Three million Yemenis have lost their homes, child malnutrition has spiked by 200 percent and one-half of all hospitals in Yemen have been destroyed or shut down in what critics are calling a forgotten war in the Middle East's poorest country.
"The politics of the situation has overcome the humanity," Jamie McGoldrick, the United Nations' senior representative in Yemen, told the BBC. "The humanity doesn't work anymore here. The world has turned a blind eye to what's happening in Yemen ... right now we are so under-resourced for this crisis, it's extraordinary."
While the world has been watching the Syrian civil war and its refugee crisis, advocates for Yemen's most afflicted say comparatively few are even aware of the civil war that began in Yemen in 2015 -- and many Americans aren't aware that the war has been prosecuted, in part, with weaponry from the U.S.
The war has been fought by four main factions -- the Iranian-backed Houthis, who control most of the country's western provinces; the Saudi-backed forces loyal to nominal Yemeni President Abdrabbuh Mansour Hadi; a resurgent al-Qaida that calls itself al-Qaida in the Arabian Peninsula; and ISIS.
The U.S., France, U.K., China, Jordan and a half dozen other countries all have their hands in the mess, most of them backing Hadi, who has fled Yemen and taken refuge in Saudi Arabia.
Caught in the middle are 20 million Yemeni civilians. Of those civilians, the U.N. says 14 million are considered "food insecure," meaning most are malnourished, don't eat regularly and don't have reliable sources of food.
Food imports have been stalled by a Saudi-led naval blockade since 2015, according to the BBC. In addition to problems getting food, 14 million people lack access to safe drinking water. Of the more than 3 million Yemenis who have been forced from their homes -- or left voluntarily to escape violence -- tens of thousands live in makeshift accommodations, including tent cities.
Compounding the problem are outbreaks of cholera and infectious diseases, and the country's remaining hospitals cannot treat most people because they lack doctors and medical supplies.
The U.N. has appealed for $1.6 billion to help address the worsening crisis in Yemen, but in a new report -- in which the U.N. issued its largest-ever request for humanitarian aid funds -- said it has only raised 58 percent of that money. The consequences of that shortfall will be disastrous.
"In Yemen, underfunding, outstanding pledges, and bureaucratic impediments limit the reach of humanitarian partners to save countless children dying from hunger," the U.N. said in its Global Humanitarian Overview report, released on Dec. 4. "If sufficient funds are not secured ... 4.3 million people will face heightened risk of morbidity or death due to malnutrition, food shortage, and epidemics."
While all four major factions in the protracted Yemeni civil war have killed civilians, observers say the Saudi airstrikes on the country have caused the most damage, in lives and critical infrastructure.
“It would seem the coalition is responsible for twice as many civilian casualties as all other forces put together, virtually all as a result of airstrikes," said U.N. High Commissioner for Human Rights Zeid Ra’ad al Hussein, according to Politico.
The Saudis are conducting their campaign with weapons they bought from the U.S. and the tacit approval of the U.S. government. In August, President Barack Obama approved the sale of $1.2 billion in weapons, ammunition and tanks to Saudi Arabia -- the latest of many such sales to Saudi Arabia by the Obama administration -- and the State Department has defended U.S. support of the Saudi campaign in Yemen.
Some members of Congress have been dogged and harsh in their criticism of U.S. involvement, but those stories were eclipsed by narratives about the 2016 presidential election. A group of 60 U.S. lawmakers -- Republicans and Democrats -- tried unsuccessfully to stop the Obama administration's weapons deal with Saudi Arabia, reports Defense News.
“The actions of the Saudi-led Coalition in Yemen are as reprehensible as they are illegal," Rep. Ted Lieu, a California Democrat, said in August. "The multiple, repeated airstrikes on civilians look like war crimes.”
In the meantime, millions continue to suffer. The BBC's Fergal Keane described the scene at a surviving Yemeni hospital, where infant Ibrahim Bolgaith was clinging to life as his mother tried to comfort him. Keane described the baby boy's "hollowed-out face, with ribs which press against his skin," and said the severely malnourished child "looks as if he is shrinking back into himself."
"It seems perverse to describe a child in this state as 'lucky,'" Keane wrote. "But Ibrahim has survived 21 days and doctors are hopeful he will endure. His twin brother died soon after he was born."