At sunset in Aden masses of crows fly back towards the land from the shore. They string out in front of the hills that frame the city’s harbor and come squawking to roost in the buildings and trees of the portside neighborhood of Sheikh Othman. Here is the modern sprawl of the city, the concrete fading out into the sand of Yemen’s coastal strip beyond. This is where the Médecins sans Frontières (MSF)1 hospital sits, a two-story building in which the arrival of a new patient is announced by the short ringing of a bell. After the crows settle into their perches and the preachers finish their evening prayers it is this sound, along with fireworks and short bursts of gunfire, that characterize the nights in Aden.
It is a city caught between war and peace, or perhaps more accurately a city living in uncertainty between two phases of a war now five years old. It was the taking of Aden by Ansar Allah (commonly known as the Houthis) in March 2015 that prompted then President Abdarabbuh Mansur Hadi to request a coalition of Arab states led by Saudi Arabia to intervene. The coalition launched a campaign of air strikes that has killed many civilians across the country. The fighting continues to this day in a country divided and destroyed by it.
The wreckage from that first battle is still very visible in Aden—hotels and apartment blocks with their sides blown out and walls caved in, villas with holes in their roofs where bombs smashed through. It took a few months for the coalition air strikes and local armed groups, hastily mobilized in the face of the northern rebels and the government’s collapse, to remove Ansar Allah from the city. This is the period known by Adenis as the war, as though everything that followed has been something else.
Abdel Khallaq, 19, is a child of these times. Born in Aden and raised in the city, he says he left school at 12 because his family could not afford to pay for him to attend any longer. At 13 the war arrived and he began fighting. Skinny, with a thin moustache and a shock of brown hair, he reclines on one arm in his hospital bed as he describes how he got shot in the leg. “We went out on patrol. One of my friends forgot to put the safety on his rifle. I didn’t feel pain but started trying to run away. Then I passed out and they brought me here.” This is his second injury. The first time he was sitting with a group of friends chewing qat¸ the mild stimulant used by most men in Yemen, and one of them began playing with a grenade’s pin. Abdel Khallaq took some shrapnel in the foot when it exploded.
He is tired of the life of a soldier. “Last year, in August, I deserted from the group I was with because I didn’t want to fight people from my own city,” he says, referring to the violence that shook Aden when the Southern Transitional Council (STC), a secessionist group, ousted forces loyal to the government from most of the city. “I went and joined another group in Abyan but we’ve not been paid our salaries in months. The situation now is bad. The prices are high and the people are poor.”
While he was speaking someone was dying in the emergency room. An unidentified man, shot in the heart in unclear circumstances at the local market. The blood poured out of him and the doctors were unable to save his life. The police came to take the body and patients stood on the veranda as the corpse, shrouded in a white body bag, was lifted into the back of their pickup.
The security is better in Aden than the first years after 2015, when clashes and bombings were frequent. But it is a city in the shadow of war, its streets filled with fighters and uncertainty. Last year most forces from the United Arab Emirates, which had been the dominant force in the south and the main supporter of the STC, withdrew. Saudi Arabia, the lead partner in the coalition, took over responsibility and brought together the STC and the government in Riyadh to sign a power-sharing agreement in December. The agreement seems to be dead, however, with the STC blaming the government for failing to deliver services and demanding that the STC hand over tanks and artillery in areas they say are not covered by the accords. The STC are blamed for attempting to monopolize southern representation in the government to the exclusion of other groups. It is Saudi Arabia that should be paying the salaries of soldiers like Abdel Khallaq, but they are not, leaving the town talking about what the intentions of the Saudis are in an unsustainable situation where the STC control the streets and the government the institutions.
In the meantime people try to survive. Regular work is hard to come by. Each morning men wait on the main avenues with their shovels, pickaxes and ladders, hoping for a day’s work on a construction site. Teachers are on strike because they have not been paid. Women and children beg at the roundabouts. In a city rife with criminality, security is one of the only growth industries. This was what led Muhsin, 20, to try his hand at guarding a villa. “My father died fighting the Houthis four years ago,” he says. “I live with my mum and two sisters. I don’t have a job. We get my father’s salary still but it’s not enough, so we have to take money from our relatives.” Two days after he started his new job some men tried to take the villa by force. Muhsin was shot in the foot and the bone was broken. “I was dizzy and I was saying ‘mum, mum,’ and I didn’t feel anything. I said the shehadeh. I thought I was going to die.” The two days he worked weren’t long enough to get his first paycheck, he says. It will take three months for him to recover.
“There are many things that should support this city,” explains Najwan, one of the doctors at the hospital, “the port for the economy, museums for the culture—but all this has been destroyed.” He is a proud scion of an Adeni family in a city known for being a place where most inhabitants are from elsewhere. “We, the sons of this city, know that it’s like a diamond in the hands of a miner. Someone used to pulling things out of the wall that are always covered with black dust might just throw the diamond away because it looks like coal. He might not appreciate he has something more in his hands.” There is nostalgia amongst many Adenis not just for the independent south—the flag of the old People’s Democratic Republic of Yemen is used by the secessionists today, even though they are not communists— but also for the period of British colonial rule. Time has softened memories, blurring out the injustices of imperialism and leaving an impression of order and economic well-being: attractive during days when so much is in chaos.
With the collapse of Yemen into war, the health care system has also imploded. This is particularly evident in ad-Dhale, the last town before the front line on the road north from Aden. Here the highlands begin, the slopes of smashed rock towering above villages of traditional brick houses and more recent concrete additions. A castle looks over the market, its walls partly destroyed by the fighting in 2015. A large model of an AK-47 points the way to the front from its perch on the hill and the streets below are busy with men carrying the real thing. Camps for the displaced cling to the edge of town.
The hospital is full of patients and their caretakers: soldiers in full camouflage gear with their legs in casts, old men in cast-off military jackets listlessly attached to a drip, women lifting their burqas so a doctor can inspect the incisions of a caesarean section. Here a few dedicated staff members are left to try and carry on the job of caring for the governorate’s poor—it is the only government hospital in the area. They are plainly overwhelmed, however: the hospital is dirty and the morning round reveals dressings that long since should have been changed. A cockroach scuttles for cover when the door of the sterilization room is opened. Mohammed, 35, was shot in the knee by a sniper on February 28 while trying to carry a friend who had just been hit by the same sniper. He lies in the surgical ward beneath a green blanket and talks quietly. “There’s a lot of pain,” he says, “and there is not enough staff here, they can’t take care of the patients.”2
“Sometimes I have to stop and take a step back,” says Naema, the operating theater supervisor. She’s faced with a shortage of drugs, staff and materials. “But then I go back and do what I am able to do, I try to fix what I can.” The most charitable explanation for the state of the hospital is offered by one of the doctors who says that the government has collapsed and that the budget allocated is simply not enough for the patients the hospital is expected to treat. Others offer darker tales of corruption and mismanagement. What is certain is that ad-Dhale is not only suffering from the active fighting but also from the toll five years of war takes on a country in all aspects of life. “I make 30,000 Riyals ($50) a month working here,” says Naja’, one of the guards. “My husband, a nurse, makes 85,000 Riyals ($140), which is good, but the rent on our house just went up from 40,000 Riyals ($65) to 60,000 Riyals ($100). How can we pay this? I have to take loans from people to survive, and until now I’ve not been able to pay any of them back. We eat, but it’s rice without chicken.”
Abu Ghaith decided his wife needed help after she had been sick for four days in their house. “I brought her to a hospital. A private one at first, but I couldn’t afford the care there.” She was diagnosed with a chest infection. “I am a teacher but I make only 57,000 Riyals ($95) a month. I am not able to afford all of the things I need, all the basics of life. Prices have gone up 200% during the war.”
In ad-Dhale guns are left at the gate but the bullets in a spare clip attached to Maher’s3 chest webbing glint under the waiting room’s lights. All around him is the noise and chaos of the hospital, a sick woman stretched out on a bench, patients accosting the doctor with questions, a soldier with a giant afro and a fresh bullet wound to the elbow grimacing as he enters the x-ray room. Maher had come down from the front line with a comrade who had been feeling sick and dizzy for two days. He tells his story without prompting, but speaks in a quiet voice that stands in stark contrast to many of the fighters who are boisterous with qat even though it is not yet 10 AM.
“I like the life of a civilian better than the life of a soldier,” he confesses. “In 2015 after the war I came back to Aden from Saudi Arabia for my marriage. I worked as a laborer and as a fisherman but I wasn’t able to make enough money. I wanted to be a security guard in Aden but I got sucked into coming to the front; the money is steadier than if I was just on the checkpoints.” He has been fighting for eleven months and talks with bitterness about the conditions in the dry hills where the front line is. He scrolls past pictures of himself posing with his rifle to find the pictures of his daughter, who is back in Aden, back down the road, back where he is from. Visibly upset, he pauses to collect himself.
“Me and my wife divorced because of the economy here, we fought over money. My aunt died recently, she had dengue, and then my cousin died the week after from the same thing. In Aden. They had no money for medicines.” He recounts his enthusiasm for the revolts that gripped the Arab world in 2011, his desire to see an end to dictatorships, his anger that they are more powerful than ever. “We have no idea where another cousin of mine is. Men came to take him from his house in Aden a year ago and then we received a video of him confessing to being a terrorist. It was obvious in the video he had been tortured.” He says that the family have tried to find out who is holding him from all of the various authorities and forces that are active in Aden but each of them claim to have no knowledge of him. “How can it be that they all deny having him? Who is in control of this country?”4
Later he is headed back to the front, standing up in the back of a Landcruiser filled with fighters, a soldier fighting for the money that he hopes will get him back together with his wife. The doctor confides that the friend he had brought with him was not really sick: exhausted, he was just looking for two or three days of leave from camp.
Back in Aden men sit in the shade of a fence outside the hospital gate, rifles leaning next to them, waiting for news of the patients they have brought from as far away as Shabwah, 500 km by road to the east, to seek care. In the operating theater, the surgeons dress the wounds of a man shot eight times in a feud; clean the stump of an arm left on a man who was hit by a shell on the front; and open the belly of another man shot in ad-Dhale, the small intestine uncurling quickly out of the incision, the surgeon searching for a tear, extracting small bits of shrapnel.
Sometimes the bodies of those hurt in the violence are unbearably small, like Faydeh, just a year old. Her father, Omar, does not know his age exactly but thinks he is around 60. He is from al-Hodeidah, a port city on Yemen’s west coast. This past August, his wife was feeding Faydeh in their house when a bullet came down through the roof and smashed into the baby. “We had to leave to find medical help,” he says. “I was crying, my wife was crying, I was so worried Faydeh would die. We had to walk from dawn to dusk through the dust, there was shooting and mines all around us. I was telling the children to follow exactly in my footsteps.” Finally, as the sun set they managed to reach a house where they were able to get some food and a car to take them to a hospital. Unable to deal with the severity of Faydeh’s wounds, after two days the hospital told Omar that there was no choice but to travel to Aden, at least six hours drive away. “We had to spend 20,000 Riyals ($33) to reach Aden, taking one car after another. The wound was beginning to smell and pus was coming out of it.”
After being rejected by a couple of private hospitals a government hospital took the family in but was not able to treat the wound, which had become infected with antibiotic-resistant bacteria. She is better now, after a months-long stay in the MSF hospital, where the family has been housed in the grounds. “I was a baker in Hodeidah,” Omar says, “but here there’s no work. Despite that, I don’t want to return to home, there’s nothing there but mines, shooting and hunger.”
Another NGO has found the family a place to live in Aden. So the family will begin a new life in a city whose inhabitants do not know for sure what will happen and yet are convinced that they have not seen the last of fighting, and are now increasingly worried about what the coronavirus will do to their city and to their country. Omar says he would like Faydeh to go to school. What Aden will be like by the time she is old enough to start studying is anyone’s guess.
For whom I work as a Communications Advisor ↩
MSF was supporting the hospital until November 2018 when the activities had to be stopped due to security incidents, including explosives thrown at the MSF team’s house. Other NGOs working in the town were targeted in a series of explosions in December 2019. I was visiting the hospital along with an MSF team who are restarting support to the hospital’s emergency room and operating theater. ↩
Name changed for security reasons. ↩
Human rights organizations, including Amnesty International, have documented a pattern of such disappearances in the south of Yemen. ↩