Yemen: The families trapped by landmines

MSF teams are treating large numbers of people injured by landmines - one third of them children

Yemen: The families trapped by landmines

© Agnes Varraine-Leca/MSF

© Agnes Varraine-Leca/MSF

The city of Mocha, December 2018

A bell sounds in the yard of the MSF tented hospital – more patients are about to arrive.

A pick-up truck armed with a rocket launcher screeches to a halt and unloads four patients in front of the emergency room.

Two are children covered with hastily applied bandages. The other two are already dead.

Just a few hours earlier they had been with family members in fields in Mawza - around 30 km away - when someone stepped on a landmine...

A child shows IEDs found in Mawza

© Agnes Varraine-Leca/MSF

© Agnes Varraine-Leca/MSF

Like the family that had just arrived, 14-year-old Nasser was wounded when a landmine exploded.

Standing up on his crutches for the first time, he tries to get his balance. A scar on his left hand shows where his thumb was amputated after he was hit by a bullet some years ago.

© Agnes Varraine-Leca/MSF

Nasser stepped on the mine on 7 December while he, his uncle and cousin were watching over the family’s sheep in a field in Mafraq Al Mocha, near Taïz.

Later that day, Nasser was operated on in MSF’s surgical hospital 50 km away in Mocha. Part of his right leg was amputated below the knee.

With a thumb missing, it’s hard for him to use the crutches, so MSF physiotherapist Faroukh helps him to take a few steps between the 10 beds in one of the hospital’s three inpatient wards.

© Agnes Varraine-Leca/MSF

“The bone was completely shattered so there was nothing to left to save,” says Faroukh.

Since the accident, Nasser’s father, Mohammed, has been very apprehensive about walking in the fields around Mafraq Al Mocha.

“We know mines have been planted around the town, but the problem is we don’t know exactly where,” he says.

With only a handful of signs indicating the presence of mines and only a few red-painted stones showing where it’s safe to walk, every day a muffled bang signals that yet another explosive device has been triggered.

Yemen is in the grip of a brutal war

Since March 2015, a Saudi and Emirati-led coalition has been fighting Ansar Allah forces, resulting in bombing, gun battles and widespread destruction. Ordinary people are bearing the brunt of the conflict.

Many hospitals have been destroyed and those still open are in urgent need of medical supplies. Yemenis are struggling to afford food and fuel due to unemployment and rising prices.

These conditions, combined with airstrikes and sniper fire, have turned this conflict into one of the worst man-made humanitarian crises in the world.

Map of Yemen conflict

In early 2018, fighting intensified along the frontline between the cities of Taïz and Hodeidah.

In an effort to prevent the advance of the coalition’s ground troops, thousands of mines and improvised explosive devices were planted across the region’s roads and fields.

The principal victims of these lethal hazards have been unwitting civilians, many of whom have been killed or maimed for life.

By August 2018, MSF set up a hospital in the port city of Mocha, near Taïz, where teams perform emergency surgery on people injured by mines.

Punished twice

Before the war, the area between Mocha and the frontline was agricultural.

Since the fighting started, towns and villages near the combat zones – such as Hays and Mafraq Al Mocha, where MSF provides support to advanced medical posts – have seen many of their inhabitants flee.

The surrounding fields were mined to prevent the advance of military troops, but have had the added effect of making them impossible to cultivate.

In such agricultural areas, this has deprived local people of their livelihood and taken a heavy toll on families. In some places, such as the district of Mawza - a 45-minute drive from Mocha - the population has now halved.

“People who live here are punished – not once, but twice," says Claire Ha-Duong, MSF’s head of mission in Yemen.

"The mines not only blow up their children but also prevent them from cultivating their fields. They lose their source of income as well as food for their families."

Between August and December 2018, MSF’s teams in Mocha admitted and treated more than 150 people wounded by mines, improvised explosive devices and unexploded ordnance.

Around a third of them are children who had been playing in the fields. Disabled for life, they now face uncertain futures.

By creating generations of maimed people, mines have far-reaching repercussions – not only for individual families, but for society as a whole. Their victims are likely to be more dependent on others at the same time as being more socially isolated.

Military inside Mocha city

Military presence inside Mocha city © Agnes Varraine-Leca/MSF

A child sitting near defused rockets in Mawza

A child sitting near defused rockets in Mawza © Agnes Varraine-Leca/MSF

MSF's surgical hospital in Mocha

MSF's surgical hospital in Mocha © Agnes Varraine-Leca/MSF

Military presence inside Mocha city © Agnes Varraine-Leca/MSF

A child sitting near defused rockets in Mawza © Agnes Varraine-Leca/MSF

MSF's surgical hospital in Mocha © Agnes Varraine-Leca/MSF

Mine clearance

Thousands upon thousands of explosive devices will endanger the lives of people in Yemen for decades to come.

In a recent report, UK-based organisation Conflict Armament Research pointed to Ansar Allah’s mass-production of mines and improvised explosive devices, as well as the use of anti-personnel, vehicle and naval mines.

The Yemeni army has cleared 300,000 mines between 2016 and 2018, according to the Yemen Executive Mine Action Centre

However, this process - which is managed almost exclusively by the military - is focused on roads and strategic infrastructure, with little attention paid to civilian areas.

“Specialist mine clearance organisations and the authorities must step up their efforts to demine the region in order to reduce the number of victims,” says Claire.

Amarah, 5

Amarah was playing with friends in a sheep field near the town of Dubba. She saw an object with numbers on it in the ground and touched it.

Then it exploded.

The devastating blast injured three other children and killed a young boy.

Amarah was refered to MSF’s hospital in Mocha. She was treated for injuries to her face and abdomen, and an open fracture in her left leg.

Amarah was injured by a landmine while playing near her home in Dubba

© Agnes Varraine-Leca/MSF

© Agnes Varraine-Leca/MSF

Ali, 18

Ali was meant to meet friends in a field near Mawza. He was late and started running.

Suddenly, a landmine exploded.

His right leg had to be amputated below the knee. He already has a weakened left leg due to having polio as a child.

He is currently receiving physiotherapy at the MSF hospital in Mocha.

Ali had to have his right leg amputated after stepping on a landmine near his house

© Agnes Varraine-Leca/MSF

© Agnes Varraine-Leca/MSF

A medical wasteland

Not a day goes by without war-wounded people like Amarah and Ali arriving at MSF’s hospital in Mocha from the frontlines between Taïz and Hodeidah.

© Agnes Varraine-Leca/MSF

Medical care is available in the city of Aden - a six to eight hour drive south of Hodeidah - where MSF also opened a specialist trauma hospital in 2012. However, many Yemeni's don't have the money to pay for transport to get there.

This has made the 450 km distance between the two cities into a medical wasteland for the people who live there.

MSF’s hospital in Mocha is now the only facility in the region with an operating theatre and the capacity to perform surgery.

© Agnes Varraine-Leca/MSF

“The coastal region between Hodeidah and Aden is rural and extremely poor. People have no access to medical treatment and our hospital is the only place they can go when they need surgery,” says Husni Abdallah, a nurse in the operating theatre.

“They’re essentially patients with war wounds. Some don’t manage to get to Mocha in time and die of injuries that could have been treated. Or, they’re pregnant women who die during labour due to a lack of adequate medical care.

“The war-wounded often get to Mocha very late and many are in a critical condition," says Hunsi.

"They contract infections because on the frontline they aren’t always stabilised as well as they should be.

"Mines cause particularly severe injuries, so we see complex fractures that are difficult to operate on. Patients often have to have amputations and then require months and months of rehabilitation."

Since MSF opened its hospital in Mocha, its staff have provided more than 2,000 emergency room consultations and performed around 1,000 surgical procedures.

MSF is urging the authorities as well as specialist organisations to step up mine clearance operations to reduce the number of people killed and injured by explosive devices in civilian areas.