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The Aussie GP battling a cholera epidemic in Yemen: A talk with Dr Melissa McRae

14 Nov 2017
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When did you arrive and where are you currently working?

I arrived in early April and am based in the Médecins Sans Frontières (MSF) countrywide co-ordination office in Sana’a, the largest city in Yemen, but I have spent most of my time in the field on projects in Ad Dhale, Houdaydah and Taiz. None of these cities are that far apart, but due to the numerous checkpoints and mountain passes, travelling 250km can take seven hours.

Can you give us an account of how you felt in your first week?

I honestly don’t remember, but I know I am certainly now used to frequently hearing air strikes and shelling events. The biggest change has been the increase in the number of injured civilians during my stay. At halfway through 2017, Yemen had already experienced more air strikes than in the whole of 2016.

What kind of cases are you dealing with?

Cholera and trauma are my immediate answers. MSF teams certainly treat a lot of trauma cases — adults and children, civilians and combatants. These include many war wounded and victims of road traffic accidents. The care encompasses ED stabilisation to operating room, and inpatient wards, including high dependency and ICU level care. We also treat many common health problems as there are limited other options for free, accessible, high-quality care.

One of our projects is focused on maternity and child health and we are overwhelmed with the high need for neonatal care beds and support for complicated deliveries.

The number of preterm deliveries is increasing, with younger mothers and increased malnutrition and stress all contributing factors.

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What experiences have had the biggest emotional effect on you?

There are really hundreds to reflect on, none more important than any other. I do remember the eight-year-old girl whose arm was blown off in a bus explosion, where more than 20 civilians were injured, and the rush to get her to the operating theatre to properly control the bleeding. I also remember the device that exploded under another civilian bus, but was allegedly planted to hit an ‘important leader’ of one of the warring parties.

The physical injuries are gruelling and visible and yet the impact on mental health is unfathomable.

The strength of the MSF local staff is awe-inspiring. Their lives have been turned upside down. These are the individuals who tell me that the local library or store was hit in the latest air strike.
They have lost numerous family members and left their homes, which are now looted and overrun.

They occasionally tell me of the struggles they must endure to get to work, as the road is blocked or unsafe. While I tell them to stay home, they arrive ‘better late than never’. They keep on going. They are the real humanitarians here, and we are lucky to have their skills and dedication to keep our MSF operations running to support the population in need.

People say we live in troubled times, but the war in Yemen has been called the ‘forgotten war’ by Amnesty International.

As I have been living and working in Yemen for the past six months, it’s hard to imagine how this is the ‘forgotten war’, but I understand it’s a situation where it can be hard to fully comprehend what’s going on.

The civilians are paying an extremely high price in this conflict. They live under the constant threat and reality of violence, fear and displacement, while trying to afford everyday commodities in the face of increasing prices and job insecurity.

We need the international community to step up and address the crisis in Yemen, not only by stepping up humanitarian solutions, but by addressing the factors that create such enormous humanitarian needs.