The Great Health Robbery

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THE GREATBaby Milk andMedicines in Yemen

by Dinnna Melroso

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First printed in 1981Oxfam 1981

ISBN 0 85598 054 0

Printed by Henry Stone and Son (Printers) Ltd.BanburyPublished by OXFAM,274 Banbury Road,Oxford OX2 7DZ.

This book converted to digital file in 2010


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Contents1) Introd uction 12) The Und erdevelopmen t 3

of Health in Yemen3) The Raym ah Health 12Project4) Baby Milk 175) Medicines 276) Action 40

No tes and References 44

A pp en dix : Useful Addresses, 48Film Hire andFurther Reading

THE YELLOW PAG ES: i-ivFacts on Yemen


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Besides this booklet, OXFAM has produced a film about babymilk and medicines in Yemen, also entitled "The Great HealthRobbery". This booklet may be read on its own or used inconjunction with the film.The film, which is 21 minutes in length, can be obtained fromyour nearest OXFAM Regional Office (see the Appendix at theend of this Report) or from the Concord Films Council, 201Felixstowe Road, Ipswich IP3 9BJ, telephone 0473 76012 .


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1. IntroductionThis booklet looks at health in Yemen, where on average,people can only expect to live for 39 years (compared with73 in Britain) and where three quarters of young children aremalnourished.In Yemen, as in other Third World countries, ill-health is them ost obvious sym ptom of pov erty. People in Yem en are dyingof prev entab le, infectious diseases, such as diarrhoea, TB andmeasles, caused by social conditions not unlike those in nine-teenth century Britain.Disease has social roots in all societies and the poorest carrythe burden of ill-health. Even in affluent Britain, the 1980Black Report, Inequalities in Health, shows that ill-healthhas far more to do with poverty, with the poorest sufferingmore diseases and dying younger.1This booklet describes social conditions in Yemen and looksbriefly at the political, economic and cultural factors withinthe country that create obstacles to better health. I t examinesexisting health services in Yemen and the implications for theeffectiveness of their being modelled on the western curativeapproach to medicine. One Chapter looks at the RaymahHealth Project, an attempt to improve the health of Yemenisby demystifying the causes of sickness and involving people inprevention.Bu t th e problem of ill-health in Yem en is n o t som ething com -pletely divorced from those of us living in countries like Britain.The focus of this booklet is on one aspect of how the rich world,often unwittingly, aggravates poverty and ill-health in the poorwo rld. We look a t the m arketing of prod ucts designed for usein rich countries, which can aggravate ill-health in countrieslike Yemen.Artificial baby milk marketed in Yemen can prove lethalbecause social conditions make its safe use virtually impossible.

ASana'a


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Modern medicines dispensed by untrained shop assistants canalso endanger the health of Yemenis. Their promotion helpsbuild up the myth that health can be bought from a bottle.Medicines can bec om e a false pan ace a, draining limited resourcesthat should go into preventing sickness rather than curing it.We exam ine the problem s and suggest what could be done bo thin Yemen and in Britain to ensure better health for the poorin Yemen. We hope that by doing so we can reveal to the readersome of the problems that afflict poor people throughout theThird World.


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2.The Underdevelopmentof Health in YemenNine tenths of the people of Yemen* live in rural areas, many inisolated villages with no access to roads, schools, clean wateror health services. The vast majority of working people areemployed in agriculture but very few have any land of theirown. Yemen is worse off than many Third World countriesbecause, with the exception of rock salt, it has no knownmineral resources. Yemen is poor but, surprisingly, not one ofthe poorest countries in the world.A Rich NeighbourThis is because immediately to the north of Yemen is SaudiArabia. It has similarities with Yemen since they are bothtraditional, male-dominated, Muslim societies. But, in starkcontrast to Yemen, Saudi Arabia's oil has made it one of therichest nations in the world. Yemeni men, who for manyyears have had to look for work outside the country, havebeen leaving for Saudi Arabia and the other oil-rich Gulf statesin ever-increasing numbers, especially since oil prices rocketedin 1974. Now one third of Yemeni men of working age areliving outside the country. The money they send back hastransformed Yemen from a cou ntry d epe nd ent on subsistencefarming into a rapidly growing, but precarious, cash economy.Prosperity on the SurfaceMoney sent back by the workers is going to families who, untilrecently, were desperately poor. It has also fuelled a consumerboom, making the value of Yemen's imports 100 times higherthan its total exports.2 Consum er go ods, such as televisions,are appearing in m ore and m ore Y emeni ho m es, giving a surfaceimpression of prosperity. But how well off are people in Yemen?The total amount earned by Yemenis (inside and outside thecountry) in a year divided by the total population gives someidea. In 1 97 8 this figure was 2 55 . This is considerably m orethan the figure of 88 for India, but still very little compared*This booklet is about the Yemen Arab Republic (North Yemen) called'Yemen' for short. This does not include the separate nation to the south,the People's Dem ocratic Republic of Y emen (formerly Aden).


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The Great Health Robbery