Bombing in populated areas has wiped out decades of development in Yemen, according to a new Humanity & Inclusion report, “Death Sentence to Civilians: The Long-Term Impact of Explosive Weapons in Populated Areas in Yemen.”

In five years of war, Yemen has experienced every manner of explosive weapons—aerial bombs and missiles, artillery, mortars, and improvised explosive devices (IEDs), and much more. The explosions destroy bridges, ports, roads, hospitals, water systems, and generate long lasting civilian harm. When explosive weapons strike roads and bridges, they greatly increase the time it takes to re-supply cities. Such damage cuts deeply into food and water access, and has negative effects on population health.

“Bombing urban areas is a slow and silent health crime,” says Alison Bottomley, Advocacy Advisor for Humanity & Inclusion. “Vital medical health structures are being wiped out: 50% of health facilities can no longer fully function, reducing the country's medical and health-care capacity by half. Repetitive bombing of medical facilities and the destruction of sewage systems is decimating Yemen’s health infrastructure, encouraging the return of water-related diseases.”

The report highlights six case studies, showing the extent and impact of such bombings. The effects of the Hodeidah port bombing in 2015 can still be felt today. This single event triggered major, ongoing disruptions to the supply of basic goods, and resulted in steep price hikes for essential items, such as food. 

In fact, up to 600 civilian infrastructures were destroyed or damaged each month in 2018, according to the Humanitarian Needs Overview. In a country where 24.1 million people (three quarters of the population) need humanitarian aid, such damages only exacerbate the humanitarian crisis.

Fifty percent of medical facilities no longer function, while 19.7 million people are in need of healthcare and 17.8 million people lack access to safe water and sanitation. The economic blockade and disruption to the economy have inflated the cost of food and fuel.

With social and medical services disorganized and further weakened, the population is left acutely exposed in health emergencies like the COVID-19 pandemic. “Entire populations—especially displaced people—are extremely vulnerable and have the least access to the health, water, and sanitation services they need to protect themselves from COVID-19,” Bottomley adds.

Civilian harm

Explosive weapons killed or injured nearly 16,300 people in Yemen between 2015 and 2018, according to the organization Action on Armed Violence (AOAV). About 80% of them were civilians. When explosive weapons were used in populated areas in Yemen, AOAV found that 95% of casualties were civilians.

“Bombing and shelling in Yemen kills and injures civilians on the spot,” Bottomley adds. “It also has a lingering and long-term impact for generations of people that will survive the war. If the war in Yemen were to end today, people would still have to bear the brunt of destroyed roads, bridges, hospitals and harbors. Even before the conflict, Yemen had insufficient health, water, and transportation infrastructure. Access to basic goods, including medicine and basic services, is much more limited now.”

Extensive bombing of populated areas has set Yemen back 21 years, according to the 2019 UNDP report, Assessing the Impact of War on development in Yemen. That’s a whole generation. Yemen will not be able to bear the appalling cost of reconstruction, or even the vital decontamination of explosive remnants of war that will be necessary prior to any reconstruction.

Diplomatic process to end bombing in urban areas

Humanity & Inclusion, as a co-founding member of International Network on Explosive Weapons (INEW), is working with States to develop a strong political declaration to end the use of explosive weapons with wide area effects in populated areas and to ensure support to the victims of these weapons.

Negotiations for a political declaration to end the human suffering caused by the use of explosive weapons in populated areas started in Vienna on October 1-2, 2019. Two rounds of negotiations took place in Geneva during November 2019 and February 2020 and will be followed by another round of consultations later in 2020. This diplomatic process will be finalized with a political declaration that will be opened for endorsement.

So far, the U.S. has sent a delegation to meetings about the political declaration, but has opposed the political declaration.

More than five years of brutal war in Yemen have left millions of Yemenis weakened by malnutrition and disease, and decimated Yemen’s health system. The imminent threat of COVID-19 will exacerbate an already dire humanitarian situation--80% of the population is in need of humanitarian assistance, the majority of whom are women and children; two-thirds of the country lacks adequate access to clean water and sanitation; millions are living on the brink of starvation; nearly 20 million people lack access to adequate healthcare; and cholera, dengue, and other preventable diseases are already rife. These factors create an environment dangerously conducive to the severe and rapid spread of the COVID-19 virus, threatening countless civilian lives.

Especially in light of this extraordinary threat, we, the undersigned NGOs, cautiously welcome the announcement by the Kingdom of Saudi Arabia of a temporary cessation of hostilities in Yemen. We urge all parties to the conflict in Yemen to immediately halt fighting, to implement a ceasefire on the ground without delay, to release all detainees and those forcibly disappeared, and to work with the UN Special Envoy to urgently restart comprehensive and inclusive political negotiations to end the conflict.  

A ceasefire alone cannot stop the spread of COVID-19 in Yemen. All parties must immediately lift restrictions and end interference with vital humanitarian operations; ensure immediate access to populations in need; facilitate the movement of humanitarian workers and goods and of commercial imports; and end blockades and other actions and policies that prevent or restrict essential commercial imports into Yemen, to maintain the humanitarian response for the millions of Yemenis who need aid to survive, and to support Yemenis’ economic livelihood. Yemeni civil society must also be supported to continue their essential role in responding to the crisis. Simultaneously, the international community must ramp up funding for the full range of humanitarian programming in Yemen. Amid this global pandemic, any suspension of life-saving assistance for Yemen, or politicization of humanitarian access and funding, will leave Yemen’s already vulnerable civilian population at heightened risk.

A cessation of hostilities in Yemen can only be a first step. Yemenis need a durable ceasefire, a comprehensive and inclusive political settlement to the current conflict, unencumbered access to humanitarian aid and commercial imports, and accountability for the violations all sides have committed during this war. Yemen cannot wait any longer for an end to the conflict and humanitarian devastation that has ravaged the civilian population for over five years.

Signed by:

1. ACAT-France (Action by Christians Against Torture)
2. Action against Hunger
3. Action Corps
4. Alliance for Peacebuilding
5. Alliance internationale pour la défense des droits et des libertés (AIDL)
6. ALQST for Human Rights
7. Avaaz
8. Bread for the World
9. Cairo Institute for Human Rights Studies
10. CARE International
11. Center for Civilians in Conflict (CIVIC)
12. Center for International Policy
13. Center for Policy Analysis in Horn of Africa
14. CIVICUS
15. Cordaid - Catholic Organisation for Relief and Development
16. Cure Violence Global
17. Danish Refugee Council
18. Dhameer for Rights and Freedoms
19. Freedom Forward
20. Friends Committee on National Legislation
21. Global Centre for the Responsibility to Protect
22. Global Communities
23. Humanity & Inclusion (the new name of Handicap International) 
24. Human Rights First
25. International Civil Society Action Network
26. International Federation for Human Rights
27. International Rescue Committee
28. Islamic Relief Worldwide
29. Karuna Center for Peacebuilding
30. Médecins du Monde
31. Mercy Corps
32. Mothers of Abductees Association
33. Musaala for Human Rights Organization
34. Mwatana for Human Rights
35. Norwegian Refugee Council
36. Observatoire des armements
37. Oxfam
38. Pax Christi International
39. Peace and Building Foundation
40. Peace Direct
41. Physicians for Human Rights
42. Première Urgence Internationale
43. Project on Middle East Democracy
44. Refugees International
45. Saferworld
46. Salam for Yemen
47. Search for Common Ground
48. Solidarités International
49. STAND: The student-led movement to end mass atrocities
50. Students for Yemen
51. Tearfund
52. United Nations Association of the National Capital Area
53. Watch for Human Rights
54. Win Without War
55. World Organisation Against Torture (OMCT)
56. Yemen Relief and Reconstruction Foundation
57. Yemen Solidarity Network
58. Yemen Civil Alliance for Peacebuilding
59. Yemeni Alliance Committee

Yasser was doing his homework with his father on the rooftop of the house in Ta'z when a missile exploded. The next day, the 12-year-old boy came out of a coma at the hospital. His father was killed, his house was destroyed, his left leg was gone. After a month of recovery, Yasser's mother decided to take him to Sana'a to follow the rehabilitation care recommended by Humanity & Inclusion's team. 

Sana, a psychologist with Humanity & Inclusion, recounts the first time meeting Yasser. "Yasser had lost the taste for everything. He no longer spoke. Refused any contact. It was necessary that we help restore his confidence and the desire to live.

"We took him out of his isolation. He was given a cane that provide better mobility than the crutches he had. He was included in a group with other children his age who were all in the same situation–having to make the same efforts to relearn how to walk. The possibility of an artificial leg gave him the hope of becoming a child again."

Since 2015, Humanity & Inclusion has provided 4,200 prosthetics and orthotics and 21,000 mobility devices such as wheelchairs, crutches, and walkers, to Yemenis like Yasser. We've also conducted 20,000 rehabilitation and psychosocial support sessions.

Photo captions: Yasser learns how to walk on his new prosthetic leg with support from physical therapists from Humanity & Inclusion.

The humanitarian situation in Yemen, one of the Arab world's poorest countries, is alarming. Humanity & Inclusion is on the ground helping victims and ensuring that the most vulnerable individuals receive vital aid.

Read the latest facts and figures report from Yemen (January 2020)

When war comes to cities, civilians need your help. Today, more than ever, your support is essential. Make a gift today.

In 2019, 13-year-old Heba was victim to an airstrike in Sada’a, Yemen. Her injuries were so severe that in order for her to survive, her leg had to be amputated.

"When I woke up from coma two days later, I saw myself without my leg,” Heba says. “I felt so miserable.”

Vital rehabilitation care

At the Al-Thawra hospital in Sana’a, Humanity & Inclusion’s team of rehabilitation experts explained the possibilities of gaining strength through physical therapy and being fit with a prosthesis. Three weeks later, the team took her measures to produce the prosthetic.

Thanks to our team of physical therapists, Heba benefited from balance exercises, gait training, and strengthening exercises which allows her to walk on her prosthetic leg.

Standing tall with pride

She is now able to go up and down the stairs. "Before, I was in bed and I couldn't stand up, walk, or balance," she says. "I’m so happy to have a prosthesis! I want to go back to school. I hope that I can become a pharmacist.”  

Future dreams

In the future, Heba dreams of one day purchasing a large piece of land so she can build a pharmacy and distribute free pharmaceuticals to people in need.

One night, as everyone was asleep, seven-year-old Marwan’s neighbor's house was bombed. Everything exploded. The house where the little boy lived with his family was plunged into chaos. There were screams of terror and pain as members of his family ran around aimlessly in the dark.

His uncle finally spotted the little boy. "I found Marwan and pulled him towards me, but his right leg was just hanging from him,” he says. “He was screaming and asking for his parents. They were all injured. We took them to the hospital where they were given first aid and referred to a bigger and better-equipped hospital in another province. The doctors said Marwan's leg needed to be amputated. He was crying so hard. After the surgery, he became sad and frustrated."

When he got out of the hospital, despite their injuries, his parents supported and encouraged him, but he became reserved and depressed. Seeing his condition worsened, his uncle gave him a pair of crutches. He refused to use them at first, but eventually hopped around on them as best he could. When Marwan’s doctor told him he could be fitted with a prosthesis, he felt hope that he might walk again.

Gaining strength through rehabilitation

Four months after the explosion, Marwan and his uncle traveled to the Sana’a rehabilitation center in Yemen, run by Humanity & Inclusion. Marwan was measured for a prosthesis and given better crutches to move around more easily while he waited. He also attended psychosocial support sessions and gradually learned how to play with other children and to share in their games again.

His prosthesis is ready, but he has to learn how to walk again. Marwan is now attending rehabilitation sessions. With his "new leg," he will be able to play his favorite game, soccer, again. His real self is beginning to shine through. He is full of energy and laughter and tells us he wants to be a doctor when he grows up: "A doctor who treats people's legs," he says, very seriously.

"My nephew can go back to school now and live like any other child," adds his uncle. "I want to thank the entire Humanity & Inclusion team for helping him cope with his disability."

Humanity & Inclusion and the Yemen crisis

Humanity & Inclusion (which operates under the name Handicap International in Yemen) operated in the country from the early 2000s up to 2012, focusing on physical rehabilitation. Since returning in 2014, our mission has grown. Today, we provide direct services to individuals affected by the ongoing conflict, particularly people with disabilities, through rehabilitation care and psychosocial support at eight public health facilities in and around Sana’a city. Learn more about our work and the Yemen crisis.

Support our work

Your gift today could help our rehabilitation teams provide vital physical therapy so that children with disabilities like Marwan can stand tall. 

Support our rehabilitation work. Make a tax-deductible gift today.

"I was riding my motorbike when the airstrike happened,” Abdulrahmam says as he remembers the day he was injured in north Yemen. “I was hit by a shard of debris in my right arm. My arm almost fall apart, I was bleeding a lot. I lost consciousness. A truck driver picked me up and took me to Abs hospital. Later on, I was transferred to Sana'a.”

Abdulrahmam Ali Salem is from Aldabrah, a small village in the Hajjah governorate in North Yemen. The 34-year old father of four works selling vegetables and as a moto-taxi driver.

The trauma of an amputation

Abdulrahmam had to undergo emergency surgery and eventually, his arm had to be amputated. After surgery, he met Humanity & Inclusion’s team. We helped him with post-operative care which included bandaging his wound and providing advice about hygiene and wound care. Abdulrahmam received personalized rehabilitation care to strengthen his left arm and gain maximum independence with one hand. He took part in gait training—a type of physical therapy that can help improve a person’s ability to stand and walk. He also received a treatment known as “mirror therapy.”

What is mirror therapy?

“Mirror therapy is the use of a mirror to create the illusion of the presence of an affected limb in order to trick the brain into thinking movement has occurred without pain,” Ahmed, a physical therapist with Humanity & Inclusion explains. “It involves placing the affected limb behind a mirror so that the reflection of the opposing limb appears in place of the hidden limb. It aims to reduce phantom limb pain.”

All the support needed

"At the beginning, I was very scared and I did not know how I could live with only one arm,” Abdulrahmam says. “Then I met with the Humanity & Inclusion team, who reassured me and showed me that many people live a normal life with only one hand. I also benefitted from psychosocial support sessions. All of this helped me to gain strength again."

Back to life

Abdulrahmam continues his steady path to recovery and now has hopes for the future. "I want to go back to my children,” he adds. “The day of my amputation, my wife gave birth. I hope to see my son very soon. I gave him the same name as me. I feel like God sent my son to replace the loss of my arm."

Humanity & Inclusion and the Yemen crisis

Humanity & Inclusion (which operates under the name Handicap International in Yemen) operated in the country from the early 2000s up to 2012, focusing on physical rehabilitation. Since returning in 2014, our mission has grown. Today, we provide direct services to individuals affected by the ongoing conflict, particularly people with disabilities, through rehabilitation care and psychosocial support at eight public health facilities in and around Sana’a city. Learn more about our work and the Yemen crisis.

Hala, 4, was playing in front of her home when she was hit by an explosion. Seriously wounded in the attack, she lost one of her legs. Hala, and her cousin Erada, are among the most recent victims of bombings that are devastating Yemen.

Hala and Erada has just received emergency surgery when Humanity & Inclusion’s team met them at a hospital in Sana’a. The family, completely devastated by the attack, was able to access medicine and food from other patients at the hospital for the two cousins who were both in a state of shock. Erada was constantly wondering about the absence of her cousin’s leg and of her own. Hala was sad, frustrated, and deeply traumatized. She cried all the time. 

Humanity & Inclusion’s team provided Hala with psychosocial support and physical therapy care. Our team gave her a walker and crutches to help her stand. Hala’s family members were informed about the nursing and hygienic care related to an amputation. HI staff also provided them with vital training so they could take care of Hala on a daily basis.

Hala’s mother immediately understood the importance of rehabilitation exercises for a quick return to mobility. "At first, Hala couldn't walk," she explains. "However, the Humanity & Inclusion team immediately provided her with crutches and patiently made her do her exercises. They needed a lot of patience. And now she is just learning how to walk with her new prosthesis! She exhausted everyone during the process but she finally got back on her feet. She made a lot of progress."

A Humanity & Inclusion staff member explains that when the team first met Hala, she was very sad. “She almost always cried,” they explain. “She was afraid of people and even of other children. We accompanied her, then gradually included her in activities for children. She started interacting with others and talking with them, exchanging toys. After many months, we fit her with a prosthesis and are now teaching her how to use it correctly. At first, Hala refused to walk with it because she was afraid. But since she loves balloons, we found that if we covered the floor in balloons, she loved walking through them!”

Things are not easy for the young Hala. When she comes to the Sana'a Rehabilitation Center, she is very shy with others. She has difficulties expressing her emotions and is still very much affected by this tragedy. For example, she sometimes stares at other children and the way they move and tries to touch their legs.

But, one year after this tragedy, Hala, with all her victories, is gradually smiling again. And that's what matters most to her mother. "I thank the members of the HI team,” she says. “I really appreciate what they have done and continue to do for us. They transformed my daughter's life and help her to overcome all the difficulties and accept her disability.”

Humanity & Inclusion and the Yemen crisis

Humanity & Inclusion (which operates under the name Handicap International in Yemen) operated in the country from the early 2000s up to 2012, focusing on physical rehabilitation. Since returning in 2014, our mission has grown. Today, we provide direct services to individuals affected by the ongoing conflict, particularly people with disabilities, through rehabilitation care and psychosocial support at eight public health facilities in and around Sana’a city. Learn more about our work and the Yemen crisis.

One morning, the same as every morning, Fatehia walked to school talking enthusiastically alongside her sister and friends. Hours later, a bomb struck their school, changing the life of this cheerful little girl and her friends. Terrified, Fatehia and her classmates ran out of their classrooms and into the courtyard. It was then that a second bomb hit the children in the schoolyard. Wafaa, Fatehia's friend died right next to her. Fatehia was seriously injured and fell unconscious. The school's vice-principal was also killed by the explosion.

After hearing about the air strike, Fatehia's father rushed to the school and found his daughter in a critical state. Fatehia lost her leg. He took her to the nearest hospital where doctors operated on the 8-year-old. After spending two weeks in the hospital, Fatehia reflects on her situation. “I was always thinking about my friend and sister, asking about them,” she says. “When I saw my sister again, I was so relieved! I felt better but I was still wondering about Wafaa, my best friend. Then my father told me that she was dead. I cried a lot. But my family was very supportive. They helped me a lot.

“Then I started to wonder if I could ever have a chance to walk again. I was brought crutches. I hated them because they made me ugly.” This new situation made Fatehia lose any desire to walk. Desperate and frustrated, she became isolated. She stopped moving and speaking.

Following this tragedy, the traumatized family left their home and settled in the city of Sana'a. Along with thousands of others Yemenis, Fatehia’s family are internally displaced individuals. They live a hard life, far from the old one.

Almost two years after the school bombing, Fatehia visited the Sana'a rehabilitation center, along with her father, uncle, sister, and brother. Fatehia and her family wondered if she would be able to walk again. Greeted by Humanity & Inclusion’s team, an HI physical therapist reassured them and explained the possibilities and progress of the treatment, which would allow Fatehia to be fitted with a prosthesis. At the same time, seeing that the family is still in a deep trauma, Humanity & Inclusion’s team offered them psychological support. Since then, Fatehia and her father visit regularly for psychosocial support sessions.

After only a few months of support from Humanity & Inclusion’s team, Fatehia has changed a lot. The uprooted and injured girl started to regain strength and confidence. Following individual and group psychosocial support sessions, she began to accept her disability. From that very moment, Fatehia, who had become mute, gradually began to talk, to share ideas, and make new friends.

Fatehia has a strong sense of humor and laughs about everything. She has become very ambitious. Indeed, since she finally can walk again, because nothing will stop her! Fatehia wants to become a dentist, but also an artist in her free time.

"I want to thank the Humanity & Inclusion team because they have made my life better with the disability. They have helped me to accept my disability, to overcome it, and to communicate with others again. They helped me to become strong again!”  

With her enthusiasm, energy, and drive, we know that Fatehia will go far in life!

Humanity & Inclusion and the Yemen crisis

Humanity & Inclusion (which operates under the name Handicap International in Yemen) operated in the country from the early 2000s up to 2012, focusing on physical rehabilitation. Since returning in 2014, our mission has grown. Today, we provide direct services to individuals affected by the ongoing conflict, particularly people with disabilities, through rehabilitation care and psychosocial support at eight public health facilities in and around Sana’a city. Learn more about our work and the Yemen crisis.

Humanity & Inclusion has been providing rehabilitation care and psychosocial support in eight health facilities in Sana'a, Yemen since 2015 and in one of Aden's main hospitals since last July. Maud Bellon, Humanity & Inclusion’s head of mission, explains the unacceptable situation civilians are facing on a daily basis. 

"Since Humanity & Inclusion launched a response in 2015, we have provided rehabilitation sessions to nearly 22,000 people," Maud explains. “We’ve distributed 23,600 mobility aids—including wheelchairs and crutches—along with special equipment. We have also fitted more than 200 people with prosthetics and orthotics.”

Since half of the country’s health facilities are no longer operational, all patients are transferred to medical facilities that have space for them. “There’s a constant flow of patients, from people injured in the conflict or car accidents, to older people and people with disabilities who need rehabilitation care. Many people need help because the country is in total chaos.”

Families cover long distances to be treated in Sana'a (North) or Aden (South), despite the risks facing travelers in Yemen, which include fighting, violence, crime and poor transport conditions due to blocked roads.

Response in southern Yemen

"We are now working in the country’s two main regions—in Sana’a, since 2015 and in Aden, since last July—with all the logistical and security challenges this entails.”

The United Nations considers Aden to be the most dangerous city in the Middle East. Armed groups and crime create serious security problems. Intense fighting last August increased the number of people arriving in the city's hospitals.

The conflict is becoming more and more complex and the number of parties to the conflict has increased.

Mental exhaustion 

Yemenis are exhausted by four years of war that has destroyed the country’s social and economic structure. Psychosocial support remains a challenge in a country where the idea of psychological distress is given little credence.

"Humanity & Inclusion’s team provided psychological support to more than 16,000 people, including direct beneficiaries of rehabilitation sessions and their caregivers. We are trying to go even further by training more than 400 health workers to treat people who have severe physical and psychological trauma.”

Contamination by explosive remnants of war

“We are planning to launch risk education campaigns very soon. We want to inform Yemenis of the dangers of mines and explosive remnants of war and how to handle them, in order to reduce accidents. Some regions are highly contaminated by explosive devices, including remnants of bombs, so there is an urgent need for action.”

Humanity & Inclusion and the Yemen crisis

Humanity & Inclusion (which operates under the name Handicap International in Yemen) operated in the country from the early 2000s up to 2012, focusing on physical rehabilitation. Since returning in 2014, our mission has grown. Today, we provide direct services to individuals affected by the ongoing conflict, particularly people with disabilities, through rehabilitation care and psychosocial support at eight public health facilities in and around Sana’a city. Learn more about our work and the Yemen crisis.

Many thanks to ECHO and the German Federal Foreign Office for supporting this vital work.