The five-year-old Yemen war is creating a catastrophe of immense proportions in the Middle East’s poorest country.

Last week, Saudi Arabia launched scores of air strikes on the capital Sana’a, Saada and other cities in the north under the control of the Houthi rebels, with the aim of killing top officials.

The attacks followed the Houthis firing missiles and drones at the Saudi capital Riyadh and military installations in Jizan, Najran, Khamis Mushayt, and Abha. While the Saudis said they had intercepted and destroyed two missiles and six drones, the Houthis claimed they had hit the Tadawin camp where Saudi and Yemeni leaders were meeting, killing and injuring dozens, as well as the Saudi Ministry of Defence.

The Houthis said their attacks were in response to the crimes of the Saudi-led coalition, the latest being the killing of four civilians, including a child, in a naval attack in May on the country’s north-western province of Hajjah, and the ongoing naval blockade of Hodeidah port that is preventing the most basic commodities, including food and pharmaceuticals, reaching Yemen’s people. Around 14 million of Yemen’s 28 million population are on the brink of starvation, while 80 percent are reliant on food aid.

The Saudis’ 257,000 aerial strikes and the United Arab Emirates (UAE) naval blockade have caused the deaths of at least 230,000 civilians, both directly and indirectly due to hunger and disease, and displaced 3.6 million. Save the Children estimated last year that at least 75,000 under the age of five have starved to death since the onset of the war. The worst cholera epidemic on record has infected an estimated 1.2 million people and led to at least 2,500 deaths, while the recent floods have sparked a dengue fever outbreak in Hadramawt. The United Nations has recorded 137,000 cases of cholera and diarrhea this year, nearly a quarter of them in children under five.

Armed gangs, militias, and former Saudi mercenaries terrorise the people and extort money. Hospitals and schools do not have basic necessities, while water supplies, telecommunications, electricity generation and the road system barely function, if at all, due to the Saudi-led coalition’s airstrikes.

Human rights organisations have reported extrajudicial detentions, beatings, nail removal and electric shocks in Yemen’s unofficial detention centres and prisons, which have expanded during the war, with abuses committed by all parties to the war. This is in addition to the atrocious conditions in the official prisons and detention centres.

The recent escalation in fighting follows the failure of the Riyadh Agreement, backed by the US and France and signed by the Hadi government and the secessionist Southern Transitional Council in November last year, for a power sharing deal, as well as the Saudis’ efforts over the last four months to effect a ceasefire. The Houthis have been reluctant to agree a ceasefire under conditions where the Saudi-led coalition has failed to make headway in a costly war it had in 2015 expected to win in a matter of weeks.

The origins of the war lie in the 2011 Arab Spring, when mass protests broke out against the 32-year-long dictatorial rule of US and Saudi-backed president, Ali Abdullah Saleh, who turned the military on the protesters. He was later forced to resign in favour of his vice-president, Abd Rabbu Mansour Hadi, paving the way for elections in February 2012 in which Hadi was the only candidate to lead a transitional government. Houthi rebels in the north of the country rejected Hadi’s cosmetic reforms, and with the support of the former dictator, captured Sana’a, forcing Hadi to take refuge in Saudi Arabia.

In March 2015, the House of Saud launched a military campaign to suppress the Houthi rebels and to reimpose their puppet, Hadi, who had taken up residence in Riyadh. It formed a military coalition with the UAE and other Arab countries. While the Saudis prosecuted the war by air, the UAE blockaded Hodeidah—Yemen’s principal Red Sea port—and provided many of the ground troops, along with local or tribal militias operating in unstable and fluid alliances, some backed by Riyadh and some by Abu Dhabi, until pulling out of the war last year.

The US and UK, along with the other major powers, have backed the Saudi-led coalition to the hilt. They have supplied it with fighter jets, sophisticated weapons, material, military intelligence, refueling facilities and even covert forces on the ground. They not only provided diplomatic cover at the United Nations Security Council, but even secured an arms embargo on the groups under the control of the Houthis and former president Saleh—until he switched sides.

The five-year-long war has turned into several conflicts and fragmented the country into three areas. The first is controlled by the Houthis, also known as Ansar Allah, in the north. The second is controlled by the UAE-backed STC in the south, which in June captured the Socotra Archipelago alongside major shipping routes near the entrance to the Gulf of Aden, and the Republican Guards on the western coast, led by former president Saleh’s nephew. The third, in the eastern provinces, is controlled by Hadi’s dwindling forces, who are battling not just the Houthis in Sana’a but the STC, based in Aden, and dissent in Shabwa, Marib and Hadhramawt governorates, testifying to the almost universal hatred of the Saudis and their local stooge.

The economy has also collapsed. Yemen’s currency, the rial, has plummeted to its lowest rate against foreign currencies since the start of the war in March 2015, falling by 12 percent since the start of 2020 to 800 rials to the US dollar, amid international warnings of further falls. This was the result not just of the ongoing military war, but also the coalition’s economic warfare on the country, including seizing control of Yemen’s oil and gas fields in the east and southern provinces, moving the Central Bank from Sana’a to Aden—to which the Houthis responded by banning the use of new banknotes printed in Aden and thereby creating two separate economic systems—and speculative attacks by market traders on the currency.

A recent humanitarian aid conference for Yemen, hosted by Riyadh, raised just $1.35 billion, around $1 billion short of the target and less than half the $3.2 billion raised last year. Mark Lowcock, head of the UN Office for the Coordination of Humanitarian Affairs (OCHA), said that unless more money was raised, Yemen “will face a horrific outcome at the end of the year”. He added, “Yemen is now on the precipice, right on the cliff edge, below which lies a tragedy of historic proportions.”

Last month, UNICEF, the UN children’s agency, warned that water, sanitation and hygiene services for four million people would start shutting down in July if it did not get $30 million by the end of the month. Sara Beysolow Nyanti, UNICEF’s representative for Yemen, said, “We are trying to prevent the health and water systems collapsing, and we were holding those pieces together. Now we are on the brink of collapse.” She added, “COVID could be the tipping point. Right now, 75 per cent of communities cannot afford to buy soap, and if they do have the money, the choice will be to buy something they can eat or medicine.”

She warned that over 6,000 children could die in the next six months from preventable diseases and malnutrition because of the terrible state of healthcare, lack of water and soap and the inability of aid workers to provide assistance because of the lack of funding. A further 30,000 children could develop life-threatening, severe acute malnutrition later this year. The total number of malnourished under-fives could rise to 2.4 million, half of that age group.

Around 1,500 cases of COVID-19 have been confirmed since the first case was recorded in April and over 400 deaths have been reported. The high death rate relative to the number of cases, nearly four times the global average, points to the lack of testing capacity in the country.