by amy pullanFor nearly six years, civil war in Yemen has endured, resulting in famine so awful that 80% of the population is dependent on aid (Al-Hamdani, 2020), a resurgence in outbreaks of preventable diseases such as cholera, destroyed infrastructure and faith (Alrubaiee, Al-Qalah and Al-Anwar, 2020), and their natural yet devastating progeny: a deep and widespread mental health crisis (Al-Hamdari, 2020). When April of 2020 brought the first confirmed case of coronavirus (Aljazeera, 2020), and with it the pandemic to Yemen, the country’s response was tragically revealing of the psychological effects of dealing with multiple incendiary crises at once. Amidst what the UN has named the world’s worst humanitarian crisis (Crawford, 2020), COVID-19 finds an unusual place in the attitudes and perception of many Yemenis. Findings based on both WEIRD and non-WEIRD populations suggest that higher entitlement leads to unethical behaviour, such as breaching coronavirus restrictions (Heng hi, 2020). In the individualistic culture of the West, this is more likely to happen than in Yemen. But what if you aren’t even given the chance to act ethically or unethically? It wasn’t until the 10th of April 2020 that the first case of coronavirus was announced in Yemen (Aljazeera, 2020). Before an official announcement from the Ministry of Health, Yemenis may not have been aware of the virus or, if they were, may not have believed that it was real (Action Against Hunger, 2020). It is important to appreciate, too, that the relative gravity of the pandemic is also different in Yemen. Whilst from an occidental point of view it feels obvious that the virus should be taken seriously, in a country undergoing civil war where 10 million people are on the brink of starvation (Amer and Murphy, 2020), the admission of yet another crisis takes psychological strength many Yemenis have been robbed of. Since its official acknowledgement, however, it could be expected that attitudes towards the virus would change, to take into account its true weight. But for many Yemenis, this is not the case. A worrying number of attitudes can be categorised as either resigned – endemic of too many crises to give attention to them all – or suspicious. According to WHO, Yemen, having lost so many health care facilities, is more than 50% below the basic health services benchmark (Alrubaiee, Al-Qalah and Al-Anwar, 2020). With little hope of improvement for at least the near future, resignation to whatever fate the pandemic will have in Yemen is a predictable – and, even, deplorably – sensible reaction. The director of a centre in Ataq last year outlined a common line of thought: Yemenis’ resilience has led to such high morale that they either avoid or quickly recover from the virus, providing an explanation for why COVID’s impact is officially so small (McKernan, 2020). Furthermore, most of the attitudes towards coronavirus of healthcare providers in Yemen show only moderate levels of anxiety (Alrubaiee, Al-Qalah and Al-Anwar, 2020). These attitudes, whilst encouraging from a mental health perspective, expose the relative insignificance of COVID-19 compared to Yemen’s other crises. The number of cases is anticipated to be much higher than recorded, and gaps in knowledge as well as attitude have been identified in Yemen (Alrubaiee, Al-Qalah and Al-Anwar, 2020), proving that the scale of the multiple crises occurring in the country has led to an event as serious as the pandemic being perceived from this skewed angle. Disbelief in the virus is prevalent in the north of Yemen, where the country’s capital, Sana’a, can be found. The area remains under the control of the Houthi rebels; as of September 2020, there were just four confirmed casualties linked to COVID (Crawford, 2020). The UN estimates that the actual fatality rate in Yemen is 30% (Crawford, 2020), and it is probable that Yemen actually holds the highest unofficial COVID-19 death rate in the world. But for psychologically battered people, traumatised from nearly six years of war, their physical and mental suffering egregiously neglected and still largely absent from Western media (Amer and Murphy, 2020), suspicion is instinctual. Distrust of those in power runs so deep that, particularly in the north where the virus is ignored by both the Houthis and the genderal population, there are Yemenis who fear that the virus is a weapon being used against them, and ‘treatment’ in the hospital actually involves being given a lethal injection of coronavirus (Crawford, 2020). This deep distrust reflects the widespread trauma of so many Yemenis. Suspicion, therefore, reveals deeply rooted anxiety and trauma. COVID-19’s arrival in Yemen has added yet another mental health trigger to the country’s mental health crisis (Al-Hamdani, 2020). Hunger and physical suffering are prioritised by aid organisations while mental health is ignored by the government, and there is a cultural stigma around getting help (Al-Hamdani, 2020). Despite the other crises in Yemen, the mental health impact of COVID should not be underestimated and cannot remain unaddressed for much longer. The detrimental psychological effects of the multitude of crises in the country are immense, and Yemenis who don’t believe in the virus may simply find this easier recourse than accepting that Yemen’s problems are multiplying rather than ameliorating. As its health system deteriorated, preventable diseases such as cholera and diphtheria returned to Yemen. Being treated for coronavirus in this climate is obviously complicated due to the lack of access to healthcare as well as financial barriers (Action Against Hunger, 2020). COVID has exacerbated the lack of reports on Yemen in Western media and even without considering this, aid is often blocked from reaching Yemenis who need it (Amer and Murphy, 2020). Evidently, these factors conflate to make coronavirus in Yemen extremely difficult to deal with, significantly worsening the mental health crisis, too. The differing attitudes towards coronavirus, whether distrustful or stoical, as well as the fracturing impact on an already fragile mental health crisis and the near-extraneity of the pandemic to other active crises all combine to betray the psychological ramifications of Yemen’s multitude of adversities. When it comes to COVID-19, an uncomfortable dichotomy of denial and cognisance paralyses a country that is constantly in crises. References
Action Against Hunger, (2020, July 27). Yemen: dealing with Covid-19. Retrieved from https://www.actionagainsthunger.org.uk/our-impact/stories/yemen-dealing-with-covid-19 Al-Hamdari, R. (2020). Yemen’s Mental Health Crisis and Its Implications for Security. Yemen Policy Center, ARK Group, The European Council for Foreign Relations Aljazeera, (2020, April 10). Yemen confirms first coronavirus case, braces for outbreak. Retrieved from https://www.aljazeera.com/news/2020/4/10/yemen-confirms-first-coronavirus-case-braces-for-outbreak Amer & Murphy, K. (2020, November 3). What’s Happening in Yemen? [Audio Podcast Episode]. In Real Arabic. https://open.spotify.com/episode/0IkLtQ2Jh2ZBIDpSWL0eQS Alrubaiee, G.G., Al-Qala, A.H. & Al-Aawar, M.S.A. (2020). Knowledge, attitudes, anxiety, and preventive behaviours towards COVID19 among health care providers in Yemen: an online cross-sectional survey. BMC Public Health 20, 1-11 Crawford, A. (2020, September 18). Coronavirus: Yemen in denial about COVID-19 – and worse still, there’s a fog of mystery over how many are dying. Retrieved from https://news.sky.com/story/coronavirus-yemen-is-in-denial-about-covid-19-and-worse-still-theres-a-fog-of-mystery-over-how-many-are-dying-12073435 Heng Hi, (2021). Follow or not follow?: The relationship between psychological entitlement and compliance with preventive measures to the COVID-19. Personality and Individual Differences 174 McKernan, B. (2020, November 27). Yemen: in a country stalked by disease, Covid barely registers. Retrieved from https://www.theguardian.com/global-development/2020/nov/27/yemen-disease-covid-war
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