Yemen's Aden: Shattered limbs and broken lives

The situation that Mohammed Musoke, the medical co-ordinator for Medecins Sans Frontieres MSF [Doctors Without Borders]  in Aden, was trying to describe was illustrated perfectly by the sound of gunfire that could be heard across the phone line.

“There is some heavy weaponry being fired at the moment,” said Musoke. “Really heavy shelling, most probably it's a tank. We have a tank quite close to where we are.”

Musoke, a Ugandan, was speaking from MSF's emergency surgical unit in Aden's Sheikh Othman district, where fighting between Houthi rebels and factions of the Yemeni military allied to them on one side, and locals resisting their advance on the other, was continuing unabated.

The fighting since March 19, before Saudi-led airstrikes began pounding targets across Yemen, has killed hundreds of people. 

Over 600 Yemenis have sought treatment at the MSF unit since the fighting began, an unprecedented number for an overstretched staff with limited supplies. The unit, which has carried out 250 surgical procedures since fighting began, was finally able to be resupplied on April 8 after a boat was permitted to arrive from Djibouti.

In the centre, gunshot wounds dominate. Musoke has seen patients as old as 65 and as young as 6 arrive at the unit, hit by either bullets or shrapnel. The MSF team are doing their best, but often have to amputate limbs to ensure the patients survive.

“They come in in shock, with completely shattered limbs,” Musoke said. “Then they wake up [after the operation] and find they're missing a limb or an organ, and then you have to break the news to their family.”

In addition to the surgical unit in Aden, MSF operate numerous facilities across Yemen, including in Amran, al-Dhalea, and Haradh.

The number of patients arriving in Aden over the past few days has actually decreased, pointing to the difficulty of accessing the Sheikh Othman area. Ambulances have been hijacked and attacked, and two Yemeni Red Cross volunteers have also been killed in the fighting.

Those who make it to the centre have often had to face difficult journeys across the Aden peninsula, with areas like Mualla and Crater witnessing heavy fighting. Some of the injured have to wait days before it is safe enough to travel, while others prefer to take fishing boats and skirt the coast to Sheikh Othman.

The access issues within Aden, and in getting staff in from abroad, has meant that the MSF team at the surgical unit is overworked and overstretched.

“I have not left the hospital since... the clashes started,” said Liqa, a Yemeni pharmacist at the unit, in a testimony posted on the MSF Facebook page. “I have not seen my family since then.”

Liqa described Aden as “extremely dangerous”, and is worried about the unit's stocks.

“Our pharmacy stock is starting to run out and we are in desperate need of drugs and medical supplies, as well as the staff that are due to arrive and support us,” Liqa said.

Anees Dayan, who works in the unit as a nurse, lives near to the hospital so is able to go home. But the proximity of his home means that many of those being received by MSF are people he knows.

“I was very sad as we are receiving people from the neighbourhood, as well as people I know personally,” Dayan said. “We were receiving all those casualties and at the same time thinking of our own families.”

Dayan's extended family in the neighbouring Abyan province have berated him for spending so much time at the hospital rather than at home, but he is adamant that he must continue working.

“I cannot be absent from the hospital. I am a nurse, and this is what I do.”