Ali’s brittle legs stuck out awkwardly from a gray onesie that hung off him, although it was meant for his age. At three months old, the Yemeni infant has already spent a third of his life fighting to keep it.
Ali was treated for acute malnutrition free of charge at the run-down Sadaqah public hospital in the southern port city of Aden. But the fragile lifeline extended to him and millions of hungry Yemeni children may snap soon.
“You have a perfect storm gathering on the horizon,” warned Philippe Duamelle, spokesman for the United Nations agency for children (UNICEF).
Russia’s invasion of Ukraine in February has sent global wheat and fuel prices skyrocketing just months after cash-strapped United Nations agencies cut food aid to 8 million Yemenis.
Further cuts are expected, as donor countries on Wednesday pledged only $1.3 billion of the $4.2 billion requested in humanitarian assistance to Yemenis over the next year.
Angelina Jolie: Situation in Yemen ‘heartbreaking, infuriating’
That could threaten the international aid that helps Yemeni hospitals keep their lights on, stock their medicine cabinets, and subsidise transport for patients from far-flung provinces – like Ali’s family, who travelled more than 480 km to reach Aden.
“We need more, not less. But we have reached a level where we need to start scaling down,” Duamelle told the Thomson Reuters Foundation.
“This is insane. This is just insane.”
UNICEF predicts that 19 million Yemenis will need food assistance by the end of 2022 – an increase of 2 million from the beginning of the year.
Among them: 2.2 million children who are projected to suffer from acute malnutrition this year.
“As usual in these environments, those who suffer the most are children – and especially children of poor families,” said Duamelle.
‘THE ONES WHO CAN’T PAY’
Yemen was already the region’s most impoverished country when war broke out in 2015, and a severe devaluation of the local currency has further crushed family budgets.
More than half of health facilities are now dysfunctional, so UNICEF began subsidising transport for families who must travel by bus for hours to reach a working hospital.
“With a lot of pain and embarrassment, parents would say, ‘we had to choose whether to spend money to get this child treated or save it to feed the other children.’ How can parents make this choice?” Duamelle said.
Private clinics remain too expensive for most, so public institutions are the only recourse.
READ: Yemenis forced to beg as food prices skyrocket, Oxfam warns
“The families who come here are the ones who can’t pay for private care,” said Maram Youssef, a doctor in the neonatal unit at Sadaqah hospital.
She spoke quietly as she checked on newborns lined up in incubators against a pink wall, their tiny chests heaving as they drew from thin tubes needled into their nostrils.
Her unit receives UN funding, which she said paid for 16 of the machines plus oxygen, as well as a staff stipend that effectively doubled salaries to about $100 per month.
Other segments of the Sadaqah hospital that do not receive external funding were noticeably more worn down.
Hallways were lined with rotting food and smelled of urine, and young kidney patients lay on grimy cots.
At the public Al-Jumhuriyah hospital, funding from the International Committee of the Red Cross has kept the generator running at a haemodialysis unit.
“Patients, including children, came from as far as 600 km away – and some had died because they could not secure transport to the centre,” said the unit’s Administrative Head, Nabiha Bamagid.
“If we lose international aid, it would be an absolute disaster,” Bamagid said.
Fuel is also crucial to operate local water pumping stations, allowing families in one of the most water-stressed countries to wash, cook and drink safely.
READ: UN Chief says at least 10,000 children killed in Yemen conflict
That, too, is at risk: UNICEF said its fuel stocks for these stations would dry up at the end of May.
Replenishing them would be even more costly, given the rise in prices – meaning families could be stuck without water at the peak of summer.
The disparity in access to health care is stark.
Flights to and from Aden are regularly packed with medical tourists who can afford to travel to Cairo and beyond for care.
The Saudi Development and Reconstruction Program for Yemen is building a state-of-the-art hospital for $56 million, according to the program director in Aden, Ahmed Madkhali.
The hospital is well stocked, with shipments of plastic-wrapped Western medical equipment filling its pristine rooms.
The hospital, though, has yet to open.
And with funding falling even shorter and the UN focused on Ukraine, it’s even less likely that gaps can be filled.
“Don’t make us make decisions between taking food from the children in Ukraine to the children in Yemen,” the head of the UN’s World Food Programme, David Beaseley, told Wednesday’s pledging conference.
Jan Egeland, head of the Norwegian Refugee Council, said he was “deeply disappointed” by the summit.
“More lives will be lost. More children will starve. More families will sleep outside. More communities will be without access to clean water. Yet, somehow, we will have less money to support them,” he said.