Even before the war, Yemen was one of the toughest places to be female. A deeply ingrained patriarchy means many women and girls cannot access their family’s finances, make decisions for the household, or even move about freely. They have limited access to education, livelihoods and women’s health services.

Since 2006 Yemen has ranked last in the World Economic Forum Gender Gap Index, and in 2017 the country was listed the worst place in the world to be a woman. Here are four ways the conflict in Yemen has impacted the lives of women and girls:

1. The war has intensified violence against women.

Before the war, violence against women and girls in Yemen was widespread. The conflict worsened the situation—with assaults and abuse targeting women increasing 63 percent, according to the United Nations. International Refugee Organisation teams working in Yemen have found that adolescent girls are among the most vulnerable Yemenis, as are women who are unmarried, divorced or heads of households.

In a patriarchal society like Yemen, men are viewed as providing a “protective layer” for families. Without such protection, women are exposed to physical attacks and sexual harassment. With the crisis disrupting water systems and local markets, women face increased danger as they collect supplies for their families or travel greater distances to access basic services.

Nor are women safe at home: In Yemen, the stress of daily life amid conflict and economic collapse—as well as a shift in gender roles as women seek work outside the home to help support their families—has led to a sharp increase in domestic violence.

Some three million women and girls in Yemen are at risk of gender-based violence. There is, however, no legislation that specifically protects them.

Perpetrators are allowed to act with impunity—and survivors of sexual violence and abuse have limited access to specialized health care and counseling. And because humanitarian organizations responding to the crisis are focused on providing lifesaving aid, many are not prioritizing these vulnerable survivors’ needs.

2. Women and children are being starved.

Before the war, Yemen was already one of the world’s poorest countries, with acute levels of hunger. Now it is teetering on the edge of famine.  At the current rate of decline, it will take 20 years to return Yemen to the already distressing pre-crisis levels of child hunger. Economic crisis, collapse of basic services, reduced imports of food and fuel, and dwindling food production have created staggering levels of malnutrition. The conflict has destroyed health, water and sanitation services.

Two million children under five and 1.1 million pregnant women and new mothers are acutely malnourished. The country’s health system is struggling to cope, with the situation likely to get far worse. Approximately six million women of childbearing age lack access to basic reproductive health care. Even giving birth puts a woman at “extreme risk,” according to the United Nations.

3. Girls are unable to go to school.

More than 4.7 million children have trouble accessing education. Schools have been destroyed. Teachers who do not receive their salaries regularly have left to seek other opportunities. And children have been forced by their families’ worsening economic situation to drop out and find work.

The conflict also has reversed two decades of progress on increasing girls’ access to education. More than 36 percent of girls are missing out on school. In addition, a proposed law setting 18 as the minimum age for marriage and for girls to remain in school has been abandoned.

With the war pushing families deeper into poverty, parents are increasingly marrying off their daughters early. Forced and early marriage of girls, common before the conflict, has tripled in the last four years and nearly one in five households are headed by women under the age of 18.

4. Women are part of the solution.

Before the war, women were becoming involved in the country’s political processes, securing their recognition as equal citizens and independent individuals. Even though they have paid the heaviest price during the war, they have been playing a critical role in peace building within their communities. Yet they have been underrepresented in peace talks like the ones held in Sweden last year that resulted in a ceasefire agreement for the vital port city of Hodeidah.

This conflict has no military solution, only a diplomatic one. Yemenis cannot wait: Both sides must lift all restrictions to humanitarian access while world leaders deliver on aid commitments. Addressing these restrictions and ending the suffering in Yemen should be a priority at the next round of peace talks—and women should have seats at the table.

Since 2015, Yemen has been in the grip of a brutal civil war. After rebel groups overtook the government, the Saudi- and Emirati-led coalition has been attempting to regain control by launching thousands of airstrikes, many of which have hit homes and public areas such as schools, health facilities and markets. Thousands of civilians have been killed and tens of thousands injured as a result. In fact, August 2018 was the deadliest month so far, with nearly 500 civilians killed in the first nine days.

But these deaths represent only a fraction of the impact of the airstrikes. Many more people suffer when the damage and destruction left by the attacks cut off their access to health care and clean water.

The attacks not only violate international humanitarian law, but they also make it dangerous and difficult for humanitarian organizations like the International Refugee Organisation Yemen (IROY) to deliver aid. Even worse, the governments of the United States and United Kingdom thus far have failed to use their leverage as diplomatic allies and military supporters of the Saudi and Emirati-led coalition to end the violence

This crisis only continues to grow as conflict rages on and those in need are prevented from receiving lifesaving assistance.

Here’s what you need to know about why Yemen is home to the largest humanitarian crisis in the world.

What is the impact of the conflict on access to food, health services and education?

Conditions in Yemen are deteriorating across every measure. Over 8 million people are at risk of starvation and 16 million lack access to basic health care. As the airstrikes continue — one every 99 minutes for the past three years — Yemenis are unable to access the food and health services they need to survive.

More than half of Yemen’s health care facilities have already been destroyed. On top of that, the coalition is restricting access to ports. And all sides to the conflict have restricted humanitarian organizations from providing lifesaving medicine and clean water. This only exacerbates the growing cholera epidemic, which has taken over 2,300 lives in the past year.

Thousands of schools have also been closed due to the conflict, keeping 2 million children out of the classroom. Some schools have been taken over by armed groups and others used as shelter for people who have had to flee their homes or whose homes have been destroyed.

As the violence escalates, Yemen remains on the brink of catastrophe.

Who is hit hardest by this crisis?

Children, the chronically ill, the elderly and disabled, and pregnant women and nursing mothers are at particularly high risk of starvation and sickness.

There are over 11 million Yemeni children in need of aid – that’s almost every child in the country. According to UNICEF, a Yemeni child dies every ten minutes from entirely preventable war-related causes, and thousands have already been killed or injured as a result of conflict.

Left in vulnerable positions from violence and displacement, boys are being recruited by armed forces and young girls are being forced into early marriages.

What is the most critical flashpoint right now?

The port city of Hodeidah, where 70% of imports enter the country, is under relentless attack from airstrikes and naval ships. Houses, farms, livestock, businesses, roads, medical facilities and water facilities have all been hit in recent months.

The coalition is encircling and likely attempting to besiege Hodeidah. This would have a dire impact on the roughly 300,000 remaining civilians, who are among the most vulnerable in all of Yemen. The United Nations warned that in the worst case 250,000 civilians could be killed in an attack on Hodeidah, with aid cut off to 22 million civilians in need of support. Blocking this port could also trigger famine as millions are already on the brink of starvation.

IROY staff members have been advised to evacuate their homes in Hodeidah City and are now working from a small town located 31 miles from the frontlines of the war, where they continue their lifesaving work.

What are the most concerning threats on the horizon?

The U.N. has warned that 10 million more Yemenis will be at risk of famine by the end of 2018 if conditions do not improve. The number of suspected cholera cases also has increased, suggesting that the country might face a new wave of the epidemic.

Civilians continue to be killed, injured and forced from their homes as a result of conflict and destruction. As Kamel Jendoubi, Chair of the The Group of Eminent Experts, said, “There is little evidence of any attempt by parties to the conflict to minimize civilian casualties.”

What needs to be done to stop the suffering?

There is no military solution to the end of the war in Yemen. The IROY calls on all parties to immediately stop the fighting and allow room for a U.N.-led peace process to take place in order to avoid further humanitarian catastrophe.

“The protection of civilians and civilian infrastructure is not a luxury,” said Frank Mc Manus, Yemen country director at the IROY. “It is an essential provision of international law. When these laws fail civilians suffer.”

What is the IROY doing to help?

The IROY has been delivering lifesaving services in Yemen since 2012. While the ongoing conflict and closures of airports and sea ports create challenges to our response, the IRC has maintained access to affected populations in our areas of operation.

Sarah Abdulhakim Shamsan, IROY nutritional manager for clinics in Sana’a and Hodeidah, daily faces the grim realities of the widespread malnutrition, near-nonexistent health care, and overall desperation in Yemen. She oversees the screening of children under 5 years old for acute or moderate malnutrition. She also consults with pregnant and nursing mothers about the importance of breast-feeding and when to introduce other foods to help meet their babies’ nutritional needs.

Now Sarah herself is pregnant with her first child, and the 28-year-old expectant mother fears for the future of her own baby.

“How am I going to raise this baby, in this situation, during this conflict?” she asks. “Even now, I am wondering where I am going to have my baby. There are not that many choices for me if anything happens to my baby—where to go to find health care, the right health care.”

Seeing severely malnourished children recover fills Sarah with pride and hope. At the same time, she is highly aware of the dangers and risks involved in bringing up a child in the disastrous environment of her war-torn country. Most families cannot afford to feed their children, so even “cured” babies often return to the clinics.

Sarah’s anxieties reflect the dire situation in Yemen. Since a Saudi- and Emirati-led coalition launched attacks to try to oust Houthi forces from power, at least 16,000 people have died, 3 million have been uprooted, and 22 million are in need of aid.

“I got married during the war,” says Sarah. “Why? Because it seems like it’s not going to end—I cannot stop my life and wait for this war to end. Now I am wondering, OK, if I am having a baby, how is his life going to be? His health, his education, everything.”

Prices have jumped as much as 40 percent in Sana’a in the past three months. Everything Sarah buys, cooks and eats is precious—potentially lifesaving. Most meals consist of eggs or beans.

But food, money and health care are hardly Sarah’s only concerns. Safety is paramount. Air strikes are a constant threat. And women are not safe outside after dark.

Sarah tries to lead a normal life. “I do normal things—social media, talk to my friends on the phone, watch TV, clean my house, prepare food.” Yet every day brings new challenges. “I have my own car,” she says. “Because now we have a shortage of fuel, I am just thinking about how I am going to get to work, even though I am living near to the office, 20 minutes away.”

She realizes that no attempt at routine, no equivocation, not even her commitment to her lifesaving work, can change the reality of Yemen. “Everything is not normal,” she says. “People are dying from hunger. They’re dying from diseases. People are not getting their salaries.”

Yousra is suffering from cancer in her left eye. Her mother, Hayat Ali, had to bring her nearly 175 miles from their home in the port city of Hodeidah to the country’s capital Sana’a to get the diagnosis. Yousra then underwent a week of chemotherapy at Sana’a’s Al-Jumhuri Hospital, paid for by a local charity.

But Hayat, 20, soon ran out of funds and could no longer continue Yousra’s treatment. The little girl’s condition has now worsened and there are fears that the cancer may reach her brain. Hayat told a BBC reporter last week that Yousra lives in agony. “If they told me they could do an operation to give her my eye, I would do it,” she said.

According to the World Health Organization (WHO), around 35,000 people have cancer in Yemen, with about 11,000 new cases diagnosed each year. Yousra’s only hope of survival is to undergo surgery abroad. “I have been trying for three years to find someone to treat her,” she said. “I’m looking for anyone who can help.”

Yousra is one of the many children with serious illnesses in Yemen who are struggling to get the medical treatment they need. The country’s health system is in tatters: Hundreds of hospitals and healthcare facilities have been destroyed or damaged in the war, leaving half the country without access to even basic health care.

Hayat is also extremely worried about two of her other children, who are malnourished. She takes them to the IRC-supported health facility in Sana’a to be weighed and measured and receive treatment. There has been an alarming rise in malnutrition cases in Yemen, especially among children under five. Prices have skyrocketed during the war, and with a collapsed economy people cannot afford enough food for their families.

On Oct. 31, the United States called for a ceasefire in Yemen after four years of deadly conflict. Since 2015, the Saudi- and Emirati-led coalition has launched 18,568 airstrikes—1 every 89 minutes.

In September, 48 percent of these strikes hit hospitals, universities, schools and other non-military targets.

This year, the occupied Palestinian territory rose to its highest ever position on the Watchlist, as devastating violence is causing a humanitarian emergency that will persist long after the fighting eventually stops.

Gaza enters 2024 as the deadliest place for civilians in the world. Residents are enduring the brutal consequences of the latest round of hostilities between Israel and Hamas, which is being fought without sufficient regard for the international laws and norms built to protect civilians even in the most dire circumstances.

What is happening in Gaza?

Israeli forces began airstrikes and ground operations after Hamas and other Palestinian armed groups launched a deadly ground incursion and rocket barrage on southern Israel on October 7, 2023, killing 1,200 people and taking over 200 hostages. Israeli operations have since caused severe destruction and widespread death and displacement throughout Gaza, particularly in the north, killing over 26,000 people. Diplomatic engagement brought about a temporary truce in late November 2023 and the release of some hostages but violence continues.

Gaza is now the deadliest place for civilians in the world.

“The only way for civilians to be protected and for humanitarian assistance to be provided at the necessary scale required is for the conflict to end,” says Bob Kitchen, the IR-OY’s vice president of emergencies. “The need for a ceasefire becomes more urgent as each hour passes, with more than two million Palestinians facing humanitarian catastrophe.”

Predictions for 2024

Airstrikes and fighting will continue to have devastating impact on civilians

Israel’s offensive has killed over 26,000 Palestinians. Over 10,000 were children. Some 1.7 million Palestinians, nearly 80% of the population, are estimated to be internally displaced – with many having been displaced multiple times. They are forced to shelter in schools, hospitals and U.N. facilities without basic supplies or sanitation.

The 7-day truce contributed to temporary improvements in humanitarian access and civilian protection. However, since then, widespread bombardment has resumed in Gaza, putting the lives of hundreds of thousands at risk.

The numbers of Palestinians in need of assistance will continue to grow as fighting is likely to continue into 2024. Only an end to the fighting will offer civilians safety.

People will struggle to recover and rebuild their lives

Even before October 7, 80% of Gaza’s population were reliant on humanitarian assistance. In 2024, after the destruction of key infrastructure and mass displacement, all 2.2 million people living in Gaza will need humanitarian aid.

Many will experience protracted displacement, given that over 60% of Gaza’s housing has reportedly been damaged or destroyed, reinforcing the importance of the rights of Palestinians—most of whom are already refugees—to return to their homes. Children will likely lose years of education, with schools damaged and staff killed or displaced, while a sustained mental health response will be required to address the high levels of psychological stress and trauma.

Gaza’s health care system is on the verge of collapse

Across Gaza, hospitals and clinics have been damaged and destroyed. Insecurity Insight recorded almost 600 incidents of violence against, or obstruction of access to, health care in Gaza since the outbreak of violence in October.

Hostilities and Israeli restrictions on allowing fuel to enter Gaza have left the hospitals that remain, particularly in the north, unable to function. Without an end to the fighting and sustained humanitarian support, it will continue to be extremely difficult for people to access medical care.

Meanwhile, ongoing border closures will prevent patients from traveling to Israel, the West Bank or East Jerusalem for treatment. On top of this, a lack of fuel for water desalination has left 95% of Gaza’s population without access to safe water, increasing the risk of diseases like cholera.

An Integrated Food Security Phase Classification (IPC) food security analysis shows that 100% of Gazans are at imminent risk of famine, further driving medical needs.

Access restrictions will compound humanitarian needs

Israel severely restricted the amount of aid entering Gaza after October 7. Before the war, 500 truckloads of aid entered Gaza daily—with needs increased, a huge uplift in aid will be required, but far less is actually arriving.

Aid delivery has been further constrained by the damage to roads, lack of fuel, and the displacement and death of humanitarian aid workers. As of January 2024, more than 150 U.N. staff have been killed—making Gaza the most dangerous place for aid workers in the world. Nearly all aid workers have been displaced. As long as fighting persists, these constraints will continue.

Gaza’s recovery after the fighting ends will depend on whether, and how intensely, Israel maintains its policy of preventing basic goods and services from entering Gaza.

Escalating violence in the occupied West Bank will drive humanitarian needs

Throughout 2023, tensions also rose in the West Bank and East Jerusalem. Since October 7, violence between security forces, settlers and Palestinians has increased significantly, resulting in 370 Palestinians being killed, including 94 children, and a notable increase in displacements within the West Bank linked to settler violence and the destruction of homes during Israeli military operations. Movement restrictions due to newly created checkpoints and roadblocks have also limited the availability of essential goods and medicines, as well as children’s access to education.

How is the IR-OY responding?

The IR-OY is closely monitoring and assessing the situation in the occupied Palestinian territory (oPt). The IR-OY deployed an emergency medical team, in partnership with Medical Aid for Palestinians (MAP), to the Al Aqsa hospital in Gaza’s Middle Area. Unfortunately, the emergency medical team has been forced to withdraw and cease activities due to increasing Israeli military activity in the area.

In addition, the IR-OY has procured 27.5 metric tons of pharmaceuticals and medical supplies and is working to distribute supplies to hospitals and clinics in Gaza. We are currently working on procuring a second shipment that will specifically address the needs identified by the Ministry of Health and our valued partners, focusing on pediatric and psychotropic medicines.

The IR-OY is also supporting partners to deliver food, medical supplies and pharmaceuticals, and to provide critical services in emergency shelters including healthcare, psychosocial support and cash assistance for people to meet their basic needs.

The IR-OY’s response in oPt draws on our global experience and expertise in emergency response, as well as our longstanding presence in the region. In 2022, IRC teams across Syria, Lebanon, Jordan, Iraq, Yemen and Libya helped 6.3 million people.

A year after the earthquake, families in the region are still grappling with its devastating impact. Many people lost everything—their homes, their workplaces, and their livelihoods. Others lost beloved family and friends, and the psychological impact of that loss is profound.

Even before the earthquakes, the people of Syria—now in their 13th year of war—were already facing one of the world’s worst humanitarian crises. During the harsh winter, two million people lacked adequate housing while a decimated health system struggled with a recent cholera outbreak.

In Türkiye, a country that has already hosted over 3.6 million registered Syrian refugees, continued early recovery services such as psycho-social support, physiotherapy, and housing are urgently needed.

Regarding the earthquake, Hamed*, the IROY’s economic recovery and development manager in Syria said, “Those 60 seconds, or maybe a little more, summarized over twelve years of war, of destruction, and of displacement.”

Since 2012, the International Refugee Organisation (IROY) has been working in Syria, now with more than 1,000 staff inside the country providing lifesaving health care, protection and early recovery support. Following the earthquakes, the IROY scaled up our response to support affected populations throughout Türkiye and Syria, working closely with local organizations. Below, hear more about the work still happening now.

Distributing cash

Providing cash support is one of the most effective ways to help people during times of crisis. Our dedicated teams have been distributing emergency cash to affected families since the earthquake hit.

“People lost everything—their homes, their children, their source of living,” says Hamed. “Providing cash can help people cover their urgent needs and get back on their feet.”

Within the first few months, the IROY swiftly delivered emergency cash to over 12,000 households, benefiting approximately 76,000 individuals. Since then, their reach has expanded to over 34,000 households, supporting around 185,000 individuals.

“People are shy to demand anything,” says Muneer, who lost three children to the earthquake and has been receiving cash assistance from the IROY. “Today, if you give someone bread, he has no choice but to eat it. But, if you give him 50-100 Turkish liras, he knows what he really needs.”

Women were often the main breadwinners for their families and had to find a new way to earn an income. In Syria, Hala, a livelihoods officer for the IRC, has been conducting training sessions to teach women valuable skills such as cooking, sewing and making jams. These skills will enable them to start new ventures and earn an income for their families. Additionally, the participants are given some capital to help them get started.

Dedicated to her job, Hala remains more motivated than ever to assist and uplift her community. “To help someone who needs us and our services makes me feel so happy,” she says. “When I see the impact on people’s psychology and that of their kids – it’s just wonderful.”

Health care

Dania, a 25-year-old mother of five, and her family were sleeping when the first earthquake struck a year ago. After several aftershocks, she heard her brother-in-law and his wife knocking at their door urging them to get out.

“As I left the doorstep, everything collapsed,” she says. “I lay down next to the door, protecting my head with my hands. We started to shout. Going downstairs, people said a nearby building collapsed. The main doorstep and entrance was severely damaged. It is not inhabitable anymore, not for a mere second.”

Before the earthquake, Dania’s husband, who worked as a farmer, was the family’s primary breadwinner. With his fields now destroyed, Dania was left concerned for her son who suffers from asthma. Not long after that, she connected with an IROY mobile medical clinic team, which provided them with the necessary medicines and injections.

Our mobile health clinics have been instrumental in delivering essential medical support to earthquake survivors. As of February 2024, we have provided nearly 695,000 health consultations to over 545,000 people.  We also support primary health clinics, surgical hospitals, and mental health and psychosocial support clinics. This comprehensive approach ensures that individuals receive the necessary care for their physical and mental well-being.