WASHINGTON - Overwhelmed by war and a dire humanitarian crisis for the past five years, Yemen, already on the brink, now faces COVID-19, which the United Nations says is spreading "fast and wide" across the country.
"We are hearing distressing reports of people with high fever and serious breathing difficulties being turned away from health facilities that are either full or unable to provide safe treatment," U.N. humanitarian chief Mark Lowcock told reporters Thursday on a call with other agency officials. "Unfortunately, people are suffering and dying at home."
Local health officials also are reporting dozens of unidentified deaths per day.
"The pandemic is widely spreading, adding to other diseases like cholera, dengue fever and chikungunya," said Adam al-Jaidi, a doctor working with the World Health Organization (WHO) on the front lines of the coronavirus response in the southwestern province of Taiz.
Al-Jaidi said local officials were not taking preventative measures seriously and warring parties were continuing to fight, further complicating the situation.
Yemen's health system has been decimated by five years of war. Only half of the health care facilities are still functioning, and most lack adequate staff, supplies and equipment for a widespread outbreak.
WHO has refitted about 38 health care facilities to accommodate COVID-19 patients, but only about half of those are fully functional. It also is setting up isolation units for positive patients, bringing in thousands of diagnostic testing kits and trying to keep medical centers equipped with a reliable supply of oxygen.
"In Taiz, for example, there is not a single isolation unit," al-Jaidi said. "There are maximum 16 functioning ventilators serving a city populated by 3 million people."
Yemen documented its first COVID-19 case April 10, and the WHO has confirmed 237 cases and 45 deaths since.
"That hugely underestimates the actual spread and impact of this disease," Mike Ryan, WHO executive director of health emergencies, told reporters Thursday.
He warned that if COVID-19 takes hold in the fragile country, its impact is likely to be "catastrophic."
Yemen is ripe for widespread transmission. Many families live in crowded conditions, unable to socially distance and without access to clean water for handwashing, which is important to help prevent transmission of the virus. The head of UNICEF, the U.N. children's agency, said Thursday that because of budget shortfalls, her agency was even running out of soap.
Yemen already has been grappling with the spread of multiple diseases, mainly cholera, malaria and chikungunya. Sara Beysolow Nyanti, the Yemen representative of UNICEF, told VOA that children under age 5 accounted for nearly a quarter of these cases, underscoring that the diseases put them at risk of death from any further severe complications, such as COVID-19. Exacerbating the situation, several cities last month were swept by a wave of flash floods, destroying homes, displacing people, and blocking access to drinking water and sanitation.
This Tuesday, Saudi Arabia, a protagonist in Yemen's conflict, will host a virtual humanitarian donors conference. The United Nations is seeking $2.4 billion, of which $180 million has been earmarked for the coronavirus response.
The U.N. humanitarian chief says the need for funding is dire, not just for COVID-19, but for a variety of lifesaving programs, several of which could be shut down imminently without a cash infusion.
'A bad moment'
"Is the world ready to simply watch Yemen fall off the cliff?" Lowcock asked. "This is a bad moment in Yemen. There are tens of millions of people whose lives are at now at risk."
The U.N. has described the situation in Yemen as the world's largest humanitarian crisis. Nearly 80 percent of the population, or 24 million people, receive some form of humanitarian assistance or protection.
Saudi Arabia, which supports the Yemeni government, began bombing the Iranian-backed Houthi rebels in March 2015. Since then, thousands of Yemenis have been killed, mostly in coalition airstrikes.
VOA's Margaret Besheer contributed to this report.