Report from the ground: How U.S.A.I.D. cuts are crippling Yemen’s healthcare system
Why It Matters
The Trump administration has slashed funding for their global aid programs by more than 90 per cent. While that is being fought in American courts, the uncertainty surrounding funding has prompted programs to pause and supply lines to dry up. On the ground, this is what it means for those fleeing war and persecution in Yemen.
By Salman Alrubaie
In Al Jufaina Camp, Marib, located around 170 kilometers east of Yemen’s capital Sana’a, 60-year-old Mohsina Mohamed clutches a small plastic bag containing the last of her diabetes medication. For years, she had collected her treatment regularly from the nearby 26 September Hospital.
But that was before the Trump administration’s decision in January to eliminate 92 per cent of U.S.A.I.D contracts globally, cutting 5,800 grants as part of a shift in U.S. foreign assistance priorities, with Yemen being among the many countries impacted.
Despite living in harsh conditions and struggling with a chronic illness, Mohsina had found some sense of stability.
After years in a makeshift tent, her family scraped together what little they could from the sale of a small plot of land and built a modest home. It offered shelter, but her survival still depended on humanitarian support for medication she could not afford.
Now, with funding drying up, that treatment is no longer guaranteed.
She sits quietly, her thin frame showing signs of strain after years of living with diabetes. As she speaks, her hand trembles slightly as she reaches for the last of her medication.
“Sometimes I go days without medicine,” she says. Her son, the family’s sole provider, works as a day labourer on construction sites, moving from one job to the next. His income is barely enough to cover their basic needs.
“Each delay makes my condition worse.”
She’s one of millions feeling the impact. Across war-torn Yemen, years of fighting and limited resources have left 17.8 million people in need of health assistance. Women make up nearly a quarter of that number, many of them facing rising health risks with fewer services to turn to.
Across the country, debilitated hospitals that have survived on aid are now scaling back services.
Medical workers, whose salaries were paid through aid – in a country where millions of government workers have not been paid consistently for years – are being laid off, and life-saving care is vanishing overnight.
For years, the U.S. funded more than half of Yemen’s aid programs, channelling $795 million into the country in 2024 alone. But the U.S. State Department’s decision in February left a fragile healthcare system on the brink of collapse.
Marib at breaking point
In Marib, the country’s largest hub for internally displaced people and where nearly two million Yemenis live in camps, the effects are immediate and severe.
The 26 September Hospital in Al Jufaina Camp, home to more than 17,000 displaced families, relied on international organizations to cover 70 per ent of its operational needs, according to its director, Abdallah Mabrouk.
The International Organization for Migration previously paid the salaries of 49 staff, covered fuel for generators, and provided essential medicines and training, Mabrook noted, but that support has now ended. Médecins du Monde, which funded the maternity emergency unit, is scheduled to fully withdraw by the end of March. Both changes, Mabrouk confirms, have left the hospital in an extremely vulnerable position.
“We’ve renewed staff contracts for three months just in case another donor steps in,” Mabrouk says.
“But hope is fading. Without support, we’ll have to dismiss most of our team.”
The hospital is even considering charging patients to stay afloat. But in camps where families survive on rations, few can afford to pay.
Working with nothing
Inside the emergency maternity unit, midwife Samar al-Hamdani moves between patients with quiet urgency. She has worked here for years, helping women through complicated births and crisis situations. But since the aid halt in February, she says, conditions have sharply deteriorated.
“We used to receive supplies regularly in the maternity emergency unit,” she explains, noting that they are now operating without the essentials.
“We’ve run out of basic supplies; antibiotics, emergency medications, even sterilized gloves,” she says.
“There’s barely enough IV fluid. Lab tests and X-rays are delayed because the equipment lacks essential operating materials.”
That shortage, she explains, is directly harming the patients. Delays in diagnosis and treatment have increased. Chronic patients are unable to access essential medication, threatening their long-term health. Pregnant women lack consistent care before and during childbirth, raising the risk of complications for both mothers and newborns.
Despite all the aid it has been receiving, Yemen’s maternal mortality rate has risen by 21 per cent since 2013, according to World Bank figures. This significant slash in aid therefore raises fear of the impact it will have on pregnant women in a country with the highest rates of deaths among pregnant women in the region.
“The shortage has increased patients’ suffering and affected the accuracy of diagnoses and the speed of treatment,” she says. “We’re losing trained colleagues who can’t keep working without pay or resources.”
To cope, the hospital has started scaling back non-urgent services and rationing the few resources left. It’s working with humanitarian partners to source supplies and prioritize critical cases but even that may not be enough.
Without new funding, Samar says, further service cuts or reduced hours are inevitable, leaving more patients without care.
Left without mental healthcare
The aid cuts haven’t only hit emergencies and physical healthcare. Some mental health services, already rare in displacement settings, have now come to a halt. The ongoing conflict in Yemen has left roughly seven million people, or a quarter of the republic’s population, struggling with psychological trauma and stress, according to the World Health Organization.
Although they all need mental health support, a mere 120,000 patients had consistent access to services.
In Al Suwaida Camp, Marib’s second-largest camp for displaced families, home to more than 1,600 families, psychologist Sabah Abu Hadi, 25, once ran a mental health program supported by the Benaa Foundation – a Yemeni humanitarian organization active in education, health, economic empowerment and emergency relief.
Sabah provided counselling to 40 to 60 people a month, including survivors of gender-based violence, elderly patients, and children grappling with trauma. However, when the foundation lost its funding, the program was shut down.
“When I lost my job, they lost the only person who listened to them,” Sabah says. “Some of them still call me, hoping I can help. But I have nothing to offer.”
Her group therapy sessions once provided a rare outlet for women to share experiences and coping strategies, helping one another through the stress of displacement and violence.
“That space helped reduce the emotional burden,” she says.
Sabah has been searching for a new job for more than a month without luck. “I worry I’ll lose the experience I’ve built over the years.”
While losing her job has been personally difficult, she says the bigger loss is the disappearance of mental health support from the camp altogether.
“Even if I don’t return to the same job, the most important thing is bringing back mental health and psychosocial support because people desperately need it.”
She even considered continuing her work as a volunteer, but the barriers were simply too high. “Even if I wanted to offer counseling for free, I don’t have a safe space, tools for assessment, or the medications and materials needed to support patients,” she explains.
Recently married and living in a tent herself, she says the environment is far from suitable.
“The conditions I’m in make it impossible to offer patients a secure or private setting, let alone run effective sessions.”
The situation is not unique to Marib. Across Yemen, 22 safe spaces for women and girls in high-risk areas have shut down, cutting off access to protection and health services for more than 11,000 people, according to the UN Office for the Coordination of Humanitarian Affairs.
Major aid organizations like the International Rescue Committee and Solidarités International have also scaled down U.S.-funded health, nutrition, and protection programs in multiple countries, including Yemen, leaving vulnerable populations with fewer options.
From 80 to eight: Marib’s healthcare shrinking
In Marib, the consequences of these cuts are playing out across the entire health system.
Only eight out of 80 health facilities are fully operational, according to Dr. Aref al-Tuffaf, director of healthcare at the Marib health office, with around 20 facilities directly affected by the latest U.S.A.I.D. funding halt. Of the remaining 72, 54 are only partially functional, while 18 are out of service due to shortages in supplies and staff.
Maternal care, chronic illness treatment, and mobile medical teams are among the hardest hit.
“Pregnant women are giving birth at home without skilled care,” al-Tuffaf says. “People with diabetes, heart disease, or kidney conditions are skipping treatment because they can’t access specialized care.”
He notes that the system depends heavily on contracted and volunteer staff, who make up 80–90 per cent of the workforce in some facilities. With funding gone, those workers are likely to leave, and many services will disappear with them.
“At the start of this year, the US-funded projects were supposed to continue through the second quarter. But with the sudden end, we’re seeing essential services shut down, especially emergency and maternity care,” he says.
In response, local health officials have coordinated with authorities, the Ministry of Health, and local and international NGOs in an effort to limit the damage, because for communities already worn down by years of war, displacement, and poverty, the loss of healthcare strips away one of the few remaining lifelines people had left.
“We urgently need support to meet the people’s needs, especially in rural and remote areas, to avoid a humanitarian health disaster that could affect thousands of people in Marib.”
This piece was published in collaboration with Egab.
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