To equip healthcare workers outside of hospital walls, Direct Relief recently shipped Emergency Medical Backpacks to outfit first responders in Abyan Governate. Each ruggedized pack contains supplies and equipment to address common disaster-related health needs, including infection control, diagnostics, trauma care, and personal protection gear.

Direct Relief initially developed, designed, and field tested the Emergency Medical Packs 10 years ago specifically for first responders to have immediate access to appropriate, standardized gear when activated and deployed in emergencies.

The latest shipment of backpacks went to first responders from the group Yemen Aid, which operates mobile medical teams providing care in conflict zones across rebel-held territories, as well as isolated communities which lack access to even basic healthcare services.

With support from Direct Relief, Yemen Aid has distributed 57 tons of medical aid to healthcare facilities throughout the country. Despite the logistical challenges of delivering aid within a conflict zone, Direct Relief has shipped over 66 tons of medicines and medical supplies to Yemen over the past two years to local groups like Yemen Aid.

In addition to Emergency Medical Backpacks, Direct Relief has also shipped Emergency Health Kits, which contain life-saving essential medicines and supplies, and Cholera Treatment Kits to combat outbreaks of the disease.

The post Treating Patients Beyond Hospital Walls in Yemen appeared first on Direct Relief.

Tropical Cyclone Sagar is churning through the Gulf of Aden and is expected to make landfall on the coast of the Horn of Africa and parts of southern Yemen on Saturday, bringing with it high winds and heavy rainfall.

Direct Relief is in the process of moving medical material aid into the region which may be used by storm impacted communities in the coming weeks. Five pallets of hospital and fistula treatment-related medications and supplies are headed for Edna Adan Hospital in Somaliland, which is in the center of the predicted storm path.

A 40-foot container of medical goods is also bound for Borama Fistula Hospital in Borama, Somaliland, and for the maternity hospital in Tog Wajalleh, which is the only functional hospital in that area and may see a significant influx of patients, depending on the flooding impact.

A second container of medical products from Direct Relief arrived in the port of Aden in Yemen a few weeks ago, with another departing from Direct Relief’s warehouse this past Tuesday. These shipments contain mostly cholera prevention and treatment drugs and supplies as well as emergency response backpacks intended for use by partner organization Yemen Aid.

Cyclones in this part of the world are considered rare given the hot dry air which normally flows out over the Arabian peninsula and acts as a natural wall against storm formation. In this case, however, communities from southern Yemen into Djibouti, Somaliland and Somalia are expected to receive deluges equal to nearly a year’s worth of their total rainfall in only a few days, which would trigger high risk of flooding and landslides for some of the most vulnerable communities in Africa.

Current predictions are that six inches of rain could fall on the parched landscape of Somaliland just on Saturday. In many other parts of the world this might be a routine event, but the Horn of Africa is not only home to hundreds of thousands of people living in extreme poverty, it is also an area in extreme drought which limits the ability of the land itself to absorb large amounts of rainfall over a short time period.

In addition to the physical risk from extreme precipitation, there is significant concern that the sudden onset of wet conditions in the countries which border the Gulf of Aden may trigger a return of the epidemic cholera conditions which have prevailed throughout Yemen for nearly the past 18 months.

Yemen has been torn by conflict for the past few years, which contributed to a cholera epidemic that has been described by the World Health Organization as “the worst cholera outbreak in the world” affecting over 1 million people. The rate of new cases has slowed considerably since the onset of the dry season in January, but Cyclone Sagar would bring those more favorable conditions to an end, enabling a resurgence of this deadly disease.

The post Yemen, Somaliland Brace for Cyclone Sagar appeared first on Direct Relief.

In parternship with @DirectRelief, a 20 pallet Cholera medication shipment arrived to Al-Thawra Hospital in #Hodeidah City. #Yemen pic.twitter.com/f4HVpBKQZ2

— Yemen Aid US (@YemenAid_US) December 12, 2017

Hodeidah is a governorate that accounted for more cholera cases in 2017 (135,000) than were reported by the World Health Organization across the entire world during 2016 (132,000.)

The specific reason for this remarkably rapid spike has still not fully been absorbed, but hinges on severe damage to water and sanitation infrastructure, destruction of health facilities and sharp curtailment of the flow of people and goods into and out of war-torn communities.

The cholera epidemic in Yemen, now one of history’s fastest spreading, began a little over a year ago, in October 2016. The country’s civil war was over a year-and-a-half old at that point. A report on Oct. 6 from health officials in the country’s capital city of Sana’a indicated that 11 of 25 acute diarrheal disease cases had just tested positive for the presence of cholera. This was sobering news given the severely damaged conditions of health and sanitation services throughout the country, and the significant challenges posed to the movement of goods and people across the war zones, but it was not evidence enough in itself to forecast what would happen over the next year.

What began as 11 cases in the capital city in the fall of last year spread to over 35,000 cases over dozens of districts by late spring of 2017.

On May 22, the number of cases began a dramatic trend upward.

From then until the beginning of November, cholera has spread like wildfire throughout the country. That serious outbreak of 35,000 cases metastasized into a world historic event, with Yemen’s millionth suspected cholera case expected to be announced sometime before the end of 2017. Almost every populated area of the country has been touched by the disease, most particularly the densely settled coastal areas along the Gulf of Aden.

That shipment from Direct Relief, much like those of dozens of other aid groups, was delayed over the past few weeks by the imposition of a blockade on Yemen’s borders imposed by the government of Saudi Arabia.

Although the blockade on humanitarian goods has been partially lifted, allowing shipments like Direct Relief’s for cholera response to enter the country through two seaports or via UN air transport into the airport in Sana’a, the blockade remains in place for non-humanitarian shipments of goods. This remains a critical problem, given that over 80 percent of all food and medicine consumed in Yemen must be imported. The United Nations and other international agencies are calling for the blockade to be lifted entirely so as to avoid famine among roughly 8 million of Yemen’s 25 million citizens.

Famine is by no means a “natural” or inevitable occurrence. In the case of Yemen, it is the specific consequence of war tactics, which prevent citizens from accessing basic goods and services, placing them, in effect, into a state of siege.

In addition to the cholera outbreak and potential famine, Yemenis are increasingly at risk of additional infectious spread, including measles and a recently detected outbreak of diphtheria. Nearly 200 cases of diphtheria, a serious respiratory illness that can result in paralysis and death, have been reported as of Dec. 1. Diptheria and measles are both vaccine-preventable diseases, which disproportionately affect children. One of the key reasons they are spreading now is that vaccines, like other goods, have been prevented from distribution to health centers and hospitals, which would ordinarily conduct childhood vaccinations. With at least the humanitarian blockade lifted, now is a crucial time to ensure that these other infections do not spread the way cholera has over the past year.

Turning the Tide of Cholera

As terrible as this year has been for Yemenis afflicted by war, disease and poverty, there have been important, but underreported, signs of progress as well. One of the most significant is in the capital Sana’a, where the outbreak began. Sana’a’s case totals were on a steady linear ascent, similar to many of the surrounding governorates, when in late summer of this year an enormous acceleration occurred. Aid was mobilized relatively quickly, including a widespread awareness campaign, and that huge spike was blunted. Cases continue to increase, but at a much slower pace than would have occurred in the absence of timely action. By the end of August, the UN was reporting reductions in cholera incidence, and not only in Sana’a.

Perhaps even more important has been the total flattening out of death totals from cholera in Sana’a. Since this past August, not one death from the disease has been reported in the capital, indicating again that timely medical intervention works. With the year coming to a close and the winter months holding additional challenges, it is vital that we in the international humanitarian community do all that we can to build on the successes that have occurred in Yemen, and make sure that 2018 represents a year of recovery and rebuilding rather than a year of famine and worsening epidemics.

The post Cholera Treatment Supplies Arrive at Yemeni Hospital appeared first on Direct Relief.

This surge of activity arrives alongside an array of equally daunting and growing long-term crises throughout the world that require significant attention, careful thought, and enormous resources. Regardless of the immediate news cycle, the need for humanitarian services globally has in many ways never been greater.

Direct Relief, along with colleague and partner organizations, remains deeply committed and involved in a large number of these ongoing events.

For a sense of the scale and scope of contemporary crises, here’s a brief and very partial survey of some of the key locations across the global humanitarian landscape and Direct Relief’s role in response:

Bangladesh: The Cox’s Bazar district in southeastern Bangladesh has seen an influx of nearly a half-million Rohingya Muslim refugees from neighboring Myanmar. Hundreds of thousands more are on the way and arriving daily.

Cox’s Bazar is home to many different refugee settlements. Discussions are now underway to merge a number of the Rohingya areas into what would become the world’s largest refugee camp. Even so, conditions in the camps are reported as being extremely harsh, with overcrowding, infectious disease transmission, poor nutrition, water and sanitation, and lack of physical security.  Flooding disasters and the coming Indian Ocean monsoon season compound what is already a dire situation that may become the largest humanitarian crisis in Bangladesh’s history.

Direct Relief is supporting Hope Hospital in Cox’s Bazar, near one of the largest refugee areas, with medical material focused on improving maternal and child healthcare, as well as increased mobile healthcare for the Rohingya.

East Africa: Drought and conflict across the East African region, from Somalia and Ethiopia to South Sudan, Uganda and northern Kenya has produced one of the world’s worst refugee crises, as well as massive increases in reported malnutrition and infectious disease. In northern Uganda, a continuing flood of refugees from South Sudan, now well over a million people, has transformed the rural hamlet of Bidi Bidi into a teeming city of the displaced.

Were it not for the size of the Rohingya crisis, Bidi Bidi would be considered unquestionably the largest refugee camp in the world, by a pretty significant margin.

Direct Relief continues to provide essential medical aid to people in northern Uganda and South Sudan through our partner Real Medicines Foundation, which acts on behalf of UNHCR as the lead healthcare implementer for the Bidi Bidi camp.

Madagascar: A fast-moving outbreak of pneumonic plague has killed 63 people and sickened hundreds of others over the past few weeks. Ordinarily, plague is a vector disease spread through rodents and tends to be restricted to remote areas.  In this case, a more serious version is spreading through airborne transmission and is threatening to spread to Madagascar’s cities, evoking urgent comparisons to the Ebola outbreak in West Africa.

The World Health Organization and Medecins Sans Frontieres emergency health teams have been dispatched to the country, and Direct Relief is in consultation with the country’s ministry of health and the United Nations Populations Fund regarding health commodity needs required to treat plague victims, protect health workers and halt the spread of the disease.

Yemen: A seemingly intractable civil war in the Middle East’s most impoverished country, which has taken on significant regional implications given direct military involvement by countries like Saudi Arabia, has resulted in the world’s largest infectious disease crisis. A massive cholera epidemic continues to tear through Yemeni communities.

The outbreak is nearing 1 million cases, including 600,000 children. Logistical blockades have fueled this crisis, but the World Food Programme and the UN Logistics Cluster have been leading efforts to open up aid flows. Direct Relief continues to work with UN partners to move cholera response kits to healthcare providers including Save the Children.

United States: An epidemic of addiction and overdose from opioid painkillers has arguably become this country’s most pressing public health crisis since the emergence of HIV/AIDS in the 1980s and 1990s.  According to the U.S. Centers for Disease Control and Prevention over 90 people are dying every day in the United States from opioid overdose, with rates of opioid overdose having increased over 400 percent annually since 2000.

Direct Relief is continuing to work with Pfizer and with community health centers throughout the country to improve awareness of the problem and increase the supply of the life-saving anti-overdose drug Naloxone.

As the unremitting 2017 hurricane season hopefully draws to a close over the next few weeks, Direct Relief will be helping to bring public attention back to these and many other areas of humanitarian work, which require all of us to remain engaged for the long term in improving the lives and well-being of the world’s most vulnerable people.

The post Beyond Hurricanes, Earthquakes and Fires: The Other Humanitarian Crises appeared first on Direct Relief.

Cholera is spreading so fast that the World Health Organization was forced in July to cancel a planned million-dose cholera vaccination campaign. The WHO judged that the epidemic was spreading too fast for a vaccination campaign to make enough of an immediate impact to justify the security risks amid ongoing conflict.

As a result, the WHO and other global health authorities are urging a rapid and distributed scale-up of conventional infection control methods, including water purification and aggressive rehydration.

While the ongoing armed conflict in Yemen compounds the difficulty of controlling the epidemic, it is still possible to get assistance to areas in need. Several national and international NGOs like Save the Children are providing essential aid in the most affected areas, and Direct Relief is continuing to supply critical medical resources needed to treat cholera.

In February of this year, the UN Secretary General announced that over 20 million people in four countries from West Africa to the Middle East were on the cusp of famine. The four countries of Nigeria, South Sudan, Somalia and Yemen all share a tragic confluence of conflict, drought and disease, which accelerates underlying issues of poverty, inequality and weak infrastructure at sufficient scale to create conditions for what the UN and many others soon named “the worst humanitarian crisis since WWII.”

Since February, conditions for these four countries have not markedly improved, nor have humanitarian funding targets come close to being met. For Yemen, the poorest country in the Middle East, famine only accelerates the country’s descent into crisis. At the end of May, the cholera epidemic in Yemen was already quite serious but still within manageable bounds, with over 35,000 suspected cases and 361 total deaths. Since that point, the cholera epidemic has reached runaway proportions as the world’s fastest moving and deadliest infectious disease outbreak.

The country has averaged over 5,600 new cases and almost 20 deaths every single day. As of Aug. 13, there were 503,484 suspected cases and 1,975 confirmed deaths, with no end in sight. Yemen’s total population is a little more than double that of Guinea’s, but the rate of disease transmission remains highly alarming. Compared to Ebola, controlling cholera should be straightforward. There wasn’t a vaccine at all for Ebola, for instance, during the 2013 outbreak. Ebola treatment also calls for stringent quarantine procedures and measures to protect health workers that go well beyond the requirements of cholera.

Given that cholera is a bacterial infection associated with contaminated drinking water and poor sanitation, basic handwashing, access to clean water and timely medical treatment can halt the formation and spread of the disease. More than 99 percent of people sick with suspected cholera and who are able access health services are now surviving, according to a July 26 statement from UNICEF, WHO and the World Food Programme.

As simple as these steps may be, they still require security for health workers and sufficient medical resources, both of which are in short supply in Yemen. Direct Relief continues to supply partners in Yemen with cholera treatment kits that enable care for hundreds of patients. The kits were designed using WHO guidelines for cholera treatment and prevention. The next Direct Relief shipment is scheduled to arrive in the coming weeks, and is being coordinated with the World Food Programme.

The risks can’t be overstated. At the same time, the cost of inaction is steep. If the global health community is not able to act soon, Yemen could find its place among history’s worst infectious outbreaks.

The post Cholera in Yemen on Track to Kill More People Than Ebola Did in Guinea appeared first on Direct Relief.

Cholera causes its victims to experience diarrhea and vomiting, leading to severe dehydration, which can often be fatal. The disease can crop up when local water supplies are compromised, and areas without safe water or sanitation can see a rapid spread of cases.

The problem can become even worse when displaced people live in close proximity to each other in overcrowded shelters or camps.

Using World Health Organization guidelines, Direct Relief designed a prepackaged kit containing all the necessary supplies to treat 100 cholera patients. Each kit has a wholesale cost of $5,500, breaking down to $55 per patient.

A severe case of the disease can become deadly within hours, but with access to safe drinking water and a few common medical supplies, such as oral rehydration salts and IV fluids, most of those who are infected can be easily treated.

Over 50 items are included in Direct Relief’s cholera treatment kit, each part of which works to:

Rehydrate a patient – Rehydration is the cornerstone of cholera treatment.  Oral rehydration salts provide the patient with the essential salts and fluids needed to treat moderate cases of dehydration.  According to the CDC, if administered in a timely manner with clean water, rehydration salts will reduce fatalities to under 1 percent of all patients. Intravenous fluids also rehydrate patients with extreme cases of dehydration, who are unable to drink water without vomiting, immediate intravenous rehydration is necessary.

Kill any infection present in the body – Key antibiotics like doxycycline and azithromycin are used to shorten the duration of diarrhea in severe cases and when IV solutions and rehydration aren’t enough to fight off bacteria.

Protect the patient and others from spreading the disease – Because cholera is highly contagious, it’s imperative that healthcare workers and other patients from also being exposed. Personal protective gear like gloves, coveralls and soaps accomplish this. Keeping drinking water safe also prevents the disease from spreading. World Health Organization-approved water purification tablets are included in each kit to purify drinking water.

Two of these kits have recently gone to places like South Sudan, a country torn apart by war and famine. Internally displaced people who have left their homes, out of fear for their safety or a lack of food, often arrive en masse to poorly equipped refugee camps, where cholera can spread.

Direct Relief is also shipping cholera treatment kits to Yemen, which could see as many as 300,000 cases over the next six months, according to the World Health Organization.

The deadly disease is easily treatable, with the right supplies at the right time. Direct Relief will continue to send cholera treatment kits across the world, wherever and whenever, they’re needed most.

The post Cholera Treatment Kits Provide Inexpensive, Yet Life-saving, Medical Aid to Those in Crisis appeared first on Direct Relief.

Two Yemeni hospitals will receive the items, many of which are critical medicines useful for treating cases of cholera, a disease that has increased exponentially over the last several months.

As of June 13, almost 130,000 suspected cholera cases have been registered across the country, a number that could double over the next six months.

The number of suspected cholera cases continues to escalate at an “unprecedented” level, according to the World Health Organization.

The country has seen outbreaks of the disease, which results from poor sanitation and lack of access to clean water. Lack of access to healthcare, political instability, damaged infrastructure and famine have all contributed to the spread of the disease.

One of the hospitals receiving half of Direct Relief’s shipment is Amran Hospital, where health staff reported to Direct Relief their highest concern is treating the cholera cases that come through their doors.

Patients with infections and emergency traumas were also being treated in high numbers at the hospital.

Al-Salakhanah Hospital, where the other half of the shipment will go, also reported cholera cases as their top concern, as well as malaria, dengue fever, traumas and severe malnutrition.

To deal with these health concerns, Direct Relief’s shipment contains two Cholera Treatment Kits, each of which contain items like antibiotics, IV solutions, and water purification supplies.

Each kit will enable hospital staff to treat 100 cholera patients.

Hospital staff also specifically requested fetal dopplers to help monitor the heartbeats of unborn babies. Direct Relief sent six of the machines, which are powered by rechargeable batteries. Because power is also a concern, a solar suitcase has also been included in the shipment.

Hospitals like the two receiving this latest shipment are administering daily care to Yemenis in the midst of dire humanitarian crisis. Many hospitals in the country are not functional, placing enormous pressure on hospitals with their doors still open.

Over 17 million people in Yemen face high levels of food insecurity. The famine has been coupled with political disruption, making aid direly needed but difficult to get into the country, with the airport into the country’s capital destroyed during the ongoing conflict.

Direct Relief has partnered with Save the Children Yemen to get medical aid into the country, and sent a shipment in early March full of critical medicines and supplies, which went to Sana’a Governorate Alghemhori Hospital to assist providers treating patients. That shipment was taken into the country on a World Food Programme flight from neighboring Djibouti, a route providing safe passage.

Save the Children has reached nearly 1.1 million people in Yemen, delivering vital medical supplies among other resources to those who need them most, and Direct Relief will continue to support the group.

The post Direct Relief Bolsters Yemeni Hospitals with Much-Needed Medicines appeared first on Direct Relief.