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Alright you guys, and introducing Claire Minera from Doctors Without Borders and she is on the line from Hamar in Yemen.
Welcome back to the show.
How are you doing Claire?
Hi, yeah fine thanks.
Good to talk to you.
Very happy to have you back on the show and jeez, I just don't know I can't even keep up with the headlines.
I don't know how you're keeping up with the ill.
When you were on my show what six weeks ago or something you said that there were thirty thousand cases of cholera I think, if I remember it right, but then the media now says it's three hundred thousand.
Is that right?
It's gotten completely that far out of control in this time?
Yeah, it definitely has.
I think when we last spoke we were receiving a hundred cases a day in our hospitals.
So and then it increased from there.
Man, incredible.
I mean, did the Saudis just bomb all the waterworks or what exactly is the problem?
Well, the problem we're facing now is quite it's a lot worse than before I think actually because at least when we're receiving cases in our hospitals we're able to treat them and even though they come in extremely sick and on the verge of death we can treat them.
But now the problem is that we're having so many people that are not able to reach us in the hospitals.
They're dying in their homes and we're spending hours traveling every day out to get to them and to provide them with the care they need so that we can keep them alive.
And it's absolutely devastating to see this every day.
So it's a bacterial infection I think you explained before.
Is it just passed from person to person or only through bad drinking water or how exactly does that work?
Yeah, it's mainly passed through bad drinking water and also contaminated food.
So before the war people didn't have very good water and sanitation anyway.
But now since the war started there is definitely a lack in drinking water for most of the people and most health facilities are not working.
So in the time that someone gets sick with cholera it can kill you in a few hours and normally they would go to a health facility close by but they're not open.
Yes, some of them have been bombed but a lot are just not functioning because the country's collapsed, the health system has collapsed.
Well, so then two questions there.
So if somebody coughs or sneezes on someone else it doesn't transmit that way?
No, it doesn't transmit that way.
It's a fecal-oral route.
So it's basically if someone gets the bacteria on their hands and then into their mouth this is how it passes.
So it lives and it survives in feces and excreta.
And then you say it can kill someone in just a few hours?
Yeah, which is the worst thing that I've had to deal with here I think because especially in children they have no resistance at all.
And the symptoms are basically intense diarrhea and vomiting which is a horrible way to die for anyone but for children it can just take a few hours and we know that this is a result of the crisis in the country and it's the children that are hit the hardest and I think this is what I find the worst to deal with.
And then, I'm sorry, I think you told me before that really what you do to treat people is just hydrate them first and foremost.
It's not even a matter of really giving them antibiotics or anything.
It's just making sure they survive the initial stages and then they'll be okay maybe, right?
Yeah, exactly.
So it's basically it's the dehydration that kills and it's such a simple way to keep people alive is through rehydration even just by sugar and salt and water people can keep themselves alive and resist cholera basically but I think a lot of people don't have the education about this but then they don't have the clean water anyway to drink so it's a double-edged sword if someone has cholera they need to rehydrate themselves to survive but the only water they have to drink is contaminated and will kill them.
Well, can't they boil it at least though?
Yeah, this is another way that you can do it.
You need to boil the water for ten minutes but because of the economic crisis people don't have the money to be using fuel to boil water.
A lot of people barely have enough to eat at the moment so they can't be doing this.
Amazing.
So but now from 30,000 to 300,000 people this is just a wildfire that people are just dropping dead everywhere, right?
How many people, what percentage of those 300,000 are going to die of it?
Well, I think we've been lucky in the place that I work.
The case fatality rate here has been below 1% and so this is an acceptable level according to international standards.
But in other places they haven't been so lucky and now what we're finding is people, they don't have any way to come to our hospital and they come very late in the last stages of cholera and dehydration so they're much more likely to die.
At least in the beginning of the outbreak people came quite quickly to get treatment but now they just, they have no way of getting transport and we have families telling us that it's not safe that because of the war they feel unable to travel so they wait and they wait and then it can be just too late for them because they wait too long.
And I'm sorry, did I get the town right?
You said it's Hamer, Yemen is where you are now?
Yeah, that's right, yes.
And I'm sorry, can you tell me where in Yemen that is and how isolated that is from the rest of the population centers and stuff?
Yeah, well, Hamer is in the north of the country so it's near the border with Saudi Arabia actually.
Yeah, it's quite a few hours away but it's along this border that there is a lot of the airstrikes and bombing that goes on and it's a very sensitive area so I think this is why people, they've been suffering a lot since the start of the war.
The Saudis are bombing this area constantly, it hasn't stopped in two years really, so people are having less and less resources just to be able to survive, to be able to eat every day and cholera has made it worse.
And now, does Doctors Without Borders also have, and for that matter other charities, are there other efforts going on elsewhere in the country against cholera?
You guys are basically the only game in town now.
No, it's been good actually.
Other agencies have really stepped up to do what they can.
We definitely need more response by other agencies because it's the rainy season starting now which is going to have a huge effect on cholera.
We're already seeing that as the rains start, the cases begin to increase, especially for families that are living alongside rivers and different water sources.
So the bacteria is basically spreading now through the waterways and in addition to malaria, which comes with the rains as well, we need everyone to increase their efforts to fight against it.
And I'm almost afraid to ask you this Claire, is it just cholera?
Well, I'd like to think that I've seen a lot of strength in the Yemeni people and the ones we've treated in the last few months of this outbreak.
They're not willing to just let go to a disease outbreak like cholera.
They've been through a lot already with the war so this is another blow to them but people are still going to fight against it.
But yes, there is all the other diseases coming, malaria plus malnutrition because of the embargo on goods coming into the country.
There are some areas that have been suffering without food for a long time as well.
So all of these things.
So is malaria then out of proportion to pre-war times as well right now?
I would say that probably the rate, the level of malaria is the same but the problem is that people have nowhere to go to get treatment.
And like cholera, malaria will also kill very quickly, especially children under five and pregnant women.
So before at least there were functioning health facilities to go to and get treatment quickly but now there's basically nothing functioning.
And people have, they've had no salaries as well for the last year.
So to pay for drugs or transport or food is becoming impossible.
Alright, well now I guess I'm not sure what else to ask you.
What am I missing here, do you know?
Any idea?
Um, well, I feel like, I don't know, there should be a more hopeful end to the story.
That maybe everything I've explained so far sounds like it's too overwhelming for people to really cope with.
But...
Now that's an important point, right?
Yeah, no, you don't want the situation to sound hopeless when it's not.
You're doing great work, you're saving people's lives there and people can help with that.
It's the kind of thing that, you know, can and must be, you know, fought against, as you say.
So, yeah, no, that's a very good point.
I don't want to make it sound too, aw shucks, what can you do kind of thing, because clearly look at what's happening right now.
You're, who you are, you're Doctors Without Borders in Yemen right now, doing the work.
So, absolutely it can be done.
Yeah, and I think the main thing is that we know that people are willing to do what they can to help themselves and that the answers for cholera are quite simple.
So we just need to be able to do our work properly and if they can think of having an end to the war and the conflict and people being able to move again freely to go about their lives, then this will accelerate really the end of the outbreak.
So that's mainly what we're hoping for every day.
Right.
Yeah, I mean, as you say, that's really the problem is the simple cure, a bag of saline and a needle is available, it just can't be distributed.
Yeah, that's right.
All right, well listen, so you mentioned this last time too and you just kind of referred a minute ago too that, you know, there are a lot of other agencies who are also doing great work here.
So I'm happy to give you the floor to plug for how people can contribute to Doctors Without Borders and especially if they want to specify that this is the issue that they care about as Yemen, this is the one they want to contribute to.
And then if there are any other agencies you want to refer people to as well, please do.
Okay, that's great.
Well, definitely I think people can make a huge impact by supporting Doctors Without Borders in Yemen through, of course, extra funds, but as well just basically providing, helping to provide chlorine and oral rehydration solution and saline.
These are the main elements that we're using.
But other agencies are also doing great work in water and sanitation.
This is what's needed right now.
I think it's a more lasting solution for agencies like Oxfam and Save the Children to improve the water sources so that people can have some hope in the future to be accessing clean water.
Then this will solve a lot of the problems they're facing.
All right, well listen, I can't tell you how much I appreciate you coming back on the show to talk about this and, of course, all your great efforts there, Claire.
Yeah, no, thanks a lot, and I'm happy to talk anytime.
All right.
Okay, everybody, that is Claire Minera.
She is at Doctors Without Borders on the line from Hamar in Yemen up there near the Saudi border in the middle of a war treating people from the cholera epidemic.
And I didn't lay this on her in the interview because it's politics kind of outside of her purview.
I don't want to taint it.
As you know, I hope all of you already do, that this is America's doing.
That Saudi Arabia cannot wage this war without the U.S.
They could have never started this war without Barack Obama telling them it was okay back in February, March 2015.
It's going on for two and a half years now.
And she's talking about these babies dying of cholera.
That's because of America.
And that can't be avoided.
People ask, where's the outrage?
Well, here's a little.
Pass it on.
All right, that's the Scott Horton Show.
Thank you very much, everybody, for listening.
Full archives are at libertarianinstitute.org and at scotthorton.org.
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