Disaster response in a civil war: Lessons on local hospitals capacity. The case of Yemen

ABSTRACT

Objectives: To explore the capacity of the health system in the  governorate in responding to disasters during the civil war of 2015.

Methods: This is a descriptive cross-section, pretest-posttest study design. It was carried in three district hospitals and one general hospitals in the coastal region of Hadhramout Governorate-Yemen. They were evaluated for their physical resources inputs, services outputs, and their human resources.

Results: The health system in the governorate showed poor effectiveness 50%, the general hospital had acquired 94% of standard resources for hospitals; there were shortages of health care providers in all hospitals, with variable skills levels in emergency care. The training of general practitioners had improved their performance in airway breathing and circulation skills (from 44% to 94%, P = 0.00), wound care (from 78% to 100%, P = 0.00), abdominal traumas (from 6% to 56%, P = 0.01) chest traumas (from 28% to 89%, P = 0.00), musculoskeletal traumas (from 28% to 72%, P = 0.00), head and spine traumas (from 22% to 78%, P = 0.00).

Conclusion: Despite the fragility of the health system, training during disaster significantly improves the skills of care providers. Evaluation of the health system during disasters needs special tools.

KEYWORDS:

• Disaster
• emergency care
• general practitioners
• nurses
• Yemen
• health system

Acknowledgments

The authors are thankful to our colleagues Dr Abdul-Baki Al-Hawthry, Dr Ryad Al-Juariri, and Dr Lyla Al-Tamimi who greatly assisted the research through helping us during data collection and providing us with the up to date documents.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Madiha Said Abdul-Razik

Dr. Madiha Said Abdul-Razik – Egypt Cellphone: [phone]  e-mail: [email protected], Academic email: [email protected] Dr. Madiha Said, a professor of public health at Cairo University, has had over thirty years of experience in the fields of public health, health services management, Health systems analysis, Demography, family planning, operations research, and strategic planning and policy analysis. Her extensive knowledge of the health system and population sector in Egypt has allowed her to serve as a consultant for several projects including. The Family Health Services Project, a joint project between the Federal Republic of Germany and the Ministry of Health, Family Health International’s Women’s Studies Project, the Institutional Development Project at the NPC, the Health Systems Research Program, a joint venture between the World Health Organization and the Ministry of Health and Population, and the USAID-sponsored Futures-lead Policy Project. Dr. Madiha, through her own research as a professor, and through her consultancies with the Research Management Unit of the National Population Council, FHI’s Woman’s Studies Project, the POLICY Project, and the World Health Organization Health Systems Analysis Projects, UNFPA, and UNICEF has extensive experience in the research process and research management, as well as in the interpretation of research.

Abdullah Mubark Kaity

Dr. Abdullah Mubark Kaity – Yemen Cellphone: [phone] email: [email protected] Linkedin: Abdullah Kaity – Skype: dr.kaity Dr. Abdullah is assistance lecturer – public health Department College of Nursing – Hadhramout University – Yemen. Dr. Abdullah was a trainer of the out-reach mobile clinic program carried by INTERSOS International NGO in Mukalla during 2016, and trainer and supervisor at- MOHP programs Mukalla - Yemen 2015.

Nawal Saeed Banafaa

Nawal Saeed Banafaa – Yemen Cellphone: [phone], [phone]- [phone] E-mail: [email protected] Dr. Nawal is the Dean of college of nursing since 2012, and the director of female cancer program in Hadhramout cancer foundation since 2010. National trainer in reproductive health STD/AIDS program, National Population Council. Director of the reproductive health and director of the demographic activities in Hadhramout Governorate 2005–2007.

Ghada Wahby El-Hady

Ghada Wahby El-Hady – Egypt Cellphone: [phone] - [phone] Primary email: [email protected], alternative: [email protected] Skype: ghada-elhady Dr. Ghada is a consultant and Head of Public Health and Preventive Medicine department- Qaseem Armed Forces Hospital- Saudi Arabia. Associate Prof. of Public Health, Preventive and Social Medicine- Faculty of Medicine – Cairo University. Dr. Ghada is a member in the following committees: Curriculum Development - Education Program Auditing Committee - Conferences Organizing Committee.