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也门内战重燃,医院不堪重负,陷入“极其危险的局面”Yemen’s civil war returns and overwhelms hospitals with 'a very dangerous situation'

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法特玛·哈立德、艾哈迈德·哈吉、卡拉·安娜·阿登,也门亚丁报道 —— 7岁的塔里克·萨拉米穿着尿布坐在那里,显得虚弱不堪。通常情况下,导致他身体衰弱的营养不良和腹泻几天内就能得到治疗,但在也门,现在已没有什么是正常的了。

FATMA KHALED, AHMED AL-HAJ, CARA ANNA ADEN, Yemen — Tarek al-Salami, aged 7, sat in a diaper, looking frail. Normally, the malnutrition and diarrhea that weakened his tiny frame would have been treated within a few days, but nothing is normal in Yemen anymore.

随着伊朗支持的叛军本月攻入,内战重燃,塔里克的父亲背着他从西南部城市摩卡步行逃离。两天后,男孩到达政府控制的亚丁市一家医院,距离270公里(170英里),但医院称没有床位。和其他医院一样,这里挤满了伤员。他们最终找到了一家治疗性喂养中心。

Tarek’s father carried him on foot from the southwestern city of Mokha as Iran-backed rebels swept in this month, bringing a return to civil war. The boy reached a hospital two days later in the government-held city of Aden, 270 kilometers (170 miles) away but it said it had no beds. Like others, it was overwhelmed by the wounded. They finally found a therapeutic feeding center. The boy arrived in “acute crisis” after the delay in care, according to the center’s director, Dr. Arwa Atef, and he only began walking again on Wednesday, over a week later.

据该中心主任阿尔瓦·阿特夫医生介绍,因治疗延误,男孩到达时处于“急性危机”状态,直到一周多后的周三才重新开始走路。

“I swear to God, when I look at him, my heart breaks,” said his father, Mohammed al-Salami. “He looks almost lifeless.” This is how the already fragile health system in the Arab world’s poorest nation is collapsing, caught in a new front of the Iran war . The Associated Press spoke with patients, medical workers and aid groups in Yemen and outside as medicines run short and some workers flee. A few facilities have been overtaken by the fighting.

“真主作证,看着他,我的心都碎了,”父亲穆罕默德·萨拉米说,“他看起来几乎没有生气。”这就是阿拉伯世界最贫穷国家本已脆弱的卫生系统正在崩溃的方式,它陷入了伊朗战争的新战线。美联社采访了也门国内外的患者、医护人员和援助机构,了解到药品短缺、部分工作人员逃离,还有几家医疗机构被战火吞没。

“I swear to God, when I look at him, my heart breaks,” said his father, Mohammed al-Salami. “He looks almost lifeless.” This is how the already fragile health system in the Arab world’s poorest nation is collapsing, caught in a new front of the Iran war . The Associated Press spoke with patients, medical workers and aid groups in Yemen and outside as medicines run short and some workers flee. A few facilities have been overtaken by the fighting.

一些卫生中心不得不拒收孕妇等急需帮助的人员,以便专注于创伤患者。脆弱的儿童挤满了保温箱,共用病床。在中东两大强国支持的战斗中,伊朗支持的胡塞武装向沙特阿拉伯支持的政府军推进,数百万人受到影响。已有超过13万人逃离家园。

Some health centers are turning pregnant women and others in need away to focus on trauma patients. Vulnerable children are filling incubators and sharing beds. Millions of people are affected by the fighting backed by two of the Middle East’s biggest powers as Iran-backed Houthis advance against government forces supported by Saudi Arabia. Over 130,000 have fled their homes. The feeding center where Tarek and other children are recovering is struggling to cope with a rise in patients in a country where many already were hungry, Atef said.

阿特夫说,塔里克和其他儿童正在康复的这家喂养中心,正努力应对患者激增的局面,而在也门,许多人早已挨饿。“我们无法跟上这种局势,”她说。

“We can’t keep up with the situation,” she said.

联合国表示,大多数受战事升级影响的医院和初级卫生中心在最初48小时内关闭,随后恢复了服务。但现在有些设施更难到达。胡塞武装已控制红海沿岸,包括重要的援助港口。

Most hospitals and primary health centers affected by the escalation in fighting closed for the first 48 hours before resuming services, the United Nations said. But some are now harder to reach. The Houthis have seized the Red Sea coast, including key ports for aid.

世界卫生组织表示,受影响的卫生中心中,不到10%完全配备了伤员所需的创伤救治服务。资源匮乏,痛苦的分诊正在进行。

Less than 10% of the affected health centers are fully equipped with the trauma services that wounded people need, the World Health Organization has said. With resources thin, a painful triage is underway.

联合国人口基金的弗朗切斯科·加尔蒂耶里表示,即使在局势升级之前,每天也有三名也门妇女死于与怀孕相关的紧急情况,这是阿拉伯世界最高的比率之一。现在能处理此类紧急情况的设施更少了。

Fewer facilities are handling the pregnancy-related emergencies that were killing three Yemeni women every day even before the escalation, said Francesco Galtieri with the United Nations Population Fund. That’s one of the highest rates in the Arab world. “Around 2,000 pregnant women are on the move,” with over 200 expected to deliver in the next week or so, he said.

他说:“大约有2000名孕妇在途中”,预计未来一周左右将有200多人分娩。

Maternity wards have been converted into emergency rooms in some hospitals close to the fighting, said Hashem Osseiran, an International Committee of the Red Cross spokesperson, adding that many lack enough anesthesia drugs, oxygen supplies and sterile surgical gloves.

国际红十字会发言人哈希姆·奥塞兰表示,一些靠近战区的医院已将产科病房改为急诊室,并补充说,许多医院缺乏足够的麻醉药物、氧气供应和无菌手术手套。

Maternity wards have been converted into emergency rooms in some hospitals close to the fighting, said Hashem Osseiran, an International Committee of the Red Cross spokesperson, adding that many lack enough anesthesia drugs, oxygen supplies and sterile surgical gloves.

在政府控制的马里卜市,一家治疗妇女儿童的医院里,艾哈迈德·莫德什医生表示,随着该市其他医院专注于治疗伤员,他们接收的紧急产科病例正在增加。

At a hospital treating mothers and children in the government-held city of Marib, Dr. Ahmed Modhesh said they are seeing more emergency maternity cases as other city hospitals focus on the wounded.

但他的这家设施——马尔泰尔·穆罕默德·海耶尔医院,缺乏重症监护专家,也没有足够的发电机在断电时维持所有科室运转。

But his facility, Martyr Mohamed Hayel hospital, lacks intensive care specialists and doesn’t have enough generators to keep all departments running if the power goes out.

一名助产士表示,该医院接生数量基本翻倍,达到约80例。一名宫外孕妇女大出血前来就诊,尽管人手不足,工作人员仍设法实施了紧急手术挽救了她的生命。这名助产士因未获授权接受媒体采访,要求匿名。

A midwife said the number of childbirths the hospital is handling has basically doubled to about 80. One woman with an ectopic pregnancy arrived bleeding heavily, yet the under-resourced staff were still able to perform an emergency procedure to save her life, the midwife said. She spoke on condition of anonymity because she wasn’t authorized to speak with the media.

即使在局势升级之前,也门的医院就依赖有限的政府支持和民间捐赠。有些医院甚至无法全额支付员工工资。

Even before the escalation, hospitals in Yemen relied on limited government support and citizen donations. Some were not able to fully pay staff.

“现在我们处于非常危险的境地,”塔伊兹省卫生办公室主任法赫德·纳扎里说,该省接收了大部分新流离失所者。“一两天内,至多一周,我们可能不得不关闭(部分设施)。事实上,有些医院已经关门了。”该省17家医院中有3家不再受政府控制。纳扎里周四表示,自胡塞武装攻占摩卡以来,塔伊兹全省医院已收治约635名伤亡者,其中包括112具尸体。伤亡者包括平民和战斗人员。“在这种情况下接收伤员,我们已精疲力竭,”纳扎里说。

Now, “we are in a very dangerous situation,” said Fahd al-Nazari, manager of the health office in Taiz province, which has received most of the newly displaced. “Within a day or two, or a week at most, we might have to close down (some facilities). In fact, some hospitals are already closed.” Three of the province’s 17 hospitals are no longer under government control. Hospitals across Taiz had received around 635 casualties, including 112 bodies, as of Thursday after the Houthis captured Mokha, al-Nazari said. They included civilians and combatants. “We’re exhausted receiving wounded people under these circumstances,” al-Nazari said.

由于摩卡与塔伊兹之间的关键补给路线基本被切断,迫使车队改走不适合大型卡车通行的山路,医疗物资和燃料告急。即使在局势升级前,该省公立医院也仅有一台核磁共振设备。

Medical supplies and fuel are running short after key supply routes between Mokha and Taiz were largely cut off, forcing convoys onto mountainous roads unsuitable for large trucks. Even before the escalation, public hospitals in the province had just one MRI machine available.

塔伊兹也门-瑞典妇幼医院总经理萨米·沙拉比表示,保温箱已满员,急诊室里两三个孩子挤在一张床上。

At the Yemeni-Swedish Maternity and Children’s Hospital in Taiz, incubators were full and two or three children were sharing beds in the emergency room, general manager Sami al-Sharabi said.

“我担心冲突会蔓延到医院,”他说。“任何击中我们的爆炸物都会摧毁医院,因为建筑部分结构已很脆弱。”即使在也门政府所在地亚丁,医院也难以应对。无国界医生组织表示,一周内阿尔-加姆胡里亚医院已收治60多名伤员。许多人急需手术或输血。

“I’m scared that the conflict would reach the hospital,” he said. “Any explosive that could hit us would destroy the hospital, as some parts of the building are already weak.” Even hospitals in Aden, where Yemen’s government is based, struggle to cope. Doctors Without Borders said more than 60 wounded people had been admitted to Al-Gamhouria hospital in a week. Many needed urgent surgery or blood transfusions.

在胡塞控制的萨那市,一家治疗叛军的私立医院里,两名医疗官员上周表示,医院已不堪重负,收治了数百名伤员。因安全顾虑,两名官员要求匿名。

At a private hospital treating rebels in the Houthi-held city of Sanaa, two medical officials last week said it was overwhelmed with hundreds of wounded. The officials spoke on condition of anonymity because of security concerns.

目前尚不清楚总共有多少胡塞武装战士伤亡。在反政府武装控制的地区,极少有援助机构开展工作,因为该组织已拘留并骚扰了数十名人道主义工作者。专家表示,胡塞武装难以向公务员(包括公立医院医生)发放薪水,并将大部分税收收入转移到了其军事部门。

It was not clear how many Houthi fighters have been killed or wounded overall. Few aid agencies operate in rebel-controlled areas, as the group has detained and harassed dozens of humanitarian workers. Experts say the Houthis have struggled to pay salaries to civil servants, including public sector doctors and diverted most tax revenues to their military wing.

国际红十字会(ICRC)是仍能在萨那开展工作的为数不多的全球性机构之一,上周表示已运送了22吨急需的医疗物资,以支持“不堪重负”的医院。

The ICRC, one of the few global agencies still able to operate in Sanaa, last week said it delivered 22 tons of badly needed medical supplies to support “overwhelmed” hospitals.

关于政府军伤亡的信息也很少,尽管一个亲政府武装团体称其有1500多名战士受伤。部分医务人员因冲突而逃离,这使得寻求医疗救治变得更加困难。

There is also little information about casualties among government forces, though one government-allied group has said over 1,500 of its fighters were wounded. Some medical workers have fled the conflict, making it harder to find care.

在摩卡,无国界医生组织表示,其小型团队仍在工作,“尽管医疗专业人员严重短缺”。该慈善机构在也门的行动副协调员埃马纽埃尔·马萨尔表示,当地另外三家医院曾关闭数天,随后才恢复服务。

In Mokha, Doctors Without Borders said its small team was still working “despite the severe shortage of health professionals.” The charity’s deputy coordinator of operations in Yemen, Emmanuel Massart, said three other hospitals there had closed for days before resuming services.

马萨尔从布鲁塞尔接受美联社采访时表示,也门对医院资金和资源的需求依然紧迫,他同时也承认,由于道路封闭,补给仍是一大挑战。

The need for hospital funding and resources in Yemen remains urgent, Massart said, speaking to the AP from Brussels, even as he acknowledged that resupplying remains a major challenge because of closed roads.

“我们不应忘记也门,”他说,“它仍然是世界上最严重的人道主义危机之一。” 卡勒德在开罗报道,安娜在耶路撒冷报道。美联社记者阿卜杜勒纳赛尔·阿尔塞迪克在亚丁、托卡·埃齐丁在开罗为本报道做出了贡献。

“We should not forget about Yemen,” he said. It “remains one of the worst humanitarian crises in the world.” Khaled reported from Cairo and Anna from Jerusalem. Associated Press writers Abdulnasser Alseddik in Aden and Toqa Ezzidin in Cairo contributed to this report.