As the Yemeni civil war enters its third year, a crippled healthcare system is struggling to keep up with what the UN Secretary-General recently described as “the world’s worst humanitarian crisis”. Already unable to provide care for a population overwhelmed by chronic famine, cholera and diphtheria, as well as ongoing airstrikes and fighting, hospitals are further hampered by the fact that they cannot reliably access fuel.

Much of Yemen relies heavily on petrol generators for electricity. A shortage of fuel has made power a scarce resource, which is having a devastating effect on healthcare. Without reliable access to fuel, medical workers are unable to transport patients and equipment, and hospitals are not able to run generators. Hospitals are thus unable to power medical equipment, to keep vaccines in refrigerated storage and to run air conditioning – a serious problem in a country known for its extreme summer temperatures. Furthermore, the fuel shortage impedes the ability to pump clean water, affecting hospitals both directly and indirectly: by limiting the amount of water that is available for consumption and use at the hospitals themselves, as well as by accelerating the spread of cholera and diphtheria that are ravaging Yemen’s population and overwhelming the healthcare system.

The principle reason behind the fuel shortage is the ongoing blockade that is being imposed by Saudi Arabia’s military coalition, with logistical and intelligence support from the US. The land, sea and air blockade, which was instated in 2015, aims to prevent Iranian weapons from reaching the Houthi militia, but is also stopping fuel from reaching any opposition-controlled areas. The Houthis monopolize fuel distribution and sales in the areas under their control, a trade that helps to finance their ongoing military campaign. The shortage has led to protests in Sanaa, as locals living without power vented their anger at the Houthis, who continue to profit from the fuel trade in spite of the desperate conditions in which most Yemenis now live.

Although Saudi Arabia has allowed a limited amount of fuel to pass through their blockade, the amount has been woefully insufficient to meet the needs of the strained healthcare system. Blockade authorities have also ignored the advice of the UN body that was established to help screen the contents of incoming shipments for Iranian weapons without delaying shipments of other vital supplies. The recent outbreak of violence in the port city of Hodeidah has exacerbated the crisis by further restricting the flow of fuel imports as well as by inundating hospitals with increased numbers of casualties.

The International Committee of the Red Cross (ICRC) bought and imported 750,000 liters of its own fuel in an attempt to mitigate the worst effects of the deepening crisis, however such measures are unlikely to offer a sustainable solution. In April 2018, the World Bank announced that it would be financing a $50 million solar power project, which is projected to provide reliable power to 1.4 million Yemenis. While such initiatives have the potential to mitigate the risk of these crises recurring in the long term, the only viable solution to the crisis at hand is for coalition authorities to ease their punitive sanctions on fuel imports to the extent that hospitals can function effectively. Failure to do so is likely to lead to an accelerated collapse of the healthcare system and a further escalation of the already dire situation.