Disaster response in a civil war: Lessons on local hospitals capacity. The case of Yemen

Abstract

ABSTRACT Objectives: To explore the capacity of the health system in the governorate in responding to disasters during the civil war of 2015. Methods: This is a descriptive cross-section, pretest-posttest study design. It was carried in three district hospitals and one general hospitals in the coastal region of Hadhramout Governorate-Yemen. They were evaluated for their physical resources inputs, services outputs, and their human resources. Results: The health system in the governorate showed poor effectiveness 50%, the general hospital had acquired 94% of standard resources for hospitals; there were shortages of health care providers in all hospitals, with variable skills levels in emergency care. The training of general practitioners had improved their performance in airway breathing and circulation skills (from 44% to 94%, P = 0.00), wound care (from 78% to 100%, P = 0.00), abdominal traumas (from 6% to 56%, P = 0.01) chest traumas (from 28% to 89%, P = 0.00), musculoskeletal traumas (from 28% to 72%, P = 0.00), head and spine traumas (from 22% to 78%, P = 0.00). Conclusion: Despite the fragility of the health system, training during disaster significantly improves the skills of care providers. Evaluation of the health system during disasters needs special tools.