Sadeq Hasan had just started his presentation when the first bomb went off in Hudeydah fish market on August 3. The explosion sounded distant and was not unusual in the city. The second one was closer. The third bomb blew the gates of the hospital, where Hasan was leading a workshop for 80 community volunteers working on cholera vaccination campaign.
“One of the bombs hit the hospital gate. We all ran out and saw the bodies, the blood, and screaming people asking for help, lying on the ground in front of the hospital. It was very difficult to see it all, many of those killed by the gate were the injured brought from the fish market that were waiting to be hospitalized,” recalls Hasan, a communications officer at WHO Yemen. “There was also total chaos inside; the medical staff couldn’t cope with the number of injured,” he says.
The impact of the bomb went beyond the immediate wounded and killed – it effectively disrupted the functionality of the hospital for days as health care staff and patients were too afraid to go to the hospital. It had devastating effects for people – the hospital, one of the biggest in the country, normally took in 1500 patients, who now couldn’t get care. “It had turned into a ghost hospital. I could barely find a doctor there,” says Hasan as he visited the hospital in the days after the attack. “It's just a coincidence and luck that I survived. I was just in the same place that was hit a few minutes before the attack,” he says.
To document attacks like the one in Hudeydah, WHO launched in December 2017, a global Surveillance System on Attacks on Health Care (SSA), that enables the collection of primary data on different types of attacks on health care. The electronic surveillance system will enable WHO and partners on the ground to report on attacks on health care in a consistent and systematic manner, to allow WHO to capture evidence on attacks in different countries, activate measures to further document their impact, and advocate at all levels for preventive and protective actions. Currently, seven countries report into the Surveillance System for Attacks on Healthcare: Syria, Afghanistan, Iraq, Yemen, Libya, Mali, and the occupied Palestinian territories.
The data is a key element of the initiative, which is providing precise information on the numbers and nature of the attacks. “We think that WHO should have the most extensive data on attacks and this is why SSA was launched. We want to make sure that all the data that we can find are put into the system, which then allows us to have a better picture of the impact of these attacks” says Rudi Coninx, WHO Humanitarian Policy and Guidance Chief.
According to the SSA, as of 6 November this year, 525 attacks on health care have been recorded by WHO in 6 major crisis countries in the Eastern Mediterranean Region, with 115 health workers and patients killed and 671 wounded as a result. In Yemen, only 50% of health facilities are functioning, versus 90% in 2013.