At least 10,000 have been killed as a result of Yemen’s four-year civil war. Another 14 million are at the brink of famine. But often overlooked in this narrative — which pits a Saudi-led coalition supporting the Yemeni government against Iran-aligned rebels — are women and children, who are the most likely to be displaced, deprived and abused.

More women are being widowed by the war each day, left without the education or skills to support their families. Rape and domestic violence are increasing. Girls are being pulled out of school to be married off for dowry money. Children are falling sick from diseases that were long-ago eradicated elsewhere in the world, and pregnant women and newborn babies are succumbing to starvation.

These are their stories.

The perils of hunger

At 4 1/2 years old, Rakan Nabeed no longer responds to his mother’s touch. He no longer smiles at the sound of her voice. He used to weigh 40 pounds. Today, Rakan weighs only nine.

Rakan and his mother, Aida Hussein Ahmed, are among the hundreds of displaced women and children streaming daily into the al-Sadaqa Hospital in the southern city of Aden. They fled their home hundreds of miles away in Hodeida, a strategic port city that has been the site of the fiercest fighting between the Saudi-led coalition and the rebels.

Historically, more than two-thirds of Yemen’s food aid has arrived through Hodeida, and 22 million Yemenis depend on it for survival. But the fighting has crippled humanitarian efforts. The result is an estimated 14 million Yemenis on the brink of starvation, according to the United Nations.

Yemenis from Hodeida and the neighboring region now account for nearly half the 400,000 Yemeni children, like Rakan, who suffer from severe acute malnutrition.

“We eat what is available,” Aida says. “It fills half a stomach.”

In the absence of men

It was to be a joyful occasion, but the birth of Sada Mohammed Saeed’s first grandchild was marred by tragedy. Her son, the baby’s father, had been killed by a mortar shell that hit their home in Hodeida shortly before the birth.

Sada’s husband, meantime, suffered a paralyzing stroke that she blames on the stress of the war.

With no men to care for them, the two women — Sada and her 8-month-pregnant daughter-in-law, Fakhira — fled to Aden and took shelter with other internally displaced people in an abandoned school.

In Yemen’s traditionally patriarchal society, men work outside the home and women care for the home and children. But because of the war, aid agencies report that the number of female-headed households has dramatically increased. Many Yemeni women must provide for their families without the skills or education needed to earn money.

After complications from giving birth, Fakhira desperately needs medication, but the family can’t afford it. Prices for medicine are skyrocketing as inflation soars and the value of the Yemeni currency collapses. So Sada says she must depend on the generosity of others.

Today, the new mother and child cling to life. “This is the baby of my dead son,” Sada says, pointing to her newborn grandchild.

Education, interrupted

Twelve-year-old Gihan al-Hanani says she can’t sleep at night because of the pain in her arms from carrying water. Every day, she walks a mile through crowded, rundown streets populated by desperate refugees and idle, young men with assault rifles to reach a water tank and refill several jerrycans.

“In Hodeida, I went to school,” Gihan says. “I wanted to stay, but there was a war.”

Gihan is one of about 2 million Yemeni children being denied an education today. With many Yemeni families lacking adequate water, shelter and security, it’s hard to put a priority on schooling. Gihan is part of a lost generation of Yemeni children — uneducated, unskilled and traumatized — who will be unprepared to rebuild the country after the conflict ends.

In this conservative country, girls are often married off young. But as the war has wrecked the economy, they’re being pulled out of school to be married even earlier than before, so their families can get dowry money to put food on the table. UNICEF estimates that 72 percent of Yemeni girls like Gihan are married off before the age of 18.

Girls are also more vulnerable to abuse during wartime. There has been a 63 percent increase in incidents of gender-based violence, including rape and sexual assault, domestic violence and forced marriage, since the conflict began, the United Nations says.

Lasting trauma

Twenty-six-year-old Miriam Abdullah and her family fled the fighting in Hodeida after the Saudi-led coalition’s bombing campaign intensified. To reach Aden, Miriam and 24 family members — all, but one, women and children — traveled treacherously winding mountain roads, risking encounters with rogue gunmen. For the past three months, she has been living in the small courtyard of a one-room office set up to help internally displaced people in Aden.

Miriam says the pain and sense of loss suffered by Yemeni children is obvious when she looks at her own.

“Just to hear the word ‘airplane’ terrifies them,” Miriam says. “They shout, ‘Mom, it’s going to hit us!’”

One of her sons, a once-energetic 9-year-old, sits listlessly, picking at scabs and watching blood trickle down his legs. He only speaks to talk about going home and wanting to see his friends. At night, he and his siblings jolt awake from nightmares.

Aid agencies report that an average of five children per day have been killed since the start of the war. Millions of Yemeni children have suffered trauma from the conflict. And because of the collapse of the country’s health-care system, psychosocial support and mental health care are essentially unavailable.

The United Nations says many of these children will carry heavy emotional burdens into their adulthood with far-reaching consequences.

The constant threat of disease

As a doctor cleans the tracheotomy tube protruding from Noora Muhammed Musa’s neck, the 4-year-old girl is writhing in her hospital bed. The pained expression on her face, the tears streaming down her cheeks, the quivering of her lips, all show that she is screaming in pain. But her cries are silent.

Known as “the strangling angel of children” for the way it blocks the airways and causes death by choking, diphtheria had already killed three of Noora’s siblings, says her grandmother, Fatima Nasser Ahmed al-Gorari.

Diphtheria, an airborne disease that had been eradicated in Yemen decades ago, is now spreading rapidly because of the conflict.

Alnoor Muhammed Abdularishi, a pediatrician at al-Sadaqa Hospital, says Yemen is short of vaccines to prevent the disease and a vast number of the country’s health centers had shuttered because of war. And as the fighting scatters the population from one place to the next, it rapidly spreads the infection.

According to UNICEF, the country’s 1.8 million malnourished children are particularly vulnerable to diseases like diphtheria and cholera, both of which can be easily prevented with access to vaccines and clean water.

“No parent should have to bury their child,” Fatima says.

Reporting was supported by The GroundTruth Project, a nonprofit news organization based at WGBH in Boston.

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