The shipments contained 6.4 million defined daily doses of medication and supplies, including trauma care supplies, vitamins, pain management medications, and more.

Brazil Flood Response

As Brazil continues to recover from devastating flooding earlier this month, Direct Relief is shipping emergency medical supplies and providing funding for healthcare providers on the ground. The flooding has been categorized as an environmental catastrophe comparable to Hurricane Katrina, impacting all of the 497 municipalities in Brazil’s Rio Grande do Sul state.

In coordination with the Brazil California Chamber of Commerce, Direct Relief has been working to identify local organizations providing relief in the affected areas. Direct Relief has issued an initial $50,000 grant to local NGO, S.O.S Irmãos do Litoral, to support their aid distribution efforts, and provided S.O.S Irmãos do Litoral with additional support, including nine pallets of nutritional products.

S.O.S Irmãos do Litoral has been actively responding since the flooding began on May 12, conducting water rescues with their fleet of boats, jet skis, and high-water vehicles. Operating a large warehouse in Rio Grande do Sul, S.O.S Irmãos do Litoral has delivered over 400 tons of aid to over 150 shelters and primary healthcare centers in flood-impacted areas.

Direct Relief will also be delivering 100 field medic packs requested by the Pan American Health Organization (PAHO). These packs include supplies and equipment to meet a variety of prevalent disaster-related medical issues, including infection control, diagnostics, trauma care, and personal protection tools.

Dengue Treatment Kits Packed for Puerto Rico

In response to recent dengue outbreaks in Puerto Rico, Direct Relief has prepared ten dengue treatment kits to aid first responders treating patients with dengue fever. There is no cure for the disease, but the kits include items to prevent transmission as well as help manage symptoms as the body fights off infection. The kits include mosquito-repellent wipes and spray, oral rehydration salts, acetaminophen for adults and children, and thermometers.

Direct Relief is donating these kits to help limit the spread of dengue and to reduce fever, dehydration, and pain among people who have contracted it. Each kit is designed to prevent dengue for about 1,000 patients and treat mild cases for about 100 patients.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 5.7 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 297 shipments containing almost two tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 9,594 shipments to 1,722 partner organizations in 54 U.S. states and territories and 72 countries.

These shipments contained 175.9 million defined daily doses of medication totaling 2.7 million lbs.

IN THE NEWS

• Limited care: Not all reproductive health care services are accessible in Lompoc – Santa Maria Sun
• 3M Named Official Respiratory Protection Sponsor for Direct Relief, Pledges 5 Million N95 Respirators Ahead of Hurricane, Wildfire Season – Market Watch

The latest 4.5-ton shipment of requested medical aid, including IV fluids, wound care products, personal protective equipment, anti-infective agents, and thermometers, arrived in Gaza on May 26 through the Kerem Shalom crossing between northern Gaza and southern Israel. 

Anera, a key regional partner of Direct Relief, received the supplies, some of which are used by its own mobile medical unit that provides primary care services directly and the remainder being distributed to healthcare professionals in Gaza caring for people in dire need.

This week’s delivery follows a large Direct Relief shipment of prenatal vitamins, breast pumps for nursing, and personal care items such as feminine hygiene products for around 50,000 people in Gaza displaced from their homes. The personal care items were kitted at Direct Relief’s Santa Barbara headquarters by local volunteers over several days.

These supplies, coupled with financial assistance from Direct Relief, have supported a series of Anera-operated mobile clinics throughout Gaza that provide comprehensive services—including primary, maternal, pediatric, and mental health care—to as many as 1,000 people per day in Deir al-Balah and Rafah.

Over the past 8 months, Direct Relief has delivered into Gaza approximately 70 tons of medical aid, valued at more than $26 million (wholesale), including cancer treatment therapies, diabetes medications and supplies, cardiac medications, syringes, sutures and wound care items, water purification tablets, oral rehydration salts, and more.  

Direct Relief, an apolitical, non-sectarian, and nongovernmental humanitarian aid organization, is committed to responding to ongoing health needs and requests for support across the region.

Additional medical essentials have been delivered to and being staged in Jordan, with more en route. Deliveries from Jordan into Gaza will be made as the shifting security and logistics channels permit.

All Direct Relief shipments to Gaza and elsewhere in the region are the result of extensive coordination with various national governments, international agencies, and on-the-ground organizations, and will continue to be delivered in accordance with U.S. sanctions laws and necessary approvals from Israeli, Egyptian, Jordanian, and other relevant authorities. 

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Addressing a National Crisis

The opioid crisis continues to be a devastating public health emergency in the United States. Over 150 deaths occur daily due to synthetic opioids like fentanyl, with overdose deaths quadrupling in the past decade.

“The opioid crisis is a public health crisis,” said Caroline Roan, Senior Vice President of Global Health and Social Impact at Pfizer Inc. “As part of our commitment to advancing breakthroughs that change patients’ lives, we’re proud to partner with Direct Relief to make Pfizer-donated opioid overdose reversal medication available at no cost to qualified U.S. nonprofit healthcare providers and local public health departments on the frontlines of the opioid epidemic.”

Direct Relief supports around 1,500 community health centers and clinics nationwide to ensure life-saving medications reach those who need them most. Since 2017, over 2.6 million doses of opioid-reversing medication have been delivered by Direct Relief through its initiative with Pfizer.

“These medications are crucial for treating substance use disorders,” said Katie Lewis, Regional Director of U.S. Programs at Direct Relief. “Providing them consistently has been transformative.”

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

These events are part of a larger cluster of extreme weather events across the U.S. that have marked the first half of 2024. Tornadoes, hail, heavy rain, and thunder have hit numerous communities in the Midwest and South. 

In response to the most recent batch of storms, Direct Relief has contacted Southern primary care associations and local partners to offer support. An emergency shipment is being shipped to Shades of Blue, a Houston-based partner focused on maternal and mental health needs. 

Medical needs are most commonly determined in the weeks following an extreme weather event when the full scale of the damage and required support becomes clear, rather than its immediate aftermath. Direct Relief will continue to communicate with local organizations and remain ready to meet health needs on the ground. 

Past extreme weather events have taught that interruptions to care are particularly dangerous. People living with chronic diseases like hypertension, asthma, and diabetes often lose or are forced to evacuate without their lifesaving medications, and can end up experiencing a deadly medical crisis if these conditions go untreated. 

For these reasons, Direct Relief keeps a cache of essential medications often requested after disasters, as well as personal care items often requested for people displaced from their homes. These medications and supplies are routinely offered to on-the-ground partners responding to or affected by natural disasters and other crises. 

Direct Relief also committed $250,000 to support healthcare needs in Texas’s Harris County area last week and provided medical aid after deadly tornadoes struck the Midwest last month. 

Direct Relief’s Response 

In response to the deadly landslide, Direct Relief is working with the Enga Provincial Health Authority and an on-the-ground partner, Hope Worldwide, to assess and determine medical needs on the ground.  
 
Direct Relief is also mobilizing an initial two emergency response shipments to the East Sepik Provincial Health Authority in the north, in response to an earlier earthquake and repeated flooding attempts. The shipments contain emergency medical backpacks, a cholera kit, an emergency health kit, water filters, and a range of requested essential medications. 

Medical Care for Displaced Populations 

Gordon Willcock, an emergency response regional director at Direct Relief, explained that in disasters like this, the most widespread medical needs do not come from injuries directly connected to the event, but from chronic and acute diseases.  
 
Adding to the complexity of the situation is the physical instability of the area. More landslides are feared, and the disaster zone, part of the densely populated Enga Province, is difficult to reach because of a blocked main road. This instability and inaccessibility make it especially difficult to gather information on the dead — or on those affected by the conflict. Approximately 1,650 people are displaced, and many are reluctant to leave for safer ground because their loved ones are under the rubble, although there is little hope of finding more survivors at this point. 
 
“These events are really about evacuees and displaced people,” Willcock said. The biggest threats to health in similar disasters have come from interruptions to primary and chronic health care, from a lack of hygiene and access to clean water caused by displacement and contamination of water supplies, and from nutritional needs. Contagious diseases are also a concern whenever people shelter in close quarters. 

Compounding Health Risks

Although Papua New Guinea is a middle-income country, about 40% of the population lives below the extreme poverty line, as income inequality is widespread. The country is confronting a high burden of infectious diseases, including malaria, tuberculosis, and HIV/AIDS. Chronic disease and high maternal mortality rates are serious concerns. 
  
The Pacific nation is also prone to disasters, many of them connected to climate change. Storms, floods, earthquakes, and droughts have all left their mark on Papua New Guinea, and earthquakes and volcanic activity pose repeated threats. 
  
Adding to concerns in the region is the ongoing presence of tribal disputes over land and other resources. New outbreaks of violence killed 49 people in February. A series of riots in January killed 20 people and led to greater economic instability. 

Looking Forward 

Direct Relief has an established record of supporting local health providers in Papua New Guinea, having provided prenatal vitamins, IV administration equipment, chronic disease and mental health medications, and more to Papua New Guinea in 2023. 
 
Direct Relief emergency response staff expect to have a clearer picture of the medical need in the coming days, and plan to allocate support accordingly. 

As part of the joint initiative, 3M has pledged to meet Direct Relief’s entire forecasted annual need for N95 filtering facepiece respirators with a donation of 5 million units. These respirators will be utilized in Direct Relief’s global humanitarian response efforts, providing essential protection to individuals in affected regions.

N95 respirators approved by NIOSH (National Institute for Occupational Safety and Health) can be used to help protect individuals within disaster-stricken areas. They help mitigate particulate smoke exposure during wildfires and offer assistance amid clean-up activities after floods, hurricanes, and earthquakes. Consequently, N95s constitute a cornerstone of Direct Relief’s disaster response framework.

Serving as the Official Respiratory Protection Sponsor, 3M’s N95s will be pre-stocked and strategically positioned to expedite relief operations to impacted communities, minimizing transit time. They will feature prominently within Direct Relief’s strategic emergency stockpile (SES), encompassing wildfire kits, emergency medical backpacks, hurricane preparedness packs, cholera kits, and an extensive network of U.S. safety net clinics.

This significant new partnership between 3M and Direct Relief emerged out of an over 20-year relationship with 3M products and cash supporting Direct Relief’s global relief, recovery, and resilience efforts including responding to various emergencies worldwide, including the Turkey earthquake, Ukraine conflict, Mozambique floods, Hurricane Dorian in the Bahamas, and hurricanes and severe weather events across the US. 

“Direct Relief is deeply thankful and privileged to work with 3M on this historic donation that will protect frontline health and emergency responders during disasters,” said Thomas Tighe, CEO and President of Direct Relief. “During disasters that are ongoing, 3M has led by example, stepping up to help protect first responders, health workers, and those at risk, and is once again providing high-quality protective equipment for people enduring fires, earthquakes, and other disasters and crises.” 

This initiative reinforces 3M’s unwavering dedication to supporting communities in need and builds on its long-term commitment to humanitarian relief efforts. Since 2016, 3M has contributed nearly 10 million N95 respirators and other requested products to Direct Relief for individuals in the United States and more than 80 countries. 

“3M is proud to continue our partnership with Direct Relief to expand access to critical protective equipment for natural disaster preparedness,” said Chris Goralski, president of 3M Safety and Industrial. “Access to N95 respirators can make a real difference in the health and safety of first responders and others providing care and support during crises. We will work together with Direct Relief to ensure these essential supplies reach the communities that need them most.”

Samdo Kunphen Clinic Breaks Ground

Direct Relief recently initiated the construction of a nurse’s room and kitchen for the Samdo Kunphen Clinic, located in rural Samdo, Nepal. The project aims to enhance the clinic’s infrastructure and facilities for both patients and staff. Direct Relief has assisted the Samdo Kunphen Clinic since a devastating earthquake affected Nepal in 2015.

The additions will be coupled with infrastructure upgrades, including improved sanitation facilities and additional rooms. This project supports Direct Relief’s mission to contribute to sustainable development and livelihood in earthquake-affected regions of Nepal.

Thermal Fogging Machines

To bolster Mexico’s healthcare system in response to a recent surge in dengue cases after Hurricane Otis, Direct Relief announced a donation of equipment and funding, including 1.5 metric tons of requested healthcare supplies.

This donation included 32 thermal fogging machines, which have already been put to use by the Vector Control Department in Acapulco.

Mental Health Summit at Direct Relief

This week, Direct Relief, Teva Pharmaceuticals, and the National Association of Free and Charitable Clinics (NAFC) hosted the Community Routes: Access to Mental Health Care Learning Summit.

Teva Pharmaceuticals has supported 11 clinics aimed at advancing health equity by increasing access to care for uninsured patients living with depression and anxiety in California, Florida, and New Jersey. The summit celebrated and acknowledged the impactful work of these clinics and their staff.

Attendees had the opportunity to collaborate and share insights on mental health awareness. Over two days of panel discussions and workshops, they explored effective strategies for treating their communities, including integrating mental health care into clinic services and providing mental health treatment outside clinic walls.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 4.1 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 375 shipments containing over eight tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 9,275 shipments to 1,692 partner organizations in 54 U.S. states and territories and 72 countries.

These shipments contained 169.3 million defined daily doses of medication totaling 2.7 million lbs.

IN THE NEWS

• Evelyn Salgado leads delivery of supplies donated by the NGO “Direct Relief” – Milenio
• With Wildfire Season Arriving, Microgrids Can Save Lives and Protect Health – Microgrid Knowledge
• Important cooperation with the Direct Relief Foundation to strengthen maternal and child care – The Ministry of Public Health and Social Welfare of Paraguay
• Medical center installs microgrid to safeguard clinic power supply – Public News Service

The confluence of events over the past year has created significant health challenges and risks for the people of Acapulco and the surrounding Guerrero state. In October 2023, Guerrero was battered by Hurricane Otis, the strongest storm recorded to make landfall in the Eastern Pacific, leaving at least 52 people dead and 32 others missing. Guerrero has since seen a surge in cases of the mosquito-borne illness dengue fever, reporting more cases than any other Mexican state.

The past few months have been hot and dry, leaving firefighters struggling to get wildfires under control. Meanwhile, the 2024 hurricane season is fast approaching, officially beginning in June, and weather forecasters point to climate conditions and unusually high ocean temperatures to predict an exceptionally high number of hurricanes this year.

The donation is Direct Relief’s largest single action and disaster response in Mexico since the organization established a Mexican unit as a Civil Association in 2014.

Supplies for Fighting Dengue Fever’s Spread and Medical Consequences

Dengue fever is surging across South and Central America and the Caribbean, with reported cases up 206% over 2023, according to the Pan American Health Organization.

Direct Relief is providing equipment and supplies both to stem the spread of dengue and to ease the suffering of those who catch a disease so painful that it is also known as break-bone fever.

In response to a request from Guerrero’s Secretariat of Health, Direct Relief is donating thermal fogging equipment and insecticide to spray in identified hot spots for mosquito breeding. The aim is to reduce the mosquito population before summer rains bring the standing water where the insects breed.

Direct Relief is also donating 1.5 metric tons of medical supplies to help limit the spread of dengue and to reduce fever, dehydration, and pain among people who have contracted it. The supplies include mosquito-repellent wipes and spray, oral rehydration salts, acetaminophen for adults and children, and thermometers. There is no medicine for curing dengue, but palliative care can provide some relief from symptoms while the body fights off the infection.

The medical supplies are being donated to Guerrero’s Centro Regulador de Urgencias Médicas (CRUM), where they will join the strategic reserve for emergency and disaster response both in the State of Guerrero and for aid to other Mexican states. In the aftermath of Hurricane Otis, other states came to Guerrero’s aid with ambulances, paramedics, doctors, mobile medical units, and more.

Rebuilding Pharmaceutical Cold-Chain Damaged by Hurricane Otis, and Preparing for 2024 Hurricanes

Hurricane Otis wreaked significant damage at health centers in and around Acapulco. Direct Relief is delivering 10 pharmaceutical refrigerators to replace equipment destroyed by Hurricane Otis, along with two ultra-low-temperature freezers needed for certain medicines and vaccines.

Increasingly, new vaccines and medications for cancer, genetic diseases, diabetes, and other medical conditions require consistent cold temperatures from the point of manufacture until dispensed to a patient. Communities that lack the infrastructure, power, and systems required to handle such medications properly often go without these therapies. Direct Relief improves cold chain infrastructure in low-resource communities by providing cash grants, donations of refrigeration equipment and expertise.

Medicine and Medical Supplies

Direct Relief is also donating 156 fully stocked emergency medical backpacks to equip Guerrero’s fire and emergency services teams, which are currently tackling wildfires but now must prepare for hurricane response. Each backpack contains supplies and equipment to meet disaster-related health needs, including infection control, diagnostics, trauma care, and PPE.

The organization has also opened up access to its inventory of emergency medicines for needs arising from the storms. Direct Relief has shipped and continues to mobilize medical aid for local organizations, including VCare Clinics, and the United Community Foundation, which have requested emergency support, including chronic disease medications and diabetes supplies, and another request of personal care kits, containing hygiene items including soap and shampoo, for people displaced by the storms.

In the wake of a disaster, healthcare organizations most frequently make requests for medical aid in the days and weeks after the most immediate threat has subsided, once it becomes possible to accurately evaluate local medical needs. For that reason, Direct Relief will continue to communicate with organizations on the ground and make its extensive medical inventory available to regional healthcare providers.

Harris County, which includes Houston, is located on the U.S. Gulf Coast. Climate change has hit the area especially hard, with hurricanes, floods, tornadoes, and fierce heat waves all increasing in frequency and intensity. In the wake of a storm or other natural disaster, continuity of care is often disrupted, making it difficult for people who need medication and supplies to manage chronic health conditions.

If conditions like diabetes and hypertension are left unmanaged, they can quickly become life-threatening, which is particularly dangerous when emergency resources are taxed.

While death counts generally only include fatalities directly connected to the storms, indirect deaths are a real and widespread concern. On Monday, more than 180,000 customers were without power in Harris County, and large-scale power outages can create their own health risks and add another layer of complexity to emergency response. Lack of access to power can harm people who rely on medical devices, rendering home supplies of insulin unusable, and exacerbating existing health issues as people struggle with the relentless heat.

Direct Relief will continue to closely monitor the health situation in Harris County and beyond to provide support as requested.

The shipments contained 11.2 million defined daily doses of medication and supplies, including insulin, prenatal vitamins, cardiovascular medications, and more.

Families Receive Medication in Iraqi Kurdistan

Iraqi Kurdistan, the Kurdish-populated part of northern Iraq, is home to over 1 million refugees and internally displaced people, or IDPs, following a genocidal ISIS campaign of the Yazidi ethnic minority group from 2014 to 2017. Public support to the IDP camps has dwindled or even formally terminated, and those living in the camps are now being told to return home to areas that remain hostile and unsafe.

Over the past 18 months, the region has seen a near-total withdrawal of foreign assistance. The result has been the suspension or deterioration of public services, economic and political volatility, and impending camp closures, compounding a humanitarian crisis for some of the most acutely marginalized groups in the region.

Medication shortages are also a challenge in the region, and Direct Relief has continued to serve as a medical supply stopgap through its support of the regional public health authority, the Duhok Directorate of Health. or DOH. In total, Direct Relief has mobilized 27 tons of medical aid worth over $86 million, including emergency prep and response products, medications for pediatric patients, cancer medication, and insulin.

IOM Egypt Receives Field Medic Packs

Recently, the International Organization for Migration, Egypt, provided 100 field medic packs to the Egyptian Ambulance Organization. Originally donated by Direct Relief, each backpack contains supplies and equipment to meet a variety of prevalent emergency-related medical issues, including infection control, diagnostics, trauma care, and personal protection tools.

A branch of the Egyptian Ministry of Health, the Egyptian Ambulance Organization operates a fleet of over 2,000 ambulances in Egypt, with many stationed at border crossing points providing emergency medical transport to people fleeing the conflicts in Gaza and Sudan.

Dr. Beatrice Wiafe Addai Shares about Breast Cancer Work in Ghana

Dr. Beatrice Wiafe Addai, Ghanaian breast cancer surgeon and president of Breast Care International, or BCI, visited Direct Relief headquarters along with her family this week. BCI, an NGO dedicated to breast cancer prevention and control in Ghana, is a long-time partner of Direct Relief, receiving $95.2 million in donated medical products since 2014.

Dr. Addai shared that, in Ghana, 60 to 70 percent of women who are diagnosed with breast cancer are already in advanced stages of the disease, due to the stigma and lack of education and awareness about the disease. Since its founding in 2002, BCI has taken a multifaceted approach to fighting breast cancer: educating women, facilitating needed medications from donors like Direct Relief to a network of health centers, and empowering survivors to share their stories.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 3.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 491 shipments containing over eight tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 8,881 shipments to 1,634 partner organizations in 54 U.S. states and territories and 71 countries.

These shipments contained 161.2 million defined daily doses of medication totaling 2.6 million lbs.

Direct Relief today announced the completion of its fifth resilient power project site in its home state of California. For a health site focused on providing services to vulnerable patients, the project will provide access to uninterrupted power in case of an outage, including from a natural disaster.

Alliance Medical Center, a Federally Qualified Health Center located in Healdsburg, California, stated that its resilient power project, made possible through a $495,000 grant funded by Direct Relief, was completed and online. The project represents a significant step forward in ensuring uninterrupted healthcare services for the Healdsburg community, particularly during times of emergency, disaster, or public safety power shutoff. Healdsburg is located in Sonoma County, which has been impacted by large wildfires in the past, including the deadly 2017 Tubbs Fire, which killed 22 people, destroyed thousands of structures, and interrupted health services in the area.

The project is part of Direct Relief’s Power for Health initiative, an effort that seeks to bring clean, renewable backup power to community health centers and free clinics to ensure they can deliver critical healthcare services during power outages. Direct Relief has provided more than $20 million in grants to health centers and clinics throughout the United States for the installation of off-grid, renewable, reliable power systems, improving resiliency and continuity of care for critical health services in vulnerable communities.

Other projects completed in the state of California are located in the communities of Laguna Beach, Los Molinos, Magalia, Mendocino, and Ventura, and 16 additional sites across the United States, including Puerto Rico, have been completed, with others slated to come online in the future.

The just-announced project features the installation of state-of-the-art backup power systems at Alliance Medical Center, including a 58-kilowatt solar array and 330-kilowatt-hour battery storage. The system is equipped to provide up to 15 hours of reliable electricity supply in case of an outage, safeguarding critical medical equipment and refrigeration of medications, and ensuring continuity of care for patients.

“We are delighted to see the completion of this important project, which will greatly enhance the resilience of Alliance Medical Center’s Healdsburg clinic and its ability to serve the healthcare needs of our community,” said Sue Labbe, CEO at Alliance Medical. “The support from Direct Relief has been instrumental in making this project a reality, and we are immensely grateful for their partnership and commitment to strengthening healthcare infrastructure.”

Direct Relief’s funding for resilient power projects like this one underscores its dedication to building resilient healthcare systems worldwide, ensuring that communities have the capacity to withstand and recover from unforeseen challenges. By investing in initiatives that enhance healthcare infrastructure and preparedness, Direct Relief aims to improve health outcomes and save lives, particularly in underserved and vulnerable populations.

“It’s a privilege for Direct Relief to support Alliance Medical Center, help boost its resiliency, and ensure that power outages won’t prevent its dedicated team from serving the essential role of providing quality health services to thousands of people who otherwise would go without,” said Thomas Tighe, Direct Relief President and CEO.

“The project at Alliance Medical Center is just a perfect example of what California’s vast nonprofit health safety net needs more of in the face of increasingly frequent and intense climate emergencies and power outages. These events disrupt essential health services when they’re most needed by people who are most vulnerable and lack other options for needed care. Direct Relief’s Power for Health initiative aims to engage more philanthropic support to build resilience in a clean, practical, efficient way for health facilities that serve people who face chronic challenges that are only intensified by emergencies, and Alliance Medical Center is a shining real-world example of why it matters.”

Rafia Rauf, a maternal health leader, heard these and many other stories as part of a qualitative study conducted by the White Ribbon Alliance in Pakistan. The goal was to better understand, on an individual level, how climate change affected women’s pregnancies and birth outcomes. “My pregnancy was the worst experience of my life” due to the heat, one woman told her.

Growing evidence shows clearly that climate change is materially, measurably harmful to pregnant women and babies. Whether it’s a climate-related disaster like a hurricane or flood, or a harmful shift in local environmental conditions, climate change is a destructive force: It increases the risk of intimate partner violence, leads to reproductive complications and even pregnancy loss, and can kill infants exposed to contaminated water.

Midwives have essential roles to play in protecting women and babies — while helping to ensure a more sustainable future. On May 6, during an International Confederation of Midwives webinar, experts discussed the ways in which midwives are “the workforce we need for a warming world.”

World Health Organization Director-General, Tedros Adhanom Ghebreyesus, described midwives in pre-recorded remarks as “first responders” whose work could save 4.3 million lives each year.

During disasters, midwives are often the first responders on the ground. Paulina Ospina, associate director of maternal and child health at Direct Relief, described the way midwives swung into action in August of 2023, when destructive wildfires broke out in Hawai’i. The very first request for medical supplies Direct Relief received was from a local midwifery group, Healthy Mothers, Healthy Babies Coalition of Hawai’i, who were moving from Oahu to Maui to care for people displaced or affected by the blazes. And by the time Direct Relief staff were on the ground, the group was already working with the local health department.

“Midwives…are already embedded in the community. They’re representative of the community,” Ospina said. Where health services are frequently disrupted during a disaster, she added, midwives are frequently motivated to continue caring for mothers and babies.

Even as disasters continue to worsen, midwifery offers a sustainable model of care — and a focus on climate adaptation that’s sensitive to cultural and environmental needs.

“Most often, pregnancy and birth do not require grand interventions or technologies,” said Jahan Zuberi, a midwife coordinator at Pakistan’s Indus Health Network. Midwives, who rely on skill, experience, and local and cultural knowledge, “respect the climate that is available to them.”

Moreover, Zuberi explained, excessive outside intervention can separate communities from trust in their own traditional practices and resources. “As we continue to bring midwifery back to the community, we’re going to be promoting practices that are inherently sustainable,” such as the use of effective local herbs, she said.

Maeve O’Connell, a professor of midwifery at the Fatima College of Health Sciences in the United Arab Emirates, offered an important example: breastfeeding. Infant formula is so intensive to produce, she said, that meeting World Health Organization breastfeeding goals would do more to protect the climate than replacing natural gas with renewable gas. “We actually have done the calculations,” she said, referencing a study she conducted with colleagues on this subject.

Moreover, she said, it’s often unsafe to dilute with water – as some formulas require – after a natural disaster, because water can be contaminated by the event.

O’Connell emphasizes that mothers are not to blame for the prevalence of formula feeding. Policy is. Predatory advertising abounds, and the support that many women need to allow them to breastfeed successfully often isn’t available. “It needs to be a collective advocacy,” she said. Midwives can “advocate for policies and practices that support breastfeeding as a sustainable choice for families and the environment.”

That means, in part, giving midwives more room to practice the full scope of their profession. Many midwives, for example, work in labor and delivery wards but aren’t given the opportunity to follow up with families postpartum.

In the wake of a disaster, midwives can ensure that resources are used effectively and meet community and cultural needs. For Zuberi, Pakistan’s 2022 floods are an illuminating example. “There were donations that never got used because that was not the community’s practices,” she said. The menstrual pads were wasted, and menstruating women and girls went without needed resources.

In general, O’Connell said, midwives are uniquely qualified to “harness the evidence” that connects climate change to sexual and reproductive health. The issue is making sure that their voices, and the voices of the people they serve, are heard.

Rauf put it straightforwardly: “Let women be the guide.”

The shipments contained 21 million defined daily doses of medication and supplies, including insulin, prenatal vitamins, oral rehydration tablets, and more.

Medications Shipped to Flooded Communities in Texas

Direct Relief has been responding to communities impacted by extreme weather over the past week, including in Texas, where heavy rainfall inundated communities in the eastern part of the state, displacing thousands and requiring water rescues for hundreds of people. Multiple counties received large amounts of rainfall, including Harris County, which contains Houston.

Direct Relief shipped requested medical aid this week to health organizations serving flooded communities, including San Jose Clinic, a nonprofit free clinic that serves uninsured or underinsured people in Houston. “During the flood, we had some patients unable to make it to appointments as they were unable to leave their home and the same for some of our team,” San Jose staff reported. Water purification tablets, antibiotics, personal protective gear, disinfecting products, and other medical essentials were shipped this week to the clinic.

TOMAGWA HealthCare Ministries, a free clinic located in Tomball, Texas, also requested support, and Direct Relief shipped personal care packs, filled with essentials like soap, shampoo, toothpaste, and more to support people displaced from their homes due to the floodwaters.

Floods Inundate Brazil with More Rain Expected in Coming Days

In Brazil, devastating flooding has coursed through more than 85 percent of the state of Rio Grande do Sul, where more than 113 people have been killed and hundreds of thousands displaced. More rain is expected this weekend, and Direct Relief is coordinating with the Brazilian Health Regulatory Authority and the Pan American Health Organization, or PAHO, to assess medical needs and requests.

Health impacts from flooding can span from water- and vectorborne illnesses to exacerbation of chronic conditions as people are displaced without access to medications needed to manage their health. Direct Relief maintains an inventory of medications commonly requested after disasters and is ready to respond.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 13.9 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 419 shipments containing over five tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 8,374 shipments to 1,607 partner organizations in 54 U.S. states and territories and 69 countries.

These shipments contained 146.9 million defined daily doses of medication totaling 2.5 million lbs.

IN THE NEWS

A Global Relief Organization Keeps the Spigot Open for Community Healthcare Providers Closer to Home – Inside Philanthropy

AWMH Donates $100,000 to Direct Relief’s Flood Relief Efforts in Brazil – Metallica.com

Direct Relief Commits $3 Million to Jamaica for Hurricane Resilience – Philanthropy News Digest

The signing ceremony, held in Brunei, was part of the 44th Meeting of the ASEAN Committee on Disaster Management and the 20th Meeting of the Governing Board of the AHA Center, which brought together the heads of the national disaster management agencies of all 10 ASEAN member states.

ASEAN, which stands for the Association of Southeast Asian Nations, includes Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam.

. ASEAN member countries combined have a population of 640 million people, and these 10 countries sit on or near the “Ring of Fire,” the zone around the Pacific Ocean that is prone to natural disasters like earthquakes and volcanic eruptions.

Direct Relief CEO and President Thomas Tighe and the Executive Director of the AHA Center, Lee Yam Ming, signed the memorandum of intent, which renews the longstanding strategic partnership between the two organizations, first signed in 2016.

“The partnership between the AHA Center and Direct Relief will bolster the facility’s response capacity in the ASEAN region,” said Lee Yam Ming, Executive Director of the AHA Center. “Through this partnership, we continuously expand and broaden our collaboration in preparedness, response, and recovery initiatives. The AHA Center is looking forward to working together with Direct Relief in realizing ASEAN as a disaster-resilient region.”

“Because of the region’s risk exposure to natural disasters, including some of the most intense earthquakes and tsunamis on record, Direct Relief stands ready to respond in coordination with the AHA Center at a moment’s notice,” said Thomas Tighe, Direct Relief CEO and President. “Today’s event signifies Direct Relief’s commitment to building on the past eight years of cooperation with the AHA Center, as well as a vision of future support in the region to help those most impacted by disasters and crises.”

Since 2008, Direct Relief has delivered more than $387 million in medical materials across ASEAN member states. Since the 2016 signing, Direct Relief has also provided $1.187 million in grant funding for the procurement and prepositioning of emergency supplies, for the reconstruction of health infrastructure, for capacity building, for AHA regional training, and for various other AHA-led programs.

In addition to regular donations of medicines and medical supplies, Direct Relief has mobilized and launched major organizational responses to disasters in the region, including the Indian Ocean Tsunami (Indonesia, 2004), Cyclone Nargis (Myanmar, 2008), Typhoon Haiyan (The Philippines, 2013), Sulawesi and Lombok earthquakes (Indonesia, 2018) and Covid-19 pandemic response throughout Southeast Asia.

Direct Relief and the AHA Center have also coordinated emergency preparedness efforts, including the pre-positioning of emergency medical supplies at ASEAN disaster supply warehouses in Malaysia and the Philippines, joint participation in emergency response exercises and policy dialogues, funding for AHA-led initiatives, information sharing, data analysis, mapping, and collaboration during large-scale emergency response operations in Indonesia, Philippines, Cambodia, Myanmar, and Laos.

Now, a Ukrainian project supported by Direct Relief has supplied portable power stations for Larisa and 79 other kidney patients in Kharkiv and other parts of the country. This means that even when the city is dark because of the intensified Russian attacks on the power grid, she and others can perform daily health procedures for the essential eight hours uninterrupted.

“This [device] doesn’t just improve life, it prolongs it,” Larisa told Direct Relief during a recent visit, the motif on her t-shirt neatly summing up the change: “Got Super Power.”

Peritoneal dialysis, or PD, is a treatment for kidney failure that uses the lining of the abdomen to filter the blood inside the body via a catheter, through which bags of dialyzing fluid are pumped. The solution is a type of cleansing liquid that contains water, salt and other additives.

Larisa has used a dialysis machine for the past three years. Like the monthly volumes of fluid (5-10 liters per day, depending on the person’s size), it was provided free of charge by the local health service. But without a steady power supply, patients can spend exhausting hours at night manually performing their treatment.

The donated type of unit, an Anker PowerHouse 757, is a 1500W battery that charges when the power supply is on and maintains a steady feed when activated. This means the patient can hook up to the dialysis machine and sleep during the procedure.

That is, if missiles, guided bombs and drones don’t rain down that night. That always wakes people, even when it’s in the distance, but “you get used to it,” said Maksim Chernyak, another Kharkivite who received a station.

Maksim, 31, is living with diabetes, and his condition deteriorated last year after an operation and left him dependent on peritoneal dialysis and at the mercy of power outages. “Because of the shelling, the situation is very unpredictable,” he said, sitting beside his equipment and an impressive collection of Star Wars figures that he amassed from childhood.

He received his power station in March, which happened to coincide with a series of strikes on the city’s electricity infrastructure. Since then, the power usually goes on and off five or six times a day, traffic lights die, causing chaos at road junctions, and lines of generators start up outside shops.

“It was fortunate timing – we were thinking that we had to buy a generator,” said Maksim, who used to work in his uncle’s fabric business until his health failed him. He now leads a very modest life on the state disability allowances paid to him and his father, Yuriy, a former fireman, who was involved in the hazardous cleanup after the Chernobyl nuclear reactor explosion in 1986.

This year, Direct Relief’s core partner in Kharkiv, the Charitable Fund Yevhen Pyvovarov, delivered 37 units in the city and region, which are among the country’s hardest hit in the more than two-year-long war. The initiative originated in Kyiv, from the president of the Ukrainian Association of Nephrologists, Dr. Dmytro Ivanov.

After some number crunching, he found that of the pre-war total of 10,708 people with severe kidney disease in Ukraine, 206 on automated peritoneal dialysis are still in the country and need such power units in the current conditions. Ivanov approached his contacts in nephrological circles for assistance. A batch of 40 stations was donated by the Netherlands and 12 by the Slovenian Society of Nephrologists, while a nephrologist colleague working with Direct Relief helped kickstart a project to supply 80 more. That leaves around 70 still to source, which the doctor will try to do through the same networking route.

“Given the current risk of blackouts, it’s crucial to ensure that all remaining patients using automated peritoneal dialysis have access to charging stations,” said Ivanov. He also wants to create a reserve of charging stations for some 400 patients who do not have dialysis machines and are still on manual PD.

“The ultimate objective is to transition all patients from manual to automated dialysis. Additionally, there’s the challenge of providing PD amid military operations, a responsibility typically shouldered by military medical personnel.”

The third patient visited is Tetyana Kozyna, 63, who, with her husband, Viktor, left their home about 15 kilometers (10 miles) from the border with Russia in June 2022. She recalled how they fled to Kharkiv with what belongings they could carry, not knowing how much of their old life would survive. “In September, we went home to find the whole house gone, walls, roof, everything,” said Tetyana.

She was already living with one kidney when the war broke out, but the organ failed amid the fear and stress caused by the fighting, and she was hospitalized when they reached the city. Then her husband was diagnosed with cancer, which he managed to successfully battle.

“First, I was sick, and he helped me get through it, then he was sick, and I helped him – that’s how we do things,” said Tetyana, with an evident strong love forged over decades of shared life.

They now rent a one-room apartment in Kharkiv while they wait for the war to end. Tetyana also received her power station in March and says that this boost to her dialysis machine affords her a degree of peace of mind that she hasn’t had for a long time.

“It’s thanks to this that I can live on,” she said, echoing Larisa’s words. “It cleans my system and makes everything easier, including going out and doing normal things.”

After everything they endured and still do, they are confident that despite the hardships, they will eventually rebuild their lives.

“We just need peace,” said Viktor. “We will take care of everything else.”

The shipments contained 6.7 million defined daily doses of medication and supplies, including insulin, prenatal vitamins, oral rehydration tablets, and more.

After Flooding, Kenya Prepares for Cyclone

In Kenya, heavy rains and flash floods have left more than 200 people dead, dozens missing, and over 150,000 people displaced across Nairobi, Makueni, West Pokot and Machakos counties according to the National Disaster Operations Center. Heavy rains have inundated the country since March, and the country is bracing for landfall from Cyclone Hidaya, expected to make landfall Friday in Kenya and Tanzania, where flooding fatalities have also continued to rise into the hundreds.

Flooding and resulting displacement can cause a host of health problems, including limited access to clean drinking water, the proliferation of water- and vector-borne illnesses, power outages, and damaged infrastructure that can limit travel to receive medical care. Those who are displaced from their homes may also face compounding health issues, as they may be cut off from medications and equipment needed to manage chronic conditions, including diabetes, which can escalate into crisis and the need for emergency care.

Direct Relief has a long history of support to Kenya, and has provided more than $40 million in medical support to health facilities across the country. This includes general medical support, insulin for patients managing diabetes, and rare disease therapies. Kenyatta National Hospital is one hospital that has received this medical support from Direct Relief in the past, and the organization is in communication with the hospital about medical needs resulting from flooding and the cyclone’s impacts. Direct Relief is also in contact with the Kenyan Red Cross Society to support their emergency medical outreach and search and rescue teams. Direct Relief also has supported medical facilities in Tanzania with more than $74 million in medical aid, including during times of disaster, such as Cyclone Idai in 2019.

Direct Relief will continue to monitor the storm’s impacts on communities in Kenya and Tanzania and respond to requests for medical support as they become known.

Supporting Health Resilience in Jamaica Ahead of Hurricane Season

Direct Relief this week announced a US$3 million grant to Jamaica as part of its ongoing commitment to bolstering resilience in the Caribbean region. This contribution, which will support the installation of a large solar energy system at a central primary pharmaceutical distribution facility, comes as part of the organization’s renewal of its ongoing partnership with the island nation, aimed at strengthening healthcare systems and infrastructure in the face of natural disasters and other emergencies.

Direct Relief staff met with members of Jamaica’s Ministry of Health and Wellness to tour the National Health Fund Pharmaceutical Distribution Facility and visit local health centers. A Memorandum of Understanding was also signed to continue the flow of medical aid and support to the nation’s health system.

Jamaica, like many other nations in the Caribbean, faces unique challenges in maintaining healthcare access, particularly in the wake of natural disasters such as hurricanes. Direct Relief’s grant seeks to address these challenges by supporting initiatives that enhance emergency preparedness, expand access to essential medical supplies and equipment, and fortify healthcare infrastructure.

Haleon Staff Support Building of Personal Care Packs

Over the past three months, Direct Relief has partnered with Haleon staff to pack 5,300 personal care kits, which include basic hygiene items like soap, shampoo, and dental care products, across nine locations. Local organizations who received these kits, including NeoMed Center, Inc. and Corporación La Fondita de Jesús, attended these events to share more about their work within the community with the Haleon team.

The kits have been distributed to local organizations working with migrant and refugee populations, people experiencing homelessness, or others in need of basic personal care items.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 5.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 552 shipments containing almost two tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 7,932 shipments to 1,591 partner organizations in 54 U.S. states and territories and 69 countries.

These shipments contained 125.6 million defined daily doses of medication totaling 2.4 million lbs.

IN THE NEWS

Kee Cha-E-Nar Corporation Receives $250k from Direct Relief’s Fund for Health Equity – The Yurok Tribe

Health Sector Receives US$3 Million from Direct Relief – Jamaica Information Service

Midwifery in the Era of Climate Change: Lessons from the wildfires in Maui – International Confederation of Midwives

Direct Relief Supporting Family Health in Ukraine – Angels in Medicine

Direct Relief Donates US$3 Million to Health Sector – Philanthropy News Digest

Direct Relief Donates $3 Million to Strengthen Jamaica’s Health System – Caribbean National Weekly

Expanding Hope: A New Dawn in Dnipro – Levitate

Direct Relief staff met with members of Jamaica’s Ministry of Health and Wellness to tour the National Health Fund Pharmaceutical Distribution Facility and visit local health centers. A Memorandum of Understanding was also signed to continue the flow of medical aid and support to the nation’s health system.

“Past assistance given, as well as forthcoming aid, are testaments to the benefits good partnership can bring to an organization and to a country. Not only have we been greatly helped, but we are also thoroughly impressed by Direct Relief’s humanitarian efforts worldwide,” said Everton Anderson, CEO of the National Health Foundation.

Jamaica, like many other nations in the Caribbean, faces unique challenges in maintaining healthcare access, particularly in the wake of natural disasters such as hurricanes. Direct Relief’s grant seeks to address these challenges by supporting initiatives that enhance emergency preparedness, expand access to essential medical supplies and equipment, and fortify healthcare infrastructure.

Direct Relief has a long history of providing humanitarian assistance in Jamaica and across the Caribbean region. From responding to the devastating effects of natural disasters to supporting ongoing healthcare needs, Direct Relief has worked closely with local partners to deliver vital medical aid where it is needed most.

“Direct Relief is deeply privileged to support the country of Jamaica and local health providers, who are incredibly committed to high-quality care for their patients and their communities,” said Dr. Byron Scott, Chief Operating Officer of Direct Relief. “With the start of hurricane season weeks away, Direct Relief is committed to strengthening the health system and health services, including power resiliency as part of disaster preparedness.”

Over the two-day visit to Jamaica, Direct Relief staff met with the Minister of Health and Wellness, Dr. the Honorable Christopher Tufton, the Most Honorable Juliet Holness, who has led previous Jamaican delegations to overseas conferences with Direct Relief, and NHF Chief Executive Officer Everton Anderson, along with other NHF representatives. The group toured the NHF’s newly refurbished Warehouse, Drug Serv Greater Portmore, and visited local community centers.

The grant to Jamaica is part of Direct Relief’s broader efforts to strengthen healthcare systems and enhance emergency preparedness in vulnerable communities worldwide. Through strategic partnerships and targeted investments, Direct Relief continues to make a meaningful impact in improving health outcomes and saving lives.

In Sulphur, Okla., a small town about 80 miles south of Oklahoma City, which sustained casualties, temporary shelters have been set up for those displaced by the storms. Local media also reported widespread damage to buildings, houses and a hospital in Marietta, Okla., which also saw casualties and endured an EF-4-rated tornado. This is the first EF-4 tornado, a classification which records wind gusts between 166 to 200 miles per hour, to hit the state since 2016, according to the National Weather Service.

Severe weather often impacts health outcomes long-term, especially for vulnerable communities such as those with chronic conditions, the young and elderly, and those without access to reliable transportation. This can occur due to interruptions in health care as a result of damage to a local facility, power outages, and other stresses that occur in the wake of a storm, such as a loss of housing.

Direct Relief has issued offers of support to health facilities, including community health centers and free and charitable clinics in Nebraska, Iowa, and Oklahoma, and will respond to requests as needed. Based on learnings from past severe weather events, Direct Relief maintains an inventory of chronic disease medications often requested after disasters, including therapies for diabetes, high blood pressure and asthma.

People who evacuate without a supply of medications needed to maintain their health can end up in the emergency room in medical crisis. The organization also maintains inventory for people displaced from their homes and living in shelter environments, including personal care kits that contain soap, toothpaste, toothbrushes, shampoo, and more.

These kits, which were shipped earlier this month to a clinic in Slidell, La. after tornadoes struck there, have been made available to partner clinics in the Midwest in addition to all available inventory should it be requested.

Direct Relief will continue to respond as requests become known.

The shipments contained 13.4 million defined daily doses of medication and supplies, including insulin, prenatal vitamins, oral rehydration tablets, and more.

Strengthening Cold Chain Capacity for Free Clinics

Recently, several pharmaceutical-grade refrigeration systems donated by Sanofi were delivered by Direct Relief to multiple clinics across the U.S., including Ozanam Charitable Pharmacy in Alabama and Welvista in South Carolina.

These fridges have expanded capacity at these sites, allowing for more storage of temperature-sensitive medications, like vaccines and insulin. The systems were donated and placed as part of Direct Relief’s ReplenishRx program, which works to provide free and charitable clinics with medications and supplies at no cost.

Supporting Care for Women in Malawi

This week, Dr. Anne Alaniz, a gynecological oncologist and founder of Pothawira International, spoke about her work in Malawi and her plans to build a new surgical center that will expand care for women in the region.

Direct Relief has supported Pothawira International with more than $5 million in oncology medications, midwife kits, which contain 50 essential items to facilitate safe births, and other requested medical aid. Pothawira, which translates to “Safe Haven,” includes an outpatient clinic, which sees 200 patients a day and a birthing center, which is expected to exceed 500 deliveries in 2024.

A new surgical center, which will include four operating rooms, will enable safe cesarean deliveries, laparoscopic surgeries, radiology services, and more for women who need cancer treatments or are experiencing birth complications. Pothawira also operates an orphanage, primary school, and sustainability farm to support community needs.

Dr. Alaniz, originally from Malawi and who moved to the U.S. at 16, now practices medicine at Houston Methodist Hospital between her medical missions in Malawi. She spoke to a gathering of about 120 people in Montecito, California, this week to raise awareness about Pothawira International and Direct Relief’s Maternal and Child Health Programs in advance of Mother’s Day.

Click here to learn more about Dr. Alaniz and Pothawira International.

Direct Relief Hosts Health Fair in Puerto Rico

Direct Relief and La Fondita de Jesús, a nonprofit focused on services to unhoused people and other vulnerable populations, hosted a health fair on April 23 in Rio Piedra, Puerto Rico. The fair offered health services, personal care kits filled with hygiene items for attendees, and more.

Direct Relief Chief Pharmacy Officer Honored

Direct Relief’s Chief Pharmacy Officer Alycia Clark, PharmD, has been selected among the “Top 50 Women in Business” by the Pacific Coast Business Times.

The Business Times honors 50 of the region’s top women leaders in a number of sectors, including finance, professional services, health care, technology, and nonprofits. Clark was selected for her outstanding contributions to public health and emergency response.

Read the full selection article here.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 13 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Included in this week’s shipments were deliveries of oral rehydration salts in response to the outbreak of dengue fever in Puerto Rico. The organization is monitoring the outbreak and will continue to respond as requested.

Direct Relief delivered 510 shipments containing over four tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 7,666 shipments to 1,573 partner organizations in 54 U.S. states and territories and 67 countries.

These shipments contained 121.6 million defined daily doses of medication totaling 2.4 million lbs.

“The truth is that if you need to go to a doctor, it takes about a 45-minute drive. If it’s an emergency, the nearest hospital is about a 50-minute drive across winding roads. That has always been a great problem for us,” said Yesenia Medina, who was born and raised in Utuado.

Located in the central western region, Utuado – as its name derived from the Taíno word “Otoao” suggests, is perched “between the mountains.” For as long as Yesenia can remember, her remote community has existed isolated and removed from accessible healthcare services.

With this in mind, community residents joined efforts to help bridge healthcare access gaps and foster socio-economic development in the region. Established in 2013, the Corporación de Servicios de Salud Primaria y Desarrollo Socioeconómico El Otoao, or COSSAO, began from this grassroots effort.

The organization, which translates to Corporation of Primary Healthcare Services and Socio-economic Development El Otoao, serves residents from five communities in Utuado and two other communities in the municipalities of Jayuya and Ciales.

Neighbors mobilized to salvage and refurbish a nearby abandoned building, setting up a small medical office staffed by volunteers. Little did they know that a few years later, Hurricane María would serve as a catalyst that would forever change the region.

In the aftermath of the storm, as medical brigades and aid from international organizations deployed to remote areas such as Mameyes, community leader and COSSAO’s executive director Francisco “Tito” Valentín saw an opportunity to transform their small operation into a fully developed community clinic that would permanently broaden access to essential medical services.

For many, the idea seemed impossible. However, during her visits to the island after the hurricane, Dr. Antonia Coello witnessed the community’s commitment and understood Valentin’s vision, joining his mission.

As both the first woman and the first Hispanic person to serve as U.S. Surgeon General, Dr. Coello gathered support from the University of Puerto Rico’s School of Public Health and Direct Relief, among other organizations, to help shape what would become the Antonia Coello Community Clinic, which opened its doors in April of 2018.

In 2021, Direct Relief awarded COSSAO a $587,680 grant to expand the clinic and improve its facilities.

A Community Effort

During the past six years, COSSAO’s community-based workforce has been pivotal in serving over 18,000 patients, effectively breaching gaps in care. For Tito Valentín, it was important that this effort also served to promote the socio-economic development of community residents.

“Health is not only pills and vaccines. Community health is a holistic concept that ensures all our communities have the necessary resources and support system to feel that they are in a place where they can raise their family,” said Valentín.

COSSAO’s clinic has created close to 20 job opportunities in construction and healthcare roles. “All of these workers are young professionals, many of whom [if it wasn’t for the clinic] would have left because of the lack of opportunities here,” said Valentín.

Yesenia Medina, who was COSSAO’s first employee and currently works in human resources, has witnessed first-hand the immense impact the clinic has had on its people. She remembers when the clinic first opened, helping people who had never seen a dentist, women who had never received reproductive healthcare, and individuals who had never visited a doctor.

Medina recalls a family of eight members, some homebound and others living with disabilities, who were cared for by their 90-year-old mother. “They don’t go anywhere. We bring them dental and medical services and diapers, because we [at COSSAO] know they need all of this.”

This personalized treatment from the staff, especially from health promoters, has contributed immensely to the clinic’s success and has ultimately improved their patients’ quality of life. “Having the clinic here has changed the lives of a lot of people,” said Medina.

Currently, COSSAO has seven health promoters who are residents from each of its seven communities. Zulma Robles has been working as a health promoter in COSSAO for five years. She lives in the Frontón community in Ciales – one of the largest communities with a population of 1,500.

As part of her role, she regularly sets out to visit each of the 600 households that make up her community to educate patients about health-related topics and identify resources to address the social determinants of health. Having community members in such roles allows them to advocate for their fellow residents to find local solutions.

During one visit, health promoters identified a family with six children who lacked almost all the basic living essentials, including a refrigerator and stove. Most of the children and their parents needed glasses and medical evaluations. The team quickly coordinated medical visits with dentists, ophthalmologists, and pediatricians and reached out to partner organizations for donations of scholastic supplies and construction materials for repairs.

“There is a true commitment with our people, which is an incredibly isolated population. Our communities are extremely impoverished. We know what it is like to not have healthcare services. If it weren’t for the clinic, unfortunately, many of them would not have any medical attention or services,” said Robles.

“Lives are saved here,” said Robles. She shares that during the pandemic lockdown, her father suffered two small heart attacks requiring treatment in Centro Médico in San Juan. In order to be discharged, he needed access to oxygen therapy. COSSAO stepped in to provide an oxygen concentrator which has dramatically improved his quality of life.

A Model to be Replicated

As part of their efforts to address community needs, COSSAO has created a community census with a socio-economic and demographic profile of each household member. This information facilitated their response efforts during both the Covid-19 pandemic and Hurricane Fiona, making it easier to identify those most at risk. From this census, across all seven communities, health promoters have identified close to 30 homebound individuals and nearly 100 individuals living with disabilities.

Since its inception, COSSAO has received guidance from medical and public health academic institutions. With their support and expertise, the clinic has been able to leverage resources to address service gaps. Collaborative efforts with residents and trainees from NOVA Southeastern University and the University of Puerto Rico’s School of Medicine, among others, have provided physical and occupational therapy, dental care and specialty gynecology and pediatrics services.

“Everybody that arrives at COSSAO falls in love with the project,” said Robles.

Dr. Ralph Rivera Gutiérrez, a professor at the University of Puerto Rico Graduate School of Public Health, has been working with COSSAO since 2015. For him, COSSAO’s model, particularly the element of community health workers (health promoters), presents an important alternative that should be replicated to combat the ongoing health crisis, particularly in remote areas.

“This is a project that begins with and from the community. It is a valuable model. Seeing the dream of a community and seeing it achieved, it is spectacular,” he said.

The shipments contained 3.3 million defined daily doses of medication and supplies, including cancer therapies, rare disease treatments, prenatal vitamins, field medic packs for triage care, and more.

Dr. Edna Adan Ismail Visits Direct Relief HQ

Dr. Edna Adan Ismail, former first lady of Somalia, 2023 Templeton Prize winner, and esteemed nurse-midwife, visited Direct Relief this week to meet with staff and speak to an audience about her work to improve the health and lives of women at Edna Adan University Hospital, in Hargeisa, Somaliland.

Adan was trained as a nurse and midwife in the United Kingdom and has worked for decades in Somaliland as an activist and health provider to end female circumcision and increase maternal access to health care.

Located in Adan’s hometown of Hargeisa, the Edna Adan University and Hospital has significantly reduced maternal mortality for women in the region, and the nonprofit charity hospital and training facility provides health services and education to the next generation of midwives. Since 2008, Direct Relief has supported the hospital with $6 million worth of medical aid, including equipment specifically to outfit trained midwives. Direct Relief’s Midwife Kits contain essential items needed to facilitate safe delivery.

Ismail toured Direct Relief’s 150,000 sq. ft. warehouse, met with staff about maternal health efforts in the region, and then spoke to the public about her vision of creating a sanctuary of care and learning.

Read More

COVID-19

The “Cruel Beast” of Covid-19: A Q&A with Edna Adan

The women’s health advocate and former Somaliland foreign minister weighs in on maternal care during Covid-19, the disease’s unknowns, and humanitarian responsibility.

MATERNAL HEALTH

What a Difference a Person Can Make: A Conversation with Edna Adan

Edna Adan has made helping mothers and babies the mission of her life, and does so in her homeland of Somaliland, where the need is great. 

MATERNAL HEALTH

Celebrating Midwives Around the World

Midwives are the first line of assistance, providing high-quality care during routine deliveries and managing basic complications. But midwives can only do their work if they have the right tools.

U.S. Wildfire Season Preparation

With the start of the U.S. wildfire season on the horizon, Direct Relief working to support healthcare providers located in historically impacted regions ahead of time. The organization recently shipped field medic packs to partners in Northern California, including Worldwide Healing Hands and Sacramento Medical Reserve Corps.

Designed with input from emergency physicians and public health officials, each pack contains supplies and equipment to meet a variety of prevalent disaster-related medical issues, including infection control, diagnostics, trauma care, and personal protection tools.

Direct Relief supports safety net providers and others responding to wildfires by providing medical aid, as well as emergency funding, funding and infrastructure for resilient power, and provides analysis for governments and first responders to help make informed decisions.

Learn more about Direct Relief’s wildfire response here.

Direct Relief Documentary Admitted to Global Film Festival

Direct Relief’s documentary, co-produced with BBC StoryWorks, ‘The Invisible Impact of Wildfires,’ was selected for admission to the Fifth ‘Health for All’ Film Festival hosted by the World Health Organization.

‘Invisible Impacts of Wildfires’ is part of a series called “The Climate and Us” by BBC StoryWorks and the Global Climate and Health Alliance. The series goes around the world exploring how the climate crisis is a health crisis while highlighting innovative healthcare solutions being used to help respond.

Watch the documentary here.

operational Snapshot

WORLDWIDE

Included in this week’s global shipments was a delivery of seven pallets of requested medical supplies and medications that departed Direct Relief’s Santa Barbara warehouse this week bound for Honduras. The shipment will be distributed to Fundación Ruth Paz, Clínica Esperanza, and Hospital Loma de Luz. (Video by Maeve Ozimec/Direct Relief)

Over the last week, Direct Relief shipped more than 1.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 527 shipments containing almost four tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 7,140 shipments to 1,523 partner organizations in 54 U.S. states and territories and 62 countries.

These shipments contained 108.5 million defined daily doses of medication totaling 2.3 million lbs.

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The event was moderated by Andrew Schroeder, co-founder of CrisisReady and Vice President of Research and Analysis for Direct Relief. CrisisReady, a research-response initiative at Harvard and Direct Relief, has been tracking trends in Haiti, where Schroeder said the current situation is the most dire since the 2010 earthquake, with violent attacks on hospitals, police stations, and financial institutions becoming increasingly commonplace, along with widespread food insecurity. Nearly 5 million Haitians are experiencing acute food insecurity, according to the United Nations.

“It’s impacted every area of society and caused a mass displacement event,” he said.

Dr. Natalie Colas, Internist and Medical Director at St. Luke Family Hospital in Port-au-Prince, described challenges at every level of the health system in Haiti, from health providers leaving the island to patients putting off coming to the hospital to existing staff being unable to get to work due to kidnapping risk.

St. Luke Foundation operates 10 health facilities, about half of which are in the capital. The organization has taken safety measures for employees, including allowing them to stay at a guest house for up to a week if demonstrations prevent them from getting home safely.

When able, health providers will give patients a three-month supply of prescription medication instead of monthly to limit trips that could put them at risk of gang violence, she said. But supplies and medications are scarce.

“Without an immediate option to refill them in the coming days, I don’t know what we’re going to do… It’s really difficult for us to run the hospital,” she said. “For now, we have a little bit of reserve for emergency patients.”

Only two or three public hospitals in the metro area remain open, she said.

St. Luke’s has oxygen production capability, an asset that allows them to continue treating patients with respiratory needs without having to make dangerous trips outside the facility to fill up oxygen canisters. Direct Relief supported the facility with oxygen canisters during the Covid-19 pandemic, and recently supported the hospital with emergency operating funds.

A noticeable spike in gang-related violence and fatalities has occurred in the country since the 2021 assassination of President Jovenel Moise, said Sandra Pellegrini, Latin America and Caribbean Regional Specialist with the Armed Conflict Location and Event Data, or ACLED. The nonprofit has been tracking news events in the country to identify trends.

Pellegrini said that civilians are bearing the brunt of the violence of armed groups and increased use of kidnapping and sexual violence, which is underreported but still “striking” in the data set.

The number of active gangs has also increased in recent years, and violence has expanded beyond the capital into the Artibonite and Centre regions, where violence has doubled. Gangs have focused on taking control of major highways and sea access with interceptions of supply boats.

Xavier Vollenweider, Director of Mobile Data Partnerships with Flowminder.org, a platform that has processed mobile data from cell provider Digicel, the main cell provider in Haiti, and has been monitoring population movement. Port au Prince has seen its population decrease since 2021, while cities like Cap Haitien and Les Cayes have increased.

Marie Rose Romain Murphy, Co-Founder and Board President of the Haiti Community Foundation and ESPWA Inc., focused on humanitarian and disaster response. The International Office of Migration has been monitoring displacement, and more than 116,000 people have fled the capital for Haiti’s southern peninsula, where Roman Murphy’s foundation operates.

The destabilization and destruction of infrastructure have been decades in the making and compounded by natural disasters, she said. Romain Murphy encouraged keeping local communities and organizations at the table where decisions are being made instead of from a distance. “It starts with community and ends with community,” she said

Direct Relief, which has a long history of supporting Haitian health facilities through crisis and natural disasters, recently committed $1 million to local health facilities to support operating expenses and staff costs.

Residents of Slidell, Louisiana, a city about an hour from New Orleans, experienced impacts consistent with at least one EF-2 tornado, damaging hundreds of homes and businesses in the area and displacing dozens. Several temporary shelters have been activated in the area, and thousands experienced power outages last week. New Orleans and surrounding areas also experienced flash flooding from the storm, with some roadways becoming inundated with heavy rains.

People displaced from their homes after natural disasters, including tornadoes, can be at medical risk if they evacuate without prescription medications needed to manage their health. On Thursday, Direct Relief shipped requested personal care items to people residing in shelters.

Staff from Baptist Community Health Services reported at least 50 families in the community lost everything, and the organization requested personal care kits from Direct Relief. The kits contain items including soap, toothpaste, toothbrushes, shampoo, and more, and are created for people displaced from their homes during times of disaster. The kits were dispatched last week and have since been distributed to people at local shelters.

Direct Relief will continue assessing needs in the area and responding as requested.

The shipments contained 10 million defined daily doses of medication and supplies, including cancer therapies, rare disease treatments, prenatal vitamins, field medic packs for triage care, and more.

Babies in Dominica NICU Receive Respiratory Support

Recently, a neonatal ventilation unit donated by Direct Relief was installed at the Dominica-China Friendship Hospital, Dominica’s largest medical facility. The unit will increase the capacity of the hospital to provide high-frequency ventilation for newborns.

Direct Relief’s commitment to emergency response and improving overall health care in the Caribbean region has continued in response to hurricanes, earthquakes, volcanoes, and other disasters. This commitment was highlighted last summer during the Caribbean Emergency Preparedness Summit in Puerto Rico, where Direct Relief brought 15 Caribbean nations together in an effort to listen and learn about the impacts that increased risk of natural disasters has on their respective country’s healthcare infrastructure.

operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 8.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

One of this week’s recipients was Care Beyond the Boulevard, a Kansas City-based organization dedicated to providing medical care to those living without permanent housing.

The group received wound care products, cardiovascular medications, and other requested medical supplies.

Direct Relief delivered 427 shipments containing over six tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 6,581 shipments to 1,474 partner organizations in 54 U.S. states and territories and 61 countries.

These shipments contained 105.2 million defined daily doses of medication totaling 2.1 million lbs.

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Pfizer México y Direct Relief se unen para distribuir más de 14 mil vacunas contra el COVID-19 en el Estado de México – Dimension Turistica Magazine

Exitosa jornada de vacunación Covid-19 de Cruz Roja Mexicana en Lerma – Asisucede

Pfizer aplicará vacunas gratis contra la Covid-19 en México – Saludiario

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Recibe Cruz Roja Mexicana 12 mil vacunas contra Covid-19 de Pfizer y Direct Relief –Reporteros en Movimiento

Cruz Roja Mexicana Recibe Donación de 12 Mil Vacunas Pfizer para Comunidades Vulnerables en el Estado de México – ContraRéplica

While the last two years provided a sharp increase in employment, report findings share that the country has not yet returned to pre-pandemic levels—especially in skilled nursing. The nation’s aging population will require more healthcare services, and while inflation has affected the economy, healthcare has historically been a safe choice for employees.

To thwart further turnover and increase job opportunities, health centers and free clinics are approaching workforce development by building career pathways and encouraging career literacy. These federally and privately funded institutions have advocated for programs that teach, train, and mentor the incoming and current healthcare workforce to support the nation’s safety net population.

In Florida, a state that has not elected to expand Medicaid, health centers serve 1.7 million patients. According to the National Association of Health Centers, the organizations created over 25,000 jobs in 2021. Steven Bennett, Director of Workforce Development Programs at the Florida Association of Community Health Centers, said the position with the highest turnover rate within Florida health centers is the entry-level position of medical assistant, followed by dental assistant.

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FACHC surveys the 54 health centers across the state every six months to learn and analyze the workforce. The latest survey, which dates to December of 2023, reported an increase in the number of unique open positions. Including medical interpreters, which are necessary given nearly 25% of health center patients do not speak English as their first language.

“I think we now sort of see what happens when the house is on fire, and we don’t have all the things in place,” Bennett said.

Community Health Center of Florida, Inc., or CHI, operates nine health center sites and 35 school-based sites for patients in Florida’s 28th congressional district. The district was created after the 2020 census results showed an uptick in the rural area’s population. Over half of the district’s census respondents identified as two or more races, and the majority of respondents identified as a minority race.

Peter Wood, Vice President for Planning and Government Affairs at CHI, said the health center has a commitment to strengthening the overall primary care sector, specifically by serving underserved communities. Patients within the communities that CHI serves are more likely to be adversely and disproportionately affected by the social determinants of health and have a higher rate of chronic conditions.

Given CHI’s commitment to the community, the health center operates a teaching program that encourages providers to take on additional educational opportunities and to use their new skills in the same location. The teaching center is the first of its kind, nationally, and includes residency programs in family medicine and psychiatry. CHI is developing the program to include a dentistry residency and an internal medicine residency program.

“A higher percentage of them would end up taking jobs and staying in those areas, as opposed to working in a hospital and then finding another job that was not serving the underserved neighborhoods or areas of the country,” said Wood.

While medical staff at any workplace must adhere to specific guidelines and educational criteria, Bennett says there are “foundational similarities, but different types of competencies,” among health center and private practice employees. They require a highly qualified workforce that is also representative of the community they serve. Health center staff are more likely to work with patients who may not have insurance, have insurance through Medicaid, do not speak English as a first language, and may not trust or have had prior experience with providers, making them less trusting of the medical process.

“It’s the whole gambit of human complexity that arrives at our front doors, and we have to staff and build a workforce that is able to not only deal with healthcare challenges but able to manage and articulate responses to those complexities as well,” Bennett said.

While recruiting a qualified workforce is important, Bennett says it’s equally important to retain current employees. The director said health centers must take a holistic approach in their efforts and consider what career pathways look like in the long term. He encourages career literacy so that potential and current employees can better understand their career options and suggests that every employee has, at minimum, a two-year plan for their career and mentoring support. He also suggests that health centers have partnerships with local organizations, faith-based centers and schools to engage more people.

Several health centers and free clinics throughout Florida have partnered with MAVEN Project, a national nonprofit that supports primary care providers, for its mentoring program. Retired physicians volunteer to mentor current providers on clinical and or leadership skills in a trusted environment.

“I was like, ‘please, sign me up’,” said Hillary Glenn, doctor of nursing practice and co-founder of Point Washington Medical Clinic in Florida.

Glenn began working with MAVEN Project pre-pandemic and requested a mentor during the height of Covid. She said there was mixed messaging throughout the state regarding the pandemic, and she wanted to confer with another medical professional. She participated in the organization’s weekly Covid update and had bi-weekly calls with her mentor to make sure that she was up-to-date on best practices and that her organization was providing the most accurate medical advice.

“It helped me a lot professionally and to guide the organization in the right direction and (to) do things that were best practice,” Glenn said.

Glenn said that it can be difficult, especially in rural and or underserved parts of the country, to find specialists who will see patients from health centers and free clinics. She said that with the Maven Project, that access is less difficult. She called the mentor program “brilliant” and “an incredible resource for the charitable sector.”

Dr. Lo-Ann Nguyen, is a volunteer mentor for MAVEN Project and finds value in the “thought partnership” it provides to current health center employees. Like Bennett, she says medical professionals must consider the full trajectory of their careers. Nguyen has worked with a physician at a health center in Florida to support their leadership capacity and their long-term career goals for the past year.

Nguyen said that the physician expressed feeling burnt out and they have worked together on how to delegate tasks and rejuvenate their enthusiasm for their work. Nguyen said it’s common for providers to experience exhaustion. She said that she reminds her mentees of their “why” so that they think about their career trajectory and are less likely to quit.

“If you have that basic value of why you went into medicine, why you spend so many years studying and training, what is it that drew you here?” she said. “And so, how do you find joy in the work?”

Both Bennett and Nguyen emphasized the need for recognition on the job. Nguyen said providers need to know that they can be leaders within the organization and that, as leaders, they should express gratitude and create a culture of positive feedback.

“Make your staff feel empowered, feel valued, and they tend to stick with you,” she said. “They will help you more, and they’ll take better care of your patients for you. So, it’s all Win-Win all around.”

One misconception about health center employment is low salary.

“Meeting market rates for compensation is essential for not only building and retaining staff but for delivering the quality care that patients deserve,” Bennett said.

According to FACHC salary reports, most health center staff earn more than the statewide average if they work the same role at a different medical practice. However, it’s not true for every role. Bennett says that’s why having career pathways is important—it prevents employees from quitting every other year for similar roles with slightly higher pay.

“The truth is, no one’s going to retire rich working at a community health center,” Bennett said. “But the good thing is, no one comes to a community health center to get rich, right? You go into your career at one of these centers because of something deep, the mission and servant of heart.”

Direct Relief has supported health workforce development and training, including through the MAVEN Project, which connects community providers with mentorship and expertise.

Of the donation, 12,000 doses were transported to the Centro Nacional de Capacitación y Adiestramiento, or CENCAD, of the Red Cross located in Toluca, State of Mexico. Another 2,500 vaccines will be administered in the Hospital Regional de Alta Especialidad of Ixtapaluca and via a vaccination campaign in the municipalities of Lerma and Huixquilucan.

The State of Mexico has recorded the second-largest number of confirmed Covid-19 cases in the country, only below Mexico City, and the state with the largest number of deaths caused by Covid-19.

“Direct Relief is deeply thankful for the privilege to work with Pfizer Mexico on this important donation, which will benefit those in need in Mexico,” said Eduardo Mendoza, National Director of Direct Relief in Mexico. “With this donation, Direct Relief hopes to have an impact on health and health equality for the Mexican people.”

“Access is the cornerstone of healthy ecosystems, that is why we are thrilled to make this alliance with Direct Relief, which will allow us to get to a sector of the vulnerable population that needs better access paths to the treatment and vaccines that they need,” said Constanza Losada, President and General Director of Pfizer Mexico.

The shipments contained 15.5 million defined daily doses of medication and supplies, including cardiovascular medicines, insulin, trauma response essentials, nutritional products, and more.

Supplies for Young People with Type 1 Diabetes Arrive in Djibouti

This week, Centre du Jeune Diabétique de Djibouti, a Direct Relief NGO partner in Djibouti, received 120,000 insulin pen needles. These needles allow the children who are patients of the clinic to reuse insulin pens, a tool for insulin injection that was also donated by Direct Relief (in coordination with Australian NGO Life for A Child) and has been shown to improve outcomes in diabetes management over the previously used method of insulin injection via vial and syringe.

Since 2021, Direct Relief has provided insulin, insulin pens, and insulin pen needles, among other supplies, for around 500 children and young people with Type 1 diabetes in Djibouti. A solar-powered refrigerator was also recently donated to Centre du Jeune Diabétique, equipping their facility with reliable cold storage space for insulin.

Learn more about Direct Relief’s support for those living with diabetes here.

Cambodian Ministry of Health Receives Large Vitamin Shipment

Direct Relief shipped over 64,000 bottles of a micronutrient formulation of 15 vitamins and minerals known as UNIMMAPS MMS, which are proven to have a positive impact on maternal and child health, to Cambodia, where they were received by longtime Direct Relief partner Hope Worldwide and passed on to the Cambodian Ministry of Health.

Hope Worldwide is a U.S.-based organization that operates Sonja Kill Memorial Hospital, a large nonprofit hospital in the Kampot region of southern Cambodia with a special focus on maternal and pediatric care. This region is among the lowest income in the country, and access to prenatal health services remains challenging, and the hospital does not have the logistical infrastructure to support other health facilities. For this reason, Hope Worldwide requested that Direct Relief consider the opportunity to donate critically needed prenatal vitamins directly to the Ministry of Health for distribution around the country to women who are at risk of maternal malnutrition.

Since 2009, Direct Relief has shipped over 43 million defined daily doses of requested medicines to partner organizations in Cambodia and is continuing to investigate ways to increase support to health-focused organizations in the country.

Increasing Medical Capacity in Honduras

Direct Relief and Ruth Paz Foundation unveiled a new medical distribution center in San Pedro Sula, Honduras, at an event on April 4, and the facility will support distribution across Honduras, connecting communities in need with medical aid. Ruth Paz Foundation operates a pediatric hospital in San Pedro Sula, as well as clinic sites and health brigade outreach efforts to bring health care to people in need.

Direct Relief has supported the Ruth Paz Foundation with $34.2 million in medical aid since 2013, in addition to financial support.

Ruth Paz Foundation was able to purchase and modify the facility with a $780,000 grant from Direct Relief, and will eliminate some of the logistical and warehousing barriers faced by nonprofits in the country receiving medical aid.

The warehouse will be a national distribution center for medications and supplies and will provide “a vital support point for the effective distribution of medical donations and supplies to vulnerable communities in an efficient, transparent and rapid manner,” the organization said in a statement.

Direct Relief staff attended the inauguration, including Thomas Tighe, President and CEO, Erick Molina, Senior Manager for Latin America, Ellen Cho, Director of Special Programs, and Jonathan Mangotich, Manager of Corporate Engagement.

operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 14.5 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 323 shipments containing over five tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 6,137 shipments to 1,402 partner organizations in 54 U.S. states and territories and 58 countries.

These shipments contained 103.3 million defined daily doses of medication totaling 2 million lbs.

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Cruz Roja Recibe Vacunas Contra COVID que Aplicarán Gratuitamente – El Valle

2024: Donations Urgently Needed for Sudan – Charity Watch

Several doctors, hospital officials, and nonprofit leaders who spoke with Direct Relief say the current situation in Haiti is the most difficult within the past 15 years, due to widespread gang violence in Port-au-Prince and a range of cascading problems that have occurred as a result, including border, airport, and port closures, food insecurity, inflation, and large numbers of internally displaced people.

On March 18, a U.S. State Department spokesperson said in reference to recent events in Haiti that “it is not hyperbole to say that this is one of the most dire humanitarian situations in the world.” Earlier this week, “the majority” of pharmacies and health clinics near the currently closed State University of Haiti Hospital, also known as General Hospital, were burned down by gangs.

“We’ve never seen a situation like this,” said Dr. Marc Edson Augustin, medical director of the St. Luke’s Foundation, which runs a hospital in Port-au-Prince and clinics nationwide that care for about 60,000 patients annually.

“Nobody is allowed to function, to move around. They fear for their lives. It’s a country in collapse,” said Augustin, whose sister, a pediatrician, was kidnapped by gangs in 2022.

“We are living in chaos,” said Hadson Albert, a communications official at St. Damien Pediatric Hospital in Port-au-Prince. Albert said gangs are active in the hospital’s neighborhood and his neighborhood. St. Damien is the only hospital providing care for children with cancer and one of the few that treats high-risk pregnancies. Part of the St. Luke’s Foundation, it is funded through donations and mostly offers free services to vulnerable populations in Haiti.

“The situation is the worst we’ve ever seen during our three-decade tenure in Haiti. There’s never been a time when the entire country has been paralyzed by the situation in Port-au-Prince like it is now,” said Project Medishare’s Jenna Green. Project Medishare provides care to about 55,000 patients annually at Hospital Bernard Mevs in Port-au-Prince and about 100,000 patients annually at its clinics in the Central Plateau region, near the border with the Dominican Republic.

Augustin said that during past natural disasters, people were able to seek to move around to find hospitals and clinics that were still open. Now, most are afraid to leave home due to gang violence and the threat of being kidnapped. He said patient levels at this hospital have been dramatically reduced since the start of the year.

“What’s been going on has been building up since the assassination of our elected president in 2021. Gangs have slowly taken control and have attacked hospitals, schools, and the government,” Augustin said. In 2023, Haiti saw its murder rate double compared to the previous year, totaling more than 4,700 deaths, according to a United Nations report.

While both St. Luke’s and St. Damien remain open, both reported drastically reduced patient flows, as many residents are afraid to leave their homes. Staff members at both hospitals have had to do extended shifts of up to 24 hours, compared to standard shifts lasting between 8 to 12 hours. Some staff members choose to stay on-site for days at a time. These measures reduce the amount of travel. Healthcare workers have been targeted for robberies and kidnappings in recent weeks.

“We are doing our best to maintain the same level of care,” Albert said.

“We’re living day by day. I’m anxious to find out if we’ll be able to be resupplied. Nothing is certain,” Augustin said.

These current obstacles, combined with crises of the past and the economic opportunities present in the United States and Canada, have led to a large exodus of medical and other professionals from Haiti in the past decade, further compounding the challenges of providing healthcare.

Countryside Concerns Increase

Outside of Port-au-Prince, in the nation’s rural areas, hospitals and clinics face severe challenges related to large numbers of internally displaced people, food shortages, and reduced access to medicine and medical supplies – even for hospitals that were prepared. Patient levels are also reported to have dropped due to fears of leaving home and the increased cost of fuel.

“We built an infrastructure to be independent,” said Jessica Laguerre, who spoke to Direct Relief from Port-au-Prince. Laguerre is the chief operating officer at Hôpital Albert Schweitzer, or HAS, which is located about 100 kilometers northwest of Port-au-Prince in the Lower Artibonite Valley. The hospital has its own power grid, solar panels, oxygen plant, access to water, staff quarters, and stockpiles of medicines and supplies to last between one and three months.

“Having that removes most challenges most institutions are facing in Haiti,” she said, interrupting her response to note gunshots she heard in the distance. The staff at HAS are all Haitian, and Laguerre believes they have higher motivation since “they are serving their family and friends.”

Still, the hospital staff are subject to violence and kidnappings, with the hospital’s surrounding area ranking second behind Port-au-Prince for gang violence. Laguerre said that a staff member had been kidnapped and that gunshot wound victims had risen from a maximum of 10 cases per year to about 10 to 12 per week.

Stressing the importance of keeping hospitals as neutral zones, she recounted a situation where a well-known gang member came in to be treated after having been shot. People in the community found out and were planning to “storm into the hospital and lynch him.”

Laguerre and her team immediately called the police to remove him to another location for treatment, which they did in an armored vehicle.

While all of the issues are troubling, Laguerre pointed out that the Lower Artibonite Valley is known as the country’s food basket, making the pervasive food insecurity-related issues even more shocking.

“You’d think a farming community would always have at least the minimum amount of food… you can only imagine what the rest of the country is facing,” she said. A new food program Laguerre and her colleagues created quickly went from one location serving 200 plates per day to five locations, with two more planned for this week, serving 600 plates each.

Hunger was also cited as a leading concern by Locally Haiti, which operates a hospital in Petit-Trou-de-Nippes, which was severely damaged during the 2021 earthquake.

“This community is not self-sufficient. A lot of food and goods come from Port-au-Prince and the Dominican Republic,” said Wynn Walent, head of Locally Haiti.

“Food is much more expensive, and people are hungry. It’s true throughout the country and also true in our area,” he said.

Walent said that there has been a large increase in population, who have mostly been displaced from Port-au-Prince and have gone to live in the countryside with family members.

“Anecdotally, we’ve seen a 25% increase in the number of students enrolled in the school we support,” Walent said.

Walent said that a substantial increase in violence has not reached Petit-Trou-de-Nippes and that the work of their hospital has not been impeded, though restocking supplies is a concern with the closed border.

“We’re not trying to trivialize concerns, but help does reach people, even in the current circumstances, and can make a difference,” he said.

Project Medishare’s clinics in the Central Plateau face a similar situation in terms of gang violence to that in Petit-Trou-de-Nippes, Jenna Green said.

“We’re in the rural areas, and there’s not as much money in the rural areas for gangs, “ she said. Project Medishare has extended deployments to three weeks for their staff due to the danger of traveling between Port-au-Prince.

Project Medishare’s two clinics are open in the Central Plateau as are two maternity centers in the same area. During one day recently, only three patients showed up across all of their clinics. Overall, Green said monthly patient totals are about half of what they were last year, due to a mix of fuel costs and security concerns.

In addition to fuel costs, pharmaceutical and supplement costs have also increased dramatically. Prenatal vitamins, for example, have increased 400% in cost compared to January 2023.

Green said the closure of the Dominican Republic border is also impacting their ability to source medications and other supplies. “We are severely lacking supplies,” she said. Hospital Bernard Mevs ran out of oxygen and blood for during a period earlier this month but remains open.

Adding to the import problem, Green said that while the port at Cap-Haitien is open for sea freight, stringent Haitian regulations prevent the import of goods for many charities since many government bureaus are closed.

Like other nonprofits throughout Haiti, Green said Project Medishare prioritizes nutrition and recently adjusted their school meal program, which serves 8,000 meals per week. To keep it active, they hired mothers of the pupils to work as chefs and bought produce and other ingredients locally, at greater cost, since it was the only viable option, given the disruptions to the supply chain.

Peace and Perceptions

Augustin, referring to over a dozen hospitals that have been attacked in recent weeks, struggled to see how the situation would stabilize without outside help.

“I have to admit, it’s starting to seem hopeless. We’ve been waiting for international support to end this nonsense… I don’t see why the gang would put down their guns if not forced to do so. They outnumber the police and have more firepower,” he said.

“We need peace,” Augustin said.

Despite the problems, Laguerre, Green, and others see reason for hope looking forward. Green noted that her optimism comes from staying open and delivering care. Laguerre focuses on the potential of the majority of Haitians rather than the minority who are creating the instability.

“It’s a small percentage of people, and they are terrorizing us, but once we do the groundwork, we can move the country in a different direction,” Laguerre said.

 “There are a lot of beautiful things happening here… there’s so much energy being directed by Haitians at any opportunity given to help,” she said.

Laguerre believes that Haiti might not be as far from stability as it may seem, even given all the current violence and associated problems.

“We’re a tiny country, and it wouldn’t take much for us to get back on track. We need a little security and help, and we’ll do the rest on our own,” she said.

Direct Relief has allocated $1 million to support the operational expenses of health facilities in Haiti during this period of civil unrest.

The shipments contained 5.6 million defined daily doses of medication and supplies, including surgical supplies, trauma response essentials, nutritional products, and more.

Shipments Arrive at Aberdeen Women’s Center

Recently, Aberdeen Women’s Center in Sierra Leone received Direct Relief’s Obstetric Fistula Repair Modules to support maternal health in the region. Each module contains surgical items, tools, and medications to equip surgeons for approximately 50 obstetric fistula repair surgeries. Obstetric fistula is a birth injury that can cause social stigma and serious health impacts if unaddressed.

The comprehensive module was created in close consultation with leading surgical experts and is endorsed by the International Federation of Gynecology and Obstetrics (FIGO). Learn more about Direct Relief’s Fistula Repair program here.

Since 2010, Aberdeen Women’s Centre has received over 16 tons of requested medical supplies totaling over $1.2 million from Direct Relief.

Children Receive Care in Ukraine

Ukrainian NGO Charity Fund Modern Village and Town, with the support of Direct Relief, recently provided medical consultations to children in need of care in Kirovohrad, Ukraine. Specialists examined and provided consultations for 250 children from newborn to 18 years of age, free of charge.

Additionally, Ukrainian Soul, an organization supported by Direct Relief in Odesa, Ukraine, received multiple shipments from Direct Relief. The deliveries included prescription flu treatments, Hepatitis B treatment, and a variety of oncology medications. The medications will be distributed to a network of medical facilities in the coming days.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 4.6 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 323 shipments containing over five tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 5,739 shipments to 1,367 partner organizations in 54 U.S. states and territories and 58 countries.

These shipments contained 90.4 million defined daily doses of medication totaling 2 million lbs.

In the News

With Frequent Outages in Tribal Communities Creating Health Risks, Direct Relief Provides $10 Million for Microgrids – Microgrid Knowledge

For Health Workers on Haiti’s Frontlines, Direct Relief Distributes $1 Million in Support – ReliefWeb

How to Do Foreign Aid Without Stepping on Federal Toes – Federal News Network

Renowned Midwife Speaks for International Women’s Day – Angels in Medicine

The country’s ongoing instability has exacerbated an already dire humanitarian situation, leading to urgent needs for essential services and support. Over the past year, Haiti has experienced a substantial resurgence of insecurity in many Port-au-Prince metropolitan area neighborhoods. This has created a hostile environment for communities, limiting access to essential resources, including food, water, shelter, and healthcare services. Additionally, Haiti has dealt with storms, flooding, landslides, and a cholera outbreak. 

Thousands of people in Haiti are now facing acute shortages of necessities like food, fuel, healthcare, and protection from violence. Recent reports indicate that hospitals in Haiti are facing critical shortages of staff and medical supplies, hindering their ability to provide adequate healthcare to the population. Partner organizations working in the country have been forced to pause the delivery of services due to the surge in violence, leaving many vulnerable individuals without access to vital support. 

The situation has been compounded by mass displacements of the population, with thousands forced to seek safety in new locations amidst the escalating instability. 

“Direct Relief is deeply committed to supporting front-line health organizations in Haiti, whose staff tirelessly serve patients every day under chronically challenging conditions that have recently become much more severe,” said Thomas Tighe, Direct Relief President and CEO. “The instability is preventing Direct Relief’s typical provision of medications and other essential health products, so this financial support is to allow these exceptional organizations and teams to sustain their essential work when it is needed most.” 

Each of the nine recipient organizations plays a crucial role in providing essential medical services and support to communities across Haiti. The funding provided is to support general operational expenses, including safe transportation for medical staff, housing provisions, and increased security measures amidst escalating unrest. Due to safety and security concerns, the names of the organizations are being withheld at this time.  

Direct Relief has been actively involved in humanitarian efforts, including providing aid to Haiti in response to various crises, such as natural disasters and health emergencies, for many years. As one of the organization’s largest aid recipient countries since the 2010 earthquake, Direct Relief has provided Haiti $418 million in medicines and medical aid among more than 200 recipient organizations and more than $5 million in grant funding support. 

Direct Relief has maintained a strong relationship with its network of healthcare-focused organizations in Haiti and also works in coordination with the Pan American Health Organization, or PAHO, to maintain a flow of medicines and supplies into the country as requested. 

In addition to the $1 million in grant funding, Direct Relief has provided more than $3.2 million in medical aid to 11 healthcare organizations in Haiti since March 2023. 

Direct Relief will continue to track the situation closely and respond to requests for support as needs arise in the days and months ahead. 

Shanti had been taken from her job in Nepal and forced into sex trafficking in India as a teenager. After escaping and returning home, Shanti’s family and community rejected her upon learning she was living with HIV, and she was forced to find work and housing on her own. For a time, she was so unwell that she had to leave her daughter, Kranti, at an orphanage. 

Then, in 2015, a 7.8-magnitude earthquake hit Nepal, and a border blockade between Nepal and India, cut off the supply of critical medications into Nepal, including the HIV treatment on which Shanti’s life depended. 

“She contacted all her friends to help her find the medicine or to get me adopted because I had no one besides her,” Kranti said. 

Despite her personal desperation, Shanti threw herself into the post-earthquake relief efforts. “With no hope of survival, I resolved that even if this was my destined death, I would want to die working for my community,” she said.

The Start of a Movement

With the help of a friend, Shanti connected with Direct Relief, which provided a supply of antiretroviral drugs for a number of Nepali people living with HIV, including Shanti.

“We love to say that Direct Relief saved my mother’s life,” Kranti shared. “And when she felt that she had been given a second chance to her life, she had to do more for her community.”

In 2016, Shanti and six other women founded the Shanti Foundation, a year after the devastating earthquake. The organization quickly got to work educating the Nepali public and government officials about trafficking, HIV, and sexual and gender-based violence. Their team also helps rescue, rehabilitate, and reintegrate trafficking survivors and people living with HIV. Even though she was still a teenager, Shanti’s daughter, Kranti, played a critical role for the new organization as she had learned English and could help translate information from Nepalese for people and organizations who were willing to support their movement.

And given the story behind her name, Kranti is a true embodiment of this movement. The doctor who delivered her called her “Kranti,” which means “revolution” in Nepalese because she was the first baby in Nepal whose mother received antiretroviral therapy treatment, which reduces the risk of a mother with HIV transmitting the disease to her newborn. 

In Nepal, HIV is still highly stigmatized. It is not uncommon for children whose parents live with HIV to be kicked out of school, and for children to abandon their parents when they learn about their parents’ condition. Kranti shared that not having HIV prevented her from experiencing much of the fear and isolation faced by her friends who are living with HIV.

“It was very hard for my friends with HIV every time they would have to take the medication during the school day. Everyone would come and ask them, ‘What are you taking medication for?’ And, of course, they will not tell it’s about HIV, but they’ll always have this fear that they’d be found out.  And one time, my friend’s mother began talking about her story and joining the [anti-trafficking, anti-HIV stigma] movement. And her friends found out, and she was just isolated.”

A Dream Come True

The persistent stigma and lack of resources for those living with HIV led Shanti and Kranti to the dream of having a community house in Nepal’s capital, Kathmandu. 

All advanced healthcare services for people living with HIV are based in Kathmandu, and even if one is lucky enough to know someone in the city, housing is often refused during treatment because of the stigma around HIV. Many are coming from poorer, rural areas of the country and can’t afford a hotel or other accommodations while they seek treatment.

With funding from Direct Relief in 2021, the Shanti Foundation was able to buy a two-story building to provide housing and community for these people left with nowhere else to go. It features two rooftops – one contains a communal kitchen, where residents take turns cooking meals, and the other provides space for a garden that produces fresh vegetables for the community. Handicraft classes also teach women skills to make and sell bracelets, necklaces and other items. “They have made [the center] very beautiful,” Kranti said.

Since the home’s opening, over 70 people living with HIV have lived at the house. Some stay for a few days, and others – often elderly or those living with advanced stages of the disease – anticipate living the rest of their lives at the center.  The center also accommodates sex trafficking survivors.

Challenges and Opportunities Ahead 

Eight years after the Shanti Foundation’s beginning, Kranti is now 21 years old, in her final year of university, and is a volunteer at the Kathmandu center as well as a volunteer development officer for the Shanti Foundation. 

The challenges and opportunities ahead of the foundation are especially clear to her now as she recently returned home from her first trip outside Nepal. After being nominated by staff at the American embassy in Kathmandu, she flew to the U.S. for a three-week leadership program sponsored by the U.S. Department of State, where groups from 22 different countries came together to learn and share about anti-trafficking efforts in their own countries and in the U.S. 

“We went to the Department of Labor, Department of Transportation, Department of Justice; everyone had their own task force for anti-human trafficking,” Kranti shared. “Each law enforcement has victim advocates, investigators, and prosecutors dedicated and trained to these programs.”

In contrast, “trafficking is regarded as just a ‘woman thing’ in our country,” she said. 

“And it is only operated by the Ministry of Women, which is always falling short on resources and things that they want to really do. And we are pressing on the Ministry of Women, because that is also that is only the institution that is really internalizing this issue. But I think we might have to embrace the challenge and go with other ministries like transportation, labor, etc., that have a big role to play in order to prevent this crime.”

Also, Kranti learned from other members of the leadership program that over 50 Nepalese women were being rescued from trafficking in Greece, and other Nepalese people had just been rescued in Cyprus.

“When they have to be repatriated back to the country, they do need support, and we’re in the country to provide that,” said Kranti. “Before now, we knew our people were there, but we didn’t know whom to contact. Now we know whom we can contact, and we can help each other.”

For Kranti, this trip was “most importantly about spreading the words of my mother around the [U.S.] and beyond.”

“Through [Direct Relief’s] support, Shanti was saved, but the impact goes far beyond, now supporting the lives of countless others.”

The shipments contained 8.2 million defined daily doses of medication and supplies, including antibiotics, personal protection equipment, personal care kits and more.

Supporting Migrants from Haiti in Mexico

This week, in collaboration with Hospitalidad y Solidaridad and the International Organization for Migration, over 500 Direct Relief personal care kits were distributed to migrants in Tapachula, Chiapas, Mexico. This initiative aims to provide vital support amid the tumultuous circumstances faced by thousands awaiting asylum processing in Tapachula.

Why It Matters:

The crisis unfolding in Tapachula underscores the urgent need for humanitarian assistance and the importance of solidarity and support for vulnerable populations. As the primary destination for many migrants fleeing violence and instability in neighboring countries, Mexico faces the challenge of providing aid and protection to those seeking refuge within its borders.

Direct Relief’s Response:

This event provides essential personal care kits, filled with hygiene items including toothpaste and shampoo, to alleviate the immediate needs of migrants, particularly from Haiti, residing in Tapachula. These kits will not only contribute to improved health and sanitation but also offer support to individuals navigating challenging circumstances.

Key Insights:

• The situation in Tapachula is indicative of broader migration trends, with Haiti surpassing Honduras as the leading source of asylum seekers in Mexico.
• Discrimination and systemic challenges persist in the asylum process, particularly for Haitian migrants who often face barriers to recognition and support.
• The testimonies of migrants highlight the dire conditions and systemic injustices driving their journeys, emphasizing the need for comprehensive solutions and international cooperation.

Strengthening Health Services in Culebra

As part of Direct Relief’s efforts to breach healthcare access gaps for vulnerable populations in Puerto Rico, Direct Relief staff, alongside medical staff from HealthProMed and La Fondita de Jesús, conducted a community health fair in the island municipality of Culebra on Friday, March 15. The team distributed personal care kits filled with hygiene items, solar-powered lights, and groceries to 100 people.

Historically, residents in Culebra have been isolated both physically and in terms of resources, including food, health services and transportation, among others. Located east of the main island, Culebra commonly experiences the impacts of hurricanes prior to their landfall in mainland Puerto Rico.

Health staff from La Fondita de Jesús evaluated more than 26 patients from their Direct Relief-donated mobile unit. The team also offered training on stress and anxiety management, proper use of medication, counseling on substance abuse and community development to more than 100 participants.

HealthProMed, a federally qualified health center in the area, offered blood pressure, glucose and HIV tests, health education and nutrition training to 96 registered patients. This community health fair further stressed the need to mobilize healthcare services to vulnerable and isolated communities. Many of the patients that were seen rely on maritime transportation to the main island to receive basic medical services.

At the island’s local public school, located adjacent to the health fair’s location, HealthProMed simultaneously held nutritional talks for over 60 students from elementary and middle school to promote increased physical activity, highlighting the importance of sports. Additionally, they hosted a basketball exhibition game for the students. Fundación Atención Atención also provided their Play-Time hour to foster emotion management and resilience through play for 35 children.

Bungie Bounty for Good

The Bungie Foundation, which has supported Direct Relief with several fundraising campaigns in the past, ran a four-hour live broadcast on Friday, May 22. The event showcased Bungie’s feature game, Destiny 2, and raised awareness of Direct Relief’s work. The Bungie Foundation has partnered with Direct Relief since 2015, beginning after the devastating earthquake in Nepal when the Bungie community rallied together to raise more than $1 million for the response efforts. Learn more about streaming and Direct Relief here.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 6.7 million defined daily doses of medication outside the U.S.

Thirty pallets of requested medical supplies and medications departed Direct Relief’s warehouse in Santa Barbara, California, on March 19, 2024, bound for Ukraine. The shipment will be received by Ukrainian Soul and distributed to local healthcare facilities.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 497 shipments containing over four tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 5,383 shipments to 1,324 partner organizations in 53 U.S. states and territories and 57 countries.

These shipments contained 85.2 million defined daily doses of medication totaling 1.5 million lbs.

In the News

Critical hospital supplies and insulin for children with diabetes are among requested shipments making their way through treacherous shipping routes – Angels in Medicine

AmeriCorps hosting homeless outreach in Isla Vista – KEYT

MEXICO CITY — As the traffic light turns red, and cars come to a halt, the driver of a truck makes a swift gesture to Wilyender, 15, and Mervin, 17, who rush towards the vehicle to clean the windshield. Both have perfectly cut hair that contrasts with their heavily worn shoes.

After approaching the driver and cleaning the windshield with serious, focused looks, the teens display big smiles while splitting the couple of coins the driver gave them. In the lane next to them, Alexandra, 10, has less luck.

“God bless you anyway, don’t worry, maybe for the next time,” Alexandra says in a notably polite and gentle voice, smiling as she moves towards the next vehicle.  

In another lane, Yordi Romero, 34, sells lollipops. He offers the candy to drivers with one hand while using his other hand to push a wheelchair carrying Nerli, 16, who is the daughter of Yordi’s partner, Kelly. Nerli has spina bifida.

The light turns green, but for these migrants, life remains on hold.

Finding Shelter

A few meters from this bustling intersection lies the Northern Bus Terminal of Mexico City, a transportation hub for the northern regions of Mexico and the U.S. border. In recent months it has become an important stop for migrants on their journey to the United States. Different nationalities, different needs and dreams converge at this point, all hoping to continue their migratory journey as quickly and safely as possible. But it is not easy for everyone to move forward.

In a parking lot nearby, there is an improvised migrant camp housing about 50 families in tents and makeshift houses constructed from found materials — and a lot of ingenuity. It is surrounded by big avenues and metro tracks, though still very much out in the open. 

From these flimsy dwellings, most migrants repeatedly attempt to secure a coveted appointment with U.S. Customs and Border Protection (CBP) through CBP One, a digital application. The app has been used by migrants to make more than 64 million requests to enter the U.S. Overloaded with this high number of users, many users report the app is often slow and unstable. With each crash, the number of requests increases, as does the number of migrants stuck in limbo in Mexico City. 

For two months, Yordi Romero, his partner, Kelly Leal, and their 4 children slept in the tents near the terminal. There were no available restrooms, much less any resources to address Nerli’s specific needs due to spina bifida. They managed to rent space in a mechanic’s workshop converted into a room for rent. Yordi has worked various jobs since arriving in Mexico, including at a nearby construction site on 10-hour shifts to pay for lodging and some food. 

The family, from Maracaibo, Venezuela, also battled the CBP One app, spending many long nights trying to cajole the app to work, while longing to continue their journey north.

The Beast or The Wait

The complex and slow immigration process pushes many individuals, and even whole families, to face the difficult decision of waiting for the luck of an appointment in rough conditions or continuing along riskier routes like the infamous “La Bestia” train. This generic term refers to a vast network of freight trains in Mexico known for multiple accidents and deaths.  

But the danger is not only accidental; armed groups linked to drug cartels often target the train and the surrounding areas it passes to rob, extort, and kidnap migrants. Police abuse and corruption by various law enforcement agencies are also a threat to migrants. 

A few months ago, during a previous visit to the train, a young Venezuelan migrant who introduced himself just as “Oriente” explained that “La Bestia” is not the train itself, but rather the migrants capable of enduring and overcoming so many obstacles and risks.  

“The real beasts are us that can ride it,” he shouted as he jumped from one wagon to another, seeking a better “seat” for the ride.

In a lonely remote area on the outskirts of Mexico City, a young couple from Venezuela said they preferred to try to reach the border by train as soon as possible rather than sleep in the street with their three kids. On the side of the tracks, their daughter Fabiana, 6, was distracted by the lights generated by her shoes with each step she took among rocks, debris, rails, cacti, and other elements that make up the beautiful, yet hostile landscape along the train route. 

Breaking the stillness, a train arrives, and about 20 people run in all directions, trying to find a spot that gives some sense of safety. Not everyone finds it. The following day, via text message, Fabiana’s father said he was separated from his wife and one of his kids. His wife was without currency, a phone, or food. The next train would not stop within walking distance of her location, and traveling with their child, she couldn’t jump on it.

He later found out that his wife and child were detained by Mexican migration police and sent to an unknown town where they had to find shelter, money and a way to get in touch with him. It would take the family over a month to be reunited closer to the border, despite only being a few hours apart. 

Clinics and Churches Fill Gaps

Sociopolitical instability in different Latin American countries and factors such as violence, repression, and climate change continue to force the displacement of thousands of people. Places like Ecuador, Nicaragua, and Haiti are enduring severe civil unrest, which also has an evident impact in increasing the complexity of migration. 

The Mexican government reported almost 700,000 migrants passed through the country from January through November last year. CBP reported 2.5 million encounters with migrants at the U.S.-Mexico border last year. As the biggest city along the migration route to the U.S., Mexico City, the most populous metropolitan area in North America, is a popular waypoint along the journey to the U.S.

Places like La Soledad Plaza in the city center, bordered by Our Lady of the Solitude church, have become increasingly long-term migrant camps. This complex is one of the city’s largest such camps, with about 3,000 people staying in a shelter next to, and run by, the church and outside on the plaza one night last November. Our Lady of the Solitude, led by Father Benito Torres, and his close collaborator, Claudia Torres, works to alleviate the various difficulties faced by hundreds of migrants.  

“Honestly, I’m not sure what I would have done without the help from this place,” Hugo Saavedra said. “I arrived in Mexico City very sick and fainted yesterday. I couldn’t even stand up, but here they have helped me with medicines, attention and a bed,” Saavedra, who came from Venezuela, said. 

Lack of clean water, public bathrooms, hygiene items, and many other necessities receive significant attention at the church’s shelter, which is coordinated by Claudia, though she gave credit to Father Benito for tirelessly sourcing needed supplies from wherever possible. She said that bed and board are provided to newcomers for three to four days. Healthcare clinics are organized continuously with the local Luis E. Ruiz Health Center.  

During these events, patients are given a complete meal and general check-up. Basic treatments are provided for mild and moderate cases; the most common conditions are respiratory and intestinal infections.  

According to Dr. Marco Antonio Rojas, leader of the medical brigade, one of the biggest challenges in treating migrant patients is their transience, which makes it difficult to monitor their health status. However, Dr. Rojas says consistent and free support is attempted from the shelter. If needed, patients are referred to the hospital network in the area, where they receive specialized care in much-requested areas such as gynecology and pneumology (respiratory system-related care).  

“The challenge often lies in the availability of medications, especially pediatric medicines and antibiotics, for the treatment of respiratory infections. We don’t have a constant supply,” Dr. Rojas said.  

Unable to predict when they will obtain their CBP One appointment, migrants in Mexico City often try to stabilize their situation by working and finding a place to rent. In Iztapalapa, Mexico City’s most populous district, even before the latest surge in migrants, Luis Gerardo Rodríguez has been waiting for confirmation of the process for over three months. He now spends his days working at a fruit and vegetable stand in a market near the shelter. He earns about US$25 a day, working up to 14 hours. It’s enough to help his mother in Venezuela and save some cash for a potential flight to the border once an appointment comes through. 

Exultation, and Next Steps

For some, the appointment finally comes. Yordi Romero and his family cry tears of joy and celebrate after learning they were approved to present themselves to the United States immigration authorities.

Kelly removes sheets from the walls of the converted car mechanic room and discovers a sign that reads “engine repairs.” Rosbelly, 8, combs her hair and ties it with a ribbon. Nerli already has her hair braided and organizes her deck of cards in a shiny gold purse with a smiley face. Yordi puts perfume on Keiner, 6, who was dressed in his Sunday best.

The family heads to the Northern Bus Terminal. Other migrants bid them farewell from their tents. Many of the well-wishers have faced similar ordeals and continue to wait for an appointment. They wave their hands, sending greetings and blessings to Yordi, Kelly, and the kids while harboring hope that they will be the next ones to continue their journey.

Direct Relief has supported medical facilities across Mexico, including regions through which many migrants travel, as well as the health system in Mexico City.

Read More

HUMANITARIAN CRISIS

Jungle, Thieves, and Worse: A Mom’s Epic Journey To Save Her Daughter

27-year-old Alejandra Jimenez recounts crossing the Darien gap in Panama with her two young children, the journey north, and the care they found at a New York City health center.

UNITED STATES

Everything For The American Dream

In many ways, Ciudad Juarez represents the last of a long list of obstacles in the extreme journey to reach the United States — and through that, to reach a job, the hope of better living conditions, and to let the imagination fly towards the American Dream.

 COLOMBIA

Healing At The Colombian Border

A community of those who have migrated and health care providers has emerged on Colombia’s eastern border.

The shipments contained 9.2 million defined daily doses of medication and supplies, including prenatal vitamins, surgical supplies, insulin and more.

This week, more than four tons of medicines, including antibiotics, antifungal medications, and painkillers, donated by Direct Relief, were received by the NGO Kurdistan Save the Children. The medications were distributed to local healthcare facilities, including hospitals, cancer treatment centers, and maternity centers, in collaboration with the Directorate of Medicines and Medical Supplies in the Kurdistan Region.

Personal Care Items Distributed in Isla Vista

On Friday, staff from AmeriCorps hosted a community coffee hour for unhoused community members in the Community Center in Isla Vista, California. Personal care kits, containing toothbrushes, shampoo, deodorant and other hygiene items, donated by Direct Relief, were distributed to attendees, as well as groceries and coffee.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 7.9 million defined daily doses of medication outside the U.S.

Thirty-one pallets of requested medical supplies and medications departed Direct Relief’s warehouse in Santa Barbara, California, on March 15, 2024, bound for Ukraine.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 472 shipments containing nearly seven tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 4,864 shipments to 1,280 partner organizations in 53 U.S. states and territories and 54 countries.

These shipments contained 77 million defined daily doses of medication totaling 1.4 million lbs.

In the News

Should I Stay or Should I Go? Charities’ Response Amid Haiti’s Violent Unrest – Charity Watch

IOM and Direct Relief team up for crisis-afflicted migrants – InfoMigrants

Direct Relief awards $7 million in health equity grants – Philanthropy News Digest

Combat to Conquest: Vasil’s Path to Success – Let’s Levitate

In reality, everyone receives a gift at Plan A Health: quality medical care at no charge to the patient.

Plan A provides reproductive and primary care health throughout the Mississippi Delta, a region that historically has had poor health outcomes and low economic status. Their small team operates a mobile medical unit, outfitted with two exam rooms, that truck driver Antoinette Roby drives from city to city. Since its inception in 2018, Plan A has expanded to include a pharmacy, mail-order prescriptions, options for contraceptives, pre-and-post-natal care for patients with HIV, and telehealth for family planning. They’ve also hired a nurse practitioner that patients can call or text directly to ask questions.

While many initiatives were created to combat health disparities in Mississippi and have worked to increase access to care, the state still needs to catch up in adequate health measures. Mississippi’s government is one of the last states to consider expanding Medicaid. The State’s Health Department reported an increase in infant mortality in 2021, making Mississippi the state with the highest number of infant deaths in the country.

Related Content: In Rural Mississippi, Plan A Goes the Distance for Patients

Plan A’s brick-and-mortar site is in a small town within the Delta, within an unassuming building off the main road that was a previous physician’s office. Their next goal includes an expansion into rural Georgia, where health disparities mimic the Mississippi Delta.

“It’s really been a delight to see how it’s grown, it’s pretty cool,” said Dr. Caroline Weinberg, CEO of Plan A.

Weinberg is the only non-Mississippi native on the team. The New Yorker founded Plan A and has hired people from the communities that Plan A serves. In turn, they’ve built trusting relationships across the Delta and more than doubled their patient base in the first three years of operation.

“If you put the trust in the community, (and understand) that they know what they need, and that services delivered by the community for the community are so important,” she said. “And then empower the people in the community to deliver those services.”

The people she’s hired are also well-known community members, like Desiree Norwood, who is the mayor of her hometown of Sunflower, Mississippi. Norwood said when the mobile medical unit arrives in Sunflower, people are excited because Plan A has built a reputable reputation.

“A lot of organizations come into the community, and they do evaluations and research and then what happens? They leave,” she said. “We’ve actually been able to fill a lot of gaps and alleviate some of those barriers that they’re facing.”

Norwood said a lot of trust-building has happened because the team lives in the areas that they are serving. They endure the same barriers to success and have remained in the Delta to improve the conditions. Norwood is known for taking her personal vehicle during off hours to visit patients who have asked for emergency contraceptives or general health inquiries. The small-town mayor said there is no such thing as a “9 to 5” for her.

“This isn’t working a job, it’s a passion,” Norwood said.

Every Plan A employee shared the same sentiments. Roby recounted a time when she followed up with a patient whose blood pressure was too high and asked him to seriously consider their suggestions on lifestyle changes. Months later, the patient’s wife approached Roby and thanked her for the conversation; her husband had listened, made changes, and was in better health.  

Roby said that many uninsured people have neglected to attend doctor appointments and that some don’t know what to say or ask for when they meet with medical staff.

“You have to break it down and give them a better understanding,” she said. “Provide a higher level of patient care.”

Roby grew up in the Delta and said that the openness to learning about health conditions is growing. The driver of the mobile clinic said that parents are willing to learn about options for contraceptives for young adults and options for pre-natal and post-natal care with trusted physicians.

Roby said working at Plan A means a lot to her personally. She’s seen the effects of health disparities on her neighbors and wants to see better outcomes. She said that too often the people of the Delta have been overlooked for access to quality care.

“We never want anyone to have to choose between taking care of their family and getting the health care that they deserve,” Roby said.

While Plan A is a complement to other affordable health options in the area, some things set them apart. Plan A staff say they want to ensure that patients have options for their care. The health center offers variations of contraceptives and birth control for those who want to use the assistance. According to Weinberg, many women stop using birth control because of the side effects and the costly expense of making more appointments and purchasing new options.

At Plan A, patients can request the birth control that works for them.

Having direct access to a provider is a “big deal,” said Telvin Harrington, a community health worker at Plan A. He said that the community has embraced their team not only because they truly care, but because they can relate to the circumstances. Patients don’t have to wait 60 to 90 days for an appointment, and while transportation barriers are persistent in the area, the mobile clinic has scheduled stops so that residents know which days of the week they can receive care.

“Going to someone who looks like you, is relatable, and (can) build meaningful relationships with them, that’s important,” he said. “I come from a low-income family, and not all of my family members who have been sick have been able to afford healthcare…so just being able to see someone who is most relatable to your circumstance, it feels better.”

Direct Relief, through grant support from Organon, has awarded $800,000 to four clinics, including Plan A, which aims to address the drivers of unintended pregnancy in the U.S. through community-informed, collaborative approaches.

Pilar Gomez, DiabetesLATAM’s founder and director, started the NGO after moving to Panama in 2017. Until then, Gomez had worked as an instructional designer and project manager for Citigroup in Emerging Markets and as a freelancer designing training programs for Shell, Petrofac, Kaplan and Schlumberger in the U.S., UK, Latin America and Asia.

She also had a son and a daughter, and with time, they both were diagnosed with Type 1 diabetes.

“I met with one of the seven endo pediatricians in the country, asking her where the charities, summer camps and support groups were,” Gomez recalled. “She replied, ‘There is nothing in Panama and a lot to do.’”

Type 1 Diabetes In Panama

In Panama, there are currently 1,755 people with Type 1 diabetes. This is according to the Type 1 Index, a data simulation tool informed by published data and a survey of over 500 endocrinologists across the globe. The Type 1 index also estimates that 600 of these people in Panama are children.

Two government agencies run the public Panamanian healthcare system: (1) the paycheck-fueled Social Security (Caja de Seguro Social, or CSS) and (2) the Ministry of Health (MINSA) system, which is typically utilized by people who are unemployed and for those working in the informal sector and not registered as employed. There are also private hospitals that require private insurance or payment out of pocket.

Though treatment provided by both public options is equally comprehensive in theory, the reality is that the country’s health system is short-staffed, making it challenging to provide timely care. “They’ll say to you, yeah, we can get you an appointment, and you can pay $5,” said Gomez. “But the waiting list to see an endocrinologist can be five years. So effectively, there’s no coverage.”

There is also a severe shortage of medications throughout the year at the hospital network funded by the Social Security Fund. “If you read their list of medications, you’ll find all the different kinds of insulins, but you must go every month to collect your insulin. And one month, they might have insulin, but they don’t have test strips, the next month, they might have test strips, but they don’t have glucose meters. And then they don’t have one of the two types of insulins,” said Gomez. “So effectively, there’s no there’s no insulin and supply security.”

Pushing for Change

Gomez was determined to help — kids like her own needed reliable access to insulin. Through contacts at the International Diabetes Federation, she got in touch with the Life for a Child team, an Australia-based NGO that, in partnership with Direct Relief, provides insulin to young people in 45 under-resourced countries. 

When plans to provide insulin and education through a local hospital fell through, Gomez created a completely volunteer-run program separate from the hospitals for families that don’t have guaranteed insulin access. The program began in August 2022 with 30 kids enrolled, and in the last two years, it has grown to support 150 kids with diabetes care. That means that DiabetesLATAM now provides care for roughly 1 out of every 10 people living with Type 1 in Panama, according to the prevalence numbers from the Type 1 Index.

Given the importance of education in diabetes management, there are three education days each year. At the end of those days, the program participants receive the insulin and other medical products they need for the next four months. Snacks and lunches with the appropriate amount of sugar are provided, and education sessions are customized for the different age groups. Participant caregivers also undergo their education sessions. They also have a medical room where each kid is weighed, their A1c level (average blood sugar measurement) is checked, and their medical record is updated digitally. 

“What we’ve done is create a diabetes clinic because we see people every four months, which is roughly how often you’d see your doctor in the private sector,” said Gomez.

And recently, DiabetesLATAM garnered some public support from the Ministry of Health. On September 12, 2023, the organization participated in a public signing of a memorandum of understanding with Panama’s Ministry of Health, which was essentially an agreement to help expedite the complex process of importing donated medical products and support the organization’s outreach efforts.

What Now?

For Gomez and her team, advocacy begins with patient education and empowerment. On education days, caretakers are taught how to make the most of the 15-minute consultations provided by doctors in public systems. DiabetesLATAM has also introduced the use of insulin pens to patients. There are several benefits to using an insulin pen over using a vial and syringe: it increases dose accuracy, features less painful needles, and allows for easy insulin injection outside the home. 

Patients now talk about these new devices and research on their effectiveness with their doctors, helping them realize that pen use increases adherence to a treatment plan. “And so [the patients] become the people who open the mind of their doctors,” Gomez shared.

Her team recently used this time and ran focus groups to gather information for patient roadmaps that outline all the steps patients have to take if they need diabetes care and are a part of the Ministry of Health or Social Security system.

“When we do advocacy [with government officials], we take these documents with us,” said Gomez. “Some people say, ‘Oh, but those people have medical coverage, and at such and such hospital, there’s that insulin,’ and then we reply, ‘Yeah, but look at the roadmap for them; they have to follow 25 steps, they have to queue in the pharmacy for two hours, then they have to go back to the doctor for another stamp, then they need to wake up at four in the morning to do their lab work.’ So it [acceptable diabetes care] might be in writing, but this is in reality what people are going through.”

For Gomez, this was never about just handing off insulin. 

“Inevitably, when you get 400 people in the same space for eight hours, there’s something that changes within them, even if it’s very difficult to measure,” said Gomez. “I think you feel lonely battling the system, poverty, difficulty, sleepless nights. And then when you come together, and you realize that you’re one of many, something changes within.” 

“And I believe people become stronger, either to carry on living the way they are because they know that they’re not alone or to make certain changes and to approach their life and the system that they’re obliged to use in a different way.”

Since 2022, Direct Relief has provided DiabetesLATAM with over $950,000 worth of insulin and other medical products, as well as a double-door pharmaceutical-grade refrigerator for insulin storage.

Distribution of the 73 pallets has begun with the products resupplying field hospitals, mobile medical units, and primary health tents in shelters both in Rafah (Southern) and Deir al-Balah (Central) Gaza. The aid delivery also includes medications to benefit thousands of individuals with chronic diseases, cardiovascular ailments, and injuries, as well as prenatal vitamins and water purification tablets.

Medical items include:

• Diabetes medications and supplies for managing a chronic condition that affects thousands in Gaza
• Drugs to prevent heart failure for individuals suffering from cardiac conditions
• Syringes and needles for administering medications and providing necessary medical care in Gaza
• Sutures and wound care for treating injuries and ensuring proper wound healing in Gaza, where access to medical supplies is limited
• Prenatal vitamins for the health and well-being of pregnant women in Gaza, where access to proper nutrition is a challenge
• Personal protective gear for healthcare workers in Gaza to protect themselves and prevent the spread of diseases
• Water purification tablets and oral rehydration salts for preventing waterborne diseases and treating people for dehydration

As with previous shipments, this delivery to Gaza was the result of weeks of ongoing coordination with various national governments, international agencies, and on-the-ground organizations.

The medical aid that arrived today was airlifted to Jordan from Direct Relief’s California headquarters and distribution center earlier this month. Upon arrival in Jordan, the supplies were received by Anera, which arranged their transport to Egypt. From there, the 73 pallets were divided into three deliveries and driven across the border into Gaza.

The third and final aid truckload arrived safely this morning at Anera’s warehouse in Rafah, Southern Gaza, bringing much-needed aid to civilians facing a dire and still-unfolding humanitarian situation.

Anera, a key regional partner of Direct Relief, is a U.S.-based nonprofit with a longstanding, robust presence and record of providing humanitarian aid in Gaza, the West Bank, Jordan, and Lebanon.

By the numbers: Today’s shipment brings the total amount of aid delivered by Direct Relief to Gaza over the past five months to 37 tons and more than $24 million in value.

Regional assistance: Direct Relief supported Israel with both financial and medical material assistance in the wake of the deadly October 7 attack by Hamas, including equipping a 50-bed emergency medical field hospital, delivering dozens of emergency medical packs, and granting $1.6 million in financial aid for first responders and trauma and psychosocial support for survivors.

Direct Relief has also supported the efforts of Anera in the West Bank with 10 tons of requested medical items, including prenatal vitamins, IV solution, and more. Amid a rise in tension and conflict regionally, Direct Relief is responding to humanitarian needs across multiple locations, including Iraq, Jordan, Lebanon, Syria, and Yemen.

What’s next: Direct Relief is also continuing to work with its partners in Gaza and throughout the region to mobilize and coordinate the delivery of more requested medical aid.

This month, Direct Relief signed an agreement with the International Organization of Migration, which will strengthen both organizations to quickly respond to emergency needs, including those in Gaza.

Direct Relief, an apolitical, non-sectarian, and nongovernmental humanitarian aid organization, is committed to responding to health needs and requests for support in Gaza and across the region. All Direct Relief shipments to Gaza and elsewhere in the region will continue to be coordinated and delivered in accordance with U.S. sanctions laws and with necessary approvals from Israeli and Egyptian authorities.

The shipments contained 2.9 million defined daily doses of medication and supplies, including personal hygiene essentials, respiratory medications, vitamins and more.

Renowned Midwife Speaks for International Women’s Day

International Women’s Day drew a crowd of over 100 people to hear firsthand about the essential work of midwives from a midwife who responded to the 2022 floods in Pakistan to serve women who had little to no access to care.

Neha Mankani spoke at Direct Relief headquarters on Friday, shortly after a short documentary called “Neha,” which chronicles her efforts to bring midwifery care to communities impacted by the catastrophic floods in Pakistan’s Sindh Province, was shown to those gathered. A volunteer event was also held to pack personal care items for women worldwide.

In November 2023, Mankani was named among the “2023 BBC 100 Women,” highlighting inspiring and influential women from across the globe. Mankani was a Fulbright Scholar and earned a master’s in public health from Columbia University, a midwife and founder of Mama Baby Fund and works with the International Confederation of Midwives to shape policy and advocate for midwives globally.

Direct Relief often supports the work of midwives during emergencies because they are usually first responders to those most vulnerable, including pregnant women and infants. Direct Relief CEO Thomas Tighe introduced Mankani and said the organization works to connect resources to midwives in the wake of disasters for just that reason. “When we see an earthquake, or a typhoon… we’re thinking of midwives because they always show up,” Tighe said.

The documentary shows Mankani working to access clinics where demand for health services far outpaced capacity after the 2022 floods and showed the devastating impacts of climate on health. Afterward, Mankani was interviewed by Paulina Ospina, Direct Relief’s Maternal and Child Health Associate Director, and the two spoke about the significant intersections of climate change and the impacts on pregnant people and young children. For example, the impacts of heat can have direct implications for the prevalence of hypertension, pre-eclampsia, and even pre-term birth, Mankani said.

Environmental factors have direct impacts on women and children, including lack of access to quality food due to crop devastation from flooding and lost livelihoods for agricultural workers. Malaria and other vector-borne diseases are also related, as well as access to clean water and timely health care. Gender inequity and gender-based violence also add layers to women accessing care and resources.

“All of these disasters are set against an already weak health system,” she said. “It makes a poor situation worse.”

The documentary showed a scene of Mankani holding a listening session with midwives in Pakistan, asking them what they need to feel empowered in their communities to do their work safely and effectively. Because many policies around health care and midwifery are made at the Ministry of Health and country level, direct feedback from midwives is often left out of the conversation. But that’s changing, Mankani said, a fact that she finds extremely hopeful.

“There’s a sense of ‘nothing about us, without us’,” she said. “There’s a recognition that a lot of the change needs to come from the ground.”

Texas Wildfires

Historic wildfires have impacted Texas, with the largest being the Smokehouse Creek Fire, which burned over one million acres with 74% containment as of Friday, March 8, according to the Texas A&M Forest Service.

In response, a shipment of requested personal care items, medications, and supplies departed Direct Relief’s warehouse in Santa Barbara, California, and this week, it was bound for Amarillo, Texas.

Regence Health Network, a federally qualified health center, will use donations to treat patients with respiratory issues related to smoke inhalation and allergies.

NACHC President Visits Direct Relief

Last week, National Association of Community Health Centers President and CEO Dr. Kyu Rhee visited Direct Relief headquarters in Santa Barbara, California. Dr. Rhee met with Direct Relief leadership and staff to discuss the organizations’ partnership and combined impacts on patients in the U.S.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 1.7 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 404 shipments containing nearly 13 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 4,381 shipments to 1,248 partner organizations in 53 U.S. states and territories and 52 countries.

These shipments contained 67.8 million defined daily doses of medication totaling 1.3 million lbs.

In the News

Direct Relief celebrates International Women’s Day – KEYT

Teva’s ESG Lead on Why Company Committed to Community-Led Mental Health Push – PR Week

“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 shipments contained 7.2 million defined daily doses of medication and supplies, including personal care products, breast pumps, surgical materials, vitamins, and more.

Medical Aid Arrives in Sudan

Direct Relief continues to respond in Sudan as the civil war has impacted healthcare facilities and infrastructure, leading to protracted shortages of medicines and medical supplies.

Recently, a Direct Relief-supported organization, MedGlobal, distributed shipments of donated supplies, including oral rehydration salts, to local healthcare providers.

Since the civil war started in April 2023, Direct Relief has sent more than 37 tons of requested medicines and medical supplies, including prenatal vitamins, surgical materials, insulin, and personal care items, amounting to $8.7 million in wholesale value.

Direct Relief has been coordinating with the Federal Ministry of Health, World Food Programme, Sudanese Children’s Diabetes Association, International Society of Better Health Access, International Organization for Migration, International Society of Nephrology, and MedGlobal.

Direct Relief will continue to respond as needed.

Equipping Volunteer Firefighters in Mexico

Two weeks ago, Direct Relief delivered 10 field medic packs to local emergency response agencies in Oaxaca, Mexico, including the Comision Nacional de Emergencia, A.C., local firefighters and Protección Civil personnel.

This week, the packs were used by local forestry brigades for the treatment of injuries as the crews fought forest fires in Oaxaca. There are currently six active fires in the state at various levels of containment. Five volunteers have died in the efforts to contain the fires.

Mexico is currently experiencing a severe drought that is affecting its southern states. While states in northern Mexico are receiving significant rainfall due to the El Niño climate pattern, states in southern Mexico are seeing far lower levels of rain and higher frequency of fires in the mountainous regions of the country.

Direct Relief Signs Agreement with IOM

Direct Relief staff met with representatives of the International Office of Migration in Washington, D.C., this week to sign a memorandum of understanding to streamline and expand aid delivery globally to migrant communities.

Beyond immediate relief efforts, the partnership will strengthen emergency preparedness and response activities, including the stockpile and pre-position medical supplies in collaboration with IOM host countries.

“Our partnership with Direct Relief opens doors to resources that are vital for delivering urgent medicines and supplies to those in need, particularly in moments of crisis,” said Ugochi Daniels, IOM’s Deputy Director General for Operations. Central to this landmark partnership is the provision of medicines, medical equipment, and healthcare supplies. This critical assistance will strengthen IOM’s capacity to respond swiftly to the acute health needs of migrants and mobile populations during humanitarian and public health emergencies.

“Direct Relief is so pleased to join in partnership with IOM to help address the tremendous humanitarian health needs that exist among the world’s migrants and the communities that host them,” said Thomas Tighe, Chief Executive Officer of Direct Relief. “Private, philanthropic resources have always been an important part of the humanitarian assistance efforts for migrants, and we look forward to extending a broader invitation to participate — in a productive, efficient manner through coordination with IOM, which will optimize all available resources and best serve people in need.”

To read the full announcement, click here.

Monitoring Texas Wildfires

Five active fires are currently impacting the Texas Panhandle, north of Amarillo. As of February 29, the Smokehouse Creek Fire has burned a total of 1,078,807 acres (3% contained), making it the largest fire in the state’s history and second largest in U.S. history. The fire is threatening to converge with the Windy Deuce Fire to the southwest, putting the town of Borger, which currently sits in between the two fires, at extremely high risk.

Direct Relief’s Research and Analysis team is monitoring and mapping the real-time mobility of those displaced by the fire, social vulnerabilities, and power outage impacts. Click the image to view the updated map here:

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 5.9 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 527 shipments containing over 3 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 3,963 shipments to 1,206 partner organizations in 53 U.S. states and territories and 51 countries.

These shipments contained 64.9 million defined daily doses of medication totaling 1.2 million lbs.

In the News

Better Health Support for People in Crisis Situations Under Direct Relief Agreement – IOM

A Maui Community Health Center Receives a Down Payment to Rebuild and Recover after Devastating Wildfire – National Association of Community Health Centers

‘Fortnite’ Raises $144 Million for Ukraine Aid Over Two-Week Span – Aol.com

The Annual Guardian Games Cup Returns – Bungie

BU Theatre Department Puts on ‘Three Sisters’ Play – Binghamton University Pipe Dream

Direct Relief’s Fund for Health Equity Awards $7 Million to 38 Organizations Across the U.S. – 3BL

Medical Aid To Ukraine Dwindling With News Fatigue: US Healthcare And Medical Providers – We Must Do More – Med City News

“This latest round of more than $7 million in grants, made possible by generous support from MacKenzie Scott, the AbbVie Foundation, and Eli Lilly and Company, is the most recent infusion of funding for organizations deeply committed in eliminating health disparities and improving healthcare quality in their communities,” said Dr. Byron Scott, Direct Relief COO and Co-Chair of the Fund for Health Equity. “Direct Relief is proud to support and grateful for the work they do every day.”

The AbbVie Foundation committed $10 million over five years to the Fund for Health Equity in 2020.  Since then, the AbbVie Foundation distributed grants to twenty organizations, and this year, the foundation is awarding $1.6 million in grants to 10 organizations, including: Central City Concern, Edward M. Kennedy Community Health Center, Family Health Centers of San Diego, Food Well Alliance, Kee Cha-E-Nar Corporation, Mexican American Opportunity Foundation, Minority Behavior Health Group, National Black Nurses Association, University of Texas – El Paso, and Vecinos, Inc.

“The AbbVie Foundation is proud to support the 2024 Fund for Health Equity grant recipients and we’re grateful for their work addressing health disparities in historically marginalized communities across the United States,” said Claudia Carravetta, President, AbbVie Foundation; Vice President, Corporate Responsibility & Global Philanthropy, AbbVie. “We believe meaningful change begins with communities, and we look forward to listening and learning from all our grant partners who are identifying innovative solutions that further advance health equity.”

Lilly also supported the Fund with a $5 million commitment in early 2021 as part of its Racial Justice Commitment, a robust endeavor to deliver resources like education, health care, economic stability, and jobs within the communities where it operates. Direct Relief distributed a portion of this initial funding to eight awardees across the U.S. since 2021.

This year, $880,000 from Lilly’s commitment will be split between four new awardees: Denver Health and Hospital Authority, Cheyenne River Youth Project, GirlTREK, Asian and Pacific Islander Wellness Center.

“Lilly’s commitment to social impact goes back nearly 150 years and we remain committed to eliminating disparities that prevent people from living the healthiest life possible today,” said Cynthia Cardona, Head of Social Impact at Lilly. “We sincerely appreciate Direct Relief’s efforts to identify and contribute to worthy organizations that are working to create real change in their local communities around the U.S.”

Since the start of the Fund in 2021, more than $50 million has been provided to support 160 organizations across the U.S.

The awardees were selected by the Fund for Health Equity’s Advisory Council, which includes the following members:

• Co-Chair Regina Benjamin, MD, MBA, 18th US Surgeon General of the United States, Founder Bayou Clinic, Inc.
• Co-Chair Byron Scott, MD, MBA, Direct Relief COO
• Martha Dawson, DNP, MSN, RN, FACHE, President and CEO President of the National Black Nurses Association, Associate Professor at the University of Alabama at Birmingham
• Jane Delgado, Ph.D., MS, President and CEO of the National Alliance for Hispanic Health
• Gail Small, JD, Head Chief Woman, a citizen of the Northern Cheyenne Tribe

Full list of 2024 Awardees:

• Alabama Interfaith Refugee Partnership, Birmingham, AL
• Asian and Pacific Islander Wellness Center, Inc., San Francisco, CA
• Camarena Health, Madera, CA
• Central City Concern, Inc., Portland, OR
• Centro Hispano de East Tennessee, Knoxville, TN
• Cheyenne River Youth Project, Inc., Eagle Butte, SD
• Children’s Village, Birmingham, AL
• Denver Health and Hospital Authority, Denver, CO
• DuPage Health Coalition, Carol Stream, IL
• East Harlem Council for Human Services, Inc., New York, NY
• Edward M. Kennedy Community Health Center, Inc., Worcester, MA
• Family Health Centers of San Diego, Inc., San Diego, CA
• Family Reach Foundation, Boston, MA
• Food Well Alliance, Inc., Atlanta, GA
• GirlTREK Incorporated, Washington, DC
• Health Outreach Prevention Education, Inc. (HOPE), Tulsa, OK
• Hispanic Health Coalition, Inc., Houston, TX
• Kee Cha-E-Nar Corporation, Klamath, CA
• La Plazita, Inc. DBA La Plazita Institute, Albuquerque, NM
• Los Barrios Unidos Community Clinic, Inc., Dallas, TX
• Mexican American Opportunity Foundation, Montebello, CA
• Minority Behavioral Health Group, Akron, OH
• Multi-Cultural Health Evaluation Delivery System, Erie, PA
• National Association of Hispanic Nurses, Inc., Lexington, KY
• National Black Nurses Association, Silver Spring, MD
• Native Action, Inc., Lame Deer, MT
• REACH, Las Vegas, NV
• Santa Cruz Barrios Unidos, Inc., Santa Cruz, CA
• Shared Harvest Foundation, Inc., Culver City, CA
• Tell Every Amazing Lady about Ovarian Cancer (T.E.A.L.®), Brooklyn, NY
• The Concilio, Dallas, TX
• The Night Ministry, Chicago, IL
• The Texas International Institute of Health Profession DBA VCare Clinics, Houston, TX
• University of Texas Foundation/University of Texas
• Vecinos, Inc., Cullowhee, NC
• Vida Senior Centers, Washington, D.C.
• Vincent Chin Institute/Asian Health Services, Oakland, CA
• Virginia Garcia Memorial Health Center, Aloha, OR

This new $10 million commitment is a focused expansion on tribal communities of Direct Relief’s Power for Health initiative. The initiative provides philanthropic support to ensure resilient power and operational continuity for nonprofit health facilities in high-risk-of-outage areas to ensure critical services are maintained, including during weather-related emergencies in which health risks are heightened.

Healthcare services are highly dependent on power being available to access electronic health records, maintain medications that require refrigeration, operate basic diagnostic equipment, and to keep the lights on. The Power for Health initiative already has provided funding of $44 million to support resilient power for 130 projects globally, including at 56 U.S. nonprofit clinics and health centers.

“Direct Relief has seen the increasingly common situation of power losses during emergencies leaving safety-net health facilities unable to function and provide care when needed most for patients without other options. Many tribal communities face intensified health risks due to already limited health care access as well as power availability, high energy costs, and more frequent outages,” said Thomas Tighe, Direct Relief CEO.

The $10 million investment is aimed specifically at achieving several objectives:

• Operational Continuity: Helping ensure that tribal health centers can continue to provide essential services during power outages.
• Economic Relief: Alleviating the burden of energy costs that weigh down on health facilities, making healthcare provision more sustainable.
• Strengthened Healthcare Safety Nets: Fortifying healthcare infrastructure within tribal communities.

The critical need for investment in resilient energy infrastructure on tribal lands is underscored by findings from a recent Department of Energy report, which sheds light on the acute electricity access and reliability challenges confronting tribal areas that are further compounded by the escalating threat of climate change-induced weather events.

According to the report:

“Climate-related threats to Tribal infrastructure are expected to increase in frequency and severity under future climate scenarios, thus being highly vulnerable to impacts associated with climate change. These climate change vulnerabilities have motivated Indian Tribes to explore options for distributed clean energy solutions.”

Other key findings from the report include:

• Tribal communities experience 6.5 times more power outages than the broader United States.
• 10 percent of on-reservation households spend more than 20 percent of their income on energy while the average US household spends less than 3 percent.
• The Department of Energy – Office of Indian Energy is only able to fund 30 percent of tribal project applications. Seventy percent of proposed projects are unable to be funded.

Direct Relief’s commitment to tribal clean energy is a response to this urgent need, aiming to mitigate these challenges through sustainable and resilient power solutions.

As a purely philanthropic initiative, grants are provided to cover the full costs of designing and installing solar and battery systems, which are then owned and maintained by the recipient tribal health organization. All financial benefits accrue to the recipient organizations.

“Direct Relief recognizes that many creative financing options exist for solar and battery projects in the U.S., but we believe this is a very strong case for philanthropic support and a compelling value-for-money proposition to enhance health services for people facing tough circumstances,” said Tighe. “The basic difference is the same as between a student loan and a scholarship – both are ways to pay for college, but one is paid back and other is not. Direct Relief’s approach is that of scholarship, not a loan, which we believe is appropriate for a charitable organization.”

Like most natural disasters, Hurricane Otis grabbed headlines in late October as a Category 5 storm that produced record-setting wind gusts of 205 miles per hour. The storm killed at least 52 people, with dozens more missing, according to the official government count. Local outlets have placed the death toll at as high as 350 people.

Now, several months later, international media has moved on even as the deadliest phase of the storm is ongoing. In the hurricane’s immediate aftermath, lack of potable water, limited or no electricity, impassable roads and damaged infrastructure, and interruptions to local food and medicine supply chains were the most pressing issues. Today, the delayed progress in rebuilding efforts has created a breeding ground for mosquitoes.

Dengue fever, also known as break-bone fever, is a viral mosquito-borne infection that can lead to painful fevers, rashes, and low platelet counts, which reduces the ability of the body to stop bleeding. While there is no cure, many cases can be treated with over-the-counter medications and rest. However, more difficult cases require anti-hemorrhaging medication, platelet transfusion, and an array of interventions in an ICU. In the most severe cases, usually due to low platelet counts, which can lead to spontaneous blood loss, patients are transferred to hospitals in Mexico City.

The mortality rate is less than 1%, though the illness can quickly fill up hospital beds. This is reflected at a new field hospital in Acapulco, where most patients are being treated for dengue fever, according to Dr. Ivan Santana, Guerrero state’s director of medical emergencies.

Months after the storm, “there still is a lot of debris and garbage, including trees, wood, sheet metal, aluminum, mud, and dust in the hurricane-effected areas (Guerrero state). It has become a breeding ground for mosquitoes,” said Dr. Santana, who noted that some roads in poorer, more rural parts of the state remain blocked.

Santana said there were about 1,500 active dengue fever cases in Guerrero as of last week, with just about all of them concentrated in areas most impacted by Hurricane Otis. He said cases were on the rise prior to the storm — Ministry of Health figures show a case count increase of almost 340% through October 2023 compared to all of 2022 — but that the numbers in Guerrero jumped significantly post-Otis. “Dengue is also present in other Mexican states, but Guerrero has the highest number, and I believe this is due to the hurricane,” he said.  

Less than two weeks after the storm, Guerrero had 1,855 confirmed cases, representing a 50% year-over-year increase in the number of cases compared to the same period the previous year. Between January 1 and February 21 this year, Guerrero had 1,497 confirmed cases, part of more than 4,700 total suspected cases, according to PAHO. These case counts are more than the total number of dengue cases in the state from January 1 to October 23, just before Otis hit last year.

Overall, since the storm, Guerrero has seen a 237% increase in cases compared to the same period the previous year, according to Ministry of Health data. Nationwide, Guerrero has about 40% of all confirmed cases, which is down from the 75% of all Mexican cases it had at the end of January. Before the storm last year, Guerrero was not among the top five states in dengue case counts.

Assessing the current healthcare priorities in Guerrero, Santana said dengue fever is at the top, even as other maladies are present, such as other mosquito-borne diseases, including chikungunya and Zika, as well as diarrheal diseases. Santana also mentioned that people with cancer and chronic diseases, such as diabetes, chronic kidney disease, and hypertension, have faced interruptions to care due to a lack of access to their medicines and treatments at facilities. Violent crime has also persisted in Guerrero, which has also curtailed the number of physicians and other first responders willing to travel to the area, according to Santana and one additional doctor who asked to remain anonymous and who decided to suspend his medical missions to Guerrero.

“Hospital infrastructure was damaged, and services were cut. Pretty much every single medical facility was affected by the hurricane so that obviously creates some issues,” Santana said. He mentioned the lack of cold chain capacity as an example of why diabetics were unable to get insulin, for example. Other medications that require being kept at low temperatures, like some vaccines, also spoiled.

Addressing what led to the recovery effort delays, Santana said the scale of the disaster was simply too large to address quickly, given available resources.

“More than 500 trucks were moving rubble right after the storm. There was lots of heavy machinery, but the magnitude of the hurricane was so massive that you couldn’t quite do it fast enough,” he said. “It was too much for any quick response to mobilize. There was too much rubble and mud, and even now there’s mud, which is a breeding ground for mosquitos.”

In the past couple of weeks, Santana said that the outbreak has been somewhat curtailed because of favorable weather conditions, specifically meager amounts of rain, as well as more fumigation. Santana believes the situation will stabilize through the spring, but that cases will likely rise again during the rainy summer months, in addition to fumigation machinery needing to be returned to the other Mexican states from which they have been loaned.

Since Hurricane Otis made landfall in Oct. 2023, Direct Relief has shipped more than 67 tons of medical aid to support health services for those impacted by the storm.

Interview translation and additional reporting by Eduardo Mendoza

Apart from the devastating human losses, the damage inflicted on Ukraine over these past two years is immense: according to the World Bank’s newly published damage and needs assessment, as of December 31, 2023, the total cost of reconstruction and recovery in Ukraine is $486 billion over the next decade.

In health care, the damage has been near-ruinous in the most war-affected parts of the country. Overall, the health sector has so far sustained approximately $1.4 billion in damage, rising to a staggering $17.8 billion if including the removal of debris, demolition of destroyed facilities, and other losses.

Of the 9,925 public facilities in the sector prewar, 1,242 have been partially or fully damaged. The destruction was especially severe in the eastern Donetsk and Luhansk regions, and the neighboring Kharkiv region, which also borders Russia. Additionally, 787 pharmacies were damaged or destroyed.

The dire health care situation was exacerbated by the huge movement of people since the start of the war. In addition to the 6.5 million people who have fled and remain outside of Ukraine since February 2022, an estimated 3.7 million remain internally displaced, placing a huge strain on healthcare facilities in more protected parts of the country.
While many refugees have since returned to their country, the humanitarian crisis and human tragedy are deepening as attacks on Ukraine’s energy infrastructure, homes, and health facilities continue to kill and injure people and cause widespread psychological trauma.

Against this stark backdrop, Direct Relief ramped up the largest humanitarian aid response in its 75-year history and has continued to assist its core partners in Ukraine, including the Ministry of Health, with more than 1,900 tons of medical aid, valued at $1.1 billion wholesale, 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 in response to the prolonged crisis.

As the war continues, Direct Relief is focused on 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, and resilient power to sustain continuous health services.

Financial Summary

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Feb. 13, 2024.

Who Donated to the Response?

In response to the crisis, Direct Relief received contributions from 105,033 donors totaling $115,067,879 from individuals, foundations, businesses, and organizations located in 84 countries (including the U.S.). Donations from all 50 U.S. states and four territories were received.

Of the total amount of Ukraine Relief-designated contributions —
• $42,194,219 was contributed by 104,358 individuals
• $61,267,946 was contributed by 314 businesses
• $10,426,607 was contributed by 212 foundations
• $1,179,107 was contributed by 149 organizations

How Were the Funds Used?

Of the total Ukraine Relief-designated cash contributions received to date, Direct Relief has expended or committed $68,763,863 to improve the health and lives of people affected by the disaster.

This includes:

• $42,358,000 on financial assistance to entities and organizations supporting emergency response
• $16,556,544 on procurement of alternative power and backup batteries, field medic packs, specialized requested equipment and other supplies
• $5,372,683 on transportation (paid and pending)
• $4,476,636 on emergency personnel costs and other organizational response management expenses

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for the Ukraine response have been used for fundraising.

(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

Medical Material Assistance

Direct Relief’s Ukraine relief response support can be divided into three categories: medical material assistance, direct financial assistance, and information assistance.

Direct Relief’s main objective in any large-scale disaster response is to deliver emergency medical resources safely and securely – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.

In January 2022, prior to the start of the war, Direct Relief had been working in coordination with Ukraine’s Ministry of Health to import specialized Covid-19 monoclonal antibody therapies, a donation that established a key relationship that would provide a channel into the country weeks later under wartime conditions.

After the war broke out, Direct Relief was in constant communication with local, regional, and country-level organizations, including the Ministry of Health, to determine needs and requests for aid.

Direct Relief’s first emergency shipment consisted of field medic backpacks outfitted with triage tourniquets and other specialized equipment for first responders treating injuries of war.

As more requests became known, Direct Relief began to channel large volumes of aid via charter flights to the region as part of the response.

In March, a 76-ton charter, with transportation donated by FedEx, included specifically requested emergency medicines and supplies, including trauma and wound care products, chronic disease medications, oxygen concentrators, and Covid-19 antiviral tablets. A subsequent 52-ton charter departed in June, and FedEx also provided funding for many of the emergency medical backpacks sent.

As of Feb. 21, 2024, Direct Relief’s Ukraine relief response efforts have resulted in the delivery or pending delivery of 1,900 tons of medical aid, valued at $1.1 billion wholesale, to support health services.

As the response continued, Direct Relief began to focus on emerging needs:

REHABILITATION SERVICES

Both military troops and civilians have endured wartime injuries, and many require significant medical interventions to repair trauma and physically rehabilitate. Supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a central tenet of Direct Relief’s financial support strategy in Ukraine.

People needing complex surgeries, long-term rehabilitation and prosthetics have sought care at Unbroken National Rehabilitation Center in Lviv. Direct Relief granted $1 million to Unbroken to procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel.

Direct Relief has also provided $250,000 to UNITED24 for renovating the Mental Health and Rehabilitation Center Veterans “Lisova Poliana” in the Kyiv region of Ukraine. The center specializes in treating disorders related to combat stress, assisting survivors of captivity and torture, and providing physical rehabilitation services.

The Protez Foundation connects Ukrainians living with amputations to customized prosthetics and rehabilitation and is another organization Direct Relief supports. While Protez has recently opened a clinic in Ukraine, some patients are flown to the U.S. as a reprieve from the combat environment and are fitted for prosthetics. They spend at least three weeks, sometimes more, learning to use their bionic limbs and have access to familial-like support through the Ukrainian-American community.

Read more: Rehabilitation Effort in the Twin Cities Helps Ukrainians Recoup from War

Direct Relief has also been able to connect amputees with high-intensity prosthetic lower limbs, or running blades, equipment that is generally not covered by the Ukrainian health system. Access to these advanced prosthetics is drastically changing the lives of many victims of the war who thought their injury had put an end to their sporting activities or ability to serve their country.

RESILIENT POWER

War-time power interruptions can greatly impact health services, so Direct Relief has focused on providing resilient power options to Ukraine. The organization has provided more than 2,000 Tesla Powerwalls - rechargeable 13.5 kW lithium-ion batteries that can provide power during peak times, outages, and at night - to help keep healthcare and educational facilities operating during disruptions to the national power grid. This is a direct response to previous Russian attempts to destroy Ukraine’s energy supply during the coldest months.

Memories are still fresh of power cuts, with surgeons operating by flashlight during relentless missile and drone attacks last winter. Building on a separate project to supply more than 500 Powerwalls donated last year by the Polish government, this further installation of Tesla units will make a huge difference going forward.

In the town of Derhachi, five miles northwest of Kharkiv, two Powerwalls donated by Poland were installed last November at the local 100-bed hospital to supplement its generators in emergencies.

The impact of the combined lines of support is amply evident on the ground in Ukraine’s hardest-hit cities like Kharkiv. Here, assistance rendered via Direct Relief’s partners, as well as aid received from other international organizations, ensures quality health care for hundreds of thousands of people.

"We are grateful for all assistance with medicines, medical supplies, and electrical power. We wouldn't have survived without such support," said Kostiantyn Loboiko, the acting director of the Kharkiv Regional Hospital, which has 830 beds, a staff of 550 doctors and serves the whole of the heavily war-impacted Kharkiv region.

MENTAL HEALTH SUPPORT

About one-third of Ukrainians may be affected by mental health issues, with up to 15 million in need of psychosocial support and 3–4 million of those requiring direct pharmacological interventions by mental health professionals, according to a United Nations Development Program report issued in June 2023. Mental health is an integral part of Direct Relief’s Ukraine response, cutting across many categories of work: medicine donations, primary care, rehabilitation aid, care for refugees and more.

The organization has funded psychosocial support programs for war-affected people, including through Razom's "Together with You” program in July 2022, providing psychological help to impacted individuals, including children. Direct Relief has provided $550,000 in funding to Razom for Ukraine for this program.

Razom currently provides care at seven centers in Lviv, Ivano-Frankivsk, Vyshkiv, Khmelnytskyi, Bucha, Kharkiv and Dnipro, where teams of experienced psychologists work with different age groups and specialize in different types of psychological trauma. In addition to individual therapy sessions, the specialists conduct group sessions at centers for displaced persons, hospitals, rehab facilities, geriatric institutions, and orphanages.

Direct Relief has also supported HromadaHub, a nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and providing emergency psychology treatment. A key project supported by Direct Relief in 2023 was its emergency psychology training for Ukrainian psychologists and members of the state civil defense service to improve care for the civilian population after military attacks, disasters, and other traumatic events.

Outside of Ukraine, Direct Relief has also funded programmatic efforts of the League for Mental Health, which provided mental health outreach to Ukrainian refugees in Slovakia.

PRIMARY CARE AND HEALTH SYSTEM STRENGTHENING

Direct Relief is engaged in several different lines of activity to bolster health care in Ukraine. In areas where rural geography and the impact of war have curtailed access, support for primary and specialized community outreach health services, expanding capacity for early diagnosis, treatment, and prevention of disease. At the same time, access to medicines is being ensured through a vetted network of non-governmental partners capable of providing regular distribution to primary health facilities and community pharmacies.

Direct Relief is continuing to support emergency, specialized, and primary health care services through the provision of funding, ambulances, medicines, and supplies in Ukraine.

Outside of Ukraine in support of primary healthcare services, Direct Relief provided funding for prescription medication support and telehealth services for Ukrainian refugees in Poland. Poland-based organization Pelion had, by the end of 2023, supported 318,000 Ukrainian refugees to purchase medicines under its Health4Ukraine program, or 18% of the total number of people that came to Poland after the war's start.

In Depth

Amid Freezing Temperatures, Ukrainian NGOs Double Down on Humanitarian Projects for 2024

Ukraine Starts Unpacking Mental Trauma as War Rages On

Tesla Powerwall Shipment Fires Up Ukraine’s Energy Fight Before Winter

Direct Financial assistance

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the war.

To date, Direct Relief has identified, vetted, and awarded emergency financial support totaling more than $42 million in cash support for groups responding to medical needs related to the war.

Funding has been focused on the following categories and organizations:

Medical material to Ukraine

• Ukraine’s Ministry of Health - $2.2 million - Granted funds to the Ukrainian government to facilitate and sustain medical logistics operations in-country through December 2023. Supported facilitation of medical logistics operations around controlled medicines in-country.
• Charity Fund Modern Village and Town - $810,000 - Bolstered the operational costs of this Ukrainian nonprofit, which has worked with Direct Relief since 2015 and provides humanitarian medical supplies to medical facilities to Ukraine’s Cherkasy region.
• Fondation Humanitaire Internationale AICM Ukraine - $500,000 -Funded operational costs as the group delivered medical aid to support 150 medical facilities concentrated in the northeast of Ukraine.
• Charitable Fund Humanitarian Hub Zhytomyr - $490,000 - Funded operational costs, including payment of the formerly all-volunteer staff, of this Ukrainian nonprofit providing humanitarian medical supplies to over 40 medical facilities in Sumy, Chernivtsi, Luhansk, Dnipro, and Kharkiv oblasts since the beginning of the conflict.
• Charity Fund "TAPS" - $390,000 - Supported the Ukrainian non-profit’s mission of the families of fallen soldiers, which they do in part by distributing medicines and medical supplies to those in need. Funding went to support their operational costs, as well as the purchase of an electrohydraulic operating table requested by the surgical team in a nearby hospital.
• HromadaHub - $370,000 - Strengthened operational needs of this Ukrainian nonprofit, providing emergency psychology treatment as well as humanitarian medical products to medical facilities in Luhansk, Donetsk, Zaporizhia, Kharkiv, Odesa, and Chernivtsi oblasts.
• Polish National Agency for Strategic Reserves (RARS) - $350,000 - The Polish Government appointed RARS to act as a humanitarian hub for medical aid intended for Ukraine. RARS has worked with Direct Relief to support the forwarding of shipments into Ukraine and to store medical aid safely.
• Kharkiv Renovation Fund - $320,000 - Funding supported the operational costs of this Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine.
• Yevgen Pyvovarov's Charity Fund - $300,000 - Funding backstopped operational costs of this Kharkiv-based Ukrainian nonprofit that began in 2020 as an initiative designed to provide humanitarian medical supplies to medical facilities throughout Ukraine.
• Charitable Organization Ukrainian Soul - $230,000 - Funding went to support the operational costs of this Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout the eastern parts of Ukraine. The organization also supports an outpatient center for internally displaced people in Ukraine.

Rehab services

• First Lviv Medical Union (National Rehabilitation Center Unbroken) - $2,870,000 – This medical center in Lviv, Ukraine, provides comprehensive rehabilitation services. Funding was used for the organization of the First National Rehabilitation Conference in April 2023, education of specialists, equipment for the newly established rehabilitation center, surgical equipment, renovation of the pediatric neurosurgery department, rehabilitation of the in-patient psychiatry department, and support towards the establishment of a burn center.
• Society of Critical Care Medicine - $2.5 million – SCCM is the largest critical care nonprofit organization globally - a global community of clinicians who provide care to critically ill or injured patients in over 100 countries. Members in Ukraine and the surrounding countries have identified critical medical aid needed for people affected by the ongoing war. The funding was used to train nonsurgical Ukrainian clinicians on how to care for trauma patients more effectively and efficiently, moving patients more quickly from the ICU to lower levels of care to free up critical ICU capacity.
• The Protez Foundation - $1,135,000 – Funding was used for prosthetics and the education of prosthetists from Ukraine.
• Levitate Technology ApS - $585,000 – Funding provided prosthetics for patients in Ukraine in collaboration with the Unbroken and the charitable organization, U+.
• Charitable Organization West Support in Ukraine - $500,000 - Bolstered CO West Support in Ukraine to support the infrastructure and resource development of the Tsybly Center to expand rehabilitation services.
• Dobrobut Hospital - $500,000 - Funding supported the biggest network of private medical facilities in Ukraine, which has been providing free medical services during the war. The funding was used for the provision of surgical and rehabilitation care.
• United24 - $250,000 – Funding was used for improving the capacity of the Mental Health and Rehabilitation Center Veterans “Lisova Poliana” in the Kyiv region of Ukraine.

Health services

• Dobrobut Hospital - $2 million - Funding supported the biggest network of private medical facilities in Ukraine, which has been providing free medical services during the war.
• Society of Critical Care Medicine - $1.5 million - Supported a global community of clinicians who provide care to critically ill or injured patients in over 100 countries. Members in Ukraine and the surrounding countries have identified critical medical aid needed for people affected by the ongoing war. The funding was used to provide training and procure small equipment needed most urgently by intensivists in Ukraine.
• Charity Fund Yevgen Pyvovarov - $280,000 – CF Yevgen Pyvovarov, in close coordination with the Association of Nephrologists in Ukraine, as well as the European Renal Association Task Force for Ukraine, has used the funding to provide batteries for patients in Ukraine who use peritoneal dialysis for their chronic renal condition, as well as specialized medicines and lab supplies.
• Charity Fund Modern Village and Town - $270,000 - The Charity Fund Modern Village and Town and the largest children's hospital in Ukraine NCSH OHMATDYT create a multidisciplinary mobile teams of hospital specialists to provide affordable consultative, diagnostic, medical and psychological and, if necessary, inpatient care in any remote area of the country.
• Razom for Ukraine - $180,000 - Funding supported for specialized services (medical missions) - A Ukrainian-American nonprofit established in 2014 to support the people of Ukraine.
• Ukrainian Diabetes Federation - $150,000 - Organization for advocacy and awareness of diabetes in Ukraine. This in-country organization distributes medical equipment and monitors where people who need insulin are located and where they are fleeing. The funding was used for operational costs - distributing material aid and gathering and sharing vital information.
• Ukrainian Midwives Union - $150,000 –Funding will support basic training on first aid, medical childbirth outside of hospital settings, and perinatal and postnatal care.
• Dobrze Urodzeni (Well Born) - $140,000 - Polish organization of midwives, doulas, psychologists, and lactation consultants that focuses on independent midwifery practice and out-of-hospital perinatal care. Grant funds were given to develop and assemble birth kits and distribute them in Ukraine.
• Tabletochki Charity Foundation - $130,000 – Tabletochki is the largest Ukrainian childhood cancer foundation. The funding was used to cover tumor molecular and genetic testing for pediatric oncology patients in Ukraine.
• Motanka - Mobile Medical Services - $120,000 - Franco-Ukrainian nonprofit organization dedicated to supporting war victims in Ukraine. These funds committed by Direct Relief will allow Motanka to procure medical and personal care products, surgical equipment, and medicines for doctors and surgeons on the frontline of the war.

Emergency services

• Crown Agents - $500,000 - Funding was for purchasing generators on behalf of the Ministry of Health.
• KIWI K.A.R.E - $300,000 – Kiwi K.A.R.E, a registered New Zealand Charitable Organization, provided medical and general humanitarian aid and evacuations; support to IDPs with a focus on children living in orphanages and refugee centers; supply continuity of wide-ranging medical aid; an outreach program and support to physical and psychological rehabilitation centers; power infrastructure support (heaters, small power banks, generators).
• UA Brokers without Borders - $300,000- Grant funding was for the purchase of 15 generators for hospitals in need of backup power.
• UA Resistance Foundation - $300,000 – Funding supported the transportation of U.S. ambulances, fire engines, and supplies into the hands of medical and fire personnel in Ukraine
• Razom for Ukraine - $250,000 - Supported payment of costs for generators, and $180,000 for specialized services and medical missions.
• Project Joint Guardian - $130,000 – Supported this group of full-time firefighters from around the world who volunteer their time to help their fellow first responders better serve their communities during both man-made and natural disasters, including responding in Ukraine.
• Charity Fund Yevgen Pyvovarov - $35,000 – the CF Yevgen Pyvovarov, in collaboration with the Ministry of Digital Transformation, has supported the transport of donated back-up power systems for Ukraine. The funding was used towards the transport and installation of the back-up units.

Mental health

• Razom for Ukraine - $550,000 - A Ukrainian-American nonprofit established in 2014 that, with this funding, is providing mental health services to war-impacted individuals in Lviv and Ivano-Frankivsk, Ukraine.
• HromadaHub - $320,000 - A Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and, with this funding, is providing emergency psychology treatment.
• Health Tech Without Borders - $100,000 - A global non-profit, Health Tech Without Borders (HTWB) serves as an innovative hub that connects qualified and vetted volunteer clinicians to survivors of humanitarian disasters, war, or assault. Since the beginning of the war on Ukraine in 2022, HTWB has provided critical tools, resources, and technology to overwhelmed and under-resourced healthcare workers. The funding was used to enhance the team’s capacity to engage, recruit, and train new volunteers.

Health care for refugees

• Doz Fundacja Dbam O Zdrowie (Pelion) - $15 million (Poland)- A Polish healthcare company that, with this funding from Direct Relief, is providing digital cash payment cards to Ukrainian refugees to help cover their healthcare cost
• League for Mental Health Slovakia - $3,700,000 – Supported mental health services and employed Ukrainian mental health specialists working with the Ukrainian refugee community in Slovakia. Part of the funding was also used to provide local transportation for Ukrainian citizens residing at a temporary housing in Slovakia.
• Fire Medical - $600,000 (Slovakia)- Operational funding provided to an ambulatory services nonprofit that acts as an out-patient clinic and operates hospital transportation services free of charge for refugees.
• International Confederation of Midwives - $583,000 - Funding provided for midwifery services for refugees over a period of 12 months, supporting the Midwife Associations in the following seven countries: Estonia, Finland, Czech Republic, Hungary, Latvia, Poland, and Romania.
• HealthInova North Macedonia - $200,000 – Provided pharmacy and medical services vouchers to cover the most immediate needs for Ukrainian patients in Macedonia.
• URTICA Foundation Poland - $120,000 – Supported children in oncological and hematological wards around Poland. Since the war broke out in Ukraine, and millions of Ukrainians were forcefully displaced, the Foundation started providing psychosocial support services for pediatric oncology patients from Ukraine as well. The funding was used to expand the provision of services throughout Poland.
• Polish Diabetes Association - $100,000 (Poland) - Patient association in Poland committed to diabetes education and advocacy. The funding was used to provide pharmacy and food vouchers to cover the most immediate needs to Ukrainian diabetes patients in Poland.

Information Assistance

In addition to the provision of medical material and financial aid in response to the crisis, Direct Relief has been a critical supplier of information. Working with software company partners, academic institutions, and medical centers, Direct Relief has used crowdsourced data, geospatial analysis, and other data collection and analytics instruments to help understand key issues in the war.

Within Ukraine, Direct Relief has focused mainly on assisting with crowdsource data collection on the needs of internally displaced persons, including their origins and destinations, access to key services and goods including health care, food, water, shelter, and livelihoods, and their sentiment in terms of subjective concerns.

At the same time, Direct Relief collected data on the needs and goods availability of over 950 private pharmacies throughout Ukraine, including many located in areas of significant conflict. The pharmacy data has been incorporated into the cross-validation of MOH needs lists. Important insights were shared with first responders, healthcare partners, and Ukrainian health officials, as well as with United Nations agencies and international assistance organizations to help them determine how to best prioritize and deploy their respective resources.

Supporting Ukrainian Refugees

Direct Relief’s principal role in providing information assistance for the refugee crisis in the European Union and Moldova comes through the analysis of human mobility data. Analysis of this data allows for an improved understanding of refugee movements at granular time and space scales for the sake of resource planning and allocation across several different sectors of activity. This analysis has been performed through Direct Relief’s CrisisReady partnership with Harvard University School of Public Health and shared broadly with a range of agencies who have requested specific types and locations of analysis.

Key analysis-sharing partners include the World Bank, UNICEF, UNHCR, IOM, the Health Cluster, Mercy Corps, and others. In partnership with Meta, Direct Relief is in the process of assembling an EU-based research network that is capable of supporting municipal-level analyses, with the immediate focal point of that effort being support for a collaboration between UNHCR and the city government of Budapest which aims to understand changes in refugee clustering throughout the city for the sake of housing retrofits for long-term refugees.

Corporate Support

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the medical product donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation. Included among them are 3M, Abbott, AbbVie, Accord Healthcare, Amgen, Apotex, AstraZeneca, Baxter, Bayer, BD, BioMarin, BMS, Boehringer Ingelheim, Carlsbad Technology, Cencora, Corza Medical, Edenbridge, Eli Lilly & Co., Embecta, Genmab, Gilead, Grifols, GSK, Haleon, Henry Schein, Hikma, ICU Medical, Integra Lifesciences, Janssen, Jazz Pharma, J&J, Kenvue, Liquid IV, McKesson, Medline, Merck & Co., Merck KGaA, Pfizer, Sandoz, Takeda, Teva, Ultragenyx, Unilever, Unite to Light, Vertex, Viatris, and Westminster.

The war continues, with no end in sight, and medical needs remain urgent as attacks continue. Direct Relief remains committed to providing support to strengthen local health systems, as well as to a number of focus areas in Ukraine.

As the response continues, Direct Relief remains able to provide support as a result of its existing strong relationships with non-governmental organizations that were already receiving Direct Relief medical product shipments, ongoing work with clinical experts in the field to guide distribution and procurement decisions, existing partnerships and contracts in place to quickly request and receive high-quality medications from pharmaceutical manufacturers and distributors, and a strong track record of shipping large volumes of product, including those requiring cold chain packaging and storage, to difficult-to-access places to reach the most vulnerable patients.

Direct Relief is focusing on these areas for long-term recovery by directing funding and medical product support for the continued strengthening of the health system.

The Maui wildfires inflicted widespread devastation on the Maui community, underscoring the critical need for comprehensive healthcare services in the aftermath of such disasters. Acknowledging the pivotal role Mālama I Ke Ola Health Center plays in the community, Direct Relief’s historic grant aims to empower the health center to provide essential healthcare resources, support immediate medical needs, and enhance overall capacity to serve the affected community.

Recognized for its commitment to transparency, efficiency, and accountability, Direct Relief provides targeted assistance to communities in need, regardless of politics, religion, or ability to pay. Direct Relief has been a steadfast supporter of Community Health Centers across the United States, demonstrating a strong commitment to improving healthcare access for underserved populations. Identifying the crucial role that Community Health Centers play in providing comprehensive and affordable healthcare, Direct Relief has collaborated extensively with the National Association of Community Health Centers (NACHC) to amplify their impact.

“NACHC is deeply appreciative of the generous grant to Mālama I Ke Ola Health Center,” said Kyu Rhee, MD, MPP, President and CEO of NACHC. “The human toll and tragedy that Lahaina residents experienced from the wildfires will take a long recovery. The funding will allow Mālama I Ke Ola Health Center to rebuild infrastructure, provide essential services to the community and help affected island residents heal. Community Health Centers, such as Mālama I Ke Ola Health Center, reach beyond the walls of the exam room to address island health disparities that include higher rates of chronic disease and premature death from environmental factors, including natural disasters. We are grateful for our longstanding partnership and collaboration with Direct Relief to support Community Health Centers as they carry out their mission as the first and last frontline responders to disasters and devastation.”

Through its work with NACHC, Direct Relief aims to address the unique challenges faced by Community Health Centers, ensuring they have the necessary resources to deliver quality healthcare services. This collaboration includes targeted assistance, such as medical donations, financial support, and logistical assistance, tailored to meet the health center’s specific needs.

Direct Relief’s support extends beyond individual grants, with the organization actively engaging with NACHC to advocate for policies that strengthen the Community Health Center model and enhance its ability to serve vulnerable communities. By fostering these strategic collaborations, Direct Relief aims to bolster resilience and effectiveness nationwide.

The organization’s commitment to Community Health Centers aligns with its broader mission to improve health outcomes for individuals affected by poverty and emergencies. Direct Relief recognizes the critical role played by Community Health Centers in delivering healthcare services to those who need it most and remains dedicated to supporting and enhancing their capacity to make a lasting impact on community health.

“This investment underscores our commitment to supporting Community Health Centers and their indispensable role in delivering healthcare to those who need it most, especially during times of crisis,” stated Thomas Tighe, Direct Relief CEO. “Direct Relief is privileged to support the work being done by Mālama I Ke Ola Health Center, as they continue to serve the community of Maui following the devasting fires in August of last year.”

As a Community Health Center, Mālama I Ke Ola Health Center plays a vital role in delivering accessible and quality healthcare services to underserved populations. The grant from Direct Relief is intended to facilitate Mālama I Ke Ola Health Center’s recovery efforts, including the restoration of facilities, provision of medical supplies, and reinforcement of the healthcare infrastructure required to meet the evolving needs of the community. The funding will further amplify the health center’s ability to address the specific challenges faced by vulnerable communities affected by the island’s wildfires.

“We are incredibly grateful for the generous $1 million grant from Direct Relief, which comes at a pivotal moment as we continue our work to address the immediate and long-term needs of our community,” said Cassie Savell, Mālama I Ke Ola Health Center COO and Deputy CEO. “This substantial contribution will allow us to significantly enhance and expand our support and services, ensuring those affected by the fires receive the care and resources they need during this challenging time. Together, with Direct Relief’s support, we are committed to rebuilding and healing our community, demonstrating the power of collaboration and compassion following the Lahaina fire devastation.”

The shipments contained 10 million defined daily doses of medication and supplies, including wound care products, cardiovascular drugs, diabetes management supplies, vitamins, and more.

Solar Installation Complete at Nepali Hospital

In 2015, a devastating earthquake struck Nepal, killing over 8,000 people and leaving thousands more injured and in dire need of help. Post-earthquake, the country’s medical infrastructure was not left unscathed. A report issued by Nepal’s Ministry of Health and Population noted that 375 of the 446 public health facilities and 16 private facilities in Nepal’s hardest-hit regions were destroyed.

To help respond to urgent health needs, Direct Relief quickly coordinated with corporate partners as well as established local and emergency response partners to send pallets full of requested medicines and medical supplies to healthcare facilities. In the decade since the earthquake, Direct Relief has supported the health system, including by providing funds to Nepali NGO Mountain Heart Nepal for the construction of Siddhasthali Rural Community Hospital, a 15-bed facility in southern Nepal. The project has been steadily making progress over the last three years, and now the hospital is set to open on April 1, 2024.

Direct Relief has also equipped the new facility with a medical oxygen plant and cold-storage capacity, as well as a recently-installed backup solar system. The solar energy system is producing electricity with surplus energy going back to the electrical grid. This surplus energy is credited back to the hospital by the Nepal Electrical Authority, thus generating extra income for the hospital.

California Storm Preparations Underway

California is bracing for another set of storm systems to move through the state over the next week, which could bring flooding and landslides in its wake. Two atmospheric rivers will bring more than five inches of rain to various parts of the state, with the heaviest impacts expected in Northern California and along the Central Coast.

In advance of the storms, Direct Relief has been in communication about potential needs with state and regional primary care associations, search and rescue organizations across the state, the Medical Reserve Corps, and other first responder groups. The organization maintains a medical inventory of medications and supplies commonly requested during emergencies, including flooding.

The latest storm system is one in a series of atmospheric rivers to inundate the state, and Direct Relief has been responding to ongoing requested for groups experiencing impacts from flooding. In February, Direct Relief dispatched multiple immediate shipments of requested aid to partner organizations across the state. An emergency health kit, a large cache of essential medicines and supplies often requested after disasters, was shipped to Los Angeles to support a damaged health facility that had lost supplies due to flooding.

Also dispatched were field medic packs, filled with items for triage care outside of clinic walls, and personal care kits, packed with hygiene items like soap, toothbrushes, and toothpaste, that departed Direct Relief’s warehouse for distribution to organizations and health facilities across the state. California Emergency Medical Services Agency (Cal EMSA) also received 40 requested field medic packs for teams deployed throughout the state in response to the storms.

The organization will continue to respond to the latest storm system as needs become known.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 6.5 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 588 shipments containing over 14 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 3,140 shipments to 1,089 partner organizations in 52 U.S. states and territories and 47 countries.

These shipments contained 52.4 million defined daily doses of medication totaling 547,723 lbs.

In the News

Humble Bundle Surpasses $250 Million Raised for Charitable Causes Around the Globe – TechPowerUp

Direct Relief Navigates Medical Aid to Yemen and Sudan Through Red Sea Shipping Attacks and Sudan’s Civil War – ReliefWeb

Turkey and Syria Earthquakes: One Year Later – ReliefWeb

Jaguar Health Donates Supply of Mytesi to Humanitarian Aid Organization Direct Relief – Yahoo! Finance

The bitter weather is a nuisance for most but can create dangerous health and living conditions for the nation’s growing, unhoused population. Chicago experienced severe cold weather in mid-January, coupled with a wind chill, or the rate of heat loss from exposed skin, at 40 degrees below zero, according to the National Weather Service. Experts in cold-weather states and working with people who are unhoused are addressing health concerns, but say the number of people with housing needs is growing.  

The frigid temperatures increase the risk of frostbite, and wounds on extremities are more frequent for people sleeping outside and those walking long distances.

“For me, when it snows in the morning, my day is disrupted because I have to drive in the snow and my commute is a little bit longer. But for [people who are unhoused], those challenges are tenfold, sometimes 100-fold, because where they stay is outside,” said Nedda Elewa, President of Street Medicine Detroit. “They stay in the cold, they stay on the streets, even those who are fortunate enough to find themselves in a bed in a shelter, that’s not guaranteed every night.”

Street Medicine Detroit provides quality medical care for Detroit, Michigan’s unhoused population. Elewa, who is also an MD candidate at Wayne State University School of Medicine, said that Street Medicine Detroit provides wound care during the colder months: frostbite, laceration repairs, infection prevention and control, and dressing changes. Elewa says these health conditions are in addition to the many chronic diseases they try to provide care for, including hypertension, asthma, and diabetes.

“Sometimes the treatment is just getting them into a warm space, which is a challenge a lot of times,” she said.

Others patients need more intensive interventions like surgery. However, most don’t have access to consistent medical care, due to social barriers like lack of identification, reliable transportation, and cell phones.

Social issues have compounded the nation’s housing and homelessness challenges.

In New York, local government has shifted policies around homelessness, like suspending the Right to Shelter rule, which requires a bed for those in need, and implementing a 60-day rule, requiring houseless people to reapply for shelter space after 60 days. The changes followed an influx of migrants in the city, who were expected to find shelter in an open field with minimal personal space. The city was already facing mass evictions after national, Covid-related housing protections were dropped and housing affordability decreased.  

“Housing instability definitely increased significantly after all of those protections were gone,” said Nathalie Interiano, Director of Policy and Advocacy at Care for the Homeless in New York, adding that the increase in homelessness over the last year and a half has been “pretty significant.” That’s concerning to Care for the Homeless, which provides health care, advocates on behalf of, and houses New York’s unhoused population.

“Health issues are so intricately linked with the population that we specifically serve,” Interiano said. “People who are dealing with unstable housing are also dealing with a variety of other health issues.”

The nationwide point-in-time count was conducted in late January. The count identifies the number of people sleeping outdoors on a single night and is used to inform federal policymakers on the scope of homelessness across the nation. In December 2023, the Department of Housing and Urban Development forewarned that the numbers from the January 2024 count would be 12% higher than in previous years.

However, some experts say the count doesn’t share the full scope of homelessness, since it is not a controlled study and is limited to those sleeping outside rather than houseless individuals and families who constantly sleep in different locations.

In 2023, New York’s point-in-time count for households experiencing homelessness was 59,572 and individuals totaled 103,200. Over 53,000 unhoused people in New York are in families with at least one child. Even though the city has over 173,000 beds year-round for families, adults, and children, they are spread out across the city and don’t always have space at each location for an entire family or individuals who would like to stay together.

Others may not want to be in a shelter environment. “Some of (the) reasons why people enter into homelessness or housing insecurity situations are attempting to find means of safety,” said Carol Sharp, President and CEO of the Night Ministry in Chicago. “That means the difference between visualizing a safe space inside of a home versus a safe space. And having the freedom to move at will and freedom to find people (who) might have similar circumstances and finding comfort in that.”

In Chicago, the Night Ministry served 600 more individuals in 2023 than previous years. Sharp said that Chicago is experiencing similar issues around homelessness as other cities, including limited affordable housing. However, she noted that people looking for a “safe space” also include those who experience mental illness or misuse substances, people who have experienced domestic violence, people who identify as transgender and non-binary, veterans, and those living with HIV/AIDS.

In Illinois, almost 1,500 homeless people were identified as having experienced domestic violence, according to HUD. The Night Ministry makes a point of meeting people where they are, using mobile units and volunteer physicians to see patients on the streets of Chicago and at partner-affiliated buildings. Similar to organizations in Detroit and New York, they treat wounds, frostbite, Covid, and influenza, and provide care for chronic diseases during the severely cold months.

Direct Relief supports health facilities and organizations across the U.S. focused on street medicine, including Street Medicine Detroit, Care for the Homeless, and the Night Ministry.

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 shipments contained 12.9 million defined daily doses of medication and supplies, including prenatal vitamins, wound care supplies, surgical essentials and more.

Responding to California Storms

California experienced two back-to-back atmospheric rivers, with the second causing widespread damage from flooding and high winds. An estimated 520 mudslides have occurred in Los Angeles alone, resulting in nine deaths. Authorities are warning of the prolonged danger of landslides as the weather has eased, but has left the ground unstable.

In response, Direct Relief dispatched multiple immediate shipments of requested aid to partner organizations across the state. Field medic packs, filled with items for triage care outside of clinic walls, and personal care kits, packed with hygiene items like soap, toothbrushes, and toothpaste, departed Direct Relief’s warehouse this week in Santa Barbara, California, for distribution to organizations, including R.OA.D.S. Community Care Clinic, Universal Community Health Center, and the Children’s Clinic.

Earlier this week, direct Relief delivered additional shipments of requested supplies to healthcare centers in San Diego, including YMCA San Diego and Imperial Beach Community Clinic. California Emergency Medical Services Agency (Cal EMSA) also received 40 requested field medic packs for teams deployed throughout the state in response to the storms.

The organization will continue to respond as needs become known.

Monitoring Chile Wildfires

Since February 1, multiple fires have impacted central and southern Chile. An intense heatwave and dry conditions led to the burning of 14,000 homes and more than 64,200 acres of land in Valparaiso and Viña del Mar, according to the Pan American Health Organization (PAHO).

Direct Relief is in direct communication with PAHO and Fundacion FEDES on emerging needs related to this event. This week, PAHO will ship ten Direct Relief field medic packs and additional emergency supplies to Chile.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 11.4 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 272 shipments containing over six tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 2,421 shipments to 988 partner organizations in 51 U.S. states and territories and 41 countries.

These shipments contained 40 million defined daily doses of medication totaling 462,143 lbs.

In the News

How to help California victims of atmospheric river floods – FOX Weather

Direct Relief and Red Cross help storm victims up and down the coast – KEYT

Volunteers help with sand bags in Montecito – KEYT