On Monday, authorities in Yemen declared a state of emergency due to a sharp rise in cholera deaths.
Yemen has been at war for more than two years — a Saudi-led coalition has been battling Shiite Houthi rebels aligned with Iran — leaving a reported 10,000 dead. The fighting has decimated much of the country's infrastructure, including its medical facilities. The World Health Organization said in April that fewer than half of Yemen's medical centers were functioning to capacity.
From Aden, Yemen, Dominik Stillhart, director of global operations at the International Committee for the Red Cross, talked with NPR's Ari Shapiro about the cholera outbreak and the dire state of health care in Yemen.
How bad is this latest outbreak?
Well, I have just spent the past four days here. The latest figures in the cholera outbreak show that there have been more than 11,000 cases, 187 people have died and the disease seems to be spreading like wildfire.
It is spread through water. Do people have access clean water and to medical care?
This is precisely one of the problems here after two years of brutal conflict that has brought this country to its knees. Not only were 8,000 people killed in the conflict and 44,000 wounded, in addition there is all the vital infrastructure like public services — health, water, sewage, sanitation, garbage collection — that are running dangerously low and creating conditions for the spread of the disease.
What do you see in the hospitals?
I visited two hospitals, actually, and both have received hundreds of new cases of people affected by watery diarrhea and suspected cholera. The scenes were heartbreaking. We saw up to four people in one single hospital bed. Patients waiting in the garden outside. I even saw one man was sitting in his car with an IV drip attached to his window because there was no place in the hospital.
What are groups like the Red Cross doing to address the cholera crisis?
We have immediately diverted all the material in our warehouses to help health centers and hospitals address the current epidemic. We are particularly concerned in places of detention, the central prison in Sanaa, which has seen the first cases. They're very crowded places and perfect situations for the spread of cholera. So we are there with our teams to ensure that cholera doesn't spread.
What's the impact of the fighting on efforts to fight cholera?
The conflict has seriously affected health here. Our estimation is that the health system is running at 45 percent of its capacity. In many ways, the conflict has made matters worse. Now what is needed is a collective effort from international organizations supporting health authorities here to address the crisis.
Do you expect things will get worse before they get better?
It's always difficult to say. It depends not only on the response, it also depends, for instance, on ... garbage collection. There is also urgent need to address the question of clean drinking water.
Yemeni authorities are asking aid organizations for help. What kind of help can they reasonably provide in a situation as chaotic as this one?
It's really a question of supplying health centers and hospitals with the necessary medical supplies such as IV fluids, rehydration salts and chloride tablets. It's a question of accelerating garbage collection in some of the towns where garbage has been piling up for weeks. And we need to ensure that in places of detention, which are very crowded, that cholera doesn't spread.