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VOL.01

ISSUE ZERO

November 1st, 2020

Historical perspective on Infectious Diseases in Yemen: importance of community-based responses

A hundred years ago, as the Spanish Flu outbreak reached northern Yemen,

<p class="font_8" style="text-align: justify">small communities struggled to deal with the devastation. Qadhi Mohammed al-Akwa (a prominent Yemeni thinker and historian?) documented the outbreak in his seminal work ‘A Page from the Social History of Yemen and the Story of my Life’ (safaha min tarikh al-Yemen al-Ijtimayy wa qasah hayaty, 1993), where he referred to the era as Sanah al-Fina’ (the Year of Extinction). Indirectly, al-Akwa highlighted the resilience of small communities responding to the health crisis, and the importance of cooperation in absence of state institutions and national strategies to contain such outbreaks. Yemen has experienced similar challenges during the most recent cholera outbreak, and now the Covid-19 period. The response to the Novel Covid-19 virus outbreak since April of 2020 has particularly highlighted the constant importance of small-scale, locally driven initiatives and the role played by Yemenis living abroad.&nbsp;</p>
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<p class="font_8" style="text-align: justify">A heightened awareness of history among Yemenis contributed to the initial alarm over the Covid-19 outbreak in 2020, especially as experts around the world compared the spread and mortality of this novel virus to the Spanish Flu outbreak that claimed nearly 50 million lives worldwide. One should note similarities between al-Akwa’s account of the fear over the potential devastation in Dhammar, for example, and fears over the Covid-19 virus (coronavirus) among the general population in 2020.</p>

<p class="font_8">Just prior to the Covid-19 outbreak, Yemen faced a compound crisis amid floods, Cholera and Diphtheria outbreaks nationwide. International organizations, who provide the bulk of funding for emergency responses, relied heavily on small-scale initiatives driven by local civil society organizations (CSOs) to implement ‘rapid response’ strategies addressing hygiene education and clean water needs. In areas of Ibb province, for example, UN agencies relied on community-based local rapid response teams, not government agencies, to distribute basic information and chlorine tablets for clean water. After decades of investment and development, but similar to conditions a century ago, Yemen’s health sector proved insufficient at the onset of this outbreak. Government institutions lacked the capacity to organize and implement a coherent response to the Cholera or Diphtheria outbreaks in recent years. Unlike governments in East Asia, who learned from the SARS (2003) and MERS (2015) outbreaks, war-torn Yemen has been unable to coordinate a government-led response to Covid-19 similar to Singapore, South Korea and Taiwan did in 2020.&nbsp;</p>
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<p class="font_8">Lack of coordination between de facto authorities across the country has also exacerbated the crisis during the Covid-19 outbreak, regarding the response to those infected and implementation of a strategy to contain the outbreak. As the gap in services grows, some highlight initiatives launched by Yemenis living abroad working to fill this gap by disseminating information to the general public, online as well as on the ground. Others organized health care experts providing expertise and equipment to local medical staff. Consequently, these small-scale initiatives have also highlighted disparities across regions, as a disproportionate number of the small-scale initiatives focus on services provided across southern provinces. In the reporting that follows, we note difficulties in accessing information from organizations operating in northern provinces, in particular.</p>

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