The pediatric ward of the Thaura Hospital in Hodeida, Yemen, is overcrowded and often two or three young patients have to share a bed. (Lorenzo Tugnoli for The Washington Post)
The escalating military confrontation between the United States and Houthi militants is threatening to deepen a humanitarian crisis in Yemen, where aid groups were already struggling to meet the country’s needs, relief workers have warned.
Nearly a decade of civil war in the Arabian Peninsula country has driven millions of people from their homes, deepened poverty and spread starvation. Now a new conflict — Houthi fighters are firing missiles on commercial shipping; American and British forces are striking back — is disrupting tentative efforts at peace.
Years of war have left more than two-thirds of the population — 21 million people — “in desperate need of food, water, and lifesaving assistance,” 26 aid organizations reported this month, expressing “grave concern over the humanitarian impacts of the recent military escalation.”
“We urge all actors to prioritize diplomatic channels over military options to deescalate the crisis and safeguard the progress of peace efforts,” groups including CARE, the International Rescue Committee and Save the Children wrote.
One major concern is the Biden administration’s decision this month to return the Houthis to a U.S. list of terrorist organizations — an attempt to isolate the group that aid workers warn could complicate efforts to deliver relief in an already fragile humanitarian landscape.
Another is whether the Houthis will allow aid organizations to continue to operate in areas they control, given the militants’ recent history of tightly restricting such groups.
On Jan. 20, the Houthis issued a letter saying American and British nationals working for the United Nations and other international aid organizations should be ready to leave Yemen within 30 days, according to a copy shared with The Washington Post by the Houthi-run Ministry of Information.
Yemen is suffering from donor fatigue and competition for aid money with Ukraine and Gaza. The country’s humanitarian response plan for 2023 was funded at only 39 percent, according to the U.N. Office for the Coordination of Humanitarian Affairs.
In December, the World Food Program announced it was pausing distribution in Houthi-controlled areas due to “limited” donor funding and a failure to resolve a long-running disagreement over reducing the number of Yemenis they serve. It was a devastating blow in a country with the highest malnutrition rate in the world.
“The situation was already really, really challenging,” said Bushra al-Dukhainah, area manager and humanitarian coordinator for CARE Yemen.
“This [U.S.] designation is adding another layer of challenges to CARE and all the other humanitarian actors working in Yemen,” she said.
The Houthis, an Iranian-allied group, started attacking commercial vessels in the Red Sea in November in a campaign they said was aimed at ending Israel’s military offensive in Gaza. The attacks have led shipping firms to avoid the Gulf of Aden and the Red Sea, waterways that link Asia to Europe and the Americas, making passages longer and more expensive.
The United States and Britain began launching airstrikes against the militant group earlier this month, an action they say is aimed at deterring the maritime attacks.
The violence so far, including airstrikes on Houthi military installations, has been limited in comparison to the carnage wrought during the vicious civil conflict that began in 2014, when fighting between Yemeni factions and airstrikes by a Saudi-led military coalition devastated cities and towns.
A tenuous cease-fire has held for the last two years, but the country remains divided between the north, controlled by the Houthis, and the south, presided over by an internationally recognized government.
The Houthis have vowed to continue their maritime assaults until Israel’s siege of Gaza is lifted. On Friday, in an escalation, they fired a ballistic missile at the USS Carney, a U.S. destroyer that is patrolling the Red Sea, according to U.S. Central Command. The Carney shot the missile down, Centcom said.
President Biden acknowledged this month that the U.S.-led airstrikes weren’t succeeding as a deterrent. “Are they stopping the Houthis? No,” he said “Are they going to continue? Yes.”
The U.S. and its allies say they are conducting a targeted campaign that limits civilian harm. “But it’s a conflict,” said one aid official, who, like others, spoke on the condition of anonymity to discuss the delicate situation. “There is only so much mitigation that can happen.”
Aid groups have struggled for years to meet Yemen’s immense needs. They’ve played a vital role in addressing a prolonged nutrition crisis has taken a particular toll on the young: At least 2.2 million children under 5 are suffering acute malnutrition.
They’ve done so while navigating the demands of two opposing governing authorities. Now, they say, they’re trying to understand the impact the U.S. designation might have on their work, which requires frequent interactions with local officials and local businesses that might be subject to sanctions.
The administration announced Jan. 17 that it would list the Houthis as “specially designated global terrorists,” which makes it illegal for Americans or people in the United States to transact business with them — an effort to shut the group out of the global financial system. The administration had taken the Houthis off the list in 2021 over concerns about aid.
Some transactions involving food, medicine, fuel, remittances and other needs are exempt. Nonetheless, aid groups fear the designation could chill commerce and the private sector and worsen conditions for those they serve.
“There are a lot of concerns around how this will impact the humanitarian sector,” one Yemen-based aid worker said. “Will this have sufficient guarantees to international banks, to shipping companies, to suppliers?”
Yemen depends on imports for the great majority of its food, medicine and fuel. Aid groups worry the U.S. designation could jeopardize the current lull in fighting and could prompt other nations to impose their own restrictions.
If that occurs, the aid worker said, “we will see prices going higher; we might see indicators of a fuel crisis and an economic situation will definitely go worse, with no peace agreement on the ground.”
The designation could make their work particularly complicated in places such as Saada, the northern province where the Houthi movement was born and where the group’s connections run especially deep.
“When we are hardly finding the support and the funding for certain activities, and we have already committed to the people in need … and just all of a sudden we say ‘Oh, we’re sorry, we will not be able to finish that,’ it’s not an easy thing to do,” said al-Dukhainah, of CARE Yemen.
The United States, the largest provider of humanitarian assistance to Yemen, spent $738 million in fiscal 2023 to help provide food, drinking water and other necessities.
The Biden administration has promised to maintain its commitment to Yemenis in need. Officials have described what they say are extensive efforts to ensure the designation doesn’t worsen conditions in the country.
The administration is delaying the sanctions from taking effect for 30 days, one official said, to provide information to shipping companies, insurers and aid groups, “avoiding de-risking and providing clarity” so sanctions don’t have “unintended impacts, particularly on the delivery of lifesaving, humanitarian assistance.”
Officials chose the Specially Designated Global Terrorist designation rather than the Foreign Terrorist Organization, they said, because it allows them to provide more effective carve-outs and shield aid and commercial organizations in Yemen from being prosecuted for supporting terrorism.
“We have been closely communicating … so our partners understand what this is and what it is not,” one official said. “It is not an FTO.”
Even with such safeguards, Yemen’s population remains in peril. For more than eight years, the international community has supported “emergency interventions” to keep Yemenis alive when what the country needed was recovery and development, a person who works in Yemen’s health care system said.
“It’s too long,” but without a “peace component,” the interventions will have to continue, said the person, who spoke on the condition of anonymity because they were not authorized to address the media.
One possible positive development — the announcement of a peace deal between the Houthis and Saudi Arabia — seemed imminent just a few months ago. Now, Yemeni analysts say, it appears to have been delayed by the new conflict.
Communication between the sides was “ongoing, ” said Nasruddin Amer, chairman of the Houthi-run Saba News Agency. But recent discussions, he said, have been “slow.”
