that reverberate even after the patient is discharged. Trauma patients with serious injuries who are not treated immediately risk living with life-long disabilities that threaten their health and livelihoods, affecting their capacity to earn a living, lead a normal life and contribute wholly to society.
“Peace is the only solution to this conflict but for now, ECHO, EMERGENCY and WHO, along with local authorities and partners, are working to ensure that trauma patients receive the help they need immediately because Yemen can’t wait,” said Altaf Musani, WHO Representative in Yemen.
Note to editors: The 2019 Yemen Humanitarian Response Plan requires US$ 4.2 billion to assist more than 20 million Yemenis, including 10 million people who rely entirely on humanitarian assistance to meet their basic needs every month. As of today, the Yemen Humanitarian Response Plan is 56% funded, we need to close this gap. At the High-Level Pledging Event for the Humanitarian Crisis in Yemen convened by the United Nations Secretary-General in February 2019, the United Nations and humanitarian partners were promised US$ 2.6 billion to meet the urgent needs. Humanitarian agencies are appealing to donors to provide funds as quickly as possible.
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2019 Yemen Humanitarian Response
European Civil Protection and Humanitarian Aid Operations
Thalassaemia patients have renewed hope through support provided by the Emergency Health and Nutrition Project
Anas is 9 years old and is suffering from thalassaemia. Anas is one of the patients being protected under the framework of the Emergency Health and Nutrition Project
5 November 2019, Yemen – The World Health Organization (WHO) and the World Bank, through the Emergency Health and Nutrition Project (EHNP), are providing life-saving support to thalassemia patients in Yemen. In 2019, blood bags provided reached almost 45 000 bag, along with laboratory reagents critical to ensuring safe blood transfusions further strengthening the capacity at the blood transfusion centres across the country.
Globally, over 50 000 people are born each year with a severe form of thalassemia – a blood disorder causing the body to make an abnormal or inadequate amount of haemoglobin. The disorder results in large numbers of red blood cells being destroyed, which leads to anaemia. An estimated 80% of these cases occur in developing countries. In Yemen 700 new cases of thalassemia are diagnosed yearly, and 50 000 cases are on record so far according to association of thalassemia.
In Yemen, a country ravaged by war, the treatment of thalassemia is a rare but much needed miracle. This is why the support provided is essential. With regular blood transfusions needed by these patients, safe blood saves lives and improves health.
“The centre receives 60–70 patients suffering from of thalassemia and anemia every day. Once a case is examined, the patient is referred to the blood transfusion centre to receive a blood transfusion,” said Muktar Alkubati, manager of the Yemeni association for Thalassemia patients and genetic blood in Yemen.
Due to shortages in blood supplies, centres such as this one struggle to meet the demands for blood transfusions. The first victims to suffer were – and still are – vulnerable children with blood disorders, with many facing the prospect of death at an early age.
“Some children died and some did not; these diseases can cause very visible deformations. Adequate and immediate blood transfusions could have saved those children’s lives,” Dr Alkubati added.
Anas, a bright, 9-year-old boy in the third grade, is living with thalassemia and has benefited from the provision of support through the EHNP. He receives a blood bag every 3 weeks, and because of this, he is healthier and able to live life with a smile on his face.
About the Emergency Health and Nutrition Project (EHNP)
WHO with its technical partner the World Bank, under the Emergency Health and Nutrition Project (EHNP) are meeting health needs in Yemen. The EHNP is a cross-cutting response framework designed specifically to provide basic health and nutrition services to meet acute health needs, supporting the national system in the midst of war.
EHNP supports 72 hospitals across Yemen with a suite of essential life-saving health services, through the health service delivery mechanism known as the Minimum Service Package (MSP). WHO and the World Bank are also working with UNICEF to strengthen the referral system from the primary, secondary, to the tertiary levels of care. In addition, EHNP is supporting public health programmes and disease response to outbreaks such as cholera and diphtheria to name a few.
