A week ago, 40 children and 11 adults were killed in an attack on a bus carrying children in Yemen. Many of the children were treated at a hospital supported by the International Committee of the Red Cross. Marta Rivas Blanco, an ICRC nurse, shares her account of the day.

They came to the hospital in cars and ambulances. Dozens of children with an array of grisly wounds. Some were screaming, some were scared. Many went straight to the morgue.

I’d like to say this was the first time I’ve treated so many civilians after an attack, but it’s not. I’ve been here too many times before, both in Yemen and in Mosul, Iraq.

What happened last week in Saada, however, was unprecedented for me in that nearly all the victims were children.



The wreckage of the bus. Photograph: Hani Mohammed/AP

As part of an ICRC mobile surgical team, we work alongside Yemeni healthcare workers at the Talh hospital on a daily basis. Yemen’s health system has been decimated by conflict and it’s a challenging environment at the best of times. What happened on Thursday was the stuff of nightmares.

A colleague called me while we were driving to the hospital in the morning. He told me there had been an attack and that we should expect an influx of patients. When he said most of them were children, my heart sank.

It was intense. Very quickly the emergency room was full, as were the two extra emergency tents outside. You can’t imagine such a scene. We’d already enacted our mass casualty plan, so everyone knew what to do.

The first thing was to triage the patients. The red cases – those with life-threatening injuries – went straight to the emergency room. They have to be treated immediately or they will die. The less severe cases went into the tents for treatment.

When you’re in this moment, you lose track of time. You focus on your job and you don’t let emotions get in the way. For around four hours everyone was working flat out. Local staff, who were not supposed to be working, came in to help out. Even the cleaners were helping. You just do your best, but sometimes even that’s not enough.

Two children died in the emergency room with me. The brutal truth is that you cannot save everyone. In total, 51 people died, including 40 children. Dozens more were injured, the majority of whom were children.



Yemenis dig graves for children killed in the attack. Photograph: AFP/Getty Images

There were a lot of children who had difficulty breathing, due to lung injuries caused by shockwaves from the blast. Some had fractures to the arms and legs, and broken glass had caused perforations to the skin. One small mercy is that there were no amputations.



Physically, the children will recover. But I worry for their mental state. Many were in shock; they had no idea what had just happened to them. One minute they were on a bus, the next they were in a hospital.

The health system in Yemen is on the brink of collapse and Saada is a very poor area. There is little by way of psychological support. This attack could affect the children long after their wounds have healed.

Funerals for some of the children were held on Monday. Those who are still in hospital are on the path to recovery. While it’s good to see wounds on the mend, the hospital is still full of children who should otherwise be at school, or outside playing. This conflict has robbed them of their childhood.

A Yemeni man mourns over a boy’s casket during a mass funeral on Monday. Photograph: AFP/Getty Images

I don’t expect we’ll get much of a break for the next fortnight. But that’s OK. To be here and to be able to help is deeply gratifying for me. On Monday I went to the office to take stock of the medical supplies. It’s in these quiet moments that you start replaying the images in your head – the anguish etched on those children’s faces, the sound of young voices screaming.

Whether in Yemen, Syria, Iraq, or any other conflict, attacks on civilians are unacceptable and cannot be idly tolerated. International humanitarian law strictly prohibits attacks against civilians and civilian objects. But I’ve found myself treating civilians more times than I care to remember. That’s why I had to go to the office: to submit an order to replenish our stock of medicines and equipment. We have to be ready for the next time.

Marta Rivas Blanco is part of the International Committee of the Red Cross (ICRC) mobile surgical team at Al-Talh hospital in Yemen.