Témoignages

Libya conflict lingers leaving nearly 2 million in need of health care

2016-01-27T20:00:00Z

As Libya's yearlong peace talks aimed at establishing a unity government stall again, the lives of millions of people needing urgent health care linger in the balance. WHO and health partners require a total of US$ 50 million in 2016 to meet the urgent life-saving needs of nearly 2 million people.

Speaking at a special briefing on Libya in Geneva, Dr Syed Jaffar Hussain, WHO Representative for Libya, urged, “We cannot wait for a political solution in order to respond, we need to act now. We need both financial resources and the international humanitarian community to step up efforts to help save the lives of children, mothers and the elderly who are most at risk. This is not about politics, it is about health needs.”

Since the escalation of the conflict in July 2014, violence and instability have spread to almost every part of the country, with more than 3 million people – nearly half of the total population – affected. Almost 2 and a half million people are in need of urgent humanitarian assistance, of which 1.9 million people have serious, unmet health needs.

“The health situation in Libya is rapidly deteriorating, with extensive displacement, damage and closure of health facilities in conflict areas. Repeated rounds of violence have not allowed for a proper recovery of the health system, which even prior to the crisis was struggling to meet the basic needs of the Libyan population,” said H.E. Dr Reida Oakely, Libya's Minister of Health.

Haemorrhaging health workforce

Even bleaker, as the security situation deteriorates due to fighting, health personnel have fled the country. More than 80% of all nursing staff were evacuated in 2014. Attacks on health care workers also continue, with 5 health workers killed and more than 20 health facilities damaged in the past 18 months alone. Consequently, several aid and UN agencies have reduced staffing levels and moved international staff to neighbouring Tunisia in 2014.

Shortage of medical supplies

In addition to staff shortages, hospitals, laboratories, blood banks and other health facilities are increasingly unable to remain functional as they face shortages in medicines and other health supplies. Most of the medical warehouses in the east of the country have been destroyed or are partially functioning, including the main warehouse in Benghazi, which was destroyed at a time when it was at its peak accumulation of stocks.

Providing impartial health care

WHO is committed to providing health care to all people irrespective of their religion, political affiliation or nationality. This is our moral obligation. “We are calling on all parties to guarantee unrestricted, long term delivery of humanitarian aid and unconditional movement of health workers,” affirmed Dr Hussain.

For 2016, WHO and health partners require US$ 50 million to respond to the needs of 1.2 million people in Libya. This funding will be used to strengthen the health system in 4 key areas.

Improving access to basic life-saving primary and emergency secondary health care services through the provision of essential medicine, medical materials and technical support.
Reducing communicable disease transmission and outbreak through detection and mitigation measures.
Strengthening the existing health structure to avoid the collapse of the health system through capacity-building measures, referral system strengthening, infrastructure rehabilitation and the strengthening of data collection and information-sharing mechanism.
Providing temporary assistance via mobile and medical outreach services.
Since November 2015, WHO has been able to reach almost 250 000 people through the provision of medicines, mobile clinics, health teams, provision of fuel and safe water. However, many more people need urgent aid, and much more needs to be done by WHO and partners to reach them. “We need to be able to reach all affected people to identify health needs, assess nutritional status, and ensure health services are available. If access for the provision of aid is not made immediately available, millions of people are at risk of facing a humanitarian and health disaster,“ added Dr Hussain.

Part of the family : Sicilians take in migrant children

2016-01-12T20:30:00Z

A network of volunteers in Sicily, one of the frontlines of Europe's migration crisis, has come up with a hands-on approach to help the record number of teenage migrants and refugees who have been arriving on the island without an adult guardian.

Lamin with Carla Frenguelli on the day he finally received his Italian ID document.
Photo : AccoglieRete

In 2015, more than 11,000 so-called unaccompanied minors crossed the Central Mediterranean, according to Save the Children. Most were rescued by the Italian coastguard and brought to Italian ports, usually in Sicily.

The usual approach had been for local authorities to designate them a guardian, often a social worker or the mayor of the town in which they disembark, and accommodate them in a reception centre.

“They were all barefoot and full of scabies,” immigration lawyer Carla Trommino from Syracuse told IRIN, recalling her 2013 visit to one such centre, where 16 Egyptian and 17 Somali boys shared the same living space as adult refugees.

Although Sicily now has a number of special reception centres for minors, many are severely underfunded and in a poor condition. Staff at one such centre in Catania – the Instituto de Assistenza ai Minori Stranieri Regina Elena – went on strike in November because their salaries had not been paid. Money is also lacking to repair broken doors and windows, let alone fund projects to help the children integrate into Italian society.

After seeing the need for an alternative, Trommino and a group of local lawyers went on to establish AccoglieRete – an NGO consisting of a network of 120 volunteers who can act as temporary legal guardians, and in some cases foster parents. Since 2013, they have assisted 600 unaccompanied children, aged between 11 and 17, mostly from Syria, Egypt, the Gambia, Somalia, Senegal, Eritrea and Mali.

The children, most of them teenage boys, receive help from their Italian guardians with applying for ID documents, registering for language classes, and even getting involved in social and sports activities.

The volunteers come from a range of backgrounds. The only prerequisites are that they live in Syracuse or the surrounding region, have no criminal record, and are willing to undertake the protection courses and children's rights training provided.

Carla Frenguelli has fostered 15 children from countries including Somalia, Egypt, and the Gambia since 2013. They were all welcomed into her home in Syracuse, where they shared Sunday lunches, watched soccer matches, and practised speaking Italian with her husband and two daughters.

Frenguelli has seen how a child's relief at having reached safety in Italy is often closely followed by disillusionment.

“Most of them are coming from Libya, where some were imprisoned and tortured,” she told IRIN. “They think life here will be easy, but when they see that finding jobs and getting documents is hard, they're disappointed. After an exhausting journey and having faced death at sea, they have to learn a new language, find employment and be accepted by people.”

An example to follow

Trommino believes refugee and migrant children are more likely to adapt and integrate into life in Italy with the support of a personally involved legal guardian. She would like to see AccoglieRete's model replicated in other parts of Italy.

The immigration lawyer has herself become the guardian of more than 20 children in the last two years, including a 16-year-old Gambian boy called Khalifa, who now lives with her family.

“Of all my work for years as a lawyer working with migrants, definitely this experience of sharing a home with Khalifa has been the richest. I have been learning a lot about cultural differences and about myself,” she said.

Another “son” from Bangladesh learned Italian, earned a degree, opened his own business, and today is supporting his family back home.

One of the most important roles played by the foster parents is helping the children in their care to obtain a national identification document that legalises their presence in Italy and ensures their access to public services such as healthcare and education.

Without this essential document, the children are at risk of becoming targets for exploitation and people traffickers, said Frenguelli. She and AccoglieRete's other volunteer guardians pay the necessary fees and navigate the bureaucratic process of applying for the document, which can take up to a year.

“A migrant's life is about documents,” said Lamin, a 17-year-old from Gambia, who was fostered by Frenguelli. “I trust Carla like a mum because she helped me a lot getting my ID. She always encourages me. Without her, my life would be so much harder here in Sicily.”

Before coming to Italy, Lamin spent four harrowing months in prison in Libya for being an undocumented migrant. He was only freed when one of the prison guards noticed how young he was.

“People from many places in Africa go to Libya to work, but what you find there is very different from what you heard before,” he said.

Passionate about soccer, Lamin wants to become a professional player. In the meantime, he is studying Italian and sending most of his 60-euro-a-month allowance from the Italian government back home to his father.

“I didn't know I was coming to Italy when I took a boat to Europe. But now I want to have a better life here. I'm happy – I have documents, I go to school and I play,” he told IRIN before rushing off to join the soccer team Frenguelli helped him find, for their Friday night match.

Government support to unaccompanied minors is cut when they turn 18, but AccoglieRete's legal guardians continue to help the youths who have been in their care by helping them further their education and search for jobs and a place to live.

“We never abandon our children because they become part of our family,” explained Trommino.

WHO calls for immediate access to Taiz City for delivery of life-saving health supplies

2016-01-07T22:13:00Z

The World Health Organization is concerned about the deteriorating health situation in Taiz, where more than 250 000 people have been living in a state of virtual siege since November 2015. All of city's 6 hospitals have been forced to partially close some services, and are overwhelmed with injured patients. Humanitarian organizations are struggling to deliver medical and surgical supplies due to the insecurity.

Photo : Almigdad Mojalli/IRIN

5 WHO trucks carrying medicines and medical supplies have been prevented from entering the city since 14 December 2015. The trucks contain trauma medicines, medicines for the treatment of diarrhoea, and other health supplies that urgently need to be delivered to Al-Thawra, Al-Jumhoori, Al-Rawdhaand Al-Mudhaffar Hospitals. 3 of the trucks are carrying 500 cylinders of oxygen that are critically needed by the hospitals.

WHO calls on all parties involved in the conflict to allow the secure movement and delivery of medical and humanitarian aid to all people, regardless of their location. In times of crisis, it is vital that health facilities remain functional and provide people in need with uninterrupted access to life-saving medical care.

Cholera vaccine supply set to double, easing global shortage

2016-01-07T22:11:00Z

The global supply of oral cholera vaccines is set to double after WHO approved a third producer, helping to address global shortages and expand access in more countries.

Globally, OCV production is low, with demands currently exceeding supply. Sudan and Haiti last year made requests to WHO for supplies of vaccines to conduct pre-emptive vaccination campaigns that could not be filled because of the global shortage.

The vaccine producer, a South Korean company, is the latest oral cholera vaccine (OCV) manufacturer to be approved under the WHO's pre-qualification programme, which ensures that drugs and vaccines bought by countries and international procurement agencies such as the United Nations Children's Fund (UNICEF) meet acceptable standards of quality, safety and efficacy.

The addition of an additional pre-qualified vaccine producer is expected to double global supply to 6 million doses for 2016, with the potential for further increased production in the future. This additional capacity will contribute to reversing a vicious cycle of low demand, low production, high price and inequitable distribution, to a virtuous cycle of increased demand, increased production, reduced price and greater equity of access.

Cholera is an acute diarrhoeal disease that can kill within hours if left untreated. There are between 1.4 million and 4.3 million cases a year, and as many as 142 000 deaths. Cholera is endemic in more than 50 countries, but usually only garners international attention during humanitarian emergencies, such as the outbreak among refugees in Goma, Democratic Republic of the Congo, in 1994 that killed tens of thousands. Climate change and El Niño may also be contributing to more frequent cholera outbreaks.

Oral cholera vaccines have been used in mass vaccination campaigns in response to humanitarian emergencies since 1997. But because the disease disproportionately affects poor communities who are often unaware that the vaccines exist, there has historically been little demand for the products.

In 2013 the WHO created the world's first OCV stockpile, undertaking to buy and use 2 million doses a year in order to stabilize and create demand for the vaccines.

Vaccination requires 2 doses per person, meaning the stockpile is sufficient to cover 1 million people.

Access to OCV has been further improved by a commitment of US$115 million over 5 years from Gavi, the Vaccine Alliance, to expand availability and the use of vaccine in countries with endemic cholera. Since the OCV stockpile was created more vaccines have been distributed and used than in the previous 15 years. A total of 21 OCV deployments of about 4 million doses to 11 countries have been used in various contexts : humanitarian crises in Cameroon, Haiti, Iraq, Nepal, South Sudan, and Tanzania ; outbreaks in Guinea and Malawi ; and in endemic hotspots such as Bangladesh and the DRC.

The creation of the stockpile and pre-qualification of a new vaccine producer highlights the success of an international joint effort through public-private partnership, including governments, non-profit organizations, manufacturers, donors and research organizations. Accompanying the use of stockpile vaccine, many donors and partners have worked together within the framework of the Global Task Force on Cholera Control (GTFCC) to demonstrate the public health potential of this vaccine when used in mass vaccination campaigns. The evidence is contributing to a body of work which will inform larger investments on the further production and use of this vaccine.

Over 3,770 Migrants Died Trying to Cross the Mediterranean to Europe in 2015

2015-12-30T20:30:00Z

With over 3,770 estimated deaths, 2015 has been the deadliest year on record for migrants and refugees crossing the Mediterranean, trying to reach Europe. In comparison, approximately 3,270 deaths were recorded in the Mediterranean in 2014. Globally, IOM estimates that over 5,350 migrants died in 2015.

Photo Alfredo D'Amato/UNHCR

The deadliest month in 2015 was April when nearly 1,250 migrants died, mainly due to the worst tragedy on record involving migrants crossing the Mediterranean from North Africa, in which an estimated 800 migrants died when their overcrowded vessel capsized off the coast of Libya. Only 28 survivors were rescued and brought to Italy.

Seventy-seven percent (77%) of the deaths occurred in the Central Mediterranean route mostly used by smugglers operating from Libyan shores. This compares to 97% of migrant deaths recorded along this route in 2014.

In 2015, 21% of deaths occurred in the Eastern Mediterranean compared to only 1% in 2014. In the Central Mediterranean, deaths recorded were down by 9% from last year with the rate of death at 18.5 deaths per every 1,000 travelers.

Estimated migrant and refugee deaths in 2015 along the Mediterranean routes

Migration Route	Deaths
Central Mediterranean	2,892
Eastern Mediterranean	805
Western Mediterranean	74
Total	3,771
An additional estimated 32 migrants died en-route to the Canary Islands

Globally, the majority of the estimated 5,350 deaths were recorded with the Mediterranean, the most deadly region, followed by Southeast Asia (mostly in the Bay of Bengal, Andaman Sea, Malaysia and Thailand) which saw at least 800 deaths this year. Within Mexico and along the US-Mexico border there have been at least 330 deaths recorded this year.

Reacting to the 2015 figures, IOM Director General William Lacy Swing, said: “It is shocking and inexcusable that desperate migrants and refugees have lost their lives in record numbers this year, when they should not. The international community world must act now to stop this trend against desperate migrants.”

“Migration has been the major theme of 2015, with record numbers of refugees and migrants arriving in Europe, fleeing from conflict and acute poverty. Throughout the year, we have been reminded that much of human mobility is not voluntary and tragically we have seen so many who felt they had no option but to leave their beloved homelands and were lost at sea, in the deserts or trapped in the back of lorries they had hoped would carry them to a safer and better life,” said Ambassador Swing.

'One of the major challenges for the coming years would be for the international community to work diligently towards changing from the current toxic migration narrative to one that is more historically accurate, namely, that migration has been overwhelmingly positive. We can do this through measures that will help governments and societies to manage diversity. This will require addressing several paradoxes of (a) national sovereignty of states and individual aspiration of migrants; and, (b) protecting national security on the one hand and human security on the other,' Ambassador Swing said.

IOM's Missing Migrants Project which draws on a range of sources to track deaths of migrants along migratory routes across the globe is managed by IOM's Global Migration Data Analysis Centre (GMDAC) in Berlin, Germany. Data from this project was initially published in the report Fatal Journeys: Tracking Lives Lost during Migration, which provided the most comprehensive global tally of migrant fatalities for 2014, and estimates deaths over the past 15 years. Since the publication of Fatal Journeys, IOM has regularly updated the global estimated figures of migrants who have gone missing or have died during the migration process.

WHO : Urgent support needed to provide health services for 15 million people in Yemen

2015-12-14T20:00:00Z

GENEVA, 15 December 2015 – The World Health Organization and health partners are appealing for US$ 31 million to ensure the continuity of health services for nearly 15 million people in Yemen affected by the ongoing conflict. Funding is urgently needed as the Yemeni health system has collapsed, leaving millions of vulnerable people without the care and medications they urgently need.

“WHO is appealing to donors to help us meet the urgent, immediate humanitarian needs of the injured, pregnant women, malnourished children and elderly who are bearing the brunt of a collapsing health system,” says Dr Ala Alwan, WHO Regional Director for the WHO Eastern Mediterranean. “We should not allow this to continue. With sufficient funds, we can reduce the risk of disease outbreaks, provide life-saving medications and vaccinate children to reduce avoidable deaths.”

Currently, WHO and health partners are providing essential medicines, supporting health services and providing mental health psychosocial support in hard-to-reach areas through mobile clinics and primary health care centres. However, more funding is required to ensure that disrupted services are restored. “The funding requested will help WHO and our partners support vital health services in 3 major areas : casualty management for those injured due to the conflict, treatment for patients with chronic diseases, and disease surveillance and vaccination activities to prevent outbreaks,” says Dr Ahmed Shadoul, WHO Representative to Yemen.

The health and humanitarian situation for the civilian population in Yemen has reached catastrophic levels. The situation in some governorates is especially critical : 100 % of the population of the Aden governorate and more than three quarters in the Taiz governorate are in need of humanitarian assistance. Since September, fighting has intensified in Taiz, and almost 240 000 vulnerable civilians are living under a virtual state of siege. In other parts of the country, the conflict has crippled the health system, making the delivery of health services and supplies extremely challenging. Almost 70 health facilities and 27 ambulances have been damaged, and there is a shortage of health workers, limiting access to health care.

Compounding the situation, fuel shortages have made it impossible for many major hospitals and health facilities to function optimally, while lack of fuel for ambulances has crippled the referral process. Surgical operations, including caesarian sections, have been disrupted. Patients whose treatment requires constant power supply are also at risk. Fuel shortages are also are creating severe challenges for the transportation of food, water, and medical supplies, and the operation of water pumps and generators. In response to this, WHO has supplied over one million litres of fuel to health facilities and ambulances to keep them functional. Support has also been provided for the delivery of water purification tablets and over 19 million litres of water to camps and areas hosting internally displaced persons.

Over the past 9 months, WHO has distributed over 250 tonnes of life-saving medical supplies to Yemeni health authorities and international, and local nongovernmental organizations, serving more than 7 million beneficiaries. Together with health partners, WHO has vaccinated 4.6 million children against polio and 1.8 million against measles in high-risk areas.

“WHO and health partners call on all donors to urgently fill this funding gap and ensure continuity of life-saving and essential health services,” says Dr Shadoul.

Raqqa civilians on the line

2015-11-17T00:59:00Z

The northeast Syrian city of Raqqa is a crucial power centre for the so-called Islamic State, important enough that many call it the group's “capital” and France chose to bomb it repeatedly as its rejoinder to this weekend's Paris attacks.

Speaking Monday, the day after French warplanes struck the city, President François Hollande promised to step up the military campaign against IS and “destroy” the group.

No civilians were reported killed in the overnight strikes but plenty remain in the area. How are they getting by? Precious little information makes it out of IS territory, but this is what we could establish:

Civilian population

Before Syria's war began in 2011, Raqqa's population was estimated at 220,000. When IS consolidated its control over the provincial capital in early 2014, many people fled the country or joined the 6.5 million Syrians who have been internally displaced by violence.

Some of the local population was replaced by an influx of IS loyalists, fighters, and their families, meaning experts can't pin down exactly how many people live there today.

The takeover of the city by IS doesn't mean all the city's current residents are behind the group, explained Columb Strack, senior Middle East analyst at the think tank IHS.

Instead, many of those left behind in Raqqa have learned to deal with the strict rules and keep their heads down. “They are making the best out of the situation,” Strack told IRIN. “They don't want to leave their homes and are just making do.”

This means enduring almost daily executions, lashings, and public displays of prisoners, he said. “But within that, to a certain extent, life goes on.”

One group of anonymous activists with a visible presence on social media, “Raqqa is Being Slaughtered Silently,” is particularly outspoken about its opposition to both IS and the regime of President Bashar al-Assad.

Separation

Raqqa has been hit plenty of times by the international coalition fighting IS, of which France has suddenly become a much more visible member. Militaries in the coalition boast of precise strikes that avoid civilian casualties, but this narrative has been questioned.

Another reason for the apparent lack of civilian casualties in Sunday night's raid may be the lack of trust between IS and the locals it rules over, said Ghadi Sary, Academy Asfari fellow at Chatham House's Middle East and North Africa Programme.

France said it targeted an IS command post, a recruitment centre, an arms depot and a training camp in its Sunday night air raid.

“Those places were known to be government headquarters before IS took over… most of them are places that civilians would avoid because IS is there, and [IS] would not want civilians to be roaming around,” said Sary.

In addition, Raqqa is regularly hit in retaliation for IS actions internationally, said Sary. “You have to wonder whether they [IS] were expecting this.”

He added that some IS installations are outside the city centre in the countryside, again helping to reduce civilian casualties.

The relative lack of non-combatant deaths from coalition strikes may not last, however. Strack posited that the French government's need to show its public a strong response could see a shift in targeting policy.

“Previously they would only conduct strikes based on extremely good intelligence when they knew they could minimise civilian casualties,” he said. “The threshold could be reduced, which would then increase deaths in built-up areas like Raqqa.”

Economic problems

In addition to the human rights abuses known to be rampant inside the territories that IS controls, Strack said daily life for civilians in Raqqa is becoming harder.

“IS has taken a hit to their income because of the constant [coalition] airstrikes,” he said. Strack listed increased conscription to IS, raised taxes, and a cut in fighters' salaries as issues the local population is facing.

In addition, UN agencies and international aid organisations are barely able to provide any assistance to the local population.

However, a UN source told IRIN that there had been no major displacement as a result of the recent bombings.

Strack expressed concern that even if they weren't hit directly by warplanes on Sunday night, civilians in Raqqa could pay the price in the coming days in other ways, potentially being executed as suspected Western informants or being used as human shields.

While the clamour grows in Western capitals for greater military action, others are urging world leaders to avoid knee-jerk reactions that might play into the hands of the extremists.

“ISIS wants to be bombed by France,” Hania Mourtada from the UK-based advocacy group the Syria Campaign told IRIN by email. “Every inevitable civilian death drives more people into the hands of the extremists.

“What would really frustrate ISIS would be redoubled efforts to bring peace to Syria, by accelerating a transition from the much greater killer of civilians: Bashar al-Assad.”

Stop the violence. Protect health care

2015-11-03T20:00:00Z

In the last few months, a number of attacks against health-care workers, medical transports and facilities have taken place in several countries, like Afghanistan, Syria and Yemen to mention a few. These incidents are taking place in countries with fragile health-care systems that are already struggling to treat the numbers of people affected by the ongoing conflicts there. In some cases, the situation is made yet worse by the restrictions placed on aid workers, preventing them from getting to the people who need them.
Both the attacks themselves and their consequences are of serious concern. These were attacks on medical personnel and facilities protected under international humanitarian law, leaving death and destruction in their wake and disrupting vital health-care services. All those involved with the Health Care in Danger initiative are alarmed by the long-term impact these attacks may have on people's health.
These are not isolated incidents. The International Committee of the Red Cross, through the Health Care in Danger project, has been gathering data in 11 countries since January 2012. By December 2014, 2,398 attacks against health-care personnel, facilities and vehicles had been recorded. This alarming situation highlights the urgent need for measures to prevent future violence.
The Health Care in Danger initiative, with the support of experts and professionals from different backgrounds, including from governments, the armed forces, humanitarian agencies, international professional associations and health-care services, as well as the International Red Cross and Red Crescent Movement, has formulated a substantive body of recommendations and identified practical measures that, if implemented by all those concerned, would increase the protection of health-care services in armed conflict or other emergencies.
As members and partners of the Health Care in Danger initiative, we call on States, weapon bearers, international and national humanitarian agencies and health organizations to give urgent attention to the recommendations resulting from the Health Care in Danger initiative.

In particular, we urge States :
to make every effort to investigate and condemn attacks against health-care personnel, facilities and medical transports that violate international law, including international humanitarian law ;

to revise their domestic legislation and its implementation to ensure that it is in line with their obligations under international law, including international humanitarian law ;

to ensure that the military are properly trained to know, abide by and respect the applicable legal framework for the protection of health care as well as ethical duties of health-care personnel ;

to cooperate with health and humanitarian organizations to ensure that health personnel are specially trained to know, apply and uphold their legal and ethical duties ;

to actively seek to raise awareness of the proper use of the red cross/red crescent/red crystal emblems by armed forces and by the population at large ;

to take the opportunity of the forthcoming International Conference of the Red Cross and Red Crescent to further their commitment to implementing recommendations and measures on protecting health care in armed conflict and other emergencies and to consider submitting specific voluntary pledges on this issue.

We urge State armed forces :
to respect in all circumstances, in particular in situations of armed conflict or other emergencies, health care workers, facilities and medical transports and to allow patients to receive adequate care, regardless of their affiliation ;

to revise military rules of engagement and operational practice and procedures to ensure that recommendations and measures for the protection of the delivery of health care are included therein and that military personnel are adequately trained in them.

We urge all non-state actors :
to respect in all circumstances, in particular in situations of armed conflict or other emergencies, health care workers, facilities and medical transports and to allow patients to receive adequate care, regardless of their affiliation ;

We encourage international and national humanitarian and health organizations :
to continue to advocate for the preservation of principled humanitarian action, the respect of the « Ethical Principles of Health Care in Times of Armed Conflict and Other Emergencies “endorsed by civilian and military health-care organizations in June 2015, and the protection of patients, health-care personnel, facilities and medical transport in armed conflict or other emergencies and to join ongoing efforts or to start their own initiatives to those ends.

To ensure that health facilities they govern are taking necessary actions to reduce the risk of violence within the facilities' premises.

Signatory organisations :
International Committee of Military Medicine ; International Committee of the Red Cross ; International Council of Nurses ; International Federation of Medical Students' Associations ; International Federation of Red Cross and Red Crescent Societies ; International Hospital Federation ; World Federation for Medical Education ; World Health Organization ; World Medical Association

WHO condemns attack on MSF hospital in Yemen

2015-10-28T20:00:00Z

The World Health Organization (WHO) condemns the bombing of the hospital in Saada province in northern Yemen that was supported by Medécins Sans Frontières (MSF). MSF estimates that this will leave 200 000 people with no access to lifesaving medical care.

The attack violates International Humanitarian Law. It is the second attack on an MSF-run health facility in a month. On 3 October, 30 people were killed when the MSF-supported medical clinic in Kunduz, Afghanistan was bombed. Twenty-seven MSF staff were injured.

The bombing represents a serious setback for both MSF and the affected community and an additional challenge to humanitarian work in Yemen.

WHO once again urges all parties in the conflict to respect the safety and neutrality of health workers and health facilities. Tragedies like this can and should be avoided, by warring parties consistently observing International Humanitarian Law and taking all necessary precautionary measures.

WHO is increasingly concerned by the continuous threats to health workers, facilities and transport, particularly in Iraq, Syria, and Yemen. WHO is working together with partners to protect patients, health workers, health infrastructure and supplies from violence and thus minimize disruptions to desperately needed health care.

Is Yemen Europe's next migration crisis?

2015-09-17T20:00:00Z

Suddenly everyone knows about Syria as hundreds of thousands of refugees flee across Europe. But further south, another Middle Eastern country is also imploding, arguably at an even faster rate. Will refugees from Yemen now also start to flee to Europe?

The ticket office in Sana'a is crowded with people, bustling to get to the front of the queue. These are Yemen's upper- and middle- classes, jostling for a spot on the next plane out of the country.

There is only one commercial route open: a once-daily flight to the Jordanian capital Amman. If you book today, the earliest you'll be able to leave will be in six weeks.

The UN's refugee agency, UNHCR, says more than 100,000 people have fled Yemen since a Saudi Arabian-led coalition began bombing the country in March to drive pro-Iranian Houthi rebels from power.

Of these, only around 40,000 are Yemenis. The rest are foreign nationals, mostly from the Horn of Africa, who have returned home.

UNHCR spokesman Andreas Needham told IRIN the actual number may be higher as the refugee agency and the Yemeni authorities only have figures for those people who approach them for assistance.

Within the country, 1.5 million people have had to flee their homes. The head of the international Red Cross said the intensity of the conflict in just five months had left Yemen looking like Syria after five years.

At the ticket office, few people wanted to stay in Jordan once they got there. The United States, Saudi Arabia, the United Arab Emirates and Malaysia were among a jumble of countries mentioned as desirable destinations.