HODEIDA, YEMEN — What is taking place at the southern tip of the Arabian peninsula is unprecedented: the U.S.-backed, Saudi-led coalition has caused a humanitarian crisis on all fronts, unlike anything else seen in the world today.

Beyond the deadly daily airstrikes, a third wave of cholera is sneaking into the hungry intestines of thousands of already starving Yemenis after the Saudi-led coalition systematically carried out a bombing campaign on the country’s water and sewage-treatment infrastructure, continues to prevent access to medicine through a crippling blockade, and is pushing the economy to total collapse.

By the time my team and I arrived, accompanied by a doctor with much-needed medicine in tow, at a cholera camp in Hodeida, Yemen’s Zabeid District, 13-year-old Ahmed Atta had already died following a day of vomiting and diarrhea. His family told us that he was one of seven who had died within the last 12 hours due to the cholera epidemic ravaging the district.

Over 1.1 million cholera cases have been reported across Yemen from April 27, 2017, to September 2, 2018. Hodeida, in western Yemen, has reportedly seen 175,075 cases, the highest of Yemen`s governorates, according to a statement from Yemen`s Health Ministry.

Over a million children were infected by cholera last year due to a lack of access to water and vaccinations. UNICEF’s Geert Cappelaere reported that one child dies every 10 minutes in Yemen from preventable diseases.

Dr. Peter Salama, World Health Organization (WHO) deputy director-general of emergency preparedness and response, said, during a UN briefing in Geneva:

We’ve had two major waves of cholera epidemics in recent years, and unfortunately the trend data that we’ve seen in the last days to weeks suggests that we may be on the cusp of the third major wave of cholera epidemics in Yemen.”

“In the past two months, the number of suspected cholera cases has increased,” UN spokesman Stephane Dujarric confirmed on August 22, adding that since April 2017, more than 1.1 million suspected cholera cases and 2,310 deaths from the disease have been reported in Yemen.

A man is treated for suspected cholera infection at a hospital in Sanaa, Yemen, July 1, 2017. Hani Mohammed | AP

Conditions create a perfect storm for cholera’s spread

Poor sanitary conditions in Yemen mean that it could be difficult to keep the number of cholera cases under control. Water chlorination is not a viable solution, summer heat is relentless, rubbish lines the streets, and the country’s healthcare system is woefully overburdened.

Moreover, more than three years of near-constant airstrikes by Saudi Arabia and the United Arab Emirates have left Yemen’s roads impassable, reduced its hospitals and clinics to rubble, and short-circuited its electricity service — while a ruinous blockade of Yemen’s ports has depleted the country’s supplies of life-saving medicine. The hospitals that have not been reduced to rubble are barely functioning; doctors have not been paid, and power cuts are frequent.

Back in Hodeida’s cholera camp, dozens of patients lie motionless on the earthen floor, and a mother watches helplessly as her child takes his last breath. Twenty-five years old and six-months pregnant, Lama Esmaiel vomits into a pan and shouts, “give me clean water … I need more.”

Hodeida’s residents — who are currently enduring a severe heat wave, have temporarily lost access to clean water. “The heat wave and rubbish have contributed to the spread of cholera in Zabeid, but the main cause is polluted water,” one doctor told MintPress.

On July 31, the wells that fed Hodeida’s water system and sewage treatment plant in the district were destroyed by Saudi airstrikes. The shortage of potable water that resulted has forced residents to drink water polluted with feces and urine, resulting in the latest cholera outbreak.

The U.S. backed, Saudi-led coalition has repeatedly, systematically and deliberately attacked water and sewage treatment infrastructure in Yemen since it began its military campaign against the country in 2015. According to the Legal Center For Rights and Development, an organization that tracks Saudi Arabia’s violations of international law in Yemen, 727 water pumps and tanks have been destroyed since 2015.

A desalination plant on Yemen’s Kamran Island lay in ruin following a Saudi coalition airstrike in July, 2017. Photo | YemenExtra

The most recent attack came on August 31, when the coalition destroyed a water treatment facility on Kamran Island, 6 km off the port of Alsalif in Hodeida. Jolien Veldwijk, CARE’s assistant country director in Yemen, told CNN:

Water and sanitation infrastructure has also been badly damaged and cholera in Hodeida is now spreading. Cholera cases in Hodeidah governorate recently rose by almost a third.”

Water treatment facilities funded by international organizations have not been immune to Saudi-coalition attack either. The UNICEF-funded al Asayed Water Network in Sadaa was destroyed by four Saudi airstrikes on July 25, leaving thousands of residents, including internally displaced families, without clean drinking water.

The coalition often claims that the destruction of water facilities is not intentional, but the organizations overseeing the facilities provide coalition forces with maps showing the locations of the facilities and indicating their responsibility for running them. The precautions, an effort to protect Yemen’s vital water treatment facilities from airstrikes, have not prevented continuous attacks by the coalition.

War takes financial and human toll

At the cholera camp in Zabeid, a doctor tells Lama`s husband that she should be moved to the Hodeida Hospital, as her health continues to deteriorate. But despite his efforts to collect enough money for the trip, her husband doesn’t have enough to pay for a rental car, let alone the cost of staying in Hodeida for days, as prices continue to increase exponentially thanks to Saudi Arabia’s economic war, which has triggered a currency collapse in the country.

The Yemeni Rial (YR) has lost more than half of its value relative to the U.S. dollar since the war began. As Lama’s husband laments:

I’d have to pay $300 just to stay a day in Hodeida, not including the of cost of [Lama’s] medicine; before the war it would have only cost $100.

Children carry buckets to fill with water from a well that alleged to be contaminated water with cholera, on the outskirts of Sanaa, Yemen. Hani Mohammed | AP

Compounding Lama’s crisis is the fact that her family, including her husband and brothers, have no money to spare, as many are employed by the government and Yemen’s civil servants haven’t been paid in months, leaving Lama no means to make the trip to the Hodeida Hospital to save herself and her child.

Even before the war, Yemen was the poorest country in the Middle East, and the war has compounded that poverty. Thousands of doctors and nurses have gone months without a paycheck and over 22.2 million of the country’s nearly 27 million people are now in dire need of food, medicine, water and shelter. Of that number, 11.3 million — mostly women, children and the elderly — are at risk of dying as a result of the war, according to international relief agencies.

Following the plunge of the Yemeni Riyal (YR) and the accompanying increase in prices for medicine and food, many Yemenis resorted to selling their belongings, borrowing and begging in order to save loved-ones from cholera. But as the war drags on and resources and options dwindle, most Yemenis now face three grim prospects: to die by U.S.-Saudi airstrikes, to die of hunger, or to die of disease.

“Even if  I had the money, I couldn’t leave the city — the Saudi-led coalition target everything that moves,” Lama`s husband told MintPress.  To reach the Hodeida Hospital, over 100 kilometers away, some have resorted to traveling the deadly route where Saudi-coalition airstrikes are commonplace. Many have been killed attempting to undertake the treacherous journey between Zabeid and Hodeida.

Ultimately Lama and her husband decide to pursue treatment in Zabeid’s cholera camp, as the cost and dangers involved in the journey to Hodeida leave them little choice.  Doctors say Lama`s condition will likely not improve; and if it does, she’ll likely fall victim to another of Yemen’s epidemics: famine.

Top Photo | Sawda Mohammed Khalil holds her malnourished daughter as they wait for treatment at the al-Khoukha Hospital in Yemen. Doctors estimate 40 percent of the children in the town suffer from malnutrition. Barefoot children fill the center’s corridors, many visibly emaciated, some with malaria or cholera. Some can barely stand. Nariman El-Mofty | AP

Ahmed AbdulKareem is a Yemeni journalist. He covers the war in Yemen for MintPress News as well as local Yemeni media.