“We couldn’t do anything,” said Shrestha, a physician and professor at Dhulikhel Hospital and Kathmandu University Hospital.

In Nepal, which shares a long and porous border with India, Covid-19 cases are surging. As bad as official numbers are, the reality is likewise worse. Testing, particularly in rural areas, is limited, according to Dr. Aban Gautam, president of the aid organization Mountain Heart Nepal.

Dhulikhel Hospital has been conducting free community Covid-19 testing in an effort to help gain control of the situation. Their positivity rate is an astonishing 60-65%, Shrestha said.

In general, said Andrew Schroeder, Direct Relief’s vice president of Research and Analysis, Nepal’s overall test positivity rate of approximately 44% “means they’re really only testing symptomatic people…That will mean that things are much more widespread than anything you have data about.”

The country is experiencing approximately 296 cases daily per million people as of May 18, compared to India’s 231. “It’s now overtaken India in terms of all the key metrics per capita in the current Covid pandemic in South Asia,” Schroeder said.

None of the 150 beds that Dhulikhel Hospital has designated for Covid-19 patients is currently available, Shrestha said, and “there is a pile of cases waiting for a bed in our emergency room.”

That’s the case all over Nepal, according to Gautam. “The problem we are facing now is mostly lack of hospital beds, particularly ICU beds, because of the increasing number of cases,” he said. “We are even getting the news that people are dying in ambulances, trying to get a bed.”

In addition, oxygen is increasingly hard to come by, Gautam said. People who can afford to purchase oxygen concentrators are disproportionately likely to have access to them, making them an increasingly precious resource. “People are dying from lack of oxygen,” he said.

A Changing Pandemic

The providers and aid organizations interviewed for this story all expressed particular concern for rural communities, where testing, masks, and oxygen are harder to come by.

“It’s a very mountainous and remote country, and getting care out to people in the remote areas is really challenging,” said Arlene Samen, founder and chief visionary officer of the aid group One Heart Worldwide.

That means, also, that getting sick individuals to much-needed – and scarce – hospital beds has proven difficult. Mountain Heart Nepal has been providing medical assistance to people being airlifted to a hospital bed, Gautam said.

Although Nepal is currently on lockdown, Shrestha said Covid-19 is spreading rapidly from urban centers to rural areas, as people lose employment in the cities and return to their homes in the villages.

“This lockdown will not help to break the chain of transmission,” he explained. Instead, more testing – which encourages people to stay in their homes and to seek medical attention – is needed.

In addition, where Nepal’s first wave of Covid-19 was particularly devastating for older adults, Shrestha is seeing more patients of younger ages succumb to the disease. He described losing five patients, of ages ranging from 20s to 40s, that same day. “They don’t have other comorbidities,” he said. “They just lost their life [to] Covid-induced pneumonia.”

Responding on the Ground

A Direct Relief-charted aircraft departed for Nepal on May 25, carrying 860 oxygen concentrators, along with PPE and medications donated by a number of corporate partners to meet requested needs. The medical aid will be distributed to several Nepal-based organizations, including Dhulikhel Hospital, One Heart Worldwide, and The Covid-19 Crisis Management Center. These organizations will distribute the donated support to Nepali hospitals and health centers.

Direct Relief’s partners on the ground are mounting their own ambitious responses. One Heart Worldwide will distribute medications and supplies on behalf of Nepal’s Ministry of Health and Population to the districts most in need of support.

Samen, who has worked closely with the Nepali government for years, said that the current situation reminds her of the devastating 2015 Nepal earthquake. “It feels like there’s that kind of chaos and overload on the health care system,” she said. “There’s just so many people dying, and they don’t have a place to put them.”

In addition to testing, Shrestha said, Dhulikhel is providing Covid-19 care to patients at its 18 rural health centers, where the hospital has set up isolation areas. Dhulikhel is also working with patients who are recovering from Covid-19 at home, providing medical counseling and psychosocial support.

“We have 20 dedicated people who are working day and night” to help patients recovering at home, Shrestha said.

Direct Relief will contribute a grant of more than $100,000 to fund a new oxygen plant that Mountain Heart Nepal is building to provide a reliable oxygen source for nearby hospitals and communities.

But Gautam points out that Nepal needs help now, and the oxygen plant will be ready in about two months. Mountain Heart Nepal is responding directly to the crisis, distributing PPE and medical equipment – including Direct Relief oxygen concentrators – to hospitals, and providing schools and rural communities with masks.

The organization’s doctors are providing medical for patients while they are airlifted to hospital beds. Gautam explained that the process primarily involves maintaining oxygen saturation, monitoring vitals, and making sure patients are hemodynamically stable. And for patients isolating after a Covid-19 diagnosis, they’re providing mental health support as well as directing them to much-needed resources, including food. They’re also providing food, prenatal vitamins, and IV fluids to vulnerable Nepali communities.

“It’s really important that we focus on those things as well,” Gautam said.

Shrestha didn’t shy away from the terrors of the pandemic. “I feel helpless,” he said. “People are deteriorating and losing [their] lives.”

But he grows more adept at treating patients as Covid-19 wears on – and it’s taught him valuable lessons.

“This pandemic taught me to be a human, a good human,” he said.

The post On the Ground, Fighting Nepal’s Covid-19 Wave appeared first on Direct Relief.

Hospitals across Nepal are nearing ICU and ventilator capacity and struggling with severe shortages of oxygen and other medical resources. Helping meet the acute need for oxygen, the May 25 flight from Chicago to Kathmandu will deliver 860 Direct Relief-purchased oxygen concentrators. Direct Relief is also helping secure a sustainable supply of medical-grade oxygen in Central Nepal by funding a new oxygen production plant at Siddhasthali Rural Community Hospital.

“On behalf of the Government of Nepal and the Embassy of Nepal in Washington, DC, I would like to express my gratitude to Direct Relief for responding to our request for humanitarian medical relief at a time when Nepal is undergoing through the most difficult phases of the ongoing pandemic,” said Dr. Yuba Raj Khatiwada, Ambassador of Nepal to the United States. “I would like to assure all individuals and organizations concerned that the Embassy of Nepal in Washington, D.C. is committed to providing all necessary coordination and facilitation to Direct Relief, including in customs clearance, receipt and distribution of donated medical supplies once delivered in Nepal.”

In addition to oxygen, the 25-ton Direct Relief airlift will include PPE and medications contributed by companies including 3M, AbbVie, Baxter, BD, Hikma Pharmaceuticals, Pfizer, Takeda Pharmaceuticals, Teva Pharmaceuticals, Tifie Humanitarian, Viatris, and others. Nepali health officials expressly requested and approved every item included on the flight.

“People in Nepal are facing the worst Covid crisis in the world today based on per-capita confirmed cases, and they need urgent help,” said Thomas Tighe, Direct Relief President and CEO. “Direct Relief has the privilege of having worked with many extraordinarily skilled and committed Nepali partners, and we will do whatever we possibly can to help. We are profoundly grateful to the people and businesses whose contributions have made this airlift possible.”

Nepal-based organizations, including One Heart Worldwide, Dhulikhel Hospital, and The Covid-19 Crisis Management Center, will receive the Direct Relief-donated supplies in Kathmandu and distribute them to hospitals and clinics throughout the country.

The humanitarian flight to Nepal follows two FedEx-donated airlifts that transported more than 4,000 oxygen concentrators and nearly 2 million KN95 masks to neighboring India. Direct Relief partnered with several organizations, including Community Partners International, Cornell Presbyterian Hospital, Navya, Northwell Health, and Tata Memorial Hospital, to mobilize and deliver the supplies.

Ambassador Statement

Click to access Statemnt-to-Direct-Relief-from-H.E.-Ambassador-1.pdf

The post Direct Relief-Chartered Airlift Bound for Nepal Amid Covid-19 Surge appeared first on Direct Relief.

Like the rest of his team, Dan Hovey, an emergency response manager at the nonprofit organization, was fielding requests for ventilators, PPE, and other Covid-19-related medical aid from all over the world. But One Heart Worldwide, a maternal health aid group and long-term Direct Relief partner, was asking for something else entirely: misoprostol, a lifesaving drug that’s used to stop postpartum hemorrhage, and that plays an essential role in preventing maternal deaths.

The medicine was intended for Nepal, where it’s an important part of the government’s strategy to prevent maternal deaths across a mountainous, geographically diverse region where help isn’t always close by or easy to reach. The pandemic was making misoprostol hard to come by – and in the process, endangering Nepali women.

A Large-Scale Effort

When it comes to preventing maternal deaths, Nepal has made significant strides in recent decades. According to the Nepal Demographic and Health Survey, the country’s maternal mortality ratio, measured at 529 deaths per 100,000 live births in 1996, decreased to 239 in 2016.

The government has placed birthing facilities in remote communities all over the country, and staffed them with skilled birth attendants. Trained female community health workers, so women are educated about safe and healthy births. Made maternal health services free of cost. Created waiting homes for women preparing to deliver – making it more likely that a woman will make it to a skilled birth attendant in time.

One Heart Worldwide has been working with the Nepali government since 2010 to improve maternal and child health outcomes. Direct Relief has been involved with those efforts since the 2015 Nepal earthquake.

Partnering with One Heart Worldwide, Direct Relief spent $775,000 over four years to build, repair, and equip public birthing centers in rural Nepal, as well as train skilled birthing attendants to staff them. The organization has also donated more than $1.7 million in medical aid to One Heart Worldwide since the earthquake.

“One of the big problems in Nepal is the lack of infrastructure,” said Arlene Samen, a maternal-fetal medicine nurse practitioner and the founder of One Heart Worldwide.

Samen explained that the country’s altitude, mountainous terrain, and lack of paved roads in some areas make local, easily accessible birthing facilities a necessity.

As part of its strategy to combat maternal mortality, the Nepali government piloted a program to give misoprostol to women unable to access a birthing center – so that, if the need arose, women could take the medication themselves.

“Nepal is the country that proved that misoprostol can be safely distributed,” said Surya Bhatta, executive director of One Heart Worldwide in Nepal.

Pandemic Threats

But Covid-19 has threatened those gains. A study in the Lancet found that, over the course of four months in lockdown in Nepal, the number of births in government institutions dropped to less than half of their previous levels, although Bhatta explained that local community birthing facilities have actually seen an increase in attendance.

“There are a lot of women in rural Nepal who remain unable to come to the health facilities to deliver their babies,” he said. “We hear of a lot of maternal deaths. We don’t feel it’s right to just stay quiet” and not help.

To save lives, the government has begun instructing female community health volunteers – an important resource in Nepali health care – in the majority of Nepal’s 77 districts to distribute misoprostol directly to women who have completed their seventh month of pregnancy. (The districts are ones in which numbers of home deliveries are high.)

Fifty-five districts are currently receiving misoprostol through these highly trusted educators and counselors. In every town or village, Bhatta said, a female community health volunteer “is a well-known person. She knows more than anybody in her community.”

A Vital Shortage

But the pandemic has also made it harder to get misoprostol in Nepal – and Samen said there have been reports of deaths specifically due to postpartum hemorrhage during home births.

Although Direct Relief maintains a large medical warehouse, the organization didn’t have misoprostol on hand.

But Hovey didn’t want to give up. He asked a colleague to reach out to a long-term partner – the pharmaceutical company Pfizer – to see if they were able to donate the medication.

Pfizer generously donated more than 34,000 doses of misoprostol, which Direct Relief sent to Nepal in late January.

“Direct Relief always comes through when we have challenges that are beyond our control,” Samen said.

Bhatta stressed that, even with essential medications and high-quality facilities, there’s a long road ahead.

“The needs are so great, the geography is so challenging, the literacy, the poverty…it is really difficult to deal with maternal death,” he said. “It takes a village to save a mom.”

The post Shortages of a Lifesaving Medication Threatened Mothers in Nepal. Direct Relief Is Sending 34,000 Doses. appeared first on Direct Relief.

Emergency Response

Direct Relief conducts its emergency relief efforts in the following stages: immediate (emergency response), short-term (disaster recovery), and long-term (disaster mitigation and preparedness).

1. Immediate Response: Only Sending What Is Needed

Immediately after the April 25 earthquake, Direct Relief began communicating with partner hospitals and health facilities in Nepal to identify their most critical needs. Thousands of people had been injured and displaced, and still-functional hospitals and clinics were overwhelmed with patients. That meant that, while there was an increased need for health services, the capacity to provide such care diminished substantially.

Direct Relief worked rapidly to mobilize emergency medicines and medical supplies for emergency medical teams and Nepalese-based organizations and health facilities responding to the disaster.

Also, through its preparedness program, Direct Relief had on hand many of the medical items required in disasters where trauma injuries, wound-related infections, dehydration, and conditions are prevalent. This program, which involves healthcare companies donating specific items to hold in inventory for disaster response purposes, enables wound care products, antibiotics, IV solutions, surgical supplies, orthopedic casting materials, and medications for diabetes and cardiovascular issues to be available for shipment immediately following a disaster.

Since the first earthquake struck Nepal, Direct Relief has delivered 144 tons of specifically requested medical material resources valued at $29 million. Direct Relief distributed these donated medicines and medical supplies to hospitals, emergency medical teams, medical outreach camps, and Nepalese NGOs caring for survivors.

In addition to donated medical resources, and based on requests from Nepal’s Ministry of Health and Population and the Emergency Operations Center, Direct Relief purchased medical supplies and equipment in India, which were delivered and distributed to specific district and referral hospitals. These items included critical care equipment such as ventilators and x-ray units, medical and surgical supplies such as orthopedic implants and hardware, and safe birth kits for use by midwives caring for pregnant women.

Facilities and organizations in Nepal that have received emergency shipments of medical material resources from Direct Relief include:

2. Short-Term Response: Anticipating Health Needs

A precise projection of health needs requires assessments that are not always possible while an emergency is still unfolding. However, the rapid provision of healthcare-related resources and support is critical to ensure that disaster survivors receive appropriate and adequate care and to prepare for the rehabilitation of the healthcare infrastructure.

Patients with severe injuries require effective care throughout the treatment and rehabilitation period. People suffering from chronic medical conditions must resume their medication and testing regimens. Those living in temporary shelters must contend with crowded and unsanitary conditions that can lead to outbreaks of life-threatening respiratory and water-borne diseases. And, in the case of Nepal, living conditions and access to medical care and resources have been significantly impacted by monsoon season rains.

To visualize the earthquakes’ impact, obtain updated information on local needs and conditions, and help identify critical issues requiring consideration in short- and long-term recovery efforts, Direct Relief used specialized Geographic Information System (GIS) software to develop a series of maps.

The mapping exercise – Open Data: Nepal Earthquake 2015 – uses a variety of data sources to understand better the changing needs and conditions in Nepal. Attributes include the location and intensity of aftershocks; where the greatest numbers of injuries occurred; the extent of damage to roads, airports, health facilities, and other infrastructure; physical locations of vulnerable populations; environmental concerns such as landslides and flooding; and the presence of health facilities and organizations.

The mapping tool provides valuable insight into earthquake-related needs and circumstances and enables Direct Relief to make more informed decisions regarding response efforts.

3. Long-term Response: Sustaining and Rebuilding the Health Infrastructure

A major emergency often requires substantial repairs to infrastructure repair, and this need is particularly acute within the health sector as disasters often severely damage health infrastructure and medical facilities throughout the health system. After the 2010 Haiti earthquake, Hurricane Sandy, 2012 Japan earthquake and tsunami, and the Ebola crisis – Direct Relief observed local groups doing great work to help survivors, but rarely did these groups even make it onto the radars of international donors. In each instance, as in Nepal, Direct Relief identified and provided such groups with cash grants to cover response-related expenses.

A deciding factor in the selection of grantees is whether they focus on the long-term treatment and care of people with disabilities. Direct Relief’s experience in post-disaster situations has reinforced the importance of supporting the institutions and services that provide specialized care for people who have suffered severe traumatic injuries.

To help strengthen and rebuild the health system in Nepal, Direct Relief has identified, vetted, and supported the following locally-run organizations:

Story of Survival: Ram

Ram was home with his wife, mother, and other relatives. His mother was working outside when she felt the earth move. As their home collapsed, she witnessed it bury her son and daughter-in-law. She raced to them and managed to move enough debris to spare the lives of Ram, his wife, and several others. Tragically, Ram’s grandmother was killed that day, and Ram suffered a spinal cord injury resulting in paralysis from the waist down.

Ram was hospitalized for several weeks before transferring to SIRC, where he has remained for roughly three months.

Ram has been making excellent progress at SIRC. He received a wheelchair customized for earthquake-affected patients who live in rural areas. The three-wheeled chair allows its owner to travel longer distances with less fatigue in hilly and off-road conditions. Ram has been learning to use his wheelchair through daily training sessions in both indoor and outdoor courses.

Ram’s wife has been staying with him at the facility, learning about his condition and helping to care for him as he moves through the comprehensive rehabilitation program. They are both optimistic about the future, and grateful for the care and support that they are receiving at SIRC.

Story of Survival: Indira

Indira, who was pregnant and just a few weeks away from the delivery of her first child, was home with her family when the earthquake struck. Their poorly constructed house collapsed instantly, crumbling around them. Falling debris killed Indira’s mother-in-law, and Indira suffered a spinal cord injury. Other family members were fortunate enough to escape with only lacerations and broken bones.

Neighbors helped to free Indira from the rubble, and after waiting for many hours, she was finally transported to Tribhuvan University Teaching Hospital in Kathmandu. Despite the severity of her injury, she received some good news at the hospital. Indira suffered an incomplete spinal cord injury, meaning that some feeling or movement was still evident below the point of injury. With considerable rehabilitation, she would be able to walk again. She also learned her unborn child hadn’t experienced any trauma or significant health-related problems.

Indira stayed at the hospital for eight days to ensure that she was in stable condition. She then transferred to SIRC and was instructed to rest until the baby was born. After two weeks of being cared for at SIRC, Indira was brought to another Direct Relief partner, Dhulikhel Hospital, where she gave birth, via C-section, to a healthy baby boy.

Indira has returned to SIRC for rehabilitation treatment. Her mother and husband have taken turns staying at the facility and helping her care for the child. Her recovery may be gradual, but thanks to SIRC, Indira should be able to return to her daily life.

Financial Support

Individuals, foundations, and businesses entrusted Direct Relief with a total of $6,524,979 to help people affected by the earthquake in Nepal, and Direct Relief has restricted every penny for that exclusive purpose:

Of the total Nepal-designated cash contributions received to date, Direct Relief has spent $2,292,275 on earthquake response activities and support of local Nepalese groups to improve the health and lives of people affected by the earthquakes.

Looking Forward

Direct Relief is committed to working with healthcare facilities and public health agencies in Nepal to provide intermediate and ongoing health care for earthquake-affected communities, and to rebuild and strengthen the country’s healthcare infrastructure.

On behalf of those who have benefitted from Direct Relief’s Nepal Earthquake Response efforts, thank you for your compassion and generosity.

The post Nepal Earthquake Response: Six Month Report appeared first on Direct Relief.

As of 11:55 a.m. local time on April 25, 2015, health indicators in Nepal were trending in the right direction. Maternal mortality had decreased in the country by 70 percent in the 17 years between 1993 and 2010. And compared to a child in 1996, a child in 2011 was twice as likely to live past the age of five.

Then, at 11:56 a.m., progress stalled. Upwards of 750,000 people lost their homes, 17,000 people suffered injuries, and 8,600 people died from what emerged as the most devastating earthquake in Nepal’s history.

Financial Summary

Direct Relief recognizes that the generous supporters who made financial contributions to Direct Relief following the earthquake in Nepal did so for the clear purpose of assisting people in Nepal.  In accepting funds for Nepal, Direct Relief understands that both those who contributed and people in Nepal for whose benefit the contributions were made deserve to know, in detail, how Direct Relief is using these funds.

Three months into the response, this report offers a summary of Direct Relief’s activities to assist people in Nepal affected by the Earthquake and support ongoing recovery efforts.

Nepal Earthquake Donations

Direct Relief has received more than 17,000 Nepal-designated financial contributions totaling $5,508,005.

100 percent of contributions received for Nepal are restricted for the exclusive use of assisting people affected by the earthquake in Nepal.

Who donated to the response?

Of the total amount of Nepal-designated contributions —

• $3,388,300 was contributed by 17,606 individuals,
• $1,834,741 was contributed by 167 businesses,
• $215,000 was contributed by 12 foundations, and
• $69,963 was contributed by 67 other organizations.

Direct Relief does not rely on any funding from government grants. 

How were donations accepted?

Of the total number of Nepal contributions, 92 percent (16,464) were made online. Online contributions totaled $2,084,605, or 38 percent of the total amount received.

Ensuring donors’ intent

Within 24 hours of the April 25 quake, Direct Relief modified its online donation page to ensure (1) that the organization’s policy regarding designated donations for the Nepal quake was prominently featured for all visitors and (2) that, before making a contribution, a person would be required to choose whether the donation was intended to be designated for Nepal or for another specified purpose or location.

This practice was adopted several years ago to avoid potential confusion about donors’ intentions, particularly following high-profile emergencies, which often spur spontaneous online financial contributions from the public wishing to help.  Direct Relief is obligated to honor the intent of donors who make contributions, and this practice ensures that donors express their intent when making a gift.

Per Direct Relief’s Privacy Policy, Direct Relief does not disclose donor information to any outside party. Direct Relief also has a policy of not sending mail to donors on behalf of other organizations.

How and for what purposes are the funds being used?

Of the total Nepal-designated donations received to date, Direct Relief has spent $2,700,365 or 49 percent on the following earthquake response activities:

• $710,699 to mobilize, transport, and deliver to health facilities more than 144 tons of specifically requested medical material valued at $28,982,827 – a ratio of $40 in medical aid for each $1 spent. This expense would be significantly higher, were it not for the emergency airlifts donated by FedEx and  in-country logistics provided free-of-charge by the World Food Program and the UN Humanitarian Air Service.
• $197,682 to purchase urgently needed, specialized medical equipment and supplies (including ventilators, digital x-ray machines, and surgical kits for orthopedic repairs)  requested by the Government of Nepal or individual facilities, and
• $1,791,984 to support – in the form of financial grants to organizations and health facilities in Nepal, outlined below — urgently needed services in the immediate term and to begin rebuilding or expanding essential services needed in the months and years ahead.
• $0.00 spent on fundraising or marketing activities.

All medical donations to Nepal are tracked and visible on Direct Relief’s Nepal Relief Aid Map. The values for medical aid donations are tracked, calculated on a daily basis, and displayed on the map. This means that the value will increase to reflect each additional shipment of medical aid into Nepal.

Earthquake Recovery Priorities

Direct Relief’s programmatic activities are devoted to immediate relief and health-focused efforts in affected areas. Consistent with Direct Relief’s organizational capabilities and resources, the remaining Nepal-designated funds will continue to support the following activities:

• Providing Medical Resources to Under-served Areas
• Supporting Long-Term Medical and Rehabilitation Services for Earthquake Survivors
• Rebuilding, Repairing, and Re-equipping Health Centers in High Risk Areas

1.  Providing Medical Resources to Under-served Areas

The outpouring of generosity following the earthquake — combined with guidance from local organizations and support from Nepal’s National Drug Administrator, Director of International Partnership for the Ministry of Health and Population, and the Director of the Department of Health Services Logistics Management Division – has enabled Direct Relief to fast-track 288,118 lbs. — more than 10 million Defined Daily Doses (DDDs) — of high-priority medications, supplies, and medical equipment to 51 recipient health facilities and organizations in Nepal.

These medical resources were donated by more than 60 health care companies and transported, in large part, aboard humanitarian charter flights donated by FedEx.

2.  Supporting Long-Term Medical and Rehabilitation Services for Earthquake Survivors

Earthquakes often cause traumatic injuries that, even if treated successfully, result in lifelong disabling conditions for the injured persons.  Direct Relief’s experience in post-disaster situations has reinforced the importance of supporting the institutions and services that provide the specialized care for such persons – and will do so for decades.  This has been a priority during the past three months, and Direct Relief believes this use of Nepal earthquake funds is important as it will provide essential long-term benefit to those left with disabling conditions from the quakes.

Direct Relief is supporting the Hospital & Rehabilitation Centre for Disabled Children (HRDC) and the Spinal Injury Rehabilitation Centre (SIRC) with medical materials and funding to sustain and expand these essential services.  These dedicated rehabilitation departments and facilities are essential to the health outcomes and quality of life for people who have sustained traumatic injuries.

The Spinal Injury Rehabilitation Centre (SIRC) was established in 2002 by Nepali nonprofit Spinal Injury Sangha Nepal. Spinal cord injuries (SCI) require specialized treatment and life-long management. SIRC is the only facility in Nepal that specializes exclusively in the rehabilitative care, treatment, education, and disability management of patients with spinal cord injuries.  Studies have shown that the mortality rates within the first year for patients who have sustained an SCI are dramatically reduced when access to a hospital-based rehabilitation department or national rehabilitation facility is established

Specializing in musculo-skeletal disorders, HRDC focuses its treatment and rehabilitation services on children below 18 years of age with priority given to those from disadvantaged backgrounds.  HRDC also conducts medical outreach missions throughout Nepal. These missions target children living in remote and underprivileged communities, where medical care is inaccessible.

3.  Rebuilding, Repairing, and Re-equipping Health Centers

The earthquake has severely impacted Nepal’s health infrastructure. A June 10th report on post-disaster needs by Nepal’s Health and Population Sector found that 462 of the country’s health facilities had been destroyed, while 765 were partially damaged.

In Nepal’s Dolakha District, 87 percent of healthcare facilities were damaged or destroyed, leaving 40 percent of the population without access to health services. To support the reconstruction and improvement of health infrastructure in Dolakha, Direct Relief is working  with Possible Health and the Ministry of Health and Population of Nepal (MOHP).

Meanwhile, in Dhading and Sindhupalchok districts, between 65 and 75 percent of health facilities were destroyed completely. The consequences extend beyond those who suffered injuries in the quake. In post-disaster situations, pregnant women and children are often excluded from the immediate recovery plan. A combined 16,000 women in the two districts give birth each year. Without sufficient health services, many women have no alternative but to deliver their children in makeshift shelters or unsafe conditions.

To help restore maternal and neonatal health services in Sindhulpalchok and Dhading districts, Direct Relief is supporting its longtime partner One Heart World-Wide with grants to renovate five damaged facilities into certified birthing centers, equip 35 birth centers, and build 45 health posts. The grants will also enable training for 80 skilled birth attendants and educate 1,300 community health volunteers in safe motherhood practices.

Earthquake Recovery Grants: By the Numbers

Direct Relief has granted a total of $1,791,984 to the following local groups and organizations that are providing essential services for earthquake survivors:

*Direct Relief had committed $70,000 to support One Heart’s work, but the planned activities have been superseded by the profoundly changed circumstances caused by the earthquake.  Direct Relief agreed with One Heart’s recommendation that those previously committed but not fully spent funds be redirected and used as part of the broader plan developed over the past three months for the same purposes of bolstering maternal health infrastructure in Dhading and Sindhupalchok districts. 

The post Nepal Earthquake: Where the Money Goes appeared first on Direct Relief.

“Women feel neither safe nor secure, and midwives– also victims of the quake — lack sufficient medical commodities,” said Kiran Bajracharya, President of MIDSON.  “I express my sincere gratitude to Direct Relief and ICM. Their support means that midwives in Nepal can provide survivors with respectful care.”

Since the earthquake struck Nepal on April 25, 2015, Direct Relief has delivered 60 tons of medical supplies and medications to several hospitals and other sites throughout the country.  With guidance from ICM and other Nepal-based organizations, Direct Relief is preparing additional deliveries that include tents to serve as birthing centers and pregnancy-specific medical supplies, delivered by One Heart World-Wide.

The post Nepal: Midwives’ Chronic Needs Become Urgent After Earthquakes appeared first on Direct Relief.

Materials Breakdown:

(NOTE: Defined Daily Dose (DDD) is a standard unit of drug utilization maintained by the World Health Organization. The DDD measures the recommended maintenance dosage of a drug for its’ primary indication in an adult for one day.)

• 118,771 pounds, 165 skids, $14,801,378.00 value, 6.2 million defined daily doses (DDD) of medications, which include:
  • 40,000 DDD of antibiotics that include amoxicillin, azithromycin, clarithromycin, ceftriaxone, cephalexin, doxycycline, gentamicin, and levofloxacin
  • 15,000 DDD of cardiac medication such as enalapril and nifedipine that reduce the risk of stroke and heart attack by treating high blood pressure, congestive heart failure, and other heart problems
  • 220,000 DDD of analgesics such as acetaminophen, celecoxib and propofol
  • 28,000 DDD of esomeprazole and lansoprazole to help prevent stomach problems caused by pain medicine
  • More than 2 million DDD of glipizide to treat type 2 diabetes

Medical Aid Enroute from India

In response to a direct request from the Nepal Ministry of Health and Population and their Emergency Operations Center, Direct Relief purchased US$260,000 worth of materials in India through Doctors for You. The supplies were then sent from Delhi to Kathmandu.

Items include:

• 5 Digital Xrays (Siemens)
• 5 Ventilators (Drager)
• Implants and Orthopedic supplies equipment
• Medicines and medical supplies

The medication/supply items were flown free of charge on Jet Airways from Delhi to Katmandu and arrived on Saturday, May 9 at 08:50.  The larger equipment items and orthopedic supplies were trucked overland from Delhi to Katmandu via three trucks and arrived in to Katmandu on the evening of May 9.

Safe Birth Kits for One Heart Worldwide

Direct Relief has procured 1,500 safe birth kits ($7,000) from a company in India. These will be trucked to One Heart from India next week. Another 10,000 kits will be available in the next two weeks. One Heart estimates there will be 16,000-20,000 deliveries in two of the hardest hit districts – Sindhupalchok and Dhading – where they work.

The post Nepal Earthquake Response: Situation Report, 5/11 appeared first on Direct Relief.

The charter carries aid from three relief organizations – Direct Relief, Heart to Heart, and Water Mission.

The plane from Memphis will land in Dubai, U.A.E, where it will meet additional relief supplies. Teams on the ground will prioritize the most urgent shipments and the plane will quickly turn around and head into Kathmandu. Relief teams in Nepal are standing by to offload and distribute the  supplies.

The same plane will return to Dubai to reload another completely full flight. It will then head back to Kathmandu to deliver the rest of the supplies. The FedEx donated transportation and logistics services amount to more than 178,000 pounds of relief supplies for Nepal in the coming days.

Supplies from Direct Relief are valued at nearly $15 million and include prescription medicines, IV solutions, anti-infective agents, gloves, nutritional products, wound care supplies, and medical equipment. The breakdown of materials are as follows:

• 118,771 pounds, 165 skids, over 6 million defined daily doses of medications
• 20 hospital tents with solar lighting to facilitate safe births
• The shipment will support 6 hospitals in and around Katmandu, 5 emergency medical teams, One Heart Worldwide, and the Ministry of Health.

The post FedEx Airlifts Two Planeloads of Relief for Nepal appeared first on Direct Relief.

Medical resource needs:

• With hospitals operating beyond capacity, medical tents are required in all affected areas (WHO 03/05/2015).
• Medical professionals also note a limited availability of rehabilitation services, the need for psychosocial support, long waits for surgeries, and an acute need for surgical equipment and supplies (WHO 03/05/2015).
• Moreover, there are reports from Gorkha and Sindhuli districts of influenza and diarrheal cases (OCHA 02/05/2015).

Direct Relief’s response:

Approximately 50 tons of requested medical materials departed Direct Relief’s warehouse today for Nepal.  Thanks to a donation by FedEx of a charter flight, the supplies will ship on Friday to help replenish the country’s depleted medical inventories.

The shipment includes:

• • Ministry of Health and Population (MoHP)= 55 pallets 
    • 50 pallets of IV solutions
    • 5 pallets of medications (antibiotics, pain relief) and supplies (gloves, IV tubing)
  • 5 Hospital Modules = 36 pallets
    • Dhulikhel Hospital = 10 pallets
    • Hospital and Rehabilitation Centre for Disabled Children  = 7 pallets
    • Katmandu Model Hospital = 6 pallets
    • Himalayan Healthcare = 5 pallets
    • Nepal Orthopedic Hospital = 8 pallets
  • One Heart World Wide = 15 pallets
    • 10 pallets of medical tents, to be used as birthing centers arrived from Utah today; 5-6 pallets of medications and supplies
  • 5 Medical teams will receive a 1-pallet shipment per specific orders. The teams include
    • MERCY Singapore
    • LBDFI
    • Medical Teams International
    • Sri Sathya Sai International
    • Maiti Nepal

Direct Relief’s cargo with five mechanical ventilators and five portable X-ray machines is arriving this week.

• • After a series of meetings and conference calls involving the Direct Relief team in Nepal, the MoHP and various hospitals in Nepal, and distributors and vendors in India and Kathmandu, a final list of critically needed items was agreed upon by all parties for Direct Relief to purchase in India and deliver to Nepal.
  • The total cost will be $260K for the urgently requested items, which are broken out in general categories in the table below.  Roughly one half of the expense ($143K) is for 5 Siemens Digital x-ray units and 5 Drager ventilators (unit brochures attached); with the remainder for orthopedic supplies and an extensive list of medications and consumables.

Funding:

A conservative number for planning purposes has increased to $1.85 million for Nepal.

The post Nepal Earthquake Response: Update 5/5 appeared first on Direct Relief.

Humanitarian charter a go:  Direct Relief has confirmed the donation of a humanitarian charter for Nepal. At this point, Direct Relief will use at least one-half of the plane’s capacity (102 “skids”), which may increase depending the space needed by a colleague nonprofit.

Emergency procurement of medical equipment:  As noted yesterday, when the Ministry of Health requested specific items and approved and pre-cleared their importation, they also asked for specific items that Direct Relief does not have in inventory (ventilators, fixation devices for fracture repair, imaging equipment, etc.)  Given the inflow of financial contributions, Direct Relief is procuring these items with a portion of the available funds and advised the MOHP of this.

Direct Relief’s team in Nepal met again with Ministry of Health officials to inquire if they had specific, pre-approved in-country vendors or suppliers, and if that is a more straightforward path. (We want to ensure that, if any equipment is procured, it is approved for use in the country and has a service contract and authorized techs in Nepal. This is to ensure the equipment can be repaired and serviced, if the need arises.)

Scaling plans to meet the health care needs in Nepal:  At this point, Direct Relief has revised its budgeting scenarios with the assumption of at least $1.5 million in designated funding. Direct Relief has begun an initial allocation for how these funds will be best used to assist Nepal in the most productive manner.

The availability of the charter is a huge force-multiplier. It allows Direct Relief to plan around transport costs, which are often among the largest expenses.

Direct Relief’s immediate focus includes:

• Procurement of specifically requested, high-priority equipment for the MOHP and other partners (several hospitals with which Direct Relief has been working on Fistula Repair have asked for similar types of items.)

• Emergency Airlift: Given the huge volumes of materials that Direct Relief has on hand and have been specifically requested by the MOHP and, increasingly, by partners as events unfold.  We’re working through the details now to sequence the flow of materials requested through available transport channels. The materials exceed 100 tons (200,000 lbs, most of which is IV solution) and have a high financial value (likely more than $50 million, with most of the value based on large volumes generic medications donated by Teva, Mylan, Actavis, and other generic producers.)

• Financial support to existing partners: Direct Relief is supporting the urgent requirements of existing partner organizations, including OneHeart and the hospitals with which Direct Relief has already been working on emergency obstetric care. We understand the important role they already were playing, and that they now are called upon to do even more.  These partners focus on women and children’s health, and because those particular people were already among the more vulnerable in Nepal, they are even more so now, so we believe that it’s important to shore up their programs.

Funding: The reddit community has raised more than $130,000 for Direct Relief’s earthquake response and comprises more than 30 percent of the 10,000-plus donations for Nepal.

Direct Relief’s response is only possible thanks to the generosity redditors and each person who’s lent their support.

Thank you.

Update: 4/29

Direct Relief staff met today with the Ministry of Health (M0H) in Nepal, which requested more than 320,000 lbs. (approx. 500 4x4x4 skid spaces) of medical items from Direct Relief’s available inventory. The MoH confirmed both the need for the specific items and a willingness to fast-track pre-approved items through customs. Direct Relief also met with the National Drug Administrator and the Director of International Partnership for the MoH, who both affirmed the Ministry’s need for such items and confirmed their importation requirements.

These approvals are essential at this stage of the response, as the typical bottle-necking that occurs post-disaster is occurring, and the offloading capacity at the airport, limited storage, and damaged roadways – as well as the unique topographical environment in Nepal – create significant challenges for in-country distribution.

Meanwhile in Dhading, a three-hour drive from Kathmandu, teams from Direct Relief and One Heart delivered emergency medical supplies to Besi District Hospital. While the hospital suffered only minor damage, it faces an average surge of 270 patients a day, up from 100. Undersupplied and underfunded even before the quake, the hospital is extremely low on basic medications and supplies such as antibiotics, IV solutions, and bandages. Patients, who before sought treatment for fractures and orthopedic surgeries in Kathmandu, now receive care in the hospital’s halls and outside.

With a large proportion of homes collapsed or visibly cracked, and people forced to sleep on the street for a lack of safe shelter, the team noted little improvement outside the hospital. People in remote areas are unable to reach hospitals for needed medical care, which makes doctors wary that more serious complications or outbreaks of cholera or other infections could take root.

Infusing essential medical material. Direct Relief, as one of the main channels for humanitarian medicines and supplies, is in discussions with the Ministry of Health and other agencies to provide medical material support at a national level. Meanwhile, Direct Relief has sent several emergency medical deliveries with teams bound for Nepal, with several more planned in the coming week.

Supporting local organizations. Direct Relief supports local organizations that focus on Maternal Child Health, specifically safe deliveries, and fistula repair.  Depending on the availability of funds, Direct Relief will provide the direct financial support necessary for rebuilding damaged/destroyed delivery centers and facilities.

Information gathering, sharing, coordination.  Working with NetHope members, Direct Relief developed a mobile app to conduct assessments of general facility status and capture specific health needs (screenshots below).  The app enables offline data collection (i.e. when a device is not connected to a network) and location information, which can be subsequently shared when connectivity exists.  Data will be automatically geo-tagged and published on the Esri platform.  The app and all information collected will be publically available and broadly shared.

For more information, visit reddit to read Direct Relief CEO Thomas Tighe’s candid “Ask Me Anything” on the response.

Direct Relief extends its deepest thanks to everyone who has supported the effort thus far.  Your support is critical to the many thousands of survivors of this devastating tragedy.

Update: 4/28

In Nepal: Direct Relief’s emergency response team is in and around Kathmandu.  They are connecting today with Doctors for You, a highly regarded partner organization that Direct Relief funded to deploy to the region.

The UN has activated its “cluster” system, which serves as the convening mechanism to (attempt to) coordinate information sharing and activities among various UN agencies with different responsibilities and assets as well as international organizations.  Direct Relief attended yesterday’s Health and Logistics cluster meetings, and then were scheduled to with the Ministry of Health to ensure Direct Relief’s resources and activities are delivered and conducted appropriately and guided by the local considerations.

Direct Relief is in regular communication with long-time partner One Heart Worldwide, a group with a strong presence in Nepal. One Heart has generously made available their facilities in Kathmandu as a temporary base of operations for the Direct Relief team.

One Heart Worldwide works in two districts of Nepal. In one area, 10 of the 20 birthing centers they staff (at Ministry of Health facilities) are utterly destroyed, and the other 10 are significantly damaged.  Overall, more than 70% of the structures in the 400,000 district had been destroyed, according to One Heart staff.

Emergency Shipments for Medical Teams En-route:  Direct Relief packed and delivered emergency shipments for two Nepal-bound medical teams yesterday, with several more in the works.  The two groups include:

• Reach Out World Wide: Eight trained doctors, firefighters, and paramedics are traveling to Kathmandu, Nepal today (Tuesday, April 27) to operate a pop-up clinic in a remote area of the disaster-affected region. Direct Relief has outfitted ROWW with more than 350 pounds of antibiotics, wound care, IV solutions, and other medicines and supplies.
• Mammoth Medical / World Wide Trekking: Four physicians and support staff are traveling to Nepal to provide surgical care to survivors of the earthquake.  Volunteers will be working out of Manamohan Memorial Hospital in Kathmandu, which is reportedly overwhelmed with patients and without internet communication. Direct Relief is shipping 250 pounds of antibiotics, wound care, and other needed medicines to support the mission.

Other activity: Direct Relief is in regular communication with roughly one dozen partner organizations based in Nepal, many of which are working to collect complete information, and other international organizations with which Direct Relief  often works such as NetHope, the consortium of Tech Companies and colleague nonprofits.

Medical Resources: Current, available inventory includes 300 pallets of materials that are likely to be needed and are being made available, include:

IV solutions (60 4x4x4 pallets total, estimated weight 108 – 120,000 lbs.):

• 48 pallets – sodium chloride .9%
• 10 pallets – dextrose/dopamine
• Two pallets – gentamicin

Hospital supplies (50 Pallets total):

• Gloves, surgical supplies, orthopedic splints and braces, IV tubing, masks, wound dressings, needles and syringes.

Rx Medications (primary care):

• Ceftriaxone INJ
• Antibiotics/Antibacterials – azithromycin, amoxicillin, doxycycline, sulfamethoxazole/trimethoprim
• Antifungals (ketoconazole)

Rx Medications (chronic care):

• Pravastatin and Simvastatin for managing cholesterol
• Antihypertensives – Amlodipine, Lisinopril, enalapril
• Mental health – fluoxetine, venlafaxine

OTC pain relief medications:

• Adult – 350,000 bottles (40 pallets)
• Pediatric – 170,000 bottles (10 pallets)

Hygiene/personal care items:

• Vaseline petroleum jelly, lotion, lip balm
• Bar soap (70 cases/1 pallet)
• Other OTCs: ulcers/heartburn:  Nexium (esomeprazole) and lansoprazole (total 45 pallets)

Healthcare Company Support: Direct Relief is in discussions with healthcare companies to mobilize wound care, sterile gauze, sutures and other items based on an initial assumption of 20,000 injured with an injury pattern consistent with prior earthquake events. This estimate will be refined as local partners make specific requests and a complete information becomes available, in addition to the obvious concerns about traumatic injury, infrastructure, contaminated water, power, fuel supply lines, etc.

Thank you to everyone who’s helped the effort thus far. Your support is critical, and it makes a difference.

Update: 4/27 – Direct Relief ups Commitment to $500,000 Cash for Nepal Earthquake Response

Donate Now

Direct Relief announced today an increase to $500,000 cash committed to the emergency response for the Nepal earthquake, up from the $50,000 announced initially on Saturday.

The increase reflects the urgency of the situation based on the still-unfolding information available, requests from longstanding partner organizations in Nepal, and the generous support that has been forthcoming from the public since Saturday’s quake.

As always, Direct Relief will use 100 percent of gifts designated for Nepal only for the response in Nepal.

Update: 4/26

While the situation in Nepal is still unfolding, initial assessments report more than 2,500 people killed, thousands injured, and hospitals and other medical facilities overwhelmed.

As has occurred in other major earthquakes to which Direct Relief has responded (Pakistan, Haiti, Indonesia), this quake has simultaneously created an enormous spike in need for emergency health services while destroying much of the already-inadequate health infrastructure through which such services are provided. The quake also has diminished the country’s general infrastructure (roads, power, water), which are needed to accommodate a much-needed surge in the support.

With news of the Nepal earthquake and in the subsequent hours, Direct Relief activated its emergency response effort and began contacting Nepal- and India-based healthcare partners to mobilize the resources needed to care for people in affected areas.

Direct Relief has a substantial medical inventory valued at over $100 million (wholesale), and yesterday made all of it available as needed for the response. Also, Direct Relief committed an initial $50,000 in cash — regardless of whether any specific Nepal-designated contributions are received — to jumpstart the response.

Direct Relief’s emergency response manager, Gordon Willcock, will be coordinating Direct Relief’s activities from Nepal, in concert with partner organizations and other international actors that also are responding. The general needs are evident and extreme, but on-the-ground coordination is essential to ensure that the resources being mobilized and delivered are targeted, well managed, and distributed efficiently within the very dynamic situation.

Since 2008, Direct Relief has delivered more than $1,000,000 of medicines and supplies to excellent, committed healthcare provider partners in Nepal, primarily those working to improve maternal and child health. The support has been ongoing, but also last year involved responding to massive flooding in the region.

With profound sadness for the tragedy that occurred in an instant yesterday, Direct Relief is responding as fast and expansively as possible to ensure that the effects of this disaster do not claim additional lives and to help those who have survived overcome the enormous challenges that exist and will remain for an extended period.

Those wanting to support the response can do so by making a donation here: http://bit.ly/nepal_quake

Donate Now

100 percent of donations for Nepal are used exclusively to help people in Nepal.

The post Nepal Earthquake Response Update appeared first on Direct Relief.

Upon learning of the devastating quake, Direct Relief contacted and offered assistance to several Nepal-based hospitals, delivery centers, midwifery programs, and other health-service delivery organizations, as well as partner organizations in India that are responding to the e​mergency. Included among them is Doctors for You, a highly regarded Indian organization deploying a medical team Monday local time.

“In Kathmandu Valley, hospitals are overcrowded, running out of room for storing dead bodies and also running short of emergency supplies,” the United Nations stated today in its situation report on the emergency. “There are reports that the hospital stocks are depleting/used up and there is a need for a government decision on bringing kits from the military.”

The UN report also noted most people are staying outside for fear of aftershocks.

As Direct Relief responds to the tragedy, it will do so in close collaboration with local groups and the government in Nepal, which have requested international assistance. Direct Relief will also continue to work with other international organizations involved in the emergency response.

The Need for Medical Resources

Direct Relief is working with many of the world’s leading healthcare companies, who have provided much of the inventory made available today.  Direct Relief will continue to collaborate with these industry partners to provide additional resources as needed. This may include materials for bone fractures, wound-care supplies, antibiotics, oral rehydration solutions, antidiarrheals, vitamins and nutritional supplement–each of which proved critical following disasters including the 2005 quake in northern Pakistan, which claimed 80,000 lives, and the massive 2010 earthquake in Haiti.

Anticipating Logistical Challenges

In this effort, Direct Relief draws on its experience aiding in the aftermath of a 2008 quake in Kashmir. Like then, this crisis will be characterized by the hugely complex logistical challenge of responding to the unfolding emergency in both cities and remote mountainous rural villages. The emergency response will be centralized in severely affected urban centers, and decentralized in remote and inaccessible rural villages.

The emergency response in Nepal will be particularly complex given the high altitude and mountainous terrain, the landslide damage to road infrastructure, the lack of landing access for fixed-wing and rotary wing aircraft in remote areas, the damage to communication lines, and the distances between affected communities.

Coordinating with Local Responders

Recognizing this complexity, Direct Relief has reached out to the local organizations best positioned to understand local needs and inform external assistance.  Such groups include the following:

• One Heart World Wide
• Possible Health
• Doctors for You
• Himalayan Health Care

• Patan Hospital
• Rescue Network Nepal
• Fistula Treatment Centers in Nepal

Direct Relief’s initial commitment of $50,000 is from its general funds, and not dependent on whether the organization receives contributions designated for this particular event.  Moreover, consistent with the obligation to honor donors’ intentions,  100% of any and all contributions designated for Nepal by donors will be used exclusively for this purpose, not for the organization’s general support or other program activities.

The post Nepal Earthquake: Direct Relief Commits Initial $50,000 Cash to Emergency Response appeared first on Direct Relief.

• One Heart World Wide
• Possible Health
• Doctors for You (Indian Medical Team)
• Himalayan Health Care
• Patan Hospital
• Rescue Network Nepal
• SSSCT (Indian emergency response organization)
• Team Rubicon
• ROWW
• Fistula Treatment Centers in Nepal

The US Geological Survey recorded at least 12 aftershocks across the region, with additional reports of casualties in India, Bangladesh, and on Mount Everest. The government has declared states of emergency in the affected areas.

Since 2008, Direct Relief has delivered over $1,000,000 worth of medicines and supplies to its charitable healthcare provider partners in Nepal.

The post Nepal Earthquake: Emergency Update appeared first on Direct Relief.

When mothers and infants have access to a safe clean delivery with a well-equipped skilled birth attendant, they have a much better chance of survival. By equipping two birthing centers in two of the most remote areas of Dolpa district—where a combined average of 350 pregnancies occur each year—we hope to save many lives, both among newborn infants and among their mothers.

In Nepal, the further a mother lives from an urban area, the more likely she is to give birth at home. It’s critical that these women who are unable to reach hospital-based settings for labor and delivery are able to receive care from a trained birth attendant, midwife, or community health worker.

Currently in Dolpa, less than five  percent of all women in the areas where the birthing centers will be located  have access to skilled care during birth. Many contributing factors, such as lack of roads, unavailability of transport, and long distances from settlements to the nearest clinic limit accessibility to trained staff in health facilities. As a result, poor birth outcomes are common.

In 2012, the maternal mortality ratio in Dolpa was 1,259 per 100,000 live births and the neonatal mortality rate was 79 per 1,000 live births. These are among the highest maternal and neonatal mortality rates in the world.

Moreover, birth is considered impure in Tibetan culture and women are forbidden to deliver inside their homes. Instead they deliver in the nearest animal shed in dirty and cold conditions, unattended by a skilled birth attendant. Not surprisingly, the lack of cleanliness, the lack of skilled attendant and the cold often cause many women and babies to die of easily preventable conditions.

To help more mothers and babies survive, this project will focus on equipping two birthing centers in the townships of Saldang and Ringmo in Dolpa district and the training and equipping of a minimum of four skilled birth attendants to serve these communities. The District Health Officer (DHO) of Dolpa District will assist One Heart World-Wide in identifying eligible nurses and health workers to be trained as skilled birth attendants. Once trained, the local government has agreed to employee them.

In addition to the two birthing centers where women can access basic obstetric care, the project will provide a functional referral system for emergency conditions, a postpartum observation unit (non animal shed) for mothers and newborns.

The post Ensuring Safe Birth Practices in Western Nepal appeared first on Direct Relief.

“Our goal is to strengthen the web of care for Tibetan women and children by helping One Heart mobilize available resources and implement their high‐impact program throughout rural Qinghai,” said Direct Relief President and CEO Thomas Tighe. “We’re pleased to take the lead funding role to support One Heart in China on this effort. We’ve worked with One Heart before, and their team has a history of implementing successful programs and saving lives.”

One Heart World-Wide is the only U.S.-based nongovernment, nonprofit organization chosen by the U.S. Ambassador to the People’s Republic of China to provide maternal and newborn care to the impoverished Yushu Region in Tibet’s Qinghai Province. As there is little or no access to transportation, medical facilities or trained health personnel, 100 out of every 100,000 pregnant women dies in childbirth and 20 out of every 1,000 newborns dies in infancy. Qinghai University Hospital provided on-site maternal care and some outreach to remote Tibetan communities for obstetrical emergencies before the earthquake. However, it is now faced with severely damaged facilities, depleted resources and few uninjured medical personnel. One Heart’s programs will address the core components of the local healthcare system that directly impact maternal and infant survival.

“Direct Relief’s support enables us to rapidly implement a program that has been proven to work in this very fragile environment,” said Arlen Samen, executive director and CEO of One Heart World-Wide. “During our ten years in Tibet, we developed a replicable, sustainable model that saved the lives of thousands of pregnant women and newborn babies. We can now begin our work in China to do the same.”

Samen founded OHW in 1998 to work with disadvantaged communities to raise awareness and teach good birth practices. In the 10 years that the One Heart program was active in Tibet, the number of women who died in childbirth annually dropped from 33 to zero. One Heart recently relocated its corporate offices to San Francisco, Calif. and manages close to $1 million in donations to support maternal-child health programs in China, Mexico, and Nepal

The post Direct Relief Grants $100,000 to One Heart World-Wide for Health Program appeared first on Direct Relief.

We met with several local NGOs who can receive funds; they have formed an organization to coordinate donations and distribution of supplies. A representative from USAID is coming tomorrow to meet with NGOs and the Civil Affairs Office to see about donating funds to buy basic supplies. Funding is needed the most to help people with immediate needs (food, shelter, water, blankets, solar generators, water purification, cooking utensils, headlamps, medicine). Long term, the entire town will have to be rebuilt. Many of the doctors died in the earthquake and medical teams are flying in to take care of the injuries that were not life-threatening.

We went to one of the hospitals today and met with several of the Tibetan families who had been rescued. Several women went into labor and were evacuated to Xining and gave birth, most of them lost everyone in their family, yet were so grateful to be alive. Everywhere in the hospital we saw families tending to the needs of their family members who were injured. I will find out later who can organize helping the families here in Xining. Everyone is homeless. There are many heartbreaking stories. The courage of the Tibetan people truly inspires me as they come together under such horrific circumstances. The hotel where we are staying has been filled with Chinese relief workers who are leaving in shifts with semi trucks filled with supplies.

It looks like we will be able to start our maternal-child health (MCH) project in the next couple of months. Once we get the project started we would like to be involved with setting up a MCH training center in Yushu. Most of the hospitals either collapsed or are badly damaged. At this time the government will have to rebuild everything. Literally, there are no undamaged structures left. I feel helpless in this moment and feel the best I can do is to help convey the message of what is needed. Our prayers and long-term support will help the Tibetans to rebuild their lives in this very fragile environment. So many people are traumatized; their faith keeps them strong.

With one heart and many hands,

Arlene”

The post Direct Relief Partner One Heart Reports from Tibet appeared first on Direct Relief.

Direct Relief is coordinating with Amitabha Foundation, One HEART, and Mercy Relief, which are sending emergency teams to China to assess damage and treat the injured.

Amitabha and One HEART have been providing medical aid in the region with Direct Relief’s support for several years, and Singapore-based Mercy Relief has expertise in providing emergency medical teams in Asia when disasters strike. Among other activities with these partner organizations, Direct Relief two years ago provided financing to Amitabha to outfit a surgical suite in Yushu, the location of the quake’s epicenter.

Direct Relief has informed the office of the U.S. Ambassador to China, Jon M. Huntsman Jr., of its financial commitment and ability to assist.

In addition to providing funding for emergency teams with deep experience in the region, Direct Relief also is exploring the potential for hand-carried medical supplies and in-country medical donations from partner healthcare companies with operations in China.

News updates report that 243 people are missing and 11,477 injured as search-and-rescue efforts continue. Tens of thousands of structures, including homes and schools, have been destroyed; 760 people have been killed in the quake, registered at a magnitude of 6.9 by the USGS and 7.1 by official Chinese agencies.

Direct Relief has extensive experience responding to earthquakes and the particular injuries they cause, including the Pakistan quake of 2005, the China earthquake in 2008, and the Haiti earthquake earlier this year. Direct Relief has provided extended support to the Pakistan Institute of Prosthetic and Orthotic Services (PIPOS), developing a comprehensive prosthetic and orthotic practice to benefit people disabled in the earthquake, and has committed $2 million to develop a similar program in Haiti.

The post Direct Relief Commits Up to $100,000 for Qinghai Quake Relief appeared first on Direct Relief.