By Justin Derbyshire, Chief Executive Officer, HelpAge International and Arun Maira, Chair, HelpAge International
Civil war in Yemen continues unabated. Over the past three years, this conflict has resulted in the death and injury of hundreds of thousands of people who have the misfortune to be caught up in a vicious cycle of destruction. Much of the country, already the poorest in the Middle East, has been torn apart, and 14 million people currently depend entirely on international aid for their survival.
The scale of this disaster requires urgent action. The situation facing older people is truly desperate; hospitals have been destroyed or damaged, and conflict has prevented medical supplies, water and food reaching those in need. The UN has reported that people are unable to reach care and are dying at home, with only half of health facilities functioning and many Yemenis too poor to access these.
Older people with chronic illnesses – who rely on life-saving medication every day – are again, particularly at risk. For example, insulin medication for diabetes needs to be refrigerated to ensure it is effective, but lack of power means these supplies go to waste even when they are available.
From HelpAge International’s humanitarian work in Yemen, where through our partner we have delivered mobile health and nutrition services to rural communities considered “hard to reach” by the international aid community, we know how dire the needs are.
We estimate that 1.65 million older people are at risk and in need of humanitarian assistance. The stark findings from a survey we carried out in 2017 revealed that only 1 in 20 people over 60 had access to any income, and less than half were able to access healthcare. Even when they can, only a tiny fraction – 2% of women and 3% of men – could afford the medicines they need. This shows how hard life for older people has become, and the likelihood is the situation has worsened as the conflict drags on.
Famine and cholera are among the greatest threats, as highlighted by Mark Lowcock, UNOCHA’s Under-Secretary-General for Humanitarian Affairs, when he stated that the immune systems of millions of people are now literally collapsing”, leaving children and older people particularly at risk.
Malnutrition is alarmingly high. Even when older people are mobile enough to overcome barriers preventing their access to food distribution sites in Yemen, the standard rations available are not suitable for many older people who may struggle to digest them.
World Health Organization figures showed that older women and men accounted for 31% of deaths from cholera, despite being only 5% of the 1.2 million suspected cholera cases reported last year. This disproportionate number of deaths shows that older people are being left behind in the humanitarian response and unable to access vital services. Instead, they are forced to rely on unsustainable coping mechanisms, such as paying others to fetch clean water for them when they are physically unable to do so.
Our research over many humanitarian crises has demonstrated that older women and men, and people with disabilities, are at greater risk of being left behind when fleeing conflict. They are often overlooked by government and humanitarian agencies, and face many barriers accessing information and services.
For those agencies able to respond, it is crucial that older people and other vulnerable groups are included in aid assessments, distributions and response activities. Four in every five older women we spoke to are entirely dependent on humanitarian aid but only a fifth of them are receiving it. There needs to be a focus on ensuring older women are able to access assistance.
With a third of Yemen’s population considered to be on the brink of starvation, increased and inclusive humanitarian aid is needed now to ensure the urgent health, nutrition and protection needs of older people in Yemen are met.
Humanitarian coordination mechanisms and agencies need to ensure tailored solutions are provided to older people and those who depend on them, including children, and they need to address the unique challenges faced by older people who have disabilities. Offering cash assistance to older people, providing medicines for chronic illnesses, ensuring age-inclusive food rations and distributions, and including older women and men in protection initiatives will help to make responses more inclusive and guarantee all who are affected have their rights to humanitarian assistance and protection upheld.
A political solution that leads to lasting peace in Yemen is critical. Until that time, HelpAge calls on those involved in the conflict and those who influence them to abide by international humanitarian law, ensuring no attacks against civilians or infrastructure such as hospitals. We also call for increased, safe and sustained humanitarian access, so that millions of people can get the life-saving support they desperately need.