Every morning at 5:30 a.m., Dr. Marwan Al-Ghafory checks into his personal Facebook page. Over coffee, he surveys the latest news and answers questions about the coronavirus pandemic back home in Yemen, posting responses to more than 156,000 followers. Then, after a 10-hour shift at the Catholic Clinic in the western German city of Essen, he logs back in until midnight.
“My aim is to warn our society about this pandemic and show them how to defend themselves against it. Because, believe it or not, there is a big problem,” he said.
Ghafory, 39, left Yemen in 1998 on a national scholarship to attend medical school in Cairo, then moved to Germany in 2011. He became known as a reliable source of Covid-19 information in late March, after publishing an article on Al-Mawqea Post, a Yemeni daily news website.
The piece detailed how the virus was spreading in Sana’a, the nation’s capital, and explained that the authorities were trying to pass it off as swine flu. It would take officials more than a month to publicly announce the first case in the city.
The article incensed Shiite Houthi rebels, who seized the capital in a 2014 coup that sparked an ongoing civil war. Houthi officials responded to Ghafory’s assertions with a flurry of articles and TV interviews, accusing him of spreading fake news.
The spokesman of the Houthi-run Ministry of Health told the Russian news outlet Sputnik that the United States and Saudi Arabia had paid Ghafory to write the piece, in order to stymie Houthi efforts to recruit warriors to the frontlines, where they have been battling a U.S.-supported, Saudi-led coalition since early 2015.
The coalition, which includes the United Arab Emirates as a prominent partner, seeks to defeat the Iran-backed Houthis and restore Yemen’s internationally recognized government to Sana’a.
According to the UN, Covid-19 could spread faster through Yemen and with deadlier consequences than in many other countries. In 2017 the nation was declared by the UN to be the site of the worst humanitarian disaster on Earth. Some 24 million people — about 80% of the population — depend on aid to survive, and millions more live on the brink of starvation.
The war has exacerbated underreporting of Covid-19 cases. Since April 10, the internationally recognized government of Abdrabbuh Mansur Hadi has declared 351 deaths and 1,318 Covid-19 cases outside Houthi-held areas, though the actual number is much higher. Houthi rebels, who control the capital and other densely populated areas, say they have detected only four cases in their territory.
While Hadi’s government has been more transparent than the Houthis during the outbreak, it has failed to provide the most basic support for medical workers, including the payment of salaries, and left most of the heavy lifting to local authorities and humanitarian aid groups.
Using his personal Facebook page and a mobile app named Tabiby (My Doctor), which he developed last year for Yemenis and others in the Middle East who lack access to healthcare, Ghafory marshals hundreds of medical professionals outside Yemen to provide free and accurate coronavirus advice.
The app, which works on Android smartphones and will soon be available on iPhones, connects patients to about 420 doctors around the world, who have volunteered to answer questions about health issues, provide psychological support, suggest realistic options for treatment and prevention, and potentially refer patients to doctors in Yemen. The app’s Covid-19 portal, launched in April, is the most visited of Tabiby’s 32 medical departments.
Ghafory is also working with Yemeni Nobel peace prize winner Tawakkol Karman to develop Combat Corona, a specialized medical team to treat Covid-19 cases in Yemen’s third-largest city, Taiz, which has been besieged by the Houthis since early in the war. They plan to replicate the initiative in other parts of Yemen.
On top of his day job and family life with his wife and young daughter, Ghafory’s coronavirus work has become its own full-time occupation. “Sometimes, I only have three or four hours of sleep to reprogram my mind for the next day. I don’t know how, but in one way or another I get it done,” he said.
According to Ghafory, Houthi disinformation related to Covid-19 has only grown as the virus has spread. Since confirming the first case in the capital — a Somali migrant, found dead in a hotel — Houthi authorities have since revealed only three additional cases in their areas of control, where around 70% of Yemen’s 30-million-strong population live.
More recently, they have confused the situation by telling the public that Covid-19 was not the only disease causing widespread fevers in Sana’a. At the same time, Health Minister Taha Al-Mutawakel convened a meeting with the heads of private hospitals in Sana’a to inform them of about 1,300 known cases of Covid-19 in and around the city.
According to one of the hospital managers at the meeting, Mutawakel’s message was, “People don’t need to know about the problem, but you all need to deal with it.” Two weeks later, Mutawakel announced that the Houthi government was conducting “promising and extensive scientific studies” to find a cure for the virus.
The Houthis now publicly acknowledge that Covid-19 is spreading in their areas of control, but have yet to release daily figures on new cases. Ghafory describes this approach as “acceptance plus negligence.”
“We would like to work together with the Houthis, and every other authority in the country, to combat this problem, but they won’t allow doctors in Sana’a to share information about the pandemic,” he said. “If they do, they are deemed betrayers.”
Last month, senior Houthi leader Mohammed Al-Houthi told the BBC in a televised interview that revealing the number of people affected by the virus would only terrify people. Rumor and supposition have filled the information void created by efforts to minimize the threat posed by the pandemic.
“The first and the biggest myth was that there is no Covid-19 here in Yemen,” said Atiaf, a Sana’a-based medical student, who works with Tabiby. She asked to be identified by a pseudonym, owing to security concerns.
Some people insist that Yemenis are immune because of “divine protection,” she said, while others dismiss reports of the disease as an international plot, related to a broader power struggle between the U.S. and China.
Atiaf believes that “the absence of an official pronouncement of the presence of Covid-19 here in Sana’a at the beginning of the outbreak had a major role” in the spread of misinformation.
Dr. Maha Abdo is a general practitioner in the capital and head of Tabiby’s media operations. She leads a team that translates the latest medical studies and news articles about Covid-19 into Arabic, and posts updates to the app and its Facebook, Twitter and Instagram accounts. Three times weekly, volunteer doctors working with the app appear on the Qatar-supported Yemen Shabab TV channel to discuss various aspects of the pandemic.
In addition to providing factual information, Abdo offers medical consultations through the app. In the first three weeks of June, about 950 people in Yemen contacted doctors through its coronavirus portal. Since then, the daily caseload has risen steadily.
“We recommend how to quarantine, the best way to wear a face mask, how the virus is transmitted and how people can protect themselves,” Abdo explained.
She added that only the worst cases arrive at hospitals now, and that the rest suffer in the privacy of their homes, for fear that the authorities will forcibly isolate their entire household.
In recent weeks, public perceptions about the realities of the coronavirus seem to be shifting.
“The most convincing thing for them seems to be the growing number of cases and deaths here in Sana’a,” said Atiaf.
But, in the absence of a coherent governmental response, the responsibility for handling the crisis is still falling to the nation’s already hard-pressed medical professionals — a fact that those fighting for control of the country do not wish to acknowledge.
As Atiaf told me, “We’re facing this problem out of the public eye.”
