Embattled Hodeidah becomes new breeding ground for cholera, says Save the Children

A UAE-Saudi-led blockade on the port city of Hodeidah - amid Yemen's hot summer months - would likely make it the perfect breeding ground for cholera, the charity said.

With a breakdown in basic infrastructure in the Hodeidah and thousands fleeing the city almost 3,000 suspected cases reported in the first week of July.

This is the highest numbers seen in Yemen since the start of the year, and a warning sign that a fresh outbreak of the disease is brewing.

Save The Children could become "ground zero for a new outbreak of the highly contagious disease", the charity said in a statement.

A siege on the city would most likely hit Hodeidah's most vulnerable inhabitants - children and the elderly, the poor and sick - leading to the spread of the disease.

Safe, drinkable water was already scarce in Hodeidah, but supplies are now severely deminished since the offensive by the Saudi- and UAE-led coalition on the port began in June.

Water and sewerage pipes have been damaged in shelling and bombing, making the city the ideal setting for a fresh outbreak of cholera.

In the al-Mighlaf district of Hodeidah - just north of the city - the number new cases of the disease rose by 110 percent between mid-May and mid-June. 

A small uptick in cases in Hodeidah poses a grave risk to other parts of Yemen, Save the Children said, due to people fleeing the city and spreading the disease. 

Surrounding areas of Hodeidah have seen the most notable impact of the exodus with makeshift camps set up to house some of the 245,000 who fled the city, which lack even basic sanitation and have no running water.

These conditions could lead to a new cholera outbreak, the charity warned.

"Cholera could spread like wildfire in Yemen, potentially infecting thousands of children and completely overwhelming an already crippled health system," said 
Save the Children International's CEO Helle Thorning-Schmidt has recently returned from Yemen.

"Many hospitals have been reduced to rubble, and those that are still standing are barely functioning. Doctors have not been paid, pharmacies are understocked, and power cuts happen constantly."

"Food and aid have been used as weapons of war and children are paying the price. They are severely malnourished and don't have access to basic supplies like food, clean drinking water and medicine," she added.

"This leaves them extremely vulnerable to diseases like cholera, which many are too weak to fight off. If people are forced to flee fighting on top of this, many children just won't stand a chance."

Cholera causes violent vomiting and diarrhoea with undernourished children the most vulnerable to contract cholera. They are the most likely to die from the disease, with their immune systems badly compromised by malnutrition.

Last year, Hodeidah saw another outbreak, with nearly 164,000 suspected cases out of more than one million reported across Yemen.

More than 2,300 people, many of them children, died in that epidemic, which started in April 2017.

A Save the Children doctor in Hodeidah said there are fears a fresh deadly outbreak of the disease is imminent.

"We're terrified of another outbreak as the number of cholera cases is increasing day-by-day. Just six weeks ago we were going to close many of our cholera treatment centres but owing to the surge of cases we have to keep them open, said Dr Mariam Aldogani.

"Current conditions mean that it could be difficult to keep the number of cases under control. Water chlorination isn't a durable solution, the summer heat is relentless, there's rubbish lining the streets and the health system is bursting at the seams."

More than 13,000 people are believed to have died in Yemen's war, which intensified in March 2015 when the Saudi-led coalition entered the war.

Around 11.3 million children in need of humanitarian assistance, while schools and hospitals have been caught in fighting. Access to food, fuel, clean water and medical supplies have also been compromised.

Nearly 8 million children are now going hungry every day and almost a third of under-fives are acutely malnourished, the charity reported.