LONDON – At 4 months of age, all Hussain Al-Kholani has known is war and desire – he weighs only 4 1/2 pounds, less than a third of the average American baby of that age.
“Hussain has suffered from malnutrition since he was born,” Ali Hussein Al-Kholani, the boy’s father, told ABC News. “They told me to take you to the malnutrition clinic in [Yemen’s capital of] Sanaa, but I have no way to get you there. “
Ali Hussein is unable to work and is forced to feed his family – son, daughter, wife and four brothers – relying on food donations from humanitarian agencies. They live in a small hut on the outskirts of Al-Dahi, a large refugee camp for internally displaced persons in the northern province of Hajah. He has no money to buy diapers for his youngest son, let alone travel around the poor country to get treatment.
The history of the Al-Kholani family is not unique: about 2 million children need treatment for severe malnutrition, with at least 360,000 at risk of dying, according to the World Food Program. For nearly six years of conflict, aid workers have been desperately struggling to deliver supplies and medical assistance to the now 24.3 million Yemenis – a staggering 80% of the total population – who need humanitarian aid.
Now added to the protracted crisis is a new risk of rapid deterioration: one of President Donald Trump’s final acts in office – designating the militant group Houthi Ansar Allah as a “Foreign Terrorist Organization” – can prevent aid agencies from working in much of the the country and, in the words of a United States senator, constitutes a “death sentence for millions”.
‘Catastrophe’
The situation in Yemen has already been categorized by the World Health Organization as the “worst humanitarian crisis in the world”. The origins of the conflict are complicated, emerging from the instability of the Arab Spring, but the war has lasted since 2015, with both sides suspected of committing war crimes. The Saudis, in particular, have received international criticism, with the United States and the United Kingdom continuing to export weapons to the Kingdom, despite accusations that the weapons have been repeatedly used to attack hospitals and civilian sites.
The fighting between the Iran-backed Houthi militia and the Saudi-backed government has reached a wide impasse. The Houthi militia now controls large areas of the country, while the Saudi government is based in Aden and is recognized by the international community.
The latest incident of violence saw 25 people killed and 110 injured in a missile attack at an airport in Aden, a city in the south, which the internationally recognized Yemeni government has attributed to the Houthis – a reminder that both sides are far from anything like a diplomatic agreement. The Houthis denied responsibility for the explosion, The Guardian reported.
The country is at a breaking point. In the first six months of 2021, about 16.2 million people, half of the total population, are expected to face “acute levels of food insecurity”, according to the WFP, which needs at least $ 1.9 billion to provide a minimum level of food assistance to prevent hunger. The UN group is now saying that conditions this year are likely to be worse than in 2018, the last time Yemen has experienced conditions similar to hunger.
“How are they going to get food?” David Beasley, the group’s executive director, asked the United Nations Security Council last week. “How are they going to get fuel? How are they going to get medicine? It’s going to be a catastrophe … we’re going to have a catastrophe on our hands.”
Last month, UNICEF warned that Yemen is “teetering on the brink of collapse” and “perhaps the most dangerous place on Earth to be a child”.
“A child dies every 10 minutes from a preventable disease,” said executive director Henrietta Fore. “Two million are out of school. And thousands have been killed, maimed or recruited since 2015.”
For Hussain, and 12 million other children, daily life is an “awake nightmare” – with conflicts occurring on 49 different front lines, the group said. Since last year, according to the WFP, 1 million pregnant or nursing women have needed treatment.
At a malnutrition clinic at Bani Hassan hospital in Hajjah province, Dr. Ali Hajer told ABC News that the food supply at the center was “zero”, as the supply of aid has been interrupted in recent months.
“The Yemen war has destroyed everything, like the economy, health and the living situation in Yemen,” he told ABC News. “This assistance is very important. If this humanitarian aid stops for the Yemeni people and Yemeni children, there will be a major catastrophe.”
COVID-19 is making the situation even more difficult for health professionals and humanitarian agencies. As of January 19, there were 2,119 confirmed cases and 615 deaths, but WHO is preparing for a second wave at a time when only half of the country’s health facilities are fully or partially functioning. In recent years, Yemen has experienced what the WHO has called the worst cholera outbreak in modern times, as well as new outbreaks of diphtheria, dengue, measles and malaria.
‘Outrage’
The situation is in danger of becoming even worse. On January 12, the United States officially designated Ansar Allah as an FTO in response to its alleged “terrorist acts, including cross-border attacks that threaten civilian populations, infrastructure and commercial navigation,” said former Secretary of State Mike Pompeo in a statement. communicated before the designation, adding that the measure “intended to advance efforts to reach a peaceful, sovereign and united Yemen that is free from Iranian interference and at peace with its neighbors”.
But the designation of FTO now means that it is illegal for individuals or groups to provide “materials or resources” to Ansar Allah, meaning that, without official exemptions, no outside agency can provide assistance to large areas of the country under his government.
Humanitarian aid organizations said that, in effect, the decision could make their work impossible to do, with supply and access lines already at constant risk of interruption. In addition, they said, the FTO designation will not end terrorism.
Amanda Cantanzano, senior director of International Programs Policy and Defense for the International Rescue Committee, told ABC News that the IRC was “outraged by the decision”.
“We see this as something that will create barriers in such a way that it will be almost impossible for us to effectively and efficiently deliver aid to those in need. And that would be a crisis anywhere. But in Yemen, it is a catastrophe,” she told ABC news.
Kirsten Fontenrose, former senior director of the NSC for Gulf Affairs, told ABC News that the designation was considered, but not sought in the early years of the Trump administration due to a number of factors. The UN reported that the designation “would make it impossible” to seek political settlement in Yemen, but eventually the administration concluded that Ansar Allah was “seizing the opportunity to operate to lead additional terrorist organizations” and “exploiting this vulnerability in the aid community”, whose members would oppose the designation.
“Ansar Allah will ensure that this designation makes humanitarian aid more difficult,” Fontenrose told ABC News. “They want to amplify voices against the designation, so they need to make the impact look as terrible as possible.”
Connecticut Senator Chris Murphy, however, said that political sabotage was a more likely reason.
UN Security Council members warned that “there can be no military solution to the conflict”. Martin Griffiths, the UN special envoy for Yemen, said that the designation of the FTO may have a “discouraging effect” in bringing the parties together for dialogue.
“What is difficult is that the language of FTO legislation is not intended to be applied to a quasi-governmental organization,” Jon Alternam, director of the Middle East Program at the Center for Strategic and International Studies, told ABC News. “So it is very comprehensive to know that you cannot have anything to do with this type of person … The Houthis control well over half of Yemen’s population. This is not how to deal with Al Qaeda.”
“This does not mean that the Houthis do not do outrageous things, it does not mean that the Houthis do not endanger civilians all the time – they do,” he said. “But how does reaching an agreement criminalize common contact with them?”
Antony Blinken, Biden’s nominee for secretary of state, said the new government would “immediately review” the designation. But that can include a very complex legal process and can take some time to resolve, according to Alternam. Murphy told ABC News that this period could be crucial, as Yemenis continue to suffer.
“This is a death sentence for millions of Yemenis because, over the next few weeks, they will run out of food and starve to death,” said Murphy. “It’s so simple. And the fact that the Trump administration has gone ahead with that designation, knowing that this would be the consequence, is absolutely devastating. It’s heartbreaking. It’s mind-blowing.”
For people like Hussain and his family, there is no end in sight – and daily decisions are becoming increasingly difficult.
“[We have] just a basket of food from the World Food Program, “said Hussain’s father.” Or we sell to take care of the boy. Or take it home so we can eat. “
Ahmed Baider and Conor Finnegan of ABC News contributed to this report.