The patients names have been changed to protect their identity.
Sanaa, Yemen – With each breath he took, the red rashes on Ahmad’s cheeks appeared to get brighter and brighter.
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After making his way up the stairs of the al-Jumhurriya hospital in the Yemeni capital Sanaa, one of the few health centres in the war-ravaged country that still provides free medical treatment to people living with HIV, the eight-year-old – looking tired and frail – took his seat in a brightly-lit waiting room next to his ailing father, waiting patiently for doctors to call him in for his latest blood test.
Three years ago, Ahmad was healthy and playful, his father Zakariyya told Al Jazeera as the sudden burst of static from an old analogue TV appeared to startle the young boy.
“When he became sick, we took him to the hospital where doctors carried out tests and told us he had problems with his immune system,” he said.
“They later told us it was HIV.
“My wife and I also took the tests and we also tested positive.”
An acronym for the human immunodeficiency virus, HIV attacks important cells that help the body fight off infections, disease, and other viruses.
When the infection goes untreated, it causes AIDS. This typically causes fever, weight loss, recurrent diarrhoeal infections and other symptoms.
While both are seen as treatable, a cure has yet to be found.
‘I take a red pill every day’
Zakariyya said his family moved to Sanaa sometime in 2016 for treatment when fighting engulfed his neighbourhood in the southwestern city of Taiz.
As Houthi fighters were being expelled from the city, air attacks and street clashes devastated Taiz, forcing at least 37 of its 40 hospitals and medical institutions to close.
According to local authorities, Doctors without Borders, best known by its French initials MSF, was one of the few aid agencies that continued providing free antiretroviral (ARV) treatment to the 600 people living with HIV/AIDS in the capital.
The situation was so dire, that some of the patients began rationing their medicines because of the difficulty associated with reaching clinics and hospitals.
Citing the case of one woman, MSF said that she began taking half a tablet instead of a whole one and even began taking them on alternate days so she didn’t have to completely stop her treatment.
Zakariyya said he and his family were among the fortunate ones and received their intended doses.
“The doctors have given us medicine,” he said. “I don’t know its name, but it’s a red pill. I take one every day.”
The government has zero funds allocated for HIV and AIDS
Thrown out of their homes
While prevalence was only 0.2 percent of the population, most Yemenis living with either of the viruses faced stigma and discrimination, even from their families.
According to the most recent report by Stigma Index, the world’s largest social research project implemented by people living with HIV, most HIV-positive Yemenis had been thrown out of their homes by family members due to fears of infection.
The research said that all the people they interviewed experienced some form of stigma because of their HIV status, with one third saying they had to “change their residence or could not rent a place” because of their condition.
Ibrahim al-Babli, a doctor at the HIV/AIDS laboratory at the al-Jumhurriya hospital, said those patients were not the only forgotten victims of this war.
A staggering 1.2 million civil servants living in Houthi-held areas had not received their salaries after the Yemeni government stopped paying them in late 2017 in an effort to start a popular uprising.
The effects were devastating, with health, education and sanitation services left without the people needed to run them.
Resources were stretched so thin, Babli said, that patients were lucky to enter a manned hospital.
“I haven’t received my salary in months, I get paid sporadically,” said Babli.
“If doctors aren’t cared for, then that means there’s no care for the patients.”
‘Zero funds for HIV/AIDS’
The United Nations has repeatedly described Yemen’s humanitarian situation as “catastrophic” and, on Wednesday, Mark Lowcock, the under-secretary-general for Humanitarian Affairs, said the situation had worsened in the past year with “more than 24 million people now needing humanitarian assistance”.
Taha al-Mutawakel, the minister of health in the Houthi-run administration, told Al Jazeera that the war had crippled the health system with “zero funds allocated for HIV and AIDS”.
“We’re currently operating with a grant of $800,000 provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria,” he said.
“Medicines are readily available and offered free of charge and distributed to each of the governorates … but the siege has had a major impact on patients seeking treatment.”
Saudi Arabia, which has been conducting an air campaign in Yemen since March 2015, intensified its embargo on the country in 2017, restricting both humanitarian aid and commercial goods from entering Houthi-held ports.
The inadequacy of services ... may increase the vulnerability to HIV/AIDS transmissions
‘Race against time’
Eltayeb Elamin, the Regional Programme adviser at UNAIDS Middle East said the situation in the country had greatly affected the movement of HIV and AIDS patients, with the “disruption to the supply system … leading to difficulties in the accessibility for available services”.
“The effect of the war on the health infrastructure is also greatly stressed with inadequate supplies hampering HIV/AIDS prevention efforts especially counselling and testing,” he said.
“The inadequacy of services … may increase the vulnerability to HIV/AIDS transmissions through lack of universal precautions and inadequacy of needed services.”
Zakariyya said while he was still in the dark about his son’s future, he was confident that with some treatment, he could go on to live a full life.
“My son nearly died. But now, all praise to God, he is doing much better,” he said. “We believe in God and have faith that our lives and our fate are in his, not our, hands.”
Meritxell Relano, UNICEF’s resident representative in Yemen, said that with the fighting showing no signs of abating, aid agencies were in a “race against time” to save children such as Ahmad.
“We urge for an end to the war on children, not tomorrow, but today,” she said. “Parties to the conflict must work to reach a negotiated political solution, prioritising and upholding the rights of the children.
“The longer this war continues, the more children are going to die on the world’s watch.”