“Walking toward the Emergency Room, shouting ricochets through the corridor. It’s not uncommon - anything of importance in Yemen seems to be communicated decibels above the norm - but this is louder. Angry.
'I have 10 children at home – it is better one dies than all ten!'
While the translator can give me the verbal interpretation, I’ve already read his body language. Wild gesticulations, the look in his eye: he’s exasperated. He looks like a man backed into a corner.
"Wild gesticulations, the look in his eye: he’s exasperated. He looks like a man backed into a corner."
'The halls are flooded with patients, and our Emergency Room is pumping'
The work week in Yemen begins with Saturday, and it’s guaranteed to be busy. The halls are flooded with patients, queuing for the Government-run outpatient department, and our own Emergency Room is pumping.
Our inpatient department is as full as I’ve seen it, with a backlog of patients from the days before. The weekend presents sicker patients than weekdays, and they are often later to bring themselves in. It’s likely compounded by recent fuel scarcity.
The yelling man is encircled by various staff, beyond whom stands his wife cradling a bundle of blankets.
We’re acquainted, these blankets and I, from an hour ago in the resuscitation room. A tiny, emaciated arm extends beyond those blankets to shake with injustice as I stand beside, shaking my head at the same.
His breathing rapid, heart racing as a fever wreaks havoc on his malnourished body, weighing a meagre 3,200 grams at five months old. That’s less than half what he should be at that age.
But he screams with an energy at odds with his size, something his mother says he’s been dedicated to for three months since her breast milk dried up.
The eleventh child of two poor parents from rural Yemen, they’re struggling to feed him. Not only starved of food, with basic access to heathcare more difficult since the conflict began, he’s unvaccinated too.
We scramble to stabilize him and start antibiotics, severe malnutrition leaving him at risk of opportunistic infections. But these are temporary solutions to a systemic issue. He needs admission to a therapeutic feeding centre, and the closest is an hour by road.
We inform his mother and begin the process of referral, adding another piece to an ongoing game of Tetris with our single ambulance. The best laid plans.
"Yemenis are not unacquainted with the consequences of a broken system, but his hands are tied. I get the impression this is not the first time he has had to barter the survival of one against the lives of many. At first I had thought he didn’t understand, but now it’s me who struggles with the nuance."
A balancing act: making difficult decisions
Enthusiastic protests in the face of reason continue from his father, with doctor, nurse, and health promoter all lining up in attempts to talk him down. We explain the severity of his child’s condition, the potential for deterioration and possible death if untreated.
At first he is a wall. Then he begins to crack.
'I have 10 children at home – it is better this one dies than all ten,' he repeats, calm but defeated.
There’s no other family, no support for the nine other children in his village. He begs to return with the baby home to his brood, a late-in-the-game promise to come back when he has enough money to support the family in his absence.
We pull together what we can for treatment, his ink-stained thumb a symbol of defeat as he stamps the discharge paperwork.
Yemenis are not unacquainted with the consequences of a broken system, but his hands are tied. I get the impression this is not the first time he has had to barter the survival of one against the lives of many.
At first I had thought he didn’t understand, but now it’s me who struggles with the nuance.
War is the face of a five-month-old child
They never came back.
It’s been a month since I met that skeletal bundle, begged his family to stay and despite my best hopes, and fastidious checking of our Emergency Room register, they didn’t return.
With no forwarding phone number, I can’t be sure he made it to six months, or to 4kg, or to his burial plot.
For me, this is the face of war. No combat boots, no blast injuries or camouflage gear. The soldiers, the bombs, the traumatic, immediate devastation is so far from the overwhelming truth I’ve found here in Yemen, and last year too, in Iraq.
War doesn’t look like a running soldier, laden with artillery shells. It’s the face of a five-month-old child, emaciated, aged exponentially in a cruel twist of irony as he dies slowly and prematurely from malnutrition.
It’s the withdrawal of humanitarian actors in rural areas as fighting parties threaten advance, then retreat. The agencies telling starving families the gaping hole won’t only be in their stomachs, but in the provision of international aid.
I wanted so dearly for that malnourished baby to return, to provide that chance of life the system was trying to deny him. I wanted hope, for myself and for the future of the Yemeni people.
Maybe I thought I was entitled to it, when in fact it is 28 million Yemenis who are entitled.To basic human rights. To healthcare. To an existence free from conflict.”