DUBAI, United Arab Emirates — As Houthi fighters swept into the western Yemeni port city of Mokha earlier this month, Saudi-backed Yemeni government forces abandoned their armored vehicles and aid groups say families fled with no time to grab their clothes.
Around 125,000 people were displaced in just a matter of days, says the U.N. World Food Programme.
The U.N. says most healthcare facilities in Mokha immediately shut down, but Mokha's General Hospital remained open as staff treated patients who cannot leave.
"There are pregnant women who need urgent care. There are women who need cesarean sections. There are children who need treatment and patients with medical conditions who simply cannot wait," says Sarah Ahmed, a health promotion supervisor with the aid group, Doctors Without Borders, in Mokha's General Hospital.
In a voice memo shared with NPR by the aid group, she says Mokha's hospital staff are focusing on only the most essential services, including caring for babies in the neonatal intensive care unit, or NICU.
Even before the latest fighting, which comes after years of civil war, Yemen was among the world's poorest countries. Years of conflict have led to widespread hunger with some 22 million people — half the population — in need of humanitarian aid.
The current fighting shattered a yearslong truce, and plunged Yemen back into conflict at a time of severe funding shortages and as the U.S. is mired in another Gulf conflict, with Iran. Aid groups say Yemen needs urgent attention and millions more in funding now.
Meanwhile, the World Health Organization says it can no longer transfer patients from Mokha to the government stronghold of Aden in the south, and that the city of Taiz quote "must plan for isolation" as roads to Aden come under fire.
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As fighting intensifies, crisis to worsen
Doctors Without Borders is one of several aid groups warning that the needs of people in western Yemen will grow as more people are displaced from the frontlines of fighting.
The Houthis, who are supported by Iran, say the Saudi Air Force has launched hundreds of airstrikes across areas of western Yemen since the group captured territory on Sept. 10 and 11, including Mokha. The U.N. confirms some civilian casualties from those airstrikes, as well as hundreds of people wounded in the fighting.
Houthi military spokesperson Yahya Saree says the group seized 5,400 square kilometers (about 2,100 square miles) of western territory, including Mokha and islands in the Bab el-Mandeb strait in the Red Sea.
The Houthis' capture of these territories from Saudi-backed Yemeni government forces helps the group, which already controls Yemen's capital, Sanaa, further consolidate control of this key waterway, where they've attacked Saudi oil tankers and blocked them from transiting.
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The Houthis have also hit Saudi air bases, as well as Saudi oil sites. Saudi Arabia says the Houthis targeted the Saudi capital, Riyadh, over the weekend with missiles, marking the first such attack on the city in years.
Additionally, the Houthis released video of the group downing a Saudi F-15 U.S.-made fighter jet. The Saudi government has yet to comment on that attack, and the fate of the pilots remains unknown.
At the same time, Saudi Arabia says Iran-backed militias in Iraq used drones to hit several areas of its east-west pipeline, which was being used to transport Saudi crude and bypass closures in the Strait of Hormuz. NPR has examined satellite images showing damage to the pipeline's pumping stations.
Those attacks, coupled with the ongoing U.S. war with Iran, have pushed Brent crude past $100 a barrel and diesel to record highs in the U.S.
Houthi leader, Abdul-Malik al-Houthi, released a video message telling Yemenis in western and southern provinces who are fleeing that they are not the target.
"The targets have always been the military build-ups brought by the Saudi aggressor to kill our people," he said, adding that the Houthis target Saudi air bases because they are used to attack Yemen, and Saudi oil sites because they are the kingdom's source of wealth and funding for attacks on Yemen.
Senior Houthi official Mohammed al-Bukthi told NPR this month that the group is imposing a blockade on Saudi oil carriers in Bab el-Mandeb to force Saudi Arabia to lift its air and sea blockade of Houthi areas.
Saudi Arabia and the U.S. say the Houthis receive arms and training from Iran. Officials in Iran do not deny supporting the Houthis, but say the group operates independently.
A Saudi official told NPR the Houthis recently met with White House officials in Oman and told them their attacks are only on Saudi ships, and that they would not attack U.S. or Israeli ships as they had done in previous years to protest the Israeli war in Gaza. The official, who spoke anonymously to discuss security matters, says the U.S. informed the Saudi crown prince about the meeting, and that the U.S. has increased the number of its military experts in Saudi Arabia to assist with planning and to provide intelligence regarding the locations of Houthi forces and weapons depots.
Displacement mostly now in western Taiz
Some of the fiercest clashes now are in Taiz, a southwestern governorate along Bab el-Mandeb, and where the port city of Mokha was captured.
Francesco Galtieri, the United Nations Population Fund (UNFPA) representative in Yemen shared the story of a single mother burnt by shelling as she fled Mokha with her four daughters, and of another woman who gave birth without any medical care in the open air.
"Unfortunately, currently we estimate around 2,000 pregnant women on the move," Galtieri told reporters during a press conference.
Aid groups, like the Norwegian Refugee Council, tell NPR they're rushing to set up new displacement camps with water, food and mattresses in parts of the governorate of Taiz.
"It's a very dynamic, moving, massive scale of displacement," says Alison Bottomley, an advocacy advisor with the Norwegian Refugee Council in Yemen.
She says people have arrived at camps that are already full of displaced people, and so had to keep walking.
"They move on or they try to find someone in the local villages that will help them. But people are also sleeping under trees. Like they're just waiting on the side of the road," she says.
Many people cannot leave Taiz. The roads to the government stronghold of Aden in the south are under missile fire, says Faisal al-Ossari, who leads the human rights group "The protection of freedoms of Taiz"— and is opposed to Houthi rule.
Others NPR reached in the city of Taiz, which remains under government control, say there have been clashes nearby as the Houthis try to advance.
"There have been attacks on the outskirts of the city, with some kids hit in their spines and facing a lifetime of disability," says Shaef al-Jabri, a Yemeni aid worker in Taiz.
Similarly, Mohammed Radman, with Yemen's Human Access aid group, says the Houthis are trying to take more territory in Taiz. He spoke with NPR from the southern al-Maafer region of the governorate of Taiz.
"We have more than 30 displacement camps here and surrounding areas, with 10,000 families," he said, adding that around 6,000 of these families are newly displaced.
Funding isn't enough for Yemen's needs
The United Nations says only 20% of its funding needs for Yemen have been met this year. Aid groups say far more is needed to reach people displaced this month alone.
"We know how to respond to the needs, we're able to do it, but we really lack the money, the funding that we need to do at the scale that's required now," says Bottomley of the Norwegian Refugee Council.
Doctors Without Borders says years of funding cuts have already left health facilities with little capacity to absorb a new wave of conflict.
Similarly, Prosper Global, formerly known as Mercy Corps, says more aid is needed for their teams in Taiz who are seeing families arriving to safer areas with no more than what they could carry and without enough food, shelter or money to meet their basic needs.
But many cannot wait for the aid to arrive. The U.N.'s International Organization of Migration says that over the course of four days last week, more than 2,400 people fled Yemen altogether, crossing by sea to Djibouti in the Horn of Africa. Most have been women and children, the U.N. refugee agency, UNHCR, says.
Anas Baba in Gaza City, Ahmed Abu Hamda in Cairo and Abu Bakr Bashir in the U.K. contributed reporting.
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