Several armed conflicts affect Yemen today and our action in the country is wide-ranging, with a budget of $34 million and 270 staff operating out of Sana'a, Saada, Taiz and Aden.
Perhaps unsurprisingly, the ICRC has been present and active in the country for over 50 years. This two-part multimedia post offers an in-depth look at a period spanning 1962 to 1969 and at an action that might well have been exemplar in the context of a conflict ICRC archivist Fabrizio Bensi describes as "asymetric".
First off, the conflict in a nutshell, First Steps, To The Frontlines and Operation Field Hospital.
The North Yemen Civil War
Royalists of theMutawakkilite Kingdom of Yemenand factions of theYemen Arab Republic fight the so-called North Yemen Civil War from October 1962 to March 1970. The conflict begins with a coup d'état carried out by the republican leader Abdullah as-Sallal against the newly crowned Imam al-Badr. As-Sallal declares Yemen a republic as the imam flees to Saudi Arabia, where he rallies support for the his cause. On the royalist side, Jordan and Saudi Arabia supply military aid while Britain provides diplomatic cover. Egypt supports the republican side and Gamal Abdel Nasser sends as many as 70,000 Egyptian troops into Yemen. Parties finally agree to a truce in 1970.
In late 1962, most royalist soldiers and civilians wounded during combat are dying due to the lack of medical personnel and facilities in the remote, mountainous areas where fighting is taking place. On November 14, 1962, the ICRC sends delegate Pierre Gaillard and interpreter Ibrahim Zeikrat to visit republican and royalist representatives in Cairo, Baghdad, Damascus, Beirut and Amman. Their objective is to gain political support for an ICRC action on both sides of the Yemen conflict and to assess of its feasibility.
ICRC medical doctors Jean-Maurice Ruggli and Guido Piderman follow, travelling to Saudi Arabia in early January to meet with Yemeni royalist commanders. They focus on health related needs and, like Gaillard and Zeikrat, gauge the levels of political support for a neutral and impartial humanitarian action in the context. In early January, ICRC headquarters sends two additional delegates to Sana'a, on the republican side. The delegates Du Pasquier and Gasser are received by Yemeni president as-Sallal who commits, at least in principle, to apply the Geneva Conventions. As an initial gesture, as-Sallal provides the delegates with the names of the royalist prisoners detained by his forces.
In Saudi Arabia, imam el-Badr, commander of the Yemeni royalist forces, also agrees to apply Article 3 of the Geneva Conventions of 1949, which covers non-international armed conflicts such as Yemen. The team proceed by travelling to the frontlines. Fighting is raging and Dr. Piderman is wounded during an aerial bombardment at Najran, an oasis and military base near the Saudi-Yemeni border.
By late January 1963 - three months after the beginning of the conflict - the ICRC has obtained a formal commitment to respect the tenets of the Geneva Conventions from two parties and starts to provide aid to thousands of Yemenis. Saudi Arabia becomes party to the Geneva Conventions on May 18, 1963. Within months, the ICRC has successfully set up an effective humanitarian response both in the Arab Republic of Yemen and in the country's north. That operation will last seven years.
The humanitarian needs are significant. Faced with summary executions of prisoners, delegates intervene with imam el-Badr, who as a result decides to pay warring tribes for each prisoner brought alive to his headquarters. In May 1963, twenty-four Egyptian soldiers captured and interned in Yemen are repatriated to their home country under ICRC auspices. On the republican side, ICRC carries out its first detention visits and assists a limited number of detainees, mostly in Sana'a. Both sides progressively agree to more regular and larger ICRC visits to detainees and internees.
Egyptian soldiers are often detained by royalist forces in remote areas. The ICRC spares no effort to reach them and their families. The many letters of gratitude received by the Yemen delegation at the time show that then as now, the reestablishment of family links, particularly for persons detained, is a fundamental humanitarian endeavour in times of war.
To the frontlines
These initial forays in the royalist camp show a complete lack of medical facilities and medical personnel. On the republican side, in Sana'a and elsewhere, there are but very few good hospitals that can treat the war-wounded. Egyptian forces do have well-trained and well-equipped medical personnel, but supplies are sorely lacking in all civilian hospitals. In February 1963, ICRC headquarters appeals to National Societies for financial and in-kind contributions. Tons of medicine and supplies soon reach Sana'a via Aden and are immediately distributed by Dr. Jurg Baer and delegate Joseph Gasser.
Preoccupied by the prevailing health situation and with support from the ICRC representatives, the Yemeni Republic founds the Yemeni Red Crescent. The ICRC flies the director of the newly founded National Society to Geneva to acquaint him with the Movement of the Red Cross and Red Crescent.
A few ICRC medical delegates, Dr. Bruno Beretta among them, now trek from one battlefield to another, often operating the wounded in dimly lit caves or out in the open. Little by little civilians hear about these foreigners. Some walk long distances to seek treatment. Many have never seen a doctor. Dr. Beretta writes that some men even bring their short wave radios for surgeons to diagnose and repair.
The ICRC again assesses the medical situation prevailing in the north during the Summer of 1963. Dr. Jean-Maurice Ruggli tours affected areas in August. His reports describe hundreds of war wounded left to die on the battlefield, scenes not unlike from those witnessed by Dunant at Solferino one hundred years earlier.
Dr. Spirgi and Dr. Wild reach royalist Yemen through Saudi Arabia in the Fall, trekking through arid high plateaux to enter Yemen. Here is an excerpt from one of their report dated October 1963, when they stop at a royalist camp:
"We proceed with long consultations and treat over 40 sick and wounded. Malaria is prevalent. We find many cases of chronic dysentria and ascaridiosis. Food is inadequate. One eats rice and dried mutton meat and some canned goods, tuna mostly. Few vegetables are available.
The next day, another round of consultations. We treat approximately 30 men. We have to pull out a few rotten teeth. Patients thank us with a great "Hurrah"! Just before sunset, we leave the camp, westward-bound. We drive into the night in our bullet hole-ridden truck. On the road, we find two soldiers seriously wounded by grenade fragments, lying in a cave. They have been waiting for help for five days. They are lying on goat skins soaked with blood and pus. One of them is comatose. There is no soap and hardly any water in that stinking cave. We administer chloromycetin and organize their evacuation. In Kharir oasis, we see about 20 patients, many children among them. A ten-year old girl has pneumonia, a twelve-year old boy is dying. We arrange for his evacuation to Najran and then Jeddah.
The necessity of a modern field hospital is increasingly being felt. It becomes an obsession for us. We are also thinking about the pulmonary tuberculosis that is rapidly spreading among hardworking women and underfed children.
We leave by donkey two days later. On the road, mothers bring us their sick children. We can only distribute a few antibiotics. After five hours, we arrive at a prisoners' camp and immediately start treating them. Then, another round of consultations with the sick. We treat cases of malaria, pneumonia, open fractures, etc. A fighter has a deep blade wound to the chest. We distribute bandages and antibiotics.
The following day, having climbed a 3000m pass, we find sick men waiting for us. One has a mangled hand. Another is covered in scars. After seeing 40 patients, we find a vehicle, also riddled by bullets, and leave. At night, we drive through the desert towards the front. We see places that were recently bombed. An officer allows us to visit prisoners who have been interned for five months. They are sleeping in a cave, alongside their guards, on the ground. We register their identities and provide them with detention cards.
We set up in the cave and welcome the first round of wounded, most of them by grenades. We first treat seven wounded, four of them in critical condition. One fighter has an open knee. Under the bandages, we find worms. The wound of another is badly infected. Our hands are full of worms. We sterilize our instruments in a rock cavity and extract shards of metal. We inject megacilin. Between two interventions, patients with advanced dysentria are brought in. They look at us with feverish eyes. Another patient comes in with a fractured hip and broken legs. He has been run over by a truck that very morning.
After a few hours' sleep, the influx of sick and wounded continues. In the afternoon, we administer our last medicine to 15 war wounded who are brought in by truck. Many are also suffering from malaria. We leave towards Narjan, 260 kilometres away. On the way, we cross an old battlefield where 100 men were killed five months ago. Their bodies have been eaten by birds. Sand is slowly covering their remains."
In their reports, Drs. Spirgi and Wild press ICRC headquarters to urgently help set up a field hospital near the frontline. Criss-crossing areas affected by the fighting, the two doctors find a little plateau surrounded on three sides by the volcanic range that straddles Yemen and Saudi Arabia. No one seems to know whether Europeans have set foot in the area before their visit. Uqd, 40 kilometres south of Najran, is chosen as the site for the ICRC field hospital the two doctors had been obsessing about when operating in the desert.
Operation Field Hospital
Uqd is ideally located: on Yemeni territory, 40 kilometers from the Saudi border and in a no man's land controlled by the United Nations. In accordance to accords signed by the parties in the summer of 1963, no military forces are allowed in the area, making it relatively safe for the ICRC to operate in. Operation Field Hospital gets underway in October 1963, less than two months after initial visits by delegate in the area.
The Swiss government covers the cost of all medical equipment, which starts to arrive in-country in November. The US Air Force lends the ICRC a Globemaster, the only aircraft that can at the time fly the Clinibox, a sort of prefab clinic, without having to dismantle it. The Clinibox encases the operating theatre and will be the heart of the 50 beds hospital to be set in tents marked with the Red Cross emblem. The facility is conceived specifically to treat war-wounded patients. Various installations - the laboratories, the radiology unit, the polyclinic - are set up around the Clinibox.
Uqd Hospital is run and administered by the ICRC but is staffed mostly by Swiss Red Cross personnel. Seven doctors, accompanied by nurses and technicians, leave Geneva on an ICRC flight. After a stopover in Jeddah, where the ICRC has an office, they land on a strip near Najran. They reach Uqd by four-wheel drive vehicles and truck. The Globemaster turns out to be too heavy to land in Najran so it lands in Riyadh instead. The Clinibox is then brought to Uqd by tractors, an 1,100 kilometres journey.
Dr. Wolfgang Schuster leads the first Uqd team. The British Red Cross contributes a surgeon and, later, a nurse. Huge Red Cross emblems are painted on the mountains that surround the hospital, signalling its presence to royalist and republican planes. The nearest water well is 25 kilometres away. Tanker trucks bring water daily; it has to be rationed. The first patients are treated at Uqd on November 19, 1963, less than two months after the report written by Dr. Spirgi and Dr. Wild is received in Geneva. The Clinibox, the generators and others facilities are operational by early December.
The hospital functions at full capacity as soon as it opens. Wounded combatants arrive daily, carried by donkeys or by their comrades. Patients often walk for several days to reach the facility. Then as now and in accordance with the Geneva Conventions, the ICRC does not allow weapons on its premises, something that is hard to grasp for men who traditionally never leave their weapons. The delegates hold their ground and after long discussions, Yemeni fighters usually agree to their demands. The reputation of the foreign doctors spreads rapidly. Sick civilians from the area and beyond now mix with wounded combatants at Uqd. Entire families start to arrive, waiting patiently for their consultations. Some set camp in caves nearby. The doctors visit them late in the day, after they are done at the Clinibox. The team soon starts to teach hygiene and first aid basics to their patients. It also trains some of the first Yemeni nurses.
Click here for a Uqd radio field report from Dr. Hoessli, describing a typical day at the hospital.
As winter sets in, medical teams use Uqd as a base for audacious field trips that bring them ever closer to the frontlines. A British Red Cross medical team led Dr. William Bartlett and nurse Arnold Plummer are accompanied by an ICRC delegate and reaches the western front, near Imam el-Badr's headquarters. There, it treats hundreds of wounded and sick over the course of two weeks. Other teams, including those led by Dr. Schuster, Dr. Piderman and the delegates Muller and Leuthold work the eastern front. They trek though mountains for periods up to three weeks, carrying medicine and equipment. They treat and operate the wounded in caves near frontlines. Some doctors and nurses collapse when the arrive back at Uqd, exhausted.
Next up, Part II, 1963-1969, where the ICRC further expends its action, grave IHL violations are committed and an ICRC historian reflects on the relevance of the '62-'69 operation.