case study of yemen

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Yemen’s Tragedy: War, Stalemate, and Suffering

• The eight-year-old conflict in Yemen is between the internationally recognized government, which is backed by a Saudi-led military coalition, and Houthi rebels supported by Iran.
• The country’s humanitarian crisis is said to be among the worst in the world, due to widespread hunger, disease, and attacks on civilians.
• Tensions eased and humanitarian conditions improved with a UN-mediated cease-fire in 2022, but the combatants failed to renew the deal after six months.

Introduction

Yemen, a small country on the Arabian Peninsula, has become the site of grievous civilian suffering amid an intractable civil war. Many analysts say the fighting, now seven years old, has turned into a proxy war: Iran-backed Houthi rebels, who overthrew the Yemeni government, are pitted against a multinational coalition led by Saudi Arabia. The involvement of other combatants, including militant Islamist groups and separatists backed by the United Arab Emirates (UAE), has complicated the picture.

The conflict has displaced more than four million people and given rise to cholera outbreaks, medicine shortages, and threats of famine. The warring parties observed a monthslong cease-fire in 2022, raising hopes for a political solution to the conflict, but that October, they failed to extend the truce.

What are Yemen’s divisions?

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Yemen has long struggled with religious and cultural differences between its north and south and the legacy of European colonialism. The modern Yemeni state was formed in 1990 with the unification of the U.S.- and Saudi-backed Yemeni Arab Republic, in the north, and the Soviet-backed People’s Democratic Republic of Yemen, in the south. Ali Abdullah Saleh, a military officer who had ruled North Yemen since 1978, assumed leadership of the new country.

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However, just four years after unification, southern separatists seceded for several months and reemerged in 2007 as the Southern Movement, which has continued to press for greater autonomy within Yemen. Al-Qaeda in the Arabian Peninsula (AQAP) , an Islamist militant group, and the related Ansar al-Sharia insurgent group have captured territory in the south and east. The Houthi movement, whose base is among the Zaydi Shiites of northern Yemen, rose up against Saleh’s government six times between 2004 and 2010.

The United States lent its support to Saleh beginning in the early 2000s, when counterterrorism cooperation against al-Qaeda and affiliate groups became Washington’s overriding regional concern. In 2000, al-Qaeda in Yemen, a group that would later become AQAP, conducted a suicide attack on a U.S. Navy warship, the USS  Cole , in the Yemeni port of Aden. Seventeen U.S. service members were killed in the bombing. Since then, the United States has provided Yemen more than $850 million in military aid, according to the online database  Security Assistance Monitor .

Rights groups  persistently charged  [PDF] that Saleh ran a corrupt and autocratic government. As the popular protests of the 2011 Arab Spring spread to Yemen, the president’s political and military rivals jockeyed to oust him. While Yemeni security forces focused on putting down protests in urban areas, AQAP made gains in outlying regions.

Under escalating domestic and international pressure [PDF], Saleh stepped aside in 2012 after receiving assurances of immunity from prosecution. His vice president, Abd Rabbu Mansour Hadi, assumed office as interim president in a transition brokered by the Gulf Cooperation Council (GCC), a regional organization based in Saudi Arabia, and backed by the United States. As part of the GCC’s timetable for a transition, the UN-sponsored National Dialogue Conference (NDC) convened 565 delegates in 2013 to formulate a new constitution agreeable to Yemen’s many factions. But the NDC ended with delegates unable to resolve disputes over the distribution of power.

What caused the current crisis?

Several factors widened these political divisions and led to full-scale military conflict.

Fuel price hikes . Under pressure from the International Monetary Fund, which had extended to Yemen a $550 million loan premised on promises of economic reforms, Hadi’s government lifted fuel subsidies in 2014. The Houthi movement, which had attracted support beyond its base with its criticisms of the UN transition, organized mass protests demanding lower fuel prices and a new government. Hadi’s supporters and the Muslim Brotherhood–affiliated party al-Islah held counterrallies.

Houthi takeover . The Houthis captured much of Sanaa by late 2014. Reneging on a UN peace deal, they consolidated control of the capital and continued their southward advance. Hadi’s government resigned under pressure in January 2015 and Hadi later fled to Saudi Arabia.

Military division . Military units loyal to Saleh aligned themselves with the Houthis, contributing to their battlefield success. Other militias mobilized against the Houthi-Saleh forces, aligning with those in the military who had remained loyal to the Hadi government. Southern separatists ramped up their calls for secession.

Saudi intervention . In 2015, with Hadi in exile, Riyadh launched a military campaign—primarily fought from the air—to roll back the Houthis and restore the Hadi administration to Sanaa.

Who are the parties involved?

The Houthi movement, named for a religious leader from the Houthi clan and officially known as Ansar Allah, emerged in the late 1980s as a vehicle for religious and cultural revivalism among Zaydi Shiites in northern Yemen. The Zaydis are a minority in the Sunni Muslim–majority country but predominant in the northern highlands along the Saudi border.

The Houthis became politically active after 2003, opposing Saleh for backing the U.S.-led invasion of Iraq but later allying with him after his resignation as president. This alliance was a tactical one: Saleh’s loyalists opposed Hadi’s UN-backed government and, feeling marginalized in the transition process, sought to  regain a leading role  in Yemen. Saleh won the allegiance of some members of Yemen’s security forces, tribal networks, and political establishment. But in 2017, after Saleh shifted his support to the Saudi-led coalition, he was killed by Houthi forces.

Iran is the Houthis’ primary international backer and has reportedly provided them with military support, including weapons. Hadi’s government also accused Hezbollah , Iran’s Lebanese ally, of aiding the Houthis. Saudi Arabia’s perception that the Houthis are an Iranian proxy rather than an indigenous movement has driven Riyadh’s military intervention. But many regional specialists say that Tehran’s influence is likely limited, especially given that Iranians and Houthis adhere to different schools of Shiite Islam. Experts also say Iran’s sway could shrink as Saudi-Iranian relations warm following a China-mediated rapprochement in early 2023. Some analysts expect Iranian weapons transfers to the Houthis to decline. 

At Hadi’s behest in 2015, Saudi Arabia cobbled together a coalition of Sunni-majority Arab states: Bahrain, Egypt, Jordan, Kuwait, Morocco, Qatar, Sudan, and the United Arab Emirates (UAE). By 2018, the coalition had expanded to include forces from Eritrea and Pakistan. They launched an air campaign against the Houthis with the aim of reinstating Hadi’s government. For Riyadh, accepting Houthi control of Yemen would mean allowing a hostile neighbor to reside on its southern border, and it would mark a setback in its long-standing contest with Tehran.

After Saudi Arabia, the UAE has played the most significant military role in the coalition, contributing some ten thousand ground troops , mostly in Yemen’s south. However, the UAE removed most of them after entering into conflict with its coalition allies in 2019, when it backed the separatist Southern Transitional Government (STC), which captured Aden. That November, Hadi and the STC president signed the Riyadh Agreement, which affirms that the factions will share power equally in a postwar Yemeni government. The separatists reneged on the deal for several months in 2020, but eventually they joined a unity government with equal representation of northerners and southerners. Though the formation of a government signaled progress in bridging Yemen’s internal divisions, it did little to accelerate peace talks. In April 2022, Hadi ceded power to a governing council and fired a deputy scorned by the Houthis in hopes that the rebels would return to the negotiating table.

Although the U.S. Congress has been  divided on the matter  [PDF], the United States has backed the Saudi-led coalition, as have France, Germany, and the United Kingdom. U.S. interests include security of Saudi borders; free passage in the Bab al-Mandeb strait, the choke point between the Arabian and Red Seas and a vital artery for the global transport of oil; and a government in Sanaa that will cooperate with U.S. counterterrorism programs. But uproar over civilian deaths in  coalition air campaigns , which often use U.S.-made weapons, and Saudi Arabia’s role in the 2018 killing of  Washington Post  journalist Jamal Khashoggi led the United States and other Western powers to limit some weapons sales and refueling of coalition aircraft. Lawmakers have also raised concerns that U.S.-made weapons are  falling into the hands  of AQAP and Houthi fighters. Still, the United States is Saudi Arabia’s largest arms supplier, and President Donald Trump thrice vetoed bills that would have halted arms sales to Saudi Arabia.

President Joe Biden said he would end U.S. support for the coalition’s military offensive, including the sale of weapons, and signaled a shift to diplomacy by appointing a special envoy to Yemen. Yet, U.S. defense contractors still oversee the servicing of Saudi aircraft that carry out offensive operations, and the administration has approved the sale of weapons to Saudi Arabia for defense purposes. Shortly after taking office, Biden reversed the Trump administration’s last-minute designation of the Houthis as a terrorist group, citing the move’s potential damage to aid deliveries in Yemen.

What is the role of al-Qaeda in the Arabian Peninsula?

AQAP, in Yemen since the early 1990s, has benefited from the more recent chaos. In 2015, it captured the coastal city of Mukalla and released three hundred inmates, many believed to be AQAP members, from the city’s prison. The militant group expanded its control westward to Aden and seized parts of the city before coalition forces recovered much of the region in 2016. AQAP has also provided Yemenis in some areas with security and public services unfulfilled by the state, which has  strengthened support  for the group.

The U.S. State Department warns that Yemen’s instability has  weakened long-running counterterrorism efforts  [PDF], which rely heavily on air strikes. The Barack Obama administration conducted an estimated 185 strikes over eight years, while the Trump administration launched nearly 200 in its four years. These air strikes have killed several high-level AQAP members, including former leader Nasser al-Wuhayshi and top official Jamal al-Badawi, who was allegedly involved in the USS  Cole  bombing. But the U.S. strikes have also resulted in the deaths of more than one hundred civilians , watchdog groups say.

For years, AQAP vied for influence with the Houthis and the self-declared Islamic State, especially in the central al-Bayda Governorate. The Islamic State marked its 2015 entrance into Yemen with suicide attacks on two Zaydi mosques in Sanaa, which killed close to 140 worshippers. Though the group has claimed other high-profile attacks, including the assassination of Aden’s governor in late 2015, its following lags behind that of AQAP. In 2021, the United Nations estimated that the Islamic State had hundreds of fighters [PDF] in Yemen, while AQAP had around seven thousand [PDF] as of mid-2020. Opposition from the Houthis has reportedly debilitated both groups, but experts warn against discounting their possible resurgence.

What has the humanitarian impact been?

With around three-quarters of its population living in poverty , Yemen has long been the Arab world’s poorest country, and its humanitarian crisis has been called one of the worst in the world. Disease runs rampant; suspected cholera cases passed two hundred thousand [PDF] in 2020. The impact of the COVID-19 pandemic is harder to assess, since there is no comprehensive caseload data. Some twelve thousand cases have been reported to the World Health Organization, but health analysts say the actual count is likely much higher. Moreover, many countries cut back on critical aid to Yemen amid the crush of the pandemic, leading the United Nations to reduce food rations for some eight million Yemenis in January 2022. Three out of four Yemenis require humanitarian aid and protection, and four million are internally displaced [PDF], according to the UN refugee agency. 

The situation has worsened under a yearslong de facto land, sea, and air blockade imposed by coalition forces, which has obstructed the flow of vital supplies of food and medicine and helped drive up prices of essential goods. Under the 2022 cease-fire, prices dropped significantly, but with the expiration of the truce, many Yemenis fear that high costs will return . The UN Development Program estimates that more than 370,000 people have died as a result of the war, with indirect causes such as lack of food, water, and health services causing almost 60 percent of deaths.

In addition, the United Nations has found [PDF] that both Houthi and coalition forces have knowingly attacked civilian targets in violation of international law. This includes the destruction of a hospital run by Doctors Without Borders in 2015. Torture, arbitrary arrests, and forced disappearances are among the other alleged war crimes perpetrated by both sides.

What are the prospects for a solution to the crisis?

UN-backed peace negotiations have made limited progress. The 2018 Stockholm Agreement averted a battle in the port city of Hodeidah, a vital hub for aid; but there has been little success in implementing the accord’s provisions, which includes the exchange of more than fifteen thousand prisoners and the creation of a joint committee to de-escalate violence in the city of Taiz.

Observers worry that friction among regional actors, including Iran, Saudi Arabia, and the UAE, is prolonging the war . Conditions deteriorated in late 2019, when the Houthis claimed responsibility for a missile attack on Saudi oil facilities. UN monitors concluded that the Houthis did not carry out the attack, while the Saudi-led coalition blamed Iran. 

Peace efforts gained momentum in April 2022 when Yemen’s new governing council helped consolidate anti-Houthi forces. Later that month, the Houthis and coalition forces coordinated their first nationwide cease-fire in years, which allowed commercial flights to resume from Sanaa and some fuel ships to dock in Hodeidah. The parties extended the truce several times, but after six months of relative peace, failed to renew it again. Recently improved relations between Saudi Arabia and Iran and ongoing talks between Riyadh and the Houthis have buoyed hopes for another extension of the cease-fire, but the exclusion of the governing council and STC from the talks has raised questions about the prospects for peace.

Recommended Resources

For Foreign Affairs , the International Crisis Group’s Michael Wahid Hanna and Peter Salisbury argue that negotiations on Yemen should be more inclusive .

CFR’s Global Conflict Tracker follows the latest developments in Yemen’s civil war.

The New York Times ’ Declan Walsh and Tyler Hicks capture the war’s human toll .

Ohio State University’s Asher Orkaby explains how Yemen’s internal divisions were centuries in the making .

In late 2021, the UN Development Program assessed the impact of Yemen’s war and charted potential pathways for recovery.

• Political Transitions

Nathalie Bussemaker, Mia Prange, and Will Rampe contributed to this report. Will Merrow created the graphic.

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Yemen and the Dynamics of Foreign Intervention in Failed States

Yemen, a small nation at the southern tip of the Arabian peninsula, has been mired in political strife and unrest since its government was overthrown in 2014 by the Houthis, a minority Shiite tribal group. Soon after, foreign intervention began, with Saudi Arabia joining the fight alongside the remains of the Yemen government authorities against the Houthis. In 2015, Iran began supporting their ally the Houthis with economic aid and materials, but not with direct military involvement. What ensued has been labeled one of the worst modern-day humanitarian crises, and it rages on to this day.

The author, Bryn Lauer

With no end to the conflict in sight, Yemen now has the status of a failed state, one with no governmental authority or rule of law. This humanitarian tragedy raises many unanswered questions about the effects of foreign intervention on failed states: Why has Yemen’s civil war continued? Why is Saudi Arabia siding with a country lacking a working government? What does Iran have to gain by allying with the Houthis, and why hasn’t it intervened directly? Has Yemen as a failed state exacerbated the conflict? What is at stake for each actor? 

The use of the term  failed state  is debated by political science researchers. Definitions of the term range from complete anarchy to a functioning government with weak institutions. In this article I use the term  failed state  for two reasons: (1) it places greater emphasis on the system of governance as a path to civil war than on extremism and terrorism (Cordesman and Molot, 2019), and (2) it has been used explicitly as justification for intervention by Saudi Arabia. I use political scientist Robert Rotberg’s commonly accepted definition of a failed state: a state which is unable to provide political goods to its inhabitants and experiences high levels of internal violence (Rotberg, 2003). My project aims to shed light on the dynamic between failed states and foreign intervention, with Yemen as a case study. I became interested in this subject because of an international politics course I took at SUNY Binghamton and have followed Yemen closely since then. After transferring to the University of New Hampshire (UNH) and completing an internship at the Department of State in the Office of Investment Affairs, I received an Undergraduate Research Award, with Dr. Elizabeth Carter as my faculty mentor, and turned my interest into a concrete research project.

Summarizing Yemen’s history over the past several decades remains a challenge, which is why I focus on the key events in this background section. Yemen’s conflict is multifaceted, with regional and domestic actors at play, a history of governmental instability, economic constraints, political fallout, and strained alliances.

The Houthis make up 5 to 10 percent of the population in Yemen. Although a revolutionary Shiite Muslim group, the Houthis’ plight began as a political one during the rule of Yemeni President Ali Abdullah Saleh from 1978 to 2011 (Haykel, 2021). For years, authoritarian President Saleh used corruption and oppression to unify the government and to repress dissent. The Houthis’ goal was to assert themselves as a dominant political group to bring an end to political marginalization and discrimination. These sentiments then cultivated six wars between the Houthis and the central government from 2004 to 2010. In 2011, President Saleh resigned because of mounting tension among supporters and was replaced by Abdu Rabbu Mansour Hadi, but Hadi’s leadership lasted only three years and included unsuccessful attempts at reform before the Houthis seized Sana’a, the highly populated capital of Yemen, thereby waging war once again on the government of Yemen. With no true foundation in place, Yemen’s government fell swiftly by January 2015, when President Hadi and other politicians were forced to resign. President Hadi fled to Saudi Arabia. Yemen’s sovereignty became porous, the remaining domestic institutions ceased to operate, and foreign actors have had free rein to exert their influence over the region since 2015.

On March 26, 2015, shortly after the Houthis overthrew Hadi’s government, Saudi Arabia launched its first military involvement in Yemen with Operation Decisive Storm, and air strikes, ground troops, and economic sanctions were deployed almost immediately (Nußberger, 2017; Gunaratne, 2018). The launch of Operation Decisive Storm in 2015 was Saudi Arabia’s first deviation from its norm of unassertive foreign policy toward Yemen (Stenslie, 2013). Saudi Arabia justified its active, open military engagement with Yemen by claiming it was countering Iranian influence while defending itself against fallout from a failed state.

Airstrike by Saudi Arabia in Sana’a, Yemen, 2015.  Source:   Wikimedia Commons

Throughout the fighting, Saudi Arabia and many prominent Western scholars have accused Iran of supporting the Houthis. Iran has historically kept a limited role in Yemeni affairs and did not become an active ally of the Houthis until Saudi Arabia’s direct involvement in 2015. However, during the 2011 Arab Spring uprisings, which were a series of anti-government protests that ricocheted throughout the Middle East, Iran had provided limited aid to the Houthis. The Houthis are not dependent on Iran and are not under their direct control (Vatanka, 2015; Milani, 2015). Nonetheless, Iran has increasingly provided more arms to the Houthis as a direct response to escalation in fighting from Saudi coalition forces (Nichols and Landay, 2021). 

As of spring 2022, the conflict is continuing to escalate, United Nations mediation attempts have repeatedly failed, and there remains no internationally recognized government in place (Aljazeera, 2022; Reuters, 2022). As of 2022, 24 million Yemenis need assistance, 100,000 Yemenis have been killed since the start of the conflict in 2015, and 4 million remain displaced (Global Conflict Tracker, 2022).  

Martin Griffiths, a UN Special Envoy to Yemen who has attempted diplomacy between the Yemeni and Houthi factions, noted that the crisis in Yemen is man-made, and that ending the war is a choice. Yet Mr. Griffiths, and others in the international community who support this premise, fail to specify exactly what allowed Yemen’s crisis to become man-made in the first place. I was interested in researching the reasons behind foreign interference in a failed state because, intuitively, intervention should be a means to end a conflict. In Yemen, the conflict has only been exacerbated, and I wanted to know what went wrong and why.

This map shows Yemen in relation to Saudi Arabia, Iran, and other regional countries.  Source:  Wikimedia Commons

To uncover why regional foreign actors interfere in failed states—specifically, Yemen—I planned several phases of research, each of which would take several weeks. First, I planned to look at when and how Yemen became a failed state, including its weaknesses, when and why each foreign and domestic actor intervened, and the overall geopolitical and societal trends of each actor. Next, I planned to examine empirical evidence from the start of the conflict in 2014 to the present, including military data, domestic and economic data, and peace data. For the final weeks of my research time, I planned to compile theories about the motives of Saudi Arabia, the Houthis, and Iran. This was done via literature review, whereby I examined the rhetoric of each actor toward Yemen and looked at the contemporary policies and overall belief system of each actor. I planned to conclude my research time by drawing conclusions and drafting an argument that would address my research goal. All research was conducted remotely using sources accessible online.

I used a variety of sources over the course of my research, including both political science and history journal articles. For empirical evidence, I relied upon data collected from the World Bank, the Yemen Data Project and Civilian Impact Monitoring Project, as well as online articles from  MediaWire, Reuters,  and  Al Jazeera.  Specifically, I collected data on the change in Saudi military expenditures, civilian casualties, coalition air raids, political violence, unemployment, government institutions, rule of law, markets, poverty, GDP, supply chains, migration flows, and peace attempts before and during the war. This data was critical, as it allowed me to quantify the potential impact of interference on factors relating to violence, political stability, and economics in a failed state—specifically, Yemen.

I adapted my research plan on numerous occasions. Most of my research was composed of searching the history of Yemen, Iran, Saudi Arabia, and the Houthis on EBSCOHost. From there, I selected data on the conflict and pieced together an argument. When I needed to fill in gaps, I searched news articles. My research was nonlinear, because the ideas grew as I went along, thereby causing me to deviate from my original plan as needed.

Results: Three Opportunities

My research suggests that foreign actors may perceive the cost of intervening in a failed state—a space devoid of authority—as low and therefore simply too good an opportunity to pass up to influence regional power. In pursuing opportunities to intervene in a failed state, foreign actors may exacerbate the conflict and plunge the state into chronic instability. After concluding my research, including my review of the articles and databases mentioned in my methods section, I argue that failed states create three opportunities for actors who intervene.

The first is the Opportunity for Security, in which foreign actors may perceive failed states to be security threats to their own inhabitants and to neighboring countries. Therefore, actors looking to gain favor domestically and regionally may claim to intervene to defend the inhabitants of the failed state while protecting themselves from regional spillover.

The second is the Opportunity for Influence. Because failed states are unable to defend themselves militarily and are unable to pursue diplomatic measures, foreign actors perceive intervention as low risk, and victorious foreign actors gain the opportunity of influencing the restructuring of the government of the failed state in their favor.

The third is the Opportunity for Amplifying Power, in which actors who intervene can amplify their regional power by securing a swift victory at a low cost.

Saudi Arabia: Opportunity for Amplifying Power

With its intervention in the conflict in Yemen, Saudi Arabia claims to pursue the Opportunity for Security, but the reality shows that it pursues the Opportunity for Amplifying Power. Despite claiming to defend the Yemeni people and restore the Hadi government, the extent and intensity of Saudi Arabia’s military efforts, their unwillingness to cooperate in peace talks with the Houthis and other actors or abide by ceasefires, their blocking of food and medicinal imports, and deliberate attacks on civilian infrastructure such as hospitals indicate they are uninterested in the well-being of Yemen’s inhabitants and its stability. Actors insecure in regional power likely pursue more aggressive intervention as a desperate attempt to amplify their regional status. Saudi Arabia’s regional power status has been waning since 2014, driven largely by their dwindling oil reserves and unsuccessful interventions in Iraq after 2003 and Lebanon in 2008 (Council, 2011), which evidences their motivation behind intervention.

As mentioned previously, Saudi Arabia has not acted in a way that suggests it is concerned with a strong Yemeni state, and especially not one as an ally. Driving Yemen into further instability has created a breeding ground for terrorism, illegal immigration, and regional spillover. Under the guise that it is pursuing the Opportunity for Security, Saudi Arabia has been able to justify its intervention as countering Iranian influence while defending itself against fallout from a failed state. In reality, Saudi Arabia’s intentions extend further than self-defense. By pursuing the Opportunity for Amplifying Power, Saudi Arabia has supported an illegitimate government, destroyed critical infrastructure, killed innocent civilians, refused to accept anything other than complete victory over the Houthis, and blocked imports, thereby guaranteeing Yemen’s instability for years to come. 

Iran: Opportunity for Influence

Iran’s intervention in Yemen suggests that it is pursuing the Opportunity for Influence. In contrast with Saudi Arabia, Iran is more stable in regional power. This is evidenced by Iran’s national sovereignty and fierce independence, and that it aligns itself with “Neither East nor West” (Maloney, 2017). Stable actors do not seek to use failed states to boost their status and can instead pursue opportunities related to “soft power”—building support domestically and regionally through positive attraction and persuasion (Nye, 1990). Iran seeks to align itself with marginalized groups—in the case of Yemen, the Houthis—to gain in soft power by being viewed as a “champion of the oppressed and marginalized” (Juneau, 2016). This is the same strategy Iran applied in Iraq and Afghanistan, where it exerted soft power through reconstruction aid, infrastructure development, media, and financial investments (Wehrey et al., 2009).

Rather than engage militarily in Yemen, Iran has supported the Houthis from a safe distance. During the 2011 Arab Spring uprisings, Iran provided limited aid to the group. By the time the Yemeni government was overthrown in 2014, Iran supplied some arms and economic support to the Houthis, and as of 2022 it continues to keep its distance (IISS, 2019). Iran’s goal is to establish ties to the Houthis should they secure victory and restructure the government. Although Iran does not directly seek to state-build in Yemen, the opportunity to maintain a steady presence with the Houthis has been low-cost and low-risk.

Map of the Yemeni civil war and Saudi Arabian intervention as of 2021. Red is controlled by the Hadi-led government; green is Houthi controlled; and yellow is controlled by the Southern Transitional Council, a secessionist organization in southern Yemen.  Source:  Wikimedia Commons

Current Situation

As of January 2022, the war continues to drag on, despite Saudi Arabia’s expectation of a quick and decisive victory. Both Saudi Arabia and the Houthis are intensifying their efforts, and Iran continues to steadily support the Houthis with arms. To complicate the situation even further, the United Arab Emirates, which has been part of Saudi Arabia’s coalition since 2015, has shown signs of increasing its role in the conflict for its own ends. All this means that peace is still far out of reach. For years, Saudi officials promised that progress was being made in their fight. Instead, Saudi Arabia finds itself struggling to exit Yemen, which has further exemplified its deteriorating regional power. It is likely that Saudi Arabia overestimated its military prowess and strategy. By using a “blank check” strategy for fighting the Houthis, Saudi Arabia has demonstrated its lack of understanding of the conflict (Horton, 2020). When compared with the fractured and weakly governed Yemeni army supported by Saudi Arabia, the Houthis have repeatedly been successful against coalition forces by striking fast and staying mobile, and, according to some Western experts, are poised to defeat the coalition forces despite the odds (Horton, 2020). 

If a peace settlement is reached through Saudi Arabia and Iran brokering a peace agreement between the Houthi and Hadi regimes, the question remains: What is to prevent intervention from occurring every time an internal conflict arises? If Yemen and other failed states experience conflicts via revolution or civil war, what can prevent external actors from intervening? As this research has demonstrated, the incentive to intervene in failed states is a powerful one. Reworking a state’s entire structure of government is complex, and there is no one-size-fits-all.

Given that Saudi Arabia sought to amplify its power, its inability to conquer an easy target will be a major blow to its regional power status. If Iran is to cease support, it is likely that the Houthis would be capable of surviving on their own. Having sought gains in soft power, Iran will not lose out as extensively. Regardless, the real loser at the end of the conflict will be Yemen. The real calamity is that unchecked intervention has degraded the state and created further conflict. Under the guise of championing the oppressed, Saudi Arabia, the Houthis, and Iran have all made for a grave future for Yemen. I hope that readers will see through the layers of complexity of the Yemen conflict and better understand why foreign intervention can be dangerous and costly.

By studying the conflict in Yemen so deeply, I have garnered a greater appreciation for research in international politics. I underestimated how in-depth and complex the research process is. Most importantly, I have learned that research is not rigid; it morphs and grows with each new discovery, and often more questions arise than answers. Because of this research, I now think about the world in terms of opportunities and incentives, on the global and personal level. My next goal is to apply the ideas that I theorized in this project to an exploration of international politics from a financial incentive perspective. This perspective is important to include in the research of world affairs, because, more often than not, money is at the heart of conflicts. After graduation, I hope to follow my passion for researching international conflict and to publish more of my writing on the subject.

Thank you to Mr. Dana Hamel, who made this research possible through a generous endowment, as well as the Hamel Center for Undergraduate Research staff. Dr. Elizabeth Carter, thank you for inspiring me to pursue international politics research in your United States in World Affairs class. I am incredibly grateful for the opportunity to complete this project and for those who helped me along this journey.

Allinson, Tom. (2019). Yemen’s Houthi rebels: Who are they and what do they want? DW: 01.10.2019.  www.dw.com/en/yemens-houthi-rebels-who-are-they-and-what-do-they-want/a-50667558 .

Al Jazeera. (2022). How the Yemen conflict flare-up affects its humanitarian crisis.   https:/www.aljazeera.com/news/2022/1/18/yemens-humanitarian-crisis-at-a-glance .

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Cordesman, A., and Molot, M. (2019). Afghanistan, Iraq, Syria, Libya, and Yemen: The long-term civil challenges and host country threats from “failed state” wars. Center for Strategic and International Studies (CSIS).  https://www.csis.org/analysis/afghanistan-iraq-syria-libya-and-yemen .

Global Conflict Tracker. (2022, March 11). War in Yemen.  https://www.cfr.org/global-conflict-tracker/conflict/war-yemen .

Gunaratne, R., and Johnsen, G. (2018). When did the war in Yemen begin?  https://www.lawfareblog.com/when-did-war-yemen-begin .

Haykel, B. (2021). The Houthis, Saudi Arabia and the war in Yemen.  https://www.hoover.org/research/houthis-saudi-arabia-and-war-yemen .

Hodali, D. (2021). “Saudi Arabia has lost the war in Yemen.”  https://www.dw.com/en/saudi- arabia-has-lost-the-war-in-yemen/a-57007568 .

Horton, M. (2020). Hot issue—the Houthi art of war: Why they keep winning in Yemen.  https://jamestown.org/program/hot-issue-the-houthi-art-of-war-why-they-keep-winning-in-yemen/ .

IISS (2019). Chapter five: Yemen. Iran’s networks of influence in the Middle East. Routledge.  https://www.iiss.org/publications/strategic-dossiers/iran-dossier .

Juneau, T. (2016). Iran’s policy towards the Houthis in Yemen: A limited return on a modest investment.  International Affairs, 92 (3), 648.

Maloney, S. (2017). The roots and evolution of Iran’s regional strategy.  https://www.atlanticcouncil.org/in-depth-research-reports/issue-brief/the-roots-drivers-and-evolution-of-iran-s-regional-strategy/ .

Milani, M. (2015, April 19). Iran’s game in Yemen: Why Tehran isn’t to blame for the civil war.  Foreign Affairs .  https://www.foreignaffairs.com/articles/iran/2015-04-19/irans-game-yemen .

Nichols, M., and Landay, J. (2021). Iran provides Yemen’s Houthis “lethal” support, U.S. official says.  https://www.reuters.com/article/us-yemen-security-usa-idUSKBN2C82H1 .

Nußberger, B. (2017). Military strikes in Yemen in 2015: Intervention by invitation and self-defence in the course of Yemen’s “model transitional process.”  Journal on the Use      of Force and International Law, 4 (1), 110–160.

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Rotberg, R. (2016). Failed states, collapsed states, weak states: Causes and indicators. Washington, D.C.: Brookings Institution.  https://www.brookings.edu/wp-content/uploads/2016/07/statefailureandstateweaknessinatimeofterror_chapter.pdf .

Stenslie, S. (2013). Not too strong, not too weak: Saudi Arabia’s policy towards Yemen. Norwegian Peacebuilding Resource Centre.  https://www.files.ethz.ch/isn/162439/87736bc4da8b0e482f9492e6e8baacaf.pdf .

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Author and Mentor Bios

Bryn Lauer  will graduate from the University of New Hampshire in spring 2022 with a bachelor of science degree in business administration: finance. She hopes to pursue work as a financial economist with a concentration in international affairs. Originally from Durham, New Hampshire, Bryn became interested in international conflict after taking some international politics classes and participating in an internship at the U.S. Department of State. Because of Yemen’s unique position as a failed state, Bryn wanted to understand the motivations of outside actors intervening and how their actions impacted the conflict there. To pursue her research interests, Bryn received an Undergraduate Research Award through the Hamel Center for Undergraduate Research. From the project Bryn gained a deep understanding of the history of Yemen, Saudi Arabia, Iran, and the Houthis, as well as learned a lot about the research process itself. Given the circumstances of the COVID-19 pandemic, Bryn unfortunately was unable to conduct field research abroad, so she had to rely only on information that was published in databases. This presented a challenge for Bryn, because she had to be able to work through contradicting data to find information that focused specifically on the effects of external intervention of foreign states. Despite the challenges, Bryn was able to piece together the data, history, and geopolitics to develop her own theories, making the research her own.

Elizabeth Carter  has been an assistant professor of political science at the University of New Hampshire since 2015. She specializes in comparative politics, political economy, and Western European politics. Dr. Carter met Bryn in her U.S. and World Affairs course and was delighted to serve as her research mentor after being impressed with an essay on Yemen that Bryn had written for the class. Though she has mentored several undergraduate students for both undergraduate honors theses and as part of Hamel Center Undergraduate Research Awards, this was Dr. Carter’s first time mentoring a student who submitted an article to  Inquiry . Dr. Carter is proud of the great work that Bryn conducted. In addition, Dr. Carter says that it was wonderful to have the experience of enhancing her understanding of a region, like Yemen, that she had not researched much herself, especially with the rigorous research and applications of political science theories and framework that Bryn incorporated into her work. Dr. Carter believes that it’s important for researchers to make research more accessible to broader audiences across multiple disciplines, not just to those engaged in that particular field.

Contact the author 

Copyright 2022, Bryn Lauer

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A Data Case Study: Famine in Yemen

Famine in Yemen, an Integrated Food Phase Classification Exercise

Since 2017, the biggest headlines to grip the world about Yemen have been repeated claims that Yemen is “on the brink” or “one step away” from the largest famine in decades or a century. [1] This has been one of the most visible sound bites of the response, bringing in hundreds of millions of dollars in funding and leading to one of the largest scale-ups in food delivery ever seen. It is a claim that has been repeated for almost four years now by top UN leadership. Mark Lowcock, while serving as the UN’s humanitarian affairs and emergency relief coordinator, routinely appeared before the Security Council warning of famine and stating that Yemenis were on the brink of mass starvation. But is it true?

The data used to build this claim comes from the Integrated Food Phase Classification exercise, known as the IPC, which was introduced in Yemen in 2011. The IPC provides a common global system for classifying acute food insecurity ( see Figure 2.3) and malnutrition situations and identifying their key drivers. Currently, the IPC is the most comprehensive and most standardized tool used to monitor food insecurity in more than 30 countries worldwide. Through the IPC process, government authorities, humanitarian actors and civil society organizations as well as other experts collaborate on data collection and analysis. Their aim is to generate food security data that can be compared across crises and used to more effectively evaluate the severity and extent of food insecurity and malnutrition in a country. This data is then used to inform emergency responses as well as longer-term programming. [2]

The definition of famine used by the IPC is, “the absolute inaccessibility of food to an entire population or sub-group of a population, potentially causing death in the short term.” [4] As famine is considered a rare and serious phenomenon, three set standards supported by reliable evidence have to be concurrently present to declare famine:

• at least 20 percent of households in an area face extreme food shortages with a limited ability to cope (usually indicating a near-complete collapse in food and livelihood systems, resulting in extreme food consumption gaps even though coping strategies have been fully employed);
• acute malnutrition rates in children exceed 30 percent; and
• a death rate that exceeds two persons a day per 10,000 people. [5]

In theory, food security data is collected on a yearly basis. IPC acknowledges that the volatile conflict situation hampers data collection in Yemen, resulting in a scarcity of data. [6] This has been confirmed by previous research done on the Yemen IPC process, which found that several types of data often are not available for the analysis (such as mortality — a key data set), that little systematic data exists, either quantitative or qualitative, and that there is a lack of data sharing and transparency. [7] The conflict and lengthy processes required to gather the data have also meant that it has been difficult to gather timely data. As a result, often the IPC analysis is undertaken with a compilation of data that has been collected at varying points in time. [8] For example, the IPC analysis released at the end of 2020 projecting into 2021 used data that was collected seven months prior. [9] This means that the same data used for the analysis measuring outcomes in March 2020 was being used to project scenarios for almost a year later. Yet, in IPC, reliability depends partly on the “timeliness” of data. It requires data to be collected within the same season and/or from a similar season in a previous year. Implicit in the use of “previous season” data is that events and circumstances since data collection have not changed, so, with other supporting context, certain inferences can be made from the data. This is where the end-of-2020 Yemen IPC analysis fell short. Data collected at inconsistent time intervals and compilations of data from various times cannot be assumed to be reflective of any similar period. [10] Taking this into account, it is debatable whether the data used for the analysis to project into 2021 remained relevant enough to project accurately. [11]

Data availability and quality became more problematic with increased interference by authorities in the process. This led, for example, to the data collection for the IPC process in 2019 being blocked completely by Houthi-based authorities in areas under their control, resulting in no data. [12] This interference also greatly undermines the independence and quality of the data collected. In theory, data collection is carried out by independent data collection teams trained in the IPC protocol and using questionnaires designed by experts, but this is not the case in Yemen. Particularly in areas under the control of the armed Houthi movement, there is extreme interference in the data collection. Questionnaires have to be approved by Houthi authorities who regularly interfere in the type of questions included in them and the data that can be collected. They also interfere in the selection of teams that collect the data and frequently collect it themselves without the presence of any independent monitors. [13] Experts admit that it is common knowledge that answers to the questionnaires in Houthi-controlled areas are often coached. [14] This opens the potential for data manipulation and bias. Unfortunately, this bias is not transparently shared as a limitation of the data in the process of analyzing the data and the publication of results. [15]

The data quality is further compromised by a lack of independent and external review of the data. During the IPC process, it is usual for external experts in food security and nutrition to be included on panels while the IPC data is processed and analyzed at the end of the data collection process. This increases independence and quality control of the data, and improves the conclusions published as an outcome of the data analysis. In Yemen, this is not possible. The Houthi authorities prohibit raw data collected in areas of Yemen they control from being taken out of the country. This means that while it is possible for IPC technical working group (IPC TWG) members present inside Yemen to access the data, it is impossible for anyone outside Yemen to verify any of the general outcomes or test for accuracy based on actual data. [16] This was made even more difficult in 2020 by COVID-19 restrictions, which severely constrained the ability of IPC TWG members to be in Yemen at the time of the analysis.

In addition to this, the IPC framework has its limitations in the Yemen context. Firstly, IPC is geared toward analysis in rural areas predominantly dependent on rural livelihood models and coping strategies. The framework was not set up for urban populations and to properly analyze urban livelihoods and the labor market. Therefore, there is a debate around whether the data accurately reflects and correctly interprets the situation for the approximately one-third of Yemenis residing in urban areas. [17] Secondly, the IPC’s Acute Food Security analysis was designed for a six- to 12-month acute hunger episode driven by a shock or convergence of stressors. The locust infestation in East Africa that began in 2019, for example, destroyed crops and pushed an area from a Phase 2 (with some Phase 3) into a Phase 3/4, but the area retained an ability to recover in a following harvest (and with some support). Another example would be a sudden outbreak of conflict and escalation of needs, such as in Tigray, Ethiopia. IPC indicators are aimed to capture outcomes, for example the sudden need to use coping strategies to mitigate food gaps. This approach is not well suited for a protracted situation when coping is no longer really an option for vulnerable populations such as those in Yemen. [18]

Furthermore, the impact of humanitarian food assistance (HFA) on food security in Yemen is not well understood because of the protracted nature of providing it. Most other countries deliver HFA through different models. In South Sudan, for example, food assistance is provided on a seasonal cycle, being distributed during lean seasons. It is, therefore, possible to understand and analyze the effects of food assistance on a population by comparing periods of HFA versus periods without it. In Yemen, food assistance is given year round and has been since the start of the L3 in 2015. In fact, food aid has scaled up massively in recent years. In December 2015, the World Food Programme (WFP) reached 1.8 million people; [19] by late 2019/early 2020, more than 12 million people were reportedly being reached. [20] Yet, with the widespread interference and diversion that has been well-evidenced, it is unclear if and how much of the food assistance reaches populations affected by food insecurity and how this impacts these people’s situation. When conducting food analysis in Yemen, it is unclear whether we are looking at populations with or without HFA, or with how much HFA, and what coping mechanisms people are using because these are not properly documented, analyzed or understood. For this reason, the impact of HFA remains unclear, detracting from the accuracy of the analysis. [21]

Despite the shortcomings evidenced above, IPC data remains at the core of strategic planning related to food and nutrition, and purportedly provides the rationale for statements by UN leaders about the severity of Yemen’s food insecurity when they seek donor funding. Therefore, IPC outcomes and data since 2017, when warnings of impending famine became routine, merit review to understand the reliability of these claims.

The 2017 IPC

The 2017 IPC classified 17 million people in Yemen as facing acute food insecurity. The data used was based on Emergency Food Security and Nutrition Assessments (EFSNAs) carried out by the UN Food and Agriculture Organization (FAO), UNICEF and WFP in 18 governorates in 2016. For two other governorates, 2014 data was used. For the two remaining governorates, it was unclear which data was used. [22] No classification was made for any pockets of the population being in Phase 5, though it was estimated that 6.8 million people (24 percent of the population) were thought to be in emergency Phase 4 of food security. [23] Nutrition data collected had major gaps, [24] but the data did not indicate the required threshold of 30 percent of acute malnutrition in children had been exceeded, which would be an IPC indicator of famine. [25] EFSNA data on mortality collected using Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey methodology found that none of the 18 governorates assessed showed a death rate (crude or under-5) of 1 or above per 10,000 people per day. [26]

In late 2017, after the Saudi-led coalition closed Yemen’s land, air and sea ports in a temporary tightening of its blockade, Lowcock began warning of “the largest famine the world has seen for many decades, with millions of victims,” [27] apparently based on the vulnerability of populations found to be in IPC Phase 4. This came despite the fact that IPC thresholds for famine were not met.

The 2018 IPC

The 2018 IPC process saw some improvement, with analysis taking place at the district level for the first time, allowing for better analysis and differentiation in areas where challenges to gathering the data were fewer or surmountable. In October 2018, two months before results of the IPC were even published, the UN began to refer to the food security situation as a “potential famine.” [28] The references to famine increased as the publication deadline of the IPC came closer, and throughout the 2018 battle for Hudaydah, the specter of famine was heavily used to advocate against a military push to oust Houthi forces from Hudaydah city. [29] The role and wisdom of humanitarian advocacy in political (and military) decisions related to Hudaydah is discussed in more detail in a later report, ‘ A Principled Response ’, but by its own criteria, the data did not bear out the rhetoric.

The 2018 IPC was the source of heated debate in humanitarian circles. Food security analysts and nutrition experts fundamentally disagreed on the results of the data collection, with nutrition experts pointing to a lack of data to support any famine declaration from their side while food security experts pushed for a famine declaration based on food consumption data alone. [30] Médecins Sans Frontières (MSF), which has a presence across Yemen, also disputed the push to declare a famine, stating its medical staff had not seen any change in mortality and nutrition rates in their treatment facilities – including in comparison to times before the conflict. [31] Despite this, using only the food security side and discounting the other required IPC thresholds in the analysis, UN leaders came out with, and media headlines amplified, fresh cries of imminent famine.

The disagreement over the data and a push to classify famine in some areas of Yemen led to the review by a famine review committee (FRC) in November 2018. It was a challenging task for the FRC, which was unable to find a solid reason for the contradictory food security and nutrition data. [32] Though internally divided, the IPC TWG ultimately confirmed the evidence did not support a famine or famine-likely classification. [33] As a result, despite high levels of the population found to be suffering from acute food insecurity, the consensus outcome of the 2018 analysis was that there was no famine, and none projected. [34] Still, senior humanitarian leaders continued to use the term and the food security data to infer a potential famine, pushing the narrative without supporting scientific evidence ( see : ‘ Challenging the Narratives ’). [35]

Despite the lack of evidence for famine, the 2018 IPC data did reflect a concerning situation. It reported that 15.9 million people — 53 percent of the population analyzed — were acutely food insecure, despite ongoing humanitarian food assistance. It estimated that 17 percent of the population (about 5 million people, and more than 1 million fewer than in the 2017 IPC) fit the food security classification of IPC Phase 4 (emergency) and that an additional 63,500 people were in IPC Phase 5 (catastrophe). [36] The 45 districts flagged as hosting populations in IPC 5 had been inaccessible to assessors, meaning that this data, like much gathered in 2018, had been collected remotely. [37] While the data collection can be questioned, sub-par food consumption and coping methods were beginning to be more widely evidenced on the ground as reflected in the data available.

2019: Process Aborted

An attempt to undertake an IPC assessment in 2019 was severely hampered by the restrictions imposed by Houthi authorities in Yemen and resulting disagreements between WFP (and the UN as a whole), and the Houthis. Ultimately, the 2019 IPC process was never completed. Initial plans to monitor the 45 districts deemed most at risk for famine based on the 2018 analysis also were hampered by access restrictions. [38] A finding within a hotspot analysis of 2019 is, however, interesting to note: Only 29 of the 45 districts that had reported pockets of population in Phase 5 in 2018 were accessible in 2019 and, therefore, could be included in the hotspot analysis, but no evidence of Phase 5 conditions was found in any of them, [39] raising questions about the veracity of the remotely gathered data initially collected from those locations.

The 2020 IPC

The next IPC analysis was published in July 2020, [40] following a fraught process that initially resulted in data only being published for areas under the control of the internationally backed Yemeni government. Eventually, a food security update was released for the whole country in December 2020, [41] although by the end of the year nutrition data had still only been published for areas outside Houthi control. [42] Following the contested process in 2018, external experts were allowed for the first time to participate in the IPC analysis process remotely. Their access to data remained limited, however, with the Houthi ban on letting raw data out of Yemen remaining in place. As a result, only generic output tables were accessible to analysts participating remotely, which meant the data quality could not be adequately tested. [43] Sources of data and how it had been collected also remained opaque. [44]

The final analysis published found that 13.5 million people (45 percent of the analyzed population) were facing high levels of acute food insecurity (IPC Phase 3 or above), despite ongoing HFA. This included 9.8 million people (33 percent) in IPC Phase 3 (Crisis), 3.6 million (12 percent) in IPC Phase 4 (Emergency) and, of greatest concern, approximately 16,500 people in IPC Phase 5 (Catastrophe), with numbers expected to increase in the first half of 2021. [45]

Some contention exists around the data outcomes. In early 2020, Houthi officials approved one type of survey needed to establish the level and severity of malnutrition. The survey was carried out soon after, before the first Covid-19 cases were detected in Yemen. When the time came for the IPC analysis, Houthi-based authorities refused to allow UN agencies and the IPC technical working group access the survey data, without giving a convincing reason as to why. [46]

One food security expert who participated in the analysis process said the final results did not reflect the data that was presented to the external review panel during the process, especially with regard to the final determination of populations in IPC Phase 5 conditions. As per the analysts’ review, “the data used was quite insufficient to make such statements, especially about Phase 4 and Phase 5 populations.” [47]

Regardless, the final outcome of the analysis found that famine in Yemen was not present and was not a likely scenario. This was backed up by Famine Early Warning Systems Network (FEWSNET) analysis, which provides additional analysis to the IPC. [48] Nutrition data for areas under the control of Houthi authorities was not available at the time of the analysis, and current, reliable mortality data remains unavailable in Yemen.

A more recent report on food security in 2020 offers interesting insight. According to the 2021 Global Report on Food Crises, Yemen showed the largest change in the number of people considered to be in crisis Phase 3; with a 15 percent improvement in food security, the largest among the improvements seen globally. [49] The numbers above also are notable, with the number of people in Phase 4 having continuously dropped over the years (from 6.8 million in 2017 to 3.6 million in 2020). The veracity of pockets of populations in IPC Phase 5 is questionable in light of the findings in 2019 (29 districts purported to have populations in famine-like conditions actually had none) and in 2020, when 16,500 persons were thought to be experiencing famine-like conditions compared to 64,000 in 2019. Rather than a country falling into famine, the data coming in has increasingly been indicating that Yemen’s food security is improving.

Still, less than two weeks before the release of the food security analysis, and with only a partial nutrition analysis conducted (which did not find any evidence to reach the nutrition threshold for famine), [50] Guterres once again declared that “Yemen is now in imminent danger of the worst famine the world has seen for decades.” [51] The purpose of the statement was to call for more funding. And despite the lack of evidence, this narrative has continued to be used indiscriminately, even following the IPC findings, mainly to push for more funding. [52]

Food Security is a Problem in Yemen, Famine is Not

Yemen is a country with a big population compared to some others in crisis. As a result, the numbers are big, and will always look big side-by-side with South Sudan or northeast Nigeria, which can warp perception (relative comparisons of figures can be seen in ‘ Challenging the Narratives ‘). In Yemen, there are large populations with acute and chronic food insecurity and pockets of people who are considered to experience severe forms of food insecurity. But there is no scientific, or anecdotal, evidence that this food insecurity is leading to increased death rates and large-scale starvation. In other places, overall numbers may be much lower, but acute food insecurity is visibly resulting in increased deaths and populations who are wasted. These places, which get little public attention, are much more at risk of famine according to assessments grounded in data-based, scientific findings. Several areas of South Sudan, for example, are considered “famine-likely” following IPC analysis. [53] Yet, months into a famine declaration in Pibor, South Sudan, there has been no visible scale-up of assistance to these areas. [54] One shock in these locations could collapse food consumption and lead to high excess mortality due to hunger and disease.

The debate on “famine” or “no famine” is an emotive one, and often, a fundraising one. As evidenced above, the accuracy of these claims has not been a concern for the UN and the Yemen humanitarian response as there is no evidence, and never has been, to support a famine declaration in Yemen. Even anecdotally, there has been no evidence of people dying in large numbers of food insecurity. Claiming famine only heightens skepticism about the fundamental basis on which the response claims to work and fundraise. It also misses the point. Food security is a problem in Yemen, famine is not, and skewing the narrative skews the appropriate response. Cries of famine simply lead to agencies such as WFP trying to increase general food distributions by throwing actual food at the problem. This does not fix the underlying problem of food security, though it greatly increases the risk of food diversion. Investment in markets and production would far more sustainably solve systemic food security problems. Until a nuanced, realistic and honest analysis and debate is held about food security in Yemen, it will not be properly addressed.

The Sana’a Center for Strategic Studies is an independent think tank that seeks to foster change through knowledge production with a focus on Yemen and the surrounding region. The Center’s publications and programs, offered in both Arabic and English, cover diplomatic, political, social, economic and security-related developments, aiming to impact policy locally, regionally, and internationally.

This report is part of the Sana’a Center project Monitoring Humanitarian Aid and its Micro and Macroeconomic Effects in Yemen, funded by the Swiss Agency for Development and Cooperation. The project explores the processes and modalities used to deliver aid in Yemen, identifies mechanisms to improve their efficiency and impact, and advocates for increased transparency and efficiency in aid delivery.

The views and information contained in this report are not representative of the Government of Switzerland, which holds no responsibility for the information included in this report. The views participants expressed in this report are their own and are not intended to represent the views of the Sana’a Center.

• “Yemen facing largest famine the world has seen for decades, warns UN aid chief,” UN News, New York, November 9, 2017, https://news.un.org/en/story/2017/11/570262-yemen-facing-largest-famine-world-has-seen-decades-warns-un-aid-chief ; Hillary Clarke, “Twelve million face famine in Yemen if bombs don’t stop, warns WFP,” CNN, October 16, 2018, https://edition.cnn.com/2018/10/15/middleeast/yemen-famine-war/index.html ; “10 million Yemenis ‘one step away from famine’, UN food relief agency calls for ‘unhindered access’ to frontline regions,” UN News, New York, March 26, 2019, https://news.un.org/en/story/2019/03/1035501 ; Peter Beaumont, “‘Open your eyes’: Yemen on brink of famine again, UN agencies warn,” The Guardian, July 22, 2020, https://www.theguardian.com/global-development/2020/jul/22/open-your-eyes-yemen-on-brink-of-famine-again-un-agencies-warn ; Hannah Summers, “Yemen on brink of ‘world’s worst famine in 100 years’ if war continues,” The Guardian, October 15, 2018, https://www.theguardian.com/global-development/2018/oct/15/yemen-on-brink-worst-famine-100-years-un
• For more information on the IPC, see : http://www.ipcinfo.org/ipcinfo-website/ipc-overview-and-classification-system/en/
• “Technical Manual Version 3.0. Evidence and Standards for Better Food Security and Nutrition Decisions,” IPC, Rome, April 2019, p. 35, http://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/manual/IPC_Technical_Manual_3_Final.pdf
• Ibid., p. 204.
• Ibid., p. 9, and “IPC and Famine: Using the appropriate terminology and scientific thresholds,” IPC Global Support Unit, March 2012, http://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/IPC_Famine_Def_Meas.pdf
• “Yemen,” Integrated Food Phase Classification, Rome, website accessed on January 19, January 2021, http://www.ipcinfo.org/ipcinfo-website/where-what/asia/yemen/en/
• Daniel Maxwell, Peter Hailey, Lindsay Spainhour Baker and Jeeyon Janet Kim, “Constraints and Complexities of Information and Analysis in Humanitarian Emergencies. Evidence from Yemen,” pp. 16, 21, 24 and 33.
• Ibid., pp. 16-17, 25, 35, 37.
• Interview with food security analyst #1, November 25, 2020.
• Follow-up interview with food security analyst #1, February 6, 2021.
• Ibid; interview with a senior food security expert, January 20, 2021.
• “2019 Humanitarian Response Plan End of Year Report,” UNOCHA, p. 18.
• Author´s experience with IPC in Yemen in 2019; evidenced through internal UN emails with challenges experienced in the IPC process shared with author during the course of this research in 2020; and interviews with UN senior staff member #3, November 30, 2020, and UN agency staff member #4, December 7, 2020.
• Interviews with food security analyst, November 25, 2020, and UN agency staff member #4, December 7, 2020.
• Interview with UN agency staff member #4, December 7, 2020; author’s experience in Yemen; and evidenced through previous research conducted by Maxwell et al., “Constraints and Complexities,” pp. 20, 29, 31, 33.
• Interviews with food security analyst #1, November 25, 2020, and senior food security expert, January 20, 2021; Maxwell et al., “Constraints and Complexities,” pp. 23-25, 33.
• Follow up interview with food security analyst #1, February 6, 2021.
• “Yemen: Emergency Dashboard,” WFP, Sana´a, February 2016, https://docs.wfp.org/api/documents/
• “Yemen: Emergency Dashboard,” WFP, Sana´a, February 2020, https://docs.wfp.org/api/documents/0779e ; 12.84 million people were assisted in January 2020, but by January 2021, this figure had gone down to 7.9 million: https://api.godocs.wfp.org/api/documents/001a
• Interviews with food security analyst #1, November 25, 2020, and senior food security expert, January 20, 2021.
• Maxwell et al., “Constraints and Complexities,” p. 16.
• “Yemen: Projected Acute Food Insecurity Situation for March-July 2017,” IPC, Rome, March 15, 2017, http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1026467/?iso3=YEM
• In 2016, only five SMART surveys (in Al-Dhalea, Hudaydah, Sa’ada, Sana’a and Taiz) were conducted, and only three (Ibb, Lahj and Shabwa) in 2017. See: SMART Surveys Reports for 2016 and 2017, OCHA Services website, https://www.humanitarianresponse.info/fr/operations/yemen/document/smart-surveys-reports-2016 and https://www.humanitarianresponse.info/fr/operations/yemen/document/smart-surveys-reports-2017
• “Emergency Food Security and Nutrition Assessment (EFSNA): Yemen,” FAO, UNICEF, WFP, June 2017, p. 123, https://reliefweb.int/sites/reliefweb.int/files/resources/yemen_efsna_-_full_report_final_2016.pdf
• Angela Dewan, “Saudi blockade pushing Yemen towards ‘worst famine in decades’,” CNN, November 9, 2017, https://edition.cnn.com/2017/11/09/middleeast/yemen-famine-saudi-arabia/index.html
• Emma Graham Harrison, “Famine in Yemen could become one of worst in living memory, UN says,” The Guardian, London, October 25, 2018, https://www.theguardian.com/world/2018/oct/25/famine-in-yemen-could-become-one-of-worst-in-living-memory-un-says
• See , for example: “International Community Must Take Action to Stop Catastrophic Famine in Yemen, Top Humanitarian Affairs Official Tells Security Council,” UN press office, New York, October 23, 2018, https://www.un.org/press/en/2018/sc13550.doc.htm ; “Yemen war: Battle for vital port of Hudaydah intensifies,” BBC News, November 7, 2018, https://www.bbc.com/news/world-middle-east-46125858 ; Geert Cappelaere, “Conflict in Yemen, a living hell for children,” full text of remarks to the press, November 4, 2018, Amman, via UNICEF, https://www.unicef.org/mena/stories/conflict-yemen-living-hell-children ; “250,000 people ‘may lose everything — even their lives’ in assault on key Yemeni port city: UN humanitarian coordinator,” United Nations, Sana’a, June 8, 2018, https://news.un.org/en/story/2018/06/1011701
• Author’s discussion with UN staff member in Sana’a in 2019; interview with humanitarian analyst #2, December 15, 2020; and Maxwell et al., “Constraints and Complexities,” p. 32. For information on areas classified as at risk of famine, see the 2018 IPC report: http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1151858/
• “Is Yemen on the Brink of Famine?” MSF, Geneva, October 24, 2018, https://www.msf.org/yemen-there-no-quality-data-available-declare-famine-imminent
• Interview with senior food security expert, January 20, 2021.
• Nicholas Haan, Peter Hailey, Daniel Maxwell, Oleg Bilhuka and Jose Lopez, “Famine Review Committee Conclusions and Recommendations on the IPC Yemen Analysis. Summary Report,” IPC, Rome, November 28, 2018, p. 3, http://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/FRC_Yemen_Summary_report.pdf
• Maxwell et al., “Constraints and Complexities,” p. 32.
• In February 2019, UN Secretary-General Antonio Guterres opened a donor conference for Yemen by saying “almost 10 million are just one step away from famine.” Within hours, US$2.6 billion had been pledged toward the UN’s US$4 billion appeal. Declan Walsh and Nick Cumming-Bruce, “U.N. Seeks $4 Billion to Save Millions from Famine in Yemen,” The New York Times, February 26, 2019, https://www.nytimes.com/2019/02/26/world/middleeast/yemen-famine-aid-donors.html ; See also, “10 million Yemenis ‘one step away from famine’, UN food relief agency calls for ‘unhindered access’ to frontline regions,” UN News, New York, March 26, 2019, https://news.un.org/en/story/2019/03/1035501 ;
• “Yemen: Acute Food Insecurity Situation December 2018 – January 2019,” IPC, Rome, December 7, 2018, http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1151858/?iso3=YEM
• Internal UN emails shared with the author during the research period by key informants, supporting knowledge gained in a debriefing of the 2018 IPC process.
• “Yemen Hotpot Analysis: Severe Acute Food Insecurity Persists in 29 Districts in Yemen,” IPC, July 2019, http://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/IPC_Yemen_AFI_Hotspot%20Analysis_2019JulySept.pdf
• “IPC Acute Food Insecurity Analysis, July – December 2020; Yemen, Partial Analysis for 133 Districts,” IPC, July 2020, https://reliefweb.int/sites/reliefweb.int/files/resources/IPC_Yemen_AcuteFoodInsecurity_2020FebDec_Report_English.pdf
• “Yemen: Acute Food Insecurity Situation October – December 2020 and Projection for January – June 2021,”IPC, December 3, 2020, http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1152947/?iso3=YEM
• “Yemen: Acute Malnutrition January — July 2020 and Projection for August — December 2020,” IPC, Rome, October 23, 2020, http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1152903/?iso3=YEM ; updated in February 2021 for the whole country: http://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1153006/?iso3=YEM
• “Yemen: Acute Food Insecurity Situation October – December 2020 and Projection for January – June 2021.”
• “Deadly Consequences. Obstruction of Aid in Yemen During Covid-19,” Human Rights Watch, New York, September 14, 2020, https://www.hrw.org/sites/default/files/media_2020/09/yemen0920_web_3.pdf
• Interview with food security analyst #2, December 3, 2020.
• “Yemen Food Security Outlook Update. December 2020 – May 2021,” FEWSNET, Rome, December 2020, https://fews.net/east-africa/yemen
• “Global Report of Food Crises 2021: Joint Analysis for Better Decisions,” Food Security Information Network and Global Network Against Food Crises, May 2021, p. 17, https://www.wfp.org/publications/global-report-food-crises-2021
• “Yemen: Acute Malnutrition January – July 2020 and Projection for August – December 2020,” IPC.
• Antonio Guterres, “Warning Yemen in ‘Imminent Danger’ of Worst Famine World Has Seen for Decades, Secretary-General Urges Immediate Action to Avert Catastrophe,” full text, United Nations, New York, November 20, 2020, https://www.un.org/press/en/2020/sgsm20432.doc.htm
• See , for example, “Window to prevent famine in Yemen is narrowing, UN agencies warn. Levels of hunger reach record levels, requiring urgent action,” UNICEF, New York, December 3, 2020, https://www.unicef.org/press-releases/window-prevent-famine-yemen-narrowing-un-agencies-warn ; Martin Chulov, “Classifying Houthis as terrorists will worsen famine in Yemen, Trump is warned,” The Guardian, December 13, 2020, https://www.theguardian.com/world/2020/dec/13/classifying-houthis-as-terrorists-will-worsen-famine-in-yemen-trump-is-warned ; Mark Lowcock, “Under Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mark Lowcock, Briefing to the Security Council on humanitarian situation in Yemen,” full text, UNOCHA, New York, January 14, 2021, https://reliefweb.int/report/yemen/under-secretary-general-humanitarian-affairs-and-emergency-relief-coordinator-mark-35
• “IPC South Sudan Alert December 2020,” IPC, Rome, December 2020, http://www.ipcinfo.org/ipcinfo-website/alerts-archive/issue-31/en/
• Follow up interview with food security analyst #1, February 6, 2021, and an internal report by an INGO in South Sudan that followed a February 2021 assessment of the Pibor area, shared with the author in February 2021.

Table of contents

• Executive Summary
• Challenging the Narratives: Is Yemen Really the Worst Humanitarian Crisis in the World?
• You're here The Myth of Data in Yemen A Data Case Study: Famine in Yemen
• To Stay and Deliver: Security
• To Stay and Deliver: Sustainable Access and Redlines A Centralized Response is a Slow, Ineffective Response
• A Principled Response: Neutrality and Politics Monitoring: Accountability Falters When Oversight is Outsourced
• Rethinking the System: Is Humanitarian Aid What Yemen Needs Most?

Content Search

Sohs 2018 case study: yemen, attachments.

This case study is one in a series of five research pieces which fed into the analysis for The State of the Humanitarian System 2018 .This research was conducted and written in April 2018.

Executive Summary

The humanitarian crisis

The situation in Yemen has been described as an ‘entirely man-made catastrophe’ (OHCHR, 2017). The internal conflict between Houthi rebels and forces loyal to the government of Abdrabbuh Mansour Hadi, combined with the misuse of many key agricultural and household resources for khat production and consumption, has led to crippling poverty and a high rate of global acute malnutrition (GAM). The continued insecurity, instability and violence have caused the displacement of approximately 3 million people, and have had a devastating impact on food security and livelihoods.

As the conflict has continued, the state of the country’s health system, water, sanitation and hygiene (WASH) infrastructure and schools has deteriorated. In addition to the high number of casualties requiring emergency medical care, the health sector response has also had to deal with the indirect impacts of the war, such as the deterioration of public health systems, people’s fear of using health structures due to their frequent bombing, and significant levels of health-related malnutrition. In April 2017, the difficulty of managing contagious diseases, combined with the degraded economic situation, led to one of the worst cholera outbreaks in recent times, with almost 1 million suspected cases and 2,216 associated deaths (WHO, 2017). Almost 2 million children (27% of the 7.3 million schoolaged children in Yemen) are currently unable to attend school, with more than 1,800 institutions affected by the conflict.

A humanitarian response implemented under major constraints

Delivering aid in Yemen is extremely challenging. Numerous constraints exist ranging from insecurity in front-line areas to administrative restrictions and logistics problems in reaching rough and mountainous terrain. As the conflict has become protracted and the humanitarian crisis has deepened, the response has struggled to cover the needs of the population.

Humanitarian workers have accused the Saudi-led coalition of hampering the delivery of humanitarian assistance by imposing a blockade and then, when it was partly lifted, by continuing to impose excessively cumbersome procedures (UN Panel of Experts on Yemen, 2018). Import restrictions and localised blockages imposed by these local armed groups on the ground are hindering the rapid delivery of critical supplies to people in need. In addition, the presence of checkpoints controlled by armed groups in many districts, and regular air strikes, have restricted the movements of humanitarian operators.

Operations in these areas are very difficult and sometimes impossible. Humanitarian workers have been denied travel permits to different cities and the parties to the conflict impose arbitrary and excessive restrictions. The UN Panel of Experts on Yemen has criticised all parties to the conflict for increasing the suffering of civilians by impeding the delivery of humanitarian assistance.  

Overall effectiveness of the response

Despite all these constraints, life-saving operations have been reasonably effective. For example, during the last cholera outbreak, the combined efforts of local actors and the international community kept the case-fatality rate low. Famine has been avoided thanks to commendable efforts to support minimal food security and the extraordinary resilience of the Yemeni people.

This conflict has highlighted the paramount importance and continued relevance of the main international humanitarian law (IHL) principles of protection of civilian populations and of the infrastructure vital to their wellbeing (under the Fourth Geneva Convention). In addition to providing life-saving assistance to communities, actors have engaged in essential, and relatively effective, advocacy to stop the targeting of medical facilities. It seems reasonable to attribute the drop in the number of facilities targeted between 2015 and 2018 to the advocacy and IHL dissemination activities implemented by specialised international organisations and several donors.

Relevance and community engagement

Humanitarian actors think that the response is relevant to the population’s most acute needs and appropriate to the local context. According to the survey led by the Community Engagement Working Group (CEWG) and published as part of the 2017 Humanitarian Needs Overview (OCHA, 2017b), 67% of respondents believe that assistance is reaching the most vulnerable, but only 12% believe this assistance is meeting priority needs.

The quality of needs assessments, the availability of real-time data and programme monitoring are severely constrained in the current security context (Van Eekelen et al., 2017). Authorisation is required from local authorities to conduct an assessment and the authorisation process is often lengthy and hazardous. Negotiation is often required to avoid being influenced by the key ‘gatekeepers’ (tribal chiefs and community leaders), which could be considered to be a breach of humanitarian principles.

Some local and international NGOs have established local community committees and worked with them on delivering services or evaluating interventions. Furthermore, some INGOs have approached the target community through a local partner to facilitate assessment and implementation, and with the aim of increasing the capacity of the local partner. However, this level of engagement is not systematic and is sometimes left to individual initiative. Many actors consider that involving and engaging local communities is a necessary but complicated process. The main barriers are the need to have frequent access to the affected population, and the limited funding from donors for community consultation. Timeliness and preparedness

There is a lack of preparedness and prevention activities to strengthen the resilience of communities and to enable the humanitarian system to be more efficient. In the case of the cholera crisis, for example, preventive activities could have helped to stop the disease from spreading. Basic preparedness measures are essential to cope properly with the multitude of risks (war-related health issues, diseases, floods, etc.), but there are hardly any resources available for this in Yemen’s aid budget.

The humanitarian-development-security nexus

The transition from emergency relief to development is more an aspiration than a reality as it requires the end of hostilities. With the war still raging, there are significant challenges to improving the links between humanitarian and development aid. The strong focus on antiterrorist actions, with strict controls on aid to prevent it ending up in terrorists’ hands, has had consequences for both national and international humanitarian organisations, as well as for the private sector, which has been adversely affected by bank de-risking regulations (El Taraboulsi-McCarthy and Cimatti, 2018). Bank transfers to local individuals, organisations or businesses are extremely difficult, which has contributed to the expansion of the black market, the war economy and corruption in Yemen. This could have serious implications for the post-conflict reconstruction process and economic rehabilitation.

A situation that calls for changes in the humanitarian system

This conflict also highlights the need for, and relevance of, new approaches to aid in fragile situations and middle-income countries. In a context where the economy is in transition and is extremely dependent on key infrastructures and institutions, when these stop functioning due to war, the consequences are dire. The rehabilitation of basic essential infrastructure should therefore complement ‘classic’ life-saving assistance. Supporting the health system and rehabilitating basic infrastructure, such as urban water pumps, electricity plants and communication infrastructure would have a major impact on people’s daily lives.

Support to the banking system makes large-scale cash transfer programmes possible and ensures that the economy functions: salaries can be paid, trade can function and the diaspora can transfer remittances. These new approaches would require different skills and therefore new partners might be needed in the humanitarian system.

Related Content

Unicef yemen humanitarian situation report, 1 - 30 november 2022, unicef yemen humanitarian situation report (end of year): 31 december 2022 [en/ar], iom yemen appeal, january-december 2023, yemen humanitarian response plan 2023 (january 2023) [en/ar].

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Estimating access to health care in Yemen, a complex humanitarian emergency setting: a descriptive applied geospatial analysis

Kent garber.

a Health, Nutrition, and Population Sector, Middle East and North Africa, World Bank, Washington, DC, USA

Charles Fox

b Department of Sustainable Development, World Bank, Washington, DC, USA

Moustafa Abdalla

Andrew tatem.

c WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK

Naseeb Qirbi

d WHO, Sana'a, Yemen

Laura Lloyd-Braff

Kahtan al-shabi, kennedy ongwae.

e Health and Nutrition Department for UNICEF Yemen, Amman, Jordan

Meredith Dyson

Kebir hassen.

f Health and Nutrition Department for UNICEF Sudan, Khartoum, Sudan

Associated Data

In conflict settings, data to guide humanitarian and development responses are often scarce. Although geospatial analyses have been used to estimate health-care access in many countries, such techniques have not been widely applied to inform real-time operations in protracted health emergencies. Doing so could provide a more robust approach for identifying and prioritising populations in need, targeting assistance, and assessing impact. We aimed to use geospatial analyses to overcome such data gaps in Yemen, the site of one of the world's worst ongoing humanitarian crises.

We derived geospatial coordinates, functionality, and service availability data for Yemen health facilities from the Health Resources and Services Availability Monitoring System assessment done by WHO and the Yemen Ministry of Public Health and Population. We modelled population spatial distribution using high-resolution satellite imagery, UN population estimates, and census data. A road network grid was built from OpenStreetMap and satellite data and modified using UN Yemen Logistics Cluster data and other datasets to account for lines of conflict and road accessibility. Using this information, we created a geospatial network model to deduce the travel time of Yemeni people to their nearest health-care facilities.

In 2018, we estimated that nearly 8·8 million (30·6%) of the total estimated Yemeni population of 28·7 million people lived more than 30-min travel time from the nearest fully or partially functional public primary health-care facility, and more than 12·1 million (42·4%) Yemeni people lived more than 1 h from the nearest fully or partially functional public hospital, assuming access to motorised transport. We found that access varied widely by district and type of health service, with almost 40% of the population living more than 2 h from comprehensive emergency obstetric and surgical care. We identified and ranked districts according to the number of people living beyond acceptable travel times to facilities and services. We found substantial variability in access and that many front-line districts were among those with the poorest access.

Interpretation

These findings provide the most comprehensive estimates of geographical access to health care in Yemen since the outbreak of the current conflict, and they provide proof of concept for how geospatial techniques can be used to address data gaps and rigorously inform health programming. Such information is of crucial importance for humanitarian and development organisations seeking to improve effectiveness and accountability.

Global Financing Facility for Women, Children, and Adolescents Trust Fund; Development and Data Science grant; and the Yemen Emergency Health and Nutrition Project, a partnership between the World Bank, UNICEF, and WHO.

Introduction

Since 2015, Yemen has faced one of the world's most devastating armed conflicts. More than 100 000 people have been killed, 3·6 million internally displaced, and nearly 80% of the country's almost 30 million people requires humanitarian assistance. 1 , 2 In 2018, the conflict in Yemen was named the world's worst humanitarian crisis, with nearly half of the country's population on the brink of famine and hundreds of thousands affected by cholera. 3 , 4 The ongoing conflict has severely affected the country's health-care system: barely half of public health facilities are fully functional; salaries for health-care workers went unpaid from October, 2016, to early 2019; and essential medications and equipment are in short supply or absent. 5

As humanitarian and development agencies seek to support health-care delivery in Yemen, timely and reliable data on the health system and access to care are essential, but hard to obtain. The most recent Yemen Demographic and Health Survey, the gold standard for public health information in most low-income and middle-income countries, was done in 2013, well before the escalation of conflict. 6 No comprehensive national or district level estimates of health-care access or household surveys have been completed since 2013. The dynamic nature of the conflict—shifting front lines, new offensives, ongoing displacement, and changing disease burdens—has complicated efforts to prioritise and target assistance.

Research in context

Evidence before this study

Timely and accurate data are crucial for guiding humanitarian and development assistance in protracted conflict settings, yet such data are often lacking. The conflict in Yemen, now in its 6th year, has severely impacted the country's health system, but data on access to health care remain scarce. No national, governorate, or regional-level estimates exist to quantify the number of people with poor access to health facilities or specific services, or to determine the locations where the largest number of people have inadequate access. Although geospatial analytics have been used to estimate access to care and inform policy making in many countries, these techniques have not been widely applied in conflict settings to inform humanitarian and development responses. We searched PubMed, Google Scholar, and grey literature in the Humanitarian Data Exchange repository for articles in English related to the use of geospatial analyses in humanitarian health emergencies and conflict settings between Jan 1, 2006, and Dec 1, 2019. We used the search terms “geospatial”, “health”, “healthcare”, “humanitarian”, “development”, AND “armed conflict”, as well as the names of specific countries classified as fragile or conflict-affected by the World Bank since 2006. We also searched more broadly for examples of geospatial analyses used for health policy and planning from non-conflict settings focusing on the measurement of access to care. Articles unrelated to the health sector were excluded.

Added value of this study

We developed a novel geospatial model to estimate access to health care in Yemen that calculates travel times to public health-care facilities and health services from any point in the country. To do so, we compiled a geospatial database of hospitals and primary care facilities containing geocoordinates, functionality, and service availability data. Using UN population estimates, satellite data, and census figures, we developed up-to-date, high-resolution population spatial distribution maps for Yemen. We built a digital road network map using satellite imagery that incorporated road closures and lines of conflict to account for the impact of conflict on population movements. Based on these inputs, a novel geospatial analytical model yielded estimates of walk and drive times to: functional hospitals and primary care facilities; and specific health services. We found, and quantified the degree to which, a large proportion of the population of Yemen faces challenges with geographical access to care. We found that access varied widely by type of service and district, and we ranked districts in terms of poorest access to care by headcount and percentage.

Implications of all the available evidence

To our knowledge, these findings provide the first comprehensive estimates of access to health care in Yemen since the current conflict began. They provide national and district level estimates of access to functional health facilities and key health services. Moreover, they provide proof of concept for how operational data and geospatial techniques can be combined to address data needs and answer key questions around access in these settings. We argue that the use of geospatial techniques offers a data-driven, methodologically rigorous approach for planning and targeting assistance that could have profound implications for humanitarian and development responses.

These challenges are not unique to Yemen. Recent responses to humanitarian emergencies have been characterised by data shortcomings that limit efforts to target programming and assess effectiveness. 7 , 8 , 9 In many protracted conflicts, baseline health system data are lacking, public health information systems are weak, and data that are collected are of low quality, fragmented, and inconsistent. 7 , 8 Additionally, data collection has become more difficult owing to administrative and movement restrictions, violence against data collectors, and other such limitations. 10

Addressing these data challenges is essential to improving the effectiveness and accountability of international assistance. One potential approach, largely unrealised in protracted health emergencies, involves using geospatial analytics to identify populations in need and improve targeting of health services and resources. Over the past decade, geospatial analyses have become increasingly commonplace in policy planning for resource allocation in many low-income and middle-income countries, as well as high-income countries. 11 , 12 Several key inputs are required for these analyses: geocoordinates of health facilities; comprehensive road network maps; and high-resolution population spatial distribution data. Using this approach, health authorities have identified where geographical access to health care is poor, thereby enabling more equitable and efficient allocation of resources. 11

Such techniques, in theory, could be used to strengthen responses to humanitarian health emergencies and protracted conflicts. In practice, however, geospatial analytics have made little progress in these contexts. Necessary data on facility functionality, service availability, population location, and road networks are often unknown, incomplete, or outdated. Moreover, to the extent that humanitarians have applied geospatial techniques in health responses, the focus has largely been on thematic mapping, that is, making maps showing basic geocoded information or simple relationships. 13 Some progress has been made using geospatial techniques to track population movements after natural disasters (eg, Nepal in 2015), model infectious disease outbreaks, and estimate mortality in conflict-affected settings. 14 , 15 However, beyond these applications, geospatial analytics remain under-utilised in the humanitarian health sector, particularly for generating data to guide real-time decision making around service delivery and health system planning. 13

In this Article, we aim to provide proof of concept for how geospatial analytics, coupled with operational data on facility functionality, service availability, road accessibility, and lines of conflict, can be used to address data gaps amid an active armed conflict such as that in Yemen. We produce national and district level estimates of access to care and propose that these outputs could substantially inform the targeting and effectiveness of assistance, as well as strengthen efforts to support the resilience of affected health systems.

Assembling a geolocated inventory of health facility locations

We derived latitude and longitude coordinates for public primary health-care facilities and hospitals from the 2018 Health Resources and Services Availability Monitoring System (HeRAMS). This assessment was done by WHO and the Yemen Ministry of Public Health and Population ( appendix p 3 ) and contains data on facility location, functionality, and service availability, including antenatal care, illness in children younger than 5 years, malnutrition, emergency obstetric care, and surgery, all of which are services relevant to the Yemen Minimum Service Package for Health. 16 Facility locations were verified when possible by cross checking them against third-party monitoring data collected by the Yemen Emergency Health and Nutrition Project, implemented by WHO, UNICEF, and the World Bank. Discrepancies between HeRAMS and third-party data were reviewed and reconciled.

Population data

To model updated population distribution, we implemented widely adopted geospatial modelling approaches developed by WorldPop ( appendix p 4 ). 17 Previous WorldPop population mapping in Yemen involved the integration of the 2004 census data with urban extents defined by Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery and 2010 district-level population estimates, 18 matching similar mapping elsewhere. 19 , 20 Because major population movements and growth have occurred in Yemen since 2010, these existing datasets were outdated and required substantial revision.

Estimates of 2018 district populations from the UN Office for the Coordination of Humanitarian Affairs (OCHA) were the basis for the new mapping. The modelling process focused on disaggregating these estimates to a spatial resolution of 100 m by 100 m. UN OCHA national and district boundaries were obtained from the Humanitarian Data Exchange. 21 The locations of 112 974 villages and settlements enumerated and mapped in the 2004 census were obtained, with the population count of each village or settlement matched to an associated point location. Additionally, the footprints of major cities and towns were obtained from two global satellite-derived datasets: the Global Human Settlement Layer (GHSL), derived from 2014 Landsat imagery; and the Global Urban Footprint (GUF), derived from 2012 synthetic-aperture radar imagery. 22

GHSL uses more recent imagery and captures urban growth more effectively, whereas GUF uses more detailed imagery and different mapping algorithms, identifying smaller settlements more precisely. Therefore, the two datasets were combined to make a joint settlement footprint dataset aligned to the WorldPop master grid. Because the GHSL-GUF combined dataset only captured cities, towns, and large villages, it missed a substantial proportion of small villages important for mapping rural populations. To rectify this, the 2004 census dataset was integrated to capture these smaller settlements. The 2004 village and settlement totals per district were rescaled to match the 2018 estimates to provide new per-village estimates.

Estimates were generated for the total population of Yemen at a 100 m spatial resolution. Population centres aggregated to 1 km by 1 km cells were used as the starting points for all journeys. We transformed the aggregated product to a vector layer of points, with each point representing the centroid of a 1 km 2 grid cell. These points were subsequently used as origins in network analyses and consisted of more than 500 000 points.

Road network data

After conducting a baseline review of the Yemen road network in OpenStreetMap, additional roads were digitised and disconnected roads were joined to the main network to create a network that could be queried for travel times between points. We added missing paved roads and connected large settlements to the main network based on satellite imagery from DigitalGlobe imagery, as provided to the OpenStreetMap project. Raw data was obtained from Geofabrik, 23 retaining street-type or way-type objects with a highway tag, signalling that they were roads. This raw inventory was refined by removing all road objects not tagged with one of several acceptable road types, then cleaning road geometries to remove interstitial nodes and non-intersections, using a process modified from the Python package OSMnx. 24 Finally, we split road sections into 2 km sections to improve network snapping fidelity. The final road network is shown in the appendix (p 5) .

Elevation data

We used elevation data gathered by NASA's Shuttle Radar Topography Mission 25 to determine the elevation of each tile in the WorldPop population layer previously described. Elevation estimates were then used to modify walk time estimates to and from the main network.

Network analysis

In our basic model, each journey had three segments: a walk from the origin point to the nearest node on the network; a driving portion along the road system; and a walk from the nearest node to the final destination. The two walking segments assume straight-line movement from point to point, with walk speed adjusted for elevation changes according to Tobler's hiking function, with a maximum off-road walk speed set at 4 km/h, based on estimates by in-country partners. Driving portions assume that the traveller always moves at the speed limit while on the road network.

We modelled all possible journeys to health-care facilities individually along our network graph and calculated weighted shortest-path journeys. All processing steps were executed in Python (version 3.6). We used the lesser of the travel time calculated using this method (walk plus drive plus walk) and the direct straight-line walking time from origin to destination. This adjustment becomes relevant in areas where road network coverage is sparse and the distance to the nearest network node is large. We repeated this calculation for each origin point to all potential destinations (health facilities); from this set we take the minimum as the minimum access time to service for that origin.

Multiple access time thresholds were modelled: less than 30 min, less than 60 min, less than 120 min, and less than 240 min. These thresholds were based upon published guidelines for hospital and primary care planning and discussions with Yemen ground partners. 26 , 27

Modifications to incorporate conflict dynamics

Given the fragility of the Yemen conflict, we incorporated several novel dynamic variables into the model to reflect the impact of conflict on access to health-care services. The variables included road closures, lines of conflict, and mode of transportation.

The UN Logistics Cluster routinely collects information on road closures and restrictions due to conflict. We used the January 2019 dataset (to reflect year-end 2018) by intersecting their road network with our own and modifying travel speeds. Closed roads in the UN model resulted in a reduction in travel speeds by 100% in our model (road impassable); restricted roads reduced travel speeds by 50%. Information on lines of conflict was obtained from ground partners, reflecting the state of conflict between December, 2018, and January, 2019. We assumed these lines to be impassable by civilians and incorporated this assumption into the model by preventing hypothetical journeys from crossing such lines at any point. These lines effectively split Yemen into five contiguous areas in the model, such that each acts as its own self-contained network. To estimate accessibility when there is no access to a vehicle, we assigned a flat walking speed of 6 km/h along roads and hold all other assumptions constant (off-road walking speed remained the same at 4 km/h).

No personal health information was collected. Ethics committee approval was not necessary.

Role of funding source

The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

We identified 275 hospitals and 4767 primary health-care facilities, for a total of 5042 health facilities in Yemen in 2018. Of the hospitals, 149 (54%) were fully functional and 98 (36%) were partially functional; of the primary health-care facilities, 2416 (51%) were fully functional and 1651 (35%) were partially functional. We verified geocoordinates for 3806 (88%) of the 4314 functional or partially functional hospital and primary health-care facilities, based on HERAMS data triangulated against third-party monitoring data. The gross locations of these facilities are illustrated in the appendix (p 3) .

We produced national-level estimates of access to health-care facilities by calculating travel times to the nearest partially or fully functional primary-care facility or hospital from any point in Yemen, assuming access to motorised transport. For primary-care facilities, of a total estimated population of 28 670 616, we estimated that 19 899 047 (69·4%) people lived within 30 min of the nearest partially or fully functional primary health-care facility; 26 056 626 (90·9%) people lived within 60 min of a facility; and 28 224 303 (98·4%) people lived within 120 min of a facility ( table 1 ; figure 1A ). For hospitals, we estimated that 10 717 094 (37·4%) people of the population lived within 30 min of a partially or fully functioning hospital; 16 525 186 (57·6%) people lived within 60 min of a hospital; and 23 087 916 (80·5%) people lived within 120 min of a hospital ( table 1 ; figure 1B ).

Population living within specified travel time of health facilities assuming motorised transport

Travel time to the nearest functional or partially functional public primary health-care facility (A) and hospital (B), 2018

At the district level, we found that access to functional health facilities varied widely among districts, in both percentage and absolute terms. Across Yemen's 333 districts, we found that the proportion of the population in each district living less than 30 min from a primary health-care facility ranged from 0% to 100%, with a mean of 62·3% (SD 23·7; IQR 47·3–79·2); the proportion living less than 1 h away from a hospital ranged from 0% to 100%, with a mean of 45·6% (SD 34·2; IQR 15·4–77·1).

We ranked districts according to the absolute number of individuals with poor access according to defined threshold times to health care ( appendix p 8 ). Thresholds were defined as 1 h for primary care and 2 h for hospital care, reflecting WHO standards and consultations regarding acceptable travel times in Yemen. 18 Headcount maps by district, with districts shaded in terms of the absolute number of people living beyond these thresholds, are provided in the appendix (pp 6, 7) . The districts with the greatest number of people living beyond these thresholds are shown in the appendix (p 8) . We found that in 29 districts, more than 20 000 people lived further than 1 h from a primary health-care facility; and in six districts, more than 50 000 people lived further than 1 h. At the hospital level, we found that in 93 districts, more than 20 000 people lived further than 2 h from the nearest hospital; in 24 districts, more than 50 000 people lived further than 2 h; and in five districts, more than 100 000 people lived further than 2 h.

We next modelled geographical access to key health services. We found poor access overall for many services, with substantial variability by service type ( table 2 ; figure 2 ). Access was highest for immunisations and malnutrition services, with 17 914 659 and 17 923 044 individuals (62·5% of the population for both categories) living within a 30-min travel to these services, followed by care of children younger than 5 years (15 416 499 people; 53·8% of the population) and antenatal care (13 028 648 people; 45·4%). By contrast, only 9 833 012 (34·3%) people could access basic emergency obstetric care, 8 078 568 (29·2%) people could access emergency obstetric care, and 7 916 210 (27·6%) people could access emergency surgery within 30-min travel time. Roughly a third of the population lived more than 1 h away from antenatal care, and nearly half lived more than 1 h away from basic emergency obstetric care. Only 17 867 326 (62·3%) and 17 641 386 (61·5%) Yemenis lived within 2-h travel time of comprehensive emergency obstetric care or surgery services. Service accessibility also varied widely among districts; in the bottom quartile of districts, for example, less than a third of the population lived within 2 h of basic emergency obstetric care, whereas in the top quartile, more than 95% of the population did. This district-level variation was seen across all service types.

National and district level estimates of access to specific health services

Travel time to the nearest health facility offering antenatal care (A) and comprehensive emergency obstetric and neonatal care (B)

CEmONC=comprehensive emergency obstetric and neonatal care.

Finally, we reran the analysis assuming no access to motorised transport ( appendix p 9 ), given that exit survey data from WHO and UNICEF supported facilities in Yemen indicate that many patients are accessing facilities by foot. In this iteration, travel times to care increased and access decreased substantially. Assuming travel on foot only, only 55% of the population lived within 30 min of a primary health-care facility ( vs 97% who lived within 120-min travel time). At the hospital level, only 17% of the population lived within a 30-min walk to a hospital (with 52% within 120 min).

Using a novel geospatial analysis, we report the first population-level estimates of access to health care in Yemen since the outbreak of the current conflict. We compiled geocoordinates of health facilities and obtained satellite imagery, UN operational and third-party monitoring data, and other datasets to generate updated road network maps and high-resolution spatial population distribution estimates. To our knowledge, these estimates are the first to reflect key infrastructure and demographic changes (eg, internal displacement) since the conflict. These inputs were analysed using geospatial network analytics to produce estimates of access to primary health-care facilities, hospitals, and key health services. These estimates identified the location and magnitude of populations with limited access to health care to a much greater degree of spatial resolution than previously available.

We found, and quantified the degree to which, a large proportion of the population of Yemen faces challenges with accessing care. In 2018, nearly 8·8 million people (30·6% of Yemenis) were estimated to live more than a 30-min travel time from the nearest partially or fully functional public primary health-care facility, and approximately 12·1 million people (42·4% of Yemenis) lived more than 1 h from the nearest partially or fully functional public hospital. Access varied widely by district, which we ranked in terms of access deprivation. Of the districts with the largest number of people with poor geographical access to care, the majority are front-line districts, reflecting access challenges faced by civilians living close to armed conflict.

We found that access varied widely by type of health service, underscoring the reality that access to a functional health facility does not guarantee access to a specific service. Access was particularly poor for resource-intensive, hospital-based services, with slightly less than 40% of the population living more than a 2-h drive from comprehensive emergency obstetric care and surgical care, as well as for certain essential outpatient services, such as antenatal care. For patients who lack access to motorised transport, we found that their access is poorer still: assuming walking only, roughly 45% of Yemenis live more than a 30-min walk to the nearest functional primary health-care facility, and 68% live more than a 60-min walk to the nearest functional hospital.

Operationally, these findings could be immediately useful to humanitarian and development responses within the country. First, although the Yemen humanitarian health cluster has identified 74 hard-to-reach districts based on reported barriers, 26 the geospatial approach presented here, which analyses access from the population perspective, provides a much higher degree of spatial resolution of the size and locations of populations in need. Second, given that many organisations are earnestly investing in outreach programming to reach remote populations, these findings could immediately inform targeting decisions (eg, where to send community health workers or mobile teams). Third, because geospatial analytical models are adaptable, this analysis could be routinely updated to reflect changing ground conditions, for example, incorporating new data on road accessibility from the UN logistics cluster, service availability from field teams, and seasonality data. Fourth, these findings can help planners to respond more effectively to changing disease burdens. Findings from this work are already being used to model how COVID-19 might affect access to basic health-care services. Likewise, given that malnutrition and cholera have been major challenges in Yemen, understanding the geospatial relationship between disease outbreaks and accessibility to care could greatly inform efforts to locate disease-specific resources where they are needed most.

This approach is also highly relevant for organisations working in other conflict settings around the world. As previously discussed, although geospatial analyses are becoming increasingly commonplace in stable contexts, they remain underutilised in the humanitarian health space apart from basic thematic mapping, infectious disease modelling, and a handful of other research applications. 13 If operationalised further, these tools could greatly inform resource allocation decisions that are too often based upon fragmented and incomplete data, with ramifications that affect millions. 7 , 8 With access to data becoming harder, the need for innovative evidence generation is real. 10 The approach described here presents a novel means of combining ground-level operational data with geospatial techniques to address key data gaps and provides proof of concept for how such an approach can provide more comprehensive, timely analytics in conflict settings.

Finally, this type of analysis holds promise for strengthening monitoring and evaluation. In recent years, humanitarian and development organisations have faced growing calls to move beyond documenting inputs, such as numbers of kits or vaccines delivered, and focus more on measuring health outcomes and impact. 28 , 29 In the health sector, this would entail finding more rigorous ways to measure access, coverage, quality, affordability, and health outcomes associated with interventions. Such calculations often require accurate estimates of the population in need within a defined area (catchment zones, districts, governorates, etc). This geospatial approach provides one method for doing so. Moreover, this analysis could be repeated with serial datasets (eg, a 2020 version of HeRAMS is currently underway in Yemen) to measure changes in access over time and serve as a reference point for health system rebuilding.

We acknowledge several limitations with this work, as well as opportunities for more strongly incorporating geospatial analytics into humanitarian and development interventions. First, we recognise that determining who needs assistance, and where assistance is needed, is not simply a matter of geographical access. Epidemiological considerations are crucial, particularly in conflicts where disease outbreaks, injuries, and other health burdens can concentrate in specific areas. 30 Organisations working in these contexts must take epidemiological trends into account, and future geospatial work should seek to incorporate geocoded epidemiological data, such as estimates of disease incidence and transmission trends. This approach would help identify not only areas with large populations who lack access to care, but also those affected by or at risk of specific disease burdens (population in need).

Second, we acknowledge that geographical access represents only one dimension of access and might overestimate true access. Populations living near a functional facility often face substantial utilisation barriers, such as lack of transportation, discrimination, security concerns, poor quality of care, and affordability. We modelled one of these barriers (lack of transportation) and found a sharp drop in access. However, each of these factors can affect care-seeking and should be further assessed to understand not only theoretical access, but actual utilisation. To that end, WHO, UNICEF, and the World Bank have invested in strengthening utilisation data collection in Yemen and are working to analyse the access–utilisation relationship.

Third, we acknowledge limitations with the completeness and quality of some data, as well its reproducibility in other contexts. HeRAMS does not cover private sector facilities and might exclude temporary facilities and outreach activities, which can play a key part in improving access for remote populations. Future work should capture contributions from these modalities. Although GPS coordinates were obtained for nearly 90% of public health facilities in Yemen, facilities for which coordinates were not available were excluded, and some coordinates from HeRAMS were identified as incorrect, which required further investigation and verification using third-party monitors when possible. Moreover, HeRAMS is not available in all conflict-affected countries; however, there is growing interest in standardising these tools in such settings. The road network map, which includes more than 145 000 digitised segments, is extensive, but not every road was digitised, meaning that access might be underestimated in some areas. Finally, conflict is, by its nature, dynamic. The analysis presented here is a snapshot in time that should be updated as new data become available.

We also acknowledge the sensitivity around geocoded health data. Over the past decade, attacks on health-care workers and health facilities in conflict zones have proliferated. 31 These attacks represent a violation of International Humanitarian Law, and despite efforts to curb them, they continue. We caution that geocoded data, particularly for health facilities, must be treated with utmost sensitivity, and that organisations involved in collecting data must be extremely thoughtful and deliberate about how such data are stored, shared, and used.

As protracted conflicts proliferate, there is growing need for accurate, timely data to guide humanitarian and development responses. In recent years, calls to strengthen public health information systems and improve data collection have increased. Such efforts are vital, but better data collection needs to be paired with more rigorous analytical approaches to improve accountability among organisations and populations at large. As the Yemen conflict continues, vulnerability in what was already one of the poorest countries in the world is growing. Understanding where assistance is needed, and assuring accountability to those in need, is more pressing than ever.

For the Global Human Settlement Laye r see https://ghsl.jrc.ec.europa.eu/

For the DigitalGlobe see https://www.digitalglobe.com/

For the OpenStreetMap see https://www.openstreetmap.org/

For the WorldPop see https://www.worldpop.org/

For HeRAMS please see https://herams.org/

Acknowledgments

The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. This work was supported by: the Global Financing Facility for Women, Children, and Adolescents Trust Fund; a Decision and Delivery Science Support for Improved Universal Health Coverage grant, supported by a collaboration between the World Bank and Bill & Melinda Gates Foundation; and the Yemen Emergency Health and Nutrition Project, a partnership between the World Bank, UNICEF, and WHO. We thank Fouzia Shafique, former Chief of Health and Nutrition, UNICEF-Yemen; Altaf Musani, WHO Representative in Yemen; and Ernest Massiah, former World Bank Practice Manager, Health, Nutrition, and Population for the Middle East and North Africa Region, for their valuable support, insights, and contributions to this work. We would also like to acknowledge Manal Al-Hajji, geospatial analyst, for her contributions to the digitisation of the Yemeni road network.

Contributors

KG, CF, and MA were responsible for the study concept and design. KG, KO, MD, KH, NQ, LL-B, and KA-S collected and analysed the data. CF, AT, and KG were responsible for the geospatial analysis. All authors contributed to the manuscript writing and editing.

Declaration of interests

KG, CF, MA, NQ, LL-B, KA-S, KO, MD, and KH have worked on the bank-financed Yemen Emergency Health and Nutrition Project, a collaboration between the World Bank, WHO, and UNICEF that has supported the Yemen health system since 2017. AT declares no competing interests.

Supplementary Material

Yemen, Naval Blockade

The case studies presented in “How does law protect in war?” are based on open-source information. The discussions that follow are developed in partnership with academia. Neither the information contained in the case studies nor the discussions necessarily reflect the opinions of the ICRC or of the authors of “How does law protect in war?”. By continuing on this website, you agree to its terms and conditions .

• Applicability of IHL
• Armed conflicts subjects to foreign intervention
• Conduct of hostilities
• Means of warfare
• Naval and air warfare
• Naval warfare
• Middle East

Case prepared by Mr. Elem Khairullin, LL.M. student at the Geneva Academy of International Humanitarian Law and Human Rights, under the supervision of Professor Marco Sassòli and Ms. Yvette Issar, research assistant, both at the University of Geneva.

  N.B. As per the  disclaimer , neither the ICRC nor the authors can be identified with the opinions expressed in the Cases and Documents.  Some cases even come to solutions that clearly violate IHL. They are nevertheless worthy of discussion, if only to raise a challenge to display more humanity in armed conflicts.  Similarly, in some of the texts used in the case studies, the facts may not always be proven;  nevertheless, they have been selected because they highlight interesting IHL issues and are thus published for didactic purposes.

A. Yemen: Events of 2015

[Source : “World Report 2016: Yemen”, Human Rights Watch , 27 January 2016. Available at https://www.hrw.org/world-report/2016/country-chapters/yemen ]

[1] In January 2015, Houthi forces, also known as Ansar Allah, effectively ousted Yemeni President Abdu Rabu Mansour Hadi and his cabinet; he subsequently relocated to Saudi Arabia and re-established a government there.

[2] In March, after Houthi and allied forces advanced south, threatening the port city of Aden, a Saudi Arabia-led coalition of Arab countries, with the participation of the United States, began a campaign of airstrikes against them. On March 26, coalition warplanes attacked Houthi forces in Sanaa, the capital, and other locations. The airstrikes continued throughout 2015 as fighting occurred across the country, with Bahrain, Sudan, Saudi Arabia, and the United Arab Emirates sending ground troops to battle Houthi and allied forces.

B. Yemen: Coalition Blocking Desperately Needed Fuel

[Source : “Yemen: Coalition Blocking Desperately Needed Fuel”, Human Rights Watch , 10 May 2015. Available at https://www.hrw.org/news/2015/05/10/yemen-coalition-blocking-desperately-needed-fuel ]

[1] (Beirut) – The Saudi Arabia-led coalition’s blockade of Yemen is keeping out fuel needed for the Yemeni population’s survival in violation of the laws of war. Yemen is in urgent need of fuel to power generators for hospitals overwhelmed with wounded from the fighting and to pump water to civilian residences.

[2] The 10-country coalition, which has United States logistics and intelligence support, should urgently implement measures for the rapid processing of oil tankers to allow the safe, secure, and speedy distribution of fuel supplies to the civilian population. The Houthis and other armed groups controlling port areas should permit the safe transfer of fuel to hospitals and other civilian entities. Fuel should be allowed to go through whether or not a proposed ceasefire takes effect.

[3] The coalition began an aerial-bombing campaign against Houthi forces on March 26, 2015, and instituted a naval and aerial blockade. Under the laws of war, fuel and other goods with military uses can be prevented from entering the country unless it would threaten the population’s survival or otherwise cause disproportionate harm to the civilian population compared with the expected military gain.

[4] But the overall situation in Yemen is dire, Human Rights Watch said. The United Nations Office for the Coordination of Humanitarian Affairs’ (OCHA) humanitarian coordinator for Yemen, Johannes van der Klaauw, stated on April 23 that Yemen’s “airports and seaports constitute a lifeline given that Yemen relies on imports for 90 percent of its food and most of its fuel. However, these lifelines have been hampered as most of Yemen’s airports are not open to civilian traffic, and transports by sea are subject to the coalition’s inspection regime related to the arms embargo mandated by the UN Security Council.”

[5] […] On May 8, the United Nation’s Children’s Fund stated that “More children in Yemen are at risk of dying from hunger and lack of health services than from bombs and bullets.”

[6] According to shipping logs, since April 16, coalition forces granted permission to 19 ships carrying rice, grain, palm oil, steel, and timber permission to berth at Hodaida and Saleef ports, and they were able to unload their cargo. […] In contrast, no fuel tankers have been able to berth at Yemeni ports since March 28, though at least seven have tried, according to shipping records.

[7] Protection Vessels International stated that as of May 1 seven ships with over 349,000 metric tons (mT) of fuel supplies were anchored outside Yemeni territorial waters awaiting permission to berth at one of the country’s ports. Sources in the shipping industry told Human Rights Watch that one of these ships, the  RISA , has been waiting to berth at western Yemen’s Hodaida port since April 21. The  RISA  is carrying around 33,000 metric tons of gasoline, which would provide Yemen with enough fuel to cover two days of its peacetime consumption needs. According to shipping logs shared with Human Rights Watch, on April 23, at 4:06 p.m., six coalition marine officers boarded the vessel and for one hour inspected its cargo, then disembarked. But the coalition has not granted the vessel permission to berth, despite its repeated requests.

[8] Shipping sources told Human Rights Watch that for the ports of Hodaida and Saleef, which is also on Yemen’s west coast, applications must be filed with the Yemeni Transport Ministry, currently based in Jeddah, Saudi Arabia, and are subject to approval by coalition forces. For Aden, applications need to be filed with an office of the “Popular Resistance Committee” in Aden, which reports to the coalition forces. They said that they have been told that vessels must additionally prove that their cargo “will not benefit the Houthis,” but that they do not understand what is required for them to do this, and the coalition has not issued any clarifying instructions.

[9] On May 7, coalition forces threatened to open fire on any vessel not complying with instructions to stay well clear of Yemen Territorial Waters, shipping sources told Human Rights Watch. […]

[10] Human Rights Watch does not know to what extent other fuel tankers are declining to head to Yemeni ports due to security and insurance considerations. Major marine insurers have advised merchant vessels to avoid Yemeni territorial waters if possible while some shipping companies have publicly declared that they will no longer accept bookings to transport cargo to or from Yemen.

Humanitarian Situation in Yemen

[11] The coalition’s naval and aerial blockade of Yemen was put in place soon after the bombing campaign began on March 26. A coalition spokesman said on March 30 that “all the navy vessels needed for the blockade are in place,” and that they would “monitor all ships entering and leaving Yemeni ports.” The United Nations Security Council on April 14 imposed an arms embargo and travel restrictions against the Houthis. Beyond this, the goods embargoed and the procedures for enforcing the blockade have not publicly been made clear.

[12] Even before the beginning of this armed conflict, according to MercyCorps, 40 percent of the country was reported as food insecure. UNICEF reported that one million children under 5 years old were acutely malnourished. At least 61 percent of the population, half of whom are children, was in need of some kind of humanitarian assistance. The WFP estimates that 12 million people are now food insecure, a 13 percent increase.

[13] The fuel shortages have exacerbated the limited access to water, given Yemenis’ heavy reliance on water trucks and pumps. OCHA reported that 13.4 million people lacked access to safe drinking water even before the beginning of the crisis. UNICEF’s representative to Yemen, Julien Harnies, said: “The vast majority of water is pumped up using diesel generators … which will mean that people will end up using very bad quality water. You will get water-borne diseases, diarrhoea and eventually cholera and people will die of that.” On May 3, the WHO noted a doubling in cases of bloody diarrhoea in children under 5 as well as measles and malaria infections since March 26.

[14] The fuel shortage has also impacted many of the country’s hospitals, which do not have enough fuel for their generators to run. Heavy fighting, including aerial bombing by coalition forces, has wounded several thousand people in urban areas, taxing the country’s already substandard healthcare system. The World Health Organization (WHO), the International Committee of the Red Cross (ICRC), and other humanitarian agencies have pointed to the imminent shutdown of hospitals and medical services for lack of fuel and basic supplies. A statement issued by the ICRC quoted Issa Alzub, head of al-Kuwait Hospital in Sanaa, the capital, saying, “We are facing tremendous logistical difficulties in trying to keep this hospital working. We are running out of diesel. Our ambulances can no longer transport patients. Only half of our staff can come to work as the hospital buses have stopped running.”

[15] The WHO said on April 21 that ambulance services and the delivery of medical supplies had been critically disrupted. It said that because of electricity cuts, refrigerated vaccine-storage sites are in danger, which may leave millions of children below age 5 unvaccinated. […]

[16] According to information obtained by the World Food Programme (WFP) on May 3, prices for fuel have increased by about 450 percent in some regions. […]

[17] The increase in fuel prices has also contributed to skyrocketing prices for basic food stuffs. […] Yemen imports 95 percent of its wheat products and 90 percent of its basic food needs, making its population extremely vulnerable to fluctuations in import prices. According to the WFP, retail prices for wheat have risen by up to 90 percent in the hardest hit locations since February. Most essential food and non-food commodities disappeared in areas such as Saada, Aden, al-Dhale`a, Lahj, Taiz, and Shabwa due to disruptions of the supply chain, market dysfunctionalities, and transport restrictions on account of fuel shortages. […]

[18] All of Yemen’s energy production is oil and gas based, according to the US Energy Information Administration (USEIA). […] [O]ver the last 15 years Yemen has increasingly relied on petroleum imports. […] Given the lack of a pipeline to its neighbors, Saudi Arabia and Oman, all fuel shipments reach Yemen via one of its six ports, making it particularly vulnerable to naval disruptions.

Blockades and the Laws of War

[19] International law on naval blockades is set out in the 1908 London Declaration concerning the Laws of Naval War and in the 1994 San Remo Manual on International Law Applicable to Armed Conflicts at Sea (“San Remo Manual”), which are widely recognized as reflecting customary laws of war at sea. Similar rules relating to aerial blockades are found in the 2009 HPCR Manual on International Law Applicable to Air and Missile Warfare.

[20] Parties to an armed conflict may enforce and maintain a blockade using methods and means of warfare that do not violate the laws of war. Blockades need to be publicly declared and be effectively enforced.

[21] A blockade is unlawful if it has the sole purpose of starving the civilian population or denies the population goods indispensable for its survival. A blockade also violates the laws of war if it has a disproportionate impact on the civilian population, when the harm to civilians is, or may be expected to be, greater than the concrete and direct military advantage anticipated from the blockade.

[22] A blockading party may capture merchant vessels “believed on reasonable grounds to be breaching a blockade.” A party may attack a merchant vessel that, after prior warning, “clearly resist[s] capture.” However, blockades cannot be used to stop needed humanitarian assistance. If inadequate food and other goods essential for the survival of the civilian population are not being adequately provided, the blockading party must provide for free passage of food and other essential supplies. To allow passage, the blockading party may set technical arrangements, including permission to “visit and search” vessels; and require distributing the supplies under the local supervision of a government or an impartial humanitarian organization. Medical supplies for both civilians and combatants shall also be permitted, subject to meeting technical arrangements, including visit and search.

[23] A blockading party can only confiscate goods on board a neutral merchant vessel (or aircraft) if they are “contraband.” Contraband is defined as goods that “are ultimately destined for territory under the control of the enemy and which may be susceptible for use in armed conflict.” A blockading party must have published contraband lists, which may vary according to the particular circumstances of the armed conflict. Contraband lists shall be reasonably specific. “Free goods” are those not subject to capture, and that include religious objects; articles intended exclusively for the treatment of the wounded and sick; and clothing, bedding, essential foodstuffs, and means of shelter for the civilian population in general, and women and children in particular, unless there is a serious reason to believe that such goods will be diverted to a military purpose; and other goods not susceptible for use in armed conflict.

Discussion 

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Developing a Multi-methodology for Conflict Resolution: Case of Yemen’s Humanitarian Crisis

• Published: 25 July 2020
• Volume 30 , pages 301–320, ( 2021 )

Cite this article

• M. Nassereddine 1 ,
• M. A. Ellakkis 1 ,
• A. Azar 1 &
• M. D. Nayeri 1  

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Conflict analysis as one of the most challenging and demanding issues within different fields of nowadays world, is generally characterized by two types of complexities: structural and behavioral. Therefore, scholars worldwide to tackle the mentioned complexities welcome a multi-methodology intervention. Consequently, this study focuses on the development and application of multi-methodological intervention benefiting from the advantages of Soft OR and Game theory to deal more effectively with the complex nature of a real-world problem. Accordingly, the paper contributes to JOURNEY making methodology through developing new concepts, making it richer information-wise, and thus more reliable. Moreover, it applied the proposed model for the Saudi-led war on Yemen, where the latter faces one of the world’s worst humanitarian crisis. In addition, a stability analysis considered investigating stable scenarios (equilibrium) for all parties. Ultimately, findings indicate that only one stable scenario can stop the war and resolve one of the world’s worst humanitarian crises.

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M. Nassereddine, M. A. Ellakkis, A. Azar & M. D. Nayeri

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Nassereddine, M., Ellakkis, M.A., Azar, A. et al. Developing a Multi-methodology for Conflict Resolution: Case of Yemen’s Humanitarian Crisis. Group Decis Negot 30 , 301–320 (2021). https://doi.org/10.1007/s10726-020-09695-x

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Published : 25 July 2020

Issue Date : April 2021

DOI : https://doi.org/10.1007/s10726-020-09695-x

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