The shipments contained 14.9 million defined daily doses of medication and supplies, including children’s vitamins, diabetes treatments and glucose monitoring supplies, vaccines, nutritional supplements, anti-inflammatories, and more.

Supporting Mobile Clinics In Nepal, Post-Earthquake

This past November, a 5.7-magnitude earthquake struck western Nepal, killing 153 people and injuring hundreds more. In this remote area of the country, patients face difficulties accessing medical care even in ordinary circumstances and are particularly medically vulnerable in emergency situations.

Mountain Heart Nepal, a Nepali non-profit that specializes in providing emergency medical care, quickly moved into action. With grant funding from Direct Relief, their teams set up four mobile clinics, reaching over 700 patients in the highly earthquake-affected districts of West Rukum and Jajarkot.

These clinics provided immediate care for the injured but also performed general health screenings, dental care, infectious disease treatment, and supplied medication refills for the management of chronic diseases, including hypertension and diabetes.

Equipping Search and Rescue Teams in Mexico

This week, the Mexican Secretariat of National Defense (SEDENA) received thirty field medic packs and three emergency health kits donated by Direct Relief. The donations contain critical medical supplies that will support Mexico’s future search and rescue operations.

Increasing support for tuberculosis care in Syria

Compounding humanitarian crises of protracted civil war and catastrophic earthquakes last February have significantly weakened the overall healthcare system in northwest Syria. Earlier this year, Syria Relief and Development, a local NGO and long-time partner of Direct Relief, was working to sustain the operations of the tuberculosis treatment center in the Azaz region.

As the sole operational TB facility within an area housing over one million people, this treatment center plays a vital role in preventing the spread of tuberculosis while also alleviating the suffering and reducing deaths associated with the disease.

To help address this pressing healthcare need, Direct Relief provided grant funding to help sustain the operations of the center. In total, 456 patients were helped with services, including TB investigations and the provision of TB treatment drugs.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped 13.1 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 369 shipments containing over 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 655 shipments to 452 partner organizations in 47 U.S. states and territories and 12 countries.

These shipments contained 11.2M defined daily doses of medication totaling 142,966 lbs.

Several tornadoes were reported in Florida’s Panhandle on Tuesday morning, including in the Panama City area, and more than a dozen counties were under tornado warning conditions as the storm moved eastward.

Snow and icy conditions had swept through many areas of the Midwest and Plains regions, with some recording blizzard conditions. Heavy rains and high winds were also present in many areas of the U.S, including the Northeast, prompting flash flood warnings.

Health needs during extreme weather can vary, from risks of hypothermia due to extreme temperature swings to health risks associated with power outages. Evacuations and displacement from tornadoes and other storms can bring risks if evacuees are without medications to manage chronic conditions for extended amounts of time.

Direct Relief is in communication with health centers, free clinics, primary care associations and other organizations about potential needs and maintains an emergency stockpile of essential medicines often requested.

The organization is ready to respond to requests as needed.

According to Santa Barbara County Fire Captain Safechuck, a major reason for the reduced death tolls over the past three years is that wildfires have stayed away from urban areas. But hoping that fires will continue to burn away from population centers is not a strategy Safechuck and his colleagues would like to rely on.

“We are constantly trying to push out information on how people in the community can stay safe,” said Safechuck, a 23-year veteran of the department. “They need to be paying attention prior to a fire happening, particularly when the conditions are right for a fast-moving fire, and have an action plan including for when kids are at school, if some family members are not ambulatory, if someone’s out of town, or other circumstances.”

Trying to instill residents in Santa Barbara with a sense of personal responsibility when it comes to wildfire safety is a key firefighting tactic of the Santa Barbara County Fire Department Fire, even as they have increased their firefighting capabilities through new technology and equipment. Still, it’s not possible for any firefighting department to immediately respond to all areas under attack during a large-scale event.

“Most people believe there is going to be a fire engine at their house during a wildfire. Eventually, that will be the case, but it takes time for us to build that system. We have to use our mutual aid system to get resources from the state. It might take days. Our crew will work as hard as they can to save the community, but it just takes time,” Safechuck said.

Safechuck also stressed the realities of being in the danger zone, further reinforcing the importance of creating an action plan ahead of a fire event.

“It’s hard for people to imagine what it is like in that (wildfire) environment. People think they’ll defend their homes with a garden hose… but it’s so hot, every breath you take is very heated, your eyes water, and you start to vomit; it’s very hard for trained professionals to operate in that environment, so compare that to someone who has not been trained, doesn’t have the right gear on, and has a limited water supply,” he said. “It’s very dangerous for them.”

Ultimately, the goals of wildfire preparations for residents are two-fold: both to create a defensible space around houses and to be able to evacuate safely if a wildfire is threatening. Both steps can play a significant role in helping local firefighters do their jobs.

“The sooner people evacuate, the roads become more freed up for firefighting vehicles. If people don’t take it (evacuation orders) seriously, they can become trapped in there, and it makes it harder for us to operate to attack the fire. If they become trapped, our priorities change. Life safety is a priority for us but it takes away from efforts of putting out the fire. If you don’t feel safe, or you’re not sure, evacuate as long as you have a route out of there,” he said.

A central aspect of the department’s public outreach strategy is the Ready, Set, Go Action Plan developed in collaboration with the U.S. Forest Service, CalFire, and several other Southern California fire departments. Ready. Set, Go is a 10-page booklet that educates residents on how to prepare for wildfires so that they have the best chance of defending their homes and saving their own lives through proactive decision-making.  

Some of the tactics include how to create a defensible space around a house, how to build a more fire-resistant house, how to prepare a house when it’s threatened by fire (for example, by closing exterior vents), an action plan guide, what to include in a to-go kit, and a checklist for what to do as a fire approaches.

Firehawks, AI, and more

In addition to a focus on public outreach, the Santa Barbara County Fire Department has been bolstered in recent years by advanced warning technology and aerial support. There are now almost a dozen remote weather stations placed around the county, including nine permanent units and two portable ones. Additionally, the county has one AI camera system, constantly scanning high-risk areas for smoke. Santa Barbara is also part of a statewide camera system that helps identify brewing wildfires.

Once a wildfire begins, the county can utilize its Firehawk helicopter, a converted U.S. Air National Guard MH-60 Pave Hawk optimized for firefighting with an external water tank, rescue hoist, improved avionics and the ability to travel about 30% faster than the department’s other aircraft, allowing it to get back to the fire area more quickly. The county’s Firehawk helicopter was previously used during two combat tours in Afghanistan. Purchased in 2019, with support from Direct Relief totaling over $1.1 million, the Firehawk has the ability to drop about 1,000 gallons of water, which is more than three times the capacity of a Huey, a smaller and older helicopter which is also part of the county’s firefighting arsenal.

But even with these tools, Safechuck said recent wildfire fatalities speak to the need for residents to stay vigilant and prepared.

“We are better at fighting fires than we’ve ever been in the past, and yet we’re still having fires that are taking the lives of a lot of people,” he said, noting that wildfires have recently occurred in areas that have not experienced them historically.

“As the population grows in more rural areas, everything is growing more laterally and pushing more into more urban interfaces. During fires in those areas in the past, maybe there were only a few homes, but now there are many more. It’s important that communities like those get up to speed so that they’re as prepared as possible,” he said.

The shipments contained 24 million defined daily doses of medication and supplies, including prenatal vitamins, vaccines, nutritional supplements, anti-inflammatories, and more.

Puerto Rico Health Fair

Recently, Direct Relief and Puerto Rican NGO La Fondita de Jesús collaborated to bring primary healthcare services to the community of Villa Calma in Tao Baja, an underserved metropolitan area composed of roughly 150 families in Puerto Rico vulnerable to flooding.

Volunteer healthcare providers from La Fondita de Jesús treated community members using a mobile medical unit donated by Direct Relief. Services included administering vaccines and visiting patients with mobility challenges to ensure they were cared for. Direct Relief team members distributed personal care items and solar-powered lights for use since the community experiences frequent power outages.

Additionally, as part of La Fondita de Jesús’ mission to empower communities on self-sustainability, the organization delivered groceries to families and provided community development education, including maintaining home gardens.

Providing Medical Oxygen in Yemen

An oxygen plant opened this week in Yemen’s Shabwah Governorate, bringing medical-grade oxygen to nearly 70,000 individuals being treated in the region’s hospitals and health centers. This project was installed and facilitated by Yemen Aid with funding from Direct Relief and will produce up to 50 cylinders of oxygen per day.

The World Health Organization classifies medical oxygen as an essential medicine and is often used in healthcare settings to treat patients with respiratory illnesses, like Covid-19 and pneumonia, during surgery and trauma care, in the neonatal intensive care unit for babies requiring additional oxygen support, and more.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped 22.1 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 528 shipments containing over three tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 344 shipments to 276 partner organizations in 42 US states and territories and 10 countries.

These shipments contained 11.2M defined daily doses of medication totaling 142,966 lbs.

After a March 2023 tornado leveled a health center in Mississippi, the organization was able to run operations via a resilient power microgrid system for the better part of a year and continue serving patients, many of whom had lost everything.

The state’s oldest federally qualified health center was struck by an EF4 tornado that swept through the state last year, killing over 20 people and injuring many more. Delta Health Center’s Rolling Fork location was destroyed by the high winds, and the group swiftly established a temporary clinic to make sure residents could continue receiving care.

Since then, the community has continued to recover from the storm, and Delta Health Center has worked alongside affected residents nonstop. The health center’s staff have gone door-to-door to provide access to care, participated in community partnerships to provide food and daily necessities, and maintained a presence in their original location.

Operating there with power was made possible by the Footprint Project, a nonprofit that provides clean energy to communities after climate-related disasters. Delta Health Center had renewable energy just three days after the storm through the beginning of November 2023. The health center was provided with a Tesla microgrid that supplied four kilowatts of solar power energy with up to 30 storage hours at a time. The Footprint Project also provided a portable solar generator and eight solar backpacks to support home health care.

“It was probably one of the longest microgrid deployments that we’ve done for a disaster,” said Will Heegaard, operations director at Footprint Project, who traveled to Mississippi after the storm to install the system.

Adoris Turner, deputy chief executive officer at DHC, said the solar power allowed the health center to offer services through the worst phases of Rolling Fork’s recovery.

“It was a lifesaver, and I literally mean a medical lifesaver,” said Turner. “The ability to see a patient who may be having an asthmatic crisis or people who are having any type of medical need, it went a long way to have our facility up and running.”

Rolling Fork is a small city with a geographic footprint of less than two miles within Sharkey County in Mississippi’s Delta. Prior to the storm, about 2,100 residents lived in the area, and half of the housing structures were renter-occupied. On March 26, President Biden declared a major disaster in Mississippi, providing a pathway for assistance in Carroll, Humphreys, Monroe, and Sharkey Counties, according to FEMA.

“It’s a really slow process,” said Temika Simmons, DHC’s Chief Public Affairs Officer. “There’s a lot of cameras, there’s a lot of assistance, and then after a few months, there’s just so many people who have left Rolling Fork.”

According to the Federal Emergency Management Association, 442 homes were affected by the tornado, with 130 completely destroyed. Less than half of the residences were insured.

Related Content: Someone to Talk To: Health Center Provides Support After Devastating Tornado

Many residents remain displaced, and some have found comfort in neighbors’ and family member’s homes. Health center staff say they have prioritized making daily necessities and accessible healthcare the highest priorities, given so many residents have yet to return to a sense of normalcy.

“If you lost everything — like you don’t even have a toothbrush, and you are still sleeping in grandma’s living room while driving your kids to a different city for school — what does that look and feel like?” Simmons asked. “You’re alive; you’re still living somewhere, but you’re not at home. So we’re thinking about ‘what do people need to feel like they are at home and get back to their normal routine?’”

Simmons said that households are still without running water, electricity, and internet service. She said that Mississippi is a transient community in that people often drive to other cities for work from where they live, making it more difficult to provide care simply based on location.

Before the solar microgrid arrived, Delta Health Center used two gas generators to operate a temporary clinic and a small tent in the health center’s parking lot. After the initial installation of the microgrid, Heegaard said that the health center staff were able to operate the solar energy source themselves.

“That entire clinic, when we were on site two or three days after the tornado, that thing was not habitable. The whole hangar was a doublewide mobile office…it was cracked, split apart by the force of the wind (of the) tornado. So you definitely couldn’t go inside, the whole facility was unusable,” he said.

The microgrid and the backpacks allowed health center staff to treat Rolling Fork patients in their hometown as well as wherever residents were calling home. The health center has 12 locations across Mississippi and six school-based care sites, according to its website. Rolling Fork residents were allowed to visit any DHC location free of charge during the recovery period.

Heegaard said that the health center used solar energy almost every day, except on severely cloudy days when there wasn’t enough back-up power. Solar energy decreased carbon emissions that contribute to localized air pollution and decreased costs for health centers, which would have purchased several gallons of gas per day to maintain the traditional generators. Heegaard said the solar microgrids are also quieter than gas generators, which supports a better atmosphere to provide medical care.

“It’s not ideal to have a bunch of loud, noisy, smelly generator units running while you’re trying to comfort people,” he said.

The health center is now using a temporary clinic through FEMA that has access to power, so the solar energy system is no longer needed. A new, permanent site will open soon, and staff will continue to offer the same health services to the community, whether they have insurance or not. The staff says that DHC remains committed to the Rolling Fork area, even though it’s unclear how many displaced residents will return to the town.

FEMA has approved $13 million for total individual and household dollars for individual assistance and over $34 million in public assistance. However, Turner says residents still need money for basic necessities. Air mattresses, toothbrushes, fresh produce, and clothing remain top requests in the area.

Direct Relief supported Delta Health Center with medical aid and financial support after the tornado, and also financially supported the Footprint Project’s microgrid installation for the clinic’s continued operations.

The shipments contained 578.9 million defined daily doses of medication and supplies, including antibiotics, prenatal vitamins, personal care kits for those displaced by disasters and emergencies, vaccines, cancer treatment therapies, insulin, and more.

2023 at a Glance

Direct Relief responded to a range of events in 2023, from natural disasters to war. The organization worked with countless health providers and community members who stepped up to help others around them. Below are some of their stories.

Supporting Local Search and Rescue

In 2023, Direct Relief, in coordination with the California Office of Emergency Services, donated multiple emergency response vehicles to bolster search and rescue efforts in California.

Southern California, where Direct Relief’s headquarters is located, experienced torrential rain last week, with some areas receiving over 15 inches.

During these rains, the Ventura County Sheriff’s Office conducted its first in-county deployment of the Medcat, a rescue vehicle donated by Direct Relief earlier this year. The vehicle assisted in the evacuation of seven residents and 10 animals as floodwaters rose.

In addition to the Medcat, Direct Relief also donated a search and rescue truck to Santa Barbara County in July to support local rescue efforts.

OPERATIONAL SNAPSHOT

WORLDWIDE

In 2023, Direct Relief shipped 492 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past year included:

UNITED STATES

Direct Relief delivered 20,600 shipments containing over 407 tons of medications over the past year to organizations, including the following:

IN THE NEWS

‘The Bell’ Symphony for Cello and Orchestra to support Direct Relief efforts in Ukraine – The Strad

Ask Amy: Annual charity column shows ways to give – The Washington Post

US trust to establish new infectious disease hubs in Aurangabad, Latur – The Times of India

The shipments contained 10.3 million defined daily doses of medication and supplies, including insulin, vaccines, emergency hygiene kits, and personal care products.

Hurricane Otis response continues

In response to Hurricane Otis, shipments of Sanofi insulin and hexavalent vaccine products donated by Direct Relief were delivered to impacted regions in Mexico. The shipment of vaccines was received by the Guerrero Ministry of Health at Hospital Raymundo Abarca Alarcón in Chilpancingo. The donated shipment of insulin was received by Federación Mexicana de Diabetes at Hospital Naval in Acapulco.

midwives address health needs in morocco

Since the devastating magnitude 6.8 earthquake that shook Morocco in September, AMSF (L’Asociation Marocaine de Sages femmes or the Moroccan Midwives Association) has been hard at work providing healthcare to women in the localities affected by the quake.

With grant funding from Direct Relief, the non-profit has launched a health caravan, essentially a clinic on wheels, that is providing sexual and reproductive health care and psychological support. Their team is also now able to undertake a preparedness and recovery training in reproductive health via a distance learning module provided by the Women’s Refugee Commission.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 9.2 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 503 shipments containing over 10 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 21,600 shipments to 2,568 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 549.2 million defined daily doses of medication valued at $2 billion (wholesale), totaling 6.2 million lbs.

IN THE NEWS

Last-minute distribution helps provide toys, hygiene kits, blankets to 100+ Santa Maria families – KSBY

‘The Bell’ Symphony for Cello and Orchestra to support Direct Relief efforts in Ukraine – The Strad

Nourishing Brands: How Liquid IV Became A Billion Dollar Hydra – The Marketing Sage

AbbVie spends $350M to bolster healthcare, education; ‘We look forward to the impact we will make in the decades to come’ – Chicago Tribune

America’s Top 100 Charities – Forbes Magazine

As a support organization, Direct Relief works to equip medical providers in their own communities. Often, this occurs during times of unimaginable crisis, when people step into the unknown to help.

A 23-year-old in eastern Ukraine deciding to stay and help his community. A midwife reaching patients by watercraft after land routes were destroyed or cut off by wildfire. A mother, with her two children in tow, leading her family through the jungle to receive life-saving medical care in the U.S.

These, and many others, are a few of the individuals Direct Relief’s work has overlapped with over the past 12 months, and they reveal the creativity required to survive — and help others — along the way.

Here are some of their stories.

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

 Alejandra Jimenez, 27, her husband, and her young daughter stayed in their hometown of Barquisimeto, Venezuela, for as long as they could. But when her daughter’s serious medical needs exceeded the care available, Jimenez made the decision to undergo the perilous journey from Venezuela to the United States. She and her family are among the 100,000 migrants who arrived in New York City from spring 2022 to August 2023.

To meet the health needs of those new arrivals, Ryan Health, a federally qualified health center, part of a national safety net clinic system that provides care for everyone who requests it regardless of their ability to pay, has stepped up.

“We reached out to the mayor’s office, catholic charities, and shelter providers in the area to offer our services because we suspected individuals would need health care,” said Daniel Pichinson, executive director of Ryan Health’s Chelsea-Clinton clinic, estimating that Ryan Health has onboarded about 3,000 migrants in the past year. Direct Relief’s Noah Smith and freelance photojournalist Oscar Castillo met Jimenez, as well as health providers meeting the needs of those seeking asylum in the United States.

Read more.

After Fighting Erupts in Eastern Ukraine, a Young Volunteer Steps Up

In May, Direct Relief’s Nick Allen met with a young volunteer in Eastern Ukraine, who was one of many whose world had been turned upside down after the Russian invasion but who quickly swung into action to help fellow Ukrainians.

“I want to be useful,” said 23-year-old Pavlo, whose last name was withheld for security reasons. Pavlo works with the Yevgen Pyvovarov Charity Fund to deliver aid to besieged communities in Eastern Ukraine.

Covid-19 had forced him to return home from a study abroad program in China, and the attack on Ukraine upended his plans once again. Pavlo and his family found themselves in occupied territory and eventually made it to Ukrainian territory. Declared unfit for military service because of a long-time knee injury, Pavlo had a decision to make: To endure the constant bombardments in Kharkiv city or head elsewhere, abroad even. “I had an opportunity to leave, but I declined. This is a decisive point for my country,” he said.

Read more of Pavlo’s story here.

Supporting Physical and Financial Health in Mississippi

Health providers screening for the social determinants of health — information about the conditions of a person’s life, from housing and transportation to access to clean air and water — is nothing new. Adding a picture of a person’s financial health and stressors, like debt burden, is a new angle.

It’s one the Aaron E. Henry Community Health Center, located in Clarksdale, Mississippi, is asking about to help their patients more holistically. It’s also the goal of the center’s Health Wealth program to address financial insecurity and its direct impact on health.

Aaron E. Henry received $100,000 from Direct Relief’s Fund for Health Equity, via the AbbVie Foundation, to launch the program with the goal that it serves patients across the Mississippi Delta, and could be replicated in health centers across the U.S.

Read more.

After the Fires, Providing Community Care in Maui

After devastating fires swept through Maui in August, local groups quickly mobilized to help those impacted. One of those groups, based in Oahu, worked to get medical care to people in any way possible.

The women of Healthy Mothers, Healthy Babies Coalition of Hawai’i and the nonprofit’s partners arrived at the site of the wildfire by jet ski, boat, and car to help those in need. Direct Relief has funded the group with emergency operating grant and has also shipped requested medicines to the group so they can continue their work providing care.

Read more.

Medical Interpreters Improving Health for Patients, One Conversation at a Time

During a medical visit, communicating the symptoms and state of one’s health is essential to receiving sound treatment and a diagnosis. For patients communicating in a language different than that of their medical provider, medical interpreters can help bridge the language gap, as well as advocate for their patients.

That’s exactly what a group of young interpreters with Centro Hispano de East Tennessee are accomplishing. They’ve expanded to include medical interpretation, one of the most requested services by both the Latino community, as well as the medical facilities in the area.

Centro Hispano received $186,000 from Direct Relief’s Fund for Health Equity, via Eli Lilly and Company, to develop a pilot program of medical Interpreters that will address current inequities by recruiting and training a group of multi-lingual youth seeking to learn new skills, join the healthcare workforce and serve their community.

Read more.

Direct Relief Equips Doctors Providing Care After Hurricane Otis

When Hurricane Otis, a devastating Category 5 storm inundated Mexico’s west coast, local groups jumped into action, including Medical Impact. After the storm left more than 100 hospitals and clinics damaged or destroyed, the group took medical care into the community to meet needs.

Read more.

Rehabilitation Effort in the Twin Cities Helps Ukrainians Recoup from War

Direct Relief’s Olivia Lewis traveled to Oakdale, Minnesota, to see the efforts of the Protez Foundation in action, which connects Ukrainians living with amputations to customized prosthetics and rehabilitation. Yakov Gradinar, a certified prosthetist and orthotist with the foundation, was working to fit people with prosthetics when Direct Relief visited the foundation in August.

Protez provides prosthetics to children and soldiers who have lost limbs during the Russo-Ukrainian War, and had provided over 260 high-quality prostheses and over 90 prosthetics. At the time of Direct Relief’s visit, six patients and their families were participating, the thirteenth group to take part in the program.

Read more about their work.

‘Death Just Beneath You’: Doctor Describes Turkey Earthquake, Ongoing Challenges

Dr. Yusuf Çekmece, 40, is a family medicine specialist based in Antakya, Turkey, which was hard hit by the devastating earthquakes on February 6, 2023, that killed more than 50,000 people.

Dr. Çekmece is part of the Turkish Medical Association, which Direct Relief has supported with grant funding to meet the needs of earthquake zone-impacted doctors, many of whom were displaced by the damage from February’s quake, including Dr. Çekmece. His home and office were destroyed, so he practices medicine from a shipping container and continues serving the community.

Read more.

“Providing Dignity to Humanity,” Free Clinics Expand Mental Health Care

About 85 miles northeast of Los Angeles, in the high desert, sit the ruins of George Air Force Base. From World War II through the end of the Cold War, activities on the site helped prepare pilots for battlefields worldwide. But today, a new fight is taking place at the decommissioned base.

Symba Center is a free clinic that operates out of a former gym that was converted into a wellness center for the community during the Covid-19 pandemic. Last year, Symba Center was among 11 free and charitable clinics which received a $75,000 grant to expand mental health care access to some of the most vulnerable populations in the United States. Over $17 million worth of mental health-targeted Teva pharmaceuticals were also made available to over 400 free and charitable clinics.

As a result of the grants, free and charitable clinics have been able to hire additional staff, launch internship programs, offer educational resources, including group sessions, increase collaborative efforts with local organizations and providers, and implement mental health screening programs for their patients. In total, these clinics have reached, directly and indirectly, about 22,000 people.

Read more.

According to a Penn State study from earlier this year that focused on children in Peru over a 15-year period, a link exists between experiencing a natural disaster or other similarly impactful economic or agricultural event and poorer testing outcomes across reading, vocabulary, and math, less food security, more time spent on household chores, and worse self-reported health outcomes. The study, authored by Carolyn B. Reyes and Heather Randell, found the effect cumulative, with poorer outcomes for those who had experienced multiple shocks.

Children who experienced these events later in childhood, between 12 and 15 years old, showed worse outcomes overall than those who experienced the events earlier on. The authors point to this older age cohort as being more aware of the event, being in the midst of either transitioning to secondary schooling or supporting their families by doing chores or working as potential reasons.

According to the United States Geological Survey, this data comes as natural disasters are increasing in both frequency and economic impact. In a 2021 report, the World Meteorological Organization found a fivefold increase in weather-driven natural disasters over the 50 years. However, resultant deaths have decreased by a factor of three in that same period.

Specific Vulnerabilities of Children

A 2016 survey of literature related to the impact of natural disasters on children by Carolyn Kousky of Resources for the Future, a Washington D.C.-based nonprofit research institute, shared similar findings as those reported by the Penn State team and outlined the ways in which natural disasters can harm a child’s mental and physical health as well as their educational outcomes over the long-term.

Kousky shared policy recommendations for ways to mitigate such damage, including reinforcing school buildings and homes and placing more emphasis on reuniting families as soon as possible following a disaster. She also highlighted the potential value of supporting existing safety net health care clinics and organizations instead of spinning up new initiatives in the wake of an event.

Kousky, Reyes, and Randell all acknowledged the relatively small sample sizes and specific geographic contexts of much of the existing research but still found pervasive indications that natural disasters harm children’s health in a variety of ways. Kousky identified that children, especially younger children, in contrast to the Peru study, may be more vulnerable than other age groups since they rely on caretakers who might be unable to care for them and are less protected from physical damage due their developing bodies, an example being that children are more at risk of dehydration due to the smaller amount of fluids in their bodies compared to adults.

In severe disasters, children have been found to be less likely to survive compared to adults, such as in the 2004 Indian Ocean tsunami, according to a 2011 study in Economic Journal, which was included in Kousky’s report.

Economic Impacts on Families and Children

On the economic side, the ability of families to stay financially resilient after a disaster depends upon a range of factors, but chief among them, across the studies reviewed by Kousky, Reyes, and Randall, was access to credit and, as reported by Kousky, insurance. Without these resources, families are forced to make do with their savings.

A natural disaster and the resulting financial impact can have dire consequences for children, as families may be forced to decrease their investments in education and might result in children being forced out of school in order to work, as was reported in this year’s Peru study. However, it remains challenging to get more granular causal data as opposed to the correlations being shared.

Health and Nutritional Impacts

Economic conditions can also translate directly into physical health conditions, as families may be unable to access the same amount of nutritious food as before the event. Access to medical care and medications is often impacted as well. Kousky shared that people living in FEMA housing in 2005, following the previous year’s Hurricane Katrina, faced “fragmented” or “nonexistent” access to medical care. In particular, many children were unable to obtain their asthma medication.

Survivors living in FEMA housing at that time also reported high levels of negative mental health impacts on their children. Specifically, half of all parents surveyed said at least one of their kids was experiencing an emotional issue that they did not have before the storm. In a different study, decreases in PTSD symptoms in children were found to occur two and three years after the storm, though more than a quarter of kids still had symptoms after three years.

Assessing additional ways to prepare for disasters, Kousky said that many nondisaster programs can be effective in recovery efforts, including increasing access to credit, offering subsidies for families to maintain continuity of education for their children, and increasing unemployment insurance.

In 2023, Direct Relief provided medical aid to more than 85 countries during both times of disaster and as part of ongoing support. The organization is focused on meeting the health needs of those most vulnerable to disasters, including children.

One free clinic located in the epicenter of the opioid crisis has gone above and beyond to save lives and connect those with substance use disorder to lifesaving resources, including opioid-overdose-reversing naloxone.

This video, produced by Pfizer and Direct Relief, highlights the efforts of Milan Puskar Health Right, a free clinic that offers harm reduction services in Morgantown, West Virginia.

The state has the highest opioid overdose death rate in the U.S., according to 2021 data from the Centers for Disease Control and Prevention. To address demand, the clinic has expanded to offer comprehensive harm reduction services, including the distribution of naloxone to those with substance use disorders and their families.

Over the past five years, more than 2.6 million doses of naloxone have been provided at no charge to organizations in all 50 U.S. states and three territories.

The shipments contained 7.2 million defined daily doses of medication and supplies, including insulin, vaccines, emergency hygiene kits, and personal care products.

Tennessee Tornadoes

Over the past weekend, tornadoes impacted multiple counties in Tennessee, killing at least six people and injuring at least two dozen more.

In response to the storms and tornadoes in Tennessee, Direct Relief sent offers of assistance to health centers and clinics in impacted areas.

In response, an initial shipment of 50 personal care kits arrived at Faith Family Medical Clinic. The kits contain items such as toothbrushes, soap, and other essentials for people displaced from their homes due to the storms.

Requested shipments of chronic disease medications, as well as vitamins and nutritional products, departed earlier this week for Neighborhood Health, a community health center with multiple locations in Davidson and Wilson Counties.

Supporting Maui Residents After the Fires

Last week, volunteers packed 5,000 kits of personal protective equipment, including gloves and boot covers, at Direct Relief’s headquarters in Santa Barbara. These kits will be shipped to Maui and provided for free to people re-entering Lahaina after the devastating fires in August.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 4.2 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 452 shipments containing almost 13 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 21,000 shipments to 2,503 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 541.3 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6.1 million lbs.

IN THE NEWS

Direct Relief ranks fifth in Forbes top 100 largest U.S. charities – KEYT

America’s Top 100 Charities – Forbes Magazine

How To Use Forbes’ Top Charities List To Guide Your Own Giving – Forbes

Direct Relief, which is funded entirely by private charitable contributions and does not accept government support, prioritizes operational efficiency through strategic partnerships with businesses and organizations. The vast majority of the donations it receives and distributes consist of in-kind donations of medicine and medical supplies. These contributions, valued at their wholesale cost, comprise the predominant share of the organization’s annual revenue.

Forbes awarded Direct Relief a score of 99% for charitable commitment (how much of a charity’s total expenses go directly to the charitable purpose) and 100% on fundraising efficiency (the percent of private donations remaining after deducting fundraising costs).

Forbes also ranked California-based Direct Relief as the largest of the six California charities included in its 2023 list.

Direct Relief, one of the world’s largest channels for humanitarian medical assistance to underserved communities and survivors of disasters, also ranks as the second largest charity in the “International Needs” category, according to Forbes.

Direct Relief in 2023

Doctors, midwives, community health workers, and other health professionals working in public-benefit health organizations around the world rely on Direct Relief to equip them with the medical resources they need to care for any patient, without regard to politics, religion, or ability to pay.

In its 2023 fiscal year, Direct Relief provided assistance in the form of essential medications, a broad range of medical supplies, and financial support in response to requests from healthcare providers and other local organizations across 88 countries and 55 US states and territories. The 2,900 tons of medical essentials provided by Direct Relief included 534 million defined daily doses of specifically requested medications, vaccines, insulin, and biologic therapies. The organization also provided $77 million in financial assistance through grants for a variety of emergency response and public-health related purposes.

In 2023, Direct Relief once again sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1.5 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies and strengthen fragile health systems in more places than ever before in its 75-year history. 

Since January 1, 2023, Direct Relief has:

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

2023 Charity Ratings

In addition to its top ranking from Forbes, Direct Relief earned a four-star rating from Charity Navigator, America’s largest independent charity evaluator.

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

Direct Relief also retains an A+ rating from Charity Watch, the highest score given by the independent charity watchdog.

Direct Relief, which receives no government funding and is supported entirely from charitable contributions, has a longstanding commitment to efficiency and frugality in all its organizational activities, including fundraising activities.

Direct Relief’s revenue includes both gifts of medications and other medical commodities and cash. Direct Relief believes it important to note that revenue associated with medical product contributions obviously may not be used for fundraising purposes, and that its modest fundraising expenses average about 2 percent of its total cash revenue. The organization pays all such fundraising expenses with earnings from a generous bequest, which means that zero percent of donated funds are used for the organization’s fundraising activities.

To learn more, please read the Direct Relief 2023 Impact Report.

Direct Relief’s Fund for Health Equity provides financial support to community health centers, free and charitable clinics, educational institutions and other community-based organizations fighting the inequities that further health disparities. Since 2021, Direct Relief, through the Fund, has granted more than $42.5 million to 145 organizations across the U.S.

This week, representatives of these organizations are coming together to meet and share their learnings in Santa Barbara, California. Their efforts, which span the country, include serving refugee populations in North Dakota, providing medical translators in Tennessee, operating a mini nurses academy in Alabama, running a clinic focused on health and financial health in Mississippi, conducting street medicine outreach in Chicago, and offering indigenous health services on the Northern Cheyenne reservation.

The summit’s agenda includes sessions on diverse topics such as data-driven storytelling, community health worker strategies, mobile health services, street medicine, maternal care, mental health, and prevention strategies, all viewed through a health equity lens.

Dr. Regina Benjamin, U.S. Surgeon General during the Obama administration and Founder and CEO of BayouClinic in Bayou La Batre, Alabama, addressed the audience Tuesday morning, emphasizing the importance of health equity and the critical roles nonprofits play in advancing health equity.

Dr. Benjamin also serves on the advisory council of Direct Relief’s Fund for Health Equity.

“You are part of an entire movement to make this a healthier nation,” she told the audience.

Daniel Dawes, Senior Vice President of Global Health & Executive Director of the Global Health Equity Institute and Founding Dean of the School of Global Public Health at Meharry Medical College, delivered the keynote address examining the country’s 400-year history of health inequities.

The inequalities seen in U.S. society — past and present — were not an accident and will take concerted political effort to undo and rectify, he said.

Dawes spoke about the “political determinants of health,” constructed barriers that keep people from living healthy lives. Dawes stressed that effective policy change is essential for rectifying these long-standing issues. Social determinants of health, like access to housing, clean food and water, and timely medical care, are often discussed, but “underlying each one is a political determinant that we can no longer ignore,” he said.

Policies that intentionally excluded healthcare for people who worked in agricultural industries and as domestic workers, highway planning that placed roads through under-resourced communities, exposing them to air contaminants, and housing policies like redlining are all examples.

“Only policy can fix what policy created,” he said.

Dawes encouraged the audience to continue their work and pointed to examples of change occurring when policy and local efforts combine. “It gives me a sense of hope about how much we can accomplish together,” he said. “This movement is not for the faint of heart. It takes tremendous courage.”

Dawes also took part in a panel discussion on the importance of collaboration and proactive health strategies with Dr. Benjamin and two other advisors of Direct Relief’s Fund for Health Equity Advisors, including Gail Small, Head Chief Woman and citizen of the Northern Cheyenne Tribe, and Martha Dawson, President and CEO of the National Black Nurses Association and Associate Professor at the University of Alabama at Birmingham.

Dr. Benjamin encouraged the conference participants to continue the work at the local level.

“Leadership starts in this room,” she said.

More than 15,000 people were without power on Monday, and shelters have been activated for people displaced from their homes due to the infrastructure damage and power interruptions. Three people were killed in Davidson County, which includes Nashville, and there other deaths were recorded in Clarksville in Montgomery County, located on the Tennessee-Kentucky border.

Direct Relief has offered assistance to health centers and free clinics in impacted areas. Direct Relief is in communication with the Faith Family Medical Clinic, Matthew Walker Comprehensive Health Center, Neighborhood Health, Siloam Health, and University Community Health, all located in Davidson County, Tennessee. The organization is also reaching out to facilities in Montgomery County about potential needs.

In addition to acute injuries from flying debris and structural damage, tornado impacts can also create a host of other health concerns, including a lack of access to chronic disease medications, which can result in emergency room visits.

Direct Relief maintains an inventory of medications commonly requested after disasters and has responded to past tornadoes in the region, most recently in December 2021, when tornadoes wreaked havoc across multiple states, including several of the areas impacted by this week’s storms.

The organization will continue to respond to needs as they become known.

The shipments contained 15.5 million defined daily doses of medication and supplies, including prenatal vitamins, insulin, rare disease therapies, personal protective equipment, and chronic disease medications.

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 donated medications and supplies, including insulin, nutritional supplements, and anti-inflammatories.

Additionally, over 4.7 million N95 masks departed Direct Relief’s warehouse this week for the Ministry of Health of Baja California. They will be distributed to multiple groups and government agencies in the region.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 13.6 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 532 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 20,500 shipments to 2,485 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 534.2 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6.1 million lbs.

IN THE NEWS

Health for All: Reflections on the Universal Declaration of Human Rights on its 75th Anniversary – LinkedIn

“It’s Amazing What Can Be Done Here.” Colorado Health Center Offers Community for Those in Recovery – National Association of Community Health Centers

Veterans Stand Down 2023 Helps More than 400 Military Vets – The Santa Barbara Independent

United We Bake Harnessing Power of Comfort Food to Aid Direct Relief’s Efforts in Israel and Gaza – Noozhawk

Meharry SACS Students Named Direct Relief Scholars – Meharry School of Applied Computational Sciences

Each year, before storm season begins on June 1, Direct Relief assembles and stages large caches of emergency medical supplies and collaborates with national health care and emergency response authorities in countries located in storm-prone regions.

Prior to the 2023 hurricane season, Direct Relief strategically placed emergency medical supplies in every Southeastern and Gulf Coast state of the United States, from Virginia to Texas, along with several locations throughout the Caribbean and Central America.

These hurricane preparedness packs contain the most commonly required medical supplies during and after a disaster, including trauma supplies, wound care supplies, and antibiotics. Additionally, they also contain medications for conditions like diabetes, hypertension, respiratory problems, psychological issues, and gastrointestinal problems.

This season, Direct Relief responded to the health needs that arose after three major storms, namely Hurricane Hilary, Hurricane Idalia, and Hurricane Otis. Direct Relief is currently continuing its response to these storms.

Hurricane Hilary

Hurricane Hilary formed on August 16, off the western coast of Mexico, and quickly grew into a Category 4 storm. It later weakened into a tropical storm before making landfall in Baja California. This was the first tropical storm to enter California since 1997. It continued to cause flooding as it moved across the southwestern United States and eventually dissipated over the Rocky Mountains.

Direct Relief took proactive measures before Hurricane Hilary made landfall by communicating with state and local organizations in Mexico to identify potential medical needs. Prior to the storm, Direct Relief supplied 18 emergency medical backpacks to the State of Baja, California, to equip first responders with medical essentials for triage care outside of clinic walls.

After the hurricane, Direct Relief sent additional medical support to the State of Baja California Sur, including ten emergency medical backpacks and an emergency health kit containing essential medicines and supplies usually requested after disasters.

These supplies were sent to Fundacion Astra in Baja California Sur, a non-profit organization that provides acute and preventive health services to vulnerable populations such as mothers and children, at-risk youth, injured and chronically ill people, and older adults.

Direct Relief was established as a Civil Association in Mexico in 2014 and has been an authorized donee since 2015. It is the only humanitarian wholesale distributor of pharmaceuticals in Mexico that fully complies with COFEPRIS regulations. This means Direct Relief can receive and process donated goods, and it’s well-positioned to respond to both immediate public health requirements and long-term healthcare service needs in underserved communities.

Hurricane Idalia

Hurricane Idalia began as a tropical depression in the Caribbean and eventually made landfall at Keaton Beach on Florida’s northern gulf coast, specifically in the Big Bend region, on August 30. This was the first major hurricane on record to hit this part of the Big Bend, and it caused significant damage to trees and structures across multiple counties. The hurricane brought winds of up to 125 mph and a storm surge of seven to 12 feet.

In preparation for Hurricane Idalia, Direct Relief had positioned 14 hurricane preparedness modules across Florida. Each module contained enough medical supplies to treat 100 patients for various conditions such as trauma injuries and chronic illnesses for a 72-hour period. The caches were strategically placed in secure locations near vulnerable areas, with seven of them located within the path of Hurricane Idalia.

After the storm, Direct Relief coordinated with the Florida Association of Community Health Centers and the Florida Association of Free and Charitable Clinics to provide more than one ton of requested medications and medical supplies, including insulin, wound care items, vitamins, and antibiotics, to healthcare facilities in these associations’ networks across Florida.

In North Miami, Mercy Mobile Clinic Provides Care Amid Chaos

One organization that provided crucial care in the aftermath of the hurricane was the North Miami Beach Medical Center. The center has been offering on-site medical assistance to victims of disasters since 2004 through its mobile health unit, which was purchased with the help of Direct Relief. When Hurricane Idalia struck their community in August, the center immediately sprang into action, providing healthcare services to the injured and those who had lost their medications and medical supplies in the storm, within the shelter setting.

People staying at the shelter reported multiple medical needs, including coronary artery disease, hypertension, diabetes, asthma and Parkinson’s disease. There were also those with injuries, including people experiencing homelessness, older adults and young children, who were treated. Two medical team members also went to those living in damaged homes to help and encourage them to come out to the shelter.

During the storm, some people with behavioral health conditions lost access to their required treatments. The Mercy Mobile team provided prescriptions and arranged for medications to be delivered to the shelter.

In the subsequent days, clinic staff treated approximately 150 patients.

Hurricane Otis

Hurricane Otis, a Category 5 storm—the strongest hurricane to hit Mexico’s Pacific Coast in recorded history—made landfall in Acapulco, Mexico, on Oct. 25, 2023, killing dozens with more still missing.

Property damage from the storm is also extensive. Otis damaged 80% of the hotel infrastructure and 96% of businesses in a city that lives mostly from tourism. More than a month after the storm, business owners and employees are still clearing debris and rubble from the streets.

Direct Relief and FedEx collaborated to pre-position three emergency health kits in Chilpancingo Guerrero, Mexico ahead of Hurricane Otis. Additionally, Direct Relief provided 53 field medic packs, containing medical essentials for providing care outside of clinic walls to health providers on the ground.

After the storm, Direct Relief immediately pledged $200,000 to support medical care providers on the ground. The organization also dispatched additional supplies to assist first responders in search and rescue operations and to help healthcare professionals in the aftermath of the hurricane.

Among the groups that received support from Direct Relief was Medical Impact, which was granted an emergency operating fund of $25,000. The group sent 12 doctors to Acapulco to provide medical aid in the affected area. The medical providers were equipped with field medic packs and an emergency health kit from Direct Relief, which included essential medical supplies commonly requested during disaster situations.

During the first week of November, Direct Relief coordinated the delivery of 20,000 liters of diesel to power the backup generators at Acapulco’s general hospital. The hospital was running out of fuel and required the generators to keep functioning. To help prevent the spread of disease, Direct Relief also delivered 100,000 units of hand sanitizer to the regional ministry of health. These units were then distributed to affected communities. Direct Relief is continuing to receive requests and assess needs, and more donations are forthcoming.

In Colorado, a federally qualified health center has provided access to healthcare and quality housing for decades. Now, the health center’s Fort Lyon location is celebrating a decade of successful substance use recovery, too.

The Denver-based health center, the Colorado Coalition for the Homeless, began offering healthcare services to those experiencing homelessness 40 years ago. The founders realized that housing was a critical part of maintaining overall health needs and began purchasing property so patients could have a place to call home.

Now, the Coalition owns over 2,000 affordable, supportive housing units for individuals and families and has repurposed a Veterans Hospital-turned-correctional facility for those with substance use disorders to live while in recovery.

Health, housing, and flexibility are the secrets to the program’s success. According to Fort Lyon, over 40% of their participants exited the program and moved into permanent housing. When transitional, long-term care was included, 58% of participants moved into permanent housing. Last year, 93% of participants said they were satisfied with their experience at Fort Lyon.

“It’s amazing what can be done here,” said Vincent Orzweiler, a current participant in the Fort Lyon program. The 62-year-old said he has struggled with alcohol dependency for 30 years. He’s tried other recovery programs in the past but said many are expensive and only allow participants to stay in recovery over strict timelines.

November marked 19 months at Fort Lyon for Orzweiler, who says he has taken a deep dive into his mental and behavioral health to better understand the reasons he consumes alcohol.

“Mentally, it’s about filling a void, the spiritual intersection of addiction,” he said. “There are mental problems that we all go through, and there are reasons that we became addicts.”

Before moving to Fort Lyon, Orzweiler had a new job and said that life was going well.

“I thought I could go back and maybe use a little here and there because my life was better,” he said. “But that addiction took control again, and I ended up losing almost everything again.”

Frustrated, his friends and family encouraged Orzweiler to seek out social services. He completed an application and was referred to Fort Lyon.

No Place for Isolation

There are few rules at Fort Lyon, other than joining at least one of the many recovery groups on site. Isolation is not an option, and enrolled participants are at Fort Lyon because they want to be there.

The program can accept up to 225 applicants at a time through referrals from social services across the state. The program is free to participants, at a cost of $18,800 per person per year for the state. Participants can stay at the facility for up to three years while working on their mental and behavioral health needs. The participants are predominantly male, at 80%. About 68% of participants are from counties outside of Denver, and most participants are between the ages of 45 and 54.

Fort Lyon is located in Colorado’s Bent County, a rural area with less than 6,000 residents and the program has been home to over 2,200 people in the past decade. Patients have access to the on-site health clinic, can choose from dozens of workgroups to participate in, go to school to gain certifications and become employed to begin rebuilding their lives. They are housed across three dormitories and 10 single-family homes across the campus.

That community has been key to Orzweiler’s recovery. He said that he is prioritizing his mental health and has learned that he needs a supportive network around him. When he leaves, he’ll return home and plans to find a therapist to continue working on his mental and behavioral health needs.

“I had to change a lot of behaviors, and it’s not just the using part,” he said. “It’s the things that I would say made me a better human being. A better citizen…Why did I cheat? Why did I steal? Why do I lie? It’s all part of the addiction, and those issues have to be addressed.”

Orzweiler said that he and many others felt “beaten down” by life tolls when they arrived to the facility. After months of therapy, he says he can’t overstate how important the mental health side of his recovery has been at Fort Lyon.

Patients expressing their own desire for recovery is also why Fort Lyon has been successful, said Lisa Trigilio, operations director. Trigilio has worked at Fort Lyon since its inception as a recovery facility. She said the “loose program” doesn’t have a lot of requirements, thus increasing the chance for patient success.

“For me, it’s the phenomenal amount of people that you meet,” she said about why she enjoys working at Fort Lyon. “We have so many wonderful people that come through here, and it just excites me to see when people are changing.”

Participants can choose whether their recovery is faith-based, medically assisted, involves group therapy, or a myriad of other options. They’re allowed to leave campus to explore the town, often to eat and find local employment. Fort Lyon is also not a closed facility—those seeking help for substance use disorders are welcome to join the on-site group discussions.

Trigilio said many have arrived at Fort Lyon feeling “very broken” and that they leave feeling “excited about life again.”

“You can’t find that anywhere else that I know of,” she said.

Fort Lyon’s health center is a satellite center to the Denver location. A physician is available two days a week, as well as a licensed professional counselor and a psychiatric nurse practitioner. They offer in-person and telehealth options. The medical services are free for participants through the state’s Medicaid program. All staff are trained to administer Naloxone, and if comfortable, carry it with them while at work.

“Taking a comprehensive history is important. Many of the patients I work with not only have addiction but also mental health concerns, co-occurring disorders,” Vickie Lucero, an on-site behavioral health provider, told Direct Relief in an email.

Lucero said that she asks patients about previous trauma, treatments and outcomes. Lucero teaches healthy boundaries, and talks to her patients about how to communicate and prioritize self-care. Many arrive at Fort Lyon with unaddressed medical issues, which can affect their overall treatment plan.

“Addressing addiction requires addressing the whole person,” Lucero wrote. “Trauma, pain, grief, education, employment (and more). They all impact how an individual copes with the challenges of life. At FLHC, we work to address all those things with care and compassion, taking care of the whole person.”

Direct Relief has supported the Colorado Coalition for the Homeless with medical aid and financial support, including a $100,000 emergency operating grant to continue work during the Covid-19 pandemic.

The shipments contained 25.4 million defined daily doses of medication and supplies, including prenatal vitamins, protective equipment, rare disease therapies, cancer treatments, and chronic disease medications.

Power and Health Summit Convened at Direct Relief

The intersection of climate and health was the focus of a panel discussion and film screening at Direct Relief this week. On Thursday, a screening of the short documentary “The Climate and Us: Invisible Impacts of Wildfires,” a co-production of Direct Relief and BBC’s StoryWorks, was shown in Direct Relief’s Hatch Hall in its Santa Barbara headquarters.

The film explores the aftermath of the 2018 Camp Fire on the Northern California community of Paradise, and how a local health center continues to help the area recover. The short film can be seen below.

The event also featured a panel discussion, featuring Former President of Navajo Nation Jonathan Nez, UCSB Professor of Economics Olivier Deschenes, and Washington Post Climate Reporter Brianna Sacks. The panel was moderated by Direct Relief CEO and President Thomas Tighe, and covered resiliency, climate and disaster planning for who is most at risk during a disaster: those most vulnerable the day before, including young children, older adults, people living with disabilities, those for whom English is a second language, and those with limited transportation options.

More than 100 power resiliency projects in 10 countries, Direct Relief’s Power for Health initiative 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.

Without power, critical health services can’t be provided – lifesaving medicines go bad, electronic health records can’t be accessed, essential medical equipment can’t be powered, and vital community health facilities serving the most vulnerable shut down. This initiative addresses health equity, the need for renewable energy, and community resiliency.

Learn more about the initiative here.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 23.2 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 585 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 20,100 shipments to 2,461 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 532.6 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6 million lbs.

in the news

Pac Biz Times reports: Direct Relief reaches milestone in aid to U.S. nonprofits – KEYT

Direct Relief shares ways you can give this holiday season – News Channel 9

EMS Agency visits Direct Relief to fight opioid epidemic – KEYT

Walmart Foundation commits $1 million to support humanitarian aid in Gaza – Yahoo Finance

Direct Relief Improves the Health and Lives of People Affected by Poverty or Emergencies – Noozhawk

Direct Relief tallies $2B in aid to U.S. nonprofits – Pacific Coast Business Times

Santa Barbara restaurant collaborates with Direct Relief to help those affected by Maui wildfires – KEYT

People continue to grieve the losses—at least 97 people were killed—while navigating the new normal for daily life. Homes and businesses were destroyed, and displaced over 6,000 residents who continue to live at nearby resorts. With years expected for rebuilding, children have returned to school in new formats, like learning at home, in church buildings, or being bussed to new schools farther away. As all of these changes are made, residents are working together to limit the amount of re-traumatization that may happen.

Dr. Felicitas Livaudais, a pediatrician at the Kihei Clinic, said the multi-generational aspects of Hawai’ian culture are highlighted in how residents say goodbye and grieve their losses. The pediatrician said the community has prioritized healing ceremonies, visiting the burn site to say goodbye to their properties, and taking part in paddle outs for surfers who host ceremonies and lay flowers in the ocean.

In September, the federal government sent 25 public health officers to Maui to assist with behavioral and support services. Public health officers included psychologists, psychiatrists, social workers and nurse practitioners to offer education, complete assessments, and medical health referrals.

“Tragedies like the Maui wildfires have a profound human impact on communities,” said Assistant Secretary for Preparedness and Response Dawn O’Connell in a September news release. “We are committed to doing all we can to assist the people of Hawai’i, and we are working with partners on the ground to assess ongoing needs to support recovery efforts.”

The following month, local health centers and organizations worked together to offer a community health fair. Residents received flu and Covid-19 vaccines donated by Direct Relief, hygiene necessities to take home, haircuts, massages, and culturally important gifts like ukuleles. Medical professionals in the area reported over 2,000 people attended the event.

Dr. Livaudais was one of the doctors on hand at the health fair to administer vaccines to children and adults, and said that supporting people with physical and behavioral health will require culturally competent practices.

In Maui, cultural traditions and beliefs are of utmost importance, and community members are trying to incorporate those practices into healing work through culture, connection, and conditions.

One example is serving musubi, a popular Hawaiian snack made of spam in a teriyaki sauce with rice wrapped in nori, during twice-weekly “Talk Story” community meetings where people are encouraged to gather together to thwart isolation.

“The community is really trying to help each other,” Livaudais said. “It’s hard, but there’s a lot of community support.”

According to the American Psychiatric Association, most people who experience a natural disaster will eventually return to their original level of functioning. However, sadness, depression, difficulty falling asleep or concentrating, and a feeling of numbness are common issues following a tragedy.

The Hawaii Department of Health conducted a needs assessment that found the greatest needs of residents were financial recovery and finding a permanent residence, followed by access to employment. According to the Department, 41% of survey respondents reported a decline in a household member’s health following the fires, and 22% reported their mental health as poor or very poor.

In an email to Direct Relief, a Department of Health representative said that the behavioral health impact of the Maui fires is expected to be significant and long-lasting and that they expect behavioral health needs to grow as the community grieves. The Department said they are making community mental health services accessible, like telehealth grief counseling and in-person therapy.;

A lack of permanent housing has contributed to stress and anxiety. According to the American Red Cross, 6,643 residents, or 2,748 households, within the non-congregate shelter program were housed at local resorts in late November.

Dr. Cassandra Simonson, a pediatrician at Mālama I Ke Ola Health Center, said that the community has tried to respond to as many requests for help as possible—including birthday cakes for kids, clothing needs, and a job opportunity for a musician. She said that while resources are available, some people remain “frozen, and unable to pivot” because they don’t have anyone to talk to and figure out how to move forward after losing everything.

Both physicians expressed concern about the mental health of health workers and first responders and have changed processes to limit emotional distress for patients and providers. In the first two months after the fires, providers asked patients intake questions to determine whether patients had housing and if their families had survived; they have since changed those methods because the questions increased patients’ emotional distress.

Instead, the health center uses sensory-inclusive rooms and play therapy to work with families. The rooms have low lighting, a “crash place” for children to lie down, a fish tank with bubbles, and the option to listen to music or play with toys. Originally intended for autism evaluations, the room is also useful for fire victims.

“It’s just so soothing, and even the parents have said that they felt calmer in those rooms,” Simonson said.

Air quality has been a top concern for her patients’ parents as children re-enrolled in school. Many were supposed to be bussed from one side of the island to the other, passing through the burn site twice daily on the school bus. Simonson warned that driving through the burn site every day could be triggering for children who had to flee their homes.

To better support the many children who survived the fires, doctors statewide are working on a hotline for children who may be in mental distress. Volunteers will answer the phones and point parents and relatives to resources for child psychiatrists, which can be difficult to access without a specific insurance carrier.

“If we can establish safety, at least a general feeling of safety, that’s the goal,” she said.

Direct Relief supported Malama I Ke Ola Health Center and other community organizations during the Keiki Health Fair for Lahaina residents in Ka’anapali, Maui, when over 2,000 people attended to receive physicals, donated vaccinations from Direct Relief (RSV, flu, Covid-19, and TDAP), and to have lost medical records recreated. Direct Relief has supported Malama I Ke Ola Health Center with medical aid since the fires and also with emergency operating funds.

In 2023, Direct Relief once again demonstrated the effectiveness of its flexible approach across all of its programmatic priorities. The organization sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies, and strengthen fragile health systems in more places than ever before in its 75-year history. This report provides an overview of how Direct Relief has leveraged contributions from generous individuals, companies, and foundations to improve the health and lives of people affected by poverty and emergencies in 2023.

2023 AID TRACKER
Unaudited totals through November 1, 2023

• $1,779,114,181 in medical assistance
• $51,300,000 in financial assistance
• 458,049,778 Defined Daily Doses of medicine
• 5,537,556 pounds of medicine and supplies
• 17,975 deliveries
• 2,371 healthcare providers supported
• 87 countries

Thank you for being part of Direct Relief

EMERGENCY RESPONSE ON A GLOBAL SCALE

Responding to humanitarian crises requires rapid mobilization of the right kind of assistance to the right partners at the right time. Direct Relief responds to emergencies using state-of-the-art data tools and guidance from its extensive global network of vetted partners. The result is swift and always tailored to specific requests from local front-line health workers. Coordination with other organizations and public agencies ensures the most efficient and precise use of resources.

The Right Products: Turkey/Syria Earthquake

A 7.8-magnitude earthquake in Turkey and Syria left 100,000 people injured and destroyed hospitals and health clinics. Within 48 hours, Direct Relief began shipping requested supplies to help establish temporary medical facilities.

In its continuing response to the disaster, Direct Relief has delivered $92 million (wholesale) in material assistance, including:

• 63 million defined daily doses of vital medications
• 945 Direct Relief Emergency Medical Backpacks to equip first responders
• 3,680 Direct Relief Hygiene Kits for 18,400 displaced persons
• Prefabricated temporary housing for medical workers

Medicine and Money to Maui

The West Maui Wildfire destroyed the town of Lahaina, disproportionately affecting residents who are low-income, elderly or very young, pregnant, or who have chronic medical conditions. People with chronic conditions may face acute medical crises if they evacuate without their medications. Wildfires generate airborne particulates that can worsen respiratory and cardiovascular disease.

Direct Relief responded within 24 hours with a commitment of $500,000 in cash assistance to maintain health services. The first emergency shipments of requested medical essentials, including asthma inhalers, diabetes medicines, antibiotics, pain relief, wound care products, and cardiovascular medications, followed within days.

Data and Emergency Preparedness

When responding to natural disasters, displacements, and disease outbreaks, time is of the essence. Early detection and early response lead to better outcomes. Direct Relief can quickly provide the right assistance to the right places at the right times by linking real-time disaster data with information about community-level vulnerability, hazards, and losses.

Each year, Direct Relief leverages data analysis to pre-position materials needed to rapidly respond to hurricanes and efficiently mobilize in response to wildfires. Direct Relief monitors population movement, tracks disaster effects, and remains responsive to evolving circumstances in the affected areas.

STRENGTHENING HEALTH SYSTEMS

Direct Relief works to improve the health of people living in high-need areas by strengthening fragile health systems and increasing access to quality health care. The organization’s medical assistance programs equip health professionals who serve vulnerable populations, and increase access to medicine for patients who would otherwise go without.

Broadening Access to Cold Chain Medicines

Increasingly, new vaccines and medications for cancer, genetic diseases, diabetes, and other medical conditions require consistent cold temperatures (cold chain medicines) 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 by providing cash grants, donations of refrigeration equipment, and expertise. In 2023, the organization delivered pharmaceutical-grade cold storage equipment to 113 healthcare facilities in low-resource communities.

With this support, health workers can store and administer important temperature-sensitive medicines for a range of conditions.

In 2023, Direct Relief delivered:

• 67 shipments of cancer treatments to 35 healthcare facilities in 24 countries
• Insulin to manage diabetes for 40,332 children with Type 1 diabetes in 32 countries
• Critical rare disease therapies to treat more than 600 patients in 17 countries

Increasing Access to Resilient Power

Modern healthcare relies on continuous power. Increasingly, record-setting emergencies result in extended power shut-offs. With healthcare systems’ growing dependence on power to provide treatment and maintain patient records, thousands of patients go without care when the power goes out.

Direct Relief’s Power for Health initiative promotes health equity by providing site-specific, reliable power to nonprofit community clinics and health centers serving the most vulnerable communities throughout the U.S. The initiative has already launched projects to provide energy solutions for 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, benefitting 1.3 million low-income patients. These projects have created an estimated $4.3 million in annual cost savings for the participating health facilities.

GETTING PATIENTS THE CARE THEY NEED

Cancer, cardiovascular disease, and diabetes have become responsible for the highest shares of death and disability globally. Cancer alone has become the leading cause of death worldwide, and approximately 70 percent of cancer deaths occur in low- and middle-income countries. Direct Relief has responded by increasing its delivery of medical products and financial assistance to bolster the treatment of these conditions.

Delivering Lifesaving Medications to Children with Cancer

Direct Relief is the principal logistics provider for Global HOPE, a collaborative initiative to improve the survival rates of children with cancer and blood disorders in Sub-Saharan Africa to bring them in line with those of wealthy countries. Currently, only 10 to 20 percent of these children survive the disease.

Since 2019, Global HOPE has treated 13,000 children and trained more than 5,600 healthcare professionals in cancer care protocols.

Expanding Access to Cancer Care for Children in Mexico

In Mexico, specialized pediatric cancer care is available only in large cities. For low-income families who live in remote rural areas, the cost of transportation puts cancer care out of reach. Direct Relief and Casa de la Amistad, or CDLA, ensure that hundreds of children from the country’s most resource-poor areas have access to cancer treatment in urban centers. In 2023, Direct Relief and CDLA facilitated cancer treatment of 650 children.

Improving Care for Mothers and Babies

Complications arising from pregnancy are significant causes of death and disability among mothers and babies in low-resource communities. Access to a trained, equipped midwife is one of the most effective ways to ensure healthy pregnancies and safe births.

This year, Direct Relief extended the range of resources available to midwives and health workers to provide care for mothers and babies in medically vulnerable communities. The organization began distribution of its newly-developed Perinatal Health Kit, designed to treat the most common causes of death and disability during and after pregnancy. In 2023, Direct Relief’s Perinatal Health Kits were delivered to maternal healthcare facilities in Bangladesh, Malawi, and Somaliland to support care for 3,750 mothers and babies.

Up to 25% of pregnant women and newborns at partner facilities are estimated to experience the conditions addressed by the Perinatal Health Kit. The amount of supplies provided in 2023 sufficiently equipped midwives and health workers to address all identified cases.

Direct Relief has prepared a 100-pallet shipment of humanitarian medical aid to depart its California distribution center next week, reaching Gaza via Jordan and Egypt.

This outbreak of war following the October 7 attack by Hamas caused a spike in humanitarian health needs and near complete shutdown of humanitarian health assistance to Gaza that Direct Relief has furnished for over a decade – all of which has flowed through Israel in the previously approved channel of assistance that has been overseen and approved by Israeli authorities.

The pending delivery containing 14 tons of requested basic health commodities valued $3.6 million will be consigned to Anera and is the result of weeks of ongoing consultation and coordination with various national governments, international agencies, and on-the-ground organizations, underscoring the commitment of Direct Relief to provide timely and critical support to people in need. These efforts are made possible by Direct Relief’s supporters, which include a recent $1 million investment from the Walmart Foundation.

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

Direct Relief also is assembling additional follow-up support for individuals with diabetes and other chronic conditions who have been unable to obtain needed medications.

Subsequent shipments will include these specialized supplies and will be conducted in accordance with U.S. sanctions laws and with necessary approvals from Israeli and Egyptian authorities.

This initiative follows a $100,000 emergency operating grant issued last month by Direct Relief to Anera to support the organization’s ongoing humanitarian work in Gaza and is part of Direct Relief’s decade-long commitment that has exceeded $100 million in medical essentials to address health needs among residents of the Palestinian territories.

These efforts follow Direct Relief’s recent provision of over $1 million in humanitarian aid to Israel in response to the deadly attacks by Hamas on October 7 and continue its apolitical mission to offer lifesaving support to communities affected by conflict and crisis, regardless of politics or religion.

The shipments contained 15.1 million defined daily doses of medication and supplies, including prenatal vitamins, protective equipment, rare disease therapies, cancer treatments, and chronic disease medications.

Medical Support Continues for Hurricane Otis

Direct Relief staff were in Acapulco last week, where they delivered medical aid to health facilities in the area and groups providing mobile medical care in rural areas.

Hurricane Otis’ impacts continue to interrupt daily life in Acapulco, Mexico. The Category 5 storm caused catastrophic damage when it made landfall in October. With medical care still limited in many areas due to damaged infrastructure, Direct Relief has been supporting medical campaigns bringing care to people where they live. Direct Relief supported the Mexican government’s medical outreach in Guerrero with 30 field medic packs containing medical essentials to provide first aid and basic medical care outside of clinic walls.

Direct Relief has also continued supporting Medical Impact, an NGO conducting mobile clinics throughout Guerrero. Direct Relief has supported the group with emergency operating funds, medicines, and supplies for patient care.

Syrian Hospital Bolsters Care for Neonatal Unit

The smallest patients at Dr. Mohammad Wassim Maaz Hospital in Aleppo, Syria, recently received more support with equipment for the hospital’s NICU. Recently, Direct Relief-donated incubators arrived and are being used to care for newborns.

The hospital run by the Independent Doctors Association, an NGO which provides medical services in northwestern Syria. Direct Relief has provided the group $12.3 million worth of medical aid since 2008.

A video of the incubators being used can be found here.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 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 196 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 19,500 shipments to 2,423 healthcare providers in 55 U.S. states and territories and 87 countries.

These shipments contained 507.2 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 5.9 million lbs.

in the news

Direct Relief Awarded Top 100% Rating by Charity Navigator for Nonprofit Impact, Efficiency, and Transparency in 2023 – PRNewswire

Local non-profit Direct Relief receives perfect score from national charity evaluator – KEYT

Direct Relief’s Medical Donations for U.S. Healthcare Safety Net Exceed $2 Billion – CSR Wire

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

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

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

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

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

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

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

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

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

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

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

Ongoing Programs

Among the many ongoing U.S. programs are:

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

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

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

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

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

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

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

Disaster Response

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

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

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

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

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

A Domestic Program Born in Crisis Response

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

The shipments contained 2.9 million defined daily doses of medication, including insulin, antibiotics, and cardiovascular and other chronic disease medications.

Direct relief provides aid for Acapulco and surrounding region

Three weeks after Hurricane Otis swept through Acapulco and the state of Guerrero in southwest Mexico, electricity is back up and running, and most places in the region have intermittent cell phone service. Some of the beaches have been cleaned of debris, but there is still substantial damage to buildings and rubble remains.

Those who continue to be most impact by the storm’s damage are infants and older adults who don’t have the resources to leave their communities to get access to cleaner drinking water and sanitation.

This week, Direct Relief staff in Acapulco met with Dr. Abel Peralta, who coordinates Mexico’s federal government-run medical campaign. The program has received volunteers from over 20 states and has conducted over 45,000 medical consultations in the past three weeks. Direct Relief gave his team 30 additional emergency medical backpacks for doctors deploying to rural areas to conduct more consultations.

Dr. Peralta mentioned that more donated medicine will be needed in the coming weeks, including medications for non-communicable diseases, since they are caring for a population of 800,000 people.

Direct Relief is continuing to assess needs and will continue to respond to Hurricane Otis throughout the recovery phase.

Morocco Earthquake Response

On September 8, 2023, Morocco was struck by a powerful magnitude 6.8 earthquake. The earthquake’s epicenter occurred in the High Atlas Mountains, approximately 40-miles southwest of the densely populated city of Marrakesh. Nearly 3,000 people have been confirmed dead and approximately 5,500 suffered serious injuries. This was Morocco’s most powerful earthquake since 1960, damaging over 60,000 homes and displacing more than 500,000 people.

Fortunately, the healthcare system did not sustain major damage and medical care has continued. Though the government has not made requests for international support, some local NGOs are experiencing shortages of supplies and are requesting support for mobile medical teams.

Direct Relief staff have been responding to the earthquake by coordinating responses with multiple groups, including the High Atlas Foundation, Association Amal Salè, Association Marocaine des Sages-Femmes, Bomberos Unidos Sin Fronteras, International Confederation of Midwives, and MedGlobal.

This week, a four-ton shipment of vitamins, wound care products, cardiovascular medications, and other medical supplies arrived at local NGO La Fondation du Sud pour le Development et Solidarité, in coordination with the regional health services for the city of Agadir.

Commemorating the 25th Anniversary of Hurricane Mitch

Direct Relief this month staff participated in the fifth Regional Platform for Anticipatory Action – Mitch +25 Forum – in San Pedro Sula, Honduras, to review progress made since Hurricane Mitch made landfall 25 years ago. The storm killed more than 11,000 people, primarily in Honduras and Nicaragua, and was the second deadliest Atlantic storm on record.

The event was hosted by the Coordination Centre for the Prevention of Natural Disasters in Central America and brought together more than 200 representatives of the emergency response sector, including humanitarian agencies, risk management experts, government officials and the private sector.

Direct Relief staff presented during the event on the need and promise of mobility data in disaster readiness and response efforts. Andrew Schroeder, Direct Relief’s vice president of research and analysis, compared mobility data for Hurricane Ian and Hurricane Otis, emphasizing how mobility data from sources like Data for Good at Meta allow response teams to evaluate evacuation dynamics, resource overload, and demographic vulnerability in near real-time.

Read more about the event here.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 1.3 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

Direct Relief also issued a $25,000 grant to Mountain Heart Nepal, a long-standing partner of Direct Relief, to support their emergency response efforts after a magnitude 5.6 earthquake struck the western region of Nepal. Funds from Direct Relief will enable the deployment of a 10-person medical team to the earthquake impacted areas.

UNITED STATES

Direct Relief delivered 476 shipments containing more than 16.1 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 19,300 shipments to 2,413 healthcare providers in 55 U.S. states and territories and 86 countries.

These shipments contained 490.4 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 5.8 million lbs.

in the news

Direct Relief deploys doctors to Mexico for medical care after Hurricane Otis – KEYT

Noozhawk’s Nonprofit Guide to Giving – Noozhawk

Best Humanitarian Charities to Donate to on GoFundMe – GoFundMe

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

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

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

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

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

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

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

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

Operational Efficiency & Transparency

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

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

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

Since rebuilding will be a long process, many people who have been displaced from their homes have found temporary housing in pre-fabricated containers. More than 150,000 people reside in the containers, and become communities in their own right, housing families and others that may not have access to permanent housing for some time.

In an effort to bring healthcare services to these areas, primary health centers have been set up in and among the containers. Doctors are practicing in the containers, but are financially responsible for outfitting the containers with medical supplies needed. Direct Relief recently committed $300,000 for medical equipment to support 58 primary health centers as they locally purchase needed items to better serve people.

Direct Relief staff recently spent time in Hatay, where health services continue to take place during the recovery phase. Since February, Direct Relief has provided more than $130 million in medical aid to Turkey and Syria as part of the earthquake emergency response.

Manuel Alberto, as his mom calls him, is entirely dependent on his parents. Unable to walk or speak, “we are his eyes, ears, and hands,” said Torres.

Although Manuel attended school until the age of 28 under the special education program, his parents felt the system did not provide the services he needed. Inclusion, they quickly realized, would never be possible.

To fill those gaps, Lina and her husband took matters into their own hands, seeking advice from the National Association for Child Development, or NACD, an organization that designs individual programs to support parents in helping their children achieve their innate potential.

For the last 17 years, Lina and her husband have been practicing the daily exercises and activities suggested by NACD. While he is still unable to walk, Lina celebrated that these activities have allowed them to ambulate him throughout the house with the help of assistive devices. “He is able to do two or three steps,” said Lina, and for them, that is an achievement on its own.

Doing these exercises requires great physical strength, and as the years go by, it becomes harder. Lina has recently faced numerous health problems, which have forced them to reduce the intensity and frequency of these activities.

She said prioritizing Manuel’s needs has factored into her and her husband putting off their medical appointments. “Our main concern [now] is taking care of ourselves so we can last longer for our son and provide him with quality of life, but we also need quality of life.”

Being a full-time caregiver can take a backbreaking toll on a person’s physical and emotional well-being. These families are often encumbered by onerous medical bills and lack of skilled care for their loved ones, given the often complicated medical issues that require a high level of expertise in handling specialized equipment such as tracheostomy tubes, ventilators, and gastric feeding pumps, among others.

According to the Puerto Rico Ombudsman for People with Disabilities, 22% of the population identifies as living with one or more disabilities. Children who have a disability in Puerto Rico are eligible to receive benefits under the Social Security Disability Insurance, which can help ease the economic burden for the family, even as they transition into adulthood. Additional economic assistance is available for children living in the continental U.S. under the Supplemental Security Income. However, those living in Puerto Rico are ineligible.

Providing Much-Needed Respite

Many studies have demonstrated that respite services can improve resilience among caretakers and their families. These services, however, are scarce in Puerto Rico. One of the few organizations addressing this dearth of resources is the nonprofit organization Apoyo a Padres de Niños con Impedimentos, or APNI, which translates to “Support for Parents of Children with Disabilities.” For 46 years, APNI has provided parents like Lina with information, training, orientation, and support services to uphold their children’s rights.

APNI has implemented a respite care program that trains and certifies assistants to provide a much-needed break for the families they serve. Celia Galán, APNI’s executive director, said that it has been challenging to obtain funding to maintain this type of project that is beneficial to these families. Direct Relief awarded APNI a $250,000 grant to expand respite services for families with children with disabilities.

Funding allows APNI to provide up to 30 hours per family for 12 months, and families can distribute them according to their needs. Respite care service assistants support families at home or at the Neonatal Intensive Care Unit.

APNI tries to find respite workers with similar experiences to better assist parents. Parents who have been through the difficult process of having their children in NICU are best able to guide and support other parents going through such stressful circumstances.

Impact Beyond Measure

Providing respite services, whether at home or in the hospital, can also be difficult as these parents ache to spend every waking moment next to their children. Through their program, APNI helps parents get to know these caregivers so that they feel comfortable taking some time for themselves. “It’s wonderful to see the beautiful comments parents leave in the evaluations after they decided to try the service, that they finally deposited their trust in someone and what it meant for them the break they received,” said Galán.

Carmen Rivera, 47, who asked that her name and that of her son be withheld to protect their privacy, has a six-year-old diagnosed with autism and attention deficit disorder. He currently attends the mainstream school system and receives five therapies after school. While Carmen’s situation differs from Lina’s, she has also received respite services from APNI.

Both Carmen and her husband work from home in marketing and event planning. They have been working hard to recover from the Covid-19 pandemic, which disrupted their jobs and significantly affected their income. “We are aware that we are in a stage where we need to be financially stable, and we want to ensure that [our son] also has a stable future,” she said.

Due to her son’s condition, self-employment was the best way to dedicate time to caregiving. She picks him up from school at 3 p.m. and then takes him to therapy. Respite services have allowed Carmen and her husband to continue working. “Sometimes I’m on a call or tending to clients, and my son comes to me and interrupts me, so in that sense having these services during those few hours to finish the work is invaluable.”

She added that APNI has been incredibly accommodating in finding respite personnel who are active and able to manage her son’s needs. The two caregivers assigned to their family have formed a strong bond with him. To facilitate their work, Carmen leaves them a daily work plan to help him with his summer reading or reviewing school lessons, among other things.

To date, APNI has provided respite services to more than 30 families. For Lina, respite services have allowed her to go to medical appointments, enjoy some free time with her husband and even rest. “I felt so tired that I just told the lady who was helping me, ‘I’m just going to rest.’ And I spent a couple of hours resting because the body feels it.”

The shipments contained 25.4 million defined daily doses of medication, including insulin, cardiovascular medications, antibiotics, chronic disease medications, PPE, and more.

Support for Nepal After Deadly Earthquake

A 5.4-magnitude earthquake shook northwestern Nepal last week, and at least 153 people have been killed, with 345 injured and about 12,000 families left homeless across seven districts, according to a preliminary report from the Nepal Red Cross Society.

The staff at Dhulikhel Hospital, which Direct Relief has supported since 2015, have already been deployed to support earthquake-affected regions in western Nepal. Dhulikhel Hospital is an independent, not-for-profit, non-government institution that operates a 475-bed hospital in addition to community health programs and 18 outreach centers that cover populations from at least 50 out of 75 districts in Nepal.

Over the past three months, Direct Relief has sent two large shipments of medical products to Dhulikhel Hospital, totaling 35 pallets, which contained surgical instruments, diagnostic equipment, PPE, nutritional products, vitamins, and ICU consumables.

Direct Relief continues to monitor the situation and is ready to respond to requests.

Hurricane Otis Response Continues in Acapulco

Two weeks have passed since deadly Hurricane Otis, a powerful Category 5 storm, made landfall in Acapulco, Mexico, but the risks from infrastructure damage may make this week and those following the deadliest phase of the hurricane yet.

Dr. Giorgio Franyuti, the founder and head of Medical Impact, a Mexico-based medical aid nonprofit that organizes monthly missions into underserved communities domestically and responds to disasters both at home and internationally, said that “the secondary disaster is bigger than the first one. The earthquake or hurricane doesn’t kill as many people as the water shortages, for example, will. The cuts in basic services will cause major death among those affected by the hurricane.”

The lack of refrigeration, combined with limited access to quality food, potable water, and gas for cooking food and boiling water, represents an extremely dangerous combination of challenges facing communities in rural Guerrero, which were vulnerable even before the storm, according to Franyuti, who said lack of clean water is the top priority.

So far, Direct Relief has allocated $500,000 for emergency response assistance, which is being used to support local NGOs and first responders like Medical Impact assisting individuals affected by the hurricane. The organization has also delivered 83 field medic packs, which contain first aid items for care outside of clinic walls. Thirteen emergency health kits, which contain medicines and supplies commonly requested after disasters, were shipped to the area, as well as 20,000 liters of diesel to power the backup generators at Acapulco’s general hospital, which were running out of fuel.

Direct Relief will continue to respond to Hurricane Otis throughout the coming days.

Turkey Continues to Recover from February Earthquakes

Recovery from the devastating February earthquakes in Turkey continues, albeit slowly. In the province of Hatay alone, 23,453 people died, and over 75,000 buildings were damaged beyond repair. Debris removal is still in process, and as rebuilding has not yet begun, cities in the region have become acres of unrecognizable rubble.

Over 150,000 people still reside in containers, and many Syrian refugees live in formal and informal tent camps. These crowded temporary living situations, which lack access to reliable water sources due to infrastructure damage, leave the population constantly vulnerable to public health risks.

Direct Relief staff recently visited Hatay and met with many of the non-profits that have received medical aid and support from Direct Relief, including a primary health center providing care out of the container pictured below.

This facility, located in Samandağ, Hatay, is typical in the earthquake zone, consisting of a container supplied by the Ministry of Health. Doctors are solely responsible for furnishing and outfitting the temporary clinics with required medical equipment. As doctors are also EQ survivors, purchasing these items has proved challenging.

Direct Relief’s recent $300,000 commitment to medical equipment procurement is supporting 58 primary health centers to locally purchase needed items to better serve the earthquake survivor population and ease the burden on healthcare professionals throughout the region.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 22.8 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 476 shipments containing more than 16.1 tons of medications over the past week to organizations, including the following:

Direct Relief also issued a $150,000 grant to One805, an organization that provides needed resources to Santa Barbara County’s first responding agencies, such as safety items or equipment, assistance to support their mental health, or help in strengthening emergency and disaster preparedness in local communities. This grant will support mental health services for firefighters in Santa Barbara County.

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 18,700 shipments to 2,402 healthcare providers in 55 U.S. states and territories and 86 countries.

These shipments contained 484.1 million defined daily doses of medication valued at $1.8 billion (wholesale), totaling 5.7 million lbs.

in the news

Shedding light on the deepening opioid crisis – USA Today

Otis’ other victims: Rural Guerrero fears being left out of recovery efforts – Courthouse News Service

Armenia Artsakh Fund [and Direct Relief] Delivers $486,000 of Medicines for Artsakh Armenians in Armenia – Ortr

Alycia Clark: Leading the Way as Head Pharmacist at Direct Relief – Montecito Journal

Emerging Leaders Program Marks Decade of Vision and Courage – Noozhawk

Energy Secretary Granholm Meets With IREC Puerto Rico Team to Discuss Energy Resilience – IREC

Finger Lakes Community Health wins innovation award – Finger Lakes Times

At this time, Hiba, who asked that her last name not be used for safety reasons, was working as a midwife at Al-Rafah Specialized Hospital in Jindires, a town in northwest Syria. She was also eight months pregnant with her first child.

Hiba, fortunately, wasn’t hurt in the earthquake, and she gave birth to her baby without complications a month later in March. She now brings him to work at the hospital, where a private attendant watches him between Hiba’s breastfeeding breaks. But the trauma from the earthquake lingers on.

“Every day I come to the hospital, and I feel like maybe it’s the last day in my life,” Hiba shared with Direct Relief through a translator. “When I feel anything that reminds me of the earthquake, any tremor and anything else around me that makes it feel like there’s an earthquake again, I take my baby and go outside the building because the building is cracked and affected by the earthquake.”

New Trauma Added to War and the Pandemic

Hiba is one of around 500 midwives in northwest Syria who face tremendous challenges in their work and personal lives amidst the overlapping crises of the last few years—including not only the February earthquake but also war and Covid-19.

Syria’s protracted civil war has lasted over a decade, and more than 12 million people (half of Syria’s pre-war population) are refugees abroad or are internally displaced, and over 2 million people are living in Syrian tent camps with limited access to basic services.

The health needs here are immense, and almost all healthcare services for the 4.6 million civilians in northwest Syria are provided for by a patchwork of NGOs and UN humanitarian assistance, which makes health funding gaps inevitable.

Health facilities have also been actively targeted. Dr. Okba Doghim, a physician and the programs director at Syria Relief and Development, an NGO based in Syria and Turkey that Direct Relief has supported since 2018, said that many people, like Hiba, are afraid to enter hospitals due to the risk of an airstrike combined with infrastructure damage from the earthquake.

Medical staff also often choose to relocate away from risk, and the remaining personnel cannot meet the present health needs. This has translated to a decrease in the quality of care in safer areas as the health system’s capacity there has not been able to scale with the population growth caused by people fleeing danger. “And we already had a staff shortage after Covid-19,” said Dr. Doghim.

“If She Will Not Die, I Will Not Go to the Health Facility”

Women of reproductive age are especially vulnerable to inadequate healthcare, particularly in the more than 1,400 camps for internally displaced people, or IDPs, in the northwest of the country. 80 percent of IDPs are women and children, and although 40 percent of the population lives in camps, only 18 percent of all health facilities are in camp settings. Because of these gaps, it is particularly critical to know what to do and where to go in a health crisis, but unfortunately, many don’t have this knowledge.

“The conflict interrupted education about sexual reproductive health, as well as regular information about the need for sexual reproductive health services,” said Dr. Doghim. “And there is no public transportation. In some communities, they prevent women and girls from going to the services without being accompanied by a man.”

And male accompaniment is not always a given. Dr. Doghim and his team recently visited an IDP camp, and he asked a resident, “When your wife is pregnant, what do you do? Do you go to antenatal care?” He said, “If she does not die, I will not take her to the healthcare facility; it’s 35 kilometers from here.” Gas is scarce and costly, making it a significant factor in this decision.

Also, there are no family planning services offered in that camp. “Almost 100% of those girls are married under 18,” he said. “All those women, they cannot go to toilets at night because they are at risk of violence and rape. They take showers inside their tents—they use clothes to cover the place where they shower. So there’s a lot of risk for gender-based violence in that camp. And all the families depend on women to work in the field. They work all day to get almost 25 Turkish Lira, which cannot do anything because it’s less than $1 for the family.”

Midwives Provide Support, but They Also Need It

Hiba shared that most of the pregnant women coming to the hospital live in an IDP camp. Implementing medical advice there is difficult due to unmanageable temperatures, lack of proper food and lack of privacy for applying medication. The number of C-sections has doubled, which Hiba attributes to the stress of the war and earthquake. “Before the earthquake, there were typically four C-sections a day, but now it is usually seven or eight,” she said.

Hiba’s hospital, even though there’s been a rise in pregnancies and risks involved, does not have the resources to hire more midwives, and the current staff is overloaded. For example, just one midwife assists with the labor and delivery process on any given day.

“We at least want another midwife to stay with the doctor in the clinic so I can then go work with the midwife who is working in the labor room,” she said. “It is a tiring process and very hard for just one midwife.”

There is a parallel shortage of nurses, which also ends up affecting the midwives. Because it is common in Syrian culture for a man to refuse to let a male nurse assist his wife in any way, a female nurse is often called upon to assist the male nurse, and she asks for the midwife’s assistance if there is more than one emergency case.

Unsteady Access to Medicines

Medicines and medical staff are in short supply, and this issue is often exacerbated by the current system for allowing aid into the country.

Every six months since 2014, the UN Security Council must reauthorize the humanitarian border crossing from Turkey into Syria. The border crossing reauthorization negotiation most recently lasted from July 10 to September 20, causing a gap of over two months in supplies and UN funding for the NGOs that run health facilities in Syria.

And the flow of supplies often halts before the border crossing renewal times out. For instance, Dr. Doghim shared, the United Nations Population Fund (UNFPA) sends family planning supplies for the first quarter (three months) after reauthorization, and then in the few months leading up to the next reauthorization there is often another interruption as the parties begin to discuss the agreement and its renewal is again in limbo. According to Dr. Doghim, the effects on medical material supply have been detrimental.

“Since the earthquake in February, there was no distribution of reproductive health kits, and many health facilities complain of supply shortages, including some critical items like oxytocin, which is given after each delivery to prevent postpartum hemorrhage.”

Fortunately, Direct Relief has recently been able to send 35 midwife kits to Syria Relief and Development during this most recent UN supplies lapse. Each kit contains the 61 essential items a midwife needs to perform 50 facility-based safe births.

“These are the best kits we receive,” Hiba said. “The contents are all there, like the scales and other delivery tools. And especially in the cases of emergency delivery attempts, everything is there, and we don’t have to buy any additional items to be prepared.”

A Sign of Hope, and a New Challenge

Despite all the challenges for families in northwest Syria, Hiba and her colleagues have seen a sign of hope: a significant increase in the number of women who want to have more children.

“Many women lost one, two, or three children [in the earthquake], and now they are coming to the hospital pregnant or trying to get pregnant, even though in many cases they are over 40 years old. This is a risk for them,” Hiba said. “And this is a new thing for us [the hospital staff]. These women didn’t want to become pregnant anymore before the earthquake, but now they are hoping to become pregnant to compensate for the loss.”

“Also, before the earthquake, when women were asked to return to the hospital for a follow-up appointment during their pregnancy, they mostly were not coming. But now, after the earthquake, most of them are committed to come and sign up for additional appointments to help implement what advice they were given,” Hiba said. “They are even now more cheerful about themselves and their children.”

“Those who live in the camps find difficulties in applying medical advice, but now they want to.”

Since 2010, Direct Relief has supported Syria Relief and Development with more than $28.2 million in medical and financial support, including for midwifery.

Dr. Giorgio Franyuti, the founder and head of Medical Impact, a Mexico-based medical aid nonprofit that organizes monthly missions into underserved communities domestically and responds to disasters both at home and internationally, said the scale of devastation was well beyond anything he had seen in his career, which has spanned war zones, earthquakes, and volcano eruptions.

“This Category 5 storm was enormous… We didn’t even know where to start,” he said.

Determining that Acapulco would receive the most resources from the government and aid groups, Franyuti and his staff physicians organized a mission inland to the mountainous rural communities of Guerrero state and traveled to five different municipalities.

Before reaching the last one on their mission, Ejido Viejo, the Mexican military had to clear a path since existing roads were completely destroyed. The town had been cut off for over a week.

“It was horrendous. The houses were still drowning in mud. The cars were drowning in mud. Bodies were yet to be found,” he said. “We discovered a massacre.”

He plans to return next week with his team to continue treating survivors. Franyuti said that in his experience, which reflects the latest medical literature, the time after a natural disaster is oftentimes more deadly than the disaster itself.

“The secondary disaster is bigger than the first one. The earthquake or hurricane doesn’t kill as many people as the water shortages, for example, will. The cuts in basic services will cause major death among those affected by the hurricane,” he said.

The lack of refrigeration, combined with limited access to quality food, potable water, and gas for cooking food and boiling water, represents an extremely dangerous combination of challenges facing communities in rural Guerrero, which were vulnerable even before the storm, according to Franyuti, who said lack of clean water is the top priority.

He said he is concerned about the spread of a range of infectious diseases. Franyuti said diarrhea could kill more people than the hurricane due to the lack of oral rehydration salts and drinkable water in the area. Mosquitos, which could flourish in standing water near homes, also present a problem as some will likely vectorize diseases such as chikungunya, dengue fever, and zika. He predicts that the scarce local services will be oversaturated by these infections.

As is the case following most natural disasters, Medical Impact is working to address the shortages and barriers vulnerable communities have towards accessing chronic disease medication, particularly therapies that require being kept at cool temperatures, such as insulin. In Mexico, complications from diabetes are the second-leading cause of death.

Despite the level of need, Franyuti said the level of response has not been in line with the situation on the ground.

“I think what is worrisome compared to other disasters in the past is that while the media has given this wide attention, stakeholders have not,” he said.

Medical Impact is preparing for at least four more missions to address this crisis, each lasting for one week. Franyuti said his team has been the only one responding to these areas.

Direct Relief has been responding to Acapulco, equipping organizations with requested medical aid, including Medical Impact. The organization received a $25,000 emergency operating grant to deploy doctors to Acapulco to provide medical care in the area. Field medic packs and an emergency health kit, which contains medical essentials commonly requested after disasters, were also provided for medical providers from Direct Relief.

While any startup and its financiers would be thrilled with these figures, for End Overdose, the stakes are much higher.

“I can’t tell you how many times I’ve had to say, ‘Your brother is dead. Your mother is dead,” said Theo Krzywicki, founder of End Overdose. “All they had to do is put naloxone in the nose and rescue breathe.”

Last year, 109,360 people died from drug overdoses, according to provisional data from the CDC. Of these deaths, 79,770 were reported to be opioid-involved.

Unlike many better-funded programs working to address the nation’s opioid epidemic, End Overdose relies on a peer-to-peer model that seeks to prevent deaths from overdoses by distributing an opioid overdose reversal drug, naloxone, and test strips that reveal the presence of fentanyl, which can be present in other drugs. Naloxone can be injected or inhaled as a nasal spray and works by connecting to opioid receptors in the body, which can block the effect of opioid drugs. The nasal spray version, branded as Narcan, is now available over the counter.

End Overdose also gives quick, on-the-spot tutorials for how to respond to a potential drug overdose and how to administer naloxone as well as to use the test strips.

In line with other harm reduction initiatives, these trainings are judgment-free and solely focused on how a person should react when a person’s life is on the line due to an opioid overdose.

“This is a simple problem, but it affects everyone at every level. Everyone has caught on to naloxone saturation, but we still have significant problems with communication. You can give it out all over the place, but if it’s not going to the right people and it’s not the right message, they won’t use it,” said Krzywicki.

For Krzywicki, who works as a firefighter and paramedic in Los Angeles, the work is not abstract.

Krzywicki took his first opioid at 13 years old after being prescribed pain medication with unlimited refills after breaking his leg. Trekking the path of the opioid crisis in the United States since the mid-1990s, Krzywicki became addicted to synthetic opioids and eventually began using heroin at his Seattle high school.

During those years, he saw many friends die from drug overdoses. But then the scourge hit even close to home.

“My fiancée overdosed,” Krzywicki said to Direct Relief. “It was just so preventable, but at that time, no one was talking about what to do when someone overdoses.”

The tragedy set Krzywicki on a different path, and he began working in drug treatment centers and later as a paramedic. “I just wanted to do something about it,” he said.

While working as a paramedic in California, Krzywicki saw how easy it was to administer naloxone to reverse an overdose and thereby save a person’s life. He wanted to distribute it as widely as possible. In 2017, he started approaching treatment centers in California. However, Krzywicki said that most treatment centers require sobriety and will kick patients out if they relapse. He said the usual path for relapsed patients is to then seek out drugs with disastrous results. Out of treatment, they would no longer have access to the naloxone. Adding to his challenge, naloxone was “extraordinarily” difficult to source.

Thinking about how to meet the most at-risk people where they are, Krzywicki pivoted to the nightlife scene. He was able to link up with various harm reduction groups, which helped him gain access to naloxone.

“When we got embedded in the nightlife, that’s when things really changed,” he said.

Tragedy would catalyze more action. In 2017, Lil Peep, a young rapper, died from an opioid overdose. His death sparked a meeting of several prominent musicians and influencers at the Echoplex in L.A. to discuss how to make nightlife safer. Krzywicki was invited to give a training on naloxone use. Invitations for trainings followed from venues in the underground L.A. music scene and then, in 2019, from the L.A. Mayor’s Office for a citywide program, which was halted due to the Covid-19 pandemic.

No Marketing Budget

From these experiences, Krzywicki had some key learnings that he felt could be used to expand his outreach among young adults further.

“We wanted attraction rather than promotion. There is nothing more obnoxious than someone working in a healthcare space harping at you to stay safe. It’s not fun,” he said.

“We wanted to use a peer-to-peer model. Nothing is better than hearing it from someone your age, who looks like you and knows your experience,” he said. End Overdose, the name of the nonprofit Krzywicki created, decided to branch out to college campuses.

Giana Uy, 23, co-founded End Overdose’s first college chapter at UCLA last year.

“I wanted to make sure my friends around me were safe,” Uy said. “I had not heard of Narcan [before getting involved with End Overdose], and I wanted to make it accessible since there was nowhere to access it on campus,” she said. “People wanted to be able to test drugs and weren’t able to do it,” she said, referring to fentanyl test strips, which reveal the presence of fentanyl in other drugs. End Overdose also provides these test strips and related training for free.

After graduating last year, Uy decided to work for End Overdose full-time, working now as its director of external affairs and programs. Despite starting last year, the group now has 31 chapters nationally. They had to turn down about 50 applications from colleges due to a lack of resources.

“It’s all grassroots. A lot of people see the work being done on other campuses and want to bring it to their campuses. We have no marketing budget. It’s just social media, friends, and people seeing it firsthand,” she said. College chapters are all set up slightly differently depending on the specifics of the campus, but each has the goal of reaching as many people as possible.

Chapters are all given onboarding training, where they learn about different overdose responses and harm reduction in general. They are also trained on how to teach others effectively. End Overdose offers three types of trainings, based on the Substance Abuse and Mental Health Services Administration’s best practices and input from a range of medical professionals and people who have experience using drugs.

Students who lead these chapters distribute naloxone and fentanyl test strips to their peers, oftentimes by setting up tables in courtyards and routes to classes.

“Our goal is to have this on major campuses in America. We definitely want to have a chapter in every state,” Uy said.

Ready for Action

At an event for military veterans last month in the L.A. area, Anthony Banuelos, End Overdose’s director of operations, greeted passersby with a big smile and energetic greetings.

“Would you like some free naloxone?” he asked, rows of nasal spray versions of it in front of him on the table, which also had stickers, fentanyl test strips, and a life-size training mannequin.

Every person he asked said yes. Many said they knew someone who had died of an overdose. Banuelos said he survived an overdose as well.

After handing out a couple of packs of the spray, along with a QR code so the group could track usage, he launched into what he described as a “wham, bam, to the point” training process for how to identify if someone is overdosing, to call 911, how to administer naloxone, and how to do rescue breathing. He also noted that Good Samaritan Laws protect people who try to help in these situations and that naloxone has no negative effect if a person is experiencing a different medical emergency.

Banuelos then demonstrated how to use the spray on the mannequin and handed it to the trainee.

“It’s real life, unfortunately,” said MGySgt. Joe Gray, USMC. Gray received the training because he said he wanted to be able to “look after his Marines” in case the need arose. Asked if he felt ready to respond after the training, he quickly said yes.

SSgt. Jaime Serrano said he stopped by the table because of Banuelos’s friendly greeting.

“It’s the first time I heard about naloxone… I’m now prepared to respond,” he said.

Donna and Jeff Watkins, along with their friend Kim Miner, said they had several friends who lost their children to fentanyl.

“It’s the first time I have access to naloxone, and now I know how to react,” Donna Watkins said.

Jeff Watkins, who works as a key grip on Hollywood sets, said he received similar training on studio sets but not on location.

“We have AEDs (automated external defibrillators) on set; we should have this too,” he said.

Asked what drives him to do this work, Banuelos said, “We want everybody to be prepared to save someone’s life.”

Though the opioid crisis is “definitely getting worse,” according to Krzywicki, he is undeterred.

“I think we can fix this. Too often, people get lost in the tragedy… But we have medicine, training and the ability to get it out there. No one else has to die. If I don’t keep going… I’d feel like I’d be abandoning something,” he said.

End Overdose has given away over 130,000 naloxone doses to date.

Since 2017, Direct Relief has provided 2.6 million doses of naloxone to health centers, free clinics, community organizations and harm reduction groups, including End Overdose.

The shipments contained 7.8 million defined daily doses of medication, including insulin, cardiovascular medications, antibiotics, chronic disease medications, PPE, and more.

Assessing Needs after Nepal Earthquake

A 5.4 magnitude earthquake shook northwestern Nepal on Friday night. At least 69 people have been reported dead, with the number expected to rise this weekend. Direct Relief is reaching out to non-profit partner organization Mountain Heart Nepal to assess medical needs.

Responding to Hurricane Otis in Acapulco

A week after Hurricane Otis, a powerful Category 5 storm, made landfall in Acapulco, Mexico, at least 58 people are still missing, according to the Mexican government. So far, 46 people have been confirmed dead. Hurricane Otis is the strongest hurricane to hit Mexico’s Pacific Coast in recorded history, recording winds of up to 165 mph.

With assistance from FedEx, Direct Relief pre-positioned three emergency health kits in Chilpancingo Guerrero, Mexico, and 53 field medic packs, filled with medical essentials needed for care outside of clinic walls, with health providers on the ground, prior to Hurricane Otis’s landfall.

Since then, additional supplies have been sent to the affected region to aid first responders in their search and rescue efforts and to support the work of other healthcare staff in the wake of the hurricane.

In addition, Medical Impact, an organization that Direct Relief supported last week with a $25,000 emergency operating grant, deployed 12 doctors to Acapulco this week to provide medical care in the area. Field medic packs and an emergency health kit, which contains medical essentials commonly requested after disasters, are outfitting the medical providers during their trip.

Direct Relief will continue to respond to Hurricane Otis throughout the coming days.

Responding to the Highland Fire in California 

Fueled by Santa Ana winds, the Highland Fire erupted earlier this week in Southern California and grew to cover nearly 2,500 acres. While the fire is now 50 percent contained, the less than 25 percent containment two days ago prompted evacuation orders and warnings in parts of Aguanga, Riverside County, located around 100 miles southeast of Los Angeles and 75 miles northeast of San Diego.

In response to the wildfire, Direct Relief has dispatched an emergency wildfire health kit shipment, which includes respiratory medications, eye drops, chronic disease medications, first aid supplies, and PPE, including N-95 masks to protect against inhalation of fine particulate matter from ash and smoke. The kit will be delivered to Health Center Partners, the regional primary care association for Riverside County, to begin assisting patients in impacted areas.

Direct Relief will continue to monitor the situation as it evolves and provide updates as they become available.

Keiki Health Fair in Maui Supported by Direct Relief

The Keiki Health Fair for Lahaina residents in Ka’anapali, Maui, took place last week, when over 2,500 people attended to receive physicals, vaccinations (RSV, flu, COVID, and TDAP), and to have lost medical records recreated. The fair was designed to provide services and support to residents, in addition to healthcare, and local groups provided free haircuts, nail salon services, and face painting for children.

Direct Relief staff were present and helped at the Healthy Mothers Healthy Babies table. This maternal and child health-focused nonprofit provides social services, clinical care, and behavioral health services across Maui, O’ahu and the Big Island, and they have been providing care to those affected by the fires since the disaster in August.

People received flu shots, and women could receive ultrasounds out of the mobile clinic (ultrasound devices, flu shots, and a vaccine fridge were donated by Direct Relief). Two pregnant women who had not received any prenatal care thus far received their first ultrasounds and were connected with Malama I Ke Ola Health Center to schedule prenatal appointments.

Last Friday, over 2,000 Lahaina residents returned to their homes for the first time after the fire. This zone was one of the most devastated and one of the largest to be opened at one time; almost every home was completely destroyed. About 1,000 kits of protective equipment donated by Direct Relief are being distributed daily.

About 20 of the 84 total zones have now been opened for reentry, and while the reentry schedule is partially determined by how quickly the Environmental Protection Agency can work, the Department of Health anticipates the reentry phase to last at least through the end of December.

Direct Relief Strengthens Disaster Response in the Philippines

The Philippine Disaster Resilience Foundation (PDRF), the country’s leading private-sector-led non-profit organization, recently held its annual Cluster Connect Conference (CCC). During the event, Direct Relief’s Ledrolen Manriquez, who is based in the Philippines, and PDRF signed an open Letter of Partnership, as a commitment to collaborate towards accountable, transparent, and inclusive strategies in responding to emergencies.

The two organizations are also committed to leveraging each other’s expertise, resources, and networks to enable effective disaster management and to foster resilient communities in the Philippines. Since 2010, Direct Relief has provided over 20.8 million doses of medicines to a network of 58 healthcare providers in the archipelago nation.

According to the Association of Southeast Asian Nations (ASEAN), which includes the Philippines and the nine other countries that sit on or near the “Ring of Fire,” the zone around the Pacific Ocean that is known for natural disasters like earthquakes and volcanic eruptions, this zone is the most natural disaster-prone region in the world. More than 50 percent of global disaster mortalities occurred in the region during the period of 2004 to 2014.

“We cannot do it alone. We need to ensure not only a whole-of-nation approach, but a whole-of-society approach to address the needs of Filipinos affected by disasters,” the Philippines Department of Social Welfare and Development (DSWD) Secretary Rex Gatchalian shared at the meeting.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 7.1 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 641 shipments containing more than 12.1 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 18,200 shipments to 2,377 healthcare providers in 55 U.S. states and territories and 86 countries.

These shipments contained 459.5 million defined daily doses of medication valued at $1.8 billion (wholesale), totaling 5.6 million lbs.

in the news

Eugenio Derbez & ‘Acapulco’ Producers Send Donation & Messages Of Support Following Hurricane Otis Devastation In Mexico – Deadline

The scale of Hurricane Otis’ damage to Acapulco is coming into focus – The World

Direct Relief and FedEx Team Up To Respond to Dengue Outbreak in Mexico – Yahoo Finance

Disaster medics warn of infectious disease outbreaks in Hurricane Otis aftermath – Courthouse News Service

Direct Relief Reaffirms Commitment to Puerto Rico’s First Responders – BNN

Better Business Bureau: Donating for Relief Efforts – Quad-City Times

CrisisReady, a research-response initiative at Harvard and Direct Relief, released a report Tuesday that outlines the team’s work over the past 12 months, including wildfires in California, hurricanes in the United States, earthquakes in Turkey and Syria, and floods in Libya.

The initiative is supported by grants from the Harvard Data Science Initiative, Google.org, Data for Good at Meta, and the World Bank GFDRR.

This year, the organization published over 90 situation reports, or “ReadyReports,” during 23 disasters, and the reports were shared with state agencies, international humanitarian organizations, and local response teams. Channels are now in place to generate these reports within 24 hours of a disaster occurring anywhere in the world.

Another tool, particularly useful in regions where data access is limited, is the ReadyMapper, CrisisReady’s data visualization tool to monitor real-time population mobility, health infrastructure status, disaster perimeters, disaster impact, and population vulnerability. The organization is also growing its datasets related to climate change and human health.

The full report can be accessed here.

In response to the wildfire, Direct Relief has dispatched an emergency wildfire health kit shipment, which includes respiratory medications, eye drops, chronic disease medications, first aid supplies, and PPE, including N-95 masks to protect against inhalation of fine particulate matter from ash and smoke. The kit will be delivered to Health Center Partners, the regional primary care association for Riverside County to begin assisting patients in impacted areas.

Beyond the immediate danger posed to nearby communities, wildfires can exacerbate chronic health issues such as asthma, bronchitis, and other respiratory problems. For those with such conditions, fires deal a harsh mix of smoke, dust, and other particulates in the air. An air quality advisory has been issued in areas across Southern California through Thursday evening as a result of the Highland fire.

Direct Relief is based in California and responds to fires each year, maintaining an inventory of fire-related items – N-95 particulate masks, inhalers, nebulizers, and personal care items – which are available to healthcare centers and clinics upon their request.

Direct Relief will continue to monitor the situation as it evolves and provide updates as they become available.

Ampla Health, a federally qualified health center system in the area, lost power at its Magalia location shortly after the fire hit, forcing the clinic to close. With support from Direct Relief’s Power for Health initiative, Ampla Health now stands ready for the next natural disaster with a cutting-edge, resilient, solar-powered system that will help healthcare providers continue to care for the most vulnerable residents by powering critical medical devices and allowing them to access records, even if the grid fails.

Direct Relief is pleased to present this original short documentary, a co-production with BBC’s StoryWorks:

“Invisible Impacts of Wildfires” is part of a series called “The Climate and Us” by the BBC 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.

The storm’s death toll has risen to 45 people, and 47 people are still missing, according to Evelyn Salgado, Guerrero state governor. She added that about 274,000 homes throughout the region had been destroyed from the storm’s high winds and flood surges. Clean water shortages and a dwindling food supply are also impacting the region.

More than 100 hospitals and clinics have been damaged, and medical care is scarce.

Direct Relief issued $200,000 in financial support last week, including to groups responding in Guerrero with emergency health services.

Medical Impact, an organization that Direct Relief supported last week with a $25,000 emergency operating grant, deployed 12 doctors to Acapulco to provide medical care in the area. Field medic packs for triage care outside clinic walls and an emergency health kit, which contains medical essentials commonly requested after disasters, are outfitting the medical providers during their trip.

The week before Hurricane Otis made landfall, Direct Relief had shipped requested medical essentials, including medications for chronic disease management such as diabetes, high blood pressure, and asthma, as well as first aid items for wound care and other medical needs.

Direct Relief is also coordinating with the Instituto Mexicano del Seguro Social, or IMSS, one of the largest providers of healthcare in the country, and has shared a list of available medications.

Direct Relief will continue to respond to Hurricane Otis throughout the coming days.

The shipments contained 11.9 million defined daily doses of medication, including Covid-19 vaccines, portable refrigeration units, rare disease therapies, prenatal vitamins, field medic packs, chronic disease medications, PPE, and more.

Hurricane Otis Response IN Mexico

In response to this week’s devastating hurricane that made landfall in Mexico, Direct Relief committed an initial $200,000 to support emergency response efforts in the region.

Hurricane Otis, a Category 5 storm, slammed Mexico’s Pacific Coast with winds of up to 165 miles per hour, and at least 27 people were killed as a result of the storm. Medical infrastructure is damaged in the Acapulco area, and power outages are widespread.

Direct Relief is in communication with its local partner network, including the Instituto Mexicano del Seguro Social, or IMSS, one of the largest healthcare providers in the country, and has shared a list of available medications. The organization will be responding to needs as they become known and had also delivered shipments of emergency medicines to the area the week before the storm.

Read more.

Vaccines Depart for Maui Health Fair

This weekend, over a dozen providers, nonprofits, associations and the Hawai’i Department of Health will host a community health fair, which will prioritize Lahaina residents and evacuees who lost their homes to the wildfires and now reside within the resorts in the area.

Direct Relief is supporting the health fair with donated vaccines, including protection against Covid-19, influenza, RSV, and pneumococcal infections such as pneumonia. Supplies and equipment are also being provided, including needles and syringes, gloves, alcohol swabs, diluent, portable refrigerators, ultra-low temperatures freezers and temperature monitoring devices for vaccine storage.

Read more.

Grassroots Organizations in India Address Climate, Health

Direct Relief staff recently traveled to Ahmedabad, Gujarat state in India to meet with the Self-Employed Women’s Association, known as SEWA, and the All-India Disaster Mitigation Institute, or AIDMI.

SEWA consists of roughly 2.5 million female members that range in occupation from domestic workers to street vendors, construction workers, salt-pan workers, small farmers, and operates across 18 states in India, as well as in several other countries in South Asia including Pakistan, Bangladesh, Afghanistan, and Sri Lanka.

Their operational focus builds from social movement-based women’s empowerment up through wage and workplace safety negotiations to generalized micro-financial services, savings programs, insurance programs, and increasingly through Direct Relief’s assistance, health care programs. AIDMI is a close ally and collaborator with SEWA, and a leading research institute in India on disaster mitigation and risk reduction, with a special focus on climate and health.

Direct Relief is supporting each organization with grants aimed at strengthening approaches around climate change adaptation, disaster mitigation and response, and health data, stemming from funds raised during the Delta wave Covid outbreak in India. Prior to these current grants, Direct Relief also supported SEWA extensively during the pandemic with supplies of PPE and cash resources for Covid-response programs.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 10.5 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 470 shipments containing more than 10 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 17,700 shipments to 2,351 healthcare providers in 55 U.S. states and territories and 86 countries.

These shipments contained 454 million defined daily doses of medication valued at $1.7 billion (wholesale), totaling 5.5 million lbs.

in the news

Direct Relief and FedEx Team Up to Respond to Dengue Outbreak in Mexico – FedEx Cares

Boy Scouts of America visit Carnival Cruise Line in Kahului – Maui Now

Teva to Provide Second Round of Funding to Clinics in California, Florida and New Jersey as Part of $2 Million Commitment Through Community Routes: Access to Mental Health Care Program – AP News

Alycia Clark: Leading the Way as Head Pharmacist at Direct Relief – Montecito Journal

Hurricane Otis leaves at least 27 dead in Mexico – Big News Network

Ruth Arnold Smarinsky, PharmD: A strong force for good – Angels in Medicine

Hurricane Otis, a Rare Category 5 Storm, Slams Mexico’s Western Coast – Relief Web

The Category 5 storm, the strongest on record in the area, made landfall on Oct. 25, slamming Mexico’s Pacific Coast with winds of up to 165 miles per hour. Major infrastructure damage has been reported in the Acapulco area, and at least 27 people were killed as a result of the storms. Medical infrastructure is damaged in the area, and power outages are widespread.

Direct Relief is in communication with its local partner network, including the Instituto Mexicano del Seguro Social, or IMSS, one of the largest providers of healthcare in the country, and has shared a list of available medications.

The organization has a long history of responding to hurricanes throughout the U.S. Gulf Coast, Caribbean region and Latin America and maintains an inventory of medications and supplies commonly requested after disruptive storms. A portion of the funds committed will support field medic packs, which contain essential medical supplies for care outside clinic walls.

Hurricanes can cause rapid displacement of entire communities, and people can become cut off from necessary medical care and prescription medications needed to manage their health. Unmanaged, chronic conditions, including diabetes, high blood pressure, and asthma, can require emergency treatment at a time when emergency rooms may already be at capacity.

Direct Relief has staff in Mexico, and the organization has been incorporated as a Civil Association since 2014 and has been an authorized donee since 2015. As the only humanitarian wholesale distributor of pharmaceuticals operating in Mexico that is fully compliant with COFEPRIS regulations, it can receive donations in-country and process internationally donated goods and is positioned to respond to both immediate public health requirements and long-term healthcare service needs in underserved communities.

The organization will continue to respond as medical needs become known.

Following major storms like Otis, widespread damage to homes and health facilities often leaves thousands displaced and at risk. Direct Relief works closely with local healthcare facilities in hurricane-prone areas around the world to ensure those in need have medication, supplies, and necessary care.

Direct Relief has initiated communication with its network of partner organizations, including Mexico’s Federal Health Secretariat organization, the Operational Center for Contingency Attention (COPAC), The National Defense Ministry of Mexico (SEDENA), and Medical Impact, A non-governmental organization dedicated to providing health services and medical aid to disadvantaged communities in Mexico. These organizations have received funding and medical aid from Direct Relief to assist them in responding to disasters just like Hurricane Otis and were equipped with emergency medical packs and emergency health kits.

The situation in Acapulco is dynamic and impacts of the storm will continue to emerge in the days ahead. Direct Relief will continue to assess the situation and will be in communication with additional healthcare providers and first responder organizations to offer additional emergency medical resources as needed.

This Saturday, over a dozen providers, nonprofits, associations and the Hawai’i Department of Health will gather at Whalers Village to host a community health fair. Participants will have access to Covid-19 and flu vaccines, health screenings, conversations with physicians, food and games. The event prioritizes Lahaina residents and evacuees who lost their homes to the wildfires and now reside within the resorts in the area; however, all are welcome.

“The idea was to bring the healthcare to them,” said Dr. Cassandra Simonson. She is a local pediatrician and member of the Hawai’i Academy of the American Academy of Pediatrics, who will be present at the health fair.

Simonson also provides care to Medicaid patients at Mālama I Ke Ola Health Center, which is a sponsor for the event. The pediatrician said health professionals in the area want to find ways to make residents feel special during this difficult time. They’ve even hired non-medical professionals to participate in the event to support the local economy. Live music will be featured, and culturally significant ukeleles, many of which were lost to the fires, have been donated to give away.

The Maui fires spread for days and 99 people died. Hundreds more were unaccounted for in the first few days of the natural disaster. The Lahaina community saw the most damage. Many have lost their jobs as the fires decimated the area’s tourism industry, and there is an ongoing housing shortage since many structures were destroyed.

Simonson said while not everyone lost their home, many still feel like they are “still running from the fire” because there is no sense of normalcy. The physician said the constant unknown of the situation affects the population’s mental health.

“It’s very hard on people’s mental health to not be able to prepare their own meals and especially for kiddos who don’t feel safe because you always feel like you’re still running from the fire,” she said. “If you don’t have a normal sense of your surroundings, you’re still in fight or flight mode even if you’re in a shelter or a hotel, it doesn’t feel stable, and it doesn’t feel normal.”

Donations of food and clothing have helped, but community members say they still need more. Some households have taken in other families. Some children have not returned to school. Mentally, many endured shock at the initial situation and are now under constant stress, which can increase health risks.

Jacquelyn Ingram, of Healthy Mothers Healthy Babies, said that some students are being bussed from one side of the island to the other to go to school while others are being homeschooled. Some parents are still figuring out educational options. But missing school can prevent some children from receiving immunizations and mental health supports they would traditionally have at school.

HMHB will also participate in the upcoming health fair. Ingram said the drop in educational enrollment is doubly concerning, given the educational disruption so many saw during the height of Covid.

Ingram said that health fair hosts hope that the community event will help people realize that they are not enduring this difficult situation alone and that many are working together to find solutions. HMHB has used its mobile unit to visit rural areas and care for people where they are since the fires were exhausted. She said providing daily necessities and ensuring residents are hydrated and clothed has been key.

Direct Relief is supporting the health fair with donated vaccines, including protection against Covid-19, influenza, RSV, and pneumococcal infections such as pneumonia. Supplies and equipment are also being provided, including needles and syringes, gloves, alcohol swabs, diluent, portable refrigerators, ultra-low temperatures freezers and temperature monitoring devices for vaccine storage.

The second round of funding to the clinics in Florida, New Jersey, and California underscores the commitment by Teva and its partners to expand access to mental health resources. The grants will support further expansion of the clinics’ innovative behavioral health services that are tailored to meet the cultural and language needs of patients in their local communities, including screening and services focused on trauma-informed care, training, continued community outreach and partnership development, new delivery sites, and continued trust-building among their patients and communities.

“Teva’s continued support for mental health across the U.S. builds on the past year’s success, connecting even more patients with quality care,” said Thomas Tighe, CEO and President of Direct Relief. “Over the past year, free clinics serving the most vulnerable patients were able to use these resources as a force multiplier for good. Direct Relief is privileged to work with these clinics, the National Association of Free and Charitable Clinics, and Teva, on this initiative that is again helping so many.”

“We know that a third of adults in the U.S. show symptoms of anxiety, depression or both – and more than 5.5 million adults with a mental illness are uninsured,” said Sven Dethlefs, PhD, Executive Vice President, North America Commercial at Teva. “Through this partnership, we are able to help address the rising need for community-based mental health care for uninsured and underserved populations.”

Nicole Lamoureux, President and CEO of NAFC said, “It is imperative that we continue to prioritize investment into mental health and behavioral programs. The funding from Community Routes provides these indispensable and trailblazing clinics with the momentum they need to create and expand mental health programs that can address the needs of their local communities.”

By the Numbers

Through the Community Routes: Access to Mental Health Care program, Teva is providing funds and a broad portfolio of generic medicines to help advance health equity and quality care for underserved populations experiencing depression and anxiety. Within the program’s first six months, the 11 grant recipients reached over 22,000 patients within underserved communities, supporting individuals already facing other challenges, including food insecurity, low literacy, homelessness, and disabilities.

Program impact includes the facilitation of more than 7,300 anxiety, depression and adverse childhood experiences, or ACE screenings, over 400 staff/volunteer and community member trainings, and nearly 20 community events across New Jersey, California, and Florida.

“Without the grant funding, there would be no access to therapy services. In a post-Covid world, there has never been more need for mental health services, both therapy and medication. We are making a difference because of the grant,” said Greg Speed, Counselor at Cape Volunteers in Medicine in Cape May Court House, New Jersey.

Visit TevaUSA.com to learn more about the Community Routes program, including a video highlighting the many voices behind the grassroots-focused program.

The 2023 grantee clinic recipients to receive continued funding through Community Routes are outlined below with an overview of their recent focus and impact made in their local communities to-date.

FLORIDA

• University of Florida Mobile Outreach in Gainesville, Florida – Create and disseminate evidence-informed, easily accessible mental health wellness curriculum and training to underserved populations via trusted community members through a mobile outreach model.
• Grace Medical Home in Orlando, Florida – Expand an existing program that proactively identifies trauma and offers individualized interventions through an integrated, whole-person, multi-disciplinary approach to improve health outcomes.
• • Talbot House Ministries of Lakeland, Inc., in Lakeland, Florida – Support medication reconciliation services provided through the pharmacy, outreach and event coordination, and outreach to homeless encampments to connect with clinical services and referrals for mental health care, patient transportation, and education.

NEW JERSEY

• Cape Volunteers in Medicine in Cape May Court House, New Jersey – Improve mental and behavioral health access and treatment among at-risk populations by expanding depression and anxiety screenings. Funding also supports community events and outreach to identify community members’ mental and physical needs.
• Bergen Volunteer Medical Initiative, Inc., in Hackensack, New Jersey – Increase capacity and fill a much-needed gap in care for Spanish-speaking patients with depression and anxiety through the support of a bilingual mental health practitioner and telehealth services to help reduce stigma and barriers to care.
• Parker Family Health Center in Red Bank, New Jersey – Support a collaboration with the Mental Health Association of Monmouth County, which allows for a bilingual therapist to offer weekly counseling and the creation of mental health education to be shared at live community events, virtually and digitally.

CALIFORNIA

• Samaritan House in San Mateo, California – Support implementation of best practices in treating depression, anxiety, and trauma, as well as working with geriatric and immigrant populations. The creation of a student-led trainee program to expand group and individual services and the adoption of psychoeducational books, in native languages, to help promote awareness and reduce stigma.

• Symba Center in Apple Valley, California – Expand partnership with local behavioral health services organization to remove barriers and support successful, trauma-informed, mental and behavioral health care at a homeless shelter site.
• Westminster Free Clinic in Thousand Oaks, California – Offer a range of culturally and linguistically competent mental health services, including individual and peer support, and a training program that empowers parents to identify the early signs of mental health issues.
• Lestonnac Free Clinic in Orange, California – Establish protocols and formalize behavioral health program under a Behavioral Health Program Manager to provide care through a trauma-informed lens and create a mentorship program for behavioral health interns from local colleges and universities.
• Savie Health in Lompoc, California – Create a screening protocol for social determinants of health, depression, and anxiety and provide culturally sensitive resources and referrals to help patients overcome barriers to mental health care.

A full-scale war raged as Russia assaulted its neighbor by land, sea and air, forcing Ukraine’s population to hide from the bombing and shelling wherever possible. Many lives were still lost due to the lack of underground shelters or because shelters were locked, as happened on June 1 in the capital, Kyiv.

“Shelters must be accessible,” President Volodymyr Zelensky said later on national television. “The situation like last night in Kyiv, when people came to the shelter, and it was closed, must never happen again.” Three days later, media reported that 1,078 shelters had been inspected in the city, half of which were found to be in a non-operable condition – either unsuitable for use or locked.

Legacy of the Soviet Planners

Ukraine had actually been well prepared by the former Moscow-led Soviet authorities. For decades, planners built deep shelters under public buildings against potential attacks by mainly Western enemies. Many of these were Cold War-era radiation shelters, while others dated to WWII and earlier.

“They protected first against the Nazis, then the Americans and now against the Russians,” said the head of a medical organization that recently converted part of a long-disused bomb shelter in the eastern city of Kharkiv. Ten feet (three meters) below ground and with a thick concrete ceiling and walls, it now makes an ideal secure storage for valuable refrigerated medicines, including those provided by Direct Relief.

Some 350 miles (560km) to the west, in the city of Zhytomyr, a subterranean shooting range built under a school for Soviet military preparation courses underwent a huge transformation. Today, the long cavern and adjoining rooms totaling 13,000 square feet (1,200 m2) form a state-of-the-art shelter, refurbished since 2016 with UNICEF funding to enable 1,250 children to study even during emergencies.

The school’s director says she did not exactly have a premonition of impending full-scale war but a “sense of alarm” after hearing stories of colleagues about students scrambling for cover during shelling in Ukraine’s eastern Donbas region, which Moscow-backed rebels seized in 2014.

So she started a superior conversion of the basement, complete with a small kitchen and medical center – just in case. This paid off after the February 24, 2022 invasion, as Zhytomyr was subjected to multiple bombing raids and missile strikes.

“We would spend hours down here in winter, and we also let in neighbors, dogs, too – what else are you going to do during a bombardment?” says the director, who envisions that after the war, the shelter will function as a “second school” with a wide range of activities and sports classes.

Ukrainian authorities say almost 3,800 educational institutions have suffered from bombing and shelling, 365 of which were destroyed completely. According to the UN’s children agency, UNICEF, only a third of Ukraine’s schoolchildren currently study in-person, while the rest study online.

In the northeastern city of Kharkiv, Mayor Ihor Terekhov recently declared his intention to build Ukraine’s first completely underground school, without giving details.

However, schools and other institutions aside, public discipline has ebbed as wailing sirens warn of possible strikes, often several times a day. People got tired of traipsing below ground at all hours when often nothing happens, and many no longer react to the alarms – sometimes with tragic results.

“Ukrainians are already used to living in war conditions,” Ukraine’s DSNS civil defense service says on its website. “However, it is extremely important for everyone to remember that you should never get used to ignoring the Air Alert signal! The enemy is counting on this!”

Not Quite a Bomb-Shelter

There is a crucial distinction between an ukryttia and a bomboskhovyshche in the Ukrainian language, rendered in English as shelter and bomb shelter, with a corresponding difference in sturdiness, depth and effectiveness.

Igor Gresko, the director of the hospital in Okhtyrka in the northeastern Sumy region, must strike a balance between the two in safeguarding his staff and patients: Built in the mid-1980s, the five-story building has a large, partially reinforced basement complex just below ground level that can serve as a shelter – but only up to a point.

“If something really heavy hits the hospital, then it’s a grave,” he says in a blunt appraisal of its protective qualities. Nevertheless, he is obliged to evacuate patients to the ukryttia during threats to the town located 25 miles (40 km) from the Russian border.

Much of the hospital’s equipment is outdated and in desperately short supply, but it still managed to set up an emergency operating theater underground, complete with an incubator for newborns.

“It has to be at least as good as what we have upstairs,” says Gresko, only hours after the latest security alert, when explosive-laden suicide drones buzzed overhead until they were shot down: “No one slept much last night in Okhtyrka,” he adds.

The shipments contained 7.2 million defined daily doses of medication, including rare disease therapies, anticoagulants, cholera treatment medications, chronic disease medications, PPE, and more.

Hospital in India Increases Capacity for Infectious Disease Diagnosis

Direct Relief staff attended the inauguration of the new Direct Relief Centers of Excellence in Infectious and Respiratory Diseases at Deenanath Mangeshkar Hospital in Pune, India. This is the culmination of a three-year project increasing capacity for DMH as the country’s leading center of infectious and respiratory diseases.

The center now has improved diagnostic testing and state-of-the-art capability to process fast and accurate lab results, which guides treatment and ultimately drives positive health outcomes and helps tackle challenges like drug-resistant infectious diseases. DMH is now also one of the few centers in the country with the capacity and capability to track COVID-19 and other viral variants.

DMH is one of the largest hospitals in Maharashtra and is a private charitable hospital, offering the same level of health services to everyone without exception and based on a sliding payment scale depending on ability to pay.

Direct Relief has provided more than $ 2 million in financial support to the hospital, including infrastructure and oxygen capacity and operational response for patient care during COVID-19.

Humanitarian Response to Israel-Hamas War 

The Gaza blockade resulting from the October 7 terrorist attack on Israel has halted established aid routes that, historically, have been the approved channels through which Direct Relief has provided medical aid to people in Gaza, consistent with U.S. law and the Israeli government’s approval.

As the stage is set for humanitarian aid to flow from Egypt into Gaza, Direct Relief is actively working to resume medical aid shipments in coordination with global agencies, including the World Health Organization (WHO) and the International Organization for Migration (IOM), and in accordance with U.S. sanctions and Israeli authorities’ approval.

Moreover, Direct Relief continues to support its longstanding regional partners, including Anera, an international nonprofit registered in both the U.S. and Israel, which has a long record of providing humanitarian assistance in Gaza, the West Bank, Jordan, and Lebanon.

Direct Relief has nine medical aid consignments prepared and ready to ship via air from its medical distribution facility to Gaza and the West Bank, which Anera requested before the terror attack last week by Hamas. Packed with essential medications, including chronic disease drugs, these shipments were placed on hold pending confirmation of their proper storage, safe transit, and pre-arranged clearances with Israeli and other relevant authorities.

Direct Relief has also approved a $100K emergency grant to help Anera evacuate its Gaza staff and support their ongoing efforts to assist civilians in Gaza amid a pressing and rapidly unfolding humanitarian situation.

This follows Direct Relief’s commitment of $1 million in financial assistance to Israel in response to last week’s terror attack by Hamas.

NGOs, Healthcare Companies Convene at Direct Relief

This week, Direct Relief hosted more than 100 attendees at its Santa Barbara, California, headquarters as part of the semi-annual meeting of the Partnership of Quality Medical Donations, or PQMD, an association of healthcare companies and NGOs focused on ensuring high standards in medical supply and service donations.

In addition to humanitarian nonprofit organizations, the meeting also included representatives from healthcare manufacturing companies, including Abbott, AbbVie, Amgen, BD, Baxter, Boehringer Ingelheim, Edwards, GSK, Hikma, Lilly, Medtronic, Merck, Pfizer and Vertex.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 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 641 shipments containing more than 12.1 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 16,600 shipments to 2,296 healthcare providers in 55 U.S. states and territories and 85 countries.

These shipments contained 435.8 million defined daily doses of medication valued at $1.7 billion (wholesale), totaling 5.3 million lbs.

in the news

Deenanath Mangeshkar Hospital opens new Centre for Excellence in Infectious Diseases tomorrow – Indian Express

Direct Relief prepares humanitarian aid for victims of Israel-Hamas war – KEYT

“No Justification For The Murder & Kidnapping Of Civilians,” SAG-AFTRA Says In Response To Hamas Attack On Israel – Deadline

Six reliable charities for those looking to help civilians affected by the Israel-Hamas war – Fortune

Santa Barbara–Based Efforts for Israel–Hamas War Aid Continue – Santa Barbara Independent

Direct Relief Reporting

Knoxville Nonprofit Bridges Language Divide in Latino Community – Public News Service

Healthcare and Housing. This Denver Health Center Offers Both. – National Association of Community Health Centers

Community Center Addresses Financial Insecurity’s Direct Impact On Health – Black Information Network

Direct Relief Commits $1 Million in Emergency Cash Assistance to Israel – ReliefWeb

However, with Israel’s announcement today permitting humanitarian aid to flow from Egypt into Gaza, Direct Relief is actively working to resume medical aid shipments in coordination with global agencies, including the World Health Organization (WHO) and the International Organization for Migration (IOM), and in accordance with U.S. sanctions and Israeli authorities’ approval.

Moreover, Direct Relief continues to support its longstanding regional partners, including Anera, an international nonprofit registered in both the U.S. and Israel, which has a long record of providing humanitarian assistance in Gaza, the West Bank, Jordan, and Lebanon.

Direct Relief has nine medical aid consignments prepared and ready to ship via air from its medical distribution facility to Gaza and the West Bank, which Anera requested prior to the terror attack last week by Hamas. Packed with essential medications, including chronic disease drugs, these shipments were placed on hold, pending confirmation of their proper storage, safe transit, and pre-arranged clearances with Israeli and other relevant authorities.

Direct Relief has also approved a $100K emergency grant to help Anera evacuate its Gaza staff and support their ongoing efforts to assist civilians in Gaza amid a pressing and rapidly unfolding humanitarian situation.

This follows Direct Relief’s commitment of $1 million in financial assistance to Israel in response to last week’s terror attack by Hamas.

The following five Israeli organizations will each receive a $200K grant for their efforts to serve Israel’s diverse population:

• Joint Distribution Committee (JDC): A century-old establishment, JDC is known for its global disaster responses. It aims to support hospitals in Israel to deal with the ongoing crisis.
• Magen David Adom (MDA): Founded in 1930, MDA serves as Israel’s principal organization for disaster relief, blood services, and ambulance transportation.
• NATAL: With over two decades in trauma treatment, NATAL provides invaluable support to those affected by traumatic incidents.
• United Hatzalah: Israel’s largest volunteer organization, United Hatzalah, offers quick emergency medical services nationwide. 
• ZAKA: Recognized by the UN, ZAKA Search and Rescue provides swift assistance during mass casualty situations globally and has paramedics ready throughout Israel.

The uninsured, underinsured, and those with private health insurance all have access to quality, affordable housing and integrated medical care in one of Denver’s oldest neighborhoods.

Through a multi-sector approach, a mixed-use structure of apartments, a healthcare provider, a pharmacy, and soon-to-be fresh produce grocery store are now offered in Denver’s Elyria- Swansea neighborhood. The structure is also two blocks away from the local light rail for those who use public transportation. In the coming year, affordable housing for people aged 55 and over and a community center are expected to open across the street. The cross-sector development approach is a nuanced solution to ongoing health and housing affordability issues in Denver’s growing metropolis.

In a 99-year land lease agreement with guaranteed renewal through Denver’s Urban Land Conservancy, the Tepeyac Community Health Center opened a new 24,500 sq. ft. building on Denver’s north side. The health center is connected to Viña apartments, a 150-unit complex with affordability options built by a Georgia-based developer.

In 2017, community survey data highlighted that 38% of respondents reported poor or fair health rather than good or excellent. Social determinants, like safe, quality housing, were a barrier to good health outcomes. At the time, residents said they lacked consistent transportation, employment opportunities and grocery stores that offered fresh food nearby. The new, commercial, mixed-use space grants the residents of Globeville and Elyria-Swansea areas access to affordable, healthy living without leaving their neighborhood.

So far, the new, integrated location has made all the difference.

When Janet Coupens had to leave work to fill a prescription by her doctor, it only took five minutes. The Community Manager at Viña Apartments said she only had to walk down a corridor to Tepeyac’s new health center for her prescription. In the past, it may have taken her an hour or more to travel and wait for care at a for-profit pharmacy.

Coupens said she’s seen the difference for her neighbors at Viña, too. When a child is sick, and a single mother must leave work to take them to the doctor, the ease of having a provider next door is helpful. Given that most of Viña’s residents don’t have cars, the ease of walkability increases the likelihood that residents will visit a physician when sick.

Tepeyac existed in the Globeville neighborhood for years, less than a 10-minute drive from their new location, which opened in February. The health center offers primary medical, behavioral, and dental services for free or at a reduced cost, and recently opened a pharmacy in September. Tepeyac’s President and CEO, Jim Garcia, said that moving to a new building was “years in the making” for their growing patient base.

Tepeyac served over 4,600 patients in 2022. Over 90% of their patients identify as Hispanic or Latino; most are best served in a language other than English. Garcia said that many are undocumented immigrants and, in the past, have not had access to healthcare. According to the 2017 community survey, Hispanic respondents reported being at-risk for diabetes at almost double the rate of non-Hispanics in the Denver area.

In 2020, state government approved a new program that offered subsidized health insurance to low-income, undocumented people called the Colorado Health Insurance Affordability Enterprise, or HIAE. At the time, the state only had enough funding to supplement healthcare for 10,000 undocumented immigrants, and policymakers have been working to expand access since the Senate bill passed.

There are over 3.2 million residents in the Denver metro area, and researchers anticipate over 900,000 more residents by 2050. According to the Denver Metro Chamber of Commerce, rapid population growth throughout the metro area and record increases in rental prices and property values, have caused a housing crisis, leaving few affordable options for working people. In a white paper published by the Chamber, researchers say they expect it will take 100 years to provide enough affordable housing for the metro area.

The Elyria-Swansea neighborhood is on the northern edge of Denver, and the area of single-family homes and the once prominent downtown area was divided by I-70, according to a 2018 Neighborhood Field Guide by the Neighborhood Association. Since the neighborhood’s heyday, the area was industrialized, causing environmental health concerns and limited employment opportunities.

Neighbors in the Globeville, Elyria-Swansea Coalition Organizing for Health and Housing Justice, say they have been promised equitable development solutions in the past that were supposed to provide employment opportunities but were only given empty promises.

The health center CEO agreed and said the area was “largely overlooked” for development opportunities for decades. He said only in the last few years has a “tidal wave” of high-rise apartments, cannabis dispensaries, and breweries opened in the neighborhood, neglecting the many ongoing needs of long-term residents. The increased tax base and gentrified area also threatened their ability to stay in the area.

However, the new Tepeyac building is a change for the better. Garcia said the partners involved held community meetings and asked for feedback about the development. Tepeyac also included a member of the GES Coalition on their board to ensure that the community was involved in decision-making processes.

Denver’s Urban Land Conservancy purchased the six-acre lot in 2015, and Aaron Miripol, the group’s CEO, said they wanted to work with a nonprofit to build something that would benefit the community. It took a year to change zoning requirements for the city to approve a mixed-use space. ULC chose Georgia-based Columbia Ventures to build and manage the apartments, which include one-, two-, and three-bedroom apartments.

Miripol said many of the apartments are secured for people earning at or below 30 to 80% of the Area Median Income. The partners used local funding repurposed through community development grants to subsidize the $57 million development.

“What was really critical was that we didn’t want to rely on vouchers,” he said. “There’s a large segment of that population that is undocumented, and because they are undocumented, they don’t have access to (housing) vouchers.”

As the Urban Land Conservancy worked to address zoning laws, Tepeyac and Columbia Ventures began conversations with the community to determine the wants and needs of the residents.

Dillon Baynes, co-founder and managing partner of Columbia Ventures, said there was a lot of mistrust among the community as the state made changes to widen the interstate, the construction of which had already divided the neighborhood, and additional neighborhood changes, like building a bridge and an amphitheater, that the residents had not asked for.

“There were a number of executions, and the neighborhood felt that it was being foisted upon them that they may not have desired that change at that level, so we came in at a time when they felt exhausted,” Baynes said.

Like their partners, Miripol said that including the community in the development phase was important to understand their wants and needs. He said that other developments had influenced involuntary displacement.

“There’s a number of communities that we’re seeing displacement and gentrification, and it kind of feels like this might be the epicenter,” Miripol said.

Even the structure of the building was important to the neighborhood. While the density of the number of apartments was important to offset costs, residents didn’t want a high-rise building looming over the existing single-family homes. The partners commissioned a local artist to add details on the building’s exterior and were intentional about how entry points to access the health center, pharmacy and grocery store.

Tepeyac stood as the trusted community partner throughout the development process. Garcia said their goal was to create a safe and welcoming environment that is echoed within the new building. The CEO said it’s best if patients want to see providers at Tepeyac simply because they offer quality, culturally competent care, and not just because it’s the only option.

“Sometimes if you don’t have insurance, you just look for the last option or you’re just trying to get by,” he said.

Baynes said that the health center had to be “neighborhood facing” and that the affordable rents at Viña are sustainable to the neighborhood.

So far, the apartment complex is at almost 95% capacity. Coupens said most are occupied by families, and in the year-and-a-half that Viña has operated, most residents have renewed their lease.

“Someone was thinking outside the box and they did a great job,” Coupens said.

Direct Relief supports hundreds of federally qualified health centers in the U.S., including Tepeyac Community Health Center.

Family HealthCare is a comprehensive primary care clinic and federally qualified health center providing medical, dental, behavioral health, and optometric care in North Dakota and western Minnesota.

The health center serves 17,000 patients, and over the past 10 years, the Fargo-Moorhead area has become the home for over 6,000 people who are refugees or recently arrived in the United States, the majority of whom seek medical care at the clinic and include people who speak over 40 different languages.

The center offers medical interpretation in 10 languages, and racial and ethnic minorities, people experiencing homelessness, Indigenous peoples, and gender-diverse people comprise a growing proportion of the clinic’s patient population.

A community needs assessment done before the pandemic uncovered that one in five respondents had been told or diagnosed by a health professional that they had depression or stress disorders. Because people in the greater Fargo-Moorhead region face several barriers to accessing mental and behavioral health services, including language barriers, homelessness or lack of social acceptance, the clinic is expanding to meet those needs.

Family HealthCare received $200,000 from Direct Relief’s Fund for Health Equity, via Eli Lilly and Company, increasing behavioral health programs available at the clinic by providing services using telepsychiatry and adding social workers and community health workers to the team, thus doubling the current capacity to provide services to patients with behavioral health needs.

The shipments contained 11.5 million defined daily doses of medication, including cardiovascular medicines, vitamins, PPE, diabetes supplies, and more.

Supporting Medical Needs After Terror Attacks in Israel

In response to the terror attacks that occurred one week ago in Israel, Direct Relief has committed $1 million to support Israeli organizations providing emergency health and social services, several of which have requested assistance to secure needed health and medical essentials.

This commitment follows an initial grant announced this week to the Ashkelon Foundation, a nonprofit focused on health and well-being in southern Israel near the border with Gaza.

The foundation is supporting Barzilai Medical Center, a 600-bed hospital that received 250 patients in the first 12 hours of the attack, fifty of whom were in critical condition.

In addition to the $1 million in cash assistance, Direct Relief has offered its extensive medical inventories and other resources, including international logistics assistance needed to mobilize additional medications or medical commodities to assist with the crisis in Israel.

The blockade resulting from the terrorist attack has interrupted the long-established channels through which humanitarian assistance is provided to civilians in Gaza under the supervision and control of Israeli authorities. It is through these approved channels that Direct Relief has provided extensive ongoing humanitarian health assistance in recent years. When authorized humanitarian channels are reestablished to help innocent civilians in Gaza caught in the crossfire, Direct Relief is prepared to assist.

Read more here.

Tornadoes Touch Down in Florida

Tornados swept through areas of west Florida Thursday, with damage reported near the Tampa area, in Citrus, Pinellas and Pasco counties. Several buildings have been significantly damaged, and roads are closed across the region. A clinical site of Langley Health Services, located in Crystal River and which receives Direct Relief support, was destroyed.

Direct Relief has been in communication with the Florida Association of Community Health Centers, and will offer assistance as needs become known.

Direct Relief Hosts Emergency Responders for Training

On Oct. 11, 2023, Direct Relief hosted emergency responders from Los Angeles County EMS Agency Region I, which conducted a training onsite at Direct Relief’s Santa Barbara headquarters. During the session, Direct Relief’s Director of Operations Doug Froelich briefed the group about Direct Relief’s mission and operational capacity.

Safety-Net Clinics, Primary Care Groups Gather in California

This week, the National Association of Free and Charitable Clinics convened its 2023 Charitable Healthcare Symposium, which gathered free and charitable clinics from across the U.S. Direct Relief staff attended the conference, including President and CEO Thomas Tighe, who spoke at the closing session for the event on Friday.

NAFC and its members are part of the nation’s healthcare safety net, and Direct Relief has supported their work with donations of medicines and other medical products, emergency support, and funding. In total, Direct Relief has provided $1 billion in medical aid and $12.5 million in grant funding to hundreds of free & charitable clinics and charitable pharmacies.

Direct Relief staff also attended the California Primary Care Association’s annual conference in Los Angeles, where staff had the opportunity to connect with health centers across the state. In the past 15 years, Direct Relief has supported health centers in California with 15,300 shipments of prescription medicines and over-the-counter items, collectively valued at $125.7M, and $20.6M in cash grants for disaster response, health equity, and resilient power, and chronic disease management programs.

Speedrun Colosseum Raises Support for Emergency Response

More than $35,000 was raised for emergency response efforts after speedrunners convened in Las Vegas for the the second annual Speedrun Colosseum live-streamed gaming event. The event featuring some of the world’s best video game speedrunners and was streamed on Twitch, the leading social video platform and community for gamers.

This year’s event was hosted by longtime speedrunner Asa “Spikevegeta” Tims and featured 30 of the world’s most talented gamers who perform intense challenges and complete games as quickly as possible, including top performers for the popular new releases Elden Ring and The Legend of Zelda: Tears of the Kingdom. The event has raised $100,000 for Direct Relief since it began last year.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 9.8 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 433 shipments containing more than 8.6 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 16,600 shipments to 2,296 healthcare providers in 55 U.S. states and territories and 85 countries.

These shipments contained 435.8 million defined daily doses of medication valued at $1.7 billion (wholesale), totaling 5.3 million lbs.

in the news

Israel–Palestine: How to Help the Victims of This Week’s Deadly Attacks – Harper’s Bazaar

Israel-Hamas conflict: here’s how you can help – TimeOut

Gaza–Israel Conflict: Top-Rated Charities Providing Aid – CharityWatch

How aid groups are responding to the Israel-Hamas war, and where to donate – ABC 7 Chicago

The Artists Behind Hypeart’s ‘Love Letters to LA’ Charity Exhibition – HypeArt

How to help victims of war in Israel, Gaza – WPTV

Here’s how you can help those impacted by the Israel-Hamas war – Boston.com

How to help victims of the deadly Israel-Hamas conflict – ABC News

Sea Glass Festival donates to Maui relief – Coastal View News

LogiPharma USA 2023: Jenifer Smith Talks About Direct Relief – Pharmaceutical Commerce

Comcast Donating $2M to Support Humanitarian Relief Amid Israel Crisis – The Hollywood Reporter

How to help relief efforts in Israel, Gaza – DC News Now

How to Help Civilian Victims of the Israel-Hamas War – The Cut

Israel-Palestine: How to Help the Victims of Yesterday’s Deadly Attack – Elle

Israel-Palestine: How to Help the Victims of the Deadly Attacks – Men’s Health

Trusted charities supporting the citizens of Israel and Gaza – Cool Mom Picks

Funding will be provided to Israeli organizations providing emergency health and social services, several of which have requested assistance to secure needed health and medical essentials.

This commitment follows an initial grant announced this week to the Ashkelon Foundation, a nonprofit focused on health and well-being in southern Israel near the border with Gaza.

The foundation is supporting Barzilai Medical Center, a 600-bed hospital that received 250 patients in the first 12 hours of the attack, fifty of whom were in critical condition. Medical staff continue caring for the influx of patients, even as rocket attacks have shaken the hospital, shattering windows in the children’s ward.

In addition to the $1 million in cash assistance, Direct Relief has offered its extensive medical inventories and other resources, including international logistics assistance needed to mobilize additional medications or medical commodities to assist with the crisis in Israel.

The following five Israeli organizations will each receive a $200K grant for their efforts to serve Israel’s diverse population:

• Joint Distribution Committee (JDC): A century-old establishment, JDC is known for its global disaster responses. It aims to support hospitals in Israel to deal with the ongoing crisis.
• Magen David Adom (MDA): Founded in 1930, MDA serves as Israel’s principal organization for disaster relief, blood services, and ambulance transportation.
• NATAL: With over two decades in trauma treatment, NATAL provides invaluable support to those affected by traumatic incidents.
• United Hatzalah: Israel’s largest volunteer organization, United Hatzalah, offers quick emergency medical services nationwide. 
• ZAKA: Recognized by the UN, ZAKA Search and Rescue provides swift assistance during mass casualty situations globally and has paramedics ready throughout Israel.

In response to the heinous attack on its people, Israel declared war on Hamas on Sunday, launching retaliatory airstrikes targeting the designated terrorist organization in Gaza and imposing a blockade of Gaza.

To address inquiries about its potential response to the humanitarian ripple effects of the terrorist attack on Israel, Direct Relief notes that the blockade resulting from the terrorist attack has interrupted the long-established channels through which humanitarian assistance is provided to civilians in Gaza under the supervision and control of Israeli authorities. It is through these approved channels that Direct Relief has provided extensive ongoing humanitarian health assistance in recent years, consistent with the requirements of U.S. sanctions law and with the consent and formal approval of Israeli authorities.

When authorized humanitarian channels are reestablished to help innocent civilians in Gaza caught in the crossfire, Direct Relief is prepared to assist through partner organizations such as Anera, a U.S. nonprofit organization with which Direct Relief has long partnered and has an extensive record of providing humanitarian aid in Gaza, the West Bank, and regionally.

Direct Relief will continue to extend assistance to people victimized by this unconscionable act of violence and respond to specific requests as they arise while monitoring the situation closely.

Tuesday’s commitment of funds will go to the Ashkelon Foundation, a nonprofit focused on health and well-being in Ashkelon, Israel, located in southern Israel near the border with Gaza.

The foundation is supporting Barzilai Medical Center, a 600-bed hospital that received 250 patients in the first 12 hours of the attack, 50 of whom were in critical condition.

Medical staff are continuing to care for the influx of patients, even as rocket attacks have shaken the hospital, shattering windows in the children’s ward.

The hospital has expressed an urgent need for funds to purchase emergency supplies and equipment to support patient care.

Direct Relief is also coordinating with other health-focused nonprofits in Israel to assess needs and direct support as requested. It will continue to respond to specific requests for assistance and provide additional updates as the situation evolves.

The death toll on Monday exceeded 2,400 and the quakes had left entire villages destroyed in the area 20 miles northwest of the city of Herat, located near Afghanistan’s western border with Iran.

Direct Relief has provided $16.3 million in medical aid since 2008, including to Afshar Hospital run by the Alliance for Medical Outreach and Relief. Direct Relief last shipped to the group in June 2023, and sent requested multivitamins and personal care items.

Shipments to the region have occurred on a much more limited basis since the country’s takeover by the Taliban in 2021. Direct Relief is contacting organizations still operating in the country to assess medical needs.

The organization will respond to requests for medical aid as they become known.