Killing Children: The Sad Politics behind the Yemen Health Crisis

Interview with Dr. Matthew Crosston about the situation in Yemen, conducted by journalist Mohammad Homaeefar for the Tehran Times in Iran. August 2017

Yemen's Ministry of Health estimates that at least 10,000 Yemenis died from lack of access to the international medical treatment that they had sought. What countries are responsible for the medieval siege that led to such catastrophe?

The obvious and easy short answer is that the Saudi-led and Saudi-constructed land, air, and sea blockade of Yemen is responsible. Since the official start of military operations on March 26, 2015 it has been incredibly difficult to import the necessary medicines needed for the treatment of both basic and more complex illnesses and diseases. Unfortunately, a more subtle and less-noticed aspect in the West about the blockade is that it has also hindered the importation of essential raw materials that would at least give local hospitals and clinics around Yemen the opportunity to manufacture their own medicines on site. The reason for this raw materials ban is the cursed multi-functionality of such resources: some of these raw materials that could make critical medicines could also, if stolen or commandeered by illicit actors, be used to manufacture explosives. Anything that has the potentiality for such dual-usage has been basically restricted by blockade forces. Alas, you can interpret that dual functionality in either liberal or conservative ways: if the latter, then local hospitals in Yemen would have access to these resources and thus be capable of manufacturing their own medicines. However, if the interpretation is liberal (and the Saudi-led blockade is certainly defining it in extremely liberal ways), then almost nothing gets through and hospitals and clinics are left to try to help the sick with almost no medicine whatsoever. This is what has caused an outbreak of illnesses and disease that really should not be existing at all.

Reports indicate that since the outbreak of Cholera in Yemen in April, attempt to get the disease under control have all been in vain. Thousands have been inflicted and around 1,900 lost their lives according to local sources. What should the UN do in this regard?

Given the information I relayed above, the only substantive and effective policy change the UN could try to do is directly appeal to and put influence on the Saudi-led coalition blockade. Specifically, the UN needs to define either a list of essential medicines or critical raw resources that could locally manufacture medicines and then ENSURE that the Saudi-led blockade would not interfere or hinder the delivery of such materials. In addition, if the UN was feeling especially pro-active and helpful (which, admittedly, it often doesn’t in active war zones), then it would also use UN-led forces to ensure the quality of the resources and their successful delivery to critical medical points all over Yemen. If these two things could be done, then there would be a significant improvement in the medical crisis in Yemen, if not necessarily a lessening of the political conflict overall.

Is the international community helping Yemen to combat cholera? What are the obstacles to the delivery of humanitarian aid?

Allow me to not repeat myself from the previous two questions and focus on some other nuances in this crisis that need more attention. First, war is not just complex, it is utterly chaotic. While the Saudi-led blockade continues to get in the way of the delivery of essential medicines and acts as a hindrance to international humanitarian organizations truly inspired and motivated to make a difference on the ground (like the Red Cross and WHO), Saudi Arabia also pledged fully, along with other countries like the United States, Kuwait, the UK, and Germany, $1.1 billion dollars to help alleviate the suffering and medical crisis in Yemen. How should we interpret this confusing contradictory policy? The nation that constructed the blockade and other major Western powers tacitly approving its continuation (which has basically caused this health crisis) are simultaneously pledging to alleviate suffering with financial aid?

One first immediate problem, of course, is that this pledge has not yet been fulfilled and so there is not nearly enough money being put into Yemen to alleviate suffering. The second problem is an internal one: as is the case with any war zone, it is nearly impossible to guarantee the safe and accurate delivery of supplies to those most in need because of organized crime, corruption, and illicit activity inside of the country. Just delivering the supplies in-country is not enough: they must be physically delivered to the very door of the needed facilities. Otherwise, the efficiency percentage plummets dramatically. In this case, not only will the cholera epidemic not improve, we will start to see the emergence of other diseases and medical crises will go unchecked. Unfairly, the pledge givers of aid usually demand that these internal problems get resolved before actual funds are dispersed. However, in this case, the same pledge-givers are the drivers of the situation creating the domestic obstacles. Hypocritical and contradictory dilemmas like these are what drive Yemen analysts to despair.

Saudi Arabia has targeted and bombed many of Yemen's hospitals and health centers. What does the regime want to accomplish by such acts?

I wish there was some unique and compelling reason being offered as to why this would be happening, but reality reveals the same tired old clichés being used on the global stage. Namely, that Saudi Arabia is not ‘purposely’ targeting civilian sites like hospitals but that ‘mistakes have sometimes taken place.’ And then, of course, the classic inversion technique is applied: the Saudis will say if only the Houthi rebels would stop mixing/hiding within civilian populations, then such mistakes would be less common. What most analysts tend to not follow up with when such statements are made is to ask Saudi Arabia if it thinks it would be more appropriate for the Houthi rebels to come out into the open on vast desert plains, far away from any civilian locations, so that they could be bombed indiscriminately?

The nature of asymmetrical warfare demands that the less-advantaged rival has to employ unorthodox tactics in order to just survive. Unfortunately, that does sometimes involve hiding within civilian areas. This is not new, by any means, or unique to the Houthis. While the rules of war have long been against such actions from smaller parties, these rules have also always been adamant that in such situations the superior military force is not supposed to engage civilian sites and must seek other strategies to ‘flush out its enemy.’ It seems apparent, as analyzed by outside global agencies, that Saudi Arabia has not truly made that effort when trying to destroy Houthi groups.

We have to be sadly careful when we think the global humanitarian community can be a force for good on this problem. To wit: the UN included Saudi Arabia in 2016 on a list of ‘violators of children’s rights’ largely because of the disturbing reports about hospital bombings. Alas, only one week later Saudi Arabia was removed from the list, pending further review. Astonishingly, former Secretary General Ban Ki-Moon said the reason for the removal was that Saudi Arabia had threatened to pull its funding of UN humanitarian programs, though the Kingdom steadfastly denied any such conversations took place. So, on an issue that seems to easily define the moral high ground (do not bomb hospitals or deny sick children medicine), we see how quickly it becomes morally bankrupt in the Yemen conflict - with elements of de facto diplomatic extortion, intimidation, and the violation of long-standing ethical tradition in war. The end result is depressingly familiar: all sides declare how horrible it is that children are suffering and that hospitals are getting destroyed but then conveniently distract us from realizing that they are very same actors ultimately causing the suffering and destruction in the first place. Killing children in the name of political expediency and the pursuit of military, political, and national interests.

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