Outside the Walls: Helping hard-to-reach populations meet their medical needs

The survival of children in Yemen is being threatened right from birth, with many born out of hospitals, without skilled birth attendants and at risk of infections and death.  Many of the causes of this tragedy are preventable. Nearly six years since conflict escalated in March 2015, only around half of health facilities are operational and those that are running face severe shortages in medicine, equipment and staff.

The World Bank International Development Association and UNICEF have partnered through the Emergency Health and Nutrition Project (EHNP) to provide health, nutrition, water, and sanitation services to the population of the Republic of Yemen.

The EHNP supports around 2,000 health facilities across the country. The project provides primary healthcare services at the primary health care level including, routine community awareness, mobile health teams, and community-based services such as community midwives and community health volunteers (CHV).

One of the most critical activities conducted by the health facilities is the regular outreach activity to reach the most vulnerable children and their mothers in remote areas where accessing health facilities is difficult.

Alawi Mohammed Ali Thabet, the Director of Nutrition at Al-Thawrah Centre, Taiz governorate, conducts field visits to remote areas with the Outside the Walls team to provide vaccination for children and women, and vitamin supplements to children and pregnant and lactating women (PLW) who are malnourished, as well as  to educate women on family planning methods and nutrition.

Alawi Mohammed says: “We provide nutrition and vaccination for nearly 30 children and 26 mothers every week through the outreach activity. We also have counseling corners to raise awareness among women on reproductive health in general, the importance of personal hygiene, and the importance of adequate nutrition in children.”

Another member of the Outside the Walls team, Dr. Abdullah Abdulellah Al-Sufiani, 39, is an internt and pediatrician, and the Head of the Al-Thawarah Maternity and Childhood Center. 

Mona Ali Ghanem, a mother of six, used to borrow money when one of her children would get sick to pay for transport and treatment. 

Mona Ali says, “I would go to the centre to do the tests and get the free medicines, and I had no money to pay for the car rental cost. Now, UNICEF team comes to us and provides us with vaccines for mothers and children, and I also receive blood pressure medicine for free.”

Dr. Nabila Mohammed Al-Bahri, 38, the Head of Immunization at Al-Thawarah Center, sees the outreach activity as a service promoting healthcare by delivering medicine, vaccines, nutrition, and awareness to people living in remote areas.

“There are pregnant and lactating women whom we visit to vaccinate them and their children, and to provide nutrition, reproductive health services, awareness, and medicine”, she explains.

During a visit with the Outside the Walls team, we met Shaimaa Mohammed Abdullah, a 15-year-old girl, who was infected with severe diarrhea and went to Al-Dhabab Health Centre for help. 

Shaimaa says, “I reached the health centre with difficulty, and they gave me the medicine for free. Now, the situation is better after the visit of the Outside the Walls team because they come to the village and provide us with treatment, vaccines, and awareness.”

The outreach activity has received a great response from the locals because it allows them to receive immunization services in their village, in particular for PLW and women of reproductive age. Both groups have limited mobility within their communities.

Overall, the project provides all the  funding to support expenses associated with operational costs, medicines, medical instruments, first aid kits, training, supervision, updated guidelines, and other necessary tools to ensure the realization of a minimum service package for childcare, including the integrated management of childhood illnesses and nutrition services.