Against the backdrop of Yemen’s long-running civil conflict and deepening humanitarian crisis, WHO is working with the Ministry of Health and EU Humanitarian Aid to sustain and strengthen the country’s only life-saving pre-hospital trauma and emergency care services, in the metropolitan area of Aden governorate.
For the fifth consecutive year, Yemen is recording the highest country caseload of conflict-related trauma in the Eastern Mediterranean Region. Injuries account for 60% of deaths among children ages 5–14, as well as 36% of deaths among persons from 15 to 64 years of age. Yet the country has no formalized prehospital services, apart from those being Supported by EU Humanitarian Aid and provide by WHO in partnership with the Ministry of Public health and population in Aden governorate. WHO, with EU Humanitarian Aid support, are working closely with the MoPHP to sustain and strengthen these life-saving pre-hospital referral system with 11 ambulances, 33 trained paramedics and drivers, 14 operating staff, and a dedicated 24/7 dispatch center on the 195-telephone number. This partnership is also keeping services running by providing operational support with fuel, medical equipment, capacity-building to improve quality of health care.
“The training courses we have received from WHO have been the key to building our experience in the field of emergency care,” Mr. Salem said. “The challenges we face are mostly operational – sometimes involving security checkpoints that can slow our movement, in addition to some coordination issues between health facilities. So, the continuation of this capacity building improves our abilities to provide quality prehospital care to patients.”
Mr. Salem credits the training he has received from WHO with substantially improving his knowledge and skills as a pre-hospital first responder.
WHO in partnership with the MoPHP in Aden has also established a prehospital care technical working group to improve the referral system. In September 2022, a total of 343 emergency calls were received through the 195 call number at referral system dispatch center in Aden, which dispatched 343 ambulances that in turn treated and transferred 318 patients to a referral hospital or health facility.
Between 1 April and end-October 2022, a total of 1,449 cases were treated and/or transferred for further treatment. Of the total calls handled during this seven-month period, 7.8% were from pediatric patients and 26.09% from elderly patients. Trauma and Medical emergency cases comprised 36.4% and Obstetric patients1.8% were. The transfer between centers comprised 59.1% of the cases. Within this percentage, 50.9% were trauma and medical emergencies. This is mainly due to the fact that the population still does not have the habit or the proper information to access the service provided and they move to the close health facility by their own, requiring increased community information campaign.
Between 1 April and end-October 2022, a total of 1,449 cases were treated and transferred for further treatment.
“I dreamed about being in the medical field since I was a child. After I completed middle school, I joined the health institute. The field I am in now provides a valuable service to people in need, so I love and enjoy my work very much,” said Ms. Mohammed, adding that she faces frequent challenges in transporting and caring for patients from their initial locations to health facilities.
“Many patients have suffered traumatic injuries resulting in severe bleeding, bone fractures, and comas,” she said. “The challenges we face include street traffic, unpaved roads, and security checkpoints that require us to open the ambulance door while the patient is in critical condition, before we are allowed to pass. The trainings I have received have exposed me to valuable information and corrected some misconceptions that I had before.”
WHO’s partnerships with EU Humanitarian Aid and health authorities is also helping to keep primary health care services operating and accessible in conflict-affected areas of Yemen. These services span reproductive, maternal, and child health, as well as non-communicable diseases, mental health and psychosocial support (MHPSS), and WASH services that are part of a health delivery mechanism referenced as the Minimum Service Package (MSP).
Going forward, WHO plans to continue capacity-building of first responders in Aden governorate, while strengthening coordination with security, civil defence, and other authorities to improve response times, especially during mass casualty events, and ensure that progress made to date can be sustained well into the future.
Story: Hanan Ishaq, Kevin Cook
Photos: Camera/ WHO