Yemen's Mukalla at breaking point as sick and injured flood in

MUKALLA, Yemen - Fatema al-Saqqaf was almost dead when she arrived to the port city of Mukalla in southeastern Yemen.

She had fled the war in the southern port city of Aden, where the fighting has been some of the worst in recent months, knowing that without urgent medical care her time would soon run out.

The 43-year-old housewife suffers from serious kidney disease and requires regular dialysis treatment, but her weekly routine was interrupted when fighting intensified in Aden in March. Since then, battles between Houthi militias - backed by forces loyal to former president Ali Abdullah Saleh, and militias commanded by exiled president Abd Rabbuh Masnour Hadi - have had a devastating impact on the local population and infrastructure.

Before long, fighting around the airport and military base in the Khour Maksar district forced local medics to shut down the dialysis clinic there, leaving patients like Saqqaf with few choices apart from seeking health services elsewhere.

“I moved with my husband to other clinics in Aden,” Saqqaf told Middle East Eye. “But weekly dialysis sessions dropped from three times [per week] to one and each session was shortened to just one hour instead of three.”

Day by day, Saqqaf and her husband watched the security situation deteriorate and violence reach every nook and cranny of Aden, which was once the country’s commercial hub.

With Saqqaf’s condition deteriorating and no end in sight to the violence, her husband decided that he would have to take his extremely sick wife to Mukalla city in the Hadramout province, a nearly eight-hour drive.

“All displaced people can survive everywhere - even under a tree, except kidney dialysis patients,” Saqqaf told MEE.

“But I am too tired. I don't eat. I feel exhausted even when I exert any simple effort.”

Saqqaf is just one of dozens of other patients who have been forced to flee other parts of Yemen and are now seeking medical care here at the dialysis centre in Mukalla where local charities have been able to provide patients with free accommodation and compensate for medical services.

The Hadramout province is also known for its vibrant charities that are mainly funded by donors from neighbouring Saudi Arabia and other Gulf states. It’s also relatively oil-rich and has not been as hard-hit by the fighting as other parts of Yemen. Despite al-Qaeda managing to seize parts of the province since early April, the group has operated with a relatively light touch here, allowing locals to move freely and not imposing its harsh interpretation of Sharia law. US drone strikes have continued to target the group, but these tend to target high-ranking al-Qaeda leaders and only occasionally wreak havoc on the wider civilian population.  

Hospitals at full capacity

At Ibn Cina hospital, where Saqqaf is having her kidney dialysis sessions, staff now say they are running at full capacity.

According to Ahmed al-Askari, the manager of Mukalla's dialysis centre, founded 18 years ago by two Saudi businessmen, the centre can treat 25 to 30 cases. As demand has grown, new arrivals are being housed in hotels downtown, and in recent days other centres in the Qaten and Seiyun districts in Hadramout have had to take on overflow.

Abdullah Qasem Ahmed, another patient, also said that he used to visit the dialysis centre in Khour Maksar in central Aden before fleeing to Mukalla.

“I could not eat during the trip. I was too exhausted. I moved my family to al-Mansoura when shelling intensified in Khour Maksar,” he said in reference to two parts of Aden.

When he arrived in Mukalla, Qasem told MEE that a local charity called Nahed housed him along with other kidney patients in a hotel and gave them 15,000 Yemeni rials ($70) cash when they arrived last month.

Qasem said that he left a large family behind in Aden and does not know what happened to his house in Khour Maksar. Locals say that the district has been almost razed to the ground as rival forces have attempted to gain control of the nearby airport and Saudi-led coalition has pounded Aden from the skies.

Other neighbourhoods have also been badly damaged.

Haidar Thabet Taleb from the Dar Saad district on the northern outskirts of Aden has also sought refuge and treatment in Mukalla.

He says that he was relatively lucky and managed to flee the southern capital in an air conditioned car, but he worries for his family members who have stayed put.

“My family lives in the Dar Saad district. They still complain about shelling,” he said. “The warplanes [have] destroyed houses that survived [the] Houthi bombardment.”

Influx of war casualties

Other health clinics in Hadramout have also seen an influx of patients, fleeing fighting in provinces like Abyan and Shabwa which both lie between Aden and Mukalla.

While resources here are often less stretched than elsewhere, the extra burden is beginning to show and clinics and hospitals are increasingly being pushed to the limit.

Things are becoming so bad that some patients are only staying for a few hours in hospitals in Mukalla before travelling to Saudi Arabia where they can get better care.

Since the beginning of their bombing operation in March, Riyadh has largely opened its southern border to let in those who have been injured by the Houthis and Saleh’s forces, although it appears to be less generous with those deemed to be on the opposing side and there have been no reports of Zaidi Shiite civilians being let in for care.

Ibn Cina hospital in Mukalla is now almost full to its capacity.

Ahmed Mohammed Nasser, a pro-Hadi soldier in Aden, told MEE that he was injured during fighting with the Houthis and was shot several times.

“They first took me to my hometown Lawder [in the Abyan province east of Aden] and then to Mukalla [to receive treatment]. We are now due to travel by bus to Saudi Arabia.”

Plenty of others have also been caught up in the fighting or injured in the ensuing chaos.

Majed Ahmed took in his young nephew for emergency head surgery and was waiting while the boy recovered. According to Ahmed, the family’s car overturned when it came under fire by Houthi militias as they tried to flee the Lawder district.

“A bullet hit [my nephews] head as their car was overturned.” Ahmed said.

As the human catastrophe grows, however, so too does determination to not give up without a fight.

Abdul Kader Saleh al-Awad is an engineer-turned-fighter from Lawder who injured his pelvis. He told MEE that people were forced to send their families to the mountains and the countryside, but that the men stayed in the city to fight off the Houthis.

“I will go back to the battlefield to fight the Houthis when I recover from my injuries,” Awad said, although days later MEE learned that he had been transferred to a Saudi hospital for treatment.

Awad and others like him are the lucky ones.

With the number of displaced pouring into Hadramout, local NGOs have been forced to appeal to the Riyadh-based government of Hadi and also to international organisations. There are no official figures on the number of internally displaced people here, but NGOs say that hundreds of poor families from Aden have reached Mukalla since March.

With no end to the fighting in sight, more are expected to follow and one of the few remaining havens in Yemen could find itself totally overwhelmed.