Since 2015, the Yemen Civil War has led to the displacement of over 3.6 million people, resulted in 24 million people (or 80 percent of the population) needing some form of humanitarian assistance, and led to the fracturing of the healthcare system, leaving it less equipped to deal with large-scale outbreaks of cholera, and more recently, COVID-19.
In recent months, humanitarian actors have raised alarm bells about the possible consequences of a COVID-19 outbreak in Yemen. Lise Grande, the UN’s Resident Coordinator for Yemen, stated last month that the number of deaths from the virus has the potential to “exceed the combined toll of war, disease, and hunger over the last five years.” Moreover, due to the virus taking additional resources from the already overburdened healthcare system, UNICEF estimates that “an additional 6,600 children under five could die from preventable causes by the end of the year.” Currently, Yemen’s healthcare system, with roughly half of its health facilities no longer in operation, is on the brink of collapse due to a lack of critical medical supplies and staff. Additionally, food aid in Yemen has been reduced in recent months due to a lack of funds from the international community, placing further constraints on Yemenis’ ability to thrive, especially in light of recent food price increases.
In the months following the announcement of Yemen’s first confirmed COVID-19 case on April 10, we took a look into submissions from our network in Yemen to gain a deeper understanding of the COVID-19 response, the impact of reductions in aid, adherence to social distancing guidelines, effects of misinformation, and behavior during the month of Ramadan.
Yemenis Looking for a Robust Response
The first COVID-19 case was officially announced on April 10, 2020, in the eastern governorate of Hadramawt. As of July 14, 2020, Yemen had 1,498 confirmed cases and 424 deaths, although the actual number is likely much higher. Response to the virus has varied widely by region. Areas less affected by the conflict, such as Hadramawt and al-Mahra in eastern Yemen, imposed curfews and restricted travel across governorates among other early response actions. In the north, Houthi leaders have drastically underreported figures and gone as far as covertly burning the bodies of COVID-19 victims in Sana’a. Figures are also likely suppressed in the south, which is subject to conflict between the UAE-backed Southern Transitional Council (STC) and the internationally recognized Hadi government. A recent CNN report found that in May undiagnosed deaths skyrocketed in the southern capital city of Aden, which was recently taken over by the STC in April. Beyond outright government suppression, undiagnosed cases are also to be expected in a country with only 700 ICU beds, 500 ventilators and 4 labs to test for the coronavirus at its disposal for a population of 28.5 million.
Recent data from Premise contributors in Yemen show strong support for government prevention measures with 38% stating that their local government took “severe measures to contain the spread, and it was the right thing to do” and 29% stating that their local government took “some measure to contain the spread, but should do more.”
Premise also noted increasing dissatisfaction amongst contributors in Yemen with regard to their general standard of living. 39% of Premise contributors in Yemen disagreed or strongly disagreed that the national government was “establishing public policies that enable a satisfactory standard of living for citizens” and 38% disagreed or strongly disagreed with regard to their local government. Both questions saw dramatic rises in the percent who were dissatisfied or very dissatisfied from the previous month.
Resources Stretched Thin as International Aid Dries Up
In June 2020, international aid donors to Yemen pledged $1.35 billion for the country, which is roughly half of the estimated $2.41 billion needed and considerably less than the $3.48 billion provided in 2019. The World Food Programme (WFP), which is the largest provider of food aid in Yemen, recently halved the amount of food aid it was delivering and is now only supplying food every other month instead of monthly, due to funding shortages. About 80% of Yemen’s population depend on outside aid for survival, and the secondary effects of a weakened humanitarian sector and economy are as pernicious to many citizens as the virus itself.
The UN also reported last month that food prices had increased up to 35% in certain parts of the country due to COVID-19, further exacerbating Yemenis’ lack of access to affordable food. In a recent survey, 49% of Premise contributors in Yemen disagreed or strongly disagreed that food prices were stable. Furthermore, 39% reported that sudden price increases of food and services as a result of the pandemic had either a moderate or major effect on themselves or their household.
Between June and July, Premise also observed indications of declining economic conditions in Yemen. For example, as of July 15, 42% of contributors disagreed or strongly disagreed that there were enough good quality jobs in their local area to support a good standard of living, marking a 35% increase from the preceding 30 days.
In a COVID-19 global impact survey running since April 2, contributors from Yemen showed concerns related to the economic situation. 74% were concerned or very concerned that their economic situation would be negatively impacted in the next 30 days. Additionally, 24% reported having lost their job as a result of the pandemic and an additional 46% reported a reduction in income.
Social Distancing Remains a Challenge
Results from recent surveys in Yemen indicate that most contributors were aware of social distancing guidelines and attempted to put practices in place.
When asked in a recent survey, roughly three-quarters of contributors reported that they were adamantly practicing social distancing or trying to as much as possible. For those who reported they were not practicing social distancing at all, 20% stated it was because few people in their community were practicing social distancing, 19% stated it was because they could not avoid public transportation, and 18% stated that their work was not supportive of social distancing measures.
Despite individuals self-reporting adherence to social distancing guidelines, in Premise’s recent review of photos submissions from Yemen, our team observed numerous examples of individuals in crowded public places but did not observe instances of these individuals wearing masks. Likewise, markets in larger cities such as Sana’a and Ibb appear to be as busy as pre-COVID-19 times. This may be because, as in many other parts of the world, a large part of the population in Yemen depends on daily work to feed their families, and staying socially distanced is not a luxury they can afford.
The Impact of Misinformation
Like other countries across the globe, Yemen has not been immune to misinformation both from official and non-official sources, particularly on social media. Humanitarian agency Médecins Sans Frontières recently reported that fear of stigma, as well as the belief that hospitals are the source of the virus, has resulted in people not seeking medical help until they are in critical condition. Moreover, the belief that Yemenis are protected from the virus for religious reasons has also spread in recent weeks. Interestingly, the majority (58%) of Premise contributors in Yemen felt very confident that they would be immune if a second wave of the virus were to emerge in the future, which could be a potential indicator about misinformation regarding immunity to the virus, as only 3% were not at all confident that they would be immune.
Yemen, similar to other countries in the MENA region, experienced a large uptick in cases throughout the holy month and following Eid celebrations marking the end of Ramadan, which lasted from April 23 to May 23. A Premise survey conducted throughout the holy month showed indications of a lack of adherence to social distancing guidelines in communities across the country. 69% of contributors who were observing Ramadan stated that they or their family planned to attend community events. Similarly, 70% of contributors in Yemen reported that their mosque was open throughout the holy month. Nearly 60% who reported that their mosque was open reported that their mosque was observing the holiday through iftar dinners, meals starting after sunset which mark the end of daily fasts.
Since first emerging in Yemen in early April, COVID-19 has had a direct and profoundly negative impact on the country’s healthcare system, overall food security, and access to essential services. Competing authorities embroiled in years-long conflict, an already constrained healthcare system, and community fears and misunderstanding of the virus have and will continue to contribute to underreporting case figures and deaths, further limiting a much needed robust response. With thousands of contributors providing real-time data and insights each month in Yemen, Premise will continue to track visual impacts on daily life and overall sentiment surrounding the spread, prevention and effects of COVID-19 across the country.
To learn more about how Premise is tracking the effects of COVID-19 in our global networks, please visit www.premise.com/COVID-19. If you would like to learn more about how Premise can help you get real-time insights from across the globe, email us at firstname.lastname@example.org.