Yemen is finally making headlines. The U.S. has called for a cease-fire in hostilities.

But in the meantime, the humanitarian crisis characterized as the world's worst by the U.N. continues unabated — and largely out of the public's mind.

Media outlets have repeatedly referred to it as an "invisible" crisis, despite its magnitude.

More than 22 million out of Yemen's total population of 29 million are in need of humanitarian assistance, according to the the U.N. Nearly 18 million of them do not know where their next meal will come from.

Already, more than 8 million people are "facing pre-famine conditions, meaning they are entirely reliant on external aid for survival," says Mark Lowcock, the U.N.'s humanitarian chief. That number is likely to reach 14 million in the coming months – half the country's population – as the effects of long-term malnutrition and compromised immune systems set in.

The situation is "catastrophic," says Caroline Seguin, program manager in Yemen for Doctors Without Borders (or MSF, the abbreviation for the organization's French name Médecins Sans Frontières).

Youth are especially hard hit. According to the U.N., about 80 percent of Yemenis under the age of 18 are facing threats to their health and survival.

"It's a living hell for its citizens and their children – honestly," says Sherin Varkey, deputy representative of the U.N. Children's Fund (UNICEF) in Yemen.

How is it that the world can turn a blind eye to the suffering of an estimated 22 million people?

Jolien Veldwijk, the assistant country director for CARE in Yemen, suggests that perhaps the numbers are just too big and abstract to register in people's minds. That's why, to make it more relatable – she compares the figures from Yemen to European countries or U.S. states.

Imagine if half of the 28.3 million people in Texas were on the brink of dying of hunger. Or if no one in the Netherlands and Norway had access to safe drinking water, food and shelter. That is the scale of suffering in Yemen.

Even before the war, Yemen was "invisible" to much of the world. It was already the poorest country in the Middle East, overshadowed by the other political, economic or cultural giants in the region, like Saudi Arabia, Egypt, Jordan and Iraq. In an oil rich region, it didn't have much reserves to offer.

When Hillary Clinton made the a surprise stop in Yemen in 2011, it was the first time a U.S. secretary of state visited the country in 20 years.

So when things got worse there, it went largely unnoticed.

"If the world didn't care about the 10 million [suffering people] in 2012 [before the war], why would it care in 2018?" asks Rasha Jarhum of Yemen, director of the Peace Track Initiative and an Aspen Institute New Voices fellow.

Veldwijk says it's also hard to relate to a conflict that is difficult to understand. And the Yemen conflict is very complicated.

In 2014, the Houthis – a Shiite rebel group loyal to the former president – captured the capital, Sanaa. In response, in 2015 Saudi Arabia led a coalition of Arab states in airstrikes against the Houthis to defend the internationally recognized government of Abdrabbuh Mansur Hadi.

The Houthis are backed by Iran, while the U.S., U.K. and France have supplied the Saudi-led coalition with weapons and technical assistance.

As this crisis has unfolded, the U.N. and human rights groups have accused both the Houthis and the Saudi-led coalition of committing war crimes that have killed or injured more than 17,000 civilians. Coalition airstrikes have destroyed civilian buildings, including homes, schools and hospitals. Houthis have also been accused of indiscriminate attacks. Meanwhile, other armed groups within the country are engaged in overlapping conflicts.

And among the conflicting parties, says Veldwijk, "you don't just have one bad guy."

That's another obstacle to engaging the public. People like to take sides, she says.

The war has destroyed Yemen's already fragile economy. About 1.25 million public servants have not received salaries consistently or at all since August 2016. Not only has this affected their ability to provide for their families, but it's also contributed to a breakdown of essential services like water, sanitation, health care and education, putting additional pressures on humanitarian organizations to compensate.

Prior to the war, Yemen imported 80 to 90 percent of its staple foods and large amounts of fuel, but blockades have delayed and limited delivery, making these essential goods more expensive and harder to obtain, and hyperinflation has undermined people's purchasing power. Before the crisis, one U.S. dollar was worth 215 Yemeni rial. By the beginning of September, that exchange rate had nearly tripled to 597 Yemeni rial per dollar. This means that even when food and other critical supplies, like fuel, are available, people can't afford to buy them. All these factors are pushing Yemen to the precipice of the "worst famine [the world has seen] in 100 years," according to the U.N.

Food security isn't the only pressing issue.

"What is very worrying is that with the economic crisis, people have much more difficulty accessing hospitals," says Seguin of Doctors Without Borders. "Just to pay for a taxi or a bus – a lot of people cannot afford this."

People are borrowing money or cutting costs in other areas to save up for a hospital visit — both for transportation and medical fees. "So now we're seeing that they're arriving [at hospitals] much later than before," says Seguin.

Bombed roads and bridges are also cutting off people's access to emergency health services. This has been especially dangerous for pregnant women, some of whom have suffered birth complications as a result of the delay when they otherwise would've had healthy births.

Collapsed health systems and infrastructure have also increased the risk of disease outbreaks. Last year, there were more than 1 million reported cases of cholera – a waterborne disease spread by poor water treatment, sanitation and hygiene. The U.N. said it was the worst cholera outbreak in history. This week, more than 4 tons of oral cholera vaccines arrived in Yemen as part of the World Health Organization and Yemeni government's effort to combat a recent resurgence of the disease.

Veldwijk says that aid workers are working as fast as they can to address the needs but just can't keep up.

"I think what needs to be really clear to everyone is humanitarian aid is not enough to stave off the impending famine," she says. "The only way forward for Yemen is a political solution to the conflict."

Yet with so many armed groups and international governments involved, as well as a lucrative weapons trade at stake, striking a peace deal has seemed completely out of reach – until now.

The death this month of Saudi journalist Jamal Khashoggi, inside a Saudi consulate in Turkey, has turned the world's attention to the Arabian kingdom's policies elsewhere as well – especially Yemen.

Public outrage over the incident led Saudi Arabia's biggest arms suppliers – the U.S. and UK – as well as Canada to call for a cease-fire to the war this week. Others, like Germany, are halting arms sales to Saudi Arabia.

In a statement released on Tuesday, U.S. Secretary of State Mike Pompeo called on the Saudi-led coalition to stop air strikes on civilians and on Houthis to stop shooting missiles and sending drones into Saudia Arabia and the UAE. He also called for U.N.-led peace talks.

"A cessation of hostilities and vigorous resumption of a political track will help ease the humanitarian crisis as well," he said. "It is time to end this conflict, replace conflict with compromise, and allow the Yemeni people to heal through peace and reconstruction."

Rasha Jarhum says she welcomes international calls for a cease-fire, but she's skeptical they're anything more than "false hope."

"We've seen [these calls] before in Syria and other countries in the region," she says, "and they've failed."

While the international community works toward a solution, 14 million Yemenis are staring down the barrel of famine.

"Any restrictions on imports, any restrictions on the movement of aid workers will only spiral Yemen further into the abyss," says Sherin Varkey of UNICEF.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

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