In the eight weeks since the first cases of coronavirus were confirmed in Yemen, the pandemic has spread rapidly among the population. The devastated health care system is unable to cope with the latest wave of disease in a country that has already endured years of cholera outbreaks.

Ravaged by more than five years of war, Yemen lacks the resources and medical equipment that many other countries take for granted. The fractured political landscape and lack of public trust in the competing claimants to power have further exacerbated the health crisis. Because of the ongoing war and the hardened divisions created by years of conflict, there is no unified political response to the pandemic. The Houthis, the internationally recognized Hadi government, and southern separatists all have incentives to downplay and conceal the spread of the virus, and the people in Yemen have good reason to distrust all of them.

Even now, the international humanitarian response to Yemen’s suffering is lacking, and it is actually getting worse than it was before the pandemic began. The Trump administration’s decision to cut off funding to the World Health Organization (WHO) and then to withdraw from the institution entirely will have significant effects on public health efforts around the world. The country that stands to suffer most from the loss of funding for WHO programs is Yemen. Considering the already shameful role of our government in supporting the war that plunged Yemen into its current straits, it is inexcusable that it is also slashing the funding that is needed to provide essential services to Yemeni civilians.

The confirmed COVID-19 count for Yemen as of last week was nearly 400 cases and 87 deaths for the entire country, but the outbreak is definitely much worse than that. Medical workers in Sanaa have reportedly been threatened by Houthi authorities to keep quiet about what they know of the outbreak. The Washington Post reports:

Doctors and aid workers say they believe that thousands of Yemenis are being infected every week and hundreds are dying. Yemenis have flooded Facebook and other social media with death condolences in recent weeks, filling their pages with “electronic obituaries,” said one United Nations worker.

The surge in deaths has been sudden and alarming. PRI spoke to Fatima Saleh, a civil society activist living in Sanaa, and this is what she told them: “I’m seeing condolences to our friends, to friends of friends, on a daily basis. It’s crazy. I mean, we’ve been in a war for, like, six years, but we’ve never seen something like this.”

Hospitals across the country are unprepared to treat COVID-19 cases, and so they have been turning the sick away and leaving them to die at home. The New York Times also reports:

The pandemic has generated rumors that patients were being euthanized at hospitals, causing many Yemenis to shy away from treatment. Yet when they can no longer avoid the hospital, they are regularly turned away for lack of beds, protective equipment and medical supplies.

Following years of being lied to and abused, many Yemenis don’t believe anything that the authorities tell them. The breakdown in public trust has further complicated efforts to bring the virus under control.

A recent spike in recorded deaths in Aden relative to a year ago suggests that the death toll from the pandemic is many times higher than the confirmed cases:

In Aden, which served as the interim seat of Yemen’s internationally recognized government until a separatist group seized it last month, burial data showed that 950 people had died in the city in the first 17 days of this month, more than triple the 306 recorded for all of May 2019, according to an analysis by Abdullah Bin Ghouth, an epidemiology professor at Hadramout Universitywho advises the minister of health in Aden.

An accurate count of the number of cases and fatalities is impossible at the moment, but there is every reason to believe that the pandemic is wreaking havoc on a population that has already been brutalized, starved, and subjected to the worst conditions in the world. The U.N. reports that the fatality rate among confirmed cases is 25 percent.

Devastated and numb. Getting a message almost every day of someone we know or family friend that suddenly got sick and died. No testing, no measures to curb, and it’s killing us at much faster rate in #Yemen that we’re not sure if #COVID anymore. Read herehttps://t.co/mpUMFbE6Ff

— Hisham Al-Omeisy هشام العميسي (@omeisy) June 4, 2020

Even more than other countries, Yemen faces a shortage in protective gear and other necessary medical equipment. The U.N. says that the entire country has only 675 intensive care beds and 309 ventilators.

Testing is virtually impossible, so there is no way to know just how widespread the outbreak has become. The cost of face masks is soaring, according to Save the Children. The lack of protective equipment has led to staff shortages as medical workers refuse to come to work without proper equipment, and sometimes this has meant the closure of hospitals. In a country where more than half of the health care facilities were already inoperable because of damage from the war, the closure of these facilities because of inadequate equipment is a particularly heavy blow.

Aden is one of the hardest-hit cities in the country. Doctors Without Borders (MSF) has reported on the lack of ventilators and protective equipment, and they detail how overwhelmed hospitals are there:

“We only see serious cases,” said Durand. “For us, the healthcare workers, it makes us feel helpless. We can’t do much but give them oxygen. There are days we have had 13 deaths in the same day.”

The centre sees a death rate that is equivalent to intensive care units in Europe and the United States, but the difference in Aden is that this is no well-equipped and well-financed hospital with a network of other hospitals and services supporting it.

MSF operates the only health center dedicated to treating COVID patients in the city, and they know that the patients they are treating are just a small fraction of the total:

“What we are seeing in our treatment center is just the tip of the iceberg, in terms of the number of people infected and dying in the city,” said Caroline Seguin, who heads MSF projects in Yemen, in a statement in mid-May. “People are coming to us too late to save, and we know that many more people are not coming at all: they are just dying at home. It is a heartbreaking situation.”

The U.N. announced last week that it was cutting aid to the country. Save the Children describes the low level of funding as “catastrophic.” One U.N. official says that the funding shortfall will mean that their operations will “go into near collapse.” The U.N. humanitarian coordinator for Yemen, Lisa Grande, now warns about the potential for disaster:

The worst-case scenario — which is the one we’re facing now — means that the death toll from the virus could exceed the combined toll of war, disease and hunger over the last five years

Given that the death toll from the war, starvation, and disease has been almost a quarter of a million people, the possible losses to the virus could be staggering.

The U.N. funding cut comes on the heels of the halt of U.S. payments to the World Health Organization. The decision to halt those payments came at the worst possible time for the people in Yemen. Because of that decision, the WHO has had to suspend about 80 pecent of its operations in the country.

Deutsche Welle spoke to a young journalist in Sanaa who described the mood in Yemen right now:

“For us, death is normal,” said Amal Mansoor. “But I am still afraid of the coronavirus.”

Our government has helped to bring Yemen to its current state of devastation through five years of support for an atrocious war, and now when they need assistance most our government yanks aid away from them as well. It is imperative that we don’t forget about the people of Yemen as they face another disaster.