With the world’s attention focused on COVID-19 in 2020, other infectious diseases continued to evolve and threaten the lives of children in Yemen. Six years into the armed conflict, the humanitarian crisis remains unparalleled with 20.7 million people in need of aid. The country’s health system operates at half capacity, while facilities that remain open lack qualified health workers, essential medicines and medical equipment. Such circumstances make it difficult to reach children with life-saving vaccines and other health services, creating the conditions for outbreaks that can undo decades of progress achieved by immunization programmes. This fear was realized in August 2020, when polio was detected in Yemen for the first time since 2005.

Minivan with a loudspeaker announces polio campaign

Yemen is experiencing an outbreak of vaccine-derived poliovirus type 1, a strain of poliovirus that occurs in areas where routine immunization or door-to-door campaigns have failed to reach many children for many years, resulting in dangerously low immunity levels. To date, 33 children in Yemen have developed paralytic polio: one in 2019, 31 in 2020 and one in 2021.

To respond to the outbreak, Yemen’s health authorities, together with WHO and UNICEF, initiated a national polio immunization campaign. In late November and early December 2020, the first round of the campaign rolled out. Vaccinators and social mobilizers moved door to door, accompanied by loudspeakers blaring from minivans and equipped with cool boxes of oral polio vaccine (OPV), in an effort to vaccinate every child under age five. In Sa’adah governorate, which concurrently is affected by outbreaks of measles and diphtheria, an integrated health outreach campaign bundled additional health services with polio: other childhood vaccines, safe drinking water, and nutritional, sanitation and hygiene support. Not only was the response rate high, but people also expressed a need for vaccines against other diseases, like measles and diphtheria and for protection from cholera and related waterborne diseases.

Following the first round of vaccination, no new polio cases have been reported. It is too early to tell definitively, but the polio programme believes this is a step in the desired direction. Plans are proceeding for a second round, including a second round of an integrated health outreach campaign in Sa’adah.

Navigating multiple epidemics

Meanwhile, another health emergency was looming. As COVID-19 spread throughout the country, it put additional pressure on an already fragile health system. Aware of the threat the virus poses to the people in Yemen, WHO in collaboration with public and private sector partners prepared in advance. 

Building on Yemen’s national strategy to counter COVID-19, WHO and the Islamic Development Bank equipped 32 treatment centres with medical devices like portable pulse oximeters, oxygen cylinders and ultrasound.[2] And together with the Hayel Saeed Anam Foundation, WHO supported hospitals and laboratories with more than 400 ventilators, around 1 million pieces of personal protective equipment, 34 000 test kits and other essential equipment. Yemeni health authorities and WHO set up nearly 60 isolation units with 675 beds for intensive care, too.[3] Vital support from other donors including the King Salman Humanitarian Aid and Relief Center has enabled and continues to enable the delivery of life-saving immunizations and medical care to millions of Yemeni children.

From the onset of the pandemic, a network of surveillance officers and more than 300 rapid response teams have conducted surveillance for COVID, have investigated contacts and referred people to designated health centres.[4] In health centres of Sa’adah governorate, WHO supported trainings in clinical case management for doctors, nurses and medical assistants.[5]

And it is these Yemeni doctors, nurses and medical assistants who are themselves vulnerable. Recent estimates indicate that most health personnel have not received salaries for at least two years. To support them and their families, the United Nations has been providing living wages to 9000 frontline health workers.[6]

The outbreaks of polio and COVID-19 add a new battle to the existing ones the people in Yemen have had to face. With international support and national commitment, the country continues to make the most with available resources.

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Photo caption: A girl in Sana’a gets her nail marked to confirm the vaccination.

Photo credit: Omar Al-Obaidy