TAIZ, YEMEN

There has been plenty of analysis about the war in Yemen. One minute the pro-Iranian Houthi rebels have the upper hand, the next it is the Saudi Arabian-led coalition. Perhaps the ousted president will return, or maybe al-Qaeda will fill the vacuum. Amid the endless opinion and speculation, one thing is certain: the only real winners so far are the mosquitoes.

Although it infects hundreds of millions of people a year and is endemic in more than 100 countries, the mosquito-borne dengue virus is not especially dangerous. The vast majority of those infected develop no symptoms and most of those who do fall sick need only basic medical care, such as a drip. This reduces the risk of death to below one percent. Conditions in Taiz in central Yemen, however, have turned an outbreak into a crisis.

Late last month, the World Health Organization made an emergency plea for humanitarian access to the city to combat “an extreme spike” in cases of the disease. The call went unheeded. As long as the fighting continues, getting care to those in need in a city rife with dengue fever is practically impossible.

Taiz is right on the frontline of Yemen’s civil war, which pits the northern Houthi rebels and breakaway parts of the army against an array of forces broadly loyal to the exiled President Abbdu Rabu Mansour Hadi and backed by a Saudi Arabian-led bombing campaign.

Daily life has disappeared: the streets deserted apart from groups of armed men and the occasional crack of a sniper’s rifle. Most residents have fled for rural areas, but thousands still cower in their homes with nowhere else to go. Schools and universities are closed, the water supply has been cut off, and the doors at the state-run Republic Hospital are shuttered as shells land nearby.

There have been 1,243 suspected cases of dengue in Taiz governorate this year, according to official figures from the WHO. Local reports, including from the Relief Coalition health group in Taiz city, say the real number of cases is 10 times higher and that 15 people have died.

Helping spread the disease is the lack of a proper water supply, which has forced people to collect what they can in open containers, leaving a plethora of perfect breeding grounds for the disease-carrying mosquitoes.

In theory, dengue fever is easily treatable through rehydration and rest, and rarely leads to death, but the extreme shortage of clean water and basic medicines in Taiz makes it an exception.

Hasan Izi, manager of the government health office in Taiz, said the level of the violence made it hard to ascertain the full scale of the outbreak, but the WHO confirmed that the situation was desperate.

"Limited access to health care services, a breakdown in safe water supply and sanitation services as well as accumulation of garbage have facilitated the spread of dengue fever in the governorate,” said Ahmed Shadoul, WHO’s representative for Yemen.

Nearly a quarter of all Yemen’s medical facilities have closed down because of the conflict, according to the UN.

"There is not enough medicine in Taiz for the complications of dengue fever, and most of the hospitals closed their doors and made this a crisis,” Izi told IRIN.

"Dengue fever is killing Taiz's residents right now and there is a large number of casualties,” he said, urging international organisations to do more to help.

Shadoul said most roads into Taiz were inaccessible, impeding the delivery of medical aid.

While street-to-street fighting and sniper fire are constant challenges, the security situation is also complicated by the Saudi Arabian-led bombing campaign, which began in March. At least 65 civilians, more than half of them women and children, were reportedly killed in airstrikes on Taiz late last month. Izi himself fled for the relative safety of the capital Sana’a three months ago.

It is perilous for aid organisations to try to deliver supplies in such an environment. However, Shadoul said the WHO had managed to get some medical aid in by coordinating with all the warring factions beforehand. It hoped to send more later this week, he added.

For those who do catch dengue in Taiz, their best bet is often to flee the city in search of peace and clean water.

Younis Jamal, a 26-year-old resident, told IRIN what happened after he developed a severe case of dengue fever last month.

“Violent clashes were ongoing in our neighbourhood so no one could take me to the hospital. Even when my elder brother took me to the state hospital, we couldn’t get proper care.”

In the end, Jamal had to travel 75 kilometres to his home village to rest and recover.

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