A life in the Balance

[Khaled Abdullah Khaled Abdullah, Photographer Reuters from Sana'a Yemen]

Born just before the outbreak of Yemen's devastating war, Ali Mohammed al-Tawaari may well not survive it.

Damaged by a lack of skilled medical care at a critical moment in his early weeks, the six-month-old infant struggles for life in a hospital in the bomb-damaged capital Sanaa.

Ali suffers malnourishment and complications from a botched circumcision performed by an unqualified practitioner.

Terlahir sebelum pecahnya perang yang menghancurkan Yaman, Ali Mohammed al-Tawaari mungkin tidak akan bertahan.

Rusak oleh kurangnya perawatan medis yang terampil pada saat kritis di minggu-minggu awal, bayi berusia enam bulan berjuang seumur hidup di sebuah rumah sakit di ibukota yang rusak akibat bom, Sanaa.

Ali menderita kekurangan gizi dan komplikasi akibat penyunatan yang dilakukan oleh praktisi yang tidak berkualifikasi.

"He is dying, you can see it," said his mother Wadha, watching his tiny skeletal figure.

"I want to turn him to the Kaaba," she said, referring to the ancient cubic shrine in Mecca which all Muslims face when they pray and when they are buried.

He was admitted to an intensive care unit at al-Sabeen hospital in the city's Haddah neighbourhood, where nurses treat infants suffering malnutrition, their skin stretched tight over the bones of wasted figures.

"Dia sekarat, Anda bisa melihatnya," kata ibunya Wadha, melihat sosok skalanya yang kecil.

"Saya ingin mengubahnya menjadi Ka'bah," katanya, mengacu pada kuil kubik kuno di Mekkah yang dihadapi semua Muslim saat mereka berdoa dan saat mereka dikuburkan.

Dia dirawat di sebuah unit perawatan intensif di rumah sakit al-Sabeen di lingkungan Haddah di kota tersebut, tempat perawat merawat bayi yang menderita kekurangan gizi, kulit mereka membentang ketat di tulang-tulang angka yang terbuang.

When the war began in March between the country’s Houthi movement and an exiled government backed by Gulf Arab states, hundreds of foreign, mostly Asian medical staff members were evacuated to their countries, leaving their jobs in Yemeni hospitals.

Local medics, nurses and doctors also left the places they were working in to go back to their home areas.

Ketika perang dimulai pada bulan Maret antara gerakan Houthi di negara itu dan pemerintah yang diasingkan yang didukung oleh negara-negara Teluk Arab, ratusan anggota staf medis asing diasingkan ke negara mereka, meninggalkan pekerjaan mereka di rumah sakit Yaman.

Petugas medis, perawat, dan dokter umum juga meninggalkan tempat mereka bekerja untuk kembali ke daerah asalnya.

The rural district three hours from Sanaa where Ali's family lives was one of the areas that lost qualified medical staff.

Without their skills, routine problems can turn lethal.

Wadha said that Ali's problems began when he was circumcised incorrectly. He bled for a whole day after the operation and later suffered diarrhea.

When he arrived at Sabeen "his condition improved the first day, but now it's deteriorated."

Malnutrition complicated Ali's state of health.

Distrik pedesaan tiga jam dari Sanaa tempat tinggal keluarga Ali adalah salah satu daerah yang kehilangan staf medis yang berkualitas.

Tanpa keterampilan mereka, masalah rutin bisa mematikan.

Wadha mengatakan bahwa masalah Ali dimulai saat dia disunat secara tidak benar. Dia berdarah selama sehari setelah operasi dan kemudian menderita diare.

Saat dia sampai di Sabeen "kondisinya membaik pada hari pertama, tapi sekarang sudah memburuk."

Malnutrisi rumit keadaan kesehatan Ali.

Disruptions of daily life caused by war have also deprived many Yemenis of their livelihoods, robbing people like Ali's parents of the financial means to help their children.

"We had a decent life before the war started, we had a business and were cultivating crops,” Wadha said. “But now diesel became expensive and my husband cannot pay for water."

Even before the war, Yemen had one of the highest child malnutrition rates in the world, according to the World Food Programme. Around half of all children under five are stunted, too short for their age as a result of malnutrition.

Gangguan kehidupan sehari-hari yang disebabkan oleh perang juga telah merampas banyak orang Yaman dari penghidupan mereka, merampok orang-orang seperti orang tua Ali yang memiliki sarana finansial untuk membantu anak-anak mereka.

"Kami memiliki kehidupan yang layak sebelum perang dimulai, kami memiliki bisnis dan sedang menanam tanaman," kata Wadha. "Tapi sekarang solar menjadi mahal dan suami saya tidak dapat membayar air."

Bahkan sebelum perang, Yaman memiliki tingkat gizi buruk tertinggi di dunia, menurut Program Pangan Dunia. Sekitar setengah dari semua anak balita kerdil, terlalu pendek untuk usia mereka sebagai akibat kekurangan gizi.

Yemen normally imports almost 90 percent of its basic food from abroad. The U.N. emergency food agency said on July 30 that the impact of traders being unable to import enough food and safely move it inside the country has led to a severe rise in prices, increasing the suffering of the poorest and most vulnerable.

The U.N. children's agency UNICEF said on July 10 it was stepping up screening for malnutrition, vaccinations and other life-saving interventions for millions of Yemeni children caught up in the crisis.

More than 16,000 children have been treated for severe malnutrition and 1.3 million children in the country are at risk of malnutrition, it said.

"But what Yemen really needs now is a return to peace, a solution to the fuel and power crisis and restoration of regular health services," Julien Harneis, UNICEF representative in Yemen, said in a statement.

For Ali, that may come too late.

Wadha gazed at her son. "If you look at his face, you can see that death is approaching."

Yaman biasanya mengimpor hampir 90 persen makanan pokoknya dari luar negeri. Badan makanan darurat U.N mengatakan pada 30 Juli bahwa dampak pedagang tidak dapat mengimpor cukup makanan dan dengan aman memindahkannya ke dalam negeri telah menyebabkan kenaikan harga yang parah, meningkatkan penderitaan orang-orang yang paling miskin dan paling rentan.

Badan anak-anak U.N. UNICEF mengatakan pada tanggal 10 Juli, pihaknya meningkatkan skrining untuk kekurangan gizi, vaksinasi dan intervensi penghematan hidup lainnya untuk jutaan anak-anak Yaman yang terjebak dalam krisis tersebut.

Lebih dari 16.000 anak-anak diobati karena kekurangan gizi parah dan 1,3 juta anak di negara tersebut berisiko mengalami gizi buruk, katanya.

"Tapi yang benar-benar dibutuhkan Yaman adalah kembalinya perdamaian, sebuah solusi untuk mengatasi krisis bahan bakar dan listrik dan pemulihan layanan kesehatan reguler," Julien Harneis, perwakilan UNICEF di Yaman, mengatakan dalam sebuah pernyataan.

Bagi Ali, itu mungkin terlambat.

Wadha menatap anaknya. "Jika Anda melihat wajahnya, Anda bisa melihat bahwa kematian sudah dekat."

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