‘Cheek bulge warfare’: The ancient plant fuelling Houthi strikes on Saudi Arabia

Yemen’s Houthi fighters have long used qat, a stimulant leaf that can keep users alert for hours.

Houthi-Saudi War: The war in the Middle East has entered a new phase. Following a dawn barrage of ballistic missiles and drones on September 19 that caused a fuel depot fire near the King Khalid International Airport in Riyadh and targeted Saudi Aramco facilities in Yanbu, Yemen's Houthi rebels have intensified energy disruptions in the region.

The latest attacks follow a rapid Houthi advance along Yemen’s west coast, giving the group greater control over areas near the Bab el-Mandeb strait, a major maritime chokepoint connecting the Red Sea with the Gulf of Aden through which millions of barrels of oil pass daily.

Along with disruption in the Strait of Hormuz because of the ongoing military confrontation between the United States and Iran, the two chokepoints have pushed Brent crude prices above $103 a barrel.

While heavy weaponry and Iranian military support dictate the strategic stakes, the daily routine among Houthi fighters is sustained by an ancient local stimulant known as ‘qat’ or 'khat'.

Photographs from the frontlines near the Bab el-Mandeb often feature the combatants with a distinct bulge protruding from one cheek, which is formed by a dense wad of fresh qat leaves kept inside the mouth and chewed continuously for five to six hours a day. It contains cathinone, a naturally occurring psychoactive compound chemically related to amphetamines.

As the juice is absorbed through the mouth's mucous membranes, cathinone acts directly on the central nervous system and produces heightened alertness, increased focus, temporary euphoria and a significant suppression of appetite, according to World Health Organisation (WHO).

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People chew qat by packing the leaves and tender stems between the molars and cheek. Hours of chewing create the familiar swollen-cheek silhouette seen among Yemeni fighters after prolonged qat use.

While qat does not provide military capability, which comes from training, Iranian support and local weapons supplies, it can help fighters stay awake during long hours in the desert and on coastal patrols.

Beyond the battlefield, it is deeply embedded in the social fabric of Yemen rather than being exclusive to combatants. Studies show that up to 90% of adult men and more than 50% of women in Yemen use it. Many spend several hours each afternoon chewing the leaves. The practice uses more of the country’s limited water supplies and affects its infrastructure. Its prolonged use can cause serious physical health problems, including high blood pressure, elevated heart rate, chronic insomnia and psychological dependence.

World Bank assessments show that qat is grown on nearly 220,000 hectares of land in Yemen and uses 1.61 billion cubic metres of groundwater each year. Its farming accounts for more than 32% of the country’s limited water use.

The situation is particularly dire in the Sana’a Basin, where groundwater extraction for qat cultivation exceeds natural annual recharge by more than four times. Agriculture is an important source of income for many Yemeni families. Qat farming also takes land away from food crops, forcing the country to import more basic food items as prices rise.

As the World Bank rolls out a $153.6 million emergency water management project to tackle Yemen's water shortage, international powers are still monitoring the situation in the Red Sea.

The Houthi movement's strikes on Riyadh and Yanbu show that energy facilities in the region are still at risk. While Washington is enforcing naval blockades in regional waters and considering its military options, Houthi commanders have strong positions along Yemen's Red Sea coast, giving the group access to an important shipping route.

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