TALE OF TWO HOSPITALS HIGHLIGHTS ROYG'S MISPLACED FISCAL PRIORITIES

C O N F I D E N T I A L SANAA 001832

SENSITIVE
SIPDIS

DEPT FOR NEA/ARP ANDREW MACDONALD

E.O. 12958: DECL: 10/06/2019
TAGS: PGOV, SOCI, ECON, PREL, UK, GM, YM
SUBJECT: TALE OF TWO HOSPITALS HIGHLIGHTS ROYG'S MISPLACED
FISCAL PRIORITIES

Classified By: Ambassador Stephen A. Seche for reasons 1.4(b) and (d)

1. (C) SUMMARY: The stark contrast between Yemen's newest
medical facility -- the Sana'a Defense Compound Hospital --
originally built as the president's personal hospital, and
the country's oldest -- the Aden Republican Hospital --
highlights a troubling sense of the ROYG's fiscal priorities
as the national budget crisis deepens, and points to its
emphasis on regime preservation over meaningful development.
The dilapidated state of the 64 year-old Aden Republican
Hospital, a 300-bed facility without a single functioning
x-ray machine, has become a source of daily humiliation and
persisent anti-northern sentiment among Aden residents,
according to hospital officials. The Ministry of Health has
ignored modest requests for additional funds to maintain
equipment, buy basic supplies, and re-paint the hospital
walls. By contrast, the ROYG self-financed the
state-of-the-art, USD eight million Sana'a Defense Compound
Hospital and, only at the urging of the president's personal
physician, agreed to open up the hospital to a handful of top
military commanders and selected civilian patients from local
hospitals. Like many reforms in the political sphere, the
need for development in Aden, Yemen's "second city," remains
glaringly obvious and lacking in presidential attention. END
SUMMARY.

ADEN HOSPITAL: 300 BEDS, NO NEW MONEY
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2. (SBU) The disparity between two Yemeni hospitals ) one
the country's oldest and the other its newest ) sheds light
on elements of daily life in southern Yemen that have long
contributed to anti-northern sentiment. The Aden Republican
Hospital is the governorate's largest public hospital,
personally inaugurated by Queen Elizabeth II in 1954 and last
renovated in 1985. Even by Yemen's low public health
standards, the Aden hospital, which local residents describe
as Yemen's most modern prior to unification, stands out as a
symbol of central government neglect. Unlike centers in
Sana'a, Mar'ib, and other regions with strong tribal
representation, the Aden hospital receives only an irregular
trickle of Ministry of Health funding and no foreign donor
assistance. ROYG officials in Sana'a describe modernizing
the Aden Hospital as a high priority, but mostly within the
context of preparations for the Gulf Cup of Nations soccer
tournament, which Aden will host in early 2010. "If we don't
fix it soon, the Aden hospital will be a major embarrassment
for the government," Faris al-Sanabani, President Saleh's
personal secretary, told EconOff in September. Dr. Jamal
Ismail, the hospital's director, claims that "for 10 years
the government has promised us money to buy new equipment or
paint the walls, but so far...nothing."

3. (SBU) The Aden hospital, whose hallways and operating
rooms evoke a sci-fi writer's post-apocalyptic vision more
than a modern public health facility, lacks a single
functioning x-ray machine and relies on two first-generation
technology, Hungarian-built sterilization machines to
disinfect material from over 300 beds. "The hospital itself
paid for the only renovation we've completed since 1985 -)
plugging holes in the ceiling to keep out rats and
cockroaches. Even that failed to keep the pests out," Dr.
Ismail told EconOff during a September 29 tour of the
facility. The fact that the hospital must send patients to
Sana'a for most laboratory tests and anything beyond basic
surgical procedures has become a source of humiliation in
daily life in Aden, according to staff physicians. "The
Health Ministry keeps the good equipment in Sana'a, so that
we have nothing here," Ismail told EconOff. Hospital
officials showed EconOff a wish list of easily procurable
items, including bedpans and stethoscopes, that Aden hospital
officials claim the Ministry of Health has ignored since the
document was compiled in 2001. In the absence of funding
from the ROYG, the hospital has begun to charge patients USD
20-40 for some operations to pay for basic medical supplies,
costs not passed on to patients in other public hospitals.

SANA'A HOSPITAL: 16 BEDS, EIGHT MILLION DOLLARS
-------------- --

4. (C) In stark contrast to the Aden hospital stands the
spotless, newly-modernized USD eight million Defense Compound

Hospital in Sana'a, self-financed by the ROYG and completed
in May 2009. The hospital, headed by Dr. Hisham al-Zubairi,
Saleh's personal physician, is staffed by German and Indian
doctors and equipped with state-of-the-art orthopedic, ear
nose and throat (ENT),and 3-D medical imagery technology.
The facility, located on the grounds of the new Ministry of
Defense complex, was originally built to serve as Saleh's
personal hospital. (Note: Saleh was treated at the Sana'a
Defense Compound Hospital following his June 2009 spill from
a mountain bike. End Note.) Dr. Zubairi told EconOff that
he had convinced Saleh to open up the hospital to a handful
of top military commanders and criticial condition cases from
local hospitals so that physicians would not grow bored or
lose their dexterity in the operating room. "It was going to
be a hospital for one man until I came along." Despite the
widened patient pool, the hospital seemed largely vacant
during a September 27 visit by EconOff, filled with three
floors of bored-looking nurses and smiling doctors with
little to do except wait for new cases to arrive.

5. (C) The new hospital is not without its detractors, even
within government circles. Aden Free Zone Chairman Abdul
Galil al-Shaibi (protect),an economic advisor to
presidential son Ahmed Ali Saleh and a member of the National
Investment Committee, told EconOff that the disparity between
the two institutions was a "shame" and decried the millions
of dollars being "wasted" on the Sa'ada conflict when a "few
thousand dollars to the Aden hospital would go much farther."
Dr. Zubairi himself comes across as slightly uncomfortable
with the grandeur of the underutilized Sana'a Defense
Compound Hospital. "We don't even treat our soldiers wounded
in Sa'ada here," he lamented.

COMMENT
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6. (C) The ROYG's lavish funding of the new military hospital
in Sana'a, and its lack of attention to the Aden hospital,
symbolizes a fiscal prioritization trend that could worsen if
the budget crisis deepens: regime preservation rather than
meaningful economic development for the Yemeni people. Few
of Yemen's urban centers are more devoid of presidential
patronage, foreign assistance, or tribal largesse than Aden.
Development needs in Aden, like political reforms in southern
Yemen, remain glaringly obvious and easily implementable if
President Saleh had the will to see them through. In the
political sphere, many local observers have long pointed to
the continued presence of a handful of Aden-based military
leaders, widely considered responsible for the worst
instances of corruption and post-unity land grabs, as a major
irritant in north-south relations. In the economic sphere,
the ROYG's neglect of essential social institutions in Aden,
such as the hospital, is seen as a symptom of Saleh's
unwillingness to take even basic measures to address southern
grievances. As the contruction of the new Sana'a military
hospital demonstrates, the ROYG's budget crisis does not
apply to items that contribute to regime preservation and the
Saleh family's personal welfare. END COMMENT.
SECHE