Tag Archives: hospitals

Dengue outbreak kills 300 in Sri Lanka, hospitals at limit

A mosquito landing on a person. Courtesy of Pixabay

COLOMBO (Reuters) – An outbreak of dengue virus has killed around 300 people so far this year in Sri Lanka and hospitals are stretched to capacity, health officials said on Monday.

They blamed recent monsoon rains and floods that have left pools of stagnant water and rotting rain-soaked trash — ideal breeding sites for mosquitoes that carry the virus.

The International Federation of Red Cross and Red Crescent Societies is scaling up emergency assistance to Sri Lanka with the Sri Lanka Red Cross to help contain the outbreak.

“Dengue patients are streaming into overcrowded hospitals that are stretched beyond capacity and struggling to cope, particularly in the country’s hardest hit western province,” Red Cross/Red Crescent said in a statement.

According to the World Health Organization, dengue is one of the world’s fastest growing diseases, endemic in 100 countries, with as many as 390 million infections annually. Early detection and treatment save lives when infections are severe, particularly for young children.

The Sri Lankan government is struggling to control the virus, which causes flu-like symptoms and can develop into the deadly hemorrhagic dengue fever.

The ministry of health said the number of dengue infections has climbed above 100,000 since the start of 2017, with 296 deaths.

“Ongoing downpours and worsening sanitation conditions raise concerns the disease will continue to spread,” Red Cross/Red Crescent said.

Its assistance comes a week after Australia announced programs to help control dengue fever in Sri Lanka.

“Dengue is endemic here, but one reason for the dramatic rise in cases is that the virus currently spreading has evolved and people lack the immunity to fight off the new strain,” Novil Wijesekara, head of health at the Sri Lanka Red Cross said in a statement.

(Reporting by Ranga Sirilal and Shihar Aneez Editing by Jeremy Gaunt.)

Afghan families search morgues, hospitals after devastating truck bomb

Relatives of victims listen to hospital officials after a blast in Kabul.

By Mirwais Harooni

KABUL (Reuters) – It took nearly 24 hours for his Afghan family to discover Hamidullah’s broken body on the bottom shelf of a morgue at Kabul’s Wazir Akhbar Khan hospital.

Around him were placed the few personal belongings he had with him when he died.

“He was engaged and was about to get married,” his cousin Abdullah told Reuters, grief clouding his eyes as he stood in the barren morgue. “All of his and his family’s dreams remained unfinished.”

Twenty-year-old Hamidullah was on his way to his print shop in Afghanistan’s capital city early on Wednesday morning when he was killed by a massive truck bomb that exploded in the middle of a busy street, killing at least 80 people and wounding more than 450.

While the intended target of the bomb remains unknown, the explosion occurred near the gates of a heavily fortified area of the city that holds many foreign embassies and government ministries.

Many of the victims, however, were working class Afghans, people who had managed to eke out livelihoods during years of violence and economic malaise.

For Hamidullah’s family, the first indication something was be wrong was the sound of a powerful explosion, followed by an expanding cloud of smoke rising over the city.

Calls to his cellphone went unanswered, and a growing number of extended family members joined huge crowds at hospitals around the city, all seeking news of friends and family caught in the attack.

“We went to several hospitals to find him,” said Abdullah.

The hospital in Wazir Akhbar Khan was one of several inundated with the wounded, and later, the bodies.

“I have never experienced such a day in all my life,” said one morgue attendant who asked for anonymity as he was not authorized to speak publicly. “All the freezers were full, and the dead bodies lined the road to the morgue as well.”

As of Thursday morning, as Hamidullah’s family gathered in small groups under the trees outside the morgue to wait for his father’s arrival, there were still a dozen unidentified bodies at the hospital, officials said.

Among those, around half are unrecognizable, the attendant added. Due to a lack of space, bodies had to be laid out on the ground and 20 were sent to a nearby military hospital.

VICTIMS REMEMBER

Among the victims were employees of Afghan and international media, a major telecommunications company and a bank as well as police officers and security guards.

Kabul’s Emergency Hospital received at least 108 victims of Wednesday’s attack, said Sakhi Shafiq, a team leader there.

From their hospital beds, survivors described the scenes of horror they had lived through.

“I felt my face and body burning and I felt blood coming out of my face,” said Karim Jan, speaking with difficulty.

With chaos all around, he staggered several blocks to Emergency Hospital where he remains, heavily bandaged, with shrapnel scars dotting his face and limbs.

Baqer Zmarai was walking to his job at the state television station and had just passed the German Embassy, which was heavily damaged in the blast, when the bomb went off.

“I fell on the ground,” he said from his bed at Wazir Akhbar Khan hospital. “It was hard to see my surroundings. I could hear people yelling for help.”

Surrounded by dirt, smoke, mangled cars and shattered buildings, Zmarai struggled to stand on injured legs.

“I tried to escape but I could not walk.”

While some of the wounded were able to go home, many remain in hospitals and the search for lost loved ones continues.

“I do not know if my son is dead or alive. I have to see and find him,” said Besmillah, who stood outside the locked gates of Emergency Hospital on Thursday, pleading with the staff to let him enter.

“I went to every single hospital but could not find my son.”

(Writing by Josh Smith; Editing by Robin Pomeroy)

More disruptions feared from cyber attack; Microsoft slams government secrecy

Indonesia's Minister of Communications and Information, Rudiantara, speaks to journalists during a press conference about the recent cyber attack, at a cafe in Jakarta, Indonesia

By Dustin Volz and Eric Auchard

WASHINGTON/FRANKFURT (Reuters) – Officials across the globe scrambled over the weekend to catch the culprits behind a massive ransomware worm that disrupted operations at car factories, hospitals, shops and schools, while Microsoft on Sunday pinned blame on the U.S. government for not disclosing more software vulnerabilities.

Cyber security experts said the spread of the worm dubbed WannaCry – “ransomware” that locked up more than 200,000 computers in more than 150 countries – had slowed but that the respite might only be brief amid fears new versions of the worm will strike.

In a blog post on Sunday, Microsoft President Brad Smith appeared to tacitly acknowledge what researchers had already widely concluded: The ransomware attack leveraged a hacking tool, built by the U.S. National Security Agency, that leaked online in April.

“This is an emerging pattern in 2017,” Smith wrote. “We have seen vulnerabilities stored by the CIA show up on WikiLeaks, and now this vulnerability stolen from the NSA has affected customers around the world.”

He also poured fuel on a long-running debate over how government intelligence services should balance their desire to keep software flaws secret – in order to conduct espionage and cyber warfare – against sharing those flaws with technology companies to better secure the internet.

“This attack provides yet another example of why the stockpiling of vulnerabilities by governments is such a problem,” Smith wrote. He added that governments around the world should “treat this attack as a wake-up call” and “consider the damage to civilians that comes from hoarding these vulnerabilities and the use of these exploits.”

The NSA and White House did not immediately respond to requests for comment about the Microsoft statement.

Economic experts offered differing views on how much the attack, and associated computer outages, would cost businesses and governments.

The non-profit U.S. Cyber Consequences Unit research institute estimated that total losses would range in the hundreds of millions of dollars, but not exceed $1 billion.

Most victims were quickly able to recover infected systems with backups, said the group’s chief economist, Scott Borg.

California-based cyber risk modeling firm Cyence put the total economic damage at $4 billion, citing costs associated with businesses interruption.

U.S. President Donald Trump on Friday night ordered his homeland security adviser, Tom Bossert, to convene an “emergency meeting” to assess the threat posed by the global attack, a senior administration official told Reuters.

Senior U.S. security officials held another meeting in the White House Situation Room on Saturday, and the FBI and the NSA were working to help mitigate damage and identify the perpetrators of the massive cyber attack, said the official, who spoke on condition of anonymity to discuss internal deliberations.

The investigations into the attack were in the early stages, however, and attribution for cyber attacks is notoriously difficult.

The original attack lost momentum late on Friday after a security researcher took control of a server connected to the outbreak, which crippled a feature that caused the malware to rapidly spread across infected networks.

Infected computers appear to largely be out-of-date devices that organizations deemed not worth the price of upgrading or, in some cases, machines involved in manufacturing or hospital functions that proved too difficult to patch without possibly disrupting crucial operations, security experts said.

Microsoft released patches last month and on Friday to fix a vulnerability that allowed the worm to spread across networks, a rare and powerful feature that caused infections to surge on Friday.

Code for exploiting that bug, which is known as “Eternal Blue,” was released on the internet last month by a hacking group known as the Shadow Brokers.

The head of the European Union police agency said on Sunday the cyber assault hit 200,000 victims in at least 150 countries and that number would grow when people return to work on Monday.

MONDAY MORNING RUSH?

Monday was expected to be a busy day, especially in Asia, which may not have seen the worst of the impact yet, as companies and organizations turned on their computers.

“Expect to hear a lot more about this tomorrow morning when users are back in their offices and might fall for phishing emails” or other as yet unconfirmed ways the worm may propagate, said Christian Karam, a Singapore-based security researcher.

The attack hit organizations of all sizes.

Renault said it halted manufacturing at plants in France and Romania to prevent the spread of ransomware.

Other victims include is a Nissan manufacturing plant in Sunderland, northeast England, hundreds of hospitals and clinics in the British National Health Service, German rail operator Deutsche Bahn and international shipper FedEx Corp

A Jakarta hospital said on Sunday that the cyber attack had infected 400 computers, disrupting the registration of patients and finding records.

Account addresses hard-coded into the malicious WannaCry virus appear to show the attackers had received just under $32,500 in anonymous bitcoin currency as of (1100 GMT) 7 a.m. EDT on Sunday, but that amount could rise as more victims rush to pay ransoms of $300 or more.

The threat receded over the weekend after a British-based researcher, who declined to give his name but tweets under the profile @MalwareTechBlog, said he stumbled on a way to at least temporarily limit the worm’s spread by registering a web address to which he noticed the malware was trying to connect.

Security experts said his move bought precious time for organizations seeking to block the attacks.

(Additional reporting by Jim Finkle, Neil Jerome Morales, Masayuki Kitano, Kiyoshi Takenaka, Jose Rodriguez, Elizabeth Piper, Emmanuel Jarry, Orathai Sriring, Jemima Kelly, Alistair Smout, Andrea Shalal, Jack Stubbs, Antonella Cinelli, Kate Holton, Andy Bruce, Michael Holden, David Milliken, Tim Hepher, Luiza Ilie, Patricia Rua, Axel Bugge, Sabine Siebold, Eric Walsh, Engen Tham, Fransiska Nangoy, Soyoung Kim, Mai Nguyen and Nick Zieminski; Editing by Mark Heinrich and Peter Cooney)

China hit by cyber virus, Europe warns of more attacks

A hooded man holds a laptop computer as blue screen with an exclamation mark is projected on him in this illustration picture taken on May 13, 2017.

By Cate Cadell and Guy Faulconbridge

BEIJING/LONDON (Reuters) – The WannaCry “ransomware” cyber attack hobbled Chinese traffic police and schools on Monday as it rolled into Asia for the new work week, while authorities in Europe said they were trying to prevent hackers from spreading new versions of the virus.

In Britain, where the virus first raised global alarm when it caused hospitals to divert ambulances on Friday, it gained traction as a political issue just weeks before a general election. The opposition Labour Party accused the Conservative government of leaving the National Health Service vulnerable.

Shares in firms that provide cyber security services rose with the prospect that companies and governments would have to spend more money on defenses.

Some victims were ignoring official advice and paying the $300 ransom demanded by the cyber criminals to unlock their computers, which was due to double to $600 on Monday for computers hit by Friday’s first wave.

Brian Lord, managing director of cyber and technology at cybersecurity firm PGI, said victims had told him “the customer service provided by the criminals is second to none”, with helpful advice on how to pay: “One customer said they actually forgot they were being robbed.”

Although the virus’s spread was curbed over the weekend in most of the world, France, where carmaker Renault was among the world’s highest profile victims, said more attacks were likely.

“We should expect similar attacks regularly in the coming days and weeks,” said Giullaume Poupard, head of French government cyber security agency ANSSI. “Attackers update their software … other attackers will learn from the method and will carry out attacks.”

Companies and governments spent the weekend upgrading software to limit the spread of the virus. Monday was the first big test for Asia, where offices had already mostly been closed for the weekend before the attack first arrived.

British media were hailing as a hero a 22-year-old computer security whiz who appeared to have helped stop the attack from spreading by discovering a “kill switch” – an internet address which halted the virus when activated.

SPREAD SLOWING

China appeared over the weekend to have been particularly vulnerable, raising worries about how well the world’s second largest economy would cope when it opened for business on Monday. However, officials and security firms said the spread was starting to slow.

“The growth rate of infected institutions on Monday has slowed significantly compared to the previous two days,” said Chinese Internet security company Qihoo 360. “Previous concerns of a wide-scale infection of domestic institutions did not eventuate.”

Qihoo had previously said the attack had infected close to 30,000 organizations by Saturday evening, more than 4,000 of which were educational institutions.

The virus hit computers running older versions of Microsoft software that had not been recently updated. Microsoft released patches last month and on Friday to fix a vulnerability that allowed the worm to spread across networks.

In a blog post on Sunday, Microsoft & President Brad Smith appeared to tacitly acknowledge what researchers had already widely concluded: the attack made use of a hacking tool built by the U.S. National Security Agency that had leaked online in April.

Infected computers appear to largely be out-of-date devices that organizations deemed not worth the price of upgrading. Some have also been machines involved in manufacturing or hospital functions, difficult to patch without disrupting operations.

“The government’s response has been chaotic, to be frank,” the British Labour Party’s health spokesman Jon Ashworth said. “They’ve complacently dismissed warnings which experts, we now understand, have made in recent weeks.”

“The truth is, if you’re going to cut infrastructure budgets and if you’re not going to allow the NHS to invest in upgrading its IT, then you are going to leave hospitals wide open to this sort of attack.”

Britain’s National Health Service (NHS) is the world’s fifth largest employer after the U.S. and Chinese militaries, Walmart and McDonald’s. The government says that under a previous Labour administration the trusts that run local hospitals were given responsibility to manage their own computer systems.

WARNINGS GIVEN

Asked if the government had ignored warnings over the NHS being at risk from cyber attack, Prime Minister Theresa May told Sky News: “No. It was clear [that] warnings were given to hospital trusts.”

An official from Cybersecurity Administration China (CAC) told local media on Monday that while the ransomware was still spreading and had affected industry and government computer systems, the spread was slowing.

Chinese government bodies from transport, social security, industry watchdogs and immigration said they had suspended services ranging from processing applications to traffic crime enforcement.

It was not immediately clear whether those services were suspended due to attacks, or for emergency patching to prevent infection.

“If a system supports some kind of critical processes those systems typically are very hard to patch … We don’t have a precedent for something of this scale (in China),” said Marin Ivezic, a cybersecurity expert at PwC in Hong Kong.

Affected bodies included a social security department in the city of Changsha, the exit-entry bureau in Dalian, a housing fund in Zhuhai and an industry watchdog in Xuzhou.

Energy giant PetroChina  said payment systems at some of its petrol stations were hit, although it had been able to restore most of the systems.

Elsewhere in Asia, the impact seems to have been more limited. Japan’s National Police Agency reported two breaches of computers in the country on Sunday – one at a hospital and the other case involving a private person – but no loss of funds.

Industrial conglomerate Hitachi Ltd. said the attack had affected its systems at some point over the weekend, leaving them unable to receive and send e-mails or open attachments in some cases.

In India, the government said it had only received a few reports of attacks on systems and urged those hit not to pay attackers any ransom. No major Indian corporations reported disruptions to operations.

At Indonesia’s biggest cancer hospital, Dharmais Hospital in Jakarta, around 100-200 people packed waiting rooms after the institution was hit by cyber attacks affecting scores of computers. By late morning, some people were still filling out forms manually, but the hospital said 70 percent of systems were back online.

South Korea’s presidential Blue House office said nine cases of ransomware were found in the country, but did not provide details on where the cyber attacks were discovered. A coal port in New Zealand shut temporarily to upgrade its systems.

(Writing by Peter Graff, editing by Peter Millership)

English hospitals say hit by suspected national cyber attack

FILE PHOTO: A National Health Service (NHS) sign is seen in the grounds of St Thomas' Hospital, in front of the Houses of Parliament in London June 7, 2011. REUTERS/Toby Melville/File Photo

By Costas Pitas and Alistair Smout

LONDON (Reuters) – Hospitals across England were being forced to divert emergency cases on Friday after suffering a suspected national cyber attack.

Among them was the Barts Health group which manages major central London hospitals including The Royal London and St Bartholomew’s.

“We are experiencing a major IT disruption and there are delays at all of our hospitals,” it said.

“We have activated our major incident plan to make sure we can maintain the safety and welfare of patients. Ambulances are being diverted to neighboring hospitals.”

Patients requiring emergency treatment across England were diverted away from the hospitals affected and the public was advised to only seek medical care for acute medical conditions.

Reuters was unable to independently verify whether the hospitals were the subject of a concerted cyber attack ahead of the June 8 election.

Britain’s National Crime Agency said it was aware of the reports of a cyber attack but made no further comment.

The National Health Service (NHS) said it was responding to the incidents.

“We are aware of a cyber security incident and we are working on a response,” said a spokesman for NHS Digital, a division of the NHS which handles information technology issues.

There was no immediate comment from the Health Ministry.

Earlier on Friday, Spain’s government warned that a large number of companies had been attacked by cyber criminals who infected computers with malicious software known as “ransomware” that locks up computers and demands ransoms to restore access.

(Additional reporting by Kate Holton, Andy Bruce, Michael Holden and David Milliken; Writing by Guy Faulconbridge; editing by Stephen Addison)

Insight: Ballooning bills – More U.S. hospitals pushing patients to pay before care

FILE PHOTO: An emergency sign points to the entrance to Scripps Memorial Hospital in La Jolla, California, U.S. March 23, 2017. REUTERS/Mike Blake/File Photo

By Jilian Mincer

(Reuters) – Last year, the Henry County Health Center in Iowa started providing patients with a cost estimate along with pre-surgery medical advice.

The 25-bed rural hospital in the southwest corner of the state implemented the protocol because of mounting unpaid bills from insured patients, a group that had previously not raised red flags.

Henry County is one of hundreds of U.S. hospitals trying to cope with an unexpected consequence of the Affordable Care Act of 2010, known as Obamacare: millions more Americans have health insurance, but it requires them to spend thousands of dollars before their insurer kicks in a dime.

Since U.S. hospitals do not want to end up footing the bill, they are now experimenting with pre-payment strategies for patients, with a growing number requiring payment before scheduled care and offering no interest loans, according to interviews with more than two dozen hospitals, doctors, patients, lenders and healthcare experts.

“Most patients are appreciative that we’re telling them up front,” said David Muhs, chief financial officer for the Henry County hospital, which provides a discount for early payment. The discussion leads some patients to skip care, others to delay it or use a no interest loans available through the hospital, he said.

The ACA extended insurance to 20 million Americans, which initially helped hospitals begin to shrink debt from uninsured patients who could not pay their medical bills. But more and more, people in Obamacare plans or in employer-based health plans are choosing insurance that features low monthly payments. The trade-off is high out of pocket costs when they need care. (For a graphic, click http://tmsnrt.rs/2oCzePS)

If President Donald Trump dismantles Obamacare as promised, these plans won’t disappear. Republicans also believe high-deductible plans curb spending, and Americans faced with medical costs that rise faster than inflation and wages will look for premiums they can afford.

The trend is expected to accelerate this year because unpaid bills are creating massive bad debt for even the most prestigious medical centers. U.S. hospitals had nearly $36 billion in uncompensated care costs in 2015, according to the industry’s largest trade group, a figure that is largely made up of unpaid patient bills.

The largest publicly-traded hospital chain, HCA Holdings Inc, reported in the fourth quarter of 2016 that its ratio of bad debt to gross revenues of more than $11 billion was 7.5 percent.

One of the first to test this new payment strategy was Novant Health, headquartered in North Carolina with 14 medical centers and hundreds of outpatient and physician facilities. It saw patient debt increase when more local employers started adopting high deductible plans, including one that made its executives pay $10,000 in out-of-pocket expenses.

“To remain financially stable, we had to do something,” said April York, senior director of patient finance at Novant, whose patient default rate dropped to 12 percent from 32 percent after it started offering no interest loans through ClearBalance.

“Patients needed longer to pay. They needed a variety of options,” she said.

IMPACT ON PATIENTS

These prepayment strategies are being rolled out by hospitals across the country because the financial equation has changed so much for patients – even the insured ones.

Almost half of Americans – 45 percent – polled by the Kaiser Family Foundation said they would have difficulty paying an unexpected $500 medical bill. The average deductible this year for the least expensive of the widely used Obamacare health plans is $6,000 for an individual – an 18 percent spike since 2014 – and more than double that for a family, according to government data.

Jessica Curtis, a senior advisor at Community Catalyst, a consumer advocacy group in Boston, said the impact on patients stretches beyond personal finance.

“They delay procedures, they don’t follow advice on prescription drugs, and when they see care, they usually are for more expensive procedures because they’ve waited,” she said

Brian Sanderson, managing principal of Crowe Horwath’s healthcare services group, said communicating with patients and providing longer repayment options is a good strategy since hospital margins have shrunk, thanks to growing unpaid medical bills from consumers.

“A well informed patient is more likely to meet their obligations,” he said. “It’s just good patient relations and it helps to minimize bad debt.”

Hospitals are doing what they can to retain patients while helping them pay medical bills that could run thousands of dollars. Many are expanding charity eligibility, and hiring companies like ClearBalance, AccessOne and Commerce Bank to provide loans to patients no matter what their credit. Most carry no interest rate for the patient, and could be extended far longer than the few months that hospitals once required before sending a bill to collections.

“People are more likely to pay a bank than a hospital,” said Mark Huebner, director of Health Services Financing at Commerce Bank, which offers its line of credit at more than 200 hospitals.

“People are aware that banks will come after them. Banks do collect on debt, and hospitals generally have been more relaxed,” he said.

Wake Forest Baptist Medical Center in North Carolina had seen its bad debt creep up in recent years as more patients saw out of pocket expenses soar, with some deductibles reaching $15,000.

“We’ve seen that many patients are unaware of the increases in their deductibles,” said CFO Chad Eckes. Wake Forest now asks for payment before non-emergency services are provided but also offers zero interest, longer repayment options.

“It’s a challenging position,” he said. “It’s a discussion no one wants to be in, and none of us enjoy.”

(Editing by Caroline Humer and Edward Tobin)

Like a nuclear bomb; cholera and destruction after hurricane in Haiti

Relatives and patients treated for cholera after Hurricane Matthew in the Hospital of Port-a-Piment, Haiti,

By Gabriel Stargardter

PORT-A-PIMENT, Haiti (Reuters) – Patients arrived every 10 or 15 minutes, brought on motorcycles by relatives with vomit-covered shoulders and hoisted up the stairs into southwest Haiti’s Port-a-Piment hospital, where they could rest their weak, cholera-sapped limbs.

Less than a week since Hurricane Matthew slammed into Haiti, killing at least 1,000 people according to a tally of numbers from local officials, devastated corners of the country are facing a public health crisis as cholera gallops through rural communities lacking clean water, food and shelter.

Reuters visited the Port-a-Piment hospital early on Sunday morning, the first day southwestern Haiti’s main coastal road had become semi-navigable by car.

At that time, there were 39 cases of cholera, according to Missole Antoine, the hospital’s medical director. By the early afternoon, there were nearly 60, and four people had died of the waterborne illness.

“That number is going to rise,” said Antoine, as she rushed between patients laid out on the hospital floor.

Although there were 13 cases of cholera before Matthew hit, Antoine said the cases had risen drastically since the hurricane cut off the desperately poor region.

The hospital lacks an ambulance, or even a car, and Antoine said many new patients were coming from miles away, carried by family members on camp beds.

Inside the hospital, grim-faced parents cradled young children whose eyes had sunk back and were unable to prop up their own heads.

“I believe in the doctors, and also in God,” said 37-year-old Roosevelt Dume, holding the head of his son, Roodly, as he tried to remain upbeat.

RUBBLE

Out on the streets, the scene was also shocking. For miles on end, almost all the houses were reduced to little more than rubble and twisted metal. Colorful clothes were littered among the chaos.

The region’s banana crop was destroyed with vast fields of plantain flattened into a leafy mush. With neither government or foreign aid arriving quickly, people relied on felled coconuts for food and water.

The stench of death, be it human or animal, was everywhere.

In the village of Labei, near Port-a-Piment, locals said the river had washed down cadavers from villages upstream. With nobody coming to move the corpses, residents used planks of driftwood to push them down the river and into the sea.

Down by the shore, the corpse of one man lay blistering in the sun. A few hundred meters to his left in a roadside gully, three dead goats stewed in the toxic slime.

“It seems to me like a nuclear bomb went off,” said Paul Edouarzin, a United Nations Environmental Program employee based near Port-a-Piment.

“In terms of destruction – environmental and agricultural – I can tell you 2016 is worse than 2010,” he added, referring to the devastating 2010 earthquake from which Haiti has yet to recover.

Damaged houses are seen after Hurricane Matthew passes in Jeremie, Haiti,

Damaged houses are seen after Hurricane Matthew passes in Jeremie, Haiti, October 9, 2016. REUTERS/Carlos Garcia Rawlins

Diarrhea-stricken residents in the village of Chevalier were well aware of the nearby cholera outbreak, but had little option except to drink the brackish water from the local well that they believed was already contaminated by dead livestock.

“We have been abandoned by a government that never thinks of us,” said Marie-Ange Henry, as she surveyed her smashed home.

She said Chevalier had yet to receive any aid and many, like her, were coming down with fever. Cholera, she feared, was on its way.

Pierre Moise Mongerard, a pastor, was banking on divine assistance to rescue his roofless church in the village of Torbeck. In his Sunday best – a sports coat, chinos and brown leather shoes – he joined a small choir in songs that echoed out into the surrounding rice fields.

“We hope that God gives us the possibility to rebuild the Church and help the victims here in this area,” he said, before the music seized him, and he slowly joined in the chant, closing his eyes and turning his palms up toward the sky.

(Editing by Frank Jack Daniel and Kieran Murray)

HELP FOR HAITI

New Famine Fears Loom in Yemen

A nurse checks a boy at a hospital intensive care unit in Sanaa, Yemen

By Jonathan Saul, Noah Browning and Mohammed Ghobari

LONDON/DUBAI (Reuters) – Intensive care wards in Yemen’s hospitals are filled with emaciated children hooked up to monitors and drips – victims of food shortages that could get even worse due to a reorganization of the central bank that is worrying importers.

With food ships finding it hard to get into Yemen’s ports due to a virtual blockade by the Saudi-led coalition that has backed the government during an 18-month civil war, over half the country’s 28 million people already do not have enough to eat, according to the United Nations.

Yemen’s exiled president, Abd Rabbuh Mansur Hadi, last month ordered the central bank’s headquarters to be moved from the capital Sanaa, controlled by Houthi rebels in the north, to the southern port of Aden, which is held by the government. He also appointed a new governor, a member of his government who has said the bank has no money.

Trade sources involved in importing food to the Arab peninsula’s poorest country say this decision will leave them financially exposed and make it harder to bring in supplies.

Diplomats and aid officials believe the crisis surrounding the central bank could adversely affect ordinary Yemenis.

“The politicization of the central bank and attempts by the parties in the conflict to use it as a tool to hurt one another … threaten to push the poorest over the edge,” said Richard Stanforth, humanitarian policy adviser with Oxfam.

“Everything is stacked against the people on the brink of starvation in Yemen.”

The effects of food shortages can already be seen. At the children’s emergency unit at the Thawra hospital in the port of Hodaida, tiny patients with skin sagging over their bones writhe in beds. Hallways and waiting rooms are crowded with parents seeking help for their hungry and dying children.

Salem Abdullah Musabih, 6, lies on a bed at a malnutrition intensive care unit at a hospital in the Red Sea port city of Hodaida, Yemen

Salem Abdullah Musabih, 6, lies on a bed at a malnutrition intensive care unit at a hospital in the Red Sea port city of Hodaida, Yemen September 11, 2016. REUTERS/Abduljabbar Zeyad

 

Salem Issa, 6, rests his stick-thin limbs on a hospital bed as his mother watches over him. “I have a sick child, I used to feed him biscuits, but he’s sick, he won’t eat,” she said.

A nurse said the ward began taking in around 10 to 20 cases in April, but now struggles with 120 patients per month.

The World Food Programme says half Yemen’s children under five are stunted, meaning they are too short for their age because of chronic malnutrition.

IMPORTERS STRUGGLING

In July, Reuters reported that importers were already struggling to buy food from abroad because $260 million worth of their funds were frozen in Yemeni banks, while Western banks had cut credit lines.

Since then, importers have guaranteed much of the risk of financing shipments themselves.

The decision to move the central bank, seen as the last impartial bastion of the country’s financial system which has helped keep the economy afloat in wartime, is viewed as a major blow for suppliers who are mistrustful of the decision and expect even more chaos ahead. Foreign exchange is already scarce and the sources do not have confidence in the new governor.

All of this will lead to further food disruptions and more hardship for Yemenis already facing impending famine, according to the trade sources.

“We have begun to cancel our forward contracts – it’s just impossible to trade when there is no financial system in place. There is no coverage from the central bank where we can trust them or know them,” said one source.

“This leaves anyone bringing in cargoes completely exposed,” added the source, who declined to be identified due to the worsening security situation and fear of reprisals.

Shipping data showed at least nine vessels carrying supplies such as wheat and sugar were on the way to the Yemeni ports of Hodaida and Salif, but the source said there were worries for forward shipments for late October and November.

A second trade source also active in Yemen confirmed the growing difficulties.

“Western banks are not willing to process payments and the whole system is freezing up. It is an ever growing struggle to do anything commercial,” the second source said.

“Obtaining foreign exchange has to be done through currency smuggling. Yemen is like a country of smugglers now  – this is unacceptable.”

A woman holds her child at the door of her hut in al-Tuhaita district of the Red Sea province of Hodaida, Yemen

A woman holds her child at the door of her hut in al-Tuhaita district of the Red Sea province of Hodaida, Yemen September 26, 2016. REUTERS/Abduljabbar Zeyad

 

DWINDLING RESERVES

The old central bank in the capital Sanaa used Yemen’s dwindling foreign exchange reserves to guarantee shipments into a country which imports 90 percent of its food.

But Hadi disliked the bank paying salaries to his foes in the army and the Iran-aligned Houthi movement opposed to his internationally recognized government.

Struggling to advance on the battlefield and keen to undermine the Houthis, Hadi dismissed the bank’s governor, Mohamed Bin Humam, named Finance Minister Monasser Al Quaiti in his place and decreed the bank be moved to Aden.

It was a sudden decision that aroused suspicion among traders.

“The governor Humam enjoyed the confidence of all parties since he was clearly independent and working in the best interests of Yemen. To now appoint a minister of finance of the government is a retrograde step and none of the traders have any confidence in him or in the bank in Aden,” the first trade source said.

The new governor of the central bank did not immediately respond to a Reuters request for comment.

Quaiti told the Saudi-owned Asharq al-Awsat newspaper on Thursday he had inherited a bank with no money, but he pledged to keep it independent.

Ibrahim Mahmoud, of Yemen’s Social Development Fund, said only an improvement in the country’s financial system and an emergency aid effort could stop the spread of hunger.

“If there is no direct and immediate intervention on behalf of the international community and state organizations, we could be threatened by famine and a humanitarian catastrophe.”

Even though moving the central bank seemed to be aimed at hurting the Houthis, Yemeni economic officials and diplomats say the group has its own financial resources.

Losing out on $100 million in salaries to its fighters as suggested by the new bank governor may hurt the Houthis, but the bank’s closure in Sanaa is likely to hurt ordinary people already suffering from a collapse in the economy due to the war.

“It risks leaving the salaries of more than a million Yemenis unpaid. There may be a long-term effect on the Houthis, but the immediate effect will be on normal people trying to put food on the table,” Yemeni economic analyst Amal Nasser said.

 

(Additional reporting by Michael Hogan in Hamburg, Stephanie Nebehay in Geneva; Editing by Giles Elgood)