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

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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