“I have experienced death”: Inside the COVID-19 hospital fighting Yemen's second wave
Inside Al-Kuwait Hospital in Sana’a, Yemen’s capital city, a chain-link fence separates two worlds.
There is the world outside the fence where a strange disease is little acknowledged by the authorities and often not believed in.
Inside the fence, there are wards full of people breathing desperately from oxygen cylinders. In this world, the reality of COVID-19 is hard to avoid.
Conflict and COVID-19
“A month ago I became sick,” says Khaled, 43, from Sana’a.
“I had a heavy cough, and I saw a doctor who told me I might have COVID-19.
"After a week, my oxygen levels were getting less and less and I started to faint. I was admitted to the intensive care unit and had to stay there 16 days. The disease is really scary.”
“The needs are huge, it’s a real struggle to provide all this oxygen. But at least this year the disease is more familiar, we know how better to treat people."
Another reason Khaled was so scared was that he knew in Yemen the options for healthcare are limited.
Six years of war have seen the healthcare system collapse, leaving large parts of the country unable to respond at all to the COVID-19 outbreak as it moves from town to town, village to village.
“We live in a country that’s at war. There is no good health system and the situation, in general, is deteriorating,” says Khaled.
“These medications that I got treated with would have cost around $8,500 [around £6,000]. I would never have been able to pay that. I would have died.”
Far from care
The COVID-19 treatment centre run by Médecins Sans Frontières / Doctors Without Borders (MSF) at Al-Kuwait Hospital is one of the very few places in Yemen where COVID-19 care is available for free.
Its 64-bed ward and 15-bed intensive care unit have been full since the beginning of April when the second wave of the disease has hit. Patients are often also waiting in the eight-bed emergency room (ER) for a space.
The centre has seen a constant stream of death amongst the old and amongst those people with chronic diseases such as diabetes.
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“There are many critical cases with symptoms of COVID-19 coming from far away,” says Mohammed al-Ghabri, who oversees medical care at the treatment centre.
“Both our male and female wards are full and we are using 500 oxygen cylinders a day in addition to the oxygen [generation] plant.
“The needs are huge, it’s a real struggle to provide all this oxygen. But at least this year the disease is more familiar, we know how better to treat people.”
The lucky ones
The families arrive in a steady stream at the ER entrance in front of the fence: in taxis, in old cars, the sick people nearly prostrate with fatigue, sometimes hooked up to an oxygen bottle and helped into a wheelchair before being admitted.
But these are the lucky ones: the families that can afford the huge sums of money necessary to come from places as far away as Al-Bayda and Hajjah.
Those who cannot pay are left to their own fate: how many of them there are, no one knows.
“When my father Mohammed got sick I took him to the hospital in Rada’a, but they could not do anything for him there,” says Ali, 36, from Al-Bayda, an area more than 60 miles southeast of Sana’a.
“I drove him to Dhamar, which took three hours. All the way I was constantly shifting my gaze between the road and my father, I was so worried about him.”
In Dhamar, Mohammed did not find a hospital that could treat his father either so he had to hire an ambulance to bring him to Sana’a, even further away.
“I was thinking that he would never make it.”
Mohammed, 40, also from Al-Bayda, is another patient who had to travel a significant distance to find care.
His family had to spend around £50 in fuel to reach the MSF hospital in Sana’a.
“We drove with our own car from Rada’a to Sana’a, which took around four hours," he says.
"We tried to find an oxygen bottle to use for the trip, but we could not find one anywhere.
“In Rada’a there are a lot of people sick.”
The impact of mistrust
Sadly, it’s hard for the medical teams to save people if they arrive at the hospital very late into their condition. However, many do, either because they have come from far away or because they have delayed coming.
Mistrust and fear of medical facilities is still widespread.
“Last year, I didn’t really believe that there was COVID-19. When I saw my dad, when I saw the other patients here, I really began hoping that this disease will stop spreading. It is a hellish illness."
“The biggest mistake I made was just bringing medicine for him from the pharmacy,” says Saif, whose father Saleh, 65, was admitted to the MSF hospital.
“I should have got a medical consultation for him. But even when I brought him to Al-Kuwait the first time and they said he needed to be admitted, I didn’t want him to be in the hospital.
“I thought to have a nurse come for him at home would be enough. Eventually, I was forced to bring him back here.”
With little information about COVID-19 made available by the authorities in northern Yemen, people are left to decide for themselves how seriously to take the disease and what to do if they or their loved ones get sick.
“Last year, I didn’t really believe that there was COVID-19,” says Saif.
“When I saw my dad, when I saw the other patients here, I really began hoping that this disease will stop spreading. It is a hellish illness.”
Khaled also shares a similar experience.
“I wasn’t really aware of what COVID-19 was and so I did not take precautions," he says.
“Now I know I have to apply these measures and protect my family because I have already experienced death: I don’t want any of them to get sick.”
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