Activists and the media frequently call Yemen “the world’s worst man-made humanitarian disaster” in a refrain that has dominated coverage of the country since 2014.

In response, a growing number of international non-governmental organizations and United Nations-administered aid programs seek to specifically address war-related malnutrition and the spread of disease. But scant tangible results and an escalating crisis have led many analysts to critique the model used to provide humanitarian assistance to Yemen. While “man-made” clearly refers to both the Saudi-led bombing campaign and blockade and the internal war led by the Yemeni Houthi movement in Sanaa, foreign-led humanitarian aid programs may also be contributing to the perpetuation of this disaster.

Instead of contributing to a resolution of the conflict and developing Yemen’s long-term stability, much of the humanitarian aid that arrives in Yemen exacerbates the war by fostering a lucrative wartime economy, disincentivizing peaceful resolutions and prolonging national dependence on foreign aid. Humanitarian assistance constitutes one of the country’s largest economic sectors, enriching an entrenched militant elite who monopolize the distribution of aid and use food and supplies as political capital. The potential for corruption and deleterious effects from humanitarian aid on a civil conflict is hardly a new phenomenon in Yemen and has been the subject of a growing number of critical studies over the past ten years.[1]

Donor-directed agendas, especially surrounding the COVID-19 pandemic, have had an unintended negative impact while growing Yemeni dependency on donors has created additional obstacles for the long-term development of the country’s national economy and health care. Even local civil society organizations, which may present a path toward increasing Yemeni agency in aid distribution and development, struggle with war-related political tensions, corruption and an absence of accountability.

The Business of Famine Response

News media has frequently declared Yemen to be on the brink of famine since 2014. While this coverage depicts serious war-related food shortages, it also serves to increase viewership and appeal to the public’s moral compass. International nongovernmental organizations (INGOs), dependent upon private donor generosity for operating and program budgets, have used the Yemen crisis extensively as part of their fundraising campaigns. OXFAM International, for example, regularly uses impassioned titles on their online pages such as “Yemen on the brink: conflict is pushing millions towards famine” juxtaposed next to “Donate Now” links. Yet how many of these donations end up reaching Yemen and how much of this funding goes toward the overhead and indirect costs of the broader organization? According to OXFAM’s 2019 annual report, 33 percent of expenditures are earmarked for non-program related items such as fundraising and marketing. Fundraising is, however, essential to running these organizations and maintaining the salaries of agency personnel. As Michael Barnett argues: “Because good causes do not sell themselves but rather have to be sold, aid agencies have developed considerable marketing prowess…they will advertise if not embellish the tragedy in order to tap into the guilt of the rich.”[2] Agency self-promotion is part of the humanitarian aid business model, although there is a fine line between utilitarianism and exploitation.

In addition to INGOs, a growing list of UN agencies and humanitarian organizations have effectively used similar crisis language to boost state contributions and private donations. The Office of the Special Envoy (OSE) for Yemen has particularly needed additional self-promotion and public justification as its annual core operational budget for 2020 increased to $18.4 million, surpassing the Syrian OSE budget of $16.2 million. In December 2018, the OSE Yemen used a supplementary grant to finance a large gathering of delegates in Stockholm, Sweden, to negotiate a ceasefire in the western Yemeni port city of Hodeidah. The negotiations and implementation of the ultimately unsuccessful Stockholm Agreement cost $56 million and produced few tangible results—a consequence of rising hardline militant influence within the Houthi movement and a general lack of progress on direct Saudi-Houthi negotiations.[3] The 2019 air travel costs alone for OSE Yemen reached $1.3 million, with an additional $3.8 million spent on hotel accommodations in Hodeidah for the 2019 UN Mission to Support the Hodeidah Agreement (UNMHA). While recognizing “the challenging operational environment of the Mission,” the UN Advisory Committee on Administrative and Budgetary Questions expressed concern in a 2019 report for the expenditures and resource utilization by the UNMHA.[4]

As Fiona Terry observed: “Emphasizing the complexities of crises has become a convenient way of deflecting responsibility for the negative consequences of humanitarian action from the international aid regime to the context in which it operates.”[5] The current conflict in Yemen is the epitome of a “complex emergency,” featuring an internationally recognized government in exile, a rebel group governing the capital city, regional military intervention, restrictions on mobility, internal displacement and a man-made humanitarian disaster. Humanitarian aid cannot solve the political conflict, but it can play a role in building local capacity, preparing Yemenis for the necessary post-war reconstruction.

Aid Politics in Yemen

The humanitarian crisis in Yemen did not begin in 2014 but is a crescendo of long-running infrastructure neglect, political corruption and internal strife. The role of foreign development aid in reshaping Yemeni agriculture is intimately connected to the making of this disaster. The process began in the 1960s in the northern Yemen Arab Republic (YAR) when USAID contributed to the construction of roads connecting the YAR’s main urban areas. Using much of the same equipment and team, USAID constructed a water supply and sewage system in the central Yemeni city of Taiz called the John F. Kennedy Water Project. Small-scale water projects were also undertaken in the surrounding villages as USAID personnel assisted locals with the development of new wells and installed modern water pumps.[6] During the 1970s, foreign aid funded a significant increase in the number and size of these pumps while Yemenis began replacing domestic food sources with cheaper imported alternatives, thus incentivizing a shift from planting food staples to more lucrative cash crops. These projects were instrumental in developing a water-intensive agricultural economy that contributed to Yemen’s alarming water crisis.[7]

Three decades of unchecked corruption under Ali Abdullah Saleh’s presidency (1990–2012) furthered the government’s mismanagement of resources as he prioritized his own family finances and political network over public services and allowed Yemen’s infrastructure to deteriorate. A country once known as the breadbasket of the Arabian Peninsula and Arabia Felix of antiquity now relies on imports for 90 percent of its staple food. The extent of Yemeni infrastructural decline was captured most strikingly in images of the destructive floods in the summer of 2020, which were exacerbated by the collapse of multiple dams. Despite the country’s historically recognized system of irrigation, Yemenis were unable to capture the valuable rainfall and could only bemoan the destruction caused by its abundance.

The food crisis in Yemen cannot be attributed to conflict alone but is tied to these longer term infrastructural and agricultural shifts that were incentivized, and sometimes directly built, through foreign aid.

The food crisis in Yemen cannot be attributed to conflict alone but is tied to these longer term infrastructural and agricultural shifts that were incentivized, and sometimes directly built, through foreign aid.

In the decades following the Cold War, a growing number of international organizations operating through the auspices of the UN, global philanthropic foundations and other national aid organizations disbursed aid to Yemen that was earmarked for development or humanitarian purposes. The potentially negative consequences of these programs often emerged from a mismatch between the agendas of the foreign organizations and the facts on the ground in Yemen. Over the past 30 years, Yemen has contended with numerous domestic conflicts from the 1994 Civil War to the Houthi Wars of 2004 to 2010, and the current conflict between Houthi rebels and the displaced Yemeni government that began in 2014. The fact that it is difficult for any international organization to operate in Yemen without appearing to be aligned with one actor or another has fomented an inherent suspicion among Yemenis of the hidden agendas of foreign workers and their financiers.

The legacy of mistrust has carried over from decades of long-term development aid and continues to impact Yemen’s relationship with foreign humanitarian aid providers during the current conflict. Between 2015 and 2019 Yemen received an estimated $15 billion in total humanitarian aid and more than $2.5 billion in Saudi bilateral support intended to stabilize the economy and prevent the collapse of the Yemeni rial currency. The year 2018 marked the apex of foreign aid when it reached $5.2 billion, or 15 percent of Yemen’s 2012 Gross Domestic Product (GDP) of $35.4 billion and nearly 20 percent of the wartime GDP in 2018. Humanitarian aid is now one of the largest economic sectors for the country, a dangerous precedent for Yemen’s current and future development.

Local political actors and militants, serving as default partners for international humanitarian organizations, seek to exercise control over the administration of aid. Houthi tribesmen and other local militias profit from the country’s humanitarian crisis and generous foreign aid by collecting inflated transit and distribution fees or delivering aid to constituents as a form of political capital. Ironically, the distribution of aid removes incentives for peace initiatives and prolongs the very crisis that the humanitarian organizations seek to alleviate. Food aid, either granted or withheld, is used by Houthi leaders to lure young men to war fronts through a system of registering fighters’ families for aid and providing the men with a stipend. In contrast, internally displaced refugees receive only minimal amounts of food aid and suffer from severe malnutrition. International relief agencies supported by the UN are left with few alternatives when working in Houthi-controlled territory where, for example, the World Food Program (WFP) works with the School Feeding and Humanitarian Relief Project of the Houthi Ministry of Education to distribute 60 percent of all food aid to north Yemen. The profit-seeking behavior of the Houthis and other militias reached new heights in 2020 as systemic interference in relief operations provoked a clash with international aid organizations, leading to their partial withdrawal without sufficient local civil society organizations in place.

The Impact of COVID-19 on Humanitarian Aid to Yemen

In May 2020, Altaf Musani, the World Health Organization’s (WHO) representative in Yemen, estimated that the entire 28 million person population of Yemen would contract COVID-19 and at least 65,000 would die from the virus.[8] In reality, Yemen is unlikely to see such high numbers but even if 65,000 die as estimated, this would translate into a 0.2 percent mortality rate. In contrast, COVID-19 mortality rates in the Western world in November 2020 were above 1.5 percent. Musani’s statement reflected two typical and unfortunate aspects of humanitarian agency operations in Yemen: overestimation of the impact of health crises and self-interested advocacy.

Given the isolation imposed by the Saudi-led blockade, the first confirmed case of COVID-19 in Yemen was identified in April 2020, making it one of the last countries to report cases. Humanitarian agency pundits had issued earlier warnings of how devastating the virus could be to the Yemeni population and also estimated the number of casualties. The first confirmed COVID-19 case announcement was a windfall for humanitarian organizations with operations in Yemen that had been facing budgetary shortfalls. For example, in response to the pandemic the WFP received a $225 million grant from the United States earmarked for its programs in Yemen. Until now there have been fewer than 7,000 confirmed cases of COVID-19, far less than the 28 million predicted, even when factoring in the relative absence of testing facilities and the inaccessibility of conflict areas.[9]

Meanwhile, Yemen’s health care system continues to face familiar, non-coronavirus related challenges, including over 150,000 new cases of cholera. The dearth of long-term investment in clean water supply and sanitation led to cholera outbreaks of epidemic proportions in 2016 and 2017 that spread across nearly every governorate in the country. Cases of dengue fever, malaria and diphtheria as well as severe malnutrition are increasingly diagnosed. The number of Yemenis without access to basic preventive care grew to 14.8 million by 2017, effectively constituting a death sentence for many from otherwise treatable chronic illnesses and noncommunicable diseases.

In 2020, the UN withdrew funding and resources from 30 of its public health programs in Yemen or shifted those funds to fighting the global pandemic within the country. As a result, primary health care, vaccination campaigns and medical facilities in Yemen have declined significantly in just one year.

In 2020, the UN withdrew funding and resources from 30 of its public health programs in Yemen or shifted those funds to fighting the global pandemic within the country. As a result, primary health care, vaccination campaigns and medical facilities in Yemen have declined significantly in just one year, exposing the health system’s reliance on foreign funding and the priorities of donor countries. The absence of basic health care, shut down by the pandemic, may ultimately lead to a higher mortality rate than COVID-19, a warning echoed by the authors of a recent study who stated that, “the closure of humanitarian lifesaving programmes and shifting support toward health security, i.e. to support COVID-19 response, at the expense of primary health care support, will undermine existing health system strengthening efforts, worsen the humanitarian crisis.”[10] It is well-known that preventative medicine is less expensive, sustainable and often more effective at treating disease in the long term.

The greatest strategic challenge for models of humanitarian assistance to Yemen is balancing the country’s short-term crises with its long-term needs. Most programming focuses on emergent public health crises such as cholera and COVID-19, which reflects donor intent rather than Yemeni priorities. But Yemen faces significant long-term public health challenges. Prior to the onset of hostilities in 2014, Yemen’s health care system also suffered from chronic shortages of medical supplies and medical staff, with only three physicians per 10,000 individuals—one of the worst physicians-to-persons ratios in the world. Foreign-directed health care priorities in Yemen have inadvertently contributed to the overall medical brain drain in Yemen, as the country increasingly relies on foreign medical expertise and personnel. The Yemeni medical professionals who could afford to leave the war-torn country have already done so, while those left behind gravitate toward better-paying international medical initiatives rather than basic health care.

The Challenges and Benefits of Local Aid Efforts

One way to address the deleterious cycle of foreign humanitarian aid and dependence is to limit the overreaching and bloated INGO bureaucracies and instead increase Yemeni agency in the strategic process of aid allocation. Collaboration with local entities both during conflict and post-conflict situations is essential to creating self-sustaining development and stability.[11] Local organizations are able to prioritize the long-term needs of capacity building over short-term humanitarian responses and can work to replace expensive foreign personnel with local Yemenis, particularly in basic health care.

For example, rather than importing food, a practice dating back to the early 1970s, local efforts of resource acquisition may allow Yemenis to invest in long-term agricultural and food security. The unchecked dumping of large quantities of imported food by humanitarian organizations can cripple local farmers, leading to a vicious cycle of impoverishment. Sustainable aid models draw instead upon locally sourced emergency food supplies to the furthest extent possible, knowing that such an investment-centric approach will reduce dependence in future years.

Rather than importing food, a practice dating back to the early 1970s, local efforts of resource acquisition may allow Yemenis to invest in long-term agricultural and food security.

The nonprofit Yemen Relief and Reconstruction Foundation (YRRF) stands out as one of the few organizations to source food locally: It purchases food from Yemeni farmers and distributes it as aid across political divides in coordination with local NGOs.[12] Although the YRRF, founded in 2017, operates on a small scale, this model of local sourcing has the potential to work on a regional level. Other grassroots organizations run by local Yemenis have joined the ranks of YRRF in operating a far more sustainable long-term model. MonaRelief, founded by Yemeni journalist and activist Fatik al-Rodaini, uses cash donations to purchase food from local farmers and vendors and deliver food baskets to families in need. Ahmad Algohbary, a Yemeni journalist based in Sanaa, founded Yemen Hope and Relief, an organization supporting crisis relief for children facing severe malnutrition. Both organizers utilize social media platforms to reach donors, journalists and families in need. Compared to massive operations like those of the UN, the overhead of these NGOs is minimal, and their humanitarian relief per dollar is far more effective.

The Yemeni diaspora community presents another path toward overcoming the otherwise insurmountable humanitarian aid gap. For example, Yemen Aid, founded in 2016 and run by Yemeni American Summer Nasser, eliminated middleman-bloated bureaucracy by creating an aid model that operates efficiently and directly with local Yemeni affiliates. According to the organization’s 2018 Annual Report, Yemen Aid commits 97 percent of its expenditures to program-related areas, while larger organizations such as OXFAM regularly commit less than 70 percent.

Local NGOs, however, are limited by the same political divisions that plague the country’s political system. Most do not have national appeal and are constrained to regional networks. MonaRelief, for example, is restricted in its programming to the governorates of Sanaa, Hodeidah and Dhamar, and does not work in the south. Yemen Aid, on the other hand, conducts much of its programming in Aden. The exception may be Itar for Social Development, run by Wameedh Shakir, which operates as a civil society consortium for local Yemeni NGOs and humanitarian organizations with active programming in the country’s northern, southern and eastern Hadramawt regions. Local civil society organizations are subject to a wide range of security challenges imposed by the Houthis and other regional militant groups, which limits their ability to operate outside of certain zones or to scale up at the national level. Nor are civil society leaders able to travel freely within Yemen or internationally as the Sanaa airport remains closed to civilian traffic, leaving only the remote airports of Seyoun and Aden as flight options.

Even the mere transfer of donor funds into Yemen presents a serious challenge for local NGOs because Sanaa-based “Houthified” banks exercise a monopoly over—and exact percentages from—foreign monetary transactions. This method of aid and cash delivery inadvertently benefits the entrenched political elite at the expense of those suffering the most from the humanitarian crisis. While the decentralization of aid management may limit the extent of Houthi control or the ability of a single militant group to monopolize the delivery of humanitarian aid, there remains a risk of corruption and mismanagement even at a local level. Without continued accountability, individual donors from abroad will have managed only to disperse centralized rent-seeking to profiteering regional actors.[13] Foreign aid funds programming but not capacity building, while at the same time requiring complicated financial and grant reporting. Aside from Itar, there is no Yemeni civil society coordination to make accountability and cross-regional programming possible. Nevertheless, extending a greater degree of agency to Yemenis in the allocation of foreign assistance and locally sourcing humanitarian aid when possible offers a way to address the growing donor dependency and aid cycle while avoiding the overhead costs of a major international aid agency.

Overall, 2020 has constituted a triple threat to Yemen’s economic stability: worker remittances sent by Yemeni migrant laborers in the Gulf countries dropped as the falling price of oil shut down oil fields; COVID-19 restrictions impeded domestic economic activity; and the level of foreign aid fell to the detriment of Yemenis reliant on donor generosity. Donor pledges following the Saudi-hosted virtual High-Level Pledging Event in June 2020 amounted to $1.35 billion, far short of the $2.4 billion requested by the United Nations. Within that commitment, funds have been shifted away from regular humanitarian assistance and refocused on COVID-19-related efforts, as per the priorities of international donors. The United States, for instance, reduced its overall amount to the WFP from $920 million in 2019 to $225 million in 2020, earmarking all of it for the south and limiting aid support for Houthi-held territories in the north.

Shifting aid from preventive medical care to pandemic response and personal protective equipment may contribute to increased mortality from non-coronavirus diseases combined with malnutrition while also deepening the country’s poverty and subsequent dependence on foreign aid. Without a clear exit strategy that transfers responsibility to local partners, humanitarian aid programs in Yemen are faced with the difficult decision of either remaining indefinitely or withdrawing prematurely, thereby leaving chaos and dependency in their wake.

[Asher Orkaby is an associate research scholar at Princeton University’s Transregional Institute and a residential fellow at the Woodrow Wilson International Center.]

Endnotes

[1] Neil Narang, "Assisting Uncertainty: How Humanitarian Aid Can Inadvertently Prolong Civil War," International Studies Quarterly 59/1 (2015).

[2] Michael Barnett, Empire of Humanity: A History of Humanitarianism (Ithaca: Cornell University Press, 2011) p. 42–43.

[3] Raiman al-Hamdani and Helen Lackner, “Talking to the Houthis: How Europeans Can Promote Peace in Yemen,” European Council on Foreign Relations (October 2020).

[4] A/74/6 (Sect. 3)/Add. 1, UN General Assembly (June 2019).

[5] Fiona Terry, Condemned to Repeat?: The Paradox of Humanitarian Action (Ithaca: Cornell University Press, 2002) p. 15–16.

[6] Asher Orkaby, Beyond the Arab Cold War: The International History of the Yemen Civil War, 1962-68 (New York: Oxford University Press, 2017).

[7] Sheila Carapico and Richard N. Tutwiler, Yemeni Agriculture and Economic Change: Case Studies of Two Highland Regions (Sanʾa: American Institute for Yemeni Studies, 1981).

[8] Sharmila Devi, "Fears of ‘Highly Catastrophic’ COVID-19 Spread in Yemen," The Lancet (British edition) 395/10238 (2020).

[9] A. A. Al-Waleedi et al., "The First 2 Months of the SARS-CoV-2 Epidemic in Yemen: Analysis of the Surveillance Data," PLoS One 15/10 (2020).

[10] Sameh Al-Awlaqi et al., "COVID-19 in Conflict: The Devastating Impact of Withdrawing Humanitarian Support on Universal Health Coverage in Yemen," Public Health in Practice 1 (November 2020).

[11] Hameed Alqatabry and Charity Butcher, "Humanitarian Aid in Yemen: Collaboration or Co-Optation?," Journal of Peacebuilding & Development 15/2 (2020).

[12] Ann Marie Kimball and Aisha Jumaan, "Yemen: The Challenge of Delivering Aid in an Active Conflict Zone," Global Security 5/1 (2020).

[13] Tim Eaton, et. al., “Conflicts Economies in the Middle East and North Africa,” Chatham House (2019).