On the rooftop of the MSF house in the city of Al-Qanawis, in the Hodeidah governorate of northwestern Yemen, I look at the stars. We all look up at the same sky, I think, but life is so different depending on your vantage point. I am in a beautiful country with a very rich history. Now, it is being destroyed by war.

You might think that injuries in war are about trauma: people become victims of bombs, gunshots or shelling. What many people don’t realise though, is that as well as physical harm, war also brings endless invisible misery. Al-Qanawis and the surrounding region is an example.

Every week, we admit dozens of newborn babies to the mother and child hospital supported by MSF in Al-Qanawis. Fighting for their lives, these children are victims of what this war has done to their country. The Hodeidah governorate has been one of the most active conflict zones in Yemen in the six years since the war began, but many of our patients come from remote villages located in desert-like regions, not from the frontline. They do not normally hear the sound of gunshots, airstrikes or shelling, but even so they feel they are at war every day.

As I speak to our patients, I come to understand that they lack access to healthcare, food, water, safe shelter and education. Many of them die due to diseases that are perfectly treatable and preventable if only they had access to a hospital with the necessary staff and medication.

As a result, the most severely affected people are the most vulnerable; children, pregnant women, elderly people, and people with chronic diseases. The first thing that a war does to a country is to burden its health system. In Yemen, the health infrastructure, which was already weak, has buckled under the extra weight.

The odyssey to reach healthcare

Wherever people live, they try to achieve the best life for their family. People don’t give up. In Yemen too, you find parents selling everything they have for a chance to send some of their children to another country in the hope that they will be able to lead a normal life, to access healthcare, get an education and find a job. 

Latifa had to be a fighter from the first day of her life. Her mother and her family live in a small, isolated village, without access to healthcare. When the war started many of the health centres in their area collapsed, either destroyed or abandoned by medical staff, or simply closed owing to a lack of medication and equipment.

"When she became pregnant, Latifa's mother, Fatima, had no access to nearby health facilities. She became sick, but didn’t have the time or the money to get transportation to seek healthcare. The contractions started suddenly one day, but it was still too early. Fatima feared for her baby. She wanted to go to a health facility because she knew it was too early to give birth and her baby would be at risk. But there was no time, and she delivered at home. The baby was born very small and with breathing difficulties.
There are mothers screaming in pain and newborns taking their last breaths, simply because they were not able to access basic medical care."
MÓNICA COSTEIRA, MSF PEDIATRICIAN 

She was far from the hospital and her baby did not survive. However, while suffering from the loss of her child, she suddenly realised that she had been carrying twins. She hadn’t been aware as she hadn’t had any antenatal checks.

She gathered the energy and resources to reach the nearest free health facility providing maternal and childhood care, the Al Qanawis MSF hospital, still hours away from her home. Fortunately, she managed to arrive at our hospital in time, and she delivered her second baby, Latifa.

Latifa, who was born underweight, was admitted to us for two months and soon became a source of love and affection for the whole team. When the day finally came for her to be discharged I felt so proud of her and of our work, of the team’s dedication and love. I hope Latifa brings hope to her family, to her community, and to her war-torn country. I hope that she sweetens the life of everyone who meets her, as she has done with us.

Lack of basic healthcare can be fatal

Complications owing to premature deliveries are the leading cause of death for newborns in this part of Yemen. There are multiple and various risk factors for low birth weight and preterm births; many of which are preventable or manageable with good antenatal care. 

Risk factors include maternal ages – younger than 17 or older than 35 – short intervals between pregnancies, maternal malnutrition, multiple pregnancies, abnormalities of the fetus as well as maternal health problems like malaria, pre-eclampsia, eclampsia, infections, among others. In Al-Qanawis, many mothers present with these risk factors. However, ensuring basic neonatal care can significantly reduce mortality and improve outcomes.

Sitting on the rooftop that night, I felt satisfied to be part of a team contributing to saving lives, but I also worried for those who can’t reach our hospital. There are mothers screaming in pain and newborns taking their last breaths, simply because they were not able to access basic medical care.

Witnessing this reality and realising how war impacts so many vulnerable people makes me wish there was more global awareness and consciousness about what is happening here. I wish our resources and our great human capabilities were used to save lives, instead of taking them.