Background Yemen has been left in shambles and almost destroyed by its devastating civil war, and is now having to deal with the spread of coronavirus. The Yemeni people have been are left to fend for themselves and faced many problems such as hunger, the ongoing war, infections, diseases and lack of equipment even before the COVID-19 pandemic. All together it is a humanitarian crisis. Only around 50% of the hospitals and healthcare facilities are in full working condition, and even those that are functioning are operating at nowhere near full potential. Healthcare staff and facilities lack necessary essential equipment and money. Conclusion As, sadly, is common in conflict-affected regions, the violence has brought with it a secondary disaster of infectious disease outbreaks. Yemen is not only battling COVID-19 amid a catastrophic war, but also has to deal with other diseases such as cholera, diphtheria and measles. A number of key measures are needed to support the current efforts against this deadly epidemic and its potential subsequent waves as well as to prevent further epidemics in Yemen.

Introduction: Much of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic. Methods: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper. Results: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time. Conclusion: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19.

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There is an emerging impetus to improve emergency medicine (EM) in Yemen, beginning with the ongoing expansion of emergency medicine residency training, to the establishment of a professional association of emergency medicine and disaster preparedness and management named the Yemeni Association of Emergency Medicine and Disasters (YAEMD). However, over the past few decades, Yemen faced many difficulties that created further challenges in the development of an effective emergency medical care. This article explores the multiple factors that have led to the current crisis in which, the already depleted Yemeni medical sector is battling the COVID-19 pandemic, on top of many other existing challenges. The paper examines the distinctive challenges that faces Yemen’s emergency departments, including epidemic diseases such cholera, diphtheria, dengue, and measles; the geopolitical impact of the ongoing civil war; and the daily threats of violence and homicide against emergency healthcare workers. Potential solutions are explored, including national and international efforts to properly allocate government funds and to implement universal health insurance plans. Further research is needed to investigate possible solutions for evaluating effective change in emergency medical services in Yemen.

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