Abdulwahid Aqlan, a resident of Sa’ada Governorate, contracted cholera, and his symptoms began to worsen until he experienced severe diarrhea and vomiting. Without delay, his family took him to the hospital, where he was immediately admitted to the intensive care and isolation ward, given the severity of his condition. Fortunately, three days later, his condition started to improve after receiving the necessary care provided by the medical staff.
In light of the ongoing conflict and difficult humanitarian conditions, Yemen is witnessing an alarming increase in cholera cases, exacerbating the daily suffering of the population and threatening the country with a humanitarian catastrophe, given the level of the spread of this epidemic. In reality, the widespread outbreak of this epidemic represents one of the biggest health challenges that Yemen is currently facing.
Moreover, there are many sources of infection that cause cholera in Yemen, with authorities vacillating between denial and acknowledgment, reminiscent of the denial phase witnessed during the COVID-19 pandemic—a detachment from reality, or, as they say, to prevent panic from claiming lives and letting the epidemic go without noise, despite the high rates of infections and deaths in the country.
Failure to Contain the Outbreak Expands the Spread
Since October 2023, Yemen has been witnessing an alarming resurgence of cholera cases across the country, as reported by Edem Wosornu, a UN official, in his report to the Security Council. Moreover, the World Health Organization classified the outbreak in Yemen as a Grade 3 emergency, which requires a comprehensive response at all three levels of the organization.
“Cancer patients face numerous risks due to their weakened immune systems. Now, the spread of cholera constitutes a new threat to their lives, as they are more susceptible to the disease. They must adopt additional preventive measures to protect themselves against the disease, as contracting cholera could result in death within three days due to their inability to withstand such infections.”
Furthermore, the outbreak of cholera was the focus of the UN Security Council's monthly session on Yemen held in mid-May 2024. UN officials confirmed that the outbreak of cholera is rapidly worsening in Yemen, with hundreds of new cases reported daily, bringing the total to around 40,000, including 160 deaths. The UN and its partners are taking urgent measures to address the issue, as heavy rains and floods are expected to exacerbate the situation.
According to another official in the organization who spoke at the Security Council session, the response will require funding to prevent the situation from spiraling out of control. He noted that the consequences of inaction are well known, reminding the council of the outbreak that occurred between 2016 and 2021, which claimed the lives of around 4,000 people, most of them children.
A Threat to Immunocompromised Patients
Additionally, cancer patients and those with immune-mediated diseases are facing a new, fierce battle to add to their already harsh suffering due to the disease and lack of access to proper health care.
In this context, Dr. Jameela Al-Surmi, a breast cancer specialist at the Al-Amal Oncology Center in Sana'a, affiliated with the National Cancer Control Foundation, tells "Khuyut" that cancer patients face numerous risks due to compromised immunity. She further emphasizes that they now face an additional threat to their lives with the spread of cholera, as they are more susceptible to contracting the disease.
According to Al-Surmi, they must adopt additional preventive measures to protect themselves against the disease, as contracting cholera could result in death within three days due to their inability to withstand such epidemic infections. She underscores the importance of awareness campaigns for cholera prevention, noting the complete absence of such initiatives amid the expanding outbreak.
Notably, she mentioned that there have been no reported cases of cholera among cancer patients thus far, especially those undergoing treatment at the Al-Amal Oncology Center. However, with the ongoing outbreak of the disease, Al-Surmi expects that there will indeed be cases among cancer patients, given the lack of preventive measures available to many of them.
In this context, the specter of the epidemic looms over Yemenis due to the diverse sources of infection spread throughout the country. Cholera is considered a disease transmitted through water and food contaminated with the bacterium Vibrio cholerae.
Given these circumstances, research conducted by health organizations in Yemen has identified potential infection sources, with raw vegetables leading at 75.1%, followed by charitable water tank “Sabil” at 39.0%, well water at 26.0%, and water transported by tankers at 21.1%. in addition to fruits at 15.0%, spring water at 8.4%, and ultimately, dairy products.
Amidst the looming threat, cholera continues to spread in Yemen, according to figures released by health authorities in Aden and Sana'a, obtained by "Khuyut". The number of cholera cases has exceeded 5700 since the outbreak began in March 2024, in areas under the control of Sana'a authority. Meanwhile, the internationally recognized government estimates the number of cases in areas under its control to be over 3500.
“Most cholera patients are reaching the Republican Hospital in Taiz in very critical condition, according to one doctor, experiencing low blood pressure, oxygen levels, and heartbeats, in addition to dehydration. After receiving initial care in the emergency department, they are transferred to cholera-specific intensive care and isolation units for medical observation.
In terms of the affected cases, reports indicate that 74% of cholera cases suffer from severe dehydration, which increases the severity of the disease and enhances its rapid spread."
Regarding the geographical distribution, Sa'ada Governorate witnesses the highest rate of infections among the provinces under the control of Sana'a authority, with the number of cases reaching approximately 1258, according to estimated data obtained by "Khuyut", followed by the capital, Sana'a. On the other hand, Aden tops the infection rates in areas under the internationally recognized government, followed by Taiz in second place, Abyan in third, and Dhale in fourth.
Severe Infections and Weak Response
On the other hand, reported cases continue to escalate due to the weak response capabilities to confront the pandemic and its widespread spread since March 2024, as its symptoms appear in the form of severe diarrhea and continuous vomiting, which leads to a severe loss of fluids and salts (dehydration) in the body. However, in severe cases, the disease can prove fatal if prompt medical intervention to replace lost fluids is not administered.
Ahmed Suleiman, a 50-year-old from Taiz Governorate (southwestern Yemen), was severely infected with cholera and fell into a coma because he did not receive proper medical attention from the beginning.
Moreover, Ahmed tells "Khuyut" that he sought medical help on the first day of his infection at Al-Muzaffar Clinic, then moved to Al-Thawra Hospital, where he did not receive adequate care. He subsequently moved to Republican Hospital, describing his condition as extremely dire, no less dire than other patients arriving from remote areas outside the city, such as Al-Turba and others, due to the long travel distances. Patients infected with the disease only reach the hospital when their condition has become extremely critical.
In light of the situation in Taiz, Dr. Abu Bakr Salem, from the Cholera Patient Care Department at the Republican Hospital in Taiz, describes to "Khuyut" that the disease is widespread, with the hospital receiving dozens of cases daily from various age groups and different areas of the city of Taiz.
According to Dr. Salem, most of those infected with cholera reach the Republican Hospital in Taiz in a very critical condition, experiencing low blood pressure, oxygen levels, and heartbeats, in addition to dehydration. After receiving initial care in the emergency department, they are transferred to cholera-specific intensive care and isolation units for medical observation.
The cholera outbreak in Yemen is serious and poses a major health challenge. Therefore, combating the epidemic requires joint efforts from local health authorities and international organizations, along with international support and essential health resources. Moreover, improving public health conditions and providing basic health services are crucial steps to reduce the spread of the disease.
In relation to international response efforts, the international organizations stress the importance of a rapid response to combat cholera in Yemen. In this regard, the United Nations pointed out that it and its humanitarian partners are working closely with relevant authorities to expand the response. Likewise, another UN official called on the international community to provide the necessary funds and supplies to combat this epidemic. However, The United Nations confirms that the humanitarian response plan for Yemen for 2024 has only been funded by 10% so far.
