HADRAMOUT, AMRAN AND TAIZZ GOVERNORATES, Yemen – An internally displaced woman named Hamsa* in labour arrived at Maifa’a Mother and Child Centre in Hadramout Governorate, known to provide free obstetric services, only to discover medical personnel gone and delivery services cut off.    Raisa*, ready to give birth to her first child, made it to Al Dhabr Health Centre in Amran Governorate but found the doors locked, no longer open around-the-clock due to lack of personnel. Hours ticked by as her pains intensified, but her family couldn’t afford transportation to another hospital.  When Amat* rushed to Al Khabt Hospital in Taizz Governorate in critical condition, she, too, realized that the obstetric care she had been counting on had vanished – and the nearest hospital that could save her and her baby’s life was precious hours away.  Funding streams dry up UNFPA is the sole provider of reproductive health medicines and is leading reproductive health service provision in Yemen. But lack of funding has forced it to scale back humanitarian operations by 25 per cent since the beginning of the year. (Only 13 per cent of a $100 million appeal has been funded so far.)  In 2021, UNFPA reached 1.6 million women and girls with reproductive health services, assisting 151,000 safe deliveries and averting 344,000 unintended pregnancies with support to 127 health facilities and payments to 2,065 health workers.  But UNFPA has had to reprioritize, currently supporting 98 health facilities and four reproductive health mobile teams with the contributions of Canada, the Central Emergency Response Fund, the European Union, the Netherlands, Qatar Fund for Development, USAID’s Bureau for Humanitarian Aid and Yemen Humanitarian Fund.  Pregnant women pay a steep price In Maifa’a, Hamsa had to seek help from a traditional birth attendant at home. The attendant did not realize she needed a Caesarean section and when she started bleeding heavily, had to be taken to the nearest hospital in Al Mukalla City 130 kilometres away. There the medical team managed to save Hamsa’s life, but not her newborn baby girl. Al Dhabr Health Centre, where Raisa tried to obtain care, had provided free reproductive health-care services since 2018, with UNFPA supporting a female doctor and trained midwife. The clinic received up to 30 cases a day but after it started charging for services and medicines (beyond affordable for most), it saw two patients a day. Until it reduced working hours from 24 to 5, the clinic had never recorded a single maternal death. The clinic, which has lost specialists, has stopped testing for birth defects, providing post-delivery incubators and performing surgeries due to lack of fuel that could cut power mid-operation.   Raisa had to go to a midwife, who advised that her critical condition warranted a visit to the hospital. With no money for transport, she went to a second midwife, who also told her she needed emergency care. Raisa, who was 32, died before reaching a hospital; her baby daughter survived.   A health system in ruins   Only half of Yemen’s hospitals remain functional, and only one in five of them provide maternal and child health services. Nineteen of the country’s 22 governorates have six maternity beds for every 10,000 people, half of what the World Health Organization deems standard. In addition, an estimated 42.4 per cent of the population lives more than one hour away from the nearest fully or partially functional public hospital. One Yemeni woman dies every two hours during childbirth from causes that are almost entirely preventable. An estimated 8.1 million women and girls of childbearing age require help accessing reproductive health services, including antenatal care, safe delivery services, postnatal care, family planning and emergency obstetric and newborn care. Among them are 1.3 million women who will deliver in 2022, of whom 195,000 are projected to develop complications that will require life-saving medical assistance.  A desperate search for help Doctors at Al Khabt Hospital referred Amat to Al Mahweet City Hospital three hours away, where the family found out that it, too, didn’t provide the services she needed, including a blood bank. “On the way, I fainted,” she recalled. “I saw my whole life wiped out just like that.” Her husband panicked when her lips turned blue. “The moment I touched her, I felt they were going to be taken away from me,” he said.  Another two-and-a-half hours away was Al Jumhori Hospital in Al Mahwit City. The largest in the governorate, it is still being supported by UNFPA – and was an unconscious and barely breathing Amat’s last chance. After nearly six hours of travelling due to poor road infrastructure, mother and baby survived.  “It’s simple,” said midwife Afrah, who helped deliver Amat’s son. “When services are readily available, we can save lives.” *Names changed for privacy and protection  

Aden – One of the greatest challenges facing society today, the warming of the planet is showing no signs of decreasing. In Yemen, where communities are confronting conflict and economic decline, temperatures have been rising faster than the global average over the last three decades. Across the country, droughts and floods periodically damage agricultural lands, reduce the availability of arable lands and threaten the livelihoods and food security of communities. “Agriculture is the main source of income for our communities, but climate change has made farming difficult and brought a decline in our economy,” said Noha Alban, a community leader from Lahj. "Climate change has caused drought and water scarcity, which has made it impossible for farmers to grow their food. They now need to dig wells which are expensive. This has forced many farmers to sell their land and move to other areas,” she added. Yemen is facing a decline in agricultural productivity and a shortage of seasonal crops on which the rural population depends, leading to increased food insecurity, high rates of malnutrition, as well as the continued shortage of groundwater and drinkable clean water. "Before we started to experience drought, heavy rain and flooding, 80 per cent of our community worked on farms but now only 30 per cent can afford seeds or the other resources they need to continue farming,” said Noha. In rural communities across Yemen, women are tackling the issue of climate change with grit and resilience. Women often work as farmers and increasingly are becoming the sole breadwinners of their families, says Noha.  They also play a pivotal role in food security and land management and help to mitigate tension over natural resources like water among local farming groups. Noha is a member of the International Organization for Migration’s (IOM) Conflict Resolution Committee which was formed to address issues that arise in communities due to displacement and competition over resources. Committee members work to raise awareness about environmental sustainability, social cohesion and peaceful solutions to conflicts through community dialogue and mediation. "The majority of people here know the climate is changing but they do not know what kinds of precautions they can take. People need more awareness about climate change to learn how to protect themselves from rain and winds, and how to store rainwater," added Noha. “Women can help to reduce the risks of climate change by talking to people and raising their awareness.”   Noha and other members work closely with male and female farmers to improve and care for their agricultural crops, as well as educate them about the complications of climate change and the causes of floods and droughts. "As a member of the Conflict Resolution Committee, I help to resolve these disputes. We also educate farmers and encourage them to support each other in the management of resources and their land," elaborated Noha. “Everyone in society should come together to solve these issues as a community, not individually.” In coordination with community leaders and local authorities and support from the European Union, IOM works extensively with its partners and the Conflict Resolution Committees with the aim of alleviating the pressure that arises from mass displacement and competition over resources and services. The committee also works to solve environmental and climate change-related problems and helps farmers find solutions for shortages related to water, seeds and other basic resources.  

UN Volunteer health professionals have been providing much-needed critical healthcare for UN operations in Yemen in times of crisis. Since 2020, the United Nations Volunteers (UNV) programme has deployed 60 UN Volunteer doctors, nurses and other medical providers, almost all of whom are nationals, in UN Clinics administered by the UN Development Programme (UNDP) in seven locations in Yemen. National UN Volunteers have been playing a key role in providing healthcare to over 6,000 UN staff and their eligible dependents. They carry out daily walk-in consultations, emergency care, inpatient care, follow up of cases and healthcare promotional activities, with proper guidance from international UN Volunteers and senior medical staff, as stipulated in the UN Clinic Standard Operating Procedures. In addition, they contribute to health consultations, workshops on universal precautions and COVID-19 awareness activities, in cooperation with relevant governmental health departments. The country-wide deployment of these UN Volunteers was meant to keep up with the needs on the ground, and to facilitate the wide international humanitarian response to the crisis in Yemen. Humanitarian and relief activities are implemented by international and national staff who, in turn, rely on a robust healthcare system to keep them well in the field. Thus, the deployment of UN Volunteer medical workers enables the work of many others. — Abdullah Al Duraibi, UNV Country Coordinator in Yemen. Accordingly, the level of expectations from these UN Volunteers went beyond the commitment required from a health worker to their patients in a normal context. Recruited in the context of a national crisis, compounded with a global pandemic situation, being prepared to go over and beyond, and having the ability to work within diverse teams were critical assets. UN Volunteer Marwah Al-Maqtari had full understanding of this context when she was recruited as a National Emergency Doctor for the UN Clinic in Sana’a back in May 2020. “Serving as a UN Volunteer within the COVID-19 team required a disciplined professional commitment around the clock,” she explains. For Marwah, being a doctor is not just about treating the patients, it is about “listening to their fears and concerns and staying by their side,” as well. These medical volunteers are part of a larger community of UN Volunteers, including ambulance drivers, human rights advocates, translators, engineers and information technology experts, among others. Together with their colleagues serving UN operations in Yemen, this volunteer community maintains knowledge-sharing platforms, renewable energy sources and updated medical procedures, upon which healthcare systems depend. Our UN Volunteers learn from one another and work closely together. This high degree of cooperation and learning contributes to capacity building and improves the care we provide. — Dr Florence Fongang, UN Physician/Health Manager with UNDP in Yemen UN Volunteer Ahmed Al Rough serves as an Emergency Nurse within the UN Clinic in Sana’a. His core duties involve providing primary healthcare to the beneficiaries of the UN Clinic, preparing medical supplies for emergency services and managing referrals. He also plays a key role in updating the daily COVID-19 statistics, which contributed greatly to the review and update of the UN country team’s COVID-19 protocols. “Unfortunately, patients often delay medical services because they are misinformed and dissuaded by stigmas,” says Dr Florence. This is an issue the UN Volunteers help to address, benefiting from their position as national volunteers embedded in the local community, which allows them build trust with local beneficiaries. Alongside his core duties, Ahmed helps counter misinformation. For example, he conducted awareness workshops and developed dashboards, flyers and other information material about COVID-19 pandemic. These activities helped local communities acquire the knowledge and skills needed to reduce disease transmission and increased transparency with real-time situation updates. Indeed, a devastating economic recession, years of conflict and political insecurity have taken a heavy toll on the healthcare sector in Yemen. These challenges have resulted in under-investment, which limited the access to and quality of medical supplies, services and continuing education opportunities.
However, through their hard work and dedication, UN Volunteers are planting the seeds of positive change. By building trust in national capabilities, they inspire hope for Yemen’s post-conflict recovery.

My journey as a UN Volunteer started with a recommendation from a friend. At the time, I had practiced medicine in my home country, Cameroon, for over 20 years. A close friend advised me to join the United Nations Volunteers (UNV) programme as a way to expand my experience in medicine, while traveling and volunteering in service of others. My recollection of my sister’s illness made me decide right away that this was right for me. When I was younger, my sister developed a medical condition. She underwent two heart surgical procedures and endured a lot of suffering, but she survived and inspired me. She later asked me to consider a career in medicine to help other young girls. When this volunteering opportunity came up, I took it and became a UN Volunteer on 27 March 2008. I was recruited for the first volunteer assignment in Haiti. As a mother of a seven year-old twins, it was not easy for me to travel and leave them behind. But I did it with the support of my husband, who understood my motives and took good care of our children while I was deployed overseas. I am sharing my experience to encourage other women, especially mothers, to not pass on such opportunities. I understand their role as caregivers. I hope learning about how I volunteered, and balanced between my work and family, will make them more confident that they can do it too. While in Haiti, I practiced medicine amidst floods, cholera, earthquakes and a severe economic recession. These harsh conditions damaged roads and threatened the supply of food and other resources to affected communities. My volunteering journey with the UN took me next to support the Ebola response in Africa, amidst lockdowns and a profound public health crisis, which garnered the world's concern. Through these emergency and disaster relief contexts, I became involved in inpatient and outpatient services, medical evacuations, capacity building, prevention and disease mitigation activities. It was especially heartwarming to see my work being recognized while knowing I was making the contributions my sister always believed I would make. Serving with UNV prepared me in ways that I couldn't have imagined. These experiences were wide-ranging and led my career growth within the UN. I eventually transitioned from a UN Volunteer Medical Officer to become the Health Manager of the UN Clinic administered by the United Nations Development Programme (UNDP), first in Somalia, then in Yemen, which is a lead medical position in the field. When COVID-19 hit the globe, I was in Yemen. Indeed, I was the one of the first female doctors to join the UN Clinic medical team in Yemen. Like my home country Cameroon, Yemen desperately needs to increase the number of doctors and nurses to improve health conditions and address humanitarian needs. My previous experience allowed me to understand both the significant role women can play in this regard and the value UN Volunteers can add in such contexts. I moved quickly to recruit, deploy and train national UN Volunteers in our UN Clinics. All while ensuring inclusion of women in the deployments, coupled with flexible schedules and remote work opportunities which promote work-life balance. Ultimately, our work in Yemen benefited significantly from the contribution of the recruited national UN Volunteer health professionals. As I travel between clinics to attend to patients and help building staff capacity, I often think of my sister and how she inspired me. I also think about my children and how my own journey would inspire them. At first, my children didn't want to study medicine. While in Cameroon, they saw me work long hours and weekends then come home tired. They struggled to embrace the career that demanded a lot of their mother's time. However, my children began to view medicine differently after I joined UNV. They began to understand how important doctors are to crisis-affected communities and now see themselves in the lives we save. This is everything to me.