Yemen has suffered years of civil war, poverty and cholera — and now COVID-19 is also rampant. Aid groups say the country is on the brink of collapse, but an international donor conference hopes to raise billions in aid.

"For us, death is normal," said Amal Mansoor. "But I am still afraid of the coronavirus."

Mansoor, 28, lives in the Yemeni capital, Sanaa. She's worried because the coronavirus, which has been in the country since mid-April, is adding to the problems of a people already made weak and vulnerable by a cholera epidemic and five years of civil war.

As of early June, Johns Hopkins University had confirmed over 320 cases of COVID-19 infection in the country, and at least 80 deaths. But no one really believes these low figures. "In Yemen, we have virtually no possibility to carry out testing. We have no idea how high the number of infections really is," said Mansoor.

Deficient health care system

Mansoor told DW she once held great hopes for her country — back in 2011, when the old government was ousted in the wake of the Arab Spring rebellions. "I absolutely wanted to stay in my country, to see for myself how it would develop," she said.

But then everything took a different course. In 2015, the war began. "And now we have the coronavirus in the country as well. My home can't cope with an epidemic," she said.

As a freelance journalist for international media outlets, Mansoor has closely observed how Yemen has handled the outbreak. She relates how the few hospitals that are still intact have refused to take in infected people, partly because staff members there lack adequate protection equipment.

"As a nurse, I want to help and treat patients," said Irene Versoza, a nurse at the University of Science and Technology Hospital in Sanaa, in a recent report from the UN Office for the Coordination of Humanitarian Affairs. "Even if I want to treat, how can I do that without personal protective equipment? My focus would shift from the patient to worrying about if I will get infected."

Mansoor reports that many Yemenis don't dare go to hospitals, for fear of becoming infected themselves. She said people in Yemen have experienced many terrible things, but said coronavirus could be the final blow.

Complex conflict

A complicated proxy war has been raging in Yemen for the last five years. At its core, it's a conflict between Houthi rebels and the internationally recognized government of exiled President Abed Rabbo Mansour Hadi. The latter, however, is backed by a military coalition led by Saudi Arabia and the United Arab Emirates.

Saudi Arabia, a Sunni monarchy, sees the Houthis as allies of its archenemy, the predominately Shia Muslim nation of Iran. The Houthis took control of large parts of Yemen in late 2014, including Sanaa, where they drove out Hadi and his government. He and Prime Minister Maeen Abdulmalik Saeed are now based in Saudi Arabia.

Aden, in southern Yemen, remained the provisional seat of government, although separatists overran the coastal city last August. They announced plans to "self-govern" the city and other southern provinces in April, amid a unilateral two-week cease-fire declared by the Saudi-led military coalition, later extended until the end of May. The cease-fire was meant to give the United Nations more time to mediate between the Houthis and the government.

Dozens dead each day in Aden

"The situation in Aden is very complicated," said Mansoor. "But even in Sanaa, the situation is anything but easy." She declined to say more about the political situation in the country.

But she said she is especially concerned by the coronavirus news coming from Aden, where many dozens of people are said to be dying every day. Images that have made the rounds show dead bodies lying in the streets, and there are reports of many people dying at home, especially in poorer districts. This has been confirmed by Doctors Without Borders (MSF), which runs the only center for treating COVID-19 patients in Aden.

"What we are seeing in our treatment center is just the tip of the iceberg, in terms of the number of people infected and dying in the city," said Caroline Seguin, who heads MSF projects in Yemen, in a statement in mid-May. "People are coming to us too late to save, and we know that many more people are not coming at all: they are just dying at home. It is a heartbreaking situation."

Government statistics on funerals also make it clear that many people must be dying at home: Eighty people died in Aden per day in mid-May, compared with just 10 a day before the coronavirus outbreak. Doctors Without Borders has also reported a high number of infections among carers and helpers.