When Um Ayman started to feel stomach pain, she didn’t think it was the beginning of labor because she was not pregnant for nine months. She went to the pharmacy, where the “volunteer doctor” was the only option for medical advice in her village, al-Malahaet.

This is an isolated place, close to the border between Yemen and Saudi Arabia, and it is also the front line of the confrontation between the Saudi and Yemeni forces and the fighters of Ansar Allah (Houthis). “The doctor told me it was not time to give birth and gave me some intravenous fluids,” she said. “But then my amniotic fluid broke.”

She spent three days of painful childbirth at home, and then her family managed to collect the money needed for the five-hour drive to the nearest town, Haidan. There, staff at the Médecins sans Frontières (MSF) hospital discovered that her baby had been lying on her uterus instead of lying upright. The baby died during childbirth and Um Ayman needed emergency surgery to remove the body and save her life.

Stories like Um Ayman are all too common in Haidan, which has traditional brown houses, lush Carter fields, and ruins of buildings bombed by Saudi jets. Although the town is no longer directly bombed—many houses, girls’ schools and even the MSF hospital were destroyed in the first few years of the war—the sound of airstrike explosions still echoes on the surrounding hills. The remoteness and inaccessibility of the area, coupled with active conflict, poverty and a nearly inoperable healthcare system, means that few residents have access to the healthcare services they need.

“We may be called a medical desert here,” said David Charo Kahindi, MSF project coordinator in Haidan. “There are few sanitation facilities, and the situation seems to be getting worse. Compared with the four months of the same period last year, our number of pediatric hospitalizations has increased by 45%. Overall, we have seen more critically ill patients come to us. : Although the number of people who come to the emergency room is stable, the number of people admitted to us is twice as much as they were last year.”

The hospital treats relatively few patients injured as a result of the fighting: about 15 people per month. On the contrary, most of the hospital’s activities are focused on the needs of the mother and her child. So far this year, the team has assisted with an average of 176 deliveries per month and admitted 92 children. Most of these children suffer from respiratory infections and diarrhea, which are usually related to poor living conditions. Only 40% of mothers who give birth in the hospital have access to prenatal care, which means that many complications will not be detected before the mother gives birth, just like Um Ayman.

“At the end of last year, we opened an operating room in the hospital so that we don’t have to refer people to Sa’ada. [a larger town some 70kms away],” Kahindi explained. “People here have had to travel many hours to reach Haidan, so now we better can provide care for women who need a C-section or other types of ordinary surgery without them. Go further. “

In recent years, as fuel prices have risen and inflation has reduced people’s purchasing power, travel has become more difficult. “We live in Lower Duweib and it takes six hours to reach Haidan,” said Hamid Ali, 33, who accompanied him to the hospital after breaking his leg in a car accident. “There is only one worker in the local health center, and they can only make small dressings, so we have to pay 100,000 YER [$165] Get a car to bring us here. “For families in the area, these are astronomical figures. Most of them are farmers and herders living in areas severely affected by the conflict. “We have livestock,” Ali said. “We can hear the sound of fighting every day. . Sometimes shelling will attack our villages, but we will try our best to live the lives of ordinary people. “

The conflict not only created additional medical and humanitarian needs in the region, but also complicated the response of humanitarian organizations. Different authorities in Yemen have supervised the work and actions of humanitarian organizations to a certain extent, and some of the conditions put forward by the Apostles of God are particularly harsh.

Due to the sensitivity of these areas, obtaining permits to work in areas close to the front lines (such as Haidan) is often particularly difficult. Currently, MSF is the only resident humanitarian organization in the region. “We see that there is a huge demand here. Although we have started new services and are expanding the hospital further, we cannot meet all the needs alone,” Kahindi said. “In order to meet existing needs and prevent the situation from getting worse, we need other organizations to commit to providing services here-and have the authorities provide them with convenience.

Um Ayman is overcoming the trauma she has experienced and is preparing to return to the operating room to clean her wound, although she is afraid. “I’m scared,” she said, “I don’t want to die and can’t see my children again.” The relatively normal complication has almost killed her and left her traumatized.

“If humanitarian organizations in the area cannot gain better access, more people like Um Ayman will suffer from preventable and treatable medical problems, and some will even die,” Kahindi said. “This cannot be allowed to happen.”

The views expressed in this article are those of the author and do not necessarily reflect Al Jazeera’s editorial stance.