The cholera outbreak in Yemen is overwhelmingly affecting rebel-controlled areas due to Saudi-led airstrikes and blockades, according to a letter by researchers from Queen Mary University of London (QMUL), published in The Lancet Global Health.
Their new analysis finds that eight out of ten of Yemen's cholera deaths occur in rebel-controlled areas.
The researchers combined WHO's latest cholera data with data that mapped areas of government and rebel control, and found that the cholera outbreak disproportionately affects areas controlled by Houthi rebels.
They found that 77.7 per cent of cholera cases (339,061 of 436,625) and 80.7 per cent of deaths from cholera (1,545 of 1,915) occurred in Houthi-controlled governorates, compared to 15.4 per cent of cases and 10.4 per cent of deaths in government-controlled governorates.
1.8 per cent of the population in Houthi-controlled areas have contracted cholera, compared to 1.0 per cent in government-controlled areas. 0.46 per cent of those who contracted cholera died in Houthi-controlled areas, compared to 0.30 per cent in government-controlled areas.
Jonathan Kennedy, Andrew Harmer and David McCoy from QMUL write: "Both sides have been accused of disregarding the wellbeing of civilians and breaching international humanitarian law. But the government and Saudi-led coalition that supports it command far greater resources. As a result, Houthi-controlled areas have been disproportionately affected by the conflict, which has created conditions conducive to the spread of cholera.
"Saudi-led airstrikes have destroyed vital infrastructure, including hospitals and public water systems, hit civilian areas, and displaced people into crowded and insanitary conditions. A Saudi-enforced blockade of imports has caused shortages of, among other things, food, medical supplies, fuel and chlorine, and restricted humanitarian access.
"As the Saudi-led coalition has played a key role in the collapse of health, water, and sanitation systems in rebel-controlled areas, it is bizarre that UNICEF recently published a press release welcoming Saudi Arabian 'generosity' after the Kingdom donated US$67 million to the cholera response in Yemen."
Jonathan Kennedy from QMUL added: "Saudi Arabia is an ally of the UK and USA. American and British companies supply Saudi Arabia with huge amounts of military equipment and their armed forces provide logistical support and intelligence. This backing has made the Saudi-led airstrikes and blockade possible, and therefore the UK and USA have played a crucial role in creating conditions conducive to the spread of cholera."
In June 2017, UNICEF and WHO released a statement declaring that Yemen is "facing the worst cholera outbreak in the world". While they acknowledged the outbreak was caused by the civil war that began in 2015, they did not suggest that one party is more responsible than another or that one side is more affected by the outbreak, stating "cholera has spread to almost every governorate".
The new analysis is published as the UN marks World Humanitarian Day, a yearly tribute to aid workers, and aimed to rally support for people affected by crises around the world. Yemen has been described as the biggest humanitarian crisis of our time.
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Notes to the editor
* Cholera is a bacterial infection that is spread by water that contains contaminated faeces. It can be easily prevented where people have access to clean water and sanitation, and it can be easily treated with antibiotics and oral rehydration therapy.
* Letter: 'The political determinants of the cholera outbreak in Yemen'. Jonathan Kennedy, Andrew Harmer and David McCoy. The Lancet Global Health. doi: 10.1016/S2214-109X(17)30332-7
The article can be found here after embargo lifts: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30332-7/fulltext?elsca1=tlxpr
About Queen Mary University of London
Queen Mary University of London (QMUL) is one of the UK's leading universities, and one of the largest institutions in the University of London, with 21,187 students from more than 155 countries.
A member of the Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research. In the most recent national assessment of the quality of research, we were placed ninth in the UK (REF 2014).
As well as our main site at Mile End - which is home to one of the largest self-contained residential campuses in London - we have campuses at Whitechapel, Charterhouse Square, and West Smithfield dedicated to the study of medicine, and a base for legal studies at Lincoln's Inn Fields.
We have a rich history in London with roots in Europe's first public hospital, St Barts; England's first medical school, The London; one of the first colleges to provide higher education to women, Westfield College; and the Victorian philanthropic project, the People's Palace at Mile End.
Today, as well as retaining these close connections to our local community, we are known for our international collaborations in both teaching and research.
QMUL has an annual turnover of £350m, a research income worth £125m (2014/15), and generates employment and output worth £700m to the UK economy each year.