Yemen has long been in the grip of a humanitarian disaster that has added to the wider crisis of displacement and conflict in the Middle East. This two-tiered political and security crisis only got worse on March 26, when the predominantly Sunni Saudi Arabia, its Gulf Cooperation Council (GCC) partners excluding Oman, and some North African states launched air strikes against an alliance of Shiite Houthi militia and military forces loyal to the former Yemeni president Ali Saleh.

The initiation of strikes under the so-called Operation Decisive Storm followed a period of heightened insecurity caused by increased Houthi agitation and the withdrawal of President Abdu Rabu Mansour Hadi and many of his supporters from the capital Sanaa to the city of Aden, which Hadi later declared the new Yemeni capital. Since then, air strikes have continued to target the Houthi and pro-Saleh forces in multiple locations of the country and have seen many civilian casualties, including at least 40 refugees in the Al-Mazrak camp.

Ground battles between various local actors have also increased in frequency in governorates in the south, specifically in Aden, Lahij and Ad Dali. The air strikes and ground battles have not, however, slowed the Houthi southward advance, and the group’s militia have since taken parts of Aden. In response, Hadi has fled to Saudi Arabia.

According to the World Health Organization, the conflict has left approximately 549 people dead and close to 2,000 wounded since March. The fighting has further exacerbated the already fragile security and political environment in the country and poses a serious long-term threat to the Yemeni state. The ability of local actors to meet and negotiate a settlement has also been severely undermined, and the basic tenets of the 2013/2014 National Dialogue Conference (NDC)—a conference established between most Yemen actors to attempt to create a stable state—are likely to be set aside as each side seeks to maximize territory under its control.

In addition, the increasing levels of fighting have threatened to further inflame already elevated regional sectarian tensions. Saudi Arabia and its GCC partners, long weary of Iran’s growing influence in the region, are largely supportive of President Hadi, while Iran is viewed as backing the Houthis and by association, Saleh. This volatile mix not only serves to heighten the stakes, but also raises the prospect of a lengthy war and, by extension, a severe humanitarian crisis. Indeed, current indications are that the Yemeni people, long suffering due to numerous political and security challenges dating back to the Arab Spring, may see something akin to that witnessed since 2011 in Syria.

The developing humanitarian crisis is a major point of concern for the United Nations. On April 6, UNICEF indicated that the conflict had already led to the internal displacement of 100,000 people. Thousands more are also thought to have fled to neighboring Djibouti and Somalia, countries which are already host to a large population of displaced persons from conflicts in the Horn of Africa. These large numbers are in addition to the already significant internally displaced persons population in Yemen (334,000 as of December 2014) as a result of conflict since 2011.

This negative state of affairs has further contributed to and complemented a severely poor economic and social environment within Yemen. It is estimated that approximately 54% of the country’s population live below the poverty line, that 16 million of its 25 million people are in need of humanitarian assistance and that 5 million others are considered to be facing critical food insecurity. Widespread unemployment and very low levels of foreign investment complete the bleak narrative.

In addition to the existing conflict zones in Saada, Al-Jawf, Amran, Sanaa, Ad Hudaydah, Al Bayda, and Taiz, escalating violence has threatened the major population centers of Aden, Lahij, and Ad Dali. In the southeast there are also indications that Al-Qaeda in the Arabian Peninsula (AQAP) is preparing to take advantage of the distraction of the country’s security forces to seize ground in the Hadramawt governorate, in operations reminiscent of those in 2011 and 2012, when it took territory in the Abyan governorate.

In multiple newly affected areas the provision of food and basic services such as water and electricity has been severely restricted or completely withdrawn, threatening hundreds of thousands of people who had previously been relatively secure. The ability of foreign aid organizations to access displaced or at-risk populations has also been reduced further by the conflict. Major international air and sea ports are either closed or have severe travel restrictions in place. Of late, the Saudi-led coalition has approved limited aid deliveries and approximately 48 tons is expected to arrive in the country on April 8-9, though obtaining clearance for these flights has been a lengthy process. Furthermore, the Red Cross is struggling to obtain clearance for a number of its own doctors and those of Medecins Sans Frontieres to travel from Dijibouti to Aden. The UN, meanwhile, withdrew its personnel in the country when the violence became too severe.

From the state’s point of view, its ability to assist its own people is low to negligible at best. The Yemen government all but collapsed following the Houthi overthrow and capture of Sanaa earlier in 2014 and early 2015. That takeover also led Yemen’s regional partners to suspend critically required foreign aid, while oil processing and export terminals have been shut in many areas affecting the state’s economic bottom line. At a regional level, some governorates remain functional but are in a poor position to assist internally displaced people and will rely heavily on foreign assistance over the medium term.

The conflict is expected to persist for the near term at least and may well escalate further with the looming prospect of a Saudi/GCC ground force intervention. As of April 7, pro-Hadi forces had lost ground in Aden, while most of central and northern Yemen was in near total Houthi control. In the southeast, AQAP forces are maintaining a menacing presence but are being held at bay by a local tribal coalition, for now.

With the removal of its local envoy Jamal Benomar and other personnel, the UN has conceded it will be “difficult” to get negotiations for peace going. Yemenis, who are already in desperate need of support, will struggle further and internally displaced individuals will increasingly seek shelter internally or abroad. The current conflict and humanitarian crisis has the potential to dwarf the Syrian refugee outflow given Yemen’s already tenuous social and economic position.

With so many people on or below the poverty line, movements into more stable areas, such as Oman, are a potential end game, though population flows like those witnessed from Syria into Lebanon could also have a seriously negative impact on Omani security and its economy, as they have in the Levant. Oman, as an abstainer from the GCC coalition, could however also act as a potential negotiator for a peaceful end to the crisis, which would build on its prominent role in the early stages of the nuclear negotiations with Iran.

It is clear that immediate attention is required to address the issue. Working through the UN, the international community will ideally look to involve all sides in seeking a ceasefire and, following that, a period of negotiation. The outcome of the NDC, including points disputed by the Houthis, could also be fully addressed as a matter or critical priority. One key NDC item is the delineation of new regions that effectively makes Houthi-controlled northern Yemen a separately administered area. Given recent events and the relative strength of the Houthis, a federal system that grants the Shiite militia a degree of autonomy in the north could be considered, or at least discussed further.