Arrived at the Al Tahl hospital

It took us around 8 hours to go from Sanaa to Al Tahl. We started early because we need to get to our destination before sunset. We had to avoid a direct route of around 3 hours journey as there are different tribes activities with number of kidnapping before. We crossed the mountains (> 2500m) on west coast first. It is a rocky, barren mountain. It is amazing to see so many habitants on the mountains. They are probably richer compared with the other mountaineers in North. There are lots of quarry mines. Their houses are more traditional type, built of stone blocks. After that we crossed a large plain of desert and a dry out river bank. Then we climbed up again the same mountain range on North and passed one of the most conflict zones – a mountain city of Hayden. I could see a lot of markings of previous fire on the buildings. Their buildings are mostly built of clay and stones. I found a lot of buildings like watchtowers built on the most strategic site on the hill top or slopes. Most of the three storey houses are like a castle with lower half built of stones and small windows on side, living place on upper half. Although it may keep warm at night, it serves well for defense purpose. This area is controlled by the rebels Al Houthi. I have a feeling that people in Yemen are born as fighters. They live on the mountains. They can survive the most difficult climate and conditions. The men are still wearing their traditional costume with a curve sword on the waist. They carry either a hand gun or AK 47 everywhere in the North or on the mountains. They have a straight, open character, like the tribal type personality. Their love and anger are very distinct. They will treat you very well once regarding you as their friend. Women are all covered in black. It’s a man dominating society. It’s difficult for us to examine our patients even for gynaecological cases. Up the mountain, there are many terrace fields growing a plant called “Kat”. People are fascinating on chewing this plant. I have tried some. It gives a stimulating effect, like caffeine. I tend to fall asleep after lunch especially on the car but I was awake during the whole journey after chewing kat. I have read an article about kat before. People criticize that kat is only an internally consumed plant. It would not have much economical benefit to the country. People should grow crops or exported plants. But the soil and climate are so unfavorable. What else can they grow? I saw children carrying bags of kats selling to the passing by drivers. At least they can earn their living on that. On the way from Saada to Al Tahl, it took the last twenty minutes of the journey. Saada has the central government offices of the Saada Governovate. There are two well equipped government hospitals there. Sometimes we have to refer our patients there. On our way, I saw many soldiers patrolling with buried dig holes, machine guns around. We met a movement of the army with some civil soldiers. The first time I really felt the tension. Luckily, they left with nothing happened. Finally, I arrived at the Al Tahl Hospital. I had a quick round. It is a government hospital which was suspended during the war. It was reopened since last November with cooperation of MSF and the Ministry of Health of the Government. MSF set up two inflatable tents for two inpatient wards, one for male, the other for female, with maximum capacity of around forty. There are one Emergency Room (ER), one Out Patient Department (OPD), one Operating Theatre, and one ICU for kids and severely malnutrition kids. There are laboratory and blood bank facilities, but no X-ray except an Ultrasound machine. The team is good, mostly supported by the local staff. There are local doctors and medical assistants looking after the ER, OPD and wards. We only have three expectorate doctors, one surgeon, one anaesthetist and one out reach doctor, plus one ward nurse. The hospital is under MSF administration. There are not too many patients in the ward. Unfortunately, three surgical cases (one child with road traffic accident suspecting rupture spleen, one obstructed labour, one fracture ) were referred out in the morning as I had not arrived yet and the surgeon was just gone. Anyway, I can have a peaceful start.