Middle East

What it’s like to give birth in a war zone

A Yemeni woman inspects the damage at a factory allegedly targeted by Saudi-led airstrikes in Sana'a, September 2016. Source: AFP

As the war in Yemen intensifies and the world’s largest humanitarian crisis takes hold, SBS News meets one mother watching her country fall apart.

Maali Jamil’s doctor had told her she could not give birth at night, no matter what. As darkness fell each day in Yemen’s capital of Sana’a, so did the missiles.

Saudi airstrikes shook ancient buildings across the city. The power flickered in and out. The sky was streaked with retaliatory anti-aircraft fire; their payloads often landing in residential neighbourhoods, killing and injuring hundreds of civilians. 

It was 7 April 2015 and 25-year-old Maali was 36 weeks pregnant with her first child. A medical complication meant she would likely require a caesarean section, but with the nightly onslaught of violence, organising a hospital, doctor and anaesthetist could only be done safely in the daylight hours.

Yemen, a country of 27 million stretched along the southern edge of the Arabian Peninsula, was at war.

It still is.

Why the bombs started falling

Saudi Arabia’s aerial bombardment of Yemen started 13 days earlier. The Middle Eastern superpower was attempting to reverse a rebel coup that had overthrown the Saudi-friendly administration of President Abdu Rabbu Mansour Hadi.

There were claims Mr Hadi had been forced to flee Sana’a in his wife’s niqab, or in a food truck, depending on which news report you read.

A map of the Middle East showing the location of Yemen to the south.
A map of the Middle East showing the location of Yemen to the south.

Months earlier, Houthi tribesmen from Yemen’s north had struck an unlikely alliance with a former foe; deposed president Ali Abdullah Saleh, and marched upon the capital. Mr Saleh’s fortunes had soured swiftly in 2011 when he was forced to resign amid Arab Spring protests. But newly allied with the Houthis, he was able to retake the ancient capital of Sana’a with relative ease. 

It was a development that alarmed the Saudis, who claimed the Houthis were proxies for Iran, Saudi Arabia’s regional nemesis. 

In coalition with a handful of allies, and backed by intelligence and logistical support from the United States, Saudi Arabia established a naval blockade and began pounding its southern neighbour with airstrikes in an effort to restore the Hadi government.

But the rebel takeover of her country mattered little to Maali that night. It was 3am and she was going into labour.

“I started to be in a lot of pain,” she tells SBS news.

Two weeks earlier, Maali heard the first bombs fall in Sana’a and quickly woke her husband. At first he didn’t believe her, but they stayed up and listened as the rumbling grew nearer and their house began to shake.

“It started to get louder and stronger,” she says.

“We knew something was going on.”

Soon they could see anti-aircraft fire from their windows. Maali called her mother to warn her, while her husband followed live updates on Twitter.

“It was all so very surreal,” Maali says.

“For us it was like a joke, it can’t be real, Saudi Arabia is not bombing Yemen.”

But two weeks later, Saudi Arabia was still bombing Yemen, and Maali was remembering the words of her doctor: ‘If you go into labour at night, you will be on your own’.

“I remember just trying to soldier through,” she says.

More than 13,000 civilians killed

The following morning, as embassies around the world scrambled to evacuate their diplomats, expats and tourists, Maali was being rushed to hospital. 

When she arrived at the hospital, missiles ploughed into the hill behind it. Saudi Arabia had started hitting targets in the daylight. She remembers the building rattling as bombs exploded nearby. 

“We could hear them, we could feel them,” she says.

“This is happening, I’m giving birth but at the same time they’re bombing here.”

A Yemeni woman inspects the damage at a factory allegedly targeted by Saudi-led airstrikes in Sana'a, September 2016.
A Yemeni woman inspects the damage at a factory allegedly targeted by Saudi-led airstrikes in Sana'a, September 2016.

Other hospitals have been hit by airstrikes in the two-and-a-half years since the war began, as have schools, factories, farms, ports, aircraft and funeral gatherings. Less than a year after Maali was admitted, a Saudi strike would land on an amusement park just across the road from the hospital.

This is happening, I’m giving birth but at the same time they’re bombing here.

- Maali Jamil

The UN has recorded more than 13,000 civilian combat deaths since the Saudi intervention - most a result of coalition airstrikes - but the actual number, the organisation says, is likely to be much higher. 

Both the allied Houthi/Saleh forces and Saudi coalition forces have also committed war crimes, including sieges, blockades, indiscriminate targeting, torture and executions, the UN claims. 

“Because the Saudis control the airspace, and because they are able to run the naval blockade, their impact is much greater,” says April Longley Alley, Project Director for the Gulf and Arabian Peninsula with the International Crisis Group.

But despite the damage to civilian infrastructure, Ms Alley says the strikes have done very little to advance the Saudi’s military progress in Yemen.

April Longley Alley on the political situation in Yemen
April Longley Alley on the political situation in Yemen

The Saudi naval blockade has, however, reduced vital medical supplies to a trickle. The bombing has damaged hundreds of medical facilities and the rebel government has been unable to pay wages. As of December 2017, less than half of Yemen’s hospitals were fully functional.

When she was admitted, Maali recalls her doctors casually discussing who hadn’t received their wages and which colleagues had already fled the city.

Following a successful caesarean, Maali would soon flee too. With a newborn son in tow and her surgery scars still raw, she and her husband began to plot their escape.

“We knew there was nothing we could do in Yemen if someone got sick, if our son got sick,” Maali says.

'A man-made catastrophe'

In dusty fields near Yemen’s makeshift displacement camps, rocks act as headstones for tiny graves. The UN says at least 1,500 children have been killed in crossfire, but that doesn’t account for the thousands more who have died from starvation and illness in what is now the world’s largest humanitarian catastrophe.

One child dies every ten minutes from preventable causes in Yemen, according to UNICEF. About 400,000 children are suffering from severe acute malnutrition and due to poor sanitation and a lack of vaccines and clean water, cases of cholera could reach one million in 2018. The country is on the brink of famine.

A Yemeni woman holds her child, who is suspected of being infected with cholera, at a makeshift hospital in Sana'a, August 2017.
A Yemeni woman holds her child, who is suspected of being infected with cholera, at a makeshift hospital in Sana'a, August 2017.

Doctor Meritxell Relano, UNICEF’s Resident Representative in Yemen, tells SBS News about a recent trip to a hospital in the port city of Aden where she met children being treated for cholera. 

“One little child, Ali, seven-years-old, the same age as my son,” she says.

“He was so thin.”

The bacterial disease causes severe diarrhoea and can be fatal if untreated.

Dr Relano asked the boy’s parents why they waited so long to bring him in. They said they had been scrambling to get money together for the trip.

“Many of the families don’t have the money even to go to a health centre,” she says.

Medical supplies are also sitting unused in ships and storage facilities due to the Saudi blockade.

“We are talking about ready to use therapeutic food, we are talking about fuel that is essential for pumping water, we are talking about medicines and vaccines that are needed.”  

The UN says more than 1,500 children in Yemen have also been used as child soldiers, mostly by the Houthi/Saleh forces. Dr Relano met some of those undergoing a rehabilitation program. 

“(They've) borne witness of things children should never be witness of,” she says.

“What frustrates me the most about the situation in Yemen is that this is a war that is created by people,”

“Unless the two parties agree on a peaceful solution, the children of Yemen … are going to suffer.”

Survivor’s guilt

Three weeks after giving birth, Maali and her husband made their first attempt to flee. 

After waiting five days to cross the Yemen/Saudi Arabia border with their young son, they were turned away by Saudi authorities. A second attempt was thwarted three weeks later when Houthi rebels stopped them on route to the border.

Their third attempt; a flight out of the damaged Sana’a airport, was successful.

The couple now live in Jordan’s capital Amman with their smiley two-and-a-half-year-old toddler. With no shortages of petrol, groceries and running water – and no threat of missile strikes – they live a life of relative luxury.

“I didn’t realise how stressful it was until I left, it hits you much later,” Maali says.

“When I first came to Amman I went to the bathroom and there was hot water in the sink … I started crying.”

Maali Jamil and her son.
Maali Jamil and her son.

Although Maali fled Yemen, her parents stayed behind. Her father became too sick to travel.

“There’s a lot of survivor’s guilt,” Maali says.

She has brothers, other family and friends still there. 

“I’m glued to my phone, I’m glued to the internet.” 

This is a war that is created by people

- Doctor Meritxell Relano, UNICEF

Maali’s father suffered a stroke in late 2014 as the Houthi/Saleh forces were taking over the capital. The family wasn’t able to get him the necessary tests because their local health facilities had no power. She remembers watching her mother struggling with her father’s medication.

“We ended up guessing his dose for the most part,” she says.

“My dad was a very kind person, he was very hard working; he just did not stop.”

In 2015 she received a message of condolence from one of her cousins. 

“And that’s when I knew that he had died.” 

Like thousands of others who have died following a lack of medical care or malnutrition, Maali’s father won’t be recorded in the war's official list of civilian combat casualties. 

'Neither side is exhausted'

Despite the war intensifying in late 2017, the conflict remains, essentially, a stalemate. For more than a year, the Saudi-backed Hadi government has been in control of the south and the rebels have been in control of the north.

The territories roughly mirror the divide between South Yemen and North Yemen, the two countries that were united to form modern-day Yemen in 1990. Some observers have suggested splitting the country again and leaving it at that, but it appears unlikely.

“The conflict is on an escalatory spiral at the moment,” says International Crisis Group’s April Longley.

“Neither side is exhausted and both are capable of continuing the fight.”

The Saudi coalition recently attempted to split Mr Saleh’s forces from his Houthi allies by offering to negotiate with him directly, an offer the former president took up. But the gamble didn’t pay off. Mr Saleh’s defection set off a week of violent clashes between Houthi and Saleh forces in Sana’a. 

On 4 December 2017, Mr Saleh, the man who had led Yemen for decades, was killed. Some reports say Houthi rebels shot him during a vehicle ambush. Footage claiming to show Mr Saleh’s body – with a severe head wound and being carried on a floral blanket by armed men – quickly circulated on social media.

Saleh's death has dimmed any prospect of peace in Yemen
Saleh's death has dimmed any prospect of peace in Yemen

'A stain on our nation'

As civilian casualties mount, there is growing unease about Western support for the war in Yemen. Several US senators and UK Labour MPs have been publicly critical of their own governments for supporting the Saudi campaign.

“This is a stain on the conscience of our nation if we continue to remain silent,” Democratic Senator Chris Murphy said in November 2017.  

“Suspend licenses for arms sales to Saudi Arabia. Stop killing children,” Scottish National Party MP Ian Blackford demanded in the House of Commons.

A Yemeni boy among the damage in the country's southern city of Taez following a mortar shell attack in February 2016.
A Yemeni boy among the damage in the country's southern city of Taez following a mortar shell attack in February 2016.

Weapons companies in the US, UK, France, Germany and China, among others, have made billions of dollars selling equipment to Saudi Arabia. The Netherlands is the only country to have enforced a weapons embargo due to likely war crimes. 

But in UN Human Rights Council and Security Council sessions, the US and the UK, among others, have shielded Saudi Arabia from diplomatic pressure and criticism. 

“There is not necessarily the concerted diplomatic effort to really break this stalemate and to push the relevant sides to the negotiating table,” Ms Alley says.

For their part, many Yemenis are also frustrated that the conflict remains only sporadically covered by Western media. Maali, watching from Jordan with her young son, says the lack of attention and action is painful.

“Not everybody’s going to care about Yemen,” she says.

“But it would be great to see more people speaking out about the atrocities that are happening and to help stop the carnage.”   

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