Direct Relief has been ranked as the fifth largest charity in the United States and one of the most effective stewards of private donations, according to Forbes’ 2024 annual list of the 100 Top U.S. Charities, which ranks organizations by private donations.

“Direct Relief, No. 5 on this 26th edition of our list, is one of the most respected and older organizations in the disaster relief business,” Forbes stated.

Forbes awarded Direct Relief a perfect score of 100% for charitable commitment, reflecting the proportion of expenses allocated directly to its charitable mission, and 100% for fundraising efficiency, highlighting the organization’s minimal fundraising costs relative to private donations.

In fiscal year 2024, which ended on June 30, Direct Relief mobilized more than $2.4 billion in humanitarian aid, including $770 million in medical aid for victims of natural disasters, war, and civil conflicts in locations such as North Carolina, Maui, Ukraine, the Middle East, Haiti, and Sudan.

Direct Relief’s impact also included providing targeted financial support for projects such as funding mobile medical clinics, prosthetics clinics in Ukraine, and search and rescue teams in California.

Forbes highlighted Direct Relief’s leadership role in disaster response, noting that it “may pump more aid into disaster relief in the U.S. and abroad than any other charity on the new Forbes list.”

Top Ten Charities in the US – 2024

Leading Position Among California and International Charities

Among the 100 largest U.S. charities recognized by Forbes in 2024, Direct Relief stands out as the largest among the six headquartered in California, emphasizing its leadership in a state renowned for philanthropy.

Top California Charities by Size – 2024

Globally, Direct Relief is ranked as the second-largest charity in the “International Needs” category, underscoring its ability to address complex global challenges and deliver impactful humanitarian aid across diverse regions.

Top International Charities by Size – 2024

2024 Charity Ratings

Beyond its Forbes ranking, Charity Navigator, the nation’s leading nonprofit evaluator, awarded Direct Relief an overall 100% charity rating for 2024, marking its 14th consecutive Four-Star rating. This distinction underscores the organization’s commitment to excellence, accountability, and measurable impact.

Charity Navigator also recognized Direct Relief as one of the Best Humanitarian Relief Charities of 2024, highlighting its responses to Hurricane Helene, Hurricane Milton, and humanitarian crises in Sudan and Ukraine. These lists identify organizations that are “extraordinarily effective at what they do, giving you the chance to support a cause where you’ll have an impact.”

Direct Relief has also earned an A+ rating from CharityWatch, the highest grade awarded by the independent watchdog.

Humanitarian Impact in 2024

In 2024, Direct Relief advanced its global humanitarian mission with the following accomplishments:

• Delivering Lifesaving Medicines: Distributed over 380 million defined daily doses of medicine to more than 2,300 healthcare facilities across 90 countries and all 50 U.S. states.
• Hurricane Responses: Responded to Hurricanes Beryl, Helene, and Milton, providing financial support and essential medicines to over 90 healthcare providers across impacted states, including Florida, Georgia, North Carolina, South Carolina, Tennessee, Texas, and Virginia.
• Middle East Humanitarian Aid: Provided $299 million in medical aid to regions including Gaza, Egypt, Israel, Lebanon, Syria, and Yemen. This included nearly 150 tons of medical supplies, valued at more than $32 million, addressing critical health needs such as cancer treatment, diabetes care, cardiac conditions, and water purification.
• Support for Ukraine: Delivered $322 million in medical aid to Ukraine in 2024, bringing the total since 2022 to 2,600 tons, valued at $1.4 billion. Current initiatives focus on rehabilitation, mental health, mobile care, and energy resilience for healthcare facilities.

Policies on Donor Funds and Valuation of In-Kind Donations

Direct Relief ensures that no donor funds are used for fundraising expenses. Such costs—averaging just 2% of cash revenue—are covered entirely by earnings from a generous bequest, ensuring that 100% of donor contributions directly support humanitarian programs.

As an organization funded exclusively by private charitable contributions, Direct Relief does not accept government support. Its operational efficiency is bolstered through strategic partnerships with businesses and nonprofit organizations.

The majority of donations received and distributed by Direct Relief are in-kind contributions of medicine and medical supplies, valued at wholesale cost. These contributions form the largest share of the organization’s annual revenue.

Direct Relief’s long-standing support for locally run facilities providing essential health services to underserved communities has enabled it to expand its reach and strengthen fragile health systems globally, marking an unparalleled level of impact in its 76-year history.

The post Direct Relief Ranked Among Forbes’ 2024 Top U.S. Charities for 100% Efficiency and Global Humanitarian Impact appeared first on Direct Relief.

Charity Navigator, America’s top independent nonprofit evaluator, has awarded Direct Relief an overall 100% charity rating for 2024. This achievement marks Direct Relief’s 14th consecutive Four-Star rating, underscoring its commitment to excellence, accountability, and measurable impact in delivering on its humanitarian mission.

In addition to its perfect score, Direct Relief was also named one of Charity Navigator’s Best Humanitarian Relief Charities in 2024. The organization also earned top rankings for its responses to Hurricane Helene, Hurricane Milton, and the humanitarian crises in Sudan and Ukraine These lists, according to Charity Navigator, recognize charities that are “extraordinarily effective at what they do, giving you the chance to support a cause where you’ll have an impact.”

Direct Relief’s Charity Ratings

Direct Relief achieved top scores across Charity Navigator’s evaluation criteria:

Within the charity watchdog’s evaluation “beacons,” Direct Relief earned a 100% rating in Accountability & Finance, Leadership & Adaptability, and Culture & Community. Within the Impact & Measurement Beacon, Direct Relief earned a 100% rating in Impact and 97% in Measurement.

Michael Thatcher, President and CEO of Charity Navigator, recognized Direct Relief for its performance, stating:

“We are delighted to provide Direct Relief with third-party accreditation that validates their operational excellence. The Four-Star Rating is the highest possible rating an organization can achieve. We are eager to see the good work that Direct Relief can accomplish in the years ahead.”

Humanitarian Impact in 2024

In 2024, Direct Relief made significant strides in advancing its global humanitarian mission, including:

• Delivering Lifesaving Medicines: Distributed 377 million defined daily doses of medicine to more than 2,300 healthcare facilities across 90 countries and all 50 U.S. states.
• Hurricane Responses: Mobilized disaster responses to Hurricanes Beryl, Helene, and Milton, providing financial support and essential medicines to over 90 healthcare providers across Florida, Georgia, North Carolina, South Carolina, Tennessee, Texas, and Virginia.
• Middle East Humanitarian Aid: Provided $299 million (wholesale value) in medical aid to regions including Gaza, Egypt, Israel, and Syria, among others. This included nearly 150 tons of medical supplies valued at $32 million to Gaza, addressing cancer treatment, diabetes care, cardiac conditions, and water purification needs.
• Support for Ukraine: Delivered $322 million in medical aid in 2024 alone to Ukraine for the benefit of people affected by war, bringing the total to 2,600 tons of aid valued at $1.4 billion since the war began in 2022. Current efforts focus on rehabilitation, mental health, mobile care, and resilient energy solutions for healthcare facilities.

Stewardship and Financial Transparency

Direct Relief is committed to maximizing the impact of every donation, ensuring funds are used responsibly and effectively to support those in need:

• 100% Allocation of Donor-Designated Funds: Every contribution earmarked for specific programs or emergencies is applied exclusively to those purposes, giving donors full assurance that their intent is honored.
• Independently Funded Operations: Direct Relief operates solely on private charitable contributions, declining government funding to maintain independence and focus on its mission.
• No Fundraising Costs Paid by Donors: Fundraising expenses, which average just 2% of total cash revenue, are entirely covered by a private bequest. This means 0% of donor contributions are used for fundraising and instead support Direct Relief’s humanitarian mission.
• Operational Efficiency: Approximately 99.5 cents of every dollar (including in-kind donations) go directly to program services, with 0.3 cents allocated to administrative costs and 0.1 cents to fundraising.
• Leveraging In-Kind Contributions: Strategic partnerships with businesses and organizations amplify the impact of donations. Contributions of medicine and medical supplies—valued at their wholesale cost—constitute the majority of Direct Relief’s revenue, allowing cash donations to stretch even further.

For a detailed overview of how Direct Relief uses its resources to advance its humanitarian mission, visit Direct Relief’s donation policies.

The post Direct Relief Earns Top 100% Rating by Charity Navigator for 2024 appeared first on Direct Relief.

Most of the deaths from hurricanes aren’t caused by drowning or flying debris. They’re caused by the disruptions hurricanes inflict upon people’s lives, displacing people from their homes and communities, disrupting their access to healthcare, wreaking havoc on their finances, and putting them under severe stress. This sets them on a path to poor health that eventually cuts short their lives.

A newly published study in Nature finds that long-term excess deaths attributable to tropical cyclones (called hurricanes in North America) can be 300 or more times higher than immediate deaths. The authors tracked the effects of all 501 hurricanes that hit the continental United States between 1930 and 2015, and found that while the average tropical cyclone caused 24 immediate deaths, the storms on average led to between roughly 7,170 and 11,430 additional deaths in the 20 years after landfall.

The hurricane-prone climate in the U.S. “imposes an undocumented mortality burden that explains a substantial fraction of the higher mortality rates along the Atlantic coast and is equal to roughly 3.2–5.1% of all deaths,” said the study, by Rachel Young and Solomon Hsiang of the University of California Berkeley.

While the magnitude of the long-term mortality increase may be shocking, the underlying idea isn’t surprising to people familiar with the impact of Hurricane Maria, which devastated Puerto Rico in 2017. The storm’s official death toll was 64, but a widely noted 2018 paper in the New England Journal of Medicine found that Maria caused more than 70 times the number of excess deaths in the U.S. territory from September 20 through December 31, 2017 – a total of 4,645 additional deaths and a 62% increase in the mortality rate in the same period in 2016.

“Disasters trigger complex cascades of events that ultimately may cause additional future mortality,” the authors of the Nature paper wrote.

They cite a range of impacts of tropical cyclones that “might affect human health through complex chains of events,” including:

• Damage to infrastructure, homes, and businesses
• Population relocation
• Social and economic disruptions
• Ecological changes
• Reduced access to basic services
• Increased pollution
• Crop damage
• Insurance payouts
• Political actions

“For example, individuals may use retirement savings to repair damage, reducing future healthcare spending to compensate; family members might move away, removing critical support when something unexpected occurs years later; or public budgets may change to meet the immediate post-[cyclone] needs of a community, reducing investments that would otherwise support long-run health,” the study said.

The long-term health effects of hurricanes have important implications for organizations – including Direct Relief and the community health centers and free clinics it supports – focused on healthcare for populations that are already vulnerable before a storm hits. Rather than focusing primarily on treating illnesses, health centers emphasize keeping their patients healthy through managing chronic conditions that increase mortality, such as diabetes and hypertension. They also focus on outreach to populations left out of other private or public healthcare systems, including uninsured people and those living in healthcare deserts.

“The importance of this study is to shine a bright and very specifically empirical light on the true scale and scope of the long tail of hurricane impacts,” said Andrew Schroeder, VP of Research and Analysis at Direct Relief. “In that context, policymakers and NGOs should focus more than ever on reducing social vulnerabilities and increasing resilience before crises hit, while maintaining thoughtful, long-term, and consistent support for community health needs.”

“Health centers see this play out each and every day,” said Gianna Van Winkle, Director of Emergency Management at the Florida Association of Community Health Centers. She noted the efforts many health centers make to reach people who are isolated or don’t have other healthcare options. “This has been ingrained in health center culture here in Florida.”

The Nature study found that 59% of excess deaths “result from ‘other’ causes, a nonspecific category that includes diabetes, suicide, sudden infant death syndrome and other causes that are not individually recorded,” with cardiovascular disease the second-leading cause.

The impacts have an especially strong mortality impact “among infants (less than 1 year of age), people 1–44 years of age, and the Black population,” the study said. However, 99% of these infant deaths occur more than 21 months after the hurricane, indicating that the infants were not conceived prior to landfall. “This suggests that cascades of indirect effects following TCs, rather than personal direct exposure to the physical event, generate this mortality.”

Due to their exposure, southeastern states have the highest proportion of total deaths attributable to tropical cyclones. The data show that 13% of deaths in Florida, 11% of deaths in North Carolina, 9% of deaths in South Carolina, and 8% of deaths in Louisiana during this period can be traced to their hurricane-prone climates.

The post Decades After Storms Like Hurricanes Helene and Milton, Mortality and Human Health Impacts Continue appeared first on Direct Relief.

“Their family cannot afford to buy their insulin, and very often we have witnessed them come to the hospital in a coma,” said Dr. Harold Previl, CEO of Hôpital Sacré Coeur, the largest private hospital in northern Haiti. “In a country where people are struggling for food, they are bearing a disease whose treatment [must be continued] for their entire lives.”

A child in Haiti diagnosed with Type 1 diabetes at age 10 has a life expectancy of 13 more years, compared to 57 more years of life for a similar child in the United States, according to a study in The Lancet Diabetes & Endocrinology. Many die before even learning they have the disease; 35,000 young people around the world died at the onset of Type 1 diabetes in 2021 without being diagnosed, according to the T1D Index.

Insulin isn’t manufactured in Haiti, leaving Haitians who need it entirely dependent on imported medicine. (All people with Type 1 diabetes and an estimated 7.5% to 15.5% of those with Type 2 diabetes require insulin.) Years of severe political instability and civil disorder have stretched Haiti’s already-fragile medical supply chains to the point of snapping.

Violence Disrupts Medicine Imports and Distribution

Haiti’s primary international airport and seaport in the capital Port-au-Prince were shut down for nearly three months earlier this year by heavily armed gangs. The land border with neighboring Dominican Republic has been periodically closed, and with gangs controlling the capital’s streets, local distribution of medicine ranges between very dangerous and impossible.

“With air and sea ports closed amid mounting violence in Haiti, access to critically needed supplies came to a sudden halt – including medicines, food, and basic necessities,” said Genevieve Bitter, Senior Director of Program Operations at Direct Relief. “For months, the only source for medicine was local vendors within Haiti.”

Successfully delivering insulin and other cold-chain medicines is especially challenging. Cold-chain medicines must be kept within a specific temperature range from the moment of manufacturing until the time they are administered to the patient. If the temperature goes above the required range for long enough, the medicine is considered potentially unsafe for patients and must be destroyed.

Getting access to insulin and other medicine under these circumstances has required creativity and persistence. Hôpital Sacré Coeur has never completely run out of insulin. “We never let that happen,” Dr. Previl said. “We look everywhere, we have to knock at the doors of everyone, and if we have to purchase it, we purchase it.”

Testing New Delivery Channels

Direct Relief is testing new transportation channels, successfully delivering two shipments of insulin in recent months into northern Haiti, which has been less disrupted by violence. The deliveries have been made possible by working with the Haiti Health Network, or HHN, a collaborative group of healthcare providers and support organizations who meet regularly to discuss current needs, share knowledge, and coordinate resources.

In July, Direct Relief and HHN flew a test shipment of insulin, donated by Eli Lilly and Company, on a small plane from Miami into the northern Haiti airport of Cap-Haitien, where it was delivered to healthcare providers including Hôpital Sacré Coeur. An earlier test shipment of insulin made it through in May, days before heavily armed men set fire to Cap-Haitien’s customs office.

HHN’s support for the insulin deliveries was driven by what it heard in monthly meetings of its members. “For a number of meetings in a row we heard first-hand crisis stories from HHN members about children in diabetic comas, patients dying needlessly from the lack of available insulin, and the stress that searching for insulin was having on healthcare providers and families,” said Rachel Bernard, Haiti country director for the Dalton Foundation, which helped launch the Haiti Health Network and continues to support its activities. “We couldn’t listen to these stories over and over and not do something to help.”

Direct Relief is working on a third test delivery of cold-chain medicines and large pharmaceutical refrigeration units, with the hopes that it can restart regular shipments of insulin to Haiti with its global diabetes partner Life for a Child, said Kelsey Grodzovsky, Direct Relief’s Director of Global Programs. The shipment is intended for La Fondation Haïtienne de Diabète et de Maladies Cardiovasculaires, or FHADIMAC, whose clinics provide care to thousands of Haitians with diabetes.

The third delivery will be sent through the Port-au-Prince airport. Because it isn’t feasible to ship large volumes of aid into the northern airport in Cap-Haitien and transport it by road to Port-au-Prince in south-central Haiti, increasing the volume of medical aid to the country will depend on being able to reliably ship through the Port-au-Prince airport, Grodzovsky said.

Beyond Security: Long-Term Challenges in Getting Medical Aid to Haiti

While Haiti’s need for donated medical supplies is high – it is the poorest country in the Western Hemisphere, and little medicine is domestically manufactured – bureaucratic hurdles have long made it a very difficult country to get medicine into. The challenges predate the security breakdown of the past three years.

The process of getting medicine through customs can be difficult and unpredictable. Shipments have gotten stuck in customs for months. Licenses to import medicine expire every three months, and renewing those licenses can take six months.

“Many businesses reported difficult and slow customs clearance processes, resulting in long waits for imported products to become available,” said the U.S. State Department in a 2024 report. And customs clearance is only the first challenge. “The proliferation of gangs in the metropolitan area of Port-au-Prince and persistent roadblocks put in place by the gangs along the main north and south access routes to the capital create major challenges for goods to freely circulate in the country.”

The post Amid Haiti Turmoil, Direct Relief and Partners Test New Pathways for Insulin Donations appeared first on Direct Relief.

Direct Relief initially developed its emergency medical backpack program in 2009 to equip volunteer Medical Reserve Corps members in California with a standardized set of supplies. Each ruggedized pack contains medicine, supplies, and equipment to meet a variety of disaster-related medical issues, including infection control, diagnostics, trauma care, and personal protection.

Fifteen years later, and with continuous financial and logistical support from FedEx, 13,000 of the packs have helped people in more than 61 countries and 50 U.S. states and territories. The packs are among Direct Relief’s most requested products by health providers around the world.

The packs were carried by first responders after last year’s Maui wildfire, delivered to rescue workers in Turkey and Syria after the 2023 earthquake, and deployed widely to medics caring for people injured in the war in Ukraine. They helped care for people injured in Haiti by 2010’s earthquake and in Mexico by 2023’s Hurricane Otis, and for those displaced by the wildfires sweeping Western forests year after year.

Despite the name, they aren’t only useful for emergencies. The backpacks have equipped primary caregivers in settings as broad-reaching as street medicine care in Santa Barbara and mobile clinic outposts in rural Puerto Rico.

“Backpack-Based Medicine”

Each week, teams of volunteers equipped with Direct Relief’s backpacks walk Santa Barbara’s streets, cleaning and treating wounds, offering antibiotics, and treating skin and foot problems for people living on the street. Santa Barbara Street Medicine provided free medical care to nearly 9,000 people last year. The group runs 16 outreach missions a week, two of them at night.

“We are backpack-based medicine,” says the organization’s co-founder and executive director Marguerite (Maggie) Sanchez. “We do not operate in a building at all, everything we do is out of the backpack. It’s basically our most important tool besides our volunteers.”

FedEx, whose collaboration with Direct Relief began more than two decades ago, was the original sponsor of the backpacks initiative in 2009 and has helped fund the program ever since as it has grown substantially. The packs are just one part of the generous support FedEx provides to help Direct Relief fulfill its mission. FedEx delivers all donated medicines sent by Direct Relief to Federally Qualified Health Centers, which are the central strands of the U.S. healthcare safety net. FedEx has also airlifted huge quantities of medicine and supplies into disaster areas around the globe.

“FedEx has been the catalyst behind so many of our emergency preparedness efforts, both in the U.S. and around the world,” said Thomas Tighe, Direct Relief’s President and CEO. “The backpack they initially invested in, specifically for California’s medical volunteers, has now become the most requested item for disasters globally.”

“We’ve formed a powerful collaboration that delivers critical aid exactly where and when it’s needed most,” said April Britt, Director, of FedEx Global Citizenship. “The long-term collaboration between Direct Relief and FedEx is forged in the shared desire to help communities struck by disaster.”

Most recently, emergency medical backpacks were dispatched to the Caribbean to support first responders in Grenada and Jamaica after Hurricane Beryl. Many more will likely be requested this year during what are shaping up to be especially active hurricane and wildfire seasons.

Validated to Meet the Highest Standards

The Medical Reserve Corps (MRC) originated as a national program to improve community preparedness in the wake of the terrorist attacks of Sep. 11, 2001. County-level MRC units are made up of local volunteer medical and health professionals who may include physicians, nurses, veterinarians, dentists, social workers, pharmacists, chaplains, paramedics, emergency medical technicians (EMTs), health educators, and others.

MRC volunteers are responsible for equipping themselves. “We thought, they’re volunteers, they shouldn’t have to purchase their own supplies, let’s see what we can do,” recounts Heather Bennett, Direct Relief’s Chief of Staff. The organization in 2009 initially donated 100 backpacks to Santa Barbara County’s MRC, and the program grew from there.

“Then we realized that this type of backpack is useful for more than just MRC volunteers, so we started deploying them after disasters to people who were doing the immediate search and rescue, and to doctors and providers that were treating patients in evacuation centers,” Bennett says.

The State of California’s Emergency Medical Services Authority has formally adopted the packs as standard equipment. In 2012, the Office of the U.S. Surgeon General recognized Direct Relief and FedEx with its National Partnership Award.

The post Direct Relief, FedEx Mark 15 Years of Supplying Emergency Medical Backpacks for Global Disasters and Health Crises appeared first on Direct Relief.

Though born in Dominica, Johnrose-Brown was working in Florida as a family medicine physician when the Category 5 storm struck her native island on September 17, 2017, with winds over 170 mph. The storm dumped up to 23 inches of rain, triggering flash floods, landslides, and a meter-high storm surge along the coast. At least 30 people were killed and 34 more were reported missing.

Johnrose-Brown and two other Dominica natives – Shanita Scotland, a pediatric ER and ICU nurse in New York, and Corinne Francis, a Texas healthcare executive – felt called to help their homeland. Francis secured a donation of medicines and medical supplies, and Johnrose-Brown and Scotland headed to the battered island with 30 other medical professionals of Caribbean origin.

Even getting to Dominica was a challenge. With the island’s airport shut down by the storm, Scotland flew to the island of St. Lucia, chartered a historic pirate ship (by then retired from plundering and used for party cruises) and then steamed for 4.5 hours to Dominica. Johnrose-Brown flew via Antigua and then traveled two hours by boat.

“We found a lot of patients who had asthma who needed treatment, diabetes, uncontrolled hypertension, wounds, and abscesses hadn’t been taken care of,” Johnrose-Brown recounts. “The health centers were also devasted, they had no electricity, they were out of vaccines.” The team provided care for more than 800 patients on their first mission. A second mission from late October to November cared for over 400 patients.

After their return to the United States, Johnrose-Brown, Scotland, and Francis formed a non-profit organization called Medical Professionals on a Mission (MPOM) to respond to medical needs of Caribbean islands after disasters. The organization, which Scotland chairs, secures medical supplies and equipment and provides training.

MPOM sent a mission to the Bahamas after 2019’s Category 5 Hurricane Dorian became the strongest hurricane to strike the Northwest Bahamas in recorded history. With funding from Direct Relief, it secured a fully equipped simulation lab for the Dominica State College School of Nursing and equipped a health center serving Dominica’s indigenous Kalinago people with exam tables, a birthing bed, EKG machine, oxygen tanks, a medical refrigerator, and surgical supplies. It also helps critical patients seeking locally unavailable medical treatment with costs and logistics of seeking treatment in another country.

Direct Relief Backs Caribbean Rapid Response Team

With 2024’s Atlantic hurricane season shaping up to be as active as early forecasts had predicted, MPOM is using a $275,000 grant from Direct Relief to organize and equip a rapid-response team of Caribbean expatriate medical professionals working in the United States, Canada and the United Kingdom, all ready to quickly deploy to the Caribbean islands to help residents recover from hurricanes. The grant will be used in part to create the communications systems needed to coordinate a roster of volunteers who deploy to a stricken country, and real-time monitoring systems to track the availability and deployment of medical resources.

The grant will also fund training for MPOM responders and equip them with a broad range of equipment and medical supplies for emergency deployments. It also includes funding to cover travel costs for two response missions. MPOM secures emergency approval from local medical licensing bodies for its volunteers.

Direct Relief’s funding will help “to ensure we are a self-sufficient, fully equipped medical mission team ready to deploy to Caribbean islands post disaster,” Scotland says.

The volunteers lined up by MPOM include physicians and nurse with specialties in emergency medicine, internal medicine, surgery, pediatrics, pathology, oncology, social work and psychiatry, as well as firefighters and police officers.

Relieving Local Health Workers

Medical volunteers who respond to calls for help from the Caribbean islands after a major hurricane aren’t just helping local patients. Their presence can be a salve for local healthcare providers, who may be overwhelmed by parallel crises: not only the long days of treating injured residents, but also the disruption of their own families’ lives and sometimes the loss of their own homes.

More than half of Dominica’s health facilities sustained moderate to severe damage from Hurricane Maria, “exacerbated by the disruption of access to electricity, water and waste management,” says a post-disaster needs assessment by the Government of Dominica. “All health workers were personally impacted.”

“We go into the hospitals to help with burnout, to give support to the medical professionals within those hospitals,” Scotland says.

Scotland adds that medical professionals don’t need to be of Caribbean origin to join the group. “We encourage all medical professionals to sign up,” she says.

MPOM is planning up to three deployments of healthcare workers this year. It is also able to provide other types of aid if the storm season warrants it and requests are received.

In response to Hurricane Beryl earlier this month, the organization shared emergency medical backpacks that had been donated by Direct Relief. As of July 15, it had not received a request from the affected islands to send personnel but was standing by.

Building the Caribbean’s Medical Resilience

For Direct Relief, it is part of a larger effort to help Caribbean island nations increase their resilience to hurricanes, backed by $12.6 million in grant funding committed since 2023. From that total, Direct Relief has allocated $3 million for health infrastructure including resilient power, cold-chain infrastructure for refrigerated medicine, medical oxygen, and mobile healthcare services, and $3 million to build a large solar and battery backup system in Jamaica for a central pharmaceutical warehouse, preventing refrigerated medicine from being spoiled during extended power outages

“Mitigating the increasing threats posed by hurricanes and other climate-related disasters is a top priority across the Caribbean,” said Dan Hovey, Direct Relief’s Senior Director of Emergency Response. “Led by members of the Caribbean diaspora, MPOM’s medical response team members have the local context and understand the needs on the ground in a post-disaster situation. In addition to providing healthcare services to impacted communities, the MPOM team will reduce burnout of local health staff, strengthening their capacity to respond and supporting the long-term recovery efforts.”

The post Caribbean Rapid Response Medical Team Prepares for Hurricane appeared first on Direct Relief.

Bracing for an Extremely Active Hurricane Season

The NOAA National Weather Service forecasts an above-normal season with 17 to 25 named storms, including eight to 13 hurricanes, four to seven of them “major hurricanes” (category 3, 4 or 5, with winds of 111 mph or higher). Recent weeks have also seen a surge of highly destructive tornadoes.

“Direct Relief is making long-term health infrastructure investments to mitigate the destructive impacts of climate disasters in hurricane-prone regions, and to strengthen the local capacity to respond and provide care,” said Dan Hovey, Direct Relief’s Senior Director for Emergency Response. “At the same time, we continue to equip healthcare providers through our extensive prepositioning of the medicines and medical supplies most commonly needed in the aftermath of a hurricane.”

Ready When Hurricanes Strike

When Hurricane Fiona dropped up to 30 inches of rain on parts of Puerto Rico in September 2022, it left most of the island without power and caused at least 21 deaths. The airport was shut down, but Direct Relief was prepared with 28 tons of prepositioned medicine and emergency response supplies in its Puerto Rico warehouse. The organization immediately distributed 25 emergency shipments across the island, including 126 fully equipped medical backpacks to first responders, and provided nine power generators to patients relying on life-sustaining medical equipment.

This year, Direct Relief is again prepositioning medical caches (Hurricane Prep Packs) throughout hurricane-prone regions to ensure aid is ready when disaster strikes. Supplies are being prepositioned across the Caribbean, including in Cuba, Barbados, Dominica, Dominican Republic, Haiti, Panama, and St. Lucia. Direct Relief is staging most of these HPPs with its multilateral partners in the region, the WHO’s Pan American Health Organization and the Organisation of Eastern Caribbean States. Additional large caches are ready for deployment from facilities in Puerto Rico and California. These international HPPs weigh 1,470 lbs. and are designed to provide enough medical supplies to care for 1,000 people for 30 days.

In the U.S., Direct Relief is prepositioning 68 Hurricane Prep Packs in states along the Gulf and Atlantic coasts, and in Hawaii, Puerto Rico, and Saipan. Each U.S. version of the pack contains 220 types of medicine and medical supplies, designed to support care for 100 people for 72 hours.

Preparing to Care for Disaster Evacuees

In northwest Louisiana, emergency response and public health partners are relying on a Direct Relief Hurricane Prep Pack to meet medical needs for a 2,400-bed emergency shelter in a vacant Sam’s Club warehouse in Shreveport. When activated, the shelter receives people arriving from across Louisiana and nearby states fleeing hurricanes and severe weather events. Based on the NOAA forecast, shelter operators anticipate needing to activate it twice this hurricane season.

As a member of the Louisiana Emergency Response Network, MLK Health & Pharmacy is prepared to care for people arriving at the Shreveport shelter, deploying its staff and the Hurricane Prep Pack it gets each year from Direct Relief. MLK Health, the only free clinic and charitable pharmacy in northern Louisiana, is also receiving two donated pharmaceutical-grade refrigerators from Direct Relief, one for the shelter and one to replace an aging refrigerator in its facility. MLK serves 1,800 patients who lack health insurance and suffer from chronic conditions like diabetes, hypertension, asthma, COPD, high cholesterol, and other diseases requiring regular medication.

“This partnership around emergency preparedness is a game changer for us in Louisiana, benefitting us at the state level and also at the local level,” said MLK Health Executive Director Jordan Ring Scroggs. “When you get that call in the middle of the night that the busses are coming, and you don’t know how many people are arriving or what condition they’re going to be in, it makes a big difference in response time to be able to immediately transport the packs to the shelter because they are already on-hand, thanks to Direct Relief’s strategic thinking.”

They also benefit from Direct Relief’s close partnership. “As soon as something hits, they’re on the phone with us, asking ‘What else do you need? How else can we be of service?’ It really makes a difference when you have partners that are as engaged as Direct Relief,” Scroggs said.

In years when no hurricane requires the caches to be opened, healthcare providers like MLK Health can integrate the items in the Hurricane Prep Packs into their regular inventory at the end of the hurricane season.

Bolstering Regional Emergency Response Capacity

Last June, Direct Relief convened top health officials from 15 Caribbean nations to increase collaboration on disaster preparation and response. At the time, Direct Relief made a $10 million commitment to fund resilience in the Caribbean region.

From the $10 million commitment:

• $3 million has been allocated to build a large solar and battery backup system in Jamaica for a central pharmaceutical warehouse, preventing refrigerated medicine from being spoiled during extended power outages.

• Amid the civil unrest in Haiti, $1 million has been donated to help nine health facilities with ongoing operational costs, including safe transportation for medical staff.

• $1 million each has been allocated to bolster disaster prep and response efforts in Puerto Rico and the Dominican Republic.
• $3 million has been allocated for health infrastructure projects in Caribbean nations. Projects include resilient power, cold-chain infrastructure for refrigerated medicine, medical oxygen, and mobile healthcare services.

• Direct Relief is helping establish a new rapid medical response network for Caribbean nations comprised of volunteer U.S.-based doctors and nurses (many of them of Caribbean origin) who are ready to deploy when a hurricane overwhelms local health capacity.

Hurricane Prep Map

The post As 2024’s Heat-Fueled Hurricane Season Looms, Direct Relief Builds Resilience of Health Providers Across U.S. Coastal States and the Caribbean appeared first on Direct Relief.

“Every day, our medical facilities are subjected to targeted attacks by Russia,” said Viktor Liashko, Minister of Health of Ukraine. “Each such attack endangers the lives of patients. Ensuring uninterrupted medical care under any conditions and being prepared for different scenarios is our main task in the realities of war.”

Attacks on the power grid in the winter of 2022-23 destroyed 61% of Ukraine’s electricity generation capacity and left around 12 million people without power, according to the UNDP.

Without electrical power, hospitals can’t pump oxygen to keep patients breathing, warm newborn babies in incubators, diagnose injuries with X-rays, or track patient care through electronic medical records.

“We are working to ensure that hospitals are equipped with everything they need and can continue to operate in the event of emergency power outages or complete blackouts,” Liashko said. “In particular, Ukrainian medical institutions are now provided with more than 10,000 generators for uninterrupted power supply. They have also begun to equip medical facilities with alternative and environmentally friendly sources of electricity, including solar panels. The initial 300 [electricity] storage systems received from Direct Relief will strengthen medical institutions in 20 regions of Ukraine. I am grateful to our international partners for this assistance.”

The war has inflicted an estimated $7.5 billion of direct damage on the electrical power sector, and has cost the sector $32 billion in lost revenue, according to the World Bank’s newly published damage and needs assessment.

The World Bank estimates it will cost $40.4 billion to rebuild Ukraine’s power sector over 10 years, using “a build back better approach with policies that align its energy model with the EU energy policy and move toward a decarbonized economy.” Of the $40.4 billion, $1.75 billion has been received.

“Ukraine has been using the [battery storage systems] since the first months of the full-scale war,” said Mykhailo Fedorov, Deputy Prime Minister for Innovation, Education, Science and Technology Development at Ukraine’s Ministry of Digital Transformation. “The systems provide backup power to hospitals, schools, emergency services and other critical infrastructure facilities. Thanks to our cooperation with Direct Relief, this year Ukraine will receive 2,000 devices as part of the Power for Health project. We continue to work on technological solutions for our country.”

Kharkiv, Ukraine’s second-largest city, was hit hard and relentlessly by artillery and air strikes in the opening stages of the full-scale war that began on February 24, 2022, and attacks have continued periodically over the past two years. The Kharkiv Regional Hospital serves the whole of the heavily war-damaged northeastern Kharkiv region, including its large population of internally displaced persons.

“But we never stopped working,” said Kostiantyn Loboiko, acting director of the hospital, which has 830 beds (including 130 in the maternity ward) and a staff of 2,000, including 550 doctors. “We also had births in the cellar, where we had some basic equipment.”

The greatest damage to the hospital to date occurred during three waves of missile strikes on the city on Dec. 29, which killed three people and injured 13. Around 90 of the hospital’s windows were blown out by a nearby impact, but only one person was injured at the site. “It was a miracle,” said Loboiko. 

The hospital has been developing its capacity to function autonomously since Russia first seized Crimea and supported a separatist rebellion in eastern Ukraine in 2014. This meant equipping the hospital with generators and its own well to ensure a water supply.

Now it is further building its resilience by adding batteries for storing electricity, purchased and donated by the Polish Government and Direct Relief, in coordination with Kharkiv-based Charity Fund Yevhen Pyvovarov. The hospital also plans to install solar panels to ensure the units work more efficiently in all seasons.

So far, eight units have been delivered to the Kharkiv hospital, with another two to four units to be added. The hospital has allocated four of those units to essential units like the emergency department, including surgery, traumatological and maternity units, and the cardiological center.

“If the Russians want to harm us, there will be a moment when the light flickers” as the batteries cut in, “and then work will continue,” said Loboiko.

In the town of Derhachi, five miles northwest of Kharkiv, two energy storage systems donated by the Polish government were installed last November at the local 100-bed hospital. These will give a further layer of energy security to the hospital, which like the Kharkiv Regional Hospital also uses generators in emergencies. “Now we can be sure that all operations will go ahead and that no patients are lost because of power outages,” said head surgeon Oleg Donchak.

Direct Relief’s battery donations to Ukraine fall at the intersection of two important programs. Direct Relief’s Power for Health initiative seeks to bring clean, renewable backup power to health facilities to ensure they can deliver critical healthcare services during power outages. The initiative has provided energy solutions for 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, benefiting 1.3 million low-income patients. These projects have created an estimated $4.3 million in annual cost savings for the participating health facilities. Direct Relief has sponsored more than 100 power resiliency projects in 10 countries.

The donations are also part of Direct Relief’s extensive humanitarian medical aid program to the people of Ukraine since the start of the war in February 2022, the largest aid response in the organization’s 75-year history. Direct Relief has donated and delivered more than 1,900 tons of medical aid, with a wholesale value of $1.1 billion, to support the efforts of health workers and community organizations. The organization has also provided more than $42 million in financial assistance to groups offering essential health services, including rehabilitation services for war-injured people, psychosocial and mental health services, support of emergency, specialized, and primary care, and support for making health care mobile as people continue to move throughout the country.

“This expansive philanthropic support from Direct Relief has been possible only because of the generous contributions from of thousands of individuals, businesses, and organizations concerned about the welfare of Ukrainian people and wishing to support humanitarian health efforts,” said Direct Relief President and CEO Thomas Tighe. “We are committed to continuing our support as expansively as we can and as resources permit.”

Ukraine and its partners have worked since the start of the war to make the country’s energy system more resilient.

“Over the spring and summer, power utilities – aided by significant grants, loans and investment from a wide range of governments, multilateral donors and the private sector – undertook the biggest energy infrastructure repair and maintenance campaign in the country’s history,” according to a January report published by the International Energy Agency. “The Ukrainian government also strengthened its air defence systems and invested in passive defence measures such as engineering fortifications to further protect energy infrastructure.”

Still, attacks on the electricity grid continue. “Tens of thousands of people were without power after a barrage of two dozen Russian drones damaged energy infrastructure in the centre of the country,” AFP reported on Feb. 2. At least 79 missiles and drones have hit residential areas of Kharkiv since Dec. 29.

The post Direct Relief Donates More Than 2,000 Battery Systems to Ukrainian Hospitals Amid Energy Grid Attacks appeared first on Direct Relief.

Direct Relief currently has two ocean containers heading to the Red Sea – one en route to Yemen’s capital Aden carrying a broad range of hospital supplies, and another headed for Port Sudan on the Red Sea’s western shore, packed with insulin and other supplies for children with diabetes.

“We need to figure out a way to get into these dangerous places, otherwise we wouldn’t be doing our job,” said Gordon Willcock, Direct Relief’s deputy director of emergency response. “There’s a correlation between the needs and the level of insecurity, and in most cases that means logistics are challenging.”

“We work with people who know their territories and know their jobs, and we take their advice and make informed decisions,” Willcock said. “We’re not going to be foolhardy or cavalier, we have a responsibility to our donors and to ensure the security of the supply chain.”

While shipping continues through the Red Sea, options have diminished and costs have risen sharply as insurers demand steep premiums for covering ships that pass near Yemen. The original cost of shipping the Yemen-bound container from California’s Port of Long Beach to Aden was just over $6,200, but a $3,000 “Red Sea Charge” was later added, raising costs by nearly 50%. For Sudan-bound containers, carriers have imposed a $1,500 “contingency surcharge” to cover the increased security risk.

Although attacks by Yemen’s Houthi rebel group have been disrupting Red Sea shipping since November, the situation has recently deteriorated. On Jan. 26, Maersk, the world’s largest container ship operator, notified customers that it was suspending shipping through the Red Sea, citing new intelligence information about heightened security risk. Maersk is rerouting ships around South Africa rather than using the Suez Canal shortcut connecting the Red Sea with the Mediterranean.

Shipping from Europe to Port Sudan by going around Africa rather than through the Suez Canal into the Red Sea adds 10-14 days to the journey, driving up costs and reducing global shipping capacity.

“The situation currently remains untenable, and we encourage customers to prepare for complications in the area to persist and for there to be significant disruption to the global network,” Maersk said.

“It’s one less carrier we can get quotes from if we need the shipment to move through the Red Sea/Gulf of Aden for a shorter transit time,” said Alisa Harnish, associate director of transportation at Direct Relief.

Direct Relief works with logistics firms like Scan Global Logistics to manage the shipping process, including finding vessels to deliver the cargo. The firm continues booking transit through the Red Sea, but many ship owners refuse to pass that way.

While ships transiting the Red Sea and the broader region around the Horn of Africa have long been vulnerable to piracy, the largest container vessels “have traditionally been difficult to attack due to the primitive boats being used historically,” said Anders Thorsen, director of Aid, Relief & Government Services for North America at Scan Global. “Of course, the attacks are different now and [it is] really difficult to defend against missile attacks. Due to this, we also see as lot of owners / masters refusing to pass through Suez due to the dangers involved.”

Yemen Aid

Yemen has long been considered one of the world’s worst humanitarian crises, suffering through nearly a decade of civil war, with almost half of its 35 million people having limited or uncertain access to food.

The shipment en route now to Yemen contains a broad range of medical supplies including prenatal vitamins, electrolytes for hydration, surgical drapes and masks, and concentrated surface disinfectant for hospitals, which will be delivered to medical teams in Yemen operated by the NGO MedGlobal.

Last year, Direct Relief delivered donated medicine to Yemen with a wholesale value of $4.7 million, including cardiovascular and gastrointestinal drugs, hormones, wound care products, central nervous system agents, anti-infective agents, vitamins and more. Direct Relief works in the country with Yemen Aid, a Yemeni-American development organization. The supplies were successfully delivered to Yemen Aid and subsequently distributed in coordination with the Ministry of Public Health and Population to public health facilities across the country to meet specifically identified needs.

Sudan Insulin Supply Chain Remains Open, But In-Country Situation is Challenging

The Red Sea turmoil has also raised costs for a crucial program on the western shore of the Red Sea: providing donated insulin for Sudanese children with type 1 diabetes, in partnership with Life for a Child.

When civil war erupted in Sudan last April, it cut off imports of the insulin that 11,000 Sudanese children with diabetes depend on to stay alive, said Dr. Salwa Musa, a pediatric endocrinologist with the Sudanese Childhood Diabetes Association (SCDA), which provides donated insulin and related supplies at pediatric diabetes clinics all over the country.

Until April, all of Direct Relief’s diabetes donations were flown into Khartoum International Airport. On April 15, the Rapid Support Forces militia seized control of the airport, which still remains out of operation. The RSF also looted the SCDA’s insulin storage facility in Khartoum, destroying a two-year supply.

No new insulin arrived in Sudan until October, when a shipment arranged by Direct Relief arrived via a new route – by ocean into Port Sudan.

“Not a lot of freight forwarders were willing to have their craft dock at Port Sudan,” said Kelsey Grodzovsky, who leads Direct Relief’s diabetes programs. “There were a lot of issues getting anyone to transport the supplies to the country. So instead of going big and sending a lot of supplies up front, we did more of a test shipment. Since it proved effective, we’re widening the supply chain, continuing to ship aid in larger volumes.”

After the successful delivery in October, several others were dispatched. A container of blood glucose meters, test strips and pen needles arrived in Port Sudan on Jan. 31, and a large shipment of insulin and insulin delivery devices is scheduled to arrive in Port Sudan by late March.

More containers are being prepared, but Direct Relief is shipping material to Sudan in smaller quantities than would be ideal to reduce risk as the country’s civil war continues. In December, the RSA militia seized control of Sudan’s second-largest city, Wad Medani, putting about 1,000 of SCDA’s childhood diabetes patients out of reach. “The Sudanese civil war is brutal, devastating and shows no sign of coming to an end,” said a February overview published by Chatham House.

“The security situation is extremely challenging,” Grodzovsky said. “We’re not bulk shipping the insulin because of the security situation, so that if something happens, we’re not losing a whole annual supply.”

The post Direct Relief Navigates Medical Aid to Yemen and Sudan Through Red Sea Shipping Attacks and Sudan’s Civil War appeared first on Direct Relief.

Direct Relief’s medicine and supplies reach individuals in medically underserved communities across the United States primarily through thousands of non-profit, local health clinics. These clinics form the key strands of the nation’s healthcare safety net.

The donations include more than $1 billion in medicine and supplies donated to community health centers (Federally Qualified Health Centers or FQHCs) providing primary care to 31.5 million – one in 11 – Americans in medically underserved communities. Direct Relief partners with more than 1,000 of these FQHCs, with an average partnership length of nine years.

The donations also include more than $1 billion in medical aid to free and charitable clinics and pharmacies, which are often volunteer-driven and offer care to people with few other options. These clinics served 1.7 million patients in the United States in 2022, 93% of them without any form of public or private health insurance.

“Direct Relief is a huge part of how we provide medication access to our patients, particularly insulin,” said Megan Doerr, Vice President, Strategy & Operations at CommunityHealth, a free clinic in Chicago. “Medication access and adherence is crucial to overall health, and being able to offer patients medications for free is invaluable. It seems almost too good to be true for individuals that hear about our services that they’re going to be able to manage their chronic diseases free of charge and not have to choose between filling their medications and paying rent or getting food.”

Direct Relief’s extensive U.S. medical aid program incorporates individual initiatives, including resilient power for health clinics, high-volume donations of insulin and the opioid overdose-reversing drug naloxone, women’s health programs like the provision of IUDs for uninsured patients at no cost, funding of mobile healthcare clinics to reach people without local transportation, and much more.

The domestic program includes continuing support during normal times and rapid response to natural disasters. Direct Relief has invested heavily in building capacity to provide medical aid to communities hit by hurricanes and wildfires, as well as public health crises such as the Covid-19 pandemic and the opioid overdose epidemic.

In addition to the more than $2 billion in donated medicine and medical supplies, Direct Relief has made $186 million in cash grants since 2004 to nonprofit healthcare providers. The grants support projects for disaster preparedness, health equity initiatives, and resilient power, and include donor-funded awards for community health innovations.

Direct Relief has reached this milestone as more Americans than ever rely on these safety net providers, with the FQHC patient population growing 30% between 2015 and 2022. Yet funding is volatile, with government shutdown threats this fall making it harder for FQHCs to commit to making hires amid a nationwide shortage of clinical staff.

In 2022 FQHCs received 43% of their revenue from Medicaid, the jointly funded state and federal healthcare program for people with limited financial resources. But more than 10.6 million people have been disenrolled from Medicaid this year through Nov. 14 as pandemic-era funding dried up.

Amy Simmons Farber, associate vice president at the National Association of Community Health Centers (NACHC), recalls Direct Relief’s role in helping health centers remain in operation at the start of the Covid-19 pandemic. “The early days of the pandemic were an extraordinary time in which community health centers mobilized and in a matter of days transformed their clinical practice. With a scarcity of resources, health centers launched testing sites, converted their facilities, transitioned to virtual visits, and diverted nonacute Covid cases from overwhelmed hospitals. Direct Relief came through with a critically needed solution, donating PPE and medicines and dollars, and that was amazingly helpful to these health centers in keeping their doors open.”

“Direct Relief is a true champion and friend of free and charitable clinics,” said Nicole Lamoureux, President & CEO of the National Association of Free & Charitable Clinics (NAFC). “We often say free and charitable clinics feel like the healthcare world’s best-kept secret, but Direct Relief’s consistent commitment and support make us feel seen, known, and appreciated. We would not be able to support our members like we do without Direct Relief.”

Ongoing Programs

Among the many ongoing U.S. programs are:

• ReplenishRx, a streamlined option for pharmaceutical companies to donate their products, via safety net clinics, to people without health insurance or other means to pay for them. The program reduces administrative burdens and the risk of patients losing access.

• Donor-funded innovation awards provide flexible funding to safety net providers for new and expanded programs that best meet community needs. In all, $18 million has been awarded to health centers, free and charitable clinics, and women’s health centers through support from AmerisourceBergen, Baxter, Bayer, BD, Eli Lilly, Pfizer and Teva.

• Direct Relief’s Fund for Health Equity, which provides flexible philanthropic funds that enable health centers to focus on high-value efforts that are not easily funded from existing revenue streams. The Fund has awarded $43.7 million in grants.

• Power for Health – Without power, critical health services can’t be provided – lifesaving medicines go bad, electronic health records can’t be accessed, essential medical equipment can’t be powered, and vital community health facilities serving the most vulnerable shut down. This initiative brings clean, renewable backup power to community health centers and free clinics to ensure they can deliver critical healthcare services during power outages.

AccessHealth, an FQHC serving two counties west of Houston, uses a mobile clinic the size of a large bus to bring care to its patients. With the mobile clinic, donated by Direct Relief, AccessHealth holds back-to-school health fairs each August serving about 2,000 families, providing the immunizations their children need to attend school, along with health screenings, eye exams and dental screenings.

About half the patients it serves lack any form of health insurance. In 2023 through November, Texas kicked 1.4 million people – 64% of all enrollees – off its Medicaid program, the highest number and largest proportion of any state, according to KFF.

“The funding Direct Relief has given us for the mobile health unit allows us to work in rural communities, both on the medical and dental side,” said Mike Dotson, CEO of AccessHealth. “The need for transportation highly affects the folks that we see, so being able to use that resource is a big win for us, and it helps our patients in a really, really positive way.”

Disaster Response

In addition to its decades-long work internationally, Direct Relief has responded to dozens of major natural disasters in the U.S. since ramping up its domestic programs nearly 20 years ago.

Climate change is driving more frequent and far more destructive hurricanes and wildfires, uprooting people from their homes and cutting them off from their healthcare providers and medicine supplies. Research has shown that in disasters like 2017’s Hurricane Maria, which devastated Puerto Rico, more people have died from interrupted access to healthcare than from physical injury. People living with medication-dependent chronic conditions like type 1 diabetes and hypertensive diseases are at particular risk.

Drawing on its long experience responding to natural disasters, Direct Relief assembles, stocks and prepositions caches of the medicines and medical supplies most commonly needed by people in the wake of a disaster, including trauma supplies, antibiotics and wound care supplies, as well as medications for diabetes, hypertension, and respiratory, psychological and gastrointestinal ailments.

Direct Relief provides the supplies both in Emergency Medical Backpacks, which can be quickly flown to disaster scenes and given to medical responders, and in Hurricane Prep Packs (HPPs), which are large caches prepositioned in hurricane-prone areas. Packed into each HPP are 220 types of medicine and medical supplies designed to provide enough medical supplies to care for 100 people for 72 hours. Ahead of the 2023 hurricane season, Direct Relief pre-positioned emergency medical supplies in every southeastern and Gulf Coast U.S. state from Virginia to Texas, as well as throughout the Caribbean and Central America.

As with its ongoing domestic programs, Direct Relief’s U.S. disaster response is delivered primarily through its health center and free clinic partners. Health center and clinic patients tend to be more medically vulnerable due to factors such as longstanding societal barriers, lower incomes, and less wealth, and these factors magnify the impact of emergencies. The health centers’ and clinics’ deep experience and earned trust within communities and among their patients, and their keen familiarity with the particular health risks that existed prior to an emergency, are essential to engage and support when an emergency occurs.

A Domestic Program Born in Crisis Response

From its founding in 1948 until the mid-2000s, Direct Relief worked almost exclusively outside the United States. In 2005, Hurricane Katrina destroyed much of New Orleans, displacing 1 million people and cutting them off from essential medicine supplies. This was a turning point for Direct Relief, spurring the organization to obtain pharmaceutical distribution licenses nationwide. In 2009 it became the first charity with licenses to distribute pharmaceuticals in all 50 states. Today, the vast majority of Direct Relief’s support for community health is provided for ongoing needs that aren’t tied to specific disasters.

The post Direct Relief’s Medical Donations for U.S. Health Safety Net Surpass $2 Billion appeared first on Direct Relief.

This recognition marks Direct Relief’s 13th consecutive four-star rating and the first time it has been evaluated in Charity Navigator’s Impact & Results beacon, where its 100% rating contributed to an overall perfect score across the key nonprofit performance indicators Charity Navigator assesses.

Charity Navigator introduced the Impact & Results beacon to gauge the “actual impact a charity has on the lives of those it serves and determine whether it is making good use of donor resources to achieve that impact.”

At the date of publication, only 2,202 or 1% of the 209,155 charities scored by Charity Navigator have earned an Impact & Results rating.

Direct Relief also earned a 100% score in Charity Navigator’s newly updated Accountability & Finance beacon, which assesses “a charity’s financial health (financial efficiency, sustainability, and trustworthiness) and its commitment to governance practices and policies.”

“We are delighted to provide Direct Relief with third-party accreditation that validates their operational excellence,” said Michael Thatcher, President and CEO of Charity Navigator. “The Four-Star Rating is the highest possible rating an organization can achieve. We are eager to see the good work that Direct Relief is able to accomplish in the years ahead.”

Reflecting Direct Relief’s key role in delivering humanitarian medical aid in response to disasters, Charity Navigator in 2023 named Direct Relief to its list of the best Humanitarian Relief Charities and among the charities it recommended donating to after disasters, including the Maui Wildfire, Flooding in Libya, Hurricane Idalia, Tropical Storm Hilary, and the earthquakes in Morocco, Turkey and Syria.

In addition to its responses to the specific disasters noted above, Direct Relief in 2023 has:

• Delivered 458 million defined daily doses of medicine to more than 2,300 healthcare facilities in 87 countries, including all 50 U.S. states.
• Donated insulin to 40,332 children with Type 1 diabetes in 32 countries.
• Provided more than 460,000 doses of lifesaving naloxone to health centers, free clinics, community organizations and harm reduction groups.
• Delivered critical rare disease therapies to treat more than 600 patients in 17 countries.
• Launched projects to provide resilient energy solutions to 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, projected to yield an estimated $4.3 million in cost savings annually.

Operational Efficiency & Transparency

Direct Relief, which is funded entirely by private charitable contributions and does not accept government support, prioritizes operational efficiency through strategic partnerships with businesses and organizations. The vast majority of the donations it receives and distributes consist of in-kind donations of medicine and medical supplies. These contributions, valued at their wholesale cost, comprise the predominant share of the organization’s annual revenue, with approximately 99.5 cents out of every donated dollar going to program expenses, 0.3 cents to administration and 0.1 cents to fundraising expenses.

Direct Relief seeks to be efficient and frugal in all organizational activities, including fundraising activities.

While Direct Relief’s modest fundraising expenses average about 2 percent of its total cash revenue, its fundraising expenses are paid by the earnings from a generous bequest, meaning zero percent of donated funds support the organization’s fundraising activities.

The post Direct Relief Awarded Top 100% Rating by Charity Navigator for Nonprofit Impact, Efficiency and Transparency in 2023 appeared first on Direct Relief.

Before the crisis, Sri Lanka relied on imports for about 85% of its pharmaceutical needs and about 80% of its medical supplies. Sri Lanka imported $815 million in medicine in 2021, but by May of 2022 it had only about $25 million in foreign reserves to pay for imports, so the vast majority of medicines became scarce or completely unavailable.

With hospitals lacking anesthesia, most general surgeries in the country ceased. Life-extending kidney transplants were performed at a significantly lower rate, while cancer patients couldn’t get the chemotherapy agents to treat their deadly disease. Hospitals ran out of stents and guide wires for heart procedures, and common supplies like bandages and cotton balls became unobtainable.

Hundreds of widely used drugs become extremely scarce. For example, there was a severe shortage of the immunosuppressant drug cyclophosphamide, without which a transplanted kidney’s lifetime can be cut in half. Currently, there are shortages of intravenous basiliximab, intravenous methylprednisolone, antithymocyte globulin (equine), and dialysis filters.

Hence, it’s a dynamic situation, said Dr. Mathu Selvarajah, President of the Sri Lanka Society of Nephrology. “With a disease like lupus nephritis, if you don’t treat it aggressively, there is irreversible kidney damage. The sooner we treat it, the sooner you’ll stop the ongoing damage.”

For cardiac care, early in the crisis, the country ran out of the most effective thrombolytics, which dissolve blood clots, and “we had virtually no medicine to give for heart attacks,” said Dr. Chandrike Ponnamperuma, president of the Sri Lanka College of Cardiology. “There is a severe shortage of cath lab consumables like stents, guide wires, balloons, and catheters,” he said.

“Sri Lankan patients who are relying on free medicines through the government hospitals in many cases seem to not have most simple consumables items or the essential medicines in some of the peripheral hospitals in this dynamic situation Sri Lanka is in,” said Ayusha Amarakone, a Sri Lankan-American who is Executive Director of Medical Help International-USA, which works closely with Direct Relief to identify needs and direct donations.

Other Sri Lankan medical leaders Direct Relief has spoken with report shortages of widely needed medicines, including insulin and supplies, such as plasters and suture materials.

Sri Lanka has an especially high need for dialysis fluids due to a high prevalence of chronic kidney disease. One study among a rural population in Sri Lanka found that 58% of individuals with hypertension also had chronic kidney disease, a rate 1.6 and 3.4 times that found in Bangladesh and Pakistan, respectively.

Direct Relief has been the largest charitable donor of medicine and medical supplies in Sri Lanka since the financial crisis began, securing and delivering donations of insulin, oncology medicine, dialysis fluid, and much more. Between April 2022 and August 2023, Direct Relief shipped 41.5 million daily defined doses of medicine (weighing 221 tons) with a wholesale value of $126.9 million.

In its response, the organization has worked closely with Sri Lanka’s Ministry of Health, the Prime Minister’s Office, the Ministry of Foreign Affairs, the Medical Supplies Division, the National Medicines Regulatory Authority, the College of Endocrinologists, the Government Medical Officers’ Association, Sri Lanka’s Embassy in Washington and its Los Angeles Consulate.

“Direct Relief has been strategically positioned to respond to this crisis, largely due to the commitment from our pharmaceutical company partners willing to support the people of Sri Lanka,” said Chris Alleway, Direct Relief’s manager of emergency response & new initiatives. “Our goals are to maintain the close working relationships with the Ministry of Health, the Government Medical Officers Association, the College of Endocrinologists, and the individual health facilities that have helped us to continue the flow of aid. As Sri Lanka strives for stability, Direct Relief will remain a resource during this difficult time.”

“I would like to express appreciation on behalf of the Sri Lanka Medical Association to Direct Relief,” said Dr. Vinya Ariyaratne, President of the Sri Lanka Medical Association, in a recent meeting with Direct Relief.

While the International Monetary Fund in March approved $3 billion in loans to help restore financial stability, the funds are being released only slowly, starting with $333 million in March, and the medicine shortages are expected to persist. In June, the World Bank approved $700 million in budgetary and welfare support for Sri Lanka.

“Sri Lanka has been facing tremendous economic and social challenges with a severe recession amid high inflation, depleted reserves, an unsustainable public debt, and heightened financial sector vulnerabilities,” the IMF said upon approving its package in March. It recommended that “social safety nets should be strengthened and better targeted to the poor.”

In addition to shortages of medical supplies, Sri Lankans also are losing many experienced healthcare providers to emigration. “The migration of health care workers due to increased living expenses and having to struggle with basic commodities like fuel and electricity is another reason that causes a crisis in the health care system in the country these days,” said the Ministry of Health, Nutrition & Indigenous Medicine in a January report. “The huge demand created for healthcare professionals in other countries has encouraged healthcare worker migration even more.”

Sri Lanka’s economy continues to shrink while costs soar. Consumer prices are projected to rise 28% in 2023, after a 46% spike last year, while the economy is projected to contract 3% this year, after an 8.7% fall in GDP in 2022, according to the IMF. Sri Lanka’s poverty rate nearly doubled from 13% to 25% between 2021 and 2022 and is projected to increase by another 2.4 percentage points in 2023, the World Bank said in June.

Fuel shortages have also shaken the economy. By mid-2022, fishing boats lacked the fuel to go to sea, slashing the availability of seafood, a major protein source for Sri Lanka.

Overall, the food insecurity situation has improved. In March 2023, about 3.9 million people (17% of the population) were estimated to be “moderately acute” food insecure, down from 6.2 million in that condition in May 2022, according to a joint FAO/WFP Crop and Food Security Assessment Mission report published in May 2023. However, the same report forecasts a 14% drop in aggregate cereal production in 2023, “mainly affected by the inadequate availability of fertilizers” due to high prices and low supplies. Chicken meat and egg production, “vital for local protein intake, is forecast to drop substantially in 2023,” and fish production is also projected to decline.

“Sri Lanka’s journey to recovery has just started,” the Asian Development Bank said in an April announcement.

The financial crisis came after two crucial sectors of the country’s economy were disrupted. Spending by foreign international tourists – which brought in foreign currency and accounted for the equivalent of 24% of Sri Lanka’s total exports in 2019 – plunging 93% between 2019 and 2021 amid the Covid crisis, according to the World Travel & Tourism Council. Tourist arrivals in 2021 amid the Covid crisis were down 92% from their 2018 peak. Meanwhile, the country’s agricultural production dropped sharply when the government suddenly banned the use of agricultural chemicals in 2021, the World Food Programme noted in a 2022 report on food security in the country.

While donations of medicine are helping address current needs, longer-term reforms are needed to ensure adequate long-term medical supplies, according to a November editorial in the BMJ. “The government must support initiatives to increase local production of pharmaceuticals, improve national information systems to include real-time tracking of drug shortages, and establish mechanisms to stabilize power and fuel supply to essential healthcare facilities, including hospitals,” the editorial said. “Additionally, the government must make comprehensive, sustainable plans to request and use international development assistance for health, targeted towards restoring the supply of essential medicines, supporting healthcare workers, and improving delivery of services.”

The post Seventeen Months into Sri Lanka’s Financial Crisis, Crucial Medicines Remain in Short Supply appeared first on Direct Relief.

In response to the brutal fighting, continuing attacks on Ukraine’s civilians, destruction of the country’s electricity infrastructure, and infliction of widespread psychological trauma, Direct Relief has conducted its largest and most sustained humanitarian aid response in its 75-year history.

The $1 billion milestone reached this month includes more than 292 million daily defined doses of prescription medicine for all kinds of conditions, including diabetes, infections, seizures, cancer, hypertension, psychological conditions, transplants and more, reaching millions of Ukrainians.

As Direct Relief operates without government funding, the $1 billion in donations comes entirely from private sources. (The U.S. government has provided $3.9 billion in humanitarian assistance since the war’s start.)

In the city of Kremenchuk along the Dnieper River, the children’s hospital had received no new supplies from early February through April, when a large shipment of Direct Relief donations arrived, delivered by the Association Internationale de Coopération Médicale (AICM), Direct Relief’s core partner in the eastern Poltava region. The hospital was treating around 250 children, many of them suffering war wounds, when the supplies arrived.

The donations from Direct Relief “should sustain us for the next six months,” Deputy Director Iryna Roman told Direct Relief.

“It is hard to overestimate the impact of Direct Relief’s emergency response to the war in Ukraine,” said Nataliia Bohachenko, head of Ukrainian Soul, an Odesa-based NGO that is a partner of Direct Relief. “Continuous support, diversified grant programs and repeating shipments helped to fill gaps in the supply of Ukrainian hospitals and other healthcare facilities caused by war, thus helping and saving the lives of many Ukrainians who needed the help.”

For people with diabetes, Direct Relief has delivered 2.2 million bottles and vials of insulin, 3.7 million needles and syringes, and 4.1 million test strips. Direct Relief has been the largest humanitarian supplier of insulin to Ukraine since the war began.

The aid also has included large quantities of medical supplies ranging from battlefield tourniquets to diabetes test strips to prenatal vitamins.

The $1 billion total figure represents the wholesale value of the products delivered between Feb. 2022 and August 2023. Direct Relief has based the valuation on the wholesale costs of prescription medications in Europe, where prices for certain products are as much as 70% lower than comparable products sold in the United States

In addition to the $1 billion in donated medicine and supplies, Direct Relief has committed $35 million in grants in financial support to local healthcare organizations providing care in Ukraine and others in countries, including Poland and Slovakia, that have opened their doors to Ukrainian refugees.

That funding has covered medication costs for more than 266,000 Ukrainian refugees in Poland, provided mental health care for close to 25,000 Ukrainian refugees in Slovakia, and funded rehabilitation programs focused on working with amputees, occupational therapy, speech therapy, and psychosocial support. Direct Relief is also providing funding to support Ukraine’s national system for distributing medicine around the country to the people who need it.

“Direct Relief has reached this milestone through the generous support of people in 84 countries around the world, as well as from dozens of the world’s leading pharmaceutical makers,” said Thomas Tighe, Direct Relief’s President and CEO. “It reflects the breadth of support for the people of Ukraine and our ongoing commitment to help them through this terrible national ordeal.”

Support from Companies and Organizations

Seventy-nine pharmaceutical and medical supply companies and organizations donated their products to Direct Relief’s Ukraine response. Of the 292 million daily defined doses of medicine donated to Ukraine, about 163 million have been of generic drugs. The companies that provided donations include:

3M
Abbott
AbbVie
Accord Healthcare
Ajanta Pharma USA
Alvogen
AmerisourceBergen
Amgen
Apotex
AstraZeneca
Baxter Europe
Baxter International
Bayer AG
Bayer USA
BD
BD Europe
Belmora
Biogen
Boehringer Ingelheim
Cal OES
Carlsbad Technology
Coherus Biosciences
Covidien
CVS
DeVilbiss Healthcare GmBH
Dragerwerk AG
Drive Medical GmBH
Edenbridge Pharmaceuticals
Eli Lilly & Company
Encube Ethicals
Ethicon
Genentech
Gilead
Grifols US
Greenstone
Grifols Worldwide
GSK
GSMS Incorporated
Haleon
Henry Schein
Hikma Pharmaceuticals
ICU Health
ICU Medical
Inogen
Integra LifeSciences
Janssen Pharmaceuticals
Jazz Pharmaceuticals
J&J Consumer
Kate Farms
Kenvue
Kirk Humanitarian
LifeScan
Liquid IV
McKesson Medical-Surgical
Medline Industries
Medtronic
Merck & Co.
Merck KGaA
Meitheal Pharmaceuticals
MSD
Novo Nordisk A/S
Organon
Perrigo Pharmaceuticals
Pfizer
Purdue Pharma
Sanofi
Society of Critical Care Medicine
Takeda Pharmaceuticals USA
Mepha Schweiz
Teva Pharmaceuticals Europe
Teva Pharmaceuticals USA
Trifecta
Unilever
Unite to Light
Viatris Europe
Viatris USA
ViiV Healthcare
Westminster Pharmaceuticals
Zydus Pharmaceuticals

Support for Rehabilitation

Events of the past 18 months have made some of the long-term health consequences of the war very clear. People who have sustained disabling injuries will require lifetime care, including children who have lost limbs and will require new prosthetic devices as they grow up. Supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a core focus of Direct Relief. The organization has allocated $15 million to specifically support rehabilitation and injury recovery efforts in Ukraine, including support for the Unbroken National Rehabilitation Center in Lviv.

Helping Ukrainians Manage Psychological Trauma

A significant portion of the Ukrainian population has suffered from psychological trauma. Trauma-focused psychologists are providing care at the scene of Russian attacks, to help victims begin to process what they have experienced. Direct Relief has provided funding to organizations, including a $550,000 grant to Razom for Ukraine, a Ukrainian-American nonprofit that, with this funding, is providing mental health services to war-impacted individuals in Lviv and Ivano-Frankivsk, Ukraine.

A $320,000 grant has enabled HromadaHub, a Ukrainian nonprofit, to train Ukrainian psychologists to provide emergency psychological support. During five-day sessions, it has so far trained more than 300 participants on how to interact with people at the site of attacks, as well as those who have suffered trauma accumulated over longer periods.

“By organizing the training, we are not giving the fish but the fishing rod to the psychologists so they can start helping their communities,” Hromada Hub’s head Lily Bortych told Direct Relief. The goal is to build up the resilience and sustainability of the country’s psychological support system. “Ukraine doesn’t have to rely only on foreign specialists but can build up an army of trained emergency psychologists speaking the same language, living in the same area, and sharing the same problems with the people they help,” Bortych said.

“Miracles happen when you work with the right people,” Hromada Hub’s emergency psychology coordinator Melinda Endrefy told Direct Relief.

“There is a proverb in Ukrainian: ‘In grief and your hour of trouble, you will recognize a loyal person,’” said Marina Makarenko, head of Charitable Fund Modern Village and Town. “From the first day of the war, we have felt the support of a friend – Direct Relief. Thanks to this powerful financial support of our charitable projects and initiatives, ambulances, medicines, oxygen concentrators, and emergency medical aid backpacks, our NGO was able to withstand the first week of the war and continue to help thousands of Ukrainians.”

Medical Support for Ukraine

The post Direct Relief Delivers $1 Billion in Donated Medicine and Medical Supplies to Ukraine appeared first on Direct Relief.

The organization is currently distributing medicines and medical supplies to sites across the island, including shelters, mobile medical clinics, and first responders.

Direct Relief is immediately disbursing $200,000 into four $50,000 grants to help fund operations by local medical responders.

• Healthy Mothers, Healthy Babies Coalition of Hawai’i
• Malama I Ke Ola Health Center (Community Clinic of Maui)
• Maui Search and Rescue
• Hui No Ke Ola Pono (Native Hawai’ian Health Center)

In a Sunday staff meeting on the Maui response, Direct Relief President and CEO Thomas Tighe advised team members to expect the Maui crisis to follow a pattern familiar from similar disasters, including the 2018 Camp Fire that destroyed the town of Paradise, Calif.

Amid the initial chaos, Direct Relief is focused on getting immediate medical aid and targeted financial support into the hands of health care providers on the ground. Because these disasters have years-long impacts, “the rule we use is, who is going to be there in five years?” Direct Relief starts with its long-term local partners, many of them community health centers.

While federal and state aid is needed for clearing public areas and rebuilding infrastructure, it arrives slowly. Immediate needs are best met by fast-moving non-profits, Tighe said.

Immediate risks include chronic disease going unmanaged and turning into health crises, and loss of access to dialysis materials and insulin. In the longer term, experience shows that local health facilities can struggle to maintain services if many of their medical staff have been forced to relocate after losing their homes. Around 2,200 structures – approximately 86% of them residential – were destroyed or damaged in western Maui, Hawai’i Gov. Josh Green told CNN Saturday.

Direct Relief has been in contact with all 19 of its pre-existing healthcare partners across Hawai’i, has shared currently available inventory, and received their current assessments and perspectives.

The first three deliveries sent Wednesday were used immediately by medical personnel who deployed to shelters to provide services. These deliveries were in response to a request from the Healthy Mothers Healthy Babies Coalition of Hawai’i, which Direct Relief has been supporting through its Health Equity Fund.

The materials included a pre-packed wildfire kit and emergency medical packs (designed for paramedics and other health professionals to provide services in the field), requested over-the-counter pain relief and other basics, including hygiene items.

Direct Relief has been in close contact with individual clinics on Maui, Hawai’i state health and emergency response officials, with FEMA and other federal agencies, and with the professional associations that Direct Relief works with routinely, including the Society for Critical Care Medicine. Parallel efforts have been ongoing with healthcare company supporters and other corporate representatives who have sought information about how they might help.

Emergency Funding for Response Efforts

Direct Relief has also announced an initial cash commitment of $500,000 to aid affected communities and facilitate the timely and sustained delivery of urgently needed medical supplies to clinics, shelters, and state and local emergency response agencies with which it is working.

The wildfires in Lahaina – the deadliest disaster in Hawai’ian history – have resulted in the loss of over 2,000 structures and claimed the lives of more than 80 individuals. With thousands seeking refuge in shelters across Maui and Honolulu, Direct Relief is actively addressing the pressing medical needs of these evacuees and aiding search and rescue operations.

The organization’s initial deliveries of emergency medical essentials were deployed in shelters in Maui earlier this week, and Direct Relief staff today are delivering additional requested medical essentials to Maui.

Today’s shipment includes numerous wildfire kits. These kits, developed in consultation with medical and emergency-response experts, aim to prevent emergency room visits during significant wildfire events. They contain vital medications including inhalers, nebulizer solutions, irrigation solutions, antibiotics, analgesics, wound care products, and chronic disease medications.

Beyond the immediate risks of burns, wildfires can exacerbate pre-existing health issues. Airborne particulates can worsen respiratory or cardiovascular problems, even sending those affected to the emergency room, and people with chronic conditions can face acute medical crises if they evacuate without their medications.

At the request of Maui Search and Rescue, Direct Relief is also dispatching 20 emergency medical backpacks to bolster on-the-ground relief efforts.

Based on years of disaster response experience, the packs are tailored for paramedics and health professionals to use in the field and are the standard for the State of California’s Medical Reserve Corps.

Direct Relief has also made available its medical inventory, valued at over $300 million wholesale, to healthcare providers across Hawai’i.

How Direct Relief Responds to Disasters

Direct Relief’s approach to disasters relies on long-standing collaborations with vetted local groups serving vulnerable communities. Their expertise, community trust, and existing protocols provide a foundation for the organization’s activities.

Over the past ten years, Direct Relief has provided local Hawai’ian organizations with 15.6 tons of medical resources totaling 415,305 defined daily doses of medicine, as well as $2.14 million in grant funding.
With a history of responding to wildfires across the United States, Direct Relief also is leveraging its expertise and technological resources for this crisis.

The organization’s data-driven tools, such as wildfire mapping applications and the CrisisReady initiative in partnership with Harvard, offer insights into wildfire risks and social vulnerability. Such tools inform emergency response officials and assist Direct Relief in its targeted efforts.

The post Maui Wildfire Response: Medical Aid for Shelters, Mobile Clinics and First Responders appeared first on Direct Relief.

In response, Direct Relief is taking a regional approach to help countries in the Caribbean and Central America prepare for hurricane season. This includes pre-positioning medical aid in depots across the region, close coordination with a set of intergovernmental organizations, and on-the-ground staffing in Direct Relief’s Puerto Rico response hub.

2023’s Atlantic hurricane season officially begins June 1, but Direct Relief has been preparing for months, assembling and staging large caches of emergency medical supplies, and collaborating with national health care and emergency response authorities in countries across the storm-prone region.

Direct Relief is pre-positioning emergency medical supplies in every southeastern and Gulf Coast U.S. state from Virginia to Texas, as well as throughout the Caribbean and Central America. The caches, called hurricane prep packs, or HPPs, contain the medical items most commonly needed in the wake of a disaster, including trauma supplies, antibiotics and wound care supplies, as well as medications for diabetes, hypertension, and respiratory, psychological and gastrointestinal ailments.

Internationally, Direct Relief is shipping 18 HPPs to countries in the Northern Hemisphere including Anguilla, Bahamas, Barbados, British Virgin Islands, Cuba, Dominica, Dominican Republic, El Salvador, Haiti, Honduras, Panama and St. Lucia. It will ship additional packs in November to Fiji and Vanuatu ahead of their cyclone season. These international HPPs weigh 1,470 lbs., designed to provide enough medical supplies to care for 1,000 people for 30 days.

Direct Relief is shipping 70 smaller versions of the pack to health partners in 12 U.S. states and territories. Each of these packs weighs 180 lbs., is sized to accommodate a small clinic’s operations, and is staged with a higher number of health clinics than the mid-sized HPPs used in previous years. Packed into each HPP are 220 types of medicine and medical supplies, designed to provide enough medical supplies to care for 100 people for 72 hours.

The HPPs are designed to be opened in case of emergency. If they haven’t been opened by the end of hurricane season, the health partners storing the stockpiles open them and distribute the material for ongoing healthcare operations.

Currently, Direct Relief has 25 tons of emergency medical supplies staged in Puerto Rico and three tons at a hub in Panama.

“We launched our Hurricane Preparedness Program in response to Hurricane Katrina in 2005, and it’s grown to become the largest medical hurricane pre-positioning program in the world,” said Daniel Hovey, Direct Relief’s Director of Emergency Response and New Initiatives.

2022’s hurricane season saw the highest-ever number of hurricane preparation packs opened, deployed and utilized in the Caribbean and Central America. These included six HPPs in Puerto Rico, two in the Dominican Republic, one in Cuba (plus another one transported to Cuba from Panama), one in Honduras and one in Nicaragua, along with more than 100 emergency medical backpacks packed with supplies.

In the Dominican Republic, Direct Relief Medical Aid Helps Thousands after Hurricane Fiona

As part of its Hurricane Fiona response last September, Direct Relief sent 30 medical backpacks to the Dominican Republic from its Puerto Rico hub.

“We carried out a medical operation in the community of Caciquillo in El Seibo, where with only the medicines donated by you [Direct Relief] we were able to impact more than two thousand people,” said Sanil Garcia, a staff member at Patronato Benefico Oriental, a children-focused social services nonprofit in La Romana, Dominican Republic. In all, “some 6,854 people have been impacted with the prep pack medications.”

Regional Partners

Direct Relief is increasingly working closely with intergovernmental organizations to prepare for disasters and to coordinate disaster aid. These organizations have strong ties to national healthcare systems and also provide regional disaster response coordination.

Direct Relief has been working closely with the Pan American Health Organization, or PAHO, a United Nations agency focused on public health in the Americas. PAHO has representatives working with every country in the Western Hemisphere, easing international cooperation.

In Nicaragua during 2022’s Hurricane Julia, emergency responders tapped into an HPP that Direct Relief had pre-positioned at a PAHO hub there. As Hurricane Ian hit Cuba last year, an HPP packed with emergency medical supplies that had been positioned by Direct Relief and PAHO at the U. N. Humanitarian Response Depot in Panama was quickly transported to Cuba.

Late last year, Direct Relief renewed its partnership with the Organisation of Eastern Caribbean States, which represents 11 small countries in the Leeward and Windward Islands, the chain extending north to south from the British Virgin Islands to Grenada. Other regional organizations Direct Relief works with during disasters include the Caribbean Disaster Emergency Management Agency.

Direct Relief’s Puerto Rico Hub Enables Rapid Regional Response

Direct Relief’s Puerto Rico regional hub keeps large stocks of medical supplies on hand for rapid delivery to the Caribbean or Central American nations struck by hurricanes, while emergency response personnel stationed in Puerto Rico are ready to respond immediately to regional emergencies.

When a 7.2-magnitude earthquake struck Haiti in 2021, killing more than 2,000 people and injuring more than 12,000, Direct Relief’s Puerto Rico team quickly dispatched seven pallets of emergency medical backpacks and PPE to equip Haitian health workers, accompanied by a Puerto Rico-based staff member. The regional hub in Puerto Rico also enabled a fast response to the 2021 eruption of a volcano on St. Vincent and to the 2020 Covid outbreak in Dominica.

The Puerto Rico hub was an outgrowth of Direct Relief’s intensive response to 2017’s Hurricane Maria, which is estimated to have led to nearly 3,000 deaths in the U.S. territory and left much of the island without power for months.

In addition to staging medical supplies in regions vulnerable to hurricanes, Direct Relief has also increased its ability to deliver hurricane relief supplies directly from its Santa Barbara, California, headquarters. This includes the ability to get emergency shipments, even into areas cut off from normal services, by working with its disaster response transportation provider FedEx.

Improving Coordination Through Data Sharing

Ultimately, hurricanes are only one of the often-interrelated environmental challenges people are facing.

“Everywhere in the world, the problem is really this alternation between deep drought and intense storms,” said Andrew Schroeder, Direct Relief’s VP of research & analysis. Other problems associated with intense storms include damage to crops, trees and topsoil, adding economic stress to local people. “These are complicated, really tough issues.”

Direct Relief has continued extending the availability of data systems that inform the actions of health and emergency response agencies, working through partnerships like CrisisReady, a collaboration of Harvard University and Direct Relief. Last week, CrisisReady was using anonymized Facebook mobility data to report on a large movement of people from the giant refugee camp in Bangladesh’s Cox’s Bazar as Cyclone Mocha made landfall.

“You have displacement being driven by drought and food security crisis, and then you have these large-scale storms that hit communities already vulnerable for reasons related to poverty,” Schroeder said. “We need better responsive coordination structures in order to be able to effectively manage through them.”

The post Medical Caches Shore Up Critical Health Facilities Ahead of Hurricane Season appeared first on Direct Relief.

Like much of the Ukrainian people’s response to the attack on their country, the rehabilitation effort is marked by scrappiness, speed and adaptability.

In a three-month sprint, Unbroken turned a vacant seven-story building adjacent to the Lviv First Medical Union hospital, where it had already been operating, into a modern rehabilitation center. The building, which opened April 11, is equipped with a robotic walking system, exoskeletons, robotic gloves to move arms, a swimming pool for water rehabilitation, a simulated store where patients can practice shopping with their prosthetic arms, and an ergotherapy apartment with a kitchen where patients can learn to care for themselves once again.

The organization’s rehabilitation program includes amputation recovery, speech therapy, and psychosocial support. Occupational therapists help patients relearn how to hold a toothbrush or pen.

Unbroken manufactures and fits prostheses to help people return to normal life. In a comprehensive approach to the patient’s needs, a patient’s multidisciplinary team includes a surgeon, a traumatologist, a prosthetist, a rehabilitation specialist, and a psychologist or psychotherapist.

According to the United Nations High Commissioner for Human Rights (UNHCR), More than 14,600 Ukrainian civilians have been injured since the start of the war. Over 5,000 Ukrainians have lost limbs since the start of Russia’s invasion, according to Unbroken.

On April 11 and 12, more than 300 leading scientists, researchers, practitioners, policymakers, and patients met at the new Unbroken facility to share knowledge and experience on rehabilitation services, during the first International Rehabilitation Forum.

The gathering opened with a panel of Unbroken patients who shared their stories. Among them was Olena Svitlova, a teacher who was walking down the street when a cruise missile flew into a nearby nine-story building. Debris flew in all directions, hitting her directly in the face, destroying her right eye and carving a large hole in her nose.

She ended up coming to Unbroken, where maxillofacial surgeons perform the most complex reconstructive surgeries, literally putting patients’ faces back together, closing wounds and holes in bones. In a matter of weeks, Olena was able to return her job teaching chemistry, though she shared that she doesn’t turn on her camera because she knows her students will be afraid of her. According to Project Director Iryna Gudyma, Unbroken’s “Unbroken Beauty” project is raising funds for the equipment needed for more advanced facial reconstruction surgeries, which Olena will need so she can connect face-to-face with her students.

After that, healthcare and rehabilitation leaders from Ukraine, the United States, Australia, France and Israel joined panels on rehabilitation policy, mental health, rehabilitation for war-traumatized children, the use of multidisciplinary teams in rehabilitation and more.

Attendees heard from the representatives of Ukraine’s Ministry of Health, who discussed their plans for making multi-disciplinary rehabilitative care teams available across the country. Specialists from the United Kingdom, United States and Israel provided strategic guidance and offered to continue to help support Unbroken’s staff with specialized training.

Prior to the war, rehabilitation had been a neglected topic in Ukraine, said Vasl Strilka, Director of the Department of High-Tech Medical Care and Innovations at Ukraine’s Ministry of Health. The country has since developed rehabilitation capacity, with 8,000 beds now available for patients undergoing rehabilitation. The country has defined rehabilitation as starting the day after the injury and made multi-disciplinary teams the standard of care, Strilka told the attendees.

A strong rehabilitation program is crucial not just for affected individuals but all of Ukraine, said Major General Tim Hodgetts, Surgeon General for the U.K.’s Headquarters Defense Medical Services. If soldiers know that they will be cared for, he told the gathering, it provides a huge morale boost for the war.

On April 11, Direct Relief announced plans to infuse an additional $10 million to support rehabilitation efforts for people with war injuries in Ukraine. The funding announcement was made by Direct Relief President and CEO Thomas Tighe at the Unbroken National Rehabilitation Center in Lviv during the first International Rehabilitation Forum.

Since the war’s start, supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a core focus of Direct Relief. The April 11 announcement brings to $15 million the amount Direct Relief has allocated to specifically support rehabilitation and injury recovery efforts in Ukraine.

Direct Relief has helped Unbroken procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel.

The post Ukraine’s War-Wounded: Gravely Injured but Unbroken appeared first on Direct Relief.

When medics first encounter the victim, they may struggle to find the veins or arteries they need to stanch heavy bleeding; they must determine whether the patent’s internal organs have been damaged and require immediate surgery; and they may need to locate nerves to block with anesthesia before an amputation.

In these situations, mobile ultrasound devices can be a lifesaver. These handheld versions of the stationary machines found in hospitals allow clinicians to see what is happening deep inside a patient’s body so they can take the quick action often crucial for the patient’s survival.

Physicians and other providers across Ukraine have just received 80 new mobile ultrasound devices, funded by a $750,000 grant from Direct Relief. In addition to providing the units, Direct Relief funded an ambitious series of trainings on using the devices, conducted by the Society of Critical Care Medicine (SCCM) and led by a team of top critical care clinicians, with specialties in emergency medicine, anesthesiology and internal medicine, from the United States and several other countries.

“This is one of the most important devices to help patients in Ukraine,” said Dr. Natalia Matolinets, Chief Anesthesiologist at Lviv First Territorial Medical Union, the hospital where the ultrasound course was taught. “It is a fast and effective device that will give physicians the possibility to help immediately. Especially because of the war right now, a couple of minutes could save someone’s life.”

In an underground bunker below Dr. Matolinet’s hospital last month, interrupted by air raid sirens and flickering power, the SCCM team trained more than 145 Ukrainian physicians and military medics to use mobile ultrasound across the wide variety of emergency situations they may encounter.

With Direct Relief funding, SCCM selected and purchased 80 mobile ultrasound devices made by Butterfly Network Inc., which can display images on an iPhone or Android device. Butterfly offered the devices and services at a discounted rate. SCCM also loaded 150 donated iPads with its ultrasound training materials, which had been translated into Ukrainian. Students received the iPads for free, as well as a two-year membership to SCCM that includes access to medical journals, educational materials, and more.

In addition to three sessions for direct training that instructed a total of 135 clinicians, SCCM held an advanced “train the trainers” course for 12 people who will now go on to train many more Ukrainian clinicians on using mobile ultrasound in emergency situations.

Ukraine’s Ministry of Health supported the initiative, selecting the clinicians receiving the “train the trainers” course and allocating the ultrasound devices across the country.

“This is a very important event for the medical community,” said Ukraine’s First Deputy Minister of Health Sergii Dubrov, who participated in the training, in a Ministry of Health news release. “The acquired knowledge will help our specialists save lives more effectively on the battlefield and in intensive care units.”

The SCCM training mission was led by Dr. José L. Díaz-Gómez of the Texas Heart Institute at Baylor St. Luke’s Medical Center in Houston, where he serves as section chief of cardiothoracic, mechanical circulatory support, and transplant critical care. Dr. Díaz-Gómez also serves on SCCM’s council.

The program has had an immediate impact. Within three days of being trained, one of the military medics shared with his trainers a video of himself assessing a wounded soldier with a mobile ultrasound device.

“The mission was only feasible because of Direct Relief’s role,” said Dr. Díaz-Gómez. “It’s a nice and unique symbiosis between Direct Relief having the funds and resources, and SCCM providing the expertise on the specific skillset people need.”

The work on mobile ultrasound is the latest in a series of collaborations between Direct Relief and SCCM. With advice from SCCM, Direct Relief developed an ICU kit containing enough ICU medications and supplies for at least 100 hospitalized patients. During the early months of the Covid-19 crisis, when hospitals across the country were running out of crucial supplies, Direct Relief donated dozens of ICU kits to hospitals in states including Florida, Texas and New York; hundreds of oxygen concentrators; and more than 2,350 Powered Air-Purifying Respirators.

SCCM and Direct Relief are now working on an extensive plan to increase medical oxygen capacity in key hospitals internationally, starting with pilot programs in The Gambia, Sierra Leone and Liberia. Direct Relief recently approved a grant of $5.5 million to fund this project.

The post Direct Relief, SCCM Provide Mobile Ultrasound Devices and Training to Save Ukrainian Lives appeared first on Direct Relief.

ReplenishRx is an enhanced version of a program that provided 91,000 prescriptions to more than 23,000 patients in 2022. ReplenishRx makes it easier for free clinics, community health centers, and charitable pharmacies to enroll in the program themselves, and in turn, makes it easier for providers to enroll individual patients.

ReplenishRx is a streamlined option for pharmaceutical and medical technology manufacturers to donate their products directly to safety net organizations that care for people without health insurance or other means to pay for them.

ReplenishRx provides free medicine only for people lacking any health insurance and with household income at or below 300% of the Federal poverty line. Neither patients nor private insurance companies, nor the government are billed for the medicine. People eligible for ReplenishRx assistance do not qualify for health coverage from their state’s Medicaid program and cannot afford to purchase health insurance.

Pharmaceutical companies or foundations donating medicine to ReplenishRx include AbbVie, Eli Lilly and Company, Johnson & Johnson Patient Assistance Foundation, Medicines360, and Sanofi Cares North America.

“Lilly is deeply committed to expanding access to our medicines,” said Patrik Jonsson, Executive Vice President; President, Lilly Immunology and Lilly USA; and Chief Customer Officer. “We appreciate that Direct Relief’s ReplenishRx program not only reduces administrative burdens on safety-net clinics but also streamlines the process so that patients with limited resources can get the medicines they need, when they need them.”

Lilly and Sanofi both donate insulin through ReplenishRx.

Direct Relief set up its original Replenishment program in 2008 to streamline availability of medicine to uninsured patients at safety net clinics that primarily serve uninsured patients, including Federally Qualified Health Centers and free and charitable clinics and pharmacies. The program was designed to make it easier for patients to get medicine, while improving delivery and management of inventory for safety net clinics and pharmaceutical manufacturers. It helps clinics and charitable pharmacies provide a steady supply of vital medicine to patients lacking insurance, without the need to apply to individual Patient Assistance Programs (PAPs) offered by pharmaceutical companies.

Pharmaceutical manufacturers ship donated medicine to Direct Relief’s warehouse in Santa Barbara, California. Direct Relief manages clinic enrollment, distribution logistics, and compliance oversight of the health clinics. The clinics enroll patients based on strict eligibility guidelines, track all inventory received from Direct Relief, dispense prescribed products to eligible patients, and report product usage back to Direct Relief. Direct Relief’s ReplenishRx enables manufacturers to reach a growing network of safety-net organizations.

“The program provides a consistent, steady supply of medication for patients who have no insurance, who are low-income and have diabetes or another chronic disease,” said Marisa Barnes, who runs the ReplenishRx program at Direct Relief. “We’re reducing the amount of paperwork that’s required to participate, which means more clinics and more patients will be able to take part in the program. We’re anticipating rapid growth, particularly in the provision of insulin.”

Traditional PAPs are most often used by individual patients, who seek out programs for specific drugs, apply themselves for admission and then apply for annual renewals. Many safety-net providers help patients submit and manage the paperwork or do it on their behalf. Each patient, including those enrolled by clinics, requires a separate application from each drug maker. Clinics often rely on volunteers to help patients manage the paperwork.

Direct Relief acts as a single point of contact between each clinic and all the pharmaceutical makers it works with. Each clinic requests all its donated medicine once a month for its eligible patients from Direct Relief, and each pharmaceutical company deals only with Direct Relief to distribute its donated medicine to enrolled clinics. Rather than having to continuously request refills for each drug, enrolled healthcare organizations each month report how much of a medicine they have used, and Direct Relief sends them the same amount of the drug again in a single monthly shipment.

ReplenishRx enables patients to receive medicine at the clinic during the same visit when it is prescribed, reducing the risk that the patient won’t follow through to obtain and take the medicine, and thus improving overall health outcomes.

“Direct Relief’s Replenishment Program streamlines the process of participating in manufacturers’ patient assistance programs for our low-income, uninsured patients,” said Jennifer Buxton, Acting Executive Director and Chief Operating Officer of Cape Fear Clinic Inc. in Wilmington, N.C. “But, perhaps more importantly, it removes the treatment delay by allowing our clinic to keep inventory on hand that is immediately available for use.”

“Direct Relief’s Replenishment Program has been a complete game-changer for NC MedAssist’s Free Pharmacy Program,” said Dustin Allen, Chief Operating Officer & Director of Pharmacy Operations at NC MedAssist in Charlotte, N.C., the only statewide nonprofit pharmacy in North Carolina. “By ordering medications via a single interface as opposed to four separate ones, it not only cuts down on time needed for order placement but also ensures consistent delivery of medications.”

The original Replenishment program required participating pharmacies to use pharmacy software that many of the smallest healthcare organizations lack. Under ReplenishRx, enrolled organizations can upload the necessary information from their electronic health record systems, allowing a wider degree of participation.

Direct Relief has also made it faster and easier for small healthcare organizations to enroll in the program. Under the original program, it could take eight months to a year for an organization to develop and document the standard operating procedures needed to ensure compliance with donation program requirements, which differ among pharma companies. Direct Relief has now developed a Standard Operating Procedures manual that healthcare organizations can integrate into their processes.

ReplenishRx is just one of the many ways Direct Relief provides support to health centers, free and charitable clinics and charitable pharmacies. Direct Relief’s core Safety Net Program donates medicine and medical supplies to more than 1,300 health clinic and charitable pharmacy locations. The program allows them to request donations of specific drugs, which Direct Relief allocates according to available supply and the number of patients each organization serves. In 2022, the Safety Net Program donated medicine with a wholesale value of $258 million. All the medicine Direct Relief donates to these organizations can be dispensed only to low-income patients lacking any health insurance.

The post Direct Relief’s ReplenishRx Increases Access to Donated Medicine for People Unable to Afford It appeared first on Direct Relief.

Unlike Russia’s invasion of Ukraine and the recent hurricane batterings of Puerto Rico and Florida, Sri Lanka’s crisis grew slowly and has garnered few international headlines. But Sri Lankans are suffering amid the harshest economic crisis the country has confronted since gaining independence from the British empire in 1948.

With the country’s foreign reserves depleted, the nationalized healthcare system cannot afford to import medicine and medical supplies in sufficient quantities. Sri Lanka relies on imports for about 85% of its pharmaceutical needs and about 80% of its medical supplies. The country imported $815 million in medicine in 2021, but by May had only about $25 million in foreign reserves to pay for imports of any kind.

Direct Relief to Sri Lanka

Last week in Sri Lanka, Direct Relief staff participated in an extensive series of meetings with Prime Minister Dinesh Gunawardena and much of the country’s healthcare leadership while overseeing the arrival of what may be the largest donation of medicine to the country since the crisis began.

The 3,500-bed National Hospital of Sri Lanka in Columbo, which usually has 1,300 medicines in stock, is now down to requesting only the 60 most essential medicines.

With anesthesia in short supply, most general surgeries in the country have ceased, including kidney transplants. Cancer patients have lost access to medications needed to fight the deadly disease. Diabetes patients must secure and bring their own glucose meters for blood sugar checkups.

Many hospitals are stocked out of basic items like bandages and cotton balls. The stockouts are forcing rural clinics to close their doors and refer patients to larger facilities in urban areas, which also are overwhelmed by the flow of patients.

Due to a severe fuel shortage, the country’s fishing fleets cannot go far out to sea, slashing the supply of fish that is a significant source of protein in the country, including at its largest children’s hospital.

In addition to Sri Lanka’s Prime Minister and the Ministery of Health, Direct Relief staff met with the chairs of the country’s medical universities, including the colleges of oncology, psychiatry, nephrology, hematology, endocrinology, critical care medicine, anesthesiology, and maternal & child health.

Sri Lanka is also losing clinicians as they migrate to other countries with more opportunities, while its medical colleges see the number of applicants for medical education decline sharply.

“Every one of the medical college leaders informed us that they are in a dire situation, with major shortages across the board for everything,” said Chris Alleway, Direct Relief’s manager of emergency response and new initiatives. “A lot of them were very emotional in our conversations. You could tell that they’re holding together the health care system to the best of their abilities with limited to no resources.”

Responding to the crisis spurred by Sri Lanka’s default in June of this year, Direct Relief has delivered eight humanitarian shipments totaling 27 tons and 16 million defined daily doses of donated medicine.

The largest shipment from Direct Relief to Sri Lanka—36,600 lbs. (18 tons) of medicine and medical supplies requested explicitly by Sri Lanka’s government—arrived in recent weeks.

“Direct Relief’s donation of $10 million worth of medicine will save many lives,” Prime Minister Gunawardena said in a statement.

The 18-ton shipment included medications to treat infections, wounds, seizures, mental health conditions, glaucoma, cardiovascular disease and respiratory issues.

These products were donated to Direct Relief by companies including Accord Healthcare, Apotex, Baxter International, Teva Pharmaceuticals and Viatris. One particularly considerable contribution from Accord included nearly 200,000 defined daily doses of IV furosemide, which is used to treat edema from heart failure and liver and kidney disease.

Other companies contributing donated medicine to Sri Lanka include AbbVie, Boehringer Ingelheim Cares Foundation, Eli Lilly & Co., Hikma Pharmaceuticals, Integra LifeSciences, Meitheal Pharmaceuticals, and Merck.

Partnering with Sri Lanka’s College of Endocrinologists and the Life for a Child program, Direct Relief has also donated and delivered two shipping containers of insulin that went to 25 health facilities for the benefit of patients under the age of 14 with diabetes.

Direct Relief works closely with Sri Lanka’s Ministry of Health, Ministry of Foreign Affairs, the Sri Lankan Embassy in the United States, the Medical Supply Division, and the National Medicines Regulatory Authority to deliver supplies and will continue to do so.

Direct Relief has also received invaluable assistance from Medical Help Sri Lanka, an organization formed by Sri Lankans in the United States.

“Direct Relief has established trusted relationships at all levels of the government and will continue to provide support as needed,” Alleway said.

In April, Sri Lanka suspended repayment of nearly $7 billion in foreign debt due this year out of a total foreign debt of more than $51 billion. On Sept. 1, the International Monetary Fund announced $2.9 billion in loans “to restore macroeconomic stability and debt sustainability while safeguarding financial stability, reducing corruption vulnerabilities and unlocking Sri Lanka’s growth potential.”

The loans, however, are not expected to restore Sri Lanka’s ability to import medicine quickly. In the meantime, Direct Relief will continue assisting the country to the fullest extent possible, with additional medical aid shipments already underway.

The post 22 Million Sri Lankans Lose Their Access to Medicine appeared first on Direct Relief.

Under a collaboration agreement, Ukraine’s Ministry of Health is working with Direct Relief to secure medicine donations from pharmaceutical manufacturers, enabling the use of Direct Relief’s existing contractual and working relationships, smoothing the processes of securing the drugs and then ensuring their timely delivery. Direct Relief has secured and delivered critical medical aid (with over 10% of the pallets requiring cold-chain handling and logistics) specifically requested or approved by the Ministry of Health since the war began. Direct Relief began its collaboration with Ukraine’s Ministry of Health in the year before the invasion working together to provide monoclonal antibody therapies to help address the large Covid-19 outbreaks in the country.

Novo Nordisk Manufactures Insulin Specifically for Ukraine Donation

Among the large prescription medicine donors is Novo Nordisk A/S, which has provided many different types of human and analog insulin for Direct Relief’s humanitarian response in Ukraine, including a large donation of insulin that was manufactured to donate specifically for Direct Relief’s humanitarian efforts. In total, the Denmark-based company has helped meet the needs of tens of thousands of patients with diabetes.

“While we are still deeply concerned with the ongoing aggression against Ukraine, we are grateful that we have been able to team up with Direct Relief, other humanitarian actors and the Ministry of Health to safeguard the supply of our lifesaving medicines to the people who depend on them in Ukraine. I would like to extend my gratitude to the staff of Direct Relief, who work tirelessly in times of crises to serve unmet needs for health care around the world,” said Lars Fruergaard Jørgensen, President and CEO of Novo Nordisk.

Pfizer Donates Critical Anti-infective and Other Medicines to Direct Relief for Ukraine

Pfizer has been among the largest donors to Direct Relief’s response in Ukraine, providing lifesaving therapies to address severe bacterial and fungal infections, as well as medicines to treat patients with Covid-19 infections, which was very important given the recent Covid-19 waves that impacted Ukraine over the past six months. In addition, Pfizer provided various chronic disease medicines and therapies to address uncontrolled bleeding (critical for trauma and wound victims) and chemical warfare antidotes. Pfizer made these donations to Direct Relief’s Ukraine response from the United States and its European affiliates.

Caroline Roan, Pfizer Senior Vice President of Global Health and Social Impact, said: “Ensuring critical medicines continue to reach patients impacted by this tragic and challenging war is paramount to Pfizer. We are committed to contributing to ongoing humanitarian efforts that support the safety, health and wellbeing of people affected by these terrible events. We are very proud to be one of Direct Relief’s largest donors in this program – as part of our broader humanitarian commitments in support of the people of Ukraine, and complementing our efforts to improve access to healthcare worldwide.”

Baxter Donates 10 Truckloads of IV Fluids, Dialysis-Related Products, and More for Ukraine

Baxter International Inc. made one of the largest donations by volume, delivering to Direct Relief more than ten truckloads of critical medical products needed for Ukrainian patients with trauma and wounds, as well as vulnerable patients with renal conditions that required dialysis.

Given the critical need within Ukraine, Baxter provided the products from its facility in nearby Poland, allowing more time to get these essential medicines where they are needed.

“We are deeply grateful to the Direct Relief team for their incredible actions in Ukraine and surrounding countries and are proud to have supported their efforts with donations of more than 100 different types of Baxter products. Our longstanding partnership has been a critical factor in our response efforts as we collaborate on community health needs in the region,” said ​Cristiano Franzi, ​Senior Vice President, and President, EMEA, Baxter International Inc.

The list of pharmaceutical and medical technology manufacturers that made large product donations through Direct Relief (and examples of the types of products provided) to benefit the Ukrainian people include:

• 3M: various wound care dressings and products, N-95 masks, and stethoscopes
• Abbott: diabetes meters and test strips, OTC medications, and infant baby formula
• AbbVie: anesthesia and medicines to treat ocular conditions, thyroid conditions, and cancer
• Accord Healthcare: essential and chronic disease medicines
• Ajanta Pharma: type 2 diabetes medicines
• Alvogen: essential and chronic disease medicines
• Amgen: specialized cancer medications, steroids, and antibiotics
• AmerisourceBergen: bandages and wound care products
• Apotex: essential and chronic disease medicines
• AstraZeneca: respiratory inhalers, cancer therapies, and chronic disease medicine
• Baxter International Inc.: nephrology, anesthesia, surgical products, and IV fluids
• Bayer: antibiotics for hospitalized patients with serious respiratory or skin infections
• Boehringer Ingelheim: type 2 diabetes and cardiovascular medications, and bronchial inhalers
• ConvaTec: wound dressings
• Eli Lilly: various types of insulin, and therapies to treat cancer, mental health conditions and Covid-19
• Grifols: human albumin for hospitalized patients with severe conditions
• GSK: essential chronic disease medicines to treat infections, epilepsy, and mental health conditions
• Hikma: essential, nephrology, chronic disease, and oncology medicines
• ICU Medical: IV catheters and IV solutions
• Johnson & Johnson: medicines for mental health conditions, cardiovascular disease, and diabetes
• LifeScan: diabetes meters and test strips
• McKesson: consumable medical products
• Meitheal Pharma: cancer therapies and muscle relaxants used as an adjunct to general anesthesia
• Medtronic: sutures, skin stapler, catheters, and surgical mesh
• Merck KGaA, Germany: medicines for type 2 diabetes, hypertension, and thyroid conditions
• MSD / Merck & Co.: antibiotics, oral Covid-19 therapies, type 2 diabetes medicines
• Novo Nordisk A/S: various types of insulin, including a sizeable manufacture-to-donate batch for Ukraine
• Organon: cardiovascular disease medicines
• Pfizer: medicines for infections, uncontrolled bleeding, and chronic disease, Covid-19 antiviral medication, chemical warfare antidotes
• Sanofi – through Foundation S: hypodermic needles for medicine injections
• Takeda: medicines for nephrology, hemophilia, gastrointestinal conditions, inflammation, and human albumin
• Teva: medicines for infections, edema, pain, respiratory conditions, and other chronic diseases
• Viatris: medicines for infections, cancer, cardiovascular disease, and other chronic diseases

The post Direct Relief Works with Ukrainian Ministry of Health and Global Drug Makers to Deliver 890 Tons of Medical Aid to Ukraine appeared first on Direct Relief.

The insulin, manufactured and provided to Direct Relief by the drug maker Eli Lilly and Company, was delivered to Ukraine over the past two weeks and will be allocated by Ukraine’s Ministry of Health to hospitals, clinics, and programs treating people with diabetes around the country.

There are 2.3 million adults living with diabetes in Ukraine in 2022 – one in every 14 adults – 40% of whom are undiagnosed, according to the International Diabetes Federation’s Diabetes Atlas. All people with Type 1 diabetes and roughly 30% of people with Type 2 diabetes require daily insulin injections, while many depend on other medications to control the condition.

Direct Relief and its partners estimate that Ukraine needs 115,000 10 ml vials of long-acting insulin per month. In this single supply of medicine, Lilly provided 673,000 quick-injection pens, each containing 3 ml of long-acting insulin glargine, equivalent to 202,191 10 ml vials, or enough to cover Ukraine’s needs for more than seven weeks.

When a person has diabetes, their body doesn’t make enough insulin to control their blood sugar level, making them susceptible to health problems including heart disease, blindness, lower-limb amputations and more. Diabetes is among the world’s most widespread and most harmful noncommunicable diseases. In 2021 alone, diabetes caused an estimated 6.7 million deaths and at least $966 billion in health expenditures worldwide, according to the IDF, which has worked closely with Direct Relief in planning and facilitating large-scale insulin donations to countries in crisis around the world.

“IDF expresses its immense gratitude to our partner Direct Relief for the organization’s quick and efficient mobilization of resources to deliver medical supplies and aid to support Ukrainian citizens living with diabetes,” said Prof. Andrew Boulton, president of IDF. “In times of crises, when resources are scarce, caring for diabetes can be extremely difficult. People living with diabetes require uninterrupted access to the medicines and care they need to manage their condition and prevent life-threatening complications. IDF’s long-term partner Lilly has been incredibly generous in supporting people with diabetes affected by the war in Ukraine. We applaud this latest donation of insulin, which will help bolster the country’s supply of this essential medicine.”

People with diabetes take long-acting insulins like the insulin glargine donated by Lilly once a day to provide a baseline insulin level in their blood. Most people who depend on injected insulin also need short-acting insulin to level their blood sugar after meals.

“Lilly recognizes the challenges people continue to face in Ukraine in accessing essential medicines like insulin. This collaboration with Direct Relief is critical to ensuring our medicines reach the healthcare providers and patients who need them,” said Michael B. Mason, president of Lilly Diabetes.

The huge charitable supply of insulin is the latest action in Direct Relief’s extensive aid for Ukrainians with diabetes since Russia invaded Ukraine on February 24. Since then, Direct Relief has secured and delivered 1.4 million insulin quick-injection pens, 733,800 insulin pen needles, 188,833 10 ml insulin vials, nearly 25,000 glucose meters with 400,000 test strips, and over 3.2 million oral diabetes tablets equivalent to almost 1.5 million daily defined doses. Direct Relief has also provided a $150,000 grant to the Ukrainian Diabetes Federation (UDF) for managing and distributing insulin and diabetes-related medical supplies and testing equipment.

Under a bi-lateral partnership agreement, Ukraine’s Ministry of Health is working with Direct Relief to secure medicine donations from pharmaceutical manufacturers, leveraging Direct Relief’s existing relationships, smoothing the processes of securing the drugs, and ensuring their timely delivery. Lilly supplied the insulin to Direct Relief, which arranged cold-chain transportation to Kyiv to benefit Ukrainian patients. Since the war erupted, Ukraine’s government has been covering access to insulin for its population with diabetes.

“Direct Relief is deeply grateful to Lilly for its leadership and commitment reflected in this donation for the people of Ukraine,” said Thomas Tighe, Direct Relief president and CEO. “Lilly’s support is an incredible example of what’s needed to address this crisis from a humanitarian standpoint.”

Since Russia’s invasion of Ukraine, Direct Relief has provided more than 900 tons of requested medical aid to Ukraine and neighboring countries hosting Ukrainian refugees.

The post Ukraine Receives Seven-Week Supply of Long-Acting Insulin from Direct Relief appeared first on Direct Relief.

When a major disaster strikes, the loss of access to life-sustaining medicine and medical care can lead to more deaths and severe illness than physical injury.

Direct Relief donates the hurricane supplies to local health organizations serving communities most vulnerable to severe storms. The modules vary in size from 112 pounds for individual clinics in the United States to larger 1,680-pound modules for international destinations.

Direct Relief this year is once again staging the emergency modules at health facilities in every Southeastern and Gulf Coast state from Virginia to Texas, as well as in Hawaii, Puerto Rico, and Saipan.

Internationally, Direct Relief is prepositioning the modules throughout Central America and the Caribbean, including in Anguilla, the Bahamas, Barbados, British Virgin Islands, Cuba, Dominica, Dominican Republic, Haiti, Honduras, Jamaica, Panama, St. Lucia, St. Vincent and the Grenadines, and Bangladesh. Fiji and Vanuatu received modules in late 2021, before the Southern Hemisphere hurricane season.

In late August 2021, Hurricane Ida made landfall in Louisiana as a Category 4 hurricane, killing at least 107 people and causing more than $75 billion in damage, making it the fourth-costliest storm ever to strike the United States. In New Orleans, power outages and staffing shortages kept many doctors’ offices and health centers closed for many weeks.

Hurricane Ida “brought back so many memories of Hurricane Katrina for our community,” said Nancy Tardy, Director of Patient Engagement at Baptist Community Health Services in New Orleans. The health center reached out to Direct Relief when the storm struck, “and within about 48 hours we had insulin and other medications and basic supplies on their way. In addition, we received a set of solar-powered refrigerators to keep our vaccines safe as power was intermittent for several days.”

Direct Relief provides year-round support to Baptist Community Health Services and community health centers and free clinics in the U.S. “We routinely use Direct Relief supplies providing much-needed medication to our community,” she said. “Many of our patients would not take their medications if it weren’t for the free supplies and medications we provide. You truly make a difference.”

Increasing Resilience of Health Systems

From Caribbean hurricanes to California wildfires, the last several years of disasters have shown how dependent health systems are on electrical power. Puerto Rico was severely disrupted by 2017’s Hurricane Maria, which cut off power for much of the island for several months. Temperature-sensitive medication spoiled, electronic health records were inaccessible, essential medical equipment was inoperable, and vital health services ceased. Towns dependent on electricity-powered pumps lost access to water.

In the Caribbean and California, Direct Relief has been helping health clinics secure solar power and battery backup to keep treating patients even during extended power outages.

The resilient infrastructure was stress-tested in April when a major Puerto Rico power plant fire plunged much of the island into darkness for days. Nonprofit organization Por Los Nuestros, with grant funding from Direct Relief, had installed solar panels and battery storage systems in communities that are not served by the Puerto Rico Aqueduct and Sewer Authority (PRASA). These non-PRASA communities rely on electric pumps to supply drinking water. During the April blackout, 24 out of 25 aqueducts continued to operate adequately. Eight community health centers with solar energy systems and batteries installed also reported operating at full capacity.

Direct Relief is equipping Puerto Rico’s health centers, clinics and community facilities with more than 1 megawatt of solar production capacity and 1.7 megawatts of battery storage. Direct Relief has furnished 93 health center sites across the island with 170 FDA-compliant pharmaceutical and laboratory refrigerators and freezers with enough capacity to store roughly 6 million vials of vaccines.

Direct Relief is now carrying out similar resilient power work in California to keep community health centers operating amid ongoing and widespread power outages linked to wildfires.

Puerto Rico Regional Response Hub

Direct Relief has increasingly used Puerto Rico as a regional hub for crisis response. Relief supplies are kept in stock on the island, and emergency response personnel are ready to respond to any emergency in the region. When a magnitude 7.2 earthquake struck Haiti last August, Direct Relief’s Puerto Rico team immediately dispatched seven pallets of PPE and emergency medical backpacks to equip Haitian health workers, accompanied by a Puerto Rico-based staff member.

Real-Time Data for Disaster Preparedness and Response

When responding to natural disasters, displacements and disease outbreaks, time is always of the essence. Early detection and early response lead to better outcomes in almost every case.

Direct Relief has expanded its focus on bringing emergency data analysis into real-time through precision alerting platforms like Dataminr and Factal, real-time population dynamics data from the Meta platform to understand evacuation and displacement, and sensor data on fire, smoke, heat, hurricane winds, and storm surge from Esri’s Living Atlas. By linking real-time data on disaster events and how communities respond to those events with baseline models on social vulnerability, hazards, and losses, Direct Relief can move quickly to provide the right assistance to the right places at the right times.

As a support organization, it isn’t enough for Direct Relief to understand these types of real-time data. Working with public sector and nonprofit organizations in Mexico, Central America, and the Caribbean, Direct Relief is building local capacity by hosting data preparedness workshops, training, and support agreements through the CrisisReady partnership with Harvard University School of Public Health to ensure responders have the emergency information they need.

“Data analysis is just as essential to emergency response as material and financial forms of aid, but it requires strong data collaborations to be effective,” said Andrew Schroeder, Direct Relief’s Vice President of Research and Analysis.

“The more that both we and our partners can use the best data sources available, including novel sources from social media, imagery, and other sensors, for rapid and effective emergency response, the more effective our efforts will be for local communities in crisis,” Schroeder said.

The post Direct Relief Pre-Positions Medical Supplies for Hurricane Season 2022 appeared first on Direct Relief.

Leveraging Poland’s existing pharmaceutical distribution and payment systems to reach Ukrainian refugees across Poland quickly and efficiently, the program offers electronic credit to cover 100% of prescription co-payments and 85% of non-prescription drug costs. Enrollment in the program is free and begins next week. Information about the program is available at www.Health4Ukraine.com.

The program is seeded with $10 million from the humanitarian nonprofit Direct Relief.

Pelion S.A., Poland’s largest healthcare sector business, will deliver payments to pharmacies through its electronic payments company epruf. Pelion is also donating $1 million in free medical consultations with Ukrainian-speaking doctors through its telemedicine service Dimedic.

Direct Relief and Pelion hope to expand the initiative to cover 400,000 refugees, including 100,000 elderly persons and 300,000 women and children. This expansion, requiring additional donor funding, would cover almost half of the over 880,000 Ukrainian citizens who have registered for a Polish state ID number (PESEL). PESEL numbers allow Polish residents to access state-provided health care and other social services.

“Direct Relief is deeply grateful for Pelion’s leadership in creating this direct and highly efficient means to assist people forced to flee their homes in Ukraine, helping them obtain the essential medications they need for their health,” said Direct Relief President and CEO Thomas Tighe. “The initial funding of $10 million comes from contributions by thousands of individuals deeply concerned about the welfare of Ukrainians who have had their lives upended and threatened. This approach connects that amazing generosity in a practical, important way to the Ukrainian people for whose benefit Direct Relief received the funds.”

“It is a special day for us and a great privilege to launch a unique, nationwide medicine support program for patients from Ukraine in cooperation with Direct Relief,” said Jacek Szwajcowski, President of the Management Board of Pelion S.A. “The $10 million donated today is extremely significant and real aid, which will go to people in need, mainly mothers with children and the elderly. The program of co-financing the purchase of medicines developed by our company is fully tested and guarantees full transparency. The assistance offered by Direct Relief is additionally supplemented with free telemedicine services in Ukrainian. We have already donated over $1 million for this purpose. I hope that the cooperation initiated today will be long-term and will encourage more donors to join the aid. The scale of the need is huge.”

How It Works

The new Direct Relief–Pelion program will cover 100% of prescription copays and 85% of costs for certain over-the-counter healthcare expenses for Ukrainian refugees by loading cash credit onto epruf’s web application. Each participant will receive access to their account in the web application, tied to each person’s PESEL number. The program works at any pharmacy in Poland. More than five million people in Poland use epruf’s payment systems.

Each participant will receive a credit of 500 Polish zloty (about 117 USD)—the estimated per-person subsidy required for six months of prescription and non-prescription medical expenses, based on more than ten years of data tracked by epruf. Participants will be eligible for a second top-up after four months.

Nearly all prescription drugs will be covered, including medicines for widespread chronic illnesses such as diabetes, hypertension, and cardiovascular disease. Because all payments will flow through the epruf system directly to pharmacies, the program provides transparency and accountability.

Many refugees fled Ukraine with little cash, are unable to return to Ukraine anytime soon, and thus must establish new lives for themselves.

Direct Relief’s Response to Date

Direct Relief is one of only a handful of non-governmental organizations recognized by the Ukrainian Ministry of Health as “international partners,” along with United Nations agencies like the World Health Organization, multilateral organizations including the International Monetary Fund and World Bank, and national government aid agencies like USAID: https://en.moz.gov.ua/international-partners?page=3.

Responding to requests from the Ministry of Health and other local healthcare providers, Direct Relief has delivered over 206 tons of medications and supplies, covering health conditions ranging from traumatic injuries to cancer to diabetes to Covid-19. Direct Relief has also fulfilled requests for medications needed to respond to chemical attacks.

The post Medicine Costs for Ukrainian Refugees in Poland Covered by New Direct Cash Aid Program appeared first on Direct Relief.

CrisisReady, a joint project of Harvard University and Direct Relief, has been analyzing mobility data from Meta, linked to an analysis of the Facebook social connectedness index. That analysis tends to indicate a pronounced westward flow of refugees towards areas of western Poland, Slovakia, and Hungary. This aligns well with social connectedness, as well as congregation occurring in major cities.

Warsaw and Krakow in Poland recently announced that reception of new refugees in those cities would be difficult, given the current numbers of arrivals. Increasingly Ukrainians are spreading throughout the European Union, particularly to the Czech Republic and Germany.

Recently the team at REACH, a humanitarian initiative providing data to aid actors, was able to conduct interviews with displaced persons at the border checkpoints for each neighboring country. According to their research, refugees were 85 percent female and 15 percent male. Seventy-three percent of interview respondents reported traveling principally in groups of one to four, with a much smaller number traveling alone (11%) or in groups of five or more (16%). Ninety percent of respondents were Ukrainian, with 4% of Russian nationality, 1% Moldovan, and 5% another nationality.  

In addition, just one percent reported traveling with a pregnant or lactating woman, and 4% reported traveling with a person with a disability. Eight percent reported traveling with an elderly person over the age of 65, with 49% traveling with children under 18. 

According to respondents, their principal destinations outside of the neighboring countries included Germany and the Czech Republic – and 56% intended to stay with family or friends – which aligns quite well with the social connectedness analysis above.

According to the Protection Cluster and the International Organization for Migration, the official number of internally displaced persons within Ukraine is approaching 2 million. Most of those people have fled from the north, east, and south of Ukraine, which are principally affected by Russian attacks and have moved towards areas bordering western Ukraine. Zakarpatska and Lvivska oblasts (districts) have received a disproportionate share of IDPs.

A range of humanitarian corridors continues to be opened up for Ukrainian cities under bombardment to allow civilians to flee. As of Tuesday morning, there were officially nine such corridors open across the country. However, according to repeated reports, those corridors are coming under attack or are otherwise declared unsafe for mass evacuations.

The situation in Mariupol is considered to be the most extreme, with accusations from the Ukrainian government and the Red Cross that the corridor for that city remains closed and that residents are at risk of starvation as a result.

Health Situation

According to the World Health Organization’s most recent situation report, issued on March 11, the principal public health issues facing Ukrainians remain physical trauma and conflict-related wounds. Following that concern, the WHO is calling attention to:

• Non-communicable diseases, particularly insofar as supplies of insulin for diabetics, cancer medications, and other supplies for cardiovascular disease are now disrupted or in extreme scarcity,
• Emergence and spread of infectious disease including polio due to the disrupted polio vaccination campaign; TB and HIV/AIDS due to disruptions of access to treatment facilities and drug supplies; Covid-19 due to low vaccination rates and the inability under current circumstances to practice most conventional infection control protocols; as well as risks of diarrheal diseases due to widespread damage to water and sanitation facilities,
• Mental health impacts related to displacement and war-related trauma,
• Protection issues including human trafficking and gender-based violence, and
• Risks posed specifically to pregnant mothers and newborn children. WHO is estimating that 80,000 infants will be born in the next three months within Ukraine.

WHO is working with Direct Relief and other humanitarian groups to solve many of the critical supply shortages for NCDs mentioned above. The organization says it has established logistical connections outside Ukraine to all major Ukrainian cities. It has also set up an emergency epidemic surveillance system, which focuses on event-based syndromic reporting, and is expanding its focus on mapping health facilities and integrating damage/status assessments into facility mapping.

Medical oxygen continues to be a high-priority need. A Ministry of Health/WHO working group on medical oxygen has been established and will be calculating needs and issuing guidance on oxygen distribution across the country. 

The WHO is establishing its first field hospital in Lviv and planning several others throughout western Ukraine.

Additionally, WHO facilities are being set up in the refugee-receiving countries to reduce pressure on the health systems in those countries. Medical supply assessments for each bordering country are ongoing and should be considered a priority. 

Food, Nutrition, and Logistics

The World Food Programme estimates that 12 million people within Ukraine require immediate food assistance. The most immediate concern in this regard is the situation in cities such as Mariupol, Kharkiv, Kherson, and parts of Kyiv, which are at least partially encircled and besieged, reducing sharply their ability to move food and other essential supplies into those areas. In addition to the closure of logistics corridors, an estimated 750,000 people have lost access to electricity or natural gas supplies, which has reduced their ability to cook and posed significant challenges for heating during a period of frigid temperatures.

Apart from the conditions within Ukrainian cities, the principal concern related to food remains the curtailment of international food shipments from both Ukraine and Russia. A couple of days ago, Russia announced that they would be suspending the export of most cereal crops, which affects a large share of the world population and depends on Russian and Ukrainian exports.

In a recent piece in The Guardian, representatives from the UN Food and Agriculture Organization called attention to the severe risks posed by rising food prices throughout many of the world’s poorest regions as a result of the ongoing war. Global wheat prices recently hit all-time highs, with additional concerns regarding corn and other crops. They also called attention to the central role of Russia and Ukraine as fertilizer exporters, which in turn has a ripple effect on agricultural production throughout much of the world. 

While the food crisis is not a top-level issue yet, the longer the war goes on, the more serious these disruptions will become, with longer-lasting effects across the world. 

Meeting Needs and Challenges

With five million people displaced in less than three weeks, the flood of Ukrainian refugees and internally displaced persons has grown faster than any crisis since World War II. For humanitarian aid organizations and multilateral agencies, the situation requires a similarly unprecedented speed and magnitude of response.

Direct Relief is doing what it does in every major disaster to which it responds, but at a much larger scale: mobilizing and delivering medicine and other medical aid to the people who urgently need it and providing support to trusted local health providers.

Because the human toll of the war will be long-lasting, Direct Relief is building channels for efficiently securing and delivering large volumes of medical aid over an extended period.

The organization is arranging direct deliveries from pharmaceutical manufacturers and warehouses across Europe to Ukraine, most often via Poland, securing space in pharmaceutical warehouses, including refrigerated facilities, and working closely with local logistics companies. The organization is also planning a series of chartered cargo flights from the US.

At least initially, securing medicine may be less of a hurdle than the logistics of getting it to the people who need it. Direct Relief has received unprecedented pledges of support from many of the world’s largest pharmaceutical manufacturers and medical supply distributors. Enough medical material has been offered in California alone to fill multiple chartered jumbo jets, which Direct Relief is now arranging.

Large aid shipments over the last two weeks have arrived safely in Ukraine. Still, with a flood of relief supplies headed to the region, there is an increasing risk of bottlenecks, including a limited supply of trucks, delays at border crossings, and security threats inside Ukraine.

To date, the largest recipient of Direct Relief aid in the crisis has been Ukraine’s Ministry of Health. Poland’s Government Agency for Strategic Reserves is expected to play an increasingly important role in upcoming shipments; it coordinates incoming aid deliveries and acts as a logistics agent to receive cargo and transfer it to Ukraine.

The post Ukraine War Is Becoming the Fastest-Growing Humanitarian Crisis Since World War II appeared first on Direct Relief.

The donations to the Americas are coming from a purchase of 89 million masks by Direct Relief, among the largest single PPE purchases by a charitable nonprofit. The masks, bought from BYD Co., will fill more than one hundred 40-foot shipping containers.

“Direct Relief continues to do everything it can to mobilize private support and respond to the still-urgent need to protect health workers and members of the public as Covid infections rage, particularly in areas of the US that have had limited access and neighboring countries where public funding is overstretched,” said Direct Relief President and CEO Thomas Tighe. “We’re deeply thankful for the public support that has enabled this large-scale infusion of high-quality PPE at this critical time.”

Direct Relief has built strong working relationships across Latin America with national health ministries, multilateral organizations and local health organizations.

In Ecuador, Direct Relief is shipping three containers to the Ministry of Public Health, which has informed Direct Relief of plans to use them in vaccination campaigns in rural areas where vaccine hesitancy is higher than in cities.

“The support of your organization has been enormous for us throughout the pandemic,” said Luis Armijos of the National Directorate of International Cooperation and Relations at Ecuador’s Ministry of Public Health.

In Panama, some of the masks will support vaccination campaigns for students and school staff, according to Fundación Unidos por Panamá, Direct Relief’s in-country partner.

In Mexico, 20 million masks have been allocated to INSABI, which provides health care to about 33 million people who fall outside of the country’s Social Security system.

Funding for the 89 million mask purchase came from private donors, including The Coca-Cola Foundation, the global philanthropic arm of The Coca-Cola Company.

In addition to PPE, Direct Relief is helping transport Covid-19 vaccines to Mexico and other countries throughout the Americas, the most recent delivery of which was a 2.7 million-dose donation from Moderna to the Government of Mexico. In total, Direct Relief has helped ship more than 12 million Covid-19 vaccine doses to the Americas.

Delivering PPE in the US AND Globally

Direct Relief is also reserving 10 million masks for US safety-net health facilities, including Federally Qualified Health Centers and Free and Charitable Clinics.

Another six shipping containers with 5.3 million masks have been allocated to Indonesia. Other shipments are planned for health care providers in Armenia, Fiji, Jordan, Lebanon and the West Bank.

Once the latest round of mask deliveries is complete, Direct Relief will have donated nearly 300 million PPE units since the pandemic began.

This includes 228 million protective masks, 93 million of which were donated through CAF-Africa, an initiative supporting community health workers on the frontlines of Africa’s Covid response.

It also includes 950 tons of PPE sent to Brazil – specifically, nearly 9 million Level 1 medical isolation gowns requested by the Brazilian Ministry of Health for facilities nationwide – part of a larger donation of 80 million gowns from McKesson to Direct Relief.

The post Direct Relief Donating 60 Million KN95 Masks for Covid-19 Fight in Latin America and the Caribbean appeared first on Direct Relief.

The credits come via a partnership between Direct Relief and Uber, aimed at reaching people who haven’t been able to get vaccinated because they may have limited access to transportation.

“Lack of access to dependable transportation shouldn’t prevent someone from receiving a vaccine,” said Julia Paige, Uber’s Director of Social Impact. “Our partnership with Direct Relief can help break down transportation barriers in underserved communities and enable those most in need to get vaccinated. This is more important than ever now that vaccines are available to children aged 5 and up.”

Each promo code pays for two UberX or XL rides costing up to $30 per ride, covering up to $60 in round-trip transportation per patient. Uber offered to provide enough credits to bring 200,000 people to be vaccinated and return them home. Health centers have thus far requested and received credits for 131,000 Uber rides, or 65,000 round trips. These were distributed to 237 partner health centers across 42 U.S. states and the District of Columbia.

These local health providers serve communities otherwise lacking access to quality health care. Many in these communities lack their own vehicles, relying instead on public transportation, which may be infrequent, making it harder to get to and from vaccination sites.

In other cases, a family owns one car, used by one parent to go to work while the other stays home to care for children. The Uber credits could be especially useful in this situation now that Covid shots have been authorized for children of ages 5-12, and boosters have been authorized for all adults over age 18.

Direct Relief partners with more than 2,000 community health centers and free & charitable clinics in the United States. These provider partners use Direct Relief’s online ordering system to specify the medicines and medical supplies they need for their patients, and Direct Relief delivers them free of charge.

Direct Relief is committed to equitable access to healthcare. Nationwide, approximately 1,400 community health centers operate 13,000 sites, providing primary and preventive care on a sliding fee scale to nearly 30 million patients each year. More than 91% of these health center patients are individuals or families living at or below 200% of the Federal Poverty Guidelines and approximately 63% are racial/ethnic minorities.

North East Medical Services (NEMS) is a community health center operating 13 clinics in the San Francisco Bay Area, targeting medically underserved Asian populations. NEMS had provided 464 of its patients with the Uber vouchers as of Nov. 5, said Hilary Djeng, Director of Operations at NEMS.

“The program has worked well for our Daly City clinic and our San Jose clinic, where most of the population are from a younger generation and are used to riding with Uber,” Djeng said. Older populations, such as elderly residents in San Francisco’s Chinatown, are less likely to be familiar with ride-sharing apps, and typically rely on family members to transport them to the clinics, she said.

The post Health Clinics Have Until Year-End to Use Uber Ride Credits for Covid-19 Vaccinations appeared first on Direct Relief.

Decades later, despite the growing prevalence of diabetes in the DRC, the disease doesn’t receive enough attention from the region’s health providers, Kakisingi says. Hospitals and health care providers in the region feel “diabetes isn’t a priority for them,” he laments. People in the DRC often learn they have diabetes only when they begin to experience the disease’s serious complications; untreated diabetes puts people at high risk of limb amputation, sight loss and premature death. Globally, around half of all adults with Type 2 diabetes are undiagnosed or unaware of their condition, according to the Lancet.

The World Health Organization has warned of a rapid increase in the related conditions of obesity, diabetes and hypertension in the DRC, keeping with a similar trend in low- and middle-income countries around the globe. One in four residents of the DRC had hypertension in 2014, one of the highest rates in Africa, according to the WHO. Diabetes prevalence increased from 11.9% to 15.6% between 2010 and 2015 among workers at the DRC’s Tenke Fungurume copper and cobalt mine, a longitudinal study of worker health records found.

Taking Action

Kakisingi cofounded and runs an organization called Association des Diabétiques du Congo, or ADIC, which educates people in eastern DRC about diabetes prevention, nutrition, self-care, and management and distributes medicine to help people control the disease. ADIC is based in the city of Goma along DRC’s eastern border with Rwanda.

The DRC has experienced decades of turmoil, including wars and ethnic conflicts involving about 150 armed groups, sometimes spilling over from Rwanda; disease outbreaks of Ebola, cholera and Covid-19; and natural disasters including flooding. In May, tens of thousands of people fled their homes as the Mount Nyiragongo volcano erupted just 12 kilometers from Goma. The DRC had 5.2 million internally displaced persons in 2020, the largest IDP population in Africa, including 2 million newly displaced persons, according to UNHCR.

The civil conflict makes travel difficult and dangerous, so ADIC works with organizations in towns and villages in eastern Congo to conduct training and get diabetes medicine to those who need it. It also operates an outpatient clinic in Goma, which treated 3,995 patients last year. When diabetes patients arrive, their blood sugar is checked and stabilized if needed. They are offered counseling on diabetes and how to manage it and given a supply of medicine if available.

Direct Relief has partnered with Merck KGaA to donate and deliver diabetes medicine to ADIC for local patients. Since 2019, Direct Relief has provided 3,222 pounds of Merck KGaA medicines to ADIC – more than 350,771 defined daily doses of medication for diabetes and hypertension. The donations to ADIC are part of a more extensive program in which Merck KGaA has donated 20 million doses of its Glucophage medicines for Type 2 diabetes, plus over 10 million doses of its hypertension medicine Concor. (Merck KGaA, based in Darmstadt, Germany, is entirely separate from U.S.-based Merck & Co., though the two companies share historical roots.)

The support of diabetes patients in the DRC by Direct Relief and Merck KGaA comes amid a global movement to bring diabetes care to people in countries experiencing a crisis. The movement includes the WHO Global Diabetes Compact, introduced in April 2021, which lays out a vision “to reduce the risk of diabetes and ensure that all people diagnosed with diabetes have access to quality care and treatment that is equitable, comprehensive and affordable.”

“Diabetes is a global epidemic,” according to the WHO’s Global Diabetes Compact. Before COVID-19 emerged, more than 420 million people were living with diabetes worldwide – 6 percent of the world’s population- four times more than in 1980, the report states. “This number is expected to rise to 570 million by 2030 and 700 million by 2045, rising most rapidly in low- and middle-income countries.”

The WHO Global Diabetes Compact cited “a chronic lack of investment in diabetes prevention, early diagnosis, appropriate treatment and care,” which “needs to be redressed without delay to reduce immense suffering among millions of people and mitigate preventable long-term social and economic costs to society.”

In partnership with Life for a Child, Direct Relief has donated supplies to ADIC to support its Type 1 diabetes patients since 2011. Since 2019, ADIC has been receiving donations of insulin and medicines for both Type 2 diabetes and cardiovascular disease, under Direct Relief’s initiative with the International Diabetes Federation to support people with diabetes in countries experiencing a crisis.

“Direct Relief’s work is part of a very large push by advocacy organizations, policy organizations, the WHO and others to put diabetes and non-communicable diseases at the forefront in humanitarian and crisis settings, to provide care and access to medicines for people all over the globe that live in these situations,” said Kelsey Grodzovsky, Program Manager for Global Programs at Direct Relief.

Improving Access to Quality Medications

The limited supply of diabetes medicine available in the DRC is often of low quality, Kakisingi said. Direct Relief provides ADIC with Merck KGaA’s top-quality branded generic medication, including Glucophage and Glucovance (oral medications to control type 2 diabetes) and the hypertension medicine Concor. These are medications originally developed by Merck KGaA that are now off-patent.

“The benefits are enormous,” Kakisingi said. “Direct Relief sends us medicine of top quality. Some of the doctors, when they see those products, they say they’ve never seen them before. Secondly, the product is sent so quickly. DR takes care of transportation and customs clearance costs, and this is a very big benefit.”

Andre Musto, Senior Vice President, Head of Cardiovascular Metabolism & Endocrinology Franchise at Merck KGaA, Darmstadt, Germany, said, “Considering the current situation of undertreatment and limited access to medicines, we take our responsibility very seriously of developing and supporting diabetes treatment and education to address the current scenario and to help healthier generations to come. We are honored to continue our collaboration with Direct Relief and support their efforts and ultimately help patients in need.”

Merck KGaA’s medications have gone to countries in crisis around the world, including the Central African Republic, DRC, Republic of Congo, Ethiopia, Haiti, Syria and Zimbabwe, among others.

In 2020, Direct Relief provided diabetes products valued at hundreds of millions of dollars to underserved people with diabetes who were affected by disasters and emergencies in over 60 countries worldwide. Working closely with the three global insulin manufacturers, Direct Relief is now one of the world’s largest humanitarian insulin providers. Direct Relief’s distribution center is significantly expanding its refrigeration capacity to store cold-chain medicines (with space for up to 677 pallets of product), allowing increased support to people who require cold-chain therapies for diabetes, cancer, hemophilia, rare diseases, and other conditions.

Direct Relief’s Rita Tshimanga provided translation support for this story.

The post In DRC, a Local NGO Fights Diabetes Amid Natural Disasters, Civil Conflict appeared first on Direct Relief.

The humanitarian organization recently completed a second cold room with 5,400 square feet of floor space, with racks rising three stories high and fully redundant refrigeration. Direct Relief’s existing cold storage room, a 2,900-square-foot facility that opened in 2018 at its California headquarters, is already full much of the time. The two rooms combined can hold up to 677 pallets of medicine for treating people with severe illnesses around the globe.

Direct Relief invested $1.5 million to build and equip the new cold room and is now working to increase its existing solar and battery capacity to help offset the room’s energy needs. The value of Direct Relief’s cold chain shipments has nearly quadrupled since 2018, from $102 million in the year ended June 30, 2018, to $387 million (wholesale) in the year ended June 30, 2021. In all, the organization delivered 37.9 million defined daily doses of refrigerated or frozen medicine to 55 countries worldwide during its 2021 fiscal year, including Covid-19 antibody treatments, insulin for children with Type 1 diabetes, and advanced chemotherapy medicine to treat pediatric cancer patients.

Cold chain is an increasingly important part of medical logistics. Global cold chain pharmaceutical production is forecasted to grow 48% between 2018 and 2024, vs. 27% growth in room-temperature pharmaceutical production, according to Pharmaceutical Commerce. In 2019, 45% of new drugs approved by the FDA required refrigeration or freezing.

“Even before Covid and the urgency of the global vaccination effort, the fact that most of the new therapies being developed to treat and cure disease are cold chain products was sobering,” said Direct Relief President and CEO Thomas Tighe. “Limited cold chain distribution capacity already creates a practical barrier to people obtaining access to medications and therapies – even when they are free. Given where research is going, if the shortcomings go unaddressed, the difference between the haves and have-nots will only intensify. People who are poor or who live in poor areas will simply not benefit from the profound scientific advances being made in health.”

Cold chain delivery of medicines requires a level of planning that far exceeds what is needed for conventional goods or non-refrigerated pharmaceuticals. Direct Relief must plan every step along the way – every link in the cold chain – to ensure the medicine remains within the required temperature range from when it leaves its warehouse until it arrives.

Direct Relief uses modeling software to  map the optimal shipment route and inform packaging requirements for conditions along the way. The medicine is placed into specially constructed boxes to assist in keeping the required temperature. The boxes are lined with materials such as vacuum insulated panels to keep the coolants at optimal temperature and protect against ambient temperature exposures and with materials that freeze at temperatures lower or higher than the freezing point of water, allowing precise control. The boxes also include devices that monitor temperature continuously, transmitting the data via cell towers along transportation routes or via download and transmission at the endpoint. Shipments are usually modeled to protect medicine for up to 120 hours in transit.

“New medications and therapies, whether for Covid-19, diabetes, cancer, or other serious illnesses, are only as good as their ability to reach patients,” said Damon Taugher, Direct Relief’s vice president of global programs. “A lot of analysis and oversight goes into our work to ensure transportation lanes are vetted and trusted and that we are confident to put these critical medicines into a supply chain to remote parts of the world.”

While efforts to vaccinate the world’s population against Covid-19 will bring some improved technology and practices, they will hardly establish a reliable global cold chain infrastructure.

“Significant capital investment is needed, not just for refrigerators and freezers, but also for resilient power,” Taugher said. “Hurricane Ida was an example of this. If health facilities don’t have adequate backup power, it doesn’t matter how good your refrigeration is; it all spoils. Power is a prerequisite for health.”

Since 2015, Direct Relief has donated more than 300 pharmaceutical refrigerators, portable coolers, and freezers to healthcare providers in nine countries, including to health clinics across the United States.

The organization has also provided solar power and backup batteries to health facilities in California, Puerto Rico, and several Caribbean countries, helping ensure that medicine remains cold if power is interrupted.

The post Direct Relief Triples Pharmaceutical Cold Chain Capacity as Global Demand Surges appeared first on Direct Relief.

The donation to Mexico via a FedEx donated aircraft was facilitated by Direct Relief, which served as the licensed distributor importing the medicine.

In June, Mexico became the first country to receive Covid vaccines donated by the U.S. government when FedEx delivered 1.35 million doses of Johnson & Johnson’s single-dose Covid-19 vaccine. That donation was also facilitated by Direct Relief.

As of Aug. 22, 44 percent of Mexicans have received at least one Covid-19 vaccine shot, according to Our World in Data.

The additional 1.75 million Mexicans who can now receive Covid vaccines will bring Mexico closer to the date when it can achieve a crucial economic goal: reopening the land border with the United States to non-essential travel. It has been closed since March 2020, battering economies on both sides of the border that depend heavily on cross-border commerce.

“These vaccines will help protect the lives of people in Mexico,” said Eduardo Mendoza, who manages Direct Relief’s operations in Mexico and who led Direct Relief’s work in facilitating the cross-border donation. “Every lot of vaccine brings us closer to the end of the pandemic.”

Gracias @Eddie_Mendoza_ de @DirectRelief y @CRSCalixto por todo el trabajo https://t.co/0ic5b5pS9k pic.twitter.com/vu6QyITF3a

— Maria Julia Marinissen (@JuliaMarinissen) August 24, 2021

The U.S. Department of State and the Department of Health and Human Services collaborated to secure and donate the vaccines. Their counterparts on Mexico’s side were the Ministry of Foreign Affairs and the Ministry of Health.

The post First Moderna Covid-19 Vaccines Delivered to Mexico appeared first on Direct Relief.

Fires now burning in California include the Dixie Fire, which on Friday became the third-largest in the state’s history, torching 676 square miles after destroying the town of Greenville on Thursday. In Susanville, 65 miles from Greenville on the opposite slope of the Sierras, 48 people were sheltering in a gymnasium Friday, while another 93 took refuge outside the same gym, according to the National Shelter System. Meanwhile, 230 people took shelter outside a high school in Grass Valley, Calif., northeast of Sacramento as the River Fire raged nearby.

As a California-based disaster relief and medical aid organization, Direct Relief has responded to wildfires in California, and throughout the U.S., for decades.

In California, Direct Relief is a long-time partner of the State of California through its Office of Emergency Services (CalOES) and the State of California Emergency Management Agency (CalEMA). Direct Relief also serves as a key member of California’s Business and Utilities Operations Center (BUOC), which was established to mobilize private resources for the public benefit during emergencies and ensure resources are deployed in coordination with public officials managing the response.

Direct Relief’s 155,000-square-foot medical distribution center, equipment, trained staff, and various other capacities are registered with the State of California as a strategic emergency resource and available for public health or emergency response purposes. Direct Relief has specifically offered the California Governor’s Office of Emergency Services (CalOES) any needed resources, including Wildfire Health Kits, its general inventory of medicine and medical supplies, and backup power resources.

In response to the Dixie fire and others burning across the Western US, Direct Relief is making its Wildfire Health Kits available to health centers and public health agencies in wildfire-affected counties. Each kit enables the treatment of about 250 people for three to five days, with medicines and supplies most requested by healthcare providers in past wildfire emergencies.

Items in the kit include inhalers and nebulizer solutions to treat respiratory irritation, irrigation solutions and antibiotics for dermal and ophthalmic injuries, analgesics for headaches, bandages and wound care items for lacerations and minor injuries like sprains and strains, and personal protective equipment (PPE) such as masks and gloves to protect health workers.

In addition to backstopping public health and response agencies with needed emergency support, Direct Relief also works closely with nonprofit health clinics in affected communities to provide supplies needed to care for people evacuating from or otherwise affected by wildfires. Work performed by these clinics includes filling prescriptions for chronic disease medicines, treating cuts and scrapes, addressing respiratory issues caused by poor air quality, and working with a local hospital to triage patients who need more extensive care.

Direct Relief’s emergency-response activities also include synthesizing a broad range of public and private data sources to map and analyze wildfire risk, social vulnerability, and population movement in fire-affected areas. These analytic tools help inform emergency response officials and are used by Direct Relief to target emergency medical resources and deploy backup power to deliver medical care. The absence of power in emergencies has been found repeatedly to impede the delivery of needed medical services as electronic health records become inaccessible and spoilage occurs of insulin, vaccine, and other medications requiring cold storage.

The post Direct Relief Commits Medicine, Equipment and Funding to Wildfire Response appeared first on Direct Relief.

The humanitarian effort comes as global temperatures keep rising and the frequency and intensity of hurricanes and other disasters increase. The 2020 hurricane season was the most active on record, producing 30 named storms, 14 of them hurricanes. Two were Category 4 storms, Eta and Iota, that crashed into Nicaragua two weeks apart, causing catastrophic damage and triggering a massive wave of displacement.

Direct Relief’s prepositioned modules contain the medical items most needed in the wake of a disaster, including trauma supplies, antibiotics, and medications for diabetes, hypertension and other chronic conditions. The supplies are made available through local health organizations serving communities most vulnerable to natural disasters. The modules vary in size from 112 pounds for individual clinics to larger 1,680-pound modules for international destinations.

Direct Relief this year is staging the emergency modules at health facilities in every Southeastern and Gulf Coast state from Virginia to Texas, as well as in Hawaii, Puerto Rico, and Saipan.

Internationally, Direct Relief is prepositioning the modules throughout Central America and the Caribbean, including in Anguilla, the Bahamas, Barbados, British Virgin Islands, Dominica, Dominican Republic, Haiti, Honduras, Jamaica, Panama, St. Lucia, and St. Vincent and the Grenadines, as well as in Bangladesh, Fiji, and India.

Increasing Health Infrastructure Resilience

Where hurricanes go, power outages follow. Most notably, in 2017’s Hurricane Maria, Puerto Rico went dark for months.

Much of the island’s temperature-sensitive medication spoiled, electronic health records were inaccessible, essential medical equipment was inoperable, and vital health services ceased. Hurricane Maria proved that power is a prerequisite for health.

With the increase of climate change-driven disasters, building resilient health infrastructure has become a core element of Direct Relief’s response activities. The organization has installed solar power arrays and battery backup systems at community health centers across the U.S.

In Puerto Rico, Direct Relief, with support from AbbVie and others, is equipping health facilities with 1.2 megawatts of solar production capacity and 2.6 megawatts of battery storage.

Projects include:

• outfitting 89 health centers across the island with 164 FDA-compliant pharmaceutical and laboratory refrigerators and freezers capable of storing roughly 6 million vials of vaccines
• furnishing 22 community water pumps with backup solar and battery storage
• installing full backup solar power and battery storage on a fire station that lost grid power for months
• and providing home-based generators to 32 children who depend on powered equipment to breathe and for other medical needs.

Data-Driven Disaster Preparation

Whether responding to storms, fires, or disease outbreaks, data increasingly guides Direct Relief’s work.

Using various data sources, including the CDC/ATSDR Social Vulnerability Index and Facebook Disaster Maps, Direct Relief can identify areas at greatest risk from hurricanes, predict whether people will evacuate, and gauge the impact on local healthcare providers.

“We’re increasingly able to get a real-time, high-resolution view of evacuation dynamics, medical needs, and the pressure placed on healthcare infrastructure,” said Andrew Schroeder, Direct Relief’s VP of Research and Analysis.

Direct Relief is also looking at long-term displacement of people whose livelihoods have been destroyed by hurricanes, such as those in parts of Central America hit sequentially last year by Hurricanes Eta and Iota. “There’s a geography to poverty that corresponds with physical risk,” Schroeder said.

Covid-19 + Summertime Disasters: Why This Year May Be Different

This hurricane and wildfire season is the second to overlap with the Covid-19 pandemic. While disease prevalence in the U.S. is down sharply from its 2020 peak, the summer of 2021 presents an additional challenge.

Last year, emergency management agencies and aid groups could maintain social distancing by relocating disaster evacuees into hotels and motels, largely empty due to the steep drop in domestic travel.

This summer, with travel rebounding sharply, those rooms will no longer be available, making it more challenging to safely shelter evacuees.

The post Preparing Hurricane-Prone Regions for Hurricane Season 2021 appeared first on Direct Relief.

Last year, there were 441 reported polio cases worldwide, according to the Centers for Disease Control and Prevention.

While the last-known case of the crippling disease in the United States was in 1979, the CDC recommends that all children should receive a series of four polio shots.

“No country is safe from polio until the virus has been eradicated globally,” says the World Health Organization.

Ecuador last month launched a national campaign to inoculate infants against polio, but it ran short of the vaccine doses needed.

Ecuador’s Ministry of Public Health issued an international appeal for polio vaccine to organizations including Direct Relief and nations including Mexico.

In its communication to Direct Relief, the Ministry warned of “a critical shortage of basic vaccines” as a side effect of the COVID-19 pandemic. Ecuador requested 95,000 doses of the polio vaccine and 138,000 doses of other vaccines commonly given to children.

The Government of Mexico responded to the appeal, offering to donate the polio vaccine from its stockpile at the national vaccine agency BIRMEX.

To transport the humanitarian aid, Mexico’s government turned to Direct Relief, which is registered as a civil association in Mexico with tax-deductible status (Donataria Autorizada).

Like most vaccines, the polio vaccine is a cold-chain medication; it must be kept refrigerated at all times to between 2 and 8 degrees Celsius, delivered in special containers, with the temperature monitored.

Pharmaceutical distributors—and Direct Relief—are among the only organizations with cold-chain vaccine shipment capability.

Direct Relief has extensive experience working with the world’s largest medical manufacturers to distribute cold-chain prescription medications connected with humanitarian and emergency-response efforts.

In 2020, Direct Relief completed 1,953 cold-chain deliveries of such products, managing end-to-end distribution to health facilities across the United States and 52 other countries. Deliveries contained 21.6 million doses of temperature-sensitive medications, including insulin, cancer drugs, hemophilia treatments, vaccines, and biologic therapies for patients with rare genetic diseases.

Direct Relief’s Mexico office managed the complex customs procedures. Its logistics partner Kuehne + Nagel packed the vaccine and flew them to Ecuador while maintaining cold-chain integrity. The 95,000 doses of bivalent oral polio vaccine landed last week at Quito International Airport.

“With this donation, Mexico joins the noble cause of the Strategic Plan of the World Health Organization (WHO) to eliminate polio in the world,” Mexico’s Ministry of Foreign Affairs said in a statement.

The post Mexico’s Government, Direct Relief Deliver Donated Polio Vaccine to Ecuador appeared first on Direct Relief.

On Jan. 14 and 15, dozens of Brazilians asphyxiated in the Amazonas state capital of Manaus after oxygen supplies ran out, according to the Washington Post. “There is a collapse in the health-care system in Manaus,” Brazilian Health Minister Eduardo Pazuello said at the time. According to the Post, Manaus is short by the amount of oxygen needed for 70 critical patients per day.

Local facilities in Amazonas can produce less than half of the daily oxygen supply needed for patients in Manaus, a city of 2.2 million people, isolated in the vast Amazon rain forest with no drivable highways connecting it to the rest of Brazil. Additional oxygen comes by truck from Venezuela, by week-long boat trip from eastern Brazil, or flown in by the Brazilian Air Force.

During the first wave of the pandemic last April, Manaus became the first city in Brazil forced to bury Covid victims in a mass grave. So many of the city’s residents had been infected by mid-2020 that researchers thought the city was becoming a natural experiment with herd immunity.

Instead, a new surge hit the city in December, and by January, more than 100 people a day were dying in the city. Worse, according to the BMJ, many new patients are infected with the P.1 variant of the Covid virus, which appears to have evolved to make it more infectious.

On January 25, Amazonas Governor Wilson Miranda Lima issued a global appeal for oxygen and other medical supplies:

“This second wave has hit us with colossal force… Right now, the ‘Lungs of the Earth’ need oxygen. We are in dire need of medical and hospital supplies, medical oxygen, and resources for the logistical support in order for these materials to be delivered as quickly as possible in the proportion and speed that Amazonas needs.”

Direct Relief responded to the plea, granting $530,000 for purchasing an estimated 350 oxygen concentrators needed to help keep the region’s Covid patients alive.

Direct Relief made the grant to the Foundation for Amazon Sustainability. The donation was facilitated by the Governors’ Climate and Forests Task Force (GCFTF, an international collaboration of state and provincial governors) and Health Bridges International (HBI, a health-focused NGO), which sought a solution to the Amazonas oxygen crisis and turned to Direct Relief.

The first 240 concentrators arrived Saturday in Manaus. The Amazonas Secretary of the Environment, Eduardo Taveira, will oversee their distribution.

“The priority is to serve rural areas and avoid the impact of the second wave on the most vulnerable communities,” Mr. Taveira said.

Oxygen is one of the most common treatment needs for patients sick with Covid-19, as the disease lowers the lungs’ ability to absorb oxygen from the air. Oxygen concentrators pull oxygen directly out of the air rather than requiring cylinders filled with oxygen, at a time when oxygen tanks and other oxygen delivery technologies have been in short supply around the world.

This is only the latest in a long series of actions Direct Relief has taken over the past year to provide oxygen to patients who otherwise wouldn’t receive it. As word of the disease spread in January 2020, Direct Relief assessed the likely needs for medicine and equipment and began securing supplies. Among these supplies were thousands of oxygen concentrators that the organization ordered and has delivered to health providers across 45 countries, including the U.S. — from Arizona and Los Angeles to Lebanon and Yemen.

“Ending a pandemic that threatens everyone demands the type of international collaboration exemplified here by the government of Amazonas, FAS, GCFTF, HBI, and others,” said Direct Relief President and CEO Thomas Tighe. “This project will deliver life-saving support to communities in need, and we are so grateful that the aforementioned partners joined forces to execute as quickly as possible.”

The post Direct Relief Donates $530,000 to Bring Oxygen to Covid-Stricken City in the Brazilian Amazon  appeared first on Direct Relief.

The recipient programs span 10 U.S. states and are a mix of urban and rural initiatives that will work to create greater health equity among the country’s most vulnerable communities. The awards program is implemented by Direct Relief and is funded by The Pfizer Foundation.

The community health centers and free clinics will undertake program approaches including:

• Mobile vans and pop-up clinics to improve patient access and reduce barriers to care
• Telehealth and health technology to improve patient care and safety
• Community partnerships to expand reach and strengthen trust within target populations
• Outreach and education to address stigma and misperceptions
• New uses of electronic health records to standardize clinical care and track progress
• Use of community leaders to build trust and promote healthcare activities

“The COVID-19 pandemic has exacerbated existing systemic health inequities, resulting in vulnerable patients and their loved ones experiencing even greater hardship,” said Caroline Roan, President, The Pfizer Foundation and Chief Sustainability Officer, Pfizer Inc. “We are proud to support Direct Relief and its network of frontline safety-net clinics across the U.S. to break down barriers to good health in underserved communities and increase access to life-saving infectious disease prevention, diagnosis, treatment and care.”

“These awards are intended in part to allow providers to test and improve new care models and solutions, which is of utmost importance as healthcare is drastically changing due to COVID-19,” said Thomas Tighe, Direct Relief President and CEO. “We are humbled by the dedication of these largely unheralded safety-net health providers to improve the lives and health of the people they care for.”

Some of the recipient providers reflect a wider trend among health clinics—ramping up vaccination campaigns against common inflections like seasonal flu that can help to strengthen future vaccine delivery, including potential COVID-19 vaccination campaigns. Others include innovative ways of reaching more marginalized and vulnerable patients.

The Community Health Center of Southeast Kansas serves a population whose immunization rates for children and adults have historically fallen far below the state average, with only half of eligible adults vaccinated against pneumonia and less than 40% receiving annual flu shots. The center has proposed an ambitious initiative to help control infectious disease throughout 10 southeast Kansas counties. The plan includes an outreach team to provide immunizations at area companies, mental health centers, churches, shelters and jails, as well as a redesign of its service delivery model to “triage” every adult patient for gaps in protection against infectious disease and make the appropriate vaccine(s) available at no out-of- pocket expense. At the same time, this effort will create the infrastructure for a COVID-19 immunization campaign once a vaccine is available.

Harbor Health Services in Mattapan, Mass., proposed a program aimed at keeping vulnerable elderly patients out of hospital emergency rooms, reducing their risk of exposure to the coronavirus that is especially dangerous to the elderly. The initiative will provide preventive and emergency care to participants in their homes. Harbor Health’s patient data shows that 50% of hospital emergency room visits were preventable and avoidable; the two most common reasons for ER visits included urinary tract infections and unspecified dementia, both of which can be treated in the patient’s home.

In Chicago, Esperanza Health Centers has introduced its Comprehensive Southwest Side HIV Services Program, providing bilingual and bicultural HIV education, prevention, screening and care in Chicago’s Southwest Side Latinx communities. Within two years, it aims to double the number of individuals receiving HIV primary care and pre-exposure prophylaxis at its clinics, and increase the proportion of patients screened for HIV to 90%.

In Palm Springs, Calif., the Desert AIDS Project aims to reduce the rapidly rising incidence of sexually transmitted infections (STIs), in particular syphilis, in the region it serves. The program will increase STI testing, treatment, education and risk-reduction counseling, both through on-site treatment in its clinic and through its mobile testing unit, reaching patients that may not otherwise come to the clinic.

Direct Relief managed the application and selection process, in consultation with a panel of infectious disease physicians who provided a clinical review.

2020 Award Recipients

• Cherokee Health Systems, Knoxville, TN
• Chiricahua Community Health Centers, Inc., Douglas, AZ
• Community Health Center of Southeast Kansas, Pittsburg, KS
• Desert AIDS Project, Palm Springs, CA
• Esperanza Health Centers, Chicago, IL
• Grace Medical Home, Orlando, FL
• Harbor Health Services Inc., Mattapan, MA
• Lawndale Christian Health Center, Chicago, IL
• Public Health Management Corporation, Philadelphia, PA
• Westside Family Healthcare, Wilmington, DE
• Zufall Health Center, Dover, NJ

The post Direct Relief and The Pfizer Foundation Support 11 New Programs to Improve Infectious Disease Care in the U.S. appeared first on Direct Relief.

But the student, who asked to be identified only as Mr. Singh, found himself facing a dilemma that cut to the core of his identify.

Before allowing students to resume their rounds, the hospital required them to pass a fit test for N95 respirators, the heavy-duty face masks that block most very small particles. Occupational Safety and Health Administration (OSHA) regulations state that N95 respirators can only be worn over a clean-shaven face to ensure a tight seal.

As a practicing member of the Sikh religion, Mr. Singh wears an unshorn beard, one of the five “articles of faith” of the religion that “serve as an external uniform that unifies Sikhs and binds them to the beliefs of the religion.” Requiring a Sikh to shave is asking him to violate a central practice of his faith.

Mr. Singh approached his superiors to discuss his concern. “As per my faith I can’t shave,” he told them, asking if there were any other alternatives. He was sent to speak to a hospital administrator, who he expected would help him find a solution.

Instead, “she told me I needed to reevaluate my priorities, in terms of practicing medicine or practicing my faith,” Mr. Singh recounts.

The ultimatum threatened to knock Mr. Singh off his life’s path. “I need to finish these core rotations before I can go on to take licensing exams,” Mr. Singh said. “I was really worried I wouldn’t be able to rotate, and that would set off a cascade of consequences.”

This past spring, Sikh doctors and medical students across the U.S. and Canada found themselves in the same bind. In one widely publicized case in Montreal, a pair of physician brothers made the agonizing decision to shave their beards. “In this time of pandemic, I am faced with an existential crisis,” one of the brothers said in a widely viewed video. “This is a decision that has left me with great sadness, and I truly mourn the loss of something that has been a major part of my identity.”

“Sadly, that video worked against a lot of our clients,” said Amrith Kaur Aakre, legal director of the Sikh Coalition, a civil rights group that has been helping Sikh medical workers pressured to shave their beards. “A lot of the hospitals then started to think that shaving one of your religious articles of faith was a choice that you can get a dispensation for.”

Tightening the personal bind, many Sikh medical workers have described their feeling that continuing to treat patients amid the crisis was a way of honoring one of the three daily principles of Sikhi, “service to humanity.” They joined other medical professionals across the United States who showed great bravery and sacrifice, caring for gravely ill patients at a time when health workers faced severe shortages of personal protective equipment in the early months of the pandemic.

Mr. Singh sat down with his parents for a very difficult conversation. Should he compromise his religious beliefs, or give up his dream of becoming a doctor? “They’ve been here since the 1970s, and said that dealing with institutional discrimination isn’t new to them, but they never expected their kids would face something like this,” he said.

“We eventually agreed that ultimately if this was going to get in the way of rotating, I would have no choice about complying,” Mr. Singh said. “But I didn’t want to do that before using all the resources we had.”

Mr. Singh asked his medical school to back him up. The school reached out to the hospital but was rebuffed, and declined to push the issue, reluctant to risk its relationship with the hospital.

Mr. Singh then approached the Sikh Coalition. The Coalition went to the hospital’s parent organization (a large health network in the Northeastern United States), where it found officials who were more sensitive to the situation and were willing to seek a solution.

The hospital arranged for Mr. Singh to have access to a then-scarce powered air-purifying device (PAPR). Unlike tight fitting respirators like the N95, PAPRs cover the user’s full face, head and shoulders under a hood with a clear visor. PAPRs don’t require that the wearer be clean shaven.

Just as with N95 respirators, PAPRs became very difficult to obtain as the pandemic spread and the need far outstripped supply. Hospitals that tried to secure PAPRs faced months-long waits for delivery.

The Sikh Coalition, together with its partner the North American Sikh Medical and Dental Association, began working to obtain a supply of controlled air purifying respirators (CAPRs) — another type of loose-fitting respirator that does not require the wearer to be clean shaven — that could be loaned to Sikh medical workers.

Direct Relief Executive Vice President and Senior Advisor Bhupi Singh, who sits on the Sikh Coalition’s strategic advisory board, heard about the effort.

Direct Relief was able to secure 24 PAPRs for the Sikh Coalition, drawing from a donation of 6,000 PAPRs from 3M that Direct Relief was distributing to hospitals and health clinics across the United States.

Reasonable Accommodation

Beyond the challenge of building awareness and support among medical leaders, Sikhs and others who need some accommodation for their religious practices face a legal hurdle.

Under Title VII of the Civil Rights Act of 1964, as amended in 1972, employers must provide “reasonable” accommodations for their employees’ religious beliefs and practices, unless those accommodations would impose an “undue hardship” on them. However, in 1977’s Trans World Airlines, Inc. v. Hardison, the U.S. Supreme Court ruled that an “undue hardship” exists whenever an accommodation would require “more than a de minimis cost” to the employer.

The Sikh Coalition in July filed an amicus brief in a case currently pending before the Supreme Court that would overturn Hardison, arguing that “since Hardison, case after case has denied Muslim and Sikh workers’ requests for reasonable accommodations under the current de minimis rule—often because of a speculative harm or small financial cost.”

Moreover, the Sikh Coalition has found that many Sikh medical professionals and students are reluctant to publicly voice their concern about the issue.

“A lot of doctors, residents and medical students who reached out to us are really concerned about retaliation and workplace hostility if they make a stink, or publicize the fact they had to go through this process and reach out to a civil rights organization in order to make the accommodations happen,” said the Sikh Coalition’s Aakre.

“We don’t want there to be this misrepresentation of how difficult or challenging it is to accommodate Sikhs,” she said, expressing concern that “all of a sudden medical schools will start pretextually not allowing Sikhs in.”

Back to Work

Ironically, during the remainder of the spring Mr. Singh never needed to use the PAPR or even an N95 respirator. He was working in a ward that had no COVID-19 patients, and the staff wore surgical masks rather than N95s. Mr. Singh started his fourth year of medical school on Aug. 31.

“I don’t think it should have been this complicated for me to practice my faith and follow my career passion to help others—I’m going to continue to do both for the rest of my life,” Mr. Singh said. “But I’m thankful to those who helped me through this process, and I’m hopeful that my experience will show anyone else who is told ‘no, you can’t do this’ that there is a way forward for them, too.”

The post A Solution for Sikh Medical Students, Physicians Caught Between Their Religion and Their Profession appeared first on Direct Relief.

The $2.5 million investment aims to triple Direct Relief’s medical refrigeration and freezer capacity. Direct Relief’s current validated-for-vaccine cold-storage warehousing can hold up to 40 million doses of vaccine in 10-dose-per-vial packaging within the typical 2-8-degree Celsius temperature range but lacks larger-volume freezer capacity that some Covid-19 vaccines may require.

The organization is in discussions with national and state health authorities, the National Association of Boards of Pharmacy, and pharmaceutical donors about Covid-19 vaccine distribution plans.

Direct Relief is one of the world’s primary channels for distributing donated charitable medications—including vaccines and other cold-chain medications (those requiring constant, carefully controlled refrigeration)—to people who otherwise would not have access. In the United States, Direct Relief is a central conduit for distributing such medications to nonprofit safety-net providers, including community health centers. These providers are critical in reaching underserved communities, and specifically people of color, who have been disproportionally affected by Covid-19.

Direct Relief’s state-of-the-art pharmaceutical distribution center, which opened in 2018 in California, is one of 665 facilities in the United States accredited by the National Association of Boards of Pharmacy as an Accredited Drug Distributor and is the only one operated by a global humanitarian aid organization.

While the specific temperature-management requirements for various Covid-19 vaccines remain unknown, Direct Relief believes global cold-chain capacity is far below what is needed for rapid, mass-vaccination efforts to immunize the U.S. population, much less the global population.

“Direct Relief is taking this step with urgency, recognizing the pressures that exist in getting approved vaccine to people who need it in a safe, secure way,” said Thomas Tighe, Direct Relief President and CEO. “Existing cold-chain channels were not built to support this scale of activity. The situation echoes the severe challenges that arose with the allocation and distribution of PPE—which did not require specialized licensing to handle, store, or track, as do prescription drugs and vaccines.”

Direct Relief has extensive experience working with the world’s largest medical manufacturers to distribute cold-chain prescription drugs, vaccines, and biologic therapies connected with humanitarian and emergency-response efforts.

In the fiscal year ended June 30, Direct Relief completed 2,103 cold-chain deliveries of such products, managing end-to-end distribution to health facilities across the United States and 33 other countries. These deliveries included 738,000 vials of insulin from Eli Lilly, Novo Nordisk, and Sanofi for patients with Type-1 and Type-2 diabetes; cancer treatment drugs from Amgen, Teva, Takeda, and Baxter; blood-clotting hemophilia treatments from Bayer, Takeda, Pfizer, and Kedrion Biopharma; and biologic therapies from Takeda and Biogen for patients with rare genetic diseases.

Direct Relief has been responding expansively to Covid-19 since reports first arose in January of cases in Wuhan, China, and the Western United States. Since Direct Relief’s first Covid-19 aid delivery on Jan. 27, the organization sent 21,083 medical aid shipments to 2,786 health facilities in 54 U.S. states and territories and 88 countries. These shipments contained 3.2 million lbs. (1,600 tons) of medical essentials, including more than 38 million N95 and surgical masks, more than 7 million gloves, more than 1 million face shields, and tens of thousands of protective suits and other items to help safeguard health workers and care for patients, as well as including 76.9 million Defined Daily Doses of medications, with a value of $747.6 million (wholesale acquisition cost).

“Because Direct Relief is a public-benefit nonprofit with the specialized licensing, capacity, and experience required for cold-chain vaccine distribution, we will do whatever we possibly can to pitch in and backstop public agencies that have their hands more than full,” Tighe said. “We also want to ensure that those most in need, whom our organization supports every day and have suffered disproportionate effects from Covid-19, have a channel to support them.”

The post Direct Relief Prepares for Covid-19 Vaccine Distribution, Investing $2.5 Million to Expand Cold-Chain Capacity appeared first on Direct Relief.

The Solidarity Fund was formed in March 2020 as a rapid response vehicle to augment the South African government’s response to Covid-19. It is focused on reducing coronavirus transmission, including through communications driving behavioral change; health response, including obtaining personal protective equipment (PPE) for frontline health workers; and humanitarian response, including food relief for people who have lost their means of sustenance.

Direct Relief is acting as the fiscal agent for the Solidarity Fund in the United States, enabling U.S. residents and corporations to easily make donations to the Fund. 100% of all donations made on the donation page will be delivered to the Solidarity Fund.

Direct Relief itself has donated $1 million to the Solidarity Fund, and has advised the Fund on purchases of large quantities of PPE from China.

“South Africa’s Solidarity Fund is exactly the type of unifying, pragmatic approach that makes sense in the face of a pandemic that threatens everyone,” said Direct Relief President and CEO Thomas Tighe, who also serves as Managing Director of Direct Relief South Africa, the organization’s South African affiliate, a Section 21 nonprofit. “Direct Relief is so pleased to participate in this important effort that is pulling people and organizations together to help address both the obvious direct threats to public health and the many related effects, particularly for those in already difficult circumstances.”

Within two months of its establishment, the Fund delivered food packages to about 300,000 vulnerable households. Each package was designed to provide a family with food essentials for two to four weeks. The Fund is now rolling out the second phase of the food relief program in the form of food vouchers, after determining it would be a more effective and efficient way to provide the assistance.

The Fund has played a catalytic role in responding to the impact of the pandemic on the health system by procuring critical medical equipment and PPE for healthcare workers and expanding testing capacity.

The Solidarity Fund has so far distributed nearly 20 million units of PPE, including gloves, gowns, masks, sanitizers, boot covers and face shields to healthcare workers in public sector hospitals and clinics, as well as to community health workers. The Fund has also provided more than 1 million surgical masks to nine medical schools across the country to help fifth- and sixth-year medical students and those in allied health sciences resume clinical blocks and complete their studies.

“We are privileged to have social partners such as Direct Relief who through their contributions have expressed confidence in the Solidarity Fund’s efforts to make an impactful contribution towards South Africa’s fight against Covid-19,” said the Fund’s Deputy Chairman Adrian Enthoven. “As a fiscal agent to the Fund, Direct Relief makes it possible for interested international donors to make a contribution in an efficient way that otherwise wouldn’t be available to the Fund. We are grateful for their support and solidarity with our mission of assisting South Africa’s health and humanitarian efforts during this challenging time.”

The Fund is being operated by more than 90 full-time voluntary staff across a network of 25 companies and organizations that are providing support services. In the spirit of unity in action, all of the talent and skills that have been mobilized to assist the Fund are doing so on a pro bono basis, with no one earning fees or a salary from the Fund. The Fund works closely with government and business, but is independent of both of them. Insurance company Old Mutual Ltd. is administering the funds on a pro bono basis, and the Fund is reporting detailed information on donations received and expenditures made.

Many of South Africa’s top political and business leaders pledged to donate 30 percent of their salaries earned over three months to the Fund.

The behavioral change initiative being run by the Fund encourages mask-wearing and hand-washing, and seeks to reduce practices that risk Covid-19 transmission, such as attending heavily-crowded funerals. It has partnered with the National House of Traditional Leaders to help traditional leaders communicate prevention messages to their communities.

The post Overcoming Covid-19 in South Africa appeared first on Direct Relief.

Unlike face masks, PAPRs cover the user’s full face, head and shoulders, and offer higher levels of respiratory protection than N95 masks. Their loose-fitting hoods don’t require fit-testing or that the wearer be clean-shaven.

The PAPRs being distributed were developed and assembled by Ford Motor Co., with design and testing consultation from 3M to provide critical personal protective equipment (PPE) to healthcare workers. 3M donated 6,000 of these devices to Direct Relief, which is distributing them to healthcare providers in need across the United States, especially to critically impacted communities in California.

Of the 6,000 devices, 2,500 were drop-shipped directly to the California Department of Public Health’s Emergency Preparedness Office in the Sacramento area. The CDPH immediately sent most of these PAPRs out to county public health departments. The largest shipment went to Imperial County, which as of July 29 had by far the state’s highest Covid-19 infection rate per 100,000 residents and whose hospitals have been so full they have had to send patients to other counties.

The State of California normally does not keep PAPRs in stock, and until now had none to distribute during the Covid-19 pandemic, said Alan Hendrickson, an emergency planner in the CDPH’s Emergency Pharmaceutical Services Unit.

The remaining 3,500 PAPRs, filling three full truckloads, arrived at Direct Relief’s Santa Barbara warehouse on July 6. Direct Relief allocated the devices—officially called the “Ford Limited-Use Public Health Emergency PAPR”—to 145 hospitals, health centers, and county and state health departments in seven of the hardest-hit states—Arizona, California, Connecticut, Massachusetts, New Jersey, New York and Texas—and Puerto Rico.

“These are incredibly hard to come by,” said Mark Lenhart, Chief Philanthropy Officer at the Society of Critical Care Medicine, which helped Direct Relief identify the health facilities with the greatest need. “It’s been a godsend.”

Lompoc Valley Medical Center in Lompoc, Calif., has several staff members who are unable to be properly fitted to an N95 mask due to facial structure or facial hair, said Chief Nursing Officer Yvette Cope. Like other health providers around the country, the hospital had struggled to obtain PAPRs.

“The arrival of these PAPRs will help us meet the need of protecting our staff who cannot wear an N95 mask and provides additional protection for clinical staff providing life-sustaining airway intubation or administering aerosolized treatments,” Cope said. “We are extremely thankful for this donation!”

The PAPR hood design can be more comfortable for users to wear for a long period of time and its motor, battery, and high-efficiency particulate air (HEPA) filter can provide up to eight hours of filtered air on a single battery charge. Its large, clear viewing window allows patients to see the full face of the wearer, enhancing interpersonal communications and the overall clinical experience. Additionally, a PAPR’s motor unit can be used by multiple health workers as long as each individual has their own hood.

“3M is dedicated to the support and safety of healthcare workers fighting Covid-19 across the country,” said Bernard Cicut, Vice President Personal Safety Division at 3M. “We are proud to build upon our relationship with Direct Relief and provide these critical PPE devices for distribution to healthcare providers in communities with limited resources and rising case counts.”

“Direct Relief is so deeply grateful for 3M’s donation of much-need PPE, which is enormously important and perfectly timed with Covid-19 cases growing,” said Direct Relief President and CEO Thomas Tighe. “We learned immediately what a huge boost this donation has been for the medical professionals who go to work every day to face this virus that the rest of us are just hoping to avoid. It’s such a great example of the type of leadership and public-spirited action these challenging times call for.”

The post Thousands of Advanced Respirators Reach Health Workers appeared first on Direct Relief.

The Direct Relief shipment includes 20 of Direct Relief’s ICU Critical Supply Modules, each with medications and supplies selected to treat up to 500 critically ill Covid-19 patients, along with 150 oxygen concentrators, five ventilators, and large quantities of personal protective equipment.

“This shipment comes at a very critical time and will have immediate impact,” Dr. Ahmed Awad Bin Mubarak, Yemen’s ambassador to the United States, told Direct Relief. For the people of Yemen, “it is a clear message to them that they don’t stand alone.”

In countries across the developing world, the equipment to deliver oxygen to Covid-19 patients is in critically short supply. Oxygen is among the most important needs of severely ill Covid-19 patients, who often arrive at hospitals with extremely low blood-oxygen levels.

“Many countries are now experiencing difficulties in obtaining oxygen concentrators,” World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus said in a June 24 speech. Oxygen availability, he said, “has been an area of intense focus for WHO since the beginning of the pandemic.”

Torn by a civil war that since 2015 has displaced more than 800,000 people, Yemen by last year was already the world’s worst humanitarian crisis, the United Nations warned. Authorities estimate that fewer than half the country’s health facilities are currently fully operational.

“The worst-case scenario—which is the one we’re facing now—means that the death toll from the virus could exceed the combined toll of war, disease and hunger over the last five years” in Yemen, said Lise Grande, the head of the UN’s humanitarian operations in Yemen, in an interview with CNN last month.

The shipment for Yemen departed Direct Relief’s Santa Barbara warehouse last week, scheduled to arrive this week in Dubai.

From Dubai, it will be flown into Aden, Yemen via the World Food Programme Logistics Cluster.

Direct Relief partner Yemen Aid will deliver the emergency supplies to Covid-19 treatment centers in Aden, Taiz, Lahij, and Abyan.

The post Direct Relief Delivers Critical Oxygen and ICU Medicine for Yemen’s Covid-19 Patients appeared first on Direct Relief.

Those are just some of the costs inflicted on four health care providers in a single California county by the largest intentional power shutdown in American history. A majority of the state’s counties lost power for portions of October, as Pacific Gas & Electric and other California utility companies shut down the grid in an attempt to prevent their infrastructure from sparking wildfires amid strong winds.

The experience of health providers in California’s Mendocino County show how vulnerable our health care system is to power outages.

“It was a wake-up call for everybody,” said Lynn Finley, chief nursing officer of Mendocino Coast District Hospital (MCDH) in Ft. Bragg. “We’re anticipating we will see this frequently, so we need to be better prepared to take care of our communities.”

In late October, Direct Relief surveyed nearly 300 community health centers in California about how they were affected by the power shut-downs. Of the 31 that responded, nearly two in five (39%) said they had lost power during the grid shut-offs, and 29% were forced to close during the outages.

Flashlights and linen: health care in the dark

In Ft. Bragg, a coastal town about 170 miles north of San Francisco, MCDH’s emergency room was swamped by double the typical number of patients, ranging from elderly people injured in falls, to people whose CPAP breathing devices had run out of power, to people simply worried and looking for a warm place to stay, Finley said.

MCDH canceled all elective surgeries scheduled for the week, about 50 in all, performing surgeries only in emergencies. The hospital initially had no heat, relying on extra linens to keep its patients warm. It eventually figured out that its heat circulator wasn’t connected to the backup generator.

A number of elderly people came to the emergency room after falling in the dark and breaking bones. Some needed surgery, but the hospital wasn’t confident it could count on its backup generators for uninterrupted power. Instead, it sent the patients 60 miles away for surgery in a Ukiah hospital with second-level generators that kick in if its first-level generators fail.

While generators allowed MCDH to keep its doors open, its affiliated community health center was hit harder. North Coast Family Health Center (NCFHC), which typically sees 100 to 150 patients each day, was forced to cancel three days of patient appointments. These appointments are difficult to reschedule as doctors are in short supply.

The center was completely closed on the first weekday during the power outage, and then offered limited service the following two days. Staff relied on flashlights and exam rooms with windows to let the daylight in, said NCFHC Practice Administrator Clara Slaughter. “We only saw patients we could safely see with our limited facilities,” she said.

“Everything is electronic now, we don’t have paper charts laying around for us to reference,” Slaughter says. Because the adjacent hospital was open and hosts NCFHC’s patient records, the clinic stationed one nurse in the hospital and another in the clinic, and they relayed patient information back and forth by cellphone, though cellphone service proved highly unreliable during the outage.

Open and shut

Another large health care provider in Ft. Bragg, Mendocino Coast Clinics (MCC), lost power for three workdays in its four clinics. Without power, it had no access to electronic health records, including lab results, prescription information, records of necessary screenings, allergy records, or reports from specialists. It had no lighting, so its doctors worked with camping headlamps on their foreheads.

Without power, MCC had no x-rays, suction or dental drills, so it was forced to close its dental clinic for three days. More than 140 dental appointments were canceled, and the dental clinic alone lost an estimated $25,000 to $30,000 in revenue, said MCC Executive Director Lucresha Renteria.

In the MCC units that remained open, no-shows were rampant. In the reproductive health and obstetric department, only 35% of the patients who had been scheduled showed up for their appointments, while only 44% of behavioral health patients showed up, Renteria said.

“Patients were either canceling because they were in their own chaos, or were no-showing because of assuming we were closed,” Renteria said.

As with most organizations today, the workflows and administrative processes of medical offices are entirely computerized. Without access to its computers and servers, MCC couldn’t set up appointments with specialists, pay bills or record staff hours. MCC’s phone systems reverted to a single analog line in each clinic that was constantly busy, making it almost impossible to get through.

While MCC lost access to electronic health records during the outage, it had received advanced warning that it would lose power, so staff took action the Friday before power went out. They printed out their list of appointments scheduled for the upcoming Monday through Wednesday period, and wrote up “scrub notes” – key facts about each patient – in advance. Fortunately, the power came back on early Thursday morning.

Some of the biggest impacts were on MCC’s staff. Staff members who were sent home—including more than half of the medical assistants—lost days of wages.

Many even lost the ability to bathe. The power outage left many staff members without hot water in their homes for days. The clinic is looking at buying a camp shower so that in future incidents its staff can come in and take hot showers, Renteria said.

As difficult as the situation was for the three Ft. Bragg facilities, it was worse in the southern Mendocino town of Boonville. The PG&E power outage left Anderson Valley Health Center without running water, forcing it to close for three days. The facility gets its water supply from a well drawn by an electricity-powered pump, and it had no backup generator.

Planning for a darker future

In Direct Relief’s late-October survey, 67% of the health centers that lost power reported they had lost access to electronic health records. Under federal and state mandates, most patient data is now stored on computers (often on computer servers in separate locations) and is unobtainable during power outages.

Of the centers that lost power, 83% lost access to lighting, 58% lost refrigeration, and 75% lost use of diagnostic equipment.

A previous Direct Relief survey conducted earlier in October revealed that only 44% of California’s community health centers have a back-up energy source available when the electricity grid fails. Even clinics that had back-up generators found they didn’t provide enough power to operate all their systems, forcing operational triage. They could run the refrigerator to protect their medication supplies, they could power the lights, or they could power a few computers.

Losing access to power is expected to become a recurring challenge for health centers. California’s utility companies plan to continue intentional power shutdowns during periods of extreme fire danger while they address a maintenance backlog that could take a decade to resolve. Meanwhile, climate change is making California’s autumns hotter, drier and longer.

The power outages have prompted health leaders across the state to take a harder look at resiliency. The Mendocino health centers showed an ability to adopt creatively to the challenges and took extraordinary steps to continue serving their patients. With a better understanding of their vulnerabilities, they are now better able to prepare for the next major outage.

“It showed me the things we can do differently in the future,” NCFHC’s Slaughter said. “It’s all a learning experience.”

The post Unplugged: How California’s Power Outage Disrupted Patient Care on the Northern Coast appeared first on Direct Relief.

Nearly two in five health centers (39%) responding to the survey said they had lost power during the grid shut-offs, and 29% were forced to close during the outages. Pacific Gas & Electric and other California utilities shut off power in a majority of the state’s counties for portions of October, trying to prevent downed power lines from sparking wildfires.

Community health centers that lost power but were still able to open found themselves crippled by the loss of power, forced to slash services, close units like dental clinics, and attempt to operate without the computer systems that are the backbone of modern healthcare.

Beginning Oct. 30, Direct Relief surveyed 114 health center partners in California, as well as 175 health center members of the California Primary Care Association, or CPCA. It received 31 responses from all parts of the state.

Among respondents, 12 centers forced by the power outage to cancel patient visits reported more than 2,800 patient visits were canceled or otherwise prevented from occurring due to power loss. Those 12 centers represent only about 1% of the more than 1,300 community health center sites in California.

“Loss of access to health care, including medications, is one of the most dangerous yet least-understood risks from natural or human-caused disasters,” said Andrew MacCalla, Direct Relief Vice President of Emergency Response. “California’s widespread power shutdowns have revealed a hidden weakness in our health care safety net. We must work together to improve the system’s resilience.”

Seven million Californians depend on nonprofit community health centers for primary health care, according to the CPCA, especially in low-income urban areas and in rural areas where they are often the only medical provider.

In Direct Relief’s survey, 67% of the health centers that lost power lost access to electronic health records. Under federal and state mandates, most patient data is now stored on computers (often on computer servers in separate locations) and is unobtainable during power outages.

Of the centers that lost power, 83% lost access to lighting, 58% lost refrigeration, and 75% lost use of diagnostic equipment.

Modern health care is built on the assumption of steady power from the electricity grid. Even if a health center stays in operation without power, without electronic health records the doctors can’t access lab results, records of current prescriptions, schedules for screening tests like mammograms, records of blood pressure and cholesterol level, or reports from specialists.

A previous Direct Relief survey conducted earlier in October revealed that only 44% of California’s community health centers have a back-up energy source available when the electricity grid fails. Even clinics that had back-up generators found they didn’t provide enough power to operate all their systems, forcing operational triage.

In response to the power outages, Direct Relief has provided back-up power units and generators to health centers and shelters working to maintain operations, in addition to providing requested medical aid, such as respiratory medications and oxygen concentrators, hygiene kits, and Emergency Medical Backpacks, which contain medicines and supplies commonly used in a disaster setting.

The post California Power Outage Toll Includes Thousands of Missed Medical Visits appeared first on Direct Relief.

Modern health care is built on the assumption of steady power from the electricity grid. But a Direct Relief survey during last week’s outage revealed that only 44% of California’s community health centers have a back-up energy source available when the electricity grid fails. Even clinics that had back-up generators found they didn’t provide enough power to operate all their systems, forcing operational triage. Seven million Californians depend on nonprofit community health centers for primary health care, especially in rural and low-income urban areas.

Pacific Gas & Electric, California’s biggest electric utility, last week shut down its power grid in 34 of California’s 58 counties, warning that some customers could be cut off for up to a week.

More than 730,000 locations were cut off, leaving an estimated 2 million people without power. PG&E took the drastic step during a period of severe wildfire risk, with strong dry winds matching conditions when downed power lines sparked devastating fires in 2017.

PG&E has acknowledged that many of its long-distance transmission lines and towers crossing California’s forests are in decrepit condition, and that its equipment ignited several of California’s massive wildfires in recent years. While this was the first preventive power cut of this scale in the United States, many more are expected to follow. PG&E plans to continue preventive shutoffs when conditions demand, as do other utilities such as Southern California Edison, the state’s second-largest power provider.

Modern health care is almost entirely dependent on availability of electricity:

• The government-mandated shift to electronic health records means little or no patient health information may be available if local power or data transmission fail.
• Direct Relief’s survey found that 97% of health centers have medications on site requiring refrigeration. Insulin, vaccines and many other medications must be kept within a specified temperature range; if they fall out of that range for more than a short period they must, by law, be discarded.
• Much of the equipment in a modern medical office requires electricity to operate.

Direct Relief’s survey was shared with 114 health center partners in California, as well as with 175 health center members of the California Primary Care Association. Of the 70 that responded, 97% (68 health facilities) store refrigerated medications on site, but only 44% (31 health facilities) have a back-up energy source available.

Of those 31 health facilities with a back-up source:

• 68% (21 sites) have diesel back-up generators,
• 13% (4 sites) use propane,
• 10% (3 sites) use natural gas,
• 10% (3 sites) have solar, and
• 3% (1 site) have both diesel and solar

Even among the 44% that had back-up power, that power is limited. Back-up generators powered by propane, diesel or natural gas are often able to provide only a limited amount of power. Direct Relief last week spoke with several health centers that had to make power triage decisions: they could either keep their pharmaceuticals refrigerated, or could run their computer networks to access health records, or power their air conditioning and lights.

In comments in their survey responses, clinics that do have back-up power generation available said:

• “But we are not able per PG&E to have back-up batteries to store our solar power as we feed back into the grid which has forced us to get a diesel generator which will not quite meet all of our needs.”
• “We only have power back-up generators for our vaccine units and they can provide only 12 hours coverage at a time.”
• “The solar is only at one site and only backs up certain items, and the system only can supply 4 hours of lighting – not all night.”
• “Portable generators gas and propane for powering refrigeration, have to be run outside with cord to fridges.”

Winters Health Care, which serves an overwhelmingly poor population in rural Northern California, chose to power their medical records system, lighting the clinic with whatever they could find at the hardware store and transporting their expensive, temperature-sensitive vaccines for safekeeping to a nearby health facility unaffected by the outage.

At LifeLong Medical Care in the East Bay, staff quickly moved vaccines and other temperature-sensitive medications to a nearby hospital for storage as their Oakland clinics lost power, and a clinician kept each location open in the darkness.

An estimated 3,000 people died due to loss of access to health care after Hurricane Maria struck Puerto Rico in 2017. Dozens of community health centers across the territory lost power for weeks or months. Direct Relief has since been setting up self-sufficient micro-grids for the centers, combining solar power, battery power storage and back-up generators to keep them in operation during future outages.

Direct Relief itself has turned its own Santa Barbara headquarters and pharmaceutical warehouse into a self-sufficient power island/micro-grid that can run off the grid for months. With potential outages scheduled over the coming days in Southern California, Direct Relief is making its facilities available to the public to charge devices and small electronics while power is down.

The post California Power Blackouts Reveal Widespread Vulnerability in Health Care System appeared first on Direct Relief.

Cold wind blasts down from the industrial fans overhead. It cuts through the parkas workers don before entering Direct Relief’s cold chain room, making it feel far colder than the 4-degree Celsius reading on the temperature gauge. Inside the room are racks of shelves rising to the ceiling, filled with cartons of insulin, vaccines and some of the world’s newest and most advanced medicines.

In late June 2018, Direct Relief opened its new headquarters and warehouse, and with it the new cold chain facility. The refrigerated room, funded by BD, combines a suburban home-sized 2,800 square feet of floor space with a three-story ceiling.

The cold chain room has been a portal to a new world of capability for Direct Relief, greatly expanding the organization’s ability to deliver medicines that require constant refrigeration. This, in turn, has already given tens of thousands of people around the world access to lifesaving insulin for controlling diabetes, vaccines for fighting a myriad of diseases, and advanced treatments for rare genetic disorders.

The “chain” in cold chain is the supply chain delivering a medicine from manufacturer to patient, during which the refrigerated product must be maintained between 2-8 degrees Celsius.

Direct Relief’s giant refrigerator is only one link along the cold chain. Each cold chain package contains a temperature data log that maintains a record of temperatures throughout the entire delivery process. The drugs are often shipped to places that take multiple flights and long trips by road and are shipped in packaging that maintains the temperature range for up to 120 hours.

The cold chain capability of Direct Relief’s new warehouse enabled the organization to double the amount of cold chain medicine it shipped in fiscal year 2019 compared to fiscal year 2018.

Prior to July 2018, Direct Relief was able to distribute a smaller amount of cold chain medicines that were stored in pharmaceutical-grade refrigerators in its warehouse or through drop shipments sent directly from the manufacturer to the end recipient. In the 2019 fiscal year that ended June 30, Direct Relief delivered 1,462 cold chain shipments with a wholesale value of $203 million, doubling the 692 shipments delivered in 2018 at a value of $103 million.

Over the past year, Direct Relief has shipped insulin to countries including Eritrea, Tajikistan, and Pakistan; shipped blood-clotting hemophilia treatments to Puerto Rico, El Salvador, and Jamaica; and shipped cancer treatment drugs to Malawi, Belarus, and Syria. Countries receiving the most shipments include the United States, South Africa, Uganda, Zimbabwe, Haiti, Honduras, Dominican Republic and Malawi.

“There’s a broad-based need for this capacity across many different health issues, from vaccination campaigns to diabetes and cancer therapies, in places where people lack access to resources,” said Thomas Tighe, CEO of Direct Relief. “Expanded cold chain capacity has let us reach more people in need of medicine that they lack any other way of obtaining.”

“It certainly opened up new opportunities to help more people,” says Dawn Long, Direct Relief’s chief operating officer. “A lot of these cold chain medicines are lifesaving.”

Trends in drug development have made cold chain increasingly important. Pharmaceutical companies have shifted their efforts away from chemicals-based small molecules to biologics and other large-molecule drugs, often created from living human cells. Most of these advanced drugs need to be refrigerated.

Some pharmaceutical makers have charitable programs that allow people who otherwise couldn’t afford a medication to apply for donated drugs. But many of these people are living in developing parts of the world that lack rapid, efficient delivery networks.

The cold chain facility has helped Direct Relief scale up its donations of insulin working with the Life for a Child program. Insulin should be kept between 2-8 degrees Celsius in order to last more than 28 days.

In fiscal year 2019, Direct Relief oversaw the end-to-end supply chain for over 275,000 vials of insulin donated by Eli Lilly and Company for the benefit of over 16,000 children with Type 1 diabetes across 30 countries including Mali, Pakistan and Bolivia.

The cold chain capacity has also enabled a growing Direct Relief rare disease program. Pharma companies often invest hundreds of millions of dollars to develop a single drug for a rare disease, which is then sold for hundreds of thousands of dollars per course of treatment. These manufacturers sometimes have charity programs in which they provide treatment for free to a limited number of people in developing countries who would otherwise have no chance of being able to afford it.

Direct Relief in fiscal year 2019 delivered $37 million in drugs donated by Takeda to treat rare genetic diseases called lysosomal storage disorders. The added cold chain capability also enabled Direct Relief to begin working with Amgen on its International Rx Access program, delivering $79 million in medications in fiscal 2019, the first year of the program.

Direct Relief uses specialized packaging to maintain a constant temperature for between 48 and 120 hours. They’re packed either with water-based gel-packs or with more advanced phase-change materials (PCMs). Direct Relief uses both summer packs and winter packs designed for different seasonal temperature ranges.

Direct Relief’s inventory management system lets it monitor the progress of every package toward its destination. Direct Relief is now working with its shipping partners on “lane assessments” evaluating potential routes to determine the most reliable ones—those most likely to allow the packages to get to their destination before the coolant stops working.

The cold chain delivery capacity goes beyond Direct Relief’s ability to manage shipments through its own refrigeration room. It is also able to better manage drop shipments—deliveries from manufacturers or other warehouse locations direct to recipients. As part of its program with Amgen, Direct Relief has managed the shipping of over 100,000 units of an essential medicine to fight life-threatening infections in underserved cancer patients undergoing chemotherapy in 15 countries.

The post Forging the Links of Cold Chain Medication appeared first on Direct Relief.

The boy and his father had migrated from violence-wracked Honduras. But instead of finding security in the United States, the child was taken away from his father by immigration authorities under the Trump Administration’s child separation policy. They put him on an airplane to New York, where he was held in a facility for several weeks.

Now, the child was staying with an aunt in Dallas, but seemed locked inside himself, refusing to eat, speak, play or interact with anyone.

“This is probably the most severe case we’ve seen so far,” but hardly the only one, says Dr. Sharon Davis, chief medical officer at Los Barrios Unidos Community Clinic, a federally qualified health center in Dallas. “We have a very high immigrant population, who are affected by the many, many traumas they get through to get here.”

Los Barrios Unidos and other Texas health centers are on the vanguard of trauma-informed care, a budding movement to recognize and respond to the widespread prevalence of trauma among patients.

The Texas Association of Community Health Centers, with up to $1 million in grant funding from Direct Relief, is working to train its member health centers in trauma-informed care. TACHC’s 73 members, with more than 400 sites across Texas, collectively provide care to 5 million patient visits per year. Community health centers typically provide primary and preventive care to medically underserved and uninsured people, the overwhelming majority of them below the poverty line.

Caring for the Health of Trauma Survivors

Trauma-informed care starts with the core assumption that a patient is more likely than not to have suffered some kind of trauma. When practicing trauma-informed care, health care providers shift from asking “What is wrong with this person?” to “What has happened to this person?”

Early detection and treatment of trauma can head off a lifetime of consequences and high medical costs. A person carrying trauma faces higher risk of substance abuse, mental health issues, heart disease and risky sexual behaviors. The trauma often goes unrecognized by medical workers, who treat the symptoms—addiction, depression, self-harm—rather than the causes.

Trauma-informed care is a relatively new field, gradually emerging since the mid-1990s and still in a formative period. While psychological trauma has always been part of the human experience, post-traumatic stress disorder, or PTSD, wasn’t recognized as a medical diagnosis in the United States until 1980, when the American Psychiatric Association added it to the third edition of its Diagnostic and Statistical Manual of Mental Disorders, the DSM-III.

Psychologists have come to believe that millions of Americans who have never been in combat are walking around carrying trauma from their own experiences. Those experiences may include sexual or physical abuse, witnessing or experiencing gun violence, or the separation of children from parents by U.S. immigration agents.

While these experiences may inflict deep trauma, “trauma can be as simple as a dog bite or a minor car wreck,” says Aimee Rachel, Trauma Informed Care Project Coordinator at TACHC. “People will often have trauma symptoms but dismiss their experience because it was not a ‘big’ trauma.”

“We recognize that the military we send into war may develop PTSD as result of being shot at with weapons of war,” says TACHC Executive Director José Camacho. But right here in the United States, he says, “we have kids today that are being shot at with weapons of war.” The duck-and-cover nuclear war drills of the 1960s have been replaced by training small children to hide from active shooters in their schools, he notes, asking whether such training itself can traumatize these children.

Children brought into a health center because of behavioral issues in school are often given medication for Attention-Deficit/Hyperactivity Disorder. But if the underlying issue is an experience of trauma, that medication will likely fail to fix the behavior and could potentially cause new harms.

Trauma-informed care doesn’t require any significant changes in health center workflows, TACHC says. Instead, it trains every staff member (especially those encountering patients) on how to recognize signs of trauma, and makes small adjustments in practice to avoid re-traumatization.

“When you drill it down, it’s caring about people,” says Dr. Roxana Cruz, TACHC’s director of medical and clinical affairs. “If we allow ourselves to care deeply about people, then they respond and tell you their deepest feelings and emotions, and thereby can be provided with support, directed to trauma-specific therapy, and taught healthy coping skills.”

Recommendations for trauma-informed care affect everything from the layout of the waiting room to the way a doctor listens to a patient’s breathing:

Because so many women have experienced sexual assault, a doctor should explain that he will use a stethoscope and ask permission before reaching toward a woman’s chest.

Because so many people have been victims of violence, parking areas and stairwells should be well-lit, and the waiting room should include chairs facing the entrance for people who fear sitting with their backs to a door.

“Health care services, with an inherent power differential between patient and physician, and which often include physical touch, removal of clothing, lack of privacy, and personal questions, can be re-traumatizing for survivors,” says Dr. Eve Rittenberg, writing in the New England Journal of Medicine.

TACHC is using a train-the-trainers model, starting this year with 10 to 12 health centers identified through surveys as being most ready. It conducted the first training sessions in April.

In each selected health center, three members are being trained: one behavioral health or substance use disorder clinician, one medical or dental provider, and one staff member “who has demonstrated ability to be a change leader within the center,” TACHC says in a fact sheet about the program. TACHC is providing full-day training workshops, monthly one-on-one and group calls for coaching, and train-the-trainer guides.

Protecting Health Workers from Psychological Impacts

Trauma-informed care extends to caring for health center staff. “Like everyone working in health care, I am vulnerable to the effects of vicarious trauma, the weight of witnessing my patients’ suffering,” writes Dr. Rittenberg. “Vicarious trauma can lead to compassion fatigue and burnout, especially when it resonates with a provider’s own prior traumatic experiences or occurs in a setting that lacks opportunities for support and discussion of the work.”

Texas clinics experienced high staff turnover after 2005’s Hurricane Katrina, which destroyed New Orleans and sent refugees flooding into Texas. While the health centers initially attributed the turnover to burnout, they eventually realized the clinicians were suffering from the secondary trauma of having to deal repeatedly with patients in crisis. When Hurricane Harvey hit in 2017, the TACHC helped train staff on secondary trauma, and the centers whose staff got training saw far lower levels of turnover, Camacho says.

While the family separation policy has officially ended, undocumented immigrants remain under stress from policies like widely publicized immigration roundups. In Dallas, no-shows spiked in mid-2018 when undocumented immigrants became afraid to drive or enter a medical facility for fear of being apprehended, Dr. Davis says.

The Dallas health center doesn’t know what became of the boy who stopped speaking. They could never get his aunt to bring him back.

The post Texas Health Centers Embrace Trauma-Informed Care for Victims of Child Separation, Disasters and Violence appeared first on Direct Relief.

In speedrunning, players compete for the fastest time to complete all levels of a game. The world’s best players, their skills honed by hundreds of hours of play time, might complete an entire game in under an hour while a typical player might finish in days, weeks, or even months.

Calithon 2019 is taking place at Direct Relief’s new headquarters and warehouse. The 155,000 square-foot facility is the largest distribution hub for humanitarian medical aid in the United States. Direct Relief is among the world’s largest providers of humanitarian medical aid, providing medical aid to recipients in 100 countries and all 50 U.S. states last year.

Calithon is being broadcast live on Twitch at https://www.twitch.tv/calithon, where viewers can donate to Direct Relief. Calithon broadcasters hope to raise as much as $50,000 for Direct Relief.

“We’re excited and humbled to bring the West Coast’s premier speedrun event to Direct Relief, where our players will get to see and hear first-hand how their game-playing skills are helping people in need around the world,” said Calithon founder Jeff Yochum.

Calithon began today at 4 pm PDT and continues through 10 pm on Sunday, Mar. 17. The speedrunning marathon (originally named Californithon) has been held annually since 2015. A mini-documentary about the event is available here: https://www.youtube.com/watch?v=KYblFdmYAH0.

Video gamers and live-streamers on platforms including Twitch, Tiltify and Humble Bundle now comprise Direct Relief’s largest supporter base.

The post North America’s Fastest Video Gamers Start Speedrunning Marathon at Direct Relief appeared first on Direct Relief.

Santa Barbara-based Direct Relief can never afford to lose power.

Its 155,000-square-foot pharmaceutical warehouse, the largest in the U.S. run by a charity, stores insulin and other drugs that need a constantly cold temperature, between 36- and 41-degrees Fahrenheit. Power is essential to maintaining that refrigeration. Such temperature-sensitive medications can spoil within hours if Direct Relief loses power. If temperatures rise even nominally, “cold chain” medicine can lose its efficacy and must be destroyed, according to law.

Worse, Direct Relief would be unable to respond to the very natural disaster that brought it offline. The group’s warehouse—2/3 the size of a Manhattan city block— is a crucial depository for emergency medicine and medical supplies needed after earthquakes, wildfires, hurricanes and other natural disasters. During the raging wildfires of 2017, Direct Relief was California’s largest source of breathing masks that protected people from the choking smoke. The organization is also responding to the deadly Camp and Woolsey Fires burning across California.

To ensure Direct Relief never loses power, Direct Relief engaged Tesla to build a microgrid that keeps the organization running and its cold-chain medicine protected even if it loses grid power for many months. The microgrid system sustainably maximizes resiliency by combining three power sources: solar panels to provide the bulk of its electricity needs; battery storage to keep the power going when the sun isn’t shining; and Direct Relief’s diesel generators as a backup. The system is run by Tesla’s smart software that is able to seamlessly switch between power sources as conditions change and send excess solar power back into the grid for others to use.

Tesla designed the microgrid system after deploying similar systems in Puerto Rico, which experienced the longest-ever blackout in U.S. history after Hurricane Maria in 2017. Health facilities lost power for weeks or months, and more than 80 percent of the island’s vaccines and other medicines that require refrigeration were destroyed as a result of power loss, according to the CDC. Tesla and Direct Relief worked together on the island in the hurricane’s aftermath to identify key health facilities, restore power, and deliver aid to residents.

Recognizing that power is a prerequisite for health, Direct Relief and Tesla continue to equip dozens of local health facilities in Puerto Rico with reliable energy sources including solar power and battery storage. The solar and battery systems are integrated with existing generators and the grid, giving each health center a smart microgrid system that can pull power from the most efficient source and prevent going dark.

Diesel generators work well for short-term power outages, but they’re unreliable and costly as a long-term solution. Some Puerto Rican clinics that had generators eventually lost power when generators broke down or fuel supplies ran out. Those that continued relying on generators during the months it took to restore electricity faced tens of thousands of dollars a month in fuel costs and unreliable results.

The organizations also deployed several mobile power units to areas of Florida and Georgia hit by the recent Hurricanes Michael and Florence.

The post To Keep Vital Medical Reserves Safe During Wildfires and Other Disasters, Direct Relief Builds a Self-Contained Power Island appeared first on Direct Relief.