On 13 June 2018, an offensive was launched by SELC-backed forces loyal to President Hadi, to seize Hodeidah from Ansar Allah forces. Clashes occurred south of Hodeidah airport, and fighting was reported along this frontline over the following three months. In August, MSF opened a surgical hospital in Mocha to treat war wounded from Hodeidah and Taiz frontlines, and pregnant women with complications requiring urgent surgery. Following Geneva peace talks failure, a new offensive on the city began mid-September, with daily clashes partially blocking the main Hodeidah-Sanaa road and raising fears of a siege around the city. In September, MSF started working at Al Salakhanah hospital, northeast of Hodeidah. Teams rehabilitated the emergency room and operating theatres so as to be able to provide emergency medical and surgical care in case fighting reached new areas of the city. From 1 November, intensification of fighting occurred on various frontlines across the country. A stronger offensive was launched in Hodeidah by SELC-backed forces at the same time, with deployment of troops on the ground and battles getting very close to Al Salakhana hospital. Al Salakhana hospital remained one of only three open and operational public hospitals in the area. Al Thawrah hospital, the main public health facility in the city, was still operational but threatened by fighting and rapidly moving frontlines.
At around the same time, MSF began working in one hospital and supporting another in Al Udayn and Far Al Udayn, as fighting in Hodeidah was displacing a large number of people out of the city, and bringing in more casualties into this area.
In mid-December, warring parties agreed to a ceasefire deal brokered in Sweden. The Stockholm Agreement includes a prisoner swap, the creation of a demilitarized zone around Hodeidah and Ansar Allah troops’ withdrawal, and a committee to discuss the future of the city of Taiz. Since then, MSF teams have observed ongoing clashes particularly at night. According to Yemen Data project, 'one air raid was recorded in Hodeidah governorate in March, bringing a total of 10 recorded air raids in Hodeidah since the ceasefire came into force, which represents a strong reduction in the pre-ceasefire high of 103 air raids in Hodeidah in November 2018'. Teams are working in Al Salakhana hospital's ER and 2 OTs + IPD. They are mainly treating trauma cases, such as people injured in road traffic accidents, by stray bullets or blasts, who need urgent surgeries.