(Beirut) – The Saudi-led coalition’s broad restrictions on aid and essential goods to Yemen’s civilian population are worsening the country’s humanitarian catastrophe, Human Rights Watch said today. Unless the coalition immediately stops blocking aid and commercial goods from reaching civilians in Houthi-controlled territory, the United Nations Security Council should impose travel bans and asset freezes on senior coalition leaders, including the Saudi crown prince and defense minister, Mohammed bin Salman.

The coalition has imposed a naval and air blockade on Yemen since the current conflict began in March 2015 that has severely restricted the flow of food, fuel, and medicine to civilians, in violation of international humanitarian law. The coalition closed all of Yemen’s entry points in response to a missile strike on Saudi’s Riyadh airport on November 4, 2017, by opposing Houthi-Saleh forces. While the coalition eased some restrictions in late November, it continues to prevent much aid and nearly all commercial imports from reaching Houthi-controlled ports, which has an unlawfully disproportionate impact on civilians’ access to essential goods.

“The Saudi-led coalition’s military strategy in Yemen has been increasingly built around preventing desperately needed aid and essential goods from reaching civilians, risking millions of lives,” said James Ross, legal and policy director at Human Rights Watch. “The Security Council should urgently sanction Saudi and other coalition leaders responsible for blocking food, fuel, and medicine, causing hunger, sickness, and death.”

Yemen, the poorest country in the Middle East, depends heavily on imported food, medicine, and fuel for 80 to 90 percent of the population’s needs. As of November, seven million people were dependent on food aid to survive, and nearly a million may have cholera. Diphtheria, a disease that should be preventable, was spreading, and had already killed more than 20 people and infected nearly 200. An estimated 2 million children are acutely malnourished. Half the country’s hospitals have been closed and nearly 16 million people lack access to clean water.

Reopening all of Yemen’s land, air, and sea ports to commercial shipments, which before November made up 80 percent of all imports, is crucial to any effort to address what the UN has described as the world’s “worst humanitarian crisis,” Human Rights Watch said.

Click to expand Image A worker is pictured in a government hospital's drug store in Sanaa, Yemen August 16, 2017. © 2017 Reuters/Khaled Abdullah

Claiming a need to strengthen vetting procedures, the coalition halted all humanitarian flights and shipments to Yemen for several days following the November 4 attack and halted all humanitarian flights and shipments to ports in Houthi-controlled territory for about three weeks. On November 22, the coalition announced that it would allow humanitarian flights to resume to the capital, Sanaa, and “urgent humanitarian and relief materials” to begin moving to the Houthi-controlled port of Hodeida.

Major restrictions on the delivery of essential goods to the civilian population remain, Human Rights Watch said. While a limited number of food shipments have reached Houthi ports on an ad hoc basis since November 22, the coalition has not indicated whether it will allow seaports under Houthi control to reopen to commercial shipments, including fuel and medicine.

The World Food Programme estimated that even with a partial lifting of the blockade, an additional 3.2 million people would be pushed into hunger and 150,000 malnourished children could die in the coming months.

On December 2, the heads of seven humanitarian agencies issued a joint statement calling on the coalition to lift restrictions: “Without the urgent resumption of commercial imports, especially food, fuel and medicines, millions of children, women and men risk mass hunger, disease and death,” they said.

Fighting broke out in Sanaa on December 1 between the Houthis and formerly allied forces loyal to former longtime president, Ali Abdullah Saleh. Dozens of people, including civilians, were killed and wounded in the fighting. On December 4, Houthi forces killed Saleh under circumstances that remain unclear. During the fighting, civilians already facing shortages of essential goods were reportedly rapidly running out of food, fuel, and medicine. Humanitarian organizations were unable to reach their warehouses to deliver aid to those in need.

Coalition military actions have violated laws-of-war prohibitions on restricting humanitarian assistance and on destroying objects essential to the survival of the civilian population. These violations, as well as the coalition’s disregard for the reported suffering of the civilian population, suggest that the coalition may also be violating the prohibition against using starvation as a method of warfare, which is a war crime.

The Security Council should urgently sanction Saudi and other coalition leaders responsible for blocking food, fuel, and medicine, causing hunger, sickness, and death. James Ross legal and policy director

The UN Security Council should impose a travel ban and asset freeze on senior leaders of the coalition, including Mohamed bin Salman, for their role in violations of international humanitarian law in Yemen, Human Rights Watch said. Under Security Council Resolution 2216, the Yemen Sanctions Committee can designate “individuals or entities” for targeted sanctions if they are “engaging in or providing support for” acts that “[obstruct] the delivery of humanitarian assistance to Yemen or access to, or distribution of, humanitarian assistance in Yemen.”

The Sanctions Committee has already imposed sanctions – including asset freezes and travel bans – on five leaders of formerly allied Houthi-Saleh forces, including Saleh. No one from the coalition has been designated for sanctions, despite information on repeated coalition violations, including the obstruction of aid, gathered by the UN Panel of Experts, which provides information on implementing the resolution.

“UN Security Council members, particularly the United States, United Kingdom, France, and other coalition allies, have shielded Saudi Arabia from serious international scrutiny even though the Saudi-led coalition has committed numerous atrocities in Yemen,” Ross said. “The Security Council urgently needs to act against coalition leaders who have added to Yemen’s humanitarian catastrophe or share in the blame.”

Yemen’s Deepening Humanitarian Crisis

Since March 2015, Human Rights Watch has conducted dozens of interviews with health professionals and humanitarian workers in Yemen regarding restrictions on access to aid and essential goods and their impact on the civilian population. Human Rights Watch also has reviewed coalition statements and UN and humanitarian community assessments on Yemen. Human Rights Watch previously documented actions by both the Saudi-led coalition and formerly allied Houthi-Saleh forces that impeded aid delivery to civilians, in violation of international humanitarian law.

Impact of Fuel Shortages

On November 6, the Saudi-led coalition imposed a full blockade on Yemen, which was partially lifted over the ensuing days and weeks. A humanitarian agency official said the “most immediate impact” of the November blockade was on fuel supply. Fuel was already often not available throughout Yemen – including in areas under Yemeni government control, such as Aden, which has repeatedly experienced fuel shortages. On November 23, the World Food Programme estimated that supplies of fuel and diesel in the country could run out in the coming weeks. The lack of fuel also makes it more difficult to pump clean water, run hospital equipment, and safely store vaccines.

Houthi and Saleh forces also contributed to the fuel shortages. The UN Panel of Experts reported in June that Houthi-Saleh forces had earned up to US$1.14 billion from fuel and oil distribution on the black market. They also use imported fuel for military purposes.

Officials at five hospitals in the Yemeni governorates of Hodeida, Taizz, and Sanaa told Human Rights Watch that after November 6 the lack of fuel was having a “catastrophic” impact on their operations. Four of the five hospitals – including the two largest in Yemen – were entirely dependent on generators, powered by fuel, to operate. The hospitals serve thousands of people.

Dr. Nasr al-Qadsi, the general director of Yemen’s second-largest hospital, in Sanaa, said the hospital needed 60,000 liters of fuel a month to power its generators, generate oxygen, and run its ambulances and buses for staff. After November 6, the hospital’s water supplier stopped providing water, telling the hospital it would have to supply the fuel to get more water. “Water and electricity and oxygen are very essential,” al-Qadsi said. “And we have problems getting all of them.”

Dr. Abdul Latif Abu Taleb, the head of Yemen’s largest hospital, also in Sanaa, which can admit about 1,000 patients, said that the November 6 decision “caused us great panic… direct[ing] all our concerns to the pursuit of the necessary diesel material to keep the hospital working.” He added: “I have 105 patients in the intensive care unit on monitors and respirator devices. If the hospital power supply stopped, a disaster will happen.”

Fuel is also crucial to provide access to clean water in the country. Less than a week after the November blockade was put in place, the UN reported fuel prices had increased by 60 percent in Sanaa and trucked-water by 133 percent. Three weeks after the blockade began, hospital officials in two governorates reported huge price increases – up to 300 percent – if fuel was available at all. “The prices jumped to the sky, so we couldn’t afford buying it,” one doctor said. Other doctors said they had diverted all hospital revenue, much of which they would normally have spent on medicine and medical supplies, to buy diesel.

Rising fuel prices, according to the UN, have caused trucked water prices to spike – up to 600 percent in some places. Nearly 17 million people in Yemen depend on public water networks – some of which are shutting down due to a lack of fuel – or commercial water. In late November, the International Committee of the Red Cross reported that nine cities lacked the fuel needed to run water treatment plants. Clean water is needed to avoid water-borne diseases, like cholera.

Click to expand Image A malnourished boy lies on a bed at a malnutrition treatment center in Sanaa, Yemen, November 21, 2017. © 2017 Reuters

The lack of fuel also increases food scarcity. Civilians have had to spend their limited money on water, giving them less income to purchase food and “further increasing the risk of widespread food insecurity and ultimately famine,” according to the UN. Fuel is needed to transport “what little food remains in Yemen, or food will be stuck in warehouses while innocent people starve nearby,” said Oxfam.

Closing Sea Ports in Houthi-Controlled Territory

Between November 6 and November 26, the Saudi-led coalition refused to allow any ships to travel to Houthi-controlled ports. On November 6, the UN Verification and Inspection Mechanism for Yemen (UNVIM) sent an email, viewed by Human Rights Watch, to vessels asking them to immediately leave the Red Sea ports of Hodeida and Saleef. Hodeida is a key port that receives food, fuel, and other goods, while Saleef is primarily for food imports. Documents shared by port officials said that vessels forced to leave were carrying wheat, fuel, and other cargo. The email said UNVIM was suspending clearance operations “until further notice.”

A few days after the complete blockade was announced, the coalition allowed vessels to travel to ports under Yemeni government control, including Aden and Mukalla. On November 26, the coalition allowed a ship carrying food to sail to a Houthi -controlled port for the first time in three weeks. During the following week, the coalition allowed several more ships carrying food to enter Hodeida and Saleef. However, four aid officials said in early December that the coalition was still severely restricting the flow of essential goods into both ports, including food, fuel, and medicine.

Since November, the coalition has refused to allow nearly all commercial ships to travel to ports under Houthi control. The coalition had not allowed any commercial fuel tankers to proceed to Houthi-controlled ports or any commercial vessels to proceed to a port primarily for bulk food imports as of December 5, according to an UNVIM spokesperson. The coalition had “refused to grant four fuel tankers access… two of these tankers have now left for other ports of Yemen due to the costs [of] the delay,” the spokesperson said.

In June, the coalition shut down the fuel port of Ras Isa, significantly curtailing fuel deliveries to the country. UNVIM has not cleared a vessel to enter Ras Isa since May. Deliveries were diverted to Hodeida until November. Ras Isa was designed for diesel imports and has a greater capacity than Hodeida, which was incapable of making up the lost capacity even before being closed to imports in November.

Closing all three ports to all shipments for three weeks and continuing to severely curtail the shipment of commercial goods to the ports deprives the civilian population of essential goods. Yemen’s population depends on commercial imports of food, fuel, and medicine for survival.

Before November 6, about 75,000 metric tons of the 350,000 metric tons of food imports Yemen requires – or about 20 percent – were humanitarian supplies, leaving 80 percent to come through commercial imports, according to the UN. The UN estimates Yemen’s fuel needs at 544,000 metric tons per month – almost all commercial imports reached Yemen via one of its six ports, making the fuel supply particularly vulnerable to naval or commercial disruptions.

The coalition has repeatedly contended that ships can be diverted to ports under the control of the Yemeni government, which it backs, but these two ports are not sufficient to meet the civilian population’s needs.

Aden port, the most used after Hodeida and Saleef, does not have the capacity to receive the hundreds of thousands of metric tons of food, fuel, medicine, and other imported goods Yemen depends on for survival. Aden currently has the capacity to take in about 50,000 metric tons of fuel and 80,000 metric tons of food a month, according to the UN – well under the country’s needs.

Allowing ports in Houthi-controlled territory to continue functioning is crucial to addressing the humanitarian crisis, Human Rights Watch said. Eighty percent of all imports – humanitarian and commercial – came through Hodeida and Saleef ports before November 6. Combined, the two ports had the capacity to take in about 150,000 metric tons of fuel, 295,000 metric tons of food, and 90,000 metric tons of non-food items each month.

When asked in early 2017 why the coalition had refused to allow imports of materials to repair or replace damaged infrastructure at Hodeida, including four US-donated cranes, then-spokesperson Brig. Gen. Ahmed Asseri said the coalition sent back those cranes “because we don’t want to continue to enhance the capabilities of the Houthis to generate money and to smuggle weapons.”

The UN has concluded: “Even at reduced capacity there is no viable substitute for [Hodeida] port.” If commercial traffic continues to be blocked, “there continues to be a grave risk of further death, disease and starvation.”

Coalition Restrictions on Essential Goods to Houthi Ports

The November restrictions are only the latest move by the coalition to unlawfully impede access for goods essential to the civilian population’s survival to reach Houthi-controlled territory, Human Rights Watch said.

In 2015, Human Rights Watch documented that the coalition had withheld permission to fuel tankers to travel to Yemen. In 2016, in recognition of the need to ensure that commercial imports could enter Yemen, the UN established the UN Verification and Inspection Mechanism to inspect and issue clearances for all commercial shipping vessels traveling to ports under Houthi control.

The coalition has repeatedly undermined the work of UNVIM. Since 2016, after ships were cleared by UNVIM, they would proceed to a demarcated “coalition holding area” in the Red Sea and wait for the coalition to inspect or give them permission to go to port. Over a four-month period in 2017, Human Rights Watch documented seven cases in which the coalition arbitrarily diverted or delayed fuel tankers headed for ports under Houthi control after the UN cleared and granted permission to each ship to proceed. The coalition has also repeatedly diverted and delayed commercial ships carrying humanitarian cargo.

A doctor in Hodeida told Human Rights Watch the hospital had been given expired or near-expired medication: “When we started to ask why, we’ve been told that the goods are taking too long at sea for inspection and the procedures for permission.” He said some medicines had “vanished from the market.” While a few goods came up from Aden, another doctor in Sanaa said, it was with extreme difficulty, in very small amounts and with increased prices, in a situation where we “don’t have the ability to buy even at regular prices.”

A Sanaa-based businessman said that friends could not obtain medicine for chronic illnesses, including kidney failure:

Medicine is a disaster, people are dying left and right. You’ll find medicine, but most of it is smuggled. Medicines need storage specifications. When these guys try and smuggle it through land, use bad warehousing, the medicine is either useless or it kills you.

Humanitarian agencies have repeatedly raised concerns about the coalition diverting all imports through government-controlled Aden. Transporting goods north from Aden requires crossing front lines and increases the risk of diversion and travel time by up to three weeks while raising costs by up to US$30 to US$70 per ton, making goods much more expensive for average Yemenis, according to the UN. In addition, armed forces affiliated with the Yemeni government and the United Arab Emirates, a coalition member, compete for control of the city, including its seaport and airport.

A source in Sanaa collected food prices from a grocery store in the city considered to have relatively low prices before the November 6 announcement and about two weeks after the full blockade was imposed. Most staple food prices – including cooking oil, flour, and rice – spiked by about 25 percent. A can of beans nearly doubled in price. A businessman in Sanaa said that his family has seen food brands disappear over past months. UN documents tracking prices, which Human Rights Watch examined, also noted severe price hikes across goods and governorates after the coalition’s November closures.

Even before the conflict, nearly 40 percent of Yemen’s population lived on less than US$2 a day. The collapse of the Yemeni riyal and the failure to pay civil servants’ salaries, including in some governorates under government control, exacerbates the impact of any price increase on average Yemenis’ ability to purchase food, fuel, and medicine.

Coalition Restrictions on Humanitarian Access

The Saudi-led coalition has increasingly restricted humanitarian access to Sanaa, Yemen’s largest city, which is under Houthi control.

The coalition suspended all commercial flights to Sanaa in August 2016. Twelve aid agencies called on the coalition to reopen the country’s main airport, noting that commercial flights “often bring in vital supplies and allow the free movement of civilians.” Mwatana, a leading Yemeni human rights organization, documented cases of people with chronic illnesses unable to travel abroad for treatment, including one woman needing heart surgery who died.

In May, the coalition tried to restrict passage on UN flights to Sanaa to UN passport holders. But non-UN passport holders include crucial staff of aid organizations, human rights groups including Human Rights Watch, and journalists. The UN was able to negotiate for staff of humanitarian organizations to continue taking the flights, but not others.

The coalition has frequently interfered with aid groups’ ability to work in Houthi-controlled territory. In August, the coalition informed the UN that international staff needed two visas – one from the Houthis and one from the Yemeni government – to travel on UN flights. The coalition had previously imposed a similar requirement on journalists, before blocking them from the flights. The Yemeni government then required all humanitarian organizations to conclude new agreements with ministries in Aden, even if they had an existing agreement with the Yemeni government. In October, the coalition again informed the UN that only UN passport holders could take UN flights. When the UN refused to ask aid groups to cease using the flights, the coalition responded by grounding flights for two days, humanitarian workers in Sanaa told Human Rights Watch.

As part of the November 6 closures, the coalition refused to allow humanitarian flights – carrying personnel or cargo – to land in Sanaa. On November 22, after eight days of negotiation, one flight was permitted to carry out a lifesaving medical evacuation of a critically ill foreign aid worker. Humanitarian flights to Sanaa resumed on November 25.

The coalition has repeatedly called for humanitarian agencies to move their operations to government-controlled Aden. In its November 6 announcement, the coalition called upon “civilian and humanitarian crews” to avoid “areas and ports exploited by [the Houthis] to smuggle weapons.” The announcement also said that humanitarian workers should avoid “areas populated by” the Houthis.

The Coalition Blockade and International Humanitarian Law

International humanitarian law, or the laws of war, prohibits deliberate and indiscriminate attacks on civilians and attacks that cause disproportionate harm to civilians compared to the expected military benefit. Blockades are permitted during armed conflict that do not cause disproportionate civilian harm. However, parties to the conflict must allow and facilitate the rapid passage of humanitarian aid for civilians in need and not arbitrarily interfere with it. Parties must also ensure the freedom of movement of humanitarian workers, which can only be restricted temporarily for reasons of imperative military necessity.

Warring parties are also prohibited from carrying out attacks on objects that are indispensable to the civilian population. These can include food stores, drinking water installations, and port facilities.

The laws of war prohibit using starvation as a method of warfare, and require parties to a conflict not to “provoke [starvation] deliberately” or deliberately cause “the population to suffer hunger, particularly by depriving it of its sources of food or of supplies.”

Since the start of the conflict, the Saudi-led coalition has unnecessarily hindered the delivery of humanitarian aid and the free movement of aid workers. Opposing Houthi and Saleh forces were also responsible for blocking and confiscating aid, denying access to populations in need, and restricting the movement of ill civilians and aid workers, with an acute impact on Yemen’s third largest city, Taizz.

During the three weeks in November that humanitarian flights to Sanaa were refused, the UN was forced to cancel more than 30 flights, stranding 220 humanitarian staff from nearly 50 agencies outside Yemen and 310 in Yemen. One humanitarian official said that 80 percent of their operations were in areas affected by the Sanaa airport closure. Another said their organization had used the airport to import vaccines and other essential medical items that require cold chain storage.

The coalition has damaged or destroyed objects that were indispensable to the survival of the civilian population in Houthi-controlled areas. In August 2015, coalition airstrikes struck Hodeida port, damaging essential port infrastructure. The coalition has refused to allow the port to replace destroyed infrastructure or import spare parts for repairs, a port official said. In January 2016, coalition airstrikes damaged Ras Isa port’s Floating Storage and Offloading terminal, closing part of the facility, Reuters reported.

The full blockade announced on November 6 immediately and predictably exacerbated existing food shortages in Yemen. For instance, a doctor in Hodeida said that prices of fuel, food, and medicine went up “wildly.” His hospital saw more severe acute malnutrition cases, which is “not a good indication…It means people reach a critical condition very quickly.”. “Most people do not have food, not even water… Hospitals are about to close. Why all this, why? People were already at the bottom, and this last decision has ended everyone.”

The coalition sought to justify the full blockade on grounds that it needed to tighten access to prevent foreign-made arms, particularly from Iran, from reaching Houthi forces. Security Council Resolution 2216 permits the coalition to inspect cargo bound for Yemen if there are “reasonable grounds” to suspect that the cargo contains weapons and other prohibited items – but not to block all cargo.

The November blockade was unlawfully disproportionate in that the expected harm to the civilian population exceeded any apparent military benefit. Taken together with the limits on humanitarian aid and the destruction of objects indispensable to the civilian population, the action suggests the coalition may have used starvation of civilians as a weapon of war. The partial lifting of the blockade could have lessened but has not ended the risk of widespread starvation and other civilian harm.

Individuals who willfully commit serious violations of international humanitarian law may be prosecuted for war crimes. This would include deliberately using starvation of civilians as a method of warfare by depriving them of objects indispensable to their survival and by impeding humanitarian aid. Military commanders and civilian leaders may be prosecuted for war crimes as a matter of command responsibility if they knew or should have known about the commission of such crimes and took insufficient measures to prevent them or punish those responsible.