The awards, totaling $750,000, are part of a multi-year initiative now in its sixth year, funded by the Baxter Foundation – the philanthropic arm of Baxter International – and implemented by Direct Relief. The program supports community health centers and free and charitable clinics in developing programs that integrate nutrition education with chronic disease management and mental health services.

The following organizations will receive funding to support 18-month programs:

• Tampa Family Health Centers – Tampa, Florida – A federally qualified health center serving Tampa’s diverse communities, has launched a weight loss program using lifestyle medicine that integrates nutritional education, physical activity support, behavioral health counseling, and emotional wellness coaching.

• Faith Community Pharmacy – Newport, Kentucky – A charitable pharmacy serving low-income residents across the region has brought together multiple community partners to address barriers to implementing healthy habits and social determinants of health.

• Aaron E. Henry Community Health Services Center – Clarksdale, Mississippi – A community health center serving rural Mississippi Delta communities, started the Healthy Weight and Wellness Program, addressing critical health challenges, implementing innovative treatment, nutritional access, and education strategies.

• St. Vincent de Paul Charitable Pharmacy – Cincinnati, Ohio – A charitable pharmacy providing medication access to uninsured and underinsured patients, created a program that offers culturally and economically responsive education tailored to each patient’s lived experience, demonstrating an important step toward advancing health equity.

• NeoMed Center – Gurabo, Puerto Rico – A community health center serving rural Puerto Rico with both fixed and mobile health services, developed the Integrated Nutrition Prescription program targeting patients with chronic conditions, food insecurity, and behavioral health conditions.

Addressing Critical Health Disparities

Community health centers and free and charitable clinics serve as the medical home for over 36 million people living in medically underserved areas across the United States. Patients at these facilities experience significantly higher rates of multiple chronic conditions compared to the general population, with 35% higher chances of having at least one chronic condition and 31% higher odds of having two or more chronic conditions.

“Nutrition is fundamental to managing chronic disease, yet many people face significant barriers in accessing healthy food and nutrition education,” said Maris Steward, program manager & regional analyst at Direct Relief. “These awards enable safety net providers to develop innovative, culturally appropriate programs that address health disparities in their communities.”

Program Impact and Innovation

The Transformative Innovation Awards support integrated healthcare models that go beyond traditional clinical care. Awardees will leverage community partnerships to expand outreach and education, creating comprehensive approaches to chronic disease management that incorporate nutrition counseling and mental health services.

“At Baxter and through the Baxter Foundation, we recognize that effective healthcare extends far beyond clinic and hospital walls and to the everyday lives of people and patients,” said Verónica Arroyave, vice president of corporate responsibility and global philanthropy at Baxter and executive director of the Baxter Foundation. “By supporting community health centers in implementing nutrition-focused programs, we’re investing in innovative, sustainable approaches to address the social determinants of health and advance resiliency in the communities we serve.”

The post Direct Relief, Baxter Foundation Announce 2025 Transformative Innovation Awards in Community Health appeared first on Direct Relief.

“There was a massive amount of people who were showing up and multiple shelters that were opening up,” recalled Mentesane, who was the executive director of MLK Health, a free clinic and pharmacy in Shreveport, Louisiana, about five hours’ drive from New Orleans. (She is currently the clinic’s grants manager.) “They had no medications and no physicians…Their pharmacies were destroyed, along with the records and data.”

Mentesane’s experience reflects a larger challenge of the Hurricane Katrina response that surprised many – although not the safety net providers working on the ground.

“Primary healthcare needs, especially among low-income and chronically ill populations who couldn’t evacuate, outweighed traditional emergency care and triage for the injured,” recalled Amy Simmons, communications director at the National Association of Community Health Centers, or NACHC. “The most pressing need among Katrina survivors wasn’t treating storm-related injuries. It was medical attention for chronic health conditions that went untreated as the public health system collapsed.”

MLK Health’s providers prescribed medicine to people displaced at Shreveport shelters, a process that often required them to examine and re-diagnose patients who’d already been diagnosed with a chronic disease.

“To be on the safe side, we didn’t just dispense 90 days’ worth of pills based on what someone told us,” Mentesane explained. That kind of patient care is time-intensive and detailed, and MLK Health at that point was a tiny free clinic with a pharmacy “the size of a walk-in closet…It was difficult, let me tell you.”

Thousands of people who’d been displaced by Hurricane Katrina stayed in the area – which was then hit by Hurricane Rita, a Category 3 storm, the following month.

Mentesane remembers it as a “chaotic” time, but one that shone a spotlight on the urgent need for healthcare in southern states – and that launched a groundswell of support for community providers like MLK Health.

“Starting from Scratch”

Hurricane Katrina made landfall on Monday, August 29, 2005. The impact was cataclysmic: 1,833 people were killed by the storm in Louisiana and Mississippi. But while the death toll was horrific on its own, that number doesn’t begin to account for Katrina’s disastrous consequences for health care access, insurance coverage, community mental health, housing, food security, or many other measures of health.

Even before the disaster, Louisiana and Mississippi were ranked the two least-healthy states in the U.S., with high rates of chronic disease, food insecurity, and other issues. Health care was an unaffordable expense for many thousands of people. The storm exacerbated many of these problems: The number of operational clinics in the New Orleans area dropped from an estimated 90 to 19. NACHC reported that 11 local health center facilities were destroyed by Katrina and 80 more significantly damaged.

In part because of the lack of available primary care, NACHC explained, many people used the overstrained local hospital system to manage their health, but a Government Accountability Office survey found that New Orleans hospital capacity in February 2006 was operating at about 20% of its pre-Katrina capacity.

In addition, thousands of physicians and other providers were forced to evacuate – one study estimated as many as 6,000 doctors had been displaced from the NOLA area – and approximately 200,000 people lost employer-sponsored health insurance after Katrina and Rita, according to NACHC.

Mental health issues such as post-traumatic stress skyrocketed, with providers in the area reporting that widespread trauma persists to this day. Health issues from toxin exposure to skin conditions to substance use disorders to gastrointestinal illnesses proliferated. Children, especially those with diseases like asthma or mental health issues, were particularly severely affected by the storm.

Dr. Keith Winfrey, now chief medical officer at the New Orleans East Louisiana Community Health Center, was working as a physician at another community health center in the city of New Orleans. (NOELA had not yet been founded.) He remembers having a staff meeting the Friday before the storm made landfall, and reviewing evacuation plans with colleagues.

“We all thought we would return to work on Monday,” he said.

Instead, Dr. Winfrey’s family, which included a toddler and an infant, fled to Alexandria, Louisiana, where Dr. Winfrey worked for three years, caring for community health center patients who had been displaced by Hurricane Katrina and were struggling to get their prescriptions, re-establish care for chronic diseases, and manage anxiety and distress related to their experiences.

“Many patients didn’t have access to their medical conditions or history, but they’d tell you they needed their medications filled,” he recalled. “You were pretty much starting from scratch in terms of trying to get a good handle on their medical conditions.”

“The Right Kind of Intervention”

Dr. Winfrey returned to New Orleans in January of 2009 as a Tulane University professor of internal medicine who also provided community health care. During appointments, he was struck by the widespread post-traumatic stress his patients were experiencing. “When they would come into their appointment, everyone would pretty much have a Katrina story,” with many patients describing witnessing bodies floating down the street or being trapped on their rooftops for days, he said. “They were there for non-communicable diseases, but the trauma was so fresh.”

“I don’t think people realize how traumatic it really is,” said James Comeaux, the executive vice president of the New Orleans-based health center Access Health Louisiana, who is also a licensed clinical social worker. “You have a whole generation of people [in New Orleans] who have PTSD.”

Access Health’s providers worked “ungodly amounts of hours” in the weeks after Katrina, Comeaux recalled. Where 35,000 patients in a year might have been a typical number, they saw 35,000 in the first month after the storm hit. Many had physical trauma or needed a tetanus or hepatitis vaccination, and many others needed their prescriptions for diabetes or hypertension filled.

But it was quickly obvious to Comeaux that mental health issues – along with a broader need for maternal health care and other integrated services – were going to drive health care needs over the long term. “Finding the need is not difficult; it’s finding the right kind of intervention,” he explained.

However, the horrors of Hurricane Katrina drew public attention to the area’s urgent health needs, and the lack of affordable health care. Tulane University, like other local players, was drawing on the groundswell of support to increase community health care in the NOLA area, expanding the presence of federally qualified health centers designed to serve low-income and underinsured or uninsured patients.

One of those health centers was NOELA, where Dr. Winfrey is now chief medical officer. The FQHC was founded by the Tulane University School of Medicine in 2008.

Hurricane Katrina “led to a sort of rebirth of how primary care was delivered in New Orleans,” Dr. Winfrey explained. The push for more available and effective care also led to the use of new kinds of electronic medical records that allowed patients’ diagnoses and treatment regimens to be widely accessible rather than locally housed.

In the aftermath of Hurricane Rita, MLK Health received enough financial support to install a generator that could power their entire pharmacy, allowing them to keep medications cold – and safely dispense them – during power losses. A few years later, they were able to upgrade their pharmacy and install an electronic medical record system that allowed them to accept and fill prescriptions from outside pharmacies. “That’s been a game-changer for displaced people,” Mentesane said. By that time, MLK Health was outgrowing its original clinic building, and purchased and renovated a new facility.

“It was a combination of not only the community need, but also community support,” she recalled.

“To Be Ready”

The combined disaster also grew MLK Health’s partnership with Direct Relief. While the organization had provided support to nonprofit healthcare providers in California, most of its work was international at that point.

For Direct Relief, too, the catastrophic impact of Hurricane Katrina was a pivotal moment.

When the storm struck the Louisiana coastline, Direct Relief had recently wrapped up a successful pilot program focused on providing medication to California community health centers and clinics, free of charge. Damon Taugher, a former director of U.S. programs at Direct Relief, called NACHC to ask if similar medical support would be helpful to health facilities serving communities impacted by Katrina.

Direct Relief had responded to international disasters for decades, but its U.S. work at that time was less extensive. The organization had never responded on a large scale to a U.S. disaster. But within six months, Direct Relief had provided more than $50 million in material medical aid and cash assistance to Gulf Coast community health centers and free clinics.

“Not only was the response among the largest in Direct Relief’s history, but it shaped the organization’s next ten years,” Taugher recalled in a 10-year retrospective essay on Hurricane Katrina’s impact. “To be ready for the next disaster, Direct Relief set out to establish relationships with a nationwide network of safety net providers.”

“Direct Relief was first introduced to the nonprofit healthcare safety net in the aftermath of Hurricane Katrina, and it quickly became clear that providers at community health centers, free and charitable clinics, and charitable pharmacies were already so deeply aware of the community needs, and so ready to serve their patients in any capacity,” said Katie Lewis, Direct Relief’s regional director, U.S. Programs. “Those partnerships were a natural fit for us.”

“Willing to Step Up”

Today, Direct Relief works with more than 2,000 community health centers, free and charitable clinics and pharmacies, and other safety net providers across the U.S., and has provided more than $2.8 billion in material medical aid and $238 million in grants to U.S. healthcare providers.

Direct Relief’s network of U.S. partnerships allows the organization to provide ongoing programmatic support to safety net providers over the long term, both in the form of grant funding and through the provision of material medical aid, such as the medicines and supplies needed to manage chronic diseases like diabetes, hypertension, and chronic obstructive pulmonary disease; vaccines; reproductive health supplies; infrastructure for cold-chain medical storage; and much more.

The organization provides more support in the U.S. than in any other country, Lewis said.

“These community health centers, clinics, and pharmacies are indispensable providers in their communities,” she explained. “They are continually being asked to do more: fill healthcare gaps, reach more people in need, respond to more frequent and severe emergencies, and help the communities they serve rebuild resilience over the long term. And despite all the challenges and limitations, they are somehow always willing to step up.”

These long-term partnerships also make it possible for Direct Relief to respond quickly and effectively during emergencies such as natural disasters, when safety net providers send out mobile medical units; dispatch doctors, nurse practitioners, and emergency responders into the field to offer emergent care; provide medical care and mental health support at shelters; and reestablish continuity of care for people who have fled immediate danger, among many other lifesaving strategies.

Direct Relief has also funded resilient power projects for safety net providers in disaster-vulnerable U.S. communities from California to Louisiana to Puerto Rico through the organization’s Power for Health program; provided financial support for mobile medical units; and distributed emergency grants to search and rescue groups and community organizations responding in the aftermath of disasters.

Over the long term, too, these safety net providers will support communities still recovering years or decades later – like New Orleans, where Hurricane Katrina is still a monumental part of the area’s history, identity, and current health landscape – from a disaster.

Research increasingly shows that communities deeply affected by tropical storms will experience vastly increased morbidity and mortality for decades to come: In some cases, the excess deaths caused by a disaster can reach 300 times the original death toll in the years following.

Community health centers, free and charitable clinics and pharmacies, and other nonprofit providers work to prevent these excess deaths by connecting people to housing, reducing food insecurity, implementing new disease prevention measures and mental health monitoring, and much more.

“People Still Don’t Realize”

Today, Mentesane said, healthcare in Louisiana is a much larger network of coordinating organizations who work together during the Gulf Coast’s frequent Atlantic storms to coordinate care.

Safety net organizations are assigned roles in local and state emergency planning – MLK Health, for example, acts as a pharmacy and distributor for people displaced by disasters, conducts preparedness drills, and has its own detailed plans in place to keep tabs on patients, provide emergency care, and reopen as quickly as possible.

MLK Health receives and stages Direct Relief’s large-scale Hurricane Preparedness Packs, which contain the medications and supplies that responding organizations most frequently request in the aftermath of a tropical storm. If the storm season is uneventful, the medical support – much of it intended for patients with chronic diseases – is used as part of the health center’s ongoing community healthcare work.

Access Health also receives a Hurricane Prep Pack from Direct Relief, which Comeaux describes as a boon. “Those supplies really do change lives,” he said, recalling a child at one of the health center’s facilities who received a nebulizer from the pack when he urgently needed one. Direct Relief also provided funding to support the purchase of two mobile medical units for Access Health.

“We have benefited from that relationship in amazing ways,” Comeaux said.

After Hurricane Katrina, “the emphasis became more on continuity of care for people with chronic diseases and disabilities,” Mentesane said. “I think that a lot of people didn’t realize – I think a lot of people still don’t realize – the amount of chronic illness in Louisiana and a lot of the southern states.”

New Orleans has changed since Dr. Winfrey’s return. Where he originally cared primarily for members of the city’s lower-income Black communities, he said people from growing Latino and Vietnamese communities in the NOLA area have become a larger percentage of his patients. Chronic diseases affect each community, but “these are unique medical conditions that can be impacted by language and culture,” he said. His patients need “someone who is culturally aware and familiar with dietary practices.”

His practice has changed along with his patients, allowing him to suggest healthy substitutes for foods like white rice and tortillas, and learn more about how his patients see issues like chronic disease prevention and cancer screening.

“Each culture has their own way of viewing the importance” of health, Dr. Winfrey said.

The post Twenty Years Ago, Hurricane Katrina Transformed American Healthcare – and Direct Relief appeared first on Direct Relief.

“So many feel like there are mental health services provided that will fit an issue or provide a solution, but it’s just touching it,” said O’Dell, who works at the free clinic. “We’re just starting to provide a service that has not been there for clients who have just been neglected for a long time.”

The free clinic began offering counseling and therapy sessions to low-income and unhoused people at the start of the year, with funding from the Community Routes: Access to Mental Health Care program, a partnership with Teva Pharmaceuticals, the National Association of Free and Charitable Clinics, and Direct Relief. Eleven free and charitable clinics/pharmacies across Alabama, Mississippi, and Texas received support to expand mental health programming to patients.

In addition to expanded services for patients, St. Michael’s Medical Clinic also expanded counseling services after a partner non-profit opened a homeless shelter in February. The area has limited options for therapeutic support, and the places that are available have waitlists, said Nannette Mudiam, the clinic’s executive director. According to Mudiam, about 12% of the area’s population is uninsured.

Putting patients on a months-long waiting list for therapy is “really not a workable solution for any person struggling with mental illness,” she said.

The clinic, which has existed for nearly 50 years, has built a trusting relationship with the community. O’Dell said that news about the counseling services spread quickly as she sees patients at the clinic and the shelter. They hope to hire another counselor who is bilingual to support the cultural diversity of the area.

A Helping Hand in Dallas

Providing culturally competent care is making a difference in Dallas, too. Accessing care is a challenge in the state, with significant barriers including high numbers of people without insurance and fewer treatment options than other states.

To address the need, Brother Bill’s Helping Hand, a nonprofit in Dallas, Texas, has built a wraparound service program to support the predominantly Latino area of West Dallas over the last 80 years. Brother Bill’s provides food to nearly 200 individuals daily and operates a primary care clinic, among several other community-based resource programs. Three counselors offer bilingual counseling services to increase patient access to care.

Ivan Esquivel, clinic director, said providing culturally competent care also means breaking cultural barriers that prevent patients from seeking care, including generational cycles, taboo, and denial.

“Mental health among the Hispanic community is a very taboo thing, especially among men,” he said. “You grow up learning that if you’re a man, you don’t cry. You’re machismo, a lot of pride, and so being vulnerable and sharing how you feel mentally can be viewed in our community as a sign of weakness.”

Esquivel said that Brother Bill’s is also working to restore dignity to their neighbors and patients enduring mental and emotional stress from hardship, including food insecurity.

The nonprofit sees 150 patients a month, and there’s a waiting list for mental health care. They created a virtual space to help the community overcome cultural stigmas around mental health. Counselors use Facebook Live to discuss taboo topics and answer questions from the community in real-time to make people more comfortable and understand that they have community support.

“Too many times in life, when you have to use these services, you have to jump through so many hoops of application qualifications, and then once you get in the program, you’re treated like you’re taking a handout,” said Esquivel. “You’re almost feeling like less than, and so everything we do here, all the way from calling them neighbor to being seen as a patient, or getting food, is providing dignity to every single aspect.”

Beyond ‘Bootstraps’

Providing care in a way that makes people feel seen, heard, and cared for is a priority in Bryan, Texas, too.

Sherri Clement, a social worker at Health For All, said that the rural areas of Texas have a high demand for mental health services and not enough counselors to cover the need. Additionally, the area’s culture doesn’t have broad support for mental health, which discourages patients from seeking care.

“We tend to have an approach of ‘pull yourself up by your bootstraps’ mentality,” Clement said. “Unfortunately, seeking mental health care services is seen as a negative thing, that it’s some sort of shortfall on a person…We know that’s not the case.”

The free clinic serves a diverse area, by culture, race, sexual orientation, and socioeconomic status. Clinic leadership said they strive to create a welcoming and respectful environment for everyone, especially for those who are marginalized and underserved.

Clement said it’s an unnecessary barrier to care in an area that doesn’t have enough options for health care. She said that cost is the biggest barrier for patients who do want to seek care. According to Census data, nearly 23 percent of the city’s population lives below the poverty line, which is 1.5 times higher than the poverty rate for the state.

The health clinic works with patients who have experienced panic attacks and may experience anxiety and depression. They offer EMDR, one-on-one counseling, and behavioral health management services.

Clement said that patients are referred when they can no longer manage on their own, even with medication assistance. Some, she said, just want to know some coping mechanisms that they can implement into their daily life.

“There are a lot of people who are experiencing this,” she said. “The solution is a light at the end of the tunnel, so it gives them hope.”

The post Through Expanded Mental Health Services, Free Clinics Provide “a Light at the End of the Tunnel” appeared first on Direct Relief.

Medications and supplies shipped this week included diabetes management medications, prenatal vitamins, rare disease therapies, and more.

Pfizer Foundation Video Features Delta Health Center

Direct Relief partnered with the Pfizer Foundation and Delta Health Center on a USA Today feature video and story that showcases the collaborative work in building healthier communities in the Mississippi Delta region.

Delta Health Center, located in Mound Bayou, Mississippi, is the first rural community health center in the United States. The center, established in 1965, aimed to improve the health of people who were impacted by severe poverty, environmental conditions, and lack of economic resources.

The health center to continues to fill key gaps in the community today, including for people who would have no other access to health care.

Read more here.

Direct Relief Featured at Academy Awards

Direct Relief was featured during the Academy of Motion Picture Arts and Sciences 97th Academy Awards, which supported Direct Relief’s Los Angeles wildfire relief response. The ceremony, which was telecast on Sunday, March 2, urged viewers, attendees, and industry partners to support multiple organizations providing aid to those impacted by the fires, including Direct Relief.

“This time of year, a lucky few get to publicly thank the Academy. Fewer still get to do it on behalf of millions. Direct Relief is honored to thank the Academy of Motion Picture Arts and Sciences for its support, which will help strengthen communities and aid wildfire-affected families,” said Dr. Byron Scott, CEO of Direct Relief.

Direct Relief continues to actively respond to the devastating fires by mobilizing critical medical aid, and providing financial assistance to community health centers serving displaced families and those in need of urgent medical care.

Field Medic Packs Equip First Responders in El Salvador

Field medic packs, filled with emergency essentials for triage care, recently arrived in El Salvador, where they will equip first responders and enhance emergency preparedness.

Last month, in coordination with NGO FUSAL and the Salvadoran American Humanitarian Foundation, Direct Relief provided 37 packs to first responders from the Salvadoran Red Cross, the Salvadoran Volunteer Stretcher Bearer Corps, the Rescue Command, and the Salvadoran Green Cross.

Earlier this year, a series of earthquakes rattled the country, the strongest of which measured a 6.2-magnitude temblor, but minimal damage was reported. The packs will ensure first responders are ready during future emergency responses.

Since 2008, Direct Relief has provided more than $219 million in medical aid to El Salvador.

Operational Snapshot

UNITED STATES

Direct Relief delivered 340 shipments containing 1.2 million doses of medication during the past month to organizations, including the following:

Around the World

Globally, Direct Relief shipped over 6.3 million defined daily doses of medication totaling 41,560 lbs., to countries including the following:

YEAR TO DATE

Since January 1, 2025, Direct Relief has delivered 5,961 shipments to 1,475 partner organizations in 54 U.S. states and territories and 65 countries. These shipments included 69.3 million defined daily doses of medication, valued at $414.1 million wholesale, totaling 1 million lbs.

News

Amgen and Amgen Foundation Donation Dollars on the Ground with Direct Relief in Wake of Southern California Fires – Amgen.com

NAU’s American Indian Nursing Program Expands With Direct Relief Grant to Tackle Critical Shortages in Native Communities – Native News Online

Direct Relief Is Prepared for a Busier 2025 – Pacific Coast Business Times

Cataract Surgery Brings Joy to Three Sisters – The Fiji Times

CIM Employees Convert Los Angeles-Area Soundstage into Fire-Victim Aid Station – CoStar

NAU’s American Indian Nursing Program Expands With Direct Relief Grant to Tackle Critical Shortages in Native Communities – Red Lake Nation News

The post Medical Aid Departs for 44 U.S. States and Territories, Plus Supporting Health in Mississippi’s Delta Region appeared first on Direct Relief.

“Every day uninsured patients face barriers to accessing basic mental health services they need,” said Carol Richardson, Sustainability and Health Equity Lead, Teva U.S. “This latest round of grant funding will enable clinics in more states to expand existing or develop innovative new behavioral health programs that meet the needs of their local patient populations”.

Over the first two years, Community Routes grantees demonstrated a significant impact across their communities reaching more than 63,000 beneficiaries. Clinics conducted 24,617 patient screenings for depression, anxiety, and adverse childhood experiences, helping identify and address previously unmet mental health needs. The program extended beyond direct patient care, with grantees training more than 2,800 community members, staff, and volunteers in mental health promotion and well-being. Additionally, clinics organized 131 community events to expand access to mental health education and services, strengthening their role as trusted healthcare resources.

Building on these achievements, this funding cycle prioritizes the creation and expansion of innovative care delivery models that integrate behavioral health services into existing clinical operations, with particular emphasis on evidence-based screening tools and treatment protocols for depression and anxiety.

“Mental health is an essential component of overall well-being, yet too many individuals in underserved communities struggle to access the care they need,” shared Nicole Lamoureux, NAFC President & CEO. “This program empowers clinics to bridge this gap by expanding behavioral health services and critical mental health support. By investing in these clinics, we are investing in the health and resilience of entire communities.”

The 2025 grant recipients include:

Alabama:

• Medical Outreach Ministries (Montgomery) – Leveraging academic partnerships through the University of Alabama at Birmingham’s psychiatry residency program to integrate mental health services into primary care.

• Ozanam Charitable Pharmacy (Mobile) – Implementing screening tools for depression and within pharmacy services and connecting patients to necessary resources.

• St. Michael’s Medical Clinic (Anniston) – Integrating mental health services with primary care and social support services to address the complex needs of uninsured and homeless populations.

Mississippi:

• Bethel Free Clinic, Inc. (Biloxi) – Enhancing mental health access for uninsured residents by integrating depression and anxiety screenings into patient care, referring those in need for further evaluation.

Texas:

• Brother Bill’s Helping Hand (Dallas) – Improving mental health access for predominantly Latino communities through integrated care, community-based outreach, and culturally competent services.

• Heal the City Free Clinic (Amarillo) – Implementing community-based stigma reduction programs to increase understanding of mental health conditions and encourage individuals to seek support.

• Health for All (Bryan) – Expanding trauma-informed mental health services access for underserved populations and delivering culturally sensitive services tailored to their diverse community’s needs.

• Ibn Sina Foundation (Houston) – Emphasizing equitable access by addressing the distinct mental health needs of multiple underserved populations.
  
• Mercy Clinic of Fort Worth – Integrating behavioral health services into routine care and establishing patient navigation systems for uninsured Spanish-speaking patients.

• The Agape Clinic (Dallas) – Developing comprehensive mental health support systems, including therapy, case management, and peer support, for the underserved patient population.

• Woven Health Clinic (Farmers Branch) – Integrating mental health services into primary care by offering screenings for depression and anxiety, connection to individual counseling, and treatment plans.

Selected programs emphasize sustainable integration of mental health services through:

• Implementation of standardized screening protocols
• Supporting the clinical workforce through partnerships
• Integration of behavioral health into primary care
• Extending cultural competency across the full continuum of patient care
• Social service referral networks

“Expanding mental health services in resource-limited settings has been a key focus of prior Community Routes funding, and this latest round will allow providers to reach even more people with critical services,” said Katie Lewis, Regional Director of U.S. Programs for Direct Relief. “These funds will allow clinics to build on successful approaches while exploring new strategies that fit the unique needs of the people and communities they serve.”

For a report on lessons learned from our Community Routes: Access to Mental Healthcare grantees, click here.

Community Routes: Access to Mental Health Care—a partnership between Teva, Direct Relief, and the National Association of Free and Charitable Clinics (NAFC)— is a unique access program that is helping to advance health equity and quality care for underserved populations across the U.S.

Teva is providing commonly used medicines that treat depression and anxiety to 400+ clinics in 10 states, as well as $4 million in grant funding to support innovative behavioral health services through local free and charitable clinics, tailored to meet the needs of their communities. To read more, click here.

The post 2025 Community Routes: Access to Mental Health Care Grants Awarded to Clinics in Alabama, Mississippi, and Texas, Funded by Teva Pharmaceuticals  appeared first on Direct Relief.

Direct Relief relies on their expertise to know what is needed, and their resilience represents the best of humanity even in the darkest of times.

This year, Direct Relief has shipped more than $1.6 billion in medical aid to 90 countries. But behind those abstract numbers are real people, working to serve others in tremendously challenging situations, whether during an emergency or while experiencing limited resources — or both.

Here are some of their stories.

Kranti Tamang on the Anti-Trafficking, Anti-Stigma Revolution

Trafficking survivor Shanti Tamang, and her daughter, Kranti, are providing safe spaces for survivors to thrive and dismantle the stigma that comes with living with HIV in Nepal.

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

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

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

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

Shanti went on to found the Shanti Foundation, which works to rescue, rehabilitate, and reintegrate trafficking survivors and people living with HIV.

 Read more.

Plan A Health Hits the Road for Patients in Mississippi Delta

A local team travels across the Mississippi Delta to ensure every adult has access to quality reproductive care, contraceptives, and trusting relationships with their medical team.

Plan A provides reproductive and primary care health throughout the Mississippi Delta, a region that historically has had poor health outcomes and low economic status. Their small team operates a mobile medical unit, outfitted with two exam rooms, that truck driver Antoinette Roby drives from city to city.

Since its inception in 2018, Plan A has expanded to include a pharmacy, mail-order prescriptions, options for contraceptives, pre-and-post-natal care for patients with HIV, and telehealth for family planning. They’ve also hired a nurse practitioner that patients can call or text directly to ask questions.

The team includes Desiree Norwood, who is the mayor of her hometown of Sunflower, Mississippi. Norwood said when the mobile medical unit arrives in Sunflower, people are excited because Plan A has built a reputable reputation.

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

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

Read more.

In Panama, Type 1 Diabetes Care Improves by Empowering Young People

Pilar Gomez, DiabetesLATAM’s founder and director, started DiabetesLATAM after moving to Panama in 2017 with a son and daughter diagnosed with Type 1 diabetes. With little in the way of services for people living with diabetes in Panama, Gomez decided to change that, reported Brianna Newport.

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

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

Read more.

“Living Day by Day,” Health Staff in Haiti Keep Hospital Doors Open as Violence Continues

Since 2010, Haiti has faced a catastrophic earthquake that killed more than 200,000 people, Hurricane Matthew, cholera outbreaks, the assassination of former President Jovenel Moïse in July 2021, and a 7.2-magnitude earthquake the following month. Gang violence continued to rock the country this year, and health providers went to heroic lengths to show up to work, putting themselves at risk, reported Direct Relief journalist Noah Smith.

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

Direct Relief provided $1 million in financial support to health organizations across the country so they could maintain operating budgets and continue serving patients.

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Health Care Hero: A Landfill Fire Was Poisoning Her Patients. She Cared for Them at Home.

Alejandra Hernandez Ezquivel was in her house in the 500-person community of Santa María Chimalhuacán, in eastern Mexico, when her husband came running indoors. The landfill nearby — the one that had appeared one day out of nowhere years earlier, with no opportunity for the community to object — was on fire.

“It was like a monster, so immense,” she told Talya Meyers, Direct Relief senior editor and writer, through a translator, recalling the fire that began raging on May 29, 2022. The blaze was out of control by the time firemen arrived at the rural community, located in the municipality of Chimalhuacán, about an hour away from Mexico City.

Ezquivel cared for patients all the while, eventually working to help establish a full-time primary care center, funded by the NGO Fundación Escala, which Direct Relief has supported with medications. With the nearest health facility two hours away, the primary care center fills a huge gap in care.

“Whatever patients need, that’s what we provide,” Ezquivel explained.

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After a Disaster, “the Mothers Will Call You to Where You Need to Be”

Picture a disaster’s first responders. A firefighter dousing a blaze or a doctor treating a critical injury might come to mind. But midwives caring for pregnant women and newborns are also critical responders during disasters, a fact that Sunny Chen, executive director of Healthy Mothers Healthy Babies Coalition of Hawai’i, knows firsthand.

“When the disaster happened, our Maui partners called us and said, ‘we need you to come,’ and so we brought the mobile clinic here and we were able to provide critical medical care and services,” she said. “That’s the amazing thing about midwives and nurses. We just do whatever it takes, and we adapt.”

The organization’s midwives and nurses were some of the first medical responders to reach Maui after the devastating 2023 wildfires and continue to provide care for families.

“When you take care of mothers and pregnant and parenting people, you really take care of a whole community,” Chen said. “The mothers will call you to where you need to be.”

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For Kids with Diabetes, This Summer Camp Is Like Any Other. But It’s Theirs.

Camp Conrad Chinnock in Southern California looks right out of a movie set: archery set, mess hall, climbing wall, flagpole, even a swimming pool. Campers laugh and lurch about, making jokes and trading stories as they walk to the next activity together, reported Direct Relief journalist Noah Smith when he visited the camp this summer.

The familiar atmosphere is precisely the aim. Camp Conrad Chinnock’s purpose is to give children with Type 1 diabetes a typical summer camp experience. Due to the nature of T1D, it’s not a simple proposition.

“The burden of diabetes management is minute-to-minute, constant, 24 hours. You can’t quit. And it’s always part of your thinking in the background. But when you come to camp, you have a support network that helps to carry your load,” said Tracy Fulkerson, a former camper who is now on the medical staff at the camp and works as a pediatric intensive care unit nurse supervisor at Rady Children’s Hospital in San Diego.

Having trained support staff and medications and supplies needed to manage diabetes allows campers to focus on fun. Direct Relief’s insulin donations, which are used every day during the camp season, keep prices affordable. Without them, the cost of attendance would multiply several times over, said Rocky Wilson, camp director.

“Camp could not exist without donated insulin.”

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Fire Destroyed an Island Hospital. Months Later, a Honduran Free Clinic Is Still Bridging the Gap.

When a fire had destroyed the only public hospital on the island of Roatán, Honduras, staff at Clinica Esperanza, a local free clinic, were part of an immediate, community-wide response.

Thousands relied on the hospital for care, reported Direct Relief journalist Olivia Lewis. Patients and hospital staff were being routed to local medical practices to receive emergency care, and Clinic Esperanza staff said they couldn’t imagine having to turn anyone away.

“I cannot handle the idea that people can die because they don’t have any other option,” said Kallie Vallecillo, CEO of Clinica Esperanza, which has operated in the community for 22 years.

Clinica Esperanza, which relies on medical students and volunteers to operate, extended its daily hours to meet the increased need.

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The post 2024: Stories of Resilience appeared first on Direct Relief.

Communities in Texas, Louisiana, Alabama, and Mississippi are likely to experience impacts from the growing storm. Experts are predicting storm surges as high as 10 feet in some areas, and up to eight inches of rain. The U.S. Gulf Coast, particularly in Texas, has already experienced repeated extreme weather events this year, including July’s Hurricane Beryl, which led to dozens of deaths, large-scale displacements, widespread power outages, and interruptions to health care.

Direct Relief’s Response

In preparation for hurricanes and tropical storms each year, Direct Relief distributes and monitors caches of medications and supplies, called hurricane preparedness packs, throughout the Gulf Coast and other vulnerable areas. The packs contain medical essentials, including chronic disease medications, wound care supplies, and other items commonly requested after storms for patient care.

Extreme weather events are likely to disrupt routine health care, leading to lost medications and unmanaged chronic diseases such as asthma, diabetes, and hypertension. A combination of rising floodwaters and increased risk of injury often creates an urgent need for first aid, tetanus vaccines, and therapies to manage water-borne illness. The aftermath of a storm often brings the risk for contagious diseases, as people shelter in close quarters, and increases the need for mental health services.

In recent years, power loss coupled with hot weather has become an increasing danger. For example, in the aftermath of Hurricane Beryl, the climbing death toll was largely caused by sweltering heat, as people were forced to shelter in their homes without air conditioning or other cooling measures.

Experts predicted that the 2024 hurricane season would be busier than normal, with up to 25 named storms. A period of relative calm in August and early September caused speculation that the season would be calmer than expected, but experts still expect a higher-than-normal amount of tropical storm activity. Hurricane season extends until November 30.

Direct Relief has an extensive history in the U.S. of responding to Gulf Coast hurricanes, and is in communication with national, state, and local organizations, including health centers and free clinics expected to be impacted by the storm.

The organization will continue to monitor Tropical Storm Francine and respond to requests for support.

The post Tropical Storm Francine, Gaining Strength and Power, Threatens U.S. Gulf Coast appeared first on Direct Relief.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The post Plan A Health Hits the Road for Patients in Mississippi Delta appeared first on Direct Relief.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The post Resilient Power Proves a “Lifesaver” for Mississippi Health Center After Catastrophic Tornado appeared first on Direct Relief.

According to the American Nurses Association, the nation’s nurse workforce experienced shortages prior to and were exacerbated during the height of the Covid-19 pandemic. Retirements, racism, unsafe work conditions, and a lack of policies that support quality care are among the many reasons nurses are leaving their jobs.

About 100,000 nurses left the workforce during the height of the pandemic and within four years, 900,000 registered nurses are predicted to leave the workforce, according to the National Council of State Boards of Nursing. The U.S. Bureau of Labor Statistics predicts over 193,000 average annual openings for registered nurses between 2020 to 2030. The median salary for a registered nurse in the U.S. is $81,220, but heavily depends on the person’s location, experience, and educational attainment. Even though there is great demand for nurses nationwide, some say there are too many barriers to entering the industry that also work against a diverse and inclusive nursing workforce.

Dr. Martha Dawson, the immediate past president of the National Black Nurses Association, is a nurse educator and supporter of health equity. She became interested in the techniques of medicine and the satisfaction of saving someone’s life.

Dawson remembers her father getting second-degree burns and helping him wrap bandages around his wounds when she was a little girl. She remembers her brother falling from a horse and breaking a bone, then watching it heal over time. When her mother bought her a doll, that remains in Dawson’s house today, she wrapped it in bandages and cared for the doll like it was a patient in the hospital.

“I keep (the doll) to remind me of my mother’s sacrifice, but also her belief in my dream and my journey into nursing,” Dawson told Direct Relief in July.

But throughout her adolescence, adults told Dawson that she would make a great teacher. Dawson said she thought to herself, ‘Why can’t I be both?’

There are few nurses who identify as Black, Indigenous, and People of Color, or BIPOC, in the U.S. They make up less than 20% of the profession, according to the National Council of State Boards for Nursing. Far fewer hold a doctorate degree, and it takes longer for BIPOC nurses with advanced degrees to obtain managerial and executive positions.

Like many BIPOC nurses, Dawson began her educational journey at community college before advancing to a four-year institution and eventually earning her doctorate.

Nursing programs can also be costly.

Dara Koppelman, the Executive Vice President of Health Services and Programs at Mary’s Center in Washington, said her one-year, accelerated nursing program cost nearly $100,000 after completing her bachelor’s degree.

“The program I did was very expensive, and I had to take out loans to complete it,” she told Direct Relief. “And that’s not always accessible to everyone.”

Koppelman comes from a long line of nurses. Her mother was a nurse, her grandmother was a nurse, and several other women in her family are nurses. She now has a master’s degree in health services administration.

The executive VP began her career at a hospital within labor and delivery and was influenced by midwives who encouraged her to try different avenues of nursing. Koppelman said she listened to their advice and worked for the health department before finding her place at Mary’s Center, a not-for-profit health center. However, she may not have found a workplace that she truly loved without their help. Koppelman said that much of what is taught in nursing school prepares students to work in hospitals, not community health.

Mary’s Center, which Koppelman said employed nearly 800 people in July, is a community health center that operates under a social change model. The executive VP said their health care model goes against what has “historically or traditionally” been thought of as health care because they focus on the social determinants of health. They lost a few nurses during the pandemic, and Koppelman says she saw nurses leaving for better paying jobs given the high demand of the industry.

The health center’s social change model includes support for staff. Mary’s Center offers a scholarship program of up to $10,000 per year for staff who wish to further their education. Koppelman said that completing advanced degrees and certifications can be challenging, especially for those who must work or support families while in school.

The health center also works with a public charter school in the area to increase access to the medical field. Students can attend a medical assistant training program for free, which typically costs $20,000.

Even after some nurses have completed their education, finding a job or advancing in their career can be difficult.

In a recent survey conducted by the National Commission to Address Racism in Nursing, 63% said they have witnessed or experienced an act of racism in the workplace.

“It takes us longer from the product to practice, meaning being in the hospital, being in an ambulatory setting, being in clinics for us to move from bedside nurse to a nurse manager, a nursing director, the chief of nursing officer and then a chief nurse executive,” Dawson said.

She also said that job postings aren’t always accessible, and some institutions place higher value on candidates based on the schools they attended, whether they have family within the industry, and how willing they are to assimilate into the traditional forms of medicine.

Dawson has been influential in training the next generation of nurses. Her NBNA colleagues founded a Mini Nurses Academy to introduce students to nursing wellness, health promotion and disease prevention.

Dawson’s successor, Dr. Sheldon Fields, is known as a unicorn in the industry. Less than 10% of nurses are male, and he’s one of the less than 20% BIPOC nurses. Fields said he fell in love with the nursing profession and was encouraged to pursue nursing by his aunt, who was also a nurse.

Fields received scholarships to pay for his bachelor’s, master’s and doctoral degrees, and says he witnessed institutional and structural racism at every step. He said there is a lot of ‘gatekeeping’ within the industry, that portrays to potential nurses, “you’re not worthy,” he told Direct Relief just before becoming President of NBNA.

“Nursing has never been upfront about it, you know, because a lot of people think ‘well, nurses are angelic and kind and altruistic’,” he said. “Well, nurses are also straight-up racist and rude and can be unkind.”

Fields said it’s “irritating” to see who is deemed capable of becoming a nurse through institutional barriers when nurses are needed nationwide. The NBNA President, who is also a college professor and policy expert, said that the industry has to change for nurses to be successful moving forward.

“Covid revealed the very fragile state of our public health infrastructure,” he said.

Carli Zeggers became a nurse in 2013. She had previously worked at a food pantry and enjoyed work that allowed her to help others. Zeggers completed an accelerated nursing program to become a nurse practitioner and began working in a hospital emergency room and in hospice care management.

It was strenuous work, and she made time to continue her education. Zeggers, a first-generation college graduate, also earned her graduate degree in business administration and her doctorate of philosophy and family practice in nursing. She began a new teaching position at Florida State University this fall and continues to work in an emergency room setting. Zeggers told Direct Relief earlier this year that working in a clinical setting has helped her become a better teacher for other nurses.

“There is a huge divide between bedside nursing in the hospital, community nursing, and any sort of leadership in academia, but they’re so disconnected,” she said. “That’s a huge issue I see.”

Zeggers said that the nursing profession is reactionary rather than proactive, which was exacerbated during the height of the pandemic. Too often, she saw nurses working extended hours, put in risky health situations, and neglected during salary negotiations.

“I was getting very frustrated and actually left a couple of hospitals because there was turmoil, and I was definitely overextended and unsafe so many times,” she said.

Pati Knight, director of corporate compliance at Southeast Mississippi Rural Health Initiative, said several of the nurses who worked at the health center retired during the height of Covid-19.

Also a nurse, Knight said that nurses who worked throughout the pandemic were emotionally and physically exhausted. There was also extreme worry among staff who questioned whether they made family members more susceptible to the virus. It was easier to retire than to continue working.

“So you ask other people to take on additional roles and pitch in,” she said. “And we just got it done with the dedicated staff…they took on additional hours.”

Knight says the health center has not replaced all nurses who left during the pandemic, but they are finding new ways to incentivize those who remain at work. Knight says the health center now offers more paid holidays, higher wages and bonuses.

Registered nurses at public hospitals have the highest turnover rate, but those who work within all levels of nursing at not-for-profit health centers, private institutions, and academia say they, too, have endured the brunt of the industry. Academics and association leaders are pressing for policy changes, and community leaders say they are advocating for staff members and colleagues in every way possible.

During the height of the pandemic, Angie Settle participated in clinical hours for West Virginia Health Right. As CEO of the free clinic, that’s not in her job description.

“I wanted to make sure that if I was establishing practices and expectations, I had to have hands-on experience doing it,” Settle, who has a doctorate in nursing practice, told Direct Relief.

Settle said that Covid-19 was the “worst-case scenario come true,” as the global pandemic strained all facets of the health industry. She’s worked at the health center for almost 30 years and had to hire additional nurses during the pandemic to support the new workload while trying to maintain her full-time staff. West Virginia Health Right hasn’t lost any full-time nurses since the beginning of the pandemic, but Settle told Direct Relief in July that the health center’s budget was strained, and employees were put in emotionally taxing situations.

The free clinic partnered with the county health department and set up a drive-thru system for rapid Covid testing. It became wildly popular, especially with first responders. However, it required long hours and a six-day work week for Settle’s employees, whose interactions with others put them at risk for Covid.

“We were out there putting ourselves on the line, and it was just day in and day out,” Settle said.

A mother of eight, Settle said she has learned to treat her employees like family. She praises them at work and in the community, while advocating for access to health care for all at the state legislature.

Direct Relief provided Mary’s Center, Southeast Mississippi Rural Health Initiative, and West Virginia Health Right with funding during Covid-19 to support health staff and operations during the pandemic. Direct Relief has also provided the National Black Nurses Association with funding to strengthen the pipeline of nurses entering the field through the Mini Nurses Academy, which introduces young people to the healthcare field.

The post Where Have All the Nurses Gone? appeared first on Direct Relief.

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

The federally qualified health center is located in Clarksdale, Mississippi, and has served the community for over 40 years. The center operates 12 sites and provides medical and dental care services, behavioral health services and more. The center began the Health Wealth program after gathering input from people across six counties to hear about obstacles to health outcomes in the community. Addressing all barriers to better health, including financial ones, was listed as a need.

So clinic staff and staff from Southern Bancorp worked to modify the clinic’s social determinants of health patient screening tool by adding questions about banking status, debt burden, and other indicators of financial distress. If patients say they’re interested, they can meet with a credit counselor on-site at the clinic.

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

The post Supporting Physical and Financial Health in Mississippi appeared first on Direct Relief.

ROLLING FORK, MISSISSIPPI — Rev. Travis Gully had just finished dinner and was cleaning up the kitchen when his goddaughter asked him about a noise outside. Gully assumed it was from a passing helicopter on its way to the hospital. The noise grew louder and he could hear one of his godsons call out to him from the living room.

“The trees are walking down the street,” the child said.

Gully’s immediate response was to yell, “Get away from the window!”

On March 24, an EF4 tornado landed in the small, rural community of Rolling Fork, Mississippi. The tornado tore through the Mississippi Delta, crushing everything in its path. Rolling Fork, which is a mile and a half wide, was instantly destroyed as winds of 180 mph whipped from house to house.

“I never want another tree close to my house again,” Gully said.

Gully was physically safe. He was able to move back into his home two weeks after the tornado. However, 13 others in Sharkey County died from the storm. Many more experienced shock and trauma. Amid the destruction and chaos, a community pillar has remained: Delta Health Center.

Since the storm, DHC employees have worked daily to support the physical and mental health needs in Rolling Fork. They’ve made calls to colleagues, like Gully, whose homes were damaged. They’ve driven vans around town to knock on doors and care for residents who were too afraid or unable to travel to the health center. They’ve donated necessities like water bottles, sanitary supplies and baby formula to families in need. Most of all, they’ve been the trusted voice and ear to the community during a tragedy.

“The most graphic one to me was the 90-year-old lady that was just sitting in a pile of rubble and refused to leave because that was all she had,” said CEO John Fairman. “And so, our folks provided some intervention to her until she (agreed to) move.”

Fairman addressed a small crowd of nonprofit supporters in mid-April at DHC’s Rolling Fork location. The structure was totaled by the storm, and a temporary clinic was created on the property. He shared that patient numbers were up from 15 per week to over 80 per week.

Rolling Fork is a predominantly Black city with just over 2,300 residents. Some fear that the storm will force residents to leave the area, and potentially Mississippi altogether. That could hurt the city’s economic conditions. The median household income in the area is $38,558, and 20% of residents live below the poverty line.

DHC received donations of a mobile unit and solar panels for power. Direct Relief supported the organization with a $10,000 grant and disaster kits with medical supplies. The health center has also applied for assistance from Federal Emergency Management Agency.

DHC’s Deputy CEO and Disaster Recovery Coordinator, Neuviska Braughur, said that so far donations have helped survivors who need bandages, antibiotics, tetanus shots, and over-the-counter medication like Benadryl and Tylenol. She rides in the van with a psychologist, family nurse practitioner, doctors, and registered nurses. They created a list of houses visited and returned to some properties to redress bandages day after day.

“The help that we provide to them (is) from our heart,” she said. “It was more than our health care touching them: it’s mentally, emotionally, being there for them to talk to. We wouldn’t have it any other way.”

Braughur said that discussions on mental health are not common in the Black community—prayer is supposed to be best, and many are unwilling to seek out therapy. Her approach is to listen first and share that more people are willing to listen at the clinic if patients want to talk more.  

“When we go out, I always pull them to the side and talk to them about where they’re at,” she said. I ask when did it happen, how do you feel now, and a lot of them say (they) were praying, or hiding, but some can tell me exactly what they did, and from there, we refer them to come to our mobile unit and get some health support.”

As for the mental and emotional health of DHC employees, the deputy CEO said they speak to one another each day. She said she encourages their team to express how they feel and what they need as they continue knocking on doors.

A History of Care

The health center has a long history of providing relief to the community when no one else would. DHC was the first rural federally qualified health center in the nation. Its main campus in Mound Bayou opened in 1965 and accepted Black patients during segregation.

“We’re trusted because we’ve been here through the worst of times, and we’ve remained through the best of times,” said Adoris Turner, DHC’s co-deputy CEO.

Turner lives outside of the area but arrived on the scene the morning after the tornado. He said many were in shock, and utter disbelief at what had happened. There were announcements at his church for missing children, a one-year-old, and a one-month-old, as people talked about fighting to hold on to their loved ones as the wind broke through their homes.

“Some saw loved ones swept into the air,” he said.

The health center granted paid leave to employees like Gully whose homes were damaged by the storm. Nona Cooper, a registration clerk at the health center, was unable to return home in mid-April. The windows to her home were shattered, a fallen tree landed on her house, and other damage made it unsafe for her to live in the residence. She told Direct Relief that her home feels like a cave.

“It was tragic, but just the fact that I’m alive… I get emotional because I think about what could have happened.”

Cooper broke down in tears as she talked about losing her neighbors, her sister and brother-in-law who had to be pulled from the rubble, and seeing the town that she grew up in wiped away within minutes.

The 64-year-old was home alone during the storm. She tried to stay on the phone with her sisters as they watched the news for updates. Then she heard the wind, which Cooper says sounded like a “train approaching with a vengeance.” She grabbed a large furniture cushion and hid in her closet while screaming as the tornado landed in Rolling Fork.

“They were telling us the cities in the path of the tornado,” she said. “Mayersville, they said, it’s about to touch down in Mayersville right now, Rolling Fork, get ready, nine minutes, get ready, and by the time he had said that three times you could hear the wind. Oh my God.”

Gully said he’s heard people talk about the sound of a tornado, but he didn’t understand until he experienced it himself.

“I thought someone was in an 18-wheeler in my backyard and was about to hit my house,” he told Direct Relief.  

Gully underestimated the extent of the damage at first. Then he heard his sister was temporarily trapped in her home. One of the two churches he pastors was destroyed, and two of his parishioners died. He drove around town after the storm to determine the damage to his church and realized that it was gone. Gully said he stood in the parking lot, in shock.

Gully, who grew up in the area, said he’s worried that resources won’t be allocated equitably across Rolling Fork to rebuild. He’s not confident that people whose homes and businesses were destroyed will remain in town and that the economy will be affected.

However, Gully continues to work with his colleagues at DHC and volunteers from out-of-town to clean up and help neighbors recover from the tornado.

“I was telling a friend that of all the times that this has happened to other communities, maybe I’ve neglected to support like I should have,” he said. “It reminded me, you never know when your day is coming, so you should always be willing to help someone else.”

Volunteers from nearby schools like Mississippi Valley State University and disaster relief organizations from all over the country are working with residents to rebuild Rolling Fork. Piles of debris lay on the sides of the road, including the remains of a water tower that the wind knocked over.

The national, united support is astonishing to them, given Mississippi’s aggressive political and racial divides.

“It’s been an amazing display of the human spirit and our humanity,” Turner said.

Cooper said that little has changed since Jim Crow laws were active and that people are still separated politically and socially. However, she believes that the storm will bring a “new beginning” to Rolling Fork.

“I’m 64, so you know I grew up during a time when it was the way that it was,” she said. “But I have seen so much togetherness where people have pulled together, and it’s like everybody just feels the need to help and be there for each other.”

The post Someone To Talk To: Health Center Provides Support After Devastating Tornado appeared first on Direct Relief.

The shipments contained 10.4 million defined daily doses of medication, including insulin, antibiotics, overdose-reversing meds, and more.

Turkey-Syria Earthquake Response

Eighty tons of medical aid has been staged for a charter flight to Turkey next week, the latest infusion of support for the region recovering from last month’s catastrophic earthquakes.

Sinan Kuzum, Turkey’s Consul-General in Los Angeles, visited Direct Relief’s Santa Barbara, California, warehouse this week before the shipment departed. Kuzum received a tour of Direct Relief’s warehouse and met with staff for a briefing on the organization’s earthquake response.

Learn more about the 80-ton chartered flight here.

Aid Arrives in Syria After Charter

Also, this week, the Independent Doctors Association and Syrian American Medical Society in Syria received shipments of requested medications and supplies donated by Direct Relief that were part of a 75-ton charter flight of medical aid. The contents will be distributed to local patients in communities recently impacted by the destructive earthquakes.

Mississippi, Alabama tornado response

In response to several devastating tornadoes this past weekend, Direct Relief has sent or is preparing to send 19 shipments of emergency medicines and medical supplies in response to requests from health centers in Mississippi and Alabama. Direct Relief staff anticipates further requests for shipments over the next few days.

Additionally, a solar power unit from Footprint Project supplied electricity to a temporary clinic set up by Delta Health Center in Rolling Fork, Mississippi, after tornadoes devastated the clinic’s health facility. Direct Relief supported the Footprint Project with a $250k emergency operating grant to deploy alternative power solutions after disasters.

Direct Relief’s Ruth Smarinsky, PharmD, Receives Prestigious Award

Ruth Arnold Smarinsky, PharmD, Senior Advisor for Direct Relief, was awarded the Hugo H. Schaefer Award this week by the American Pharmacists Association. The award recognizes those who “have made outstanding contributions to society, the professional of pharmacy, and the American Pharmacists Association.” Smarinksy has devoted her career to providing access to quality pharmaceutical care for underserved patients.

Since joining Direct Relief, Smarinsky has been intimately involved in developing multiple programs, including hurricane preparedness kits, naloxone distribution, and more. Learn more about the award here.

Material aid for Ukraine

This week, requested medications and supplies were received by several groups, including Kharkiv Renovation Fund and distributed to local healthcare providers.

Since Feb. 24, 2022, Direct Relief has provided medical aid to Ukraine weighing more than 2.6 million pounds, or 1,300 tons, with more on the way.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 9.5 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

• Ukraine
• Syria
• Lebanon
• India
• Sri Lanka
• Armenia
• Guatemala
• Turkey
• Mexico

UNITED STATES

Direct Relief delivered 389 shipments containing over 5 tons of medications over the past week to organizations, including the following:

• Health Services Inc., Alabama
• Mission Arlington Medical Clinic, Texas
• North Jefferson County Clinic Pharmacy, Texas
• Grace Medical Home, Florida
• Utah Naloxone – Andy’s, Utah
• St. Michael’s Medical Clinic, Alabama
• Homestead Community Health Center, Florida
• Good Samaritan Clinic, Alabama
• Centro San Vicente, Texas
• St. Vincent De Paul Clinic, Arizona

YEAR-TO-DATE (GLOBAL)

Since Jan. 1, 2023, Direct Relief has delivered 3,789 shipments to 1,273 healthcare providers in 53 U.S. states and territories and 52 countries.

These shipments contained 154.9 million defined daily doses of medication valued at $416.4 million (wholesale), totaling 2.2 million lbs.

In The News

Yemen Aid to Open Two Oxygen Plants in Yemen in Partnership with Direct Relief – YemenOnline: “Yemen Aid, a Yemeni-American humanitarian organization that responds to the crisis in Yemen, announced that they had received a grant from Direct Relief to support Yemen’s strained limited oxygen supply by building two oxygen plants in two needed provinces in Yemen.”

The post Solar Support for Mississippi Clinics, Continued Earthquake Relief appeared first on Direct Relief.

Delta Health Center, which operates 16 health centers throughout Mississippi, was especially affected as their Rolling Fork clinic was destroyed by the tornado that also killed 25 people in that community. Seventy-two hours after the tornado’s landfall, their team set up two tent clinics in the town (one in the parking lot of their destroyed clinic and one at nearby Mount Lula Baptist Church). After receiving a request for medical aid, Direct Relief sent a shipment of requested medications, including cardiovascular drugs and naloxone, to their team yesterday and is also preparing to send them an Emergency Health Kit, which contains essential medicine and supplies to care for 100 patients for up to three days and are designed for mobile care after disasters.

In addition, Direct Relief is providing an emergency operating grant to Delta Health Center for immediate needs. The Footprint Project has also arrived, thanks to a connection from Direct Relief staff, to help establish solar and battery power solutions for the tent clinics, as well as power solutions for those dependent on medical devices. Footprint Project, a Minnesota-based non-profit that works to provide cleaner energy for communities in crisis, is the recent beneficiary of Direct Relief-donated solar generators.

Direct Relief has dispatched or is preparing to dispatch shipments to the following health centers and clinics:

Mississippi

• Alcorn State University Family Clinic, Natchez            
• Bethesda Free Health Clinic, Ocean Springs
• Central MS Health Service, Inc., Jackson        
• Claiborne County Family Health, Port Gibson
• East Central MS Health Care, Inc., Sebastopol              
• First Baptist Medical/Dental, Vicksburg          
• Leflore County Health Center, Greenwood    
• North Mississippi Primary Health Care, Ashland            
• University of Mississippi, Jackson       
• Delta Health Center, Mound Bayou   
• Plan A Health, Louise               
• The Good Shepherd Medical, Laurel
• Good Samaritan Clinic, Tupelo

Alabama

• St Michael’s Medical Clinic, Anniston
• Good Samaritan Clinic, Tuscaloosa    
• M-Power Ministries, Birmingham       
• Ozanam Charitable Pharmacy, Mobile               
• Whatley Health Services, Inc., Tuscaloosa        
• A Promise To HELP, Birmingham

The post Insulin, Essential Medications Included in 19 Shipments Dispatched to Tornado-Impacted Communities in Mississippi, Alabama appeared first on Direct Relief.

Twenty-five people are confirmed dead from that tornado alone. Throughout the weekend, additional tornadoes caused damage and death in other parts of Mississippi, Alabama and Georgia. One additional fatality has been confirmed in Alabama.

Tornadoes and Health Impacts

Health impacts commonly follow tornadoes and other devastating storms in the immediate rescue phase of the event and during the recovery phase. Immediately following a storm, in addition to acute injuries, people can escalate into medical crisis when their chronic conditions go unmanaged. Those without access to therapies to manage diabetes, high blood pressure or asthma can end up in already stressed emergency departments.

During the recovery phase, as people begin to clean up their communities, they may be at risk of injury without protective gear. Puncture wounds from exposed nails and sharp objects can put people at risk for diseases like tetanus. Power outages from infrastructure damage can have life-threatening impacts on people depending on medical devices, and health facilities without power may lose access to electronic health records and temperature-sensitive medications.

Direct Relief’s Response

Over the weekend, Direct Relief was in contact with the Mississippi and Alabama Primary Care Associations, the Mississippi and Alabama Free Clinic Associations, and National VOAD (Voluntary Organizations Active in Disasters.) Direct Relief sent an emergency alert to all community health centers, as well as public health and emergency management partners in Mississippi and Alabama.

Direct Relief expects to dispatch medical shipments to several recipients over the coming days. One of Direct Relief’s partner health centers located in Rolling Fork, Mississippi, Delta Health Center, has reportedly lost its facility during the tornado and is currently operating a temporary clinic in the parking lot of the health center and an additional location at a local church.

“The purpose of the medical clinics is to provide urgent care to people in need, particularly those in need of insulin, blood pressure medications, tetanus shots and other medications in compliance with the state board of pharmacy,” according to the health center’s website. “Delta Health Center will waive all co-pay fees, accepts most insurances, and treats patients regardless of their ability to pay. Patients should expect no out-of-pocket expenses.”

The Delta Health Center in Mound Bayou was the first rural community health center in the United States, established by Dr. H. Jack Geiger and Dr. Count Gibson. The health center serves six counties with now operates 18 community and school-based locations, including in Rolling Fork, which was impacted by the storms.

Direct Relief will continue to monitor the situation and respond as requested.

The post Medical Needs Mount After Deadly Tornadoes in Mississippi, Alabama appeared first on Direct Relief.

Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana, Kentucky (PPGNHAIK) has two brick-and-mortar health clinics in Kentucky – one in Louisville and one in Lexington – “but we know this isn’t sufficient,” said Steven Conrad, PPGNHAIK’s institutional giving officer. Many patients lack the transportation needed to easily travel a long distance to a clinic, don’t have time, or don’t have the child care needed to make it to an appointment.

Conrad reported that 76 of Kentucky’s 120 counties have no OB/GYNs.

For people who need birth control, getting to a local clinic may not even be a desirable option. Their parents or a friend’s parents may work there, or they may just feel concerned about whom they might encounter in the waiting room.

“Sometimes folks in rural areas only have access to one county health clinic, and they may not feel comfortable going to that clinic for birth control,” Conrad said. “We sometimes hear from patients that they forego reproductive health services due to fear of judgment.”

PPGNHAIK decided to think outside the box, with an increased focus on providing virtual appointments to Kentucky patients with a clinician through their Planned Parenthood Direct app.

In many states, the Planned Parenthood Direct app, which launched in 2017 and has more than 320,000 enrolled users, can provide birth control, emergency contraception, and UTI treatments. In Kentucky, the only service currently available is birth control, although PPGNHAIK is working to change that.

Through Direct Relief’s Community Health Awards, funded by Bayer, PPGNHAIK is working to expand awareness and access to patients seeking birth control in Kentucky, with the goal of doubling the number of Kentuckians receiving contraceptive care through the Planned Parenthood Direct app. The organization is one of three that received $50,000 to expand creative programs that remove barriers to reproductive health care in underserved communities. The Community Health Awards are currently in their second year; first-year awardees are profiled here.

“This generous grant from Direct Relief will support PPGNHAIK’s efforts to increase awareness of and access to telehealth services, which is critical to providing sexual and reproductive health care in communities facing the most barriers to care,” said Rebecca Gibron, CEO of PPGNHAIK, in a statement.

According to the Guttmacher Institute, 47% of Kentucky’s pregnancies are unintended. Conrad explained that teen birth – Kentucky has the fourth-highest rate in the country – and unintended pregnancies increase the rate of childhood poverty and can perpetuate poverty over generations.

That’s particularly problematic in Kentucky, which is among the poorest states in the U.S., with a poverty rate of 16.3%. Poverty rates for women are even higher, and the country has the fourth-highest teen birth rate in the country.

“Through the Planned Parenthood Direct app, we can…provide the same quality care that [patients] would receive at a health center visit. We want every patient – no matter where they are – to be able to stay healthy and reach their life goals,” Conrad said.

In particular, he explained, the pandemic has shown the importance of providing virtual access to contraception in rural areas.

The app isn’t intended to replace in-person exams, and clinicians still counsel patients on the importance of getting preventative care. “This can be a challenge with some patients who like the comfort of telehealth services, getting them in the clinic for preventative care and continuing to follow up with those services needed,” said nurse practitioner Deborah Dlik, who provides virtual care in Kentucky through Planned Parenthood Direct.

Still, Conrad said, it’s an effective part of the picture: “PP Direct can help countless Kentuckians take control of their reproductive lives.”

Learning from local sources

Dr. Caroline Weinberg has learned a lot from launching a mobile reproductive health clinic in rural Mississippi.

“If someone had given me $1 million the day I had the idea…it wouldn’t have been a good program that was a part of the community,” she said. “You do really need that time to get to know the community.”

Weinberg was drawn to Mississippi because of its maternal health outcomes – for example, the state has approximately 33 maternal deaths per 1,000 live births, nearly twice the national average – but quickly found that providing sexual, reproductive, and primary care in a rural setting wasn’t going to be a straightforward enterprise.

“The fact that I was not from Mississippi was a barrier, and a totally legitimate one,” she said, citing a long history of “people shoving local perspectives to the side to think that they could solve every problem.”

Through conversations – often over meals – with members of local communities, she learned some indispensable lessons: Hire local, but not too local, because no one wants to run into a reproductive health provider at the supermarket. Confidentiality is everything, because sometimes clinic workers will talk – even though doing so is in violation of federal confidentiality requirements. Trusted local programs often don’t have an Internet presence. Don’t advertise that you’re offering birth control – instead, focus on whole-person wellness and primary care – “because if you do, everyone will know your business when you walk into the clinic.”

Today, the clinic provides sexual and reproductive health care, along with primary care, to people throughout rural Mississippi, often traveling to towns with populations as small as 170 people. “If you go to a town of 170 people and you see 10 people, you’ve done a really good job at outreach,” Weinberg said. “Sometimes we travel 100 miles to see 10 people, and that’s OK.”

Education is a major component of the work her team does. Weinberg gave the example of a man who came in with syphilis and was concerned it might turn into HIV/AIDS. Encouraging patients to get Pap smears and mammograms – Weinberg said many don’t bother, because they think they won’t be able to get the follow-up care that’s needed if something is wrong – is also essential.

And her team has grown accustomed to dealing with crisis situations: “Basically never a week goes by without someone coming in…with blood pressure high enough to go to the emergency room.” One patient came in with blood pressure of 220/110. The team got her to the emergency room immediately, then followed up with her.

Without the mobile clinic, many patients may not get care at all. In some cases, “you have to choose between getting food on the table or getting your kid to a doctor or getting yourself to a provider,” Weinberg said.

The grant from Direct Relief and Bayer will help Plan A try new things, like doing education in high schools and hiring a community health worker to present at events. “Part of the problem with operating on a shoestring, which a lot of mobile clinics do…is that there’s not a lot of room to experiment and see what works,” Weinberg said. “You’re worried about every dime.”

In addition, she thinks it will increase trust in the community, because they’ll be able to fulfill more needs. “We really hate saying no to people,” Weinberg said.

Creating a comfortable environment

For safety-net clinics in Oklahoma, providing sexual and reproductive health services means making patients comfortable, whether that means culturally responsive care, trauma-informed care, or simply creating a place where vulnerable patients feel willing to discuss an often uncomfortable subject.

The organization Health Alliance for the Uninsured (HAU) is working to make patients more comfortable in central Oklahoma clinics, as part of a larger collaborative project with the group Thrive OKC, a sexual health collective aimed at youth. The goal? To provide trainings to up to 30 medical staff and volunteers from 10 clinics, with the goal of improving the family planning services they provide.

The collaborative wants to “help providers to help their patients to navigate their reproductive choices,” said Dr. Ronneal Mathews, Thrive OKC’s director of community engagement. The trainings are designed to help providers “create spaces where, when adolescents do come in to access their services, it’s an environment that’s comfortable for them.”

In particular, HAU and Thrive OKC are focused on “walking clinicians through some really practical steps that they can take to make their clinics…more accessible for a younger audience.”

The training, called the One Key Question Certification Training, is built from an evidence-based curriculum by the organization Power to Decide. Mathews said the goal is for providers to begin by asking patients if they plan to become pregnant in the next year, and help patients make family planning decisions from there.  

Asked why Oklahoma in particular needed this intervention, Mathews explained, “It’s difficult in Oklahoma at this point in time for teens to find places where they can seek reproductive health services…it’s really important for them to provide care that is confidential…nonjudgmental and non-shaming.”

The post From a Digital App to Local Connections, Finding Creative Approaches to Reproductive Health Care appeared first on Direct Relief.

“[The heat]’s very unpleasant,” said Dr. Caroline Weinberg, founder and CEO of Plan A Health. “But inside it’s nice and cool.”

The “inside” in question is the interior of a 210-square-foot van that a team of women is driving around Mississippi’s Delta region. They offer free reproductive and primary healthcare services in the most rural parts of the state.  

Weinberg hatched the plan for a mobile clinic in 2018, after learning that Mississippi had one of the worst health outcomes in the country. The New York doctor began visiting the area and fundraising for a mobile unit just before the coronavirus pandemic, building trusting relationships through collard green-and-cornbread dinners with local health professionals. Her dinner companions introduced her to more people and gave her tips on how to talk about the work she would be doing.

Weinberg raised $25,000 in her first year. Now, the Plan A Team has expanded to employ a host of women from the Delta region who recently celebrated one year on the road.  

“The other day we were trailing each other (on the highway) and she passed me; she was gone,” Desiree Norwood said about her colleague driving the Plan A van. “I was just like ‘Wow, she is really driving’.”

Care in the community

Norwood is Plan A’s program coordinator. She first learned about the practice when the mobile unit was scheduled to visit her hometown of Sunflower, Mississippi, in 2020. Sunflower’s population of 1,068 people is 76% Black, and the median household income is $16,824. Half of the city’s population lives below the poverty line.

Without Plan A, Norwood would have to travel eight miles north or 13 miles south to receive care — a trip that people may not be able to take.

“I was just like ‘Wow, this is going to be something amazing’,” Norwood said.  

Mississippi reported 8.3 infant deaths per 1,000 births in 2020. The infant mortality rate has decreased by about 6% since 2019. The state has been encouraged to improve maternal health for almost a decade by supporting policies that expand access to care, improve women’s overall health before becoming pregnant, eliminate racial and ethnic inequities, and increase breastfeeding and safe sleep practices.

However, the state’s maternal mortality rate is still the fifth-highest in the country. The maternal mortality rate is 22.1 for every 100,000, higher than the national average of 17.47. The state also had the highest rates of excess deaths, from coronavirus and chronic diseases like heart disease, between 2020 and 2022.

Mississippi is one of 12 states in the country that declined expanded access to Medicaid, leaving 15% of residents under the age of 65 without medical coverage, according to the latest census data.

Many of the small Delta communities lack a brick-and-mortar health clinic, and residents must drive to other cities for medical care. Weinberg says about 98% of their clients are Black women who seek prenatal and postnatal care.

The mobile clinic travels to about three destinations per week with Antoinette Roby at the wheel.

Roby was a truck driver for 10 years prior to working with Plan A. She studied healthcare administration in school, which qualified her to be both the driver for the mobile clinic and a community health worker.

The secrets of success

The Plan A Team has prioritized the power of relationships. Norwood said they have a vested interest in the communities they serve.

“A lot of people come to the Delta to do research, do programs, and then they leave,” she said.

Weinberg said she had to learn to adjust and let go of her initial dreams of what the mobile clinic could be after she began to learn more about the needs and wants of the communities she planned for the van to go to. Since the staff are from the area, they’re familiar with local government and religious leaders, they know how to talk to patients, and they understand the culture of the communities they serve.

“It’s not like I can just pick up what I did in this Mississippi and drop it in, like, Georgia or Louisiana,” Weinberg said. “You have to like, take that time to know the community, because every place is different.”

 They were also warned by people in the community about how they may be perceived if they started conversations about access to birth control and passed out condoms (which are included within their services).

Roby said their success also has a lot to do with their welcoming attitudes and ability to share accurate information. Since many of the rural communities lack physical doctors’ offices, many seek information on the internet or by talking to those closest to them, rather than from trained medical staff.

“I pretty much have this outgoing personality and this smile, too,” Roby said

When the Supreme Court overturned Roe v. Wade this summer, Plan A was already working to increase access to reproductive services. Weinberg admitted she worries about the increased risk of maternal mortality. Plan A does not conduct abortions; however, patients can receive care regarding prenatal and postnatal care, and anything related to the cervix, uterus, and vagina. Patients also don’t have to identify as women to receive care.

Though they do their best, Weinberg admitted there’s a threshold to their capacity. Like any nonprofit, they continue to fundraise, but without policy changes at the state and federal levels, major risks remain for Mississippians.  

“There are limitations to what we can do,” Weinberg said. “We can’t solve every problem, and that’s very scary and irritating. It’s like you see the problem that you want to be able to solve it and you just can’t always solve it.”

So oftentimes the Plan A team relishes their big wins, like serving 10% of a community in one day — even if that means they saw fewer than 30 people. To them, driving the 100 miles to provide care for someone in need will always be worth the trouble.

“I felt like it was bigger than, you know, just me,” Norwood said. “To be a part of this organization where they’re going into communities that don’t have a lot of access.”

Direct Relief, in collaboration with Bayer, has awarded $50,000 to Plan A through the 2022 Community Health Awards, which aim to increase and strengthen the provision of family planning services to vulnerable populations in the U.S.

The post In Rural Mississippi, Plan A Goes the Distance for Patients appeared first on Direct Relief.

Yesterday, Direct Relief shipped over-the-counter products and requested supplies to ARcare, a Federally Qualified Health Center with locations in western Kentucky, Arkansas and Mississippi. Those supplies, including nutritional supplements, allergy medications, aspirin, and pediatric care items, arrived today at a shelter currently housing 75 people in Mayfield, Kentucky, where ARcare is treating patients via a mobile unit.

Mayfield was one of the worst-hit towns, with aerial footage showing entire blocks reduced to rubble. A local candle factory there collapsed, killing at least eight workers.

An additional shipment is leaving Santa Barbara today, bound for an ARcare facility in Paducah, Kentucky, before being transported to the Mayfield location. The shipment includes baby formula, antibiotics, lidocaine, wound care products, cardiovascular drugs, nutritional supplements, insulin, Tdap vaccines, and medicines for asthma.

After natural disasters, patients, especially from vulnerable communities with chronic diseases, often face obstacles accessing medications they rely on to manage their conditions. These can include transportation hurdles, medicine shortages, and interruptions to the power supply needed to keep some medicines within a specific range of temperatures.

To help address power supply shortages, Direct Relief is shipping two SunKit portable solar generators to the Second Christian Church in Mayfield, which is acting as a donation distribution point for the town.

Direct Relief began responding to the disaster on Saturday by reaching member clinics in impacted areas. No clinics reported damage but are treating patients in the regions that have faced, in some cases, catastrophic damage. Direct Relief is also coordinating with the Voluntary Organizations Active in Disaster (VOAD) at the national and state levels.

Additional reporting contributed by Leighton Jones and Annie Vu.

The post Multi-State Tornado Response Continues as Essential Medications Depart appeared first on Direct Relief.

• Working with the Mexican government, Direct Relief delivered 95,000 polio vaccine doses to Ecuador.

• A $200,000 grant from Direct Relief is helping Alaska’s most vulnerable receive Covid-19 vaccines.

• Covid-19 vaccine clinic held at Direct Relief HQ.

• In Mississippi, a $250,000 grant from Direct Relief is bolstering efforts to address food insecurity.

Top Stories

When Ecuador Needed Polio Vaccines, Mexico and Direct Relief Stepped Up

The situation: Last month, Ecuador launched a national campaign to inoculate infants against polio, but the country ran short of the vaccine doses needed.

The response: The Mexican government responded to the appeal, offering to donate the vaccine from its national stockpile. To transport the aid, Mexico turned to Direct Relief.

The impact: Using its cold-chain transportation experience and resources, Direct Relief delivered 95,000 doses of the vaccine, which landed last week at Quito International Airport.

Direct Relief Supports Alaskan Covid-19 Vaccination Efforts

The situation: A health center in Alaska has undertaken an ambitious plan to vaccinate people living in remote communities, some of whom need to be transported by chartered plane.

The response: Direct Relief is supporting the vaccination efforts with a $200,000 grant.

The impact: Vaccinating people in remote communities reduces the likelihood that emergencies will arise, when help is far away and dependent on weather.

At Direct Relief Headquarters, A Vaccine Clinic Aimed at Vulnerable Locals

The situation: Santa Barbara Neighborhood Clinics, a local health center, has been vaccinating the community’s most vulnerable against Covid-19.

The response: Direct Relief has hosted Santa Barbara Neighborhood Clinics for vaccine pop-up clinics on March 13 and 18, and will continue to do so.

The impact: More than 100 members of the community received the vaccine at the first clinic.

A New Program Aims to Reduce Hunger in Mississippi

The situation: Food insecurity is on the rise, and Mississippi has the highest rates in the country.

The response: A new program headed by the Community Health Center Association of Mississippi is working to reduce hunger while offering education on healthy eating. Direct Relief is supporting the program with a $250,000 grant.

The impact: Participating health centers are working to reach a range of diverse populations, from people with HIV to children experiencing hunger.

In Brief

The United States

• Over the past two weeks, Direct Relief has shipped 1,027 deliveries totaling more than $11.3 million (wholesale) to 477 health organizations in 46 states and territories.
• During that time, Direct Relief has processed more than $380,000 in grant funding to support a range of health-focused initiatives.
• Direct Relief also hosted a reproductive health webinar in honor of International Women’s Day.

Around the World

• Over the same period, Direct Relief has supported organizations in 24 countries with more than $15 million in medical aid and more than $250,000 in grant funding.
• Direct Relief is in the process of shipping more than two dozen 40-foot containers of PPE to health organizations around the world.
• Since the beginning of the pandemic, the organization has shipped 3,942 oxygen concentrators to health care providers worldwide.
• In response to a call from the Pan-American Health Organization, Direct Relief sent 1,900 pounds of medical aid to support a field hospital in Barbados.

The post Global Update: Polio Vaccines to Ecuador; Covid-19 Vaccinations in Alaska; A Local Vaccine Clinic appeared first on Direct Relief.

Dr. Jack Geiger, the founding father of the community health center movement, would send his patients to the grocery store to get healthy food. The grocer would fill the order and send the bill to the health center.

Someone told Geiger that food couldn’t be prescribed. Geiger retorted that the best cure he knew for malnutrition was food.

Robin Boyles, who’s now the chief program planning and development officer at Delta, said that treating food insecurity “really does go back to our very, very early days…You can treat someone for an illness or infection, but if you’re sending them home and they don’t have food to eat and they don’t have clean drinking water and they don’t have sanitation, they’re not going to get well.”

Food insecurity is on the rise across the United States. In Mississippi in particular, food insecurity rates are higher than the national average. A 2019 study from the USDA’s Economic Research Service found that the state had the highest rate of food insecurity in the country – 15.7% of the population experienced it.

And the state’s community health centers are coming together to do something about it – together with the Community Health Center Association of Mississippi and Direct Relief. Direct Relief provided the health center association with a $250,000 grant designed to fight hunger among Mississippi’s most vulnerable.

The result is the Cornbread Cooking Series, a program that’s designed to both increase access to food and teach people how to buy and prepare food that’s healthy and good to eat. Six Mississippi health centers will introduce or build on existing programs around food access and education.

“It’s Southern and everybody loves cornbread…it’s winter and it’s comfort,” said Janice Sherman, the association’s CEO.

But despite the homey name, Sherman is focused on new cooking techniques as well as food access. “I thought it would be an opportunity to really introduce some new areas of spices and things that will really be better for our diets,” she said.

Patients are screened for food insecurity. If they qualify, they’re referred to the program, which provides a combination of education, activities, and food vouchers or other access to healthy, nutritious food.

Sherman explained that health centers, as trusted community resources, are in an especially good position to deliver help and education. “For a provider who’s your doctor to address the fact that you need food is pretty powerful,” she said.

Three health centers participating in the program sat down with Direct Relief to talk about hunger, healthy cooking, and how they’ll use the funding.

For Patients with HIV, Closing the Cracks

At G.A. Carmichael Family Health Center, dietician Kyskie Bolton explained that there are a number of patients who are “dramatically food insecure, but don’t fall into any category where they would get significant assistance.”

In participating in the Cornbread Cooking Series, G.A. Carmichael wanted to focus on the patients who most needed intervention – in this case, by focusing on patients dealing with both food insecurity and HIV/AIDS.

Some of those patients have comorbidities such as hypertension or diabetes as well.

Bolton explained that HIV-positive patients often don’t want anyone to know their diagnosis. “They will protect it at all costs, even at the cost of their hunger or nutritional health,” she said. “These are the type of patients who are going to fall through the cracks.”

G.A. Carmichael is preparing videos of healthy cooking techniques – how to prepare vegetables, for example – and a supermarket tour, to show patients who qualify for the program how to shop around the edges of the grocery store for the healthiest food.

The goal, Bolton said, is “increasing their literacy and empowering them to make better decisions so they can utilize what they have.”

The health center is also working with nearby farmers to acquire and distribute produce to patients with chronic diseases – a long-term enterprise that the funding will help them continue. Active participants in the program will also receive vouchers and gift cards to nearby grocery stores.

For Bolton, part of the challenge is reaching a diverse patient population – one that’s both rural and relatively urban, and that includes a range of ethnicities and backgrounds – and produce materials and messaging that will appeal to everyone.

However, the population does have one thing in common: “Most people here are extremely technologically advanced and don’t have much to do with cornbread,” Bolton said.

Reducing Childhood Obesity

For Dr. Wendy Williams, a pediatrician at Coastal Family Health Center, an interest in increasing food access came about when she noticed a correlation between food insecurity and obesity in the children in her practice.

“Until we started asking the questions, I had no idea how pervasive [food insecurity] is down here,” she said. “You can’t get to the bottom of pediatric obesity until you conquer that, or at least make some dents.”

The health center started by planting a vegetable garden to teach kids about healthy food. It met an enthusiastic reception: Williams said that one child described a radish as the most beautiful thing he had ever seen before putting it in his pocket to preserve it. Another was anxious to learn to grow food – his uncle, he told Williams, didn’t have enough to eat.

The Cornbread Cooking Series grant will help Coastal Family Health Center expand its program, reaching out to local farmers to acquire excess produce for patients, and launching a cooking education series.

“Down in the South we like to do things with a lot of fat and salt, so really being cognizant of that and teaching them to use other things to make food taste good,” such as herbs, will be a priority, Williams said. “It’s definitely a mindset. You have to change how people view it.”

The health center also plans to develop food boxes, working with a local food bank to get protein sources for patients and with a produce distributor to get fruits and vegetables.

But throughout it all, the community garden remains a fixture.

“You don’t even think you’re making that big a difference in the community,” Williams said. But feedback from patients – and enthusiasm for what the garden produces – have changed her mind.

“We’re teaching kids that, from the very beginning, they can be self-reliant,” she said.

Going back to the beginning

Between the pandemic and the winter storms that blanketed large swathes of the U.S. in February, need is especially high among Delta Health Center’s patients, said Neuaviska Stidhum, the health center’s chief operating officer and chief nursing officer.

“Right now, we’re in crisis,” she said. “We really want to be able to just get the hunger out, to provide for them so they won’t have that hunger.”

Since the 1960s, Delta Health Center has played a role in alleviating hunger among its patients. The health center currently has six acres of land – cultivated by a local university – that it uses to provide a range of fresh produce, from greens and sweet potatoes to fresh fruits.

Stidhum explained that, while many of their patients qualify for public assistance, it’s often not enough, or too far away to be accessible for people who don’t have transportation.

“It’s really difficult for some of our more rural patients…especially if they don’t have transportation and have to depend on someone else,” Boyles said.

The grant will be used to provide much-needed food vouchers to patients, and health providers will give patients supplemental information about how to choose and eat healthy food that won’t break the bank.

Stidhum has hopes for a kitchen in the health center someday. For the time being, providers will refer patients to cooking videos, health services, and other resources.

“We’re just going back to the beginning, to help the people any way we can,” she said.

The post In Mississippi, Working to Treat Food Insecurity appeared first on Direct Relief.

A middle-aged man with anxiety and depression, his mother often brings him to appointments at the clinic. Before beginning the program, he was significantly overweight, and reluctant to make eye contact or speak to strangers.

A Healthier You is designed to help patients with multiple co-morbidities – serious, concurrent medical issues, such as obesity, hypertension, diabetes, and smoking – to have better health outcomes. The goal is to provide hands-on steps to help people become more active, learn how to make nutritious food choices, and achieve greater health literacy – and, in the process, to help them lose weight, lower cholesterol, and regain control of their blood sugar.

“I have had bad habits all my adult life that lead to high blood pressure, diabetes, and obesity,” Zeller’s patient said. “I tried to change many times, but did not succeed.”

After participating in the program for several months, he’d lost 40 pounds and had success controlling his blood sugar and blood pressure. He’s more willing to speak and make eye contact. “Since I have been participating in AHY, I have had the support of the staff and the other participants,” he explained.

Increasing Knowledge, Improving Health

He’s not the only one. A Healthier You has approximately 120 people – all of them patients at the free clinic – who participate in the group’s activities to varying degrees. Those include exercise classes and walking sessions, lessons in how to shop for groceries at the local megastore and farmer’s market, and classes on stress management, sleep hygiene, oral and eye health, and other essential subjects, taught by medical students at a nearby university.

With support from Teva Pharmaceuticals through the Enhancing Access2Care program and Volunteers in Medicine, Direct Relief is providing $75,000 to the Free Clinic of Meridian to fund the A Healthier You program. In total, eight grantees have received $450,000 through the Access2Care program since 2017.

Among participants, there’s a wide range of enthusiasm and knowledge, according to Zeller. “Some people in our program know what to do – they just need encouragement – and some people have no idea,” she said.

Zeller shows people how to read nutrition labels. During monthly shopping trips, she guides participants – who receive a food stipend from the clinic – in choosing healthy, cost-efficient foods.

Navigating challenges

For clinic patients, getting healthy comes with a host of challenges. Most of them are low-income but don’t qualify for government-sponsored insurance; one patient said that she “makes too much money to be on government assistance but doesn’t earn enough to pay for health insurance.”

Literacy – in addition to health literacy – is limited for some of the program’s participants. Others lack access to a car or public transportation – one person may drive fellow community members to multiple appointments a day. To counter this, Zeller uses a combination of gasoline vouchers, rideshare apps, and taxis to get patients to their appointments, so that they’ll more successfully manage their chronic conditions.

And Covid-19 has put a damper on some of A Healthier You’s activities. “I feel like an outsider looking in would say, ‘Why aren’t you doing Zoom events?’” Zeller said. But many of the program’s participants don’t have internet access or a smartphone, or aren’t familiar with the necessary technology.

Instead, group members have opted for masks and hand sanitizer so that they can continue walks and shopping trips.

Extra steps

Zeller takes a series of additional steps to help program participants live a healthy life. The clinic has negotiated for reduced costs at a local gym, and some of the program participants “love it and they’ve never had a gym membership. They are really, really trying to go very consistently,” Zeller said.

Participants can take home exercise equipment such as bands, balls, yoga mats, and workout DVDs – a popular option for people who might be self-conscious about exercising in public.

And at classes, Zeller makes an effort to offer a range of healthy new options for people to try – hummus, sparkling water, kale. “Soda and sweet tea are probably a problem everywhere, but they’re a huge problem here,” she said.

She explained that because so few of A Healthier You’s participants have income to spare, she’s concerned they wouldn’t try these things for themselves. This way, “there’s not a risk of spending money on something they won’t like.”

People seem to appreciate the program – and Zeller, who “has been real good at keeping me on track with eating healthy foods and snacks,” one patient said. “I have really learned how to take better care of myself.”

Rose Levy contributed reporting to this story.

The post From Food Shopping to Group Walks, This Clinic Helps Patients Live a Healthier Life appeared first on Direct Relief.

And these days, all three are highly in demand.

“It’s been nonstop since Covid,” MacCalla said. “We get asked to respond to almost everything now, so we’re all trying to manage how much time we can put into each thing.”

It’s been one of the worst fire seasons on record in California, and severe wildfires have devastated swathes of Oregon and Washington as well. The Gulf Coast has seen an active storm season, with Hurricane Delta now poised to make landfall later this week. Puerto Rico has experienced a series of earthquakes, a drought, and most recently, flooding. And that’s just in the United States.

On top of a Covid response that has included $53.6 million in funding, medicines, and supplies, and nearly 7,000 shipments thus far, Direct Relief has also mounted an active response to the wildfires, providing $1.4 million and 117 shipments to more than 30 organizations. After responding to the year’s storms, including Hurricanes Laura and Sally, with approximately $2.5 million and 202 shipments, the organization is poised for response to Hurricane Delta.

In addition to funding testing initiatives and a telehealth program and providing emergency and operating-room equipment, tents, and PPE to frontline health care providers in Puerto Rico, Direct Relief has also provided additional aid in response to the earthquakes and flooding. Since January 1, the organization has dedicated about $6.4 million to Puerto Rico.

All in all, 2020 has been Direct Relief’s most active year thus far.

For a society used to treating disasters as discrete events – Hurricane Katrina, Superstorm Sandy, the Camp Fire – overlapping disasters, especially piled atop a devastating pandemic, may be overwhelming, even confusing.

And worse, when multiple disasters break out at any one time, they strain much-needed resources, from manpower to medicine, making it harder to respond effectively – and harder for communities to recover.

An unusual season

During a standard season, California has enough resources to handle its own fires, said Brad Alexander, assistant director of crisis communication’s at California’s Office of Emergency Services. If help is needed, Oregon and Washington are usually among the first states to provide it.

This year has been considerably more challenging. California hosted firefighters from Canada, Mexico, and Israel, along with less usually called-upon states like Montana, Texas, and New Jersey.

“We have thousands of firefighters in the state, and we’ve essentially put every mutual aid engine on the street,” Alexander said, speaking in mid-September. “As soon as the firefighters are off one engine, we put them on another to fight another fire…They’re just getting the minimal amount of rest, and then back out to duty.”

That description likely wouldn’t surprise Tricia Wachtendorf, a sociology professor and director of the Disaster Research Center at the University of Delaware.

Multiple disasters make “the ability to rely on mutual aid agreements much more difficult,” she said. “If we have multiple events that are taking place in surrounding areas, that surge capacity has to come from further away.” That means emergency responders may take longer to get there and be less familiar with the terrain or situation when they arrive.

In addition, when it comes to overlapping events, like the wildfires and the Covid-19 pandemic, “you may still be in the middle of a response, and your response to the next event might be complicated by the fact that that other event has not yet been completed,” Wachtendorf said.

That’s been especially complicated during the pandemic because its demands often contradict those of emergency response.

“We have fairly proven ways of dealing with population during protection,” said James Schultz, a professor at the University of Miami’s medical school and director of its Center for Disaster and Extreme Event Preparedness. Evacuation – which Shultz explains means gathering people together – is a part of that. “Where we have more equivocal evidence is how you safeguard them once they are together,” he said.

For Shultz, living in hurricane-prone Florida, the question of how best to respond to concurrent disasters is a personal one. “This is not so academic. This is literally in my hometown,” he said.

Living through disasters

It’s not just first responders and NGOs that are strained by multiple disasters. First and foremost, they’re hard on the people who live through them – although researchers are still learning precisely how.

Although a lot is known about individual traumas, “we don’t have something similar at the collective level,” said Lori Peeks, a sociology professor and director of the University of Colorado, Boulder’s Natural Hazards Center. “What about when people live through multiple collective traumas where their entire communities have been evacuated multiple times?”

For one thing, researchers already know that disasters aren’t equally destructive to all. They’re more likely to devastate those who are already vulnerable – people who are low-income, Black or brown, elderly, already ill, not speakers of English.

And new research, Peek said, suggests that multiple disasters “exacerbate those existing inequalities and make them worse.” There’s even evidence that, while multiple disasters can cause financial devastation for poorer Black Americans, higher-income white Americans may experience an increase in wealth over time.

Multiple disasters also endanger people’s ability to get the support they need, Peek said. She pointed to Hurricane Sally, which despite being a destructive, major hurricane, “was barely in the national news for a day,” she said. “If you don’t garner the national media, you’re not going to garner the resources and support…
More and more communities are just feeling overlooked, left behind.”

Recovery may take longer and place more stress on the people who experience multiple disasters, Wachtendorf said: “People just get exhausted. Those support networks may be frayed,” meaning that it’s harder for them to receive informal assistance or support, to recover property losses, and to rebuild their lives.

And they may be less likely to evacuate if another disaster occurs – whether from exhaustion or lack of available resources.

Concurrent or recurring disasters – for example, Butte County, already devastated by 2018’s Camp Fire, is currently confronting the vast North Complex Fire – also have significant mental health impacts, said Emanuel Maidenberg, a clinical professor of psychiatry at UCLA who focuses on disasters.

“We have more stressors…and on the other hands, we have limited sources for positive emotions” when one disaster after another occurs. “We kind of find ourselves in this one-two punch of more stress and fewer coping possibilities.”

Some good news: Wachtendorf said that many disaster-prone communities may develop a “disaster subculture” over time, making them more knowledgeable, organized, and prepared for future events.

A non-discrete event

It may feel like disasters are coming harder and faster than ever. In ways that’s true, as disaster seasons grow more active or severe, and everything happens against a background of Covid-19. But disasters have always been compounding events, Peek said.

She used the example of Hurricane Katrina. Primarily famous as the storm that breached levies and brought catastrophic flooding, Katrina also caused a series of devastating oil spills off the Gulf Coast and a tornado outbreak that reached as far as Pennsylvania. A few short weeks later, Katrina was followed by another major Gulf Coast storm, Hurricane Rita.

For a long time, researchers and policy makers often treated disasters “as though they were discrete events,” Peek said. “Our moment is obviously teaching us how important it is to think about people and systems when there are multiple disasters that are unfolding simultaneously.”

A natural disaster, for example, may lead to a cholera outbreak, as the 2010 Haiti earthquake did. It may not always be clear which of these events is whose responsibility.

But we’re going to have to figure it out, according to Peek.

“The world that we are living in right now, emergency managers haven’t even finished their one deployment…and then another disaster happens,” she said. “There’s a layering that is happening with disasters that is outstripping our resources.”

The post Multiple Disasters Strain Response Systems, Slow Recovery, and Deepen Inequity appeared first on Direct Relief.

In the area of Florida most affected by wind shear, there are about 2.8% fewer people than usual, said Andrew Schroeder, Direct Relief’s vice president of research and analysis.

Evacuees have dispersed widely, from San Antonio, Texas in the west to Birmingham, Alabama in the north, according to Facebook data.

But what sets evacuees of the current storm – and its immediate predecessor, Hurricane Laura – apart is one striking fact: remarkably few of them are showing up in shelters.

As of September 14, Schroeder said, only a handful of people in Florida and Alabama had popped up in shelters. About 120 appeared in shelters in Mississippi.

More typically, for a Category 1 or Category 2 hurricane, Schroeder said he would expect to see about 5,000 people appear at shelters. A Category 4 storm might top out at 35,000 shelter residents. “We’re not even in the ballpark of that,” Schroeder said.

There’s a likely culprit – and it’s the most obvious one.

“It’s probably Covid,” Schroeder said. “It’s probably that people are choosing to avoid sleeping in shelters unless they really don’t have other options.” It’s likely, he suggested, that people are opting to stay in hotels, RVs, cars, and family members’ residences instead.

In part because the storm has cut such a slow path, the extent of its effects is just beginning to emerge. That’s the case for safety net health care providers – which are among the organizations Direct Relief supports during and after a disaster such as a hurricane – as well.

“Obviously, they’re in the middle of it right now, so they don’t necessarily know what the impact will be,” said Leighton Jones, Direct Relief’s director of emergency response.

But a few things have emerged from Jones’s conversations with health care organizations. “It’s the rainfall that’s the challenge, and the storm surge. It’s a flooding event [even] more than a wind event,” he explained.

In preparation for storms like this one, Direct Relief has stationed Hurricane Prep Packs at health care organizations throughout the southern United States – including packs distributed to 19 organizations in Mississippi, Alabama, and Florida that serve low-income and medically fragile patients every day and will be where they go for care when the storm passes

The packs, developed with consultation from health care experts after Hurricane Katrina and improved upon in the years since, contain a wide variety of medications and supplies, from first aid supplies to chronic care medications, that are widely requested after a hurricane or tropical storm.

In addition to the pre-staged packs, “what we usually do at this point is open the lines of communication with our partners in the area… just to say ‘We’re here if you need us,’” Jones said. “A couple of days after the storm, we usually get asked” for other essential medicines and needed supples.

Although it’s too soon to tell what the long-term effects from Sally will be, Schroeder noted some developments in the wake of Hurricane Laura that he’ll be watching closely in the weeks after Sally.

For one thing, although Facebook’s users are slightly more likely to be women than men, Schroeder said that the number of long-term displaced people from Laura are disproportionately female. Two weeks after the storm, 63.2% of those still displaced were female.

In addition, Schroeder said, people are returning much more slowly overall. Although about 18,000 evacuees were identified as leaving the areas that Laura endangered, only about 400 people a day have been returning.

“At that rate of return, it’s going to take quite a while for people to get back to their homes,” Schroeder said.

The post Amid Hurricane Sally, People Are Moving – Just Not the Way They Usually Do appeared first on Direct Relief.

“Our state hasn’t seen a storm surge like this in many many decades,” Louisiana Gov. John Bel Edwards told reporters during a briefing Wednesday.

The National Weather Service warned Wednesday of a potentially “unsurvivable storm surge” up to 15-20 feet in some areas. Surge could be recorded as far as 30 miles inland.  Many places in Laura’s path, like Port Arthur and Beaumont, Texas, suffered extensive damage when Hurricane Harvey ripped ashore in 2017. Even before that, Hurricane Rita in 2005 caused $25 billion in damage to the region. 

This week also marks the 15th anniversary of Hurricane Katrina, which ravaged the Gulf Coast, causing extensive damage to places like New Orleans.

Direct Relief has a long history of responding to hurricanes along the U.S. Gulf Coast, and most recently responded to Hurricanes Barry, Michael, Harvey and many others. The health impacts of life-threatening hurricanes go beyond rising floodwaters and high winds.

Public health concerns during events like Hurricane Laura are myriad, and disasters like the current storm can impact people very differently.

Access to transportation can hinder the ability to evacuate quickly, and elderly populations, as well as children, people with disabilities, and people who speak a primary language other than English, are also at disproportionate risk from disasters like hurricanes. 

The ongoing Covid-19 pandemic creates an additional challenge during evacuations, as people who leave their homes may be exposed to, or unwittingly contribute to, the spread of the disease. Evacuation shelters have  undergone modifications to ensure social distancing to keep evacuees safe, and many local emergency responders are working to connect evacuees with alternatives like hotel rooms for people to safely isolate out of harm’s way.

Evacuations can also cause increased health risks for people managing chronic conditions, like diabetes or high blood pressure, if they are without an adequate supply of medication.

Direct Relief has been in contact with more than 80 partner health facilities in Texas, Louisiana, Mississippi, Alabama and Florida. The organization has also been coordinating with the  Primary Care Associations of Texas, Louisiana, and Florida, and the Free Clinic Association of Texas.

Each year, caches of essential medicines are staged in hurricane-prone communities across the U.S. Gulf Coast and the Caribbean. These hurricane preparedness packs are stored at partner health facilities and contain many of the essential medications commonly requested after a disaster. Some of these medications are relied upon to keep patients with chronic medical conditions out of local emergency rooms. 

These packs are currently staged all along the Gulf Coast, including communities expected to be impacted by Laura, and can be opened immediately by health staff responding to patients.

Direct Relief is ready to respond to additional health requests as the storm advances.

The post “Unsurvivable Storm Surge” Expected from Hurricane Laura, Now a Category 4 Hurricane appeared first on Direct Relief.

The 55-year-old man, who moved to Tupelo from Georgia to take care of his dying father nearly four years ago, found manufacturing work that came with health insurance. But last month, he joined 26 million other Americans who have lost their jobs because of COVID-19 in the past five weeks.

With the job went Delbert’s health coverage — and the money to pay for medications to control his diabetes and cholesterol. Insulin alone would cost him $600 a vial. Delbert said he would be sunk without the free clinic, which opens twice a month to provide health care at no charge to anyone without insurance.

“My medications are so expensive,” Delbert said. Because of the medication assistance, he added, “I can keep my head above water.”

Typically, three rows of benches outside the clinic are filled hours before it opens. Forty volunteers coordinate paperwork, eye screenings and prescriptions. A dental clinic performs extractions based on referrals from the clinic. Through the eight hours it is open each month, the Tree of Life provides basic medical care for 175 patients, fills around 700 prescriptions and provides dental services for 30 patients.

But at the beginning of March, Dr. Joe Bailey, the clinic’s founder, consulted with local infectious disease specialists and pulmonologists to figure out how the clinic could continue to safely care for its patients as COVID-19 spread.

“They advised us to close, but I didn’t have the heart to do that,” Bailey said. “We came up with a workable compromise.”

Now, though the Tree of Life continues to open twice each month, its operations are far from routine. Patients wait in cars for the volunteer physicians to review their charts and pull together prescription refills. Volunteer medical staff cannot do physical checkups. The dental clinic is closed because the state health department ordered all elective dental care to be deferred.

The same 10 volunteers handle each session to minimize exposure for others. Six of them are over 50, with Bailey and retired cardiologist Dr. Mike Boland both 73. They’ve tried to get coveted N95 masks but do not have any personal protective equipment, known as PPE, beyond gloves and two boxes of basic disposable masks.

Across the country, other free and charity clinics are facing similar challenges as the need for them will only grow larger as more people lose their job-based insurance and struggle to pay their bills.

To adapt, the clinics are turning their delivery models on a dime, said Nicole Lamoureux, president and CEO of the National Association of Free & Charitable Clinics, which represents 1,400 organizations. Some clinics are like the Tree of Life, focusing on medication refills. Some screen patients for fever before they come in for appointments. Others are trying to establish telemedicine options, even as such clinics have been left out of federal relief packages thus far.

“It doesn’t matter if they have a $1 million budget or $95,500,” Lamoureux said. “There’s no federal funding and no access to PPE.”

Still, charity clinics are finding ways to continue their free care.

“Our role is to help people stay as healthy as they can during a scary time,” Lamoureux added. “Without that service, they would be going to the ER, no question.”

Surge Of Need Looming

The Tree of Life operates out of a West Main Street building provided rent-free by neighboring Calvary Baptist Church in this city of 38,000 in northeastern Mississippi. It sees anyone without public or private insurance, regardless of residency, work requirements or immigration status, drawing patients from around the region. In 10 years, the clinic has recorded more than 22,000 patient visits.

“It has exceeded our wildest expectations,” said Bailey, a retired gastroenterologist. “The need is greater than I anticipated.”

Yet on April 18, the clinic handled just 224 prescriptions, including 74 bottles of insulin. Bailey worried people are going without at a time when it’s most important for people with diabetes and hypertension to stay healthy.

“Ordinarily, we have 25 to 30 new patients each time,” Bailey said. “We had two or three.”

The clinic can take new patients who need help getting refills to keep their chronic conditions stable if Bailey feels he can safely prescribe to them. But the volunteers are limited in what else they can do, given the lack of protective equipment.

“We can’t do complete physicals or blood tests,” Bailey said. “We try to provide what they need. It’s not ideal.”

Charity clinics are bracing for a tsunami of new patients, though, because so many people have lost health insurance and income, Lamoureux said. The influx could come as donors and foundations are forced to scale back clinic funding because of the economic downturn.

“They see a wave coming,” she said.

Although economists can track layoffs via new unemployment claims, tracking the uninsured in real-time is trickier, as each worker can carry insurance for multiple family members, and some are able to shift to other sources of coverage. An analysis by the Economic Policy Institute estimated that 9.2 million workers were at risk of losing their health insurance coverage.

The Coverage Gap

Before COVID-19, Mississippi had a high rate of uninsured: 18% for adults ages 19-64 compared with 12% nationally, according to the Center for Mississippi Health Policy. The state did not expand Medicaid eligibility under the Affordable Care Act and very few able-bodied adults can qualify under the state’s requirements.

“We anticipate we will see a lot more people falling into the coverage gap,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program, a nonprofit that operates a helpline for consumers with Medicaid, ACA and private health insurance issues. “It will only get worse.”

He does not see how the state can continue to avoid expanding Medicaid eligibility on ideological grounds as the long-term effects of the pandemic and economic disruption hit Mississippi families and rural hospitals.

“Right now, the state needs every tool to fight coronavirus and stay safe,” Mitchell said.

Jacqueline Vance was trapped in the coverage gap even before the COVID-19 pandemic. The 37-year-old Pontotoc, Mississippi, resident has acute asthma, sarcoidosis, fibromyalgia and coronary artery disease.

“I make $100 too much for Medicaid,” Vance, who works as a school bus monitor, said as she waited at the Tree of Life clinic.

With her weak lungs, she needs to stay as healthy as possible. The ER is the last place she needs to be.

“This is really scary for me,” Vance said.

Delbert, the man who joined the uninsured after losing his manufacturing job last month, said that he hopes he will soon be back at work but that he is deeply grateful for the Tree of Life.

“They were here for me when I couldn’t help myself,” Delbert said. “This is a really big help to the community.”

This story originally appeared in Kaiser Health News, a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

The post Free Clinics Try to Fill Gaps as Covid Sweeps Away Job-Based Insurance appeared first on Direct Relief.

The tornadoes appeared along with a line of severe storms that swept through the southern United States, affecting at least 25 counties. Several of the tornadoes have proven particularly destructive, leaving dozens of heavily damaged houses and other buildings in their wake. A school and daycare center in Louisiana was evacuated mere minutes before a tornado destroyed it.

The governors of Mississippi and Alabama have declared a state of emergency in the affected area.

The current spate of extreme weather is most likely not over yet, and the storm system itself seems to be moving east over time. Yesterday, the National Weather Service issued 85 tornado warnings and 85 warnings for severe thunderstorms. Less likely, but still of concern, were tornado watches in the Florida Panhandle and southeast Georgia.

A warning indicates that an extreme weather event has been sighted or indicated by weather tracking. A warning suggests that current circumstances make an extreme weather event possible.

Direct Relief has reached out to more than two dozen partners near the affected communities in Louisiana, Mississippi, and Alabama, to offer support. As always, the organization is committed to providing both emergency medical aid and longer-term assistance, should it be needed.

The organization’s emergency response team is continuing to monitor the situation and will communicate with local organizations to offer additional support if needed.

The post Winter Storms, Tornadoes Pummel the Southern United States appeared first on Direct Relief.

In this episode of our podcast, we explore the realities of period poverty in the United States and the movement working to end it.

Transcript:

AMARICA RAFANELLI, HOST: You know those tampon dispensers in public bathrooms?

They’re like vending machines, except they give out tampons, not chips.

Insert a quarter, turn the knob. Period crisis averted.

But what if you don’t have a quarter? What if you don’t have money to buy tampons at all?

Women across America face this problem on a monthly basis. The price of period products forces women to choose between basic necessities.

JORIE NILSON: They spend their money on food because that’s the basic necessity. Any money they have goes to food.

That’s Nurse Practitioner Jorie Nilson. She’s the medical director at the Women’s Free Homeless Clinic in Santa Barbara.

NILSON: They lack food. That’s the big thing. They lack food. And they’re more concerned about food than just about anything.

RAFANELLI: OK. So if it comes down to it?

NILSON: They’ll buy food over hygiene products. That’s it for sure.

The women’s clinic happens three times a month in a transition home downtown. It’s a safe space where women can shower, eat a hot meal, and relax. In addition to offering basic medical care, the clinic provides women with free hygiene supplies—including pads.

RAFANELLI Why are you providing menstrual hygiene products for these women?

NILSON: Because it’s part of basic healthcare for a woman. And we’re trying to do everything that we can to provide the biological, psychological and social aspects of what every human being needs, but within our women’s clinic population.

RAFANELLI: I decided to go to the clinic to speak with some of the women. While I was there, I met Nancy. We talked about periods over a bowl of soup.

NANCY: I used to have go behind dumpster enclosures, go behind a tree and change real fast and hope nobody sees you. Stuff like that.

RAFANELLI: So you’d have to change your tampon or pad behind a dumpster?

NANCY: Yeah. I did it a lot. Go behind a dumpster enclosure and close the gate and change. I did that a lot. It was pretty commonplace.

RAFANELLI: Nancy was homeless for 23 years. She said when she was living on the streets, she couldn’t afford tampons or pads every month.

RAFANELLI: What would you did if you couldn’t purchase them?

Stick rags up in there. Maybe find an old shirt alongside a road and stick it up in there. I’ve done that.

RAFANELLI: Woah.

NANCY: Yeah, it’s rough out there. It’s rough out there sweetheart.

For Nancy, buying period products was just one worry on a list of many.

NANCY: Getting your stuff around in a shopping cart, I mean finding a safe dry place to sleep, yeah dealing with menstrual periods, if you got the flu, like, how you were going to recover and where you were going to sleep, staying warm, having enough blankets, having enough sweaters to stay warm at night. Yeah, it was a lot of things.

For women like Nancy, menstrual hygiene takes a backseat to buying food or finding shelter. When financial resources are stretched thin, tampons and pads are some of the first things to go.

But homeless women are not the only ones dealing with this problem. In Mississippi, immigrant women are up against the same struggle.

JOSE DELGADO: Following US Immigration and Enforcement Agency arrests that happened on August 7th where nearly 680 undocumented persons were taken into custody we realized that there were going to be a lot of persons, who unfortunately, were going to be in dire financial straits.

That’s Jose Delgado—the Vice President of patient services at Planned Parenthood Southeast. He helps manage the Planned Parenthood in Mississippi.

RAFANELLI: So were these women arrested and detained by ICE?

DELGADO: So most of the individuals, the 680 individuals who were detained, were mostly men. With that said, they had families and many of those were, not only their wives, if they did have wives, but their children are identifying as female. So, this was a big deal. We wanted to make sure that those individuals who previously had this financial resource that no longer existed were able to afford for some of the standard gynecological items that might help them with their day to day lives.

After the raid, Planned Parenthood requested menstrual hygiene products from Direct Relief. It was the first request of its kind. The Mississippi site had never provided their patients with tampons or pads before.

DELGADO: For our affiliate this is a first. It’s not that we didn’t think this product or being able to dispense these products were a necessity it’s more that it became more of a necessity with new obstacles. When you have individuals that are targeting particular families or persons things become a little bit more serious and particular families and persons are being targeted things become more serious and any help or support that these families can get becomes a little bit more of a priority.

RAFANELLI: In partnership with the nonprofit organization, Days for Girls, Direct Relief, sent Planned Parenthood 200 menstrual hygiene kits—each containing a reusable pad. Within 2 weeks, half of the kits had been distributed.

Without Planned Parenthood, these girls may have had to go without.

As menstruation becomes less taboo, more and more women are coming forward with their stories and attracting attention to the problem. In the first city-wide study of its kind, two-thirds of women in St. Louis, Missouri said they couldn’t afford period products at least once in the last year. More than 20% of these women said they experienced this problem on a monthly basis.

For activist, Jennifer Weiss-Wolf, these kinds of accounts are evidence of a national problem.

JENNIFER WEISS-WOLF: Anecdotally I would say there is almost overwhelming agreement that the ability to afford and manage menstruation is a challenge for people.

Weiss-Wolf has been hailed as a tampon crusader. She serves as vice president of development at the Brennan Center for Justice and is the co-founder of Period Equity—a non-profit that advocates for safe and affordable access to menstrual hygiene products.

WEISS-WOLF: This idea of period equity, it’s different than period poverty actually, and it’s not rooted in the experience of any one person, but the idea of equitable participation and engagement in civic life. Whether that is one’s education or workplace or any aspect of public life requires that we have a full understanding of menstruation. That we have the ability to manage menstruation. And I’ve taken up the issue with that perspective in mind. It’s surely about helping those that are most marginalized and most in need be able to manage menstruation fully, fairly, with dignity, and all of that. But it’s more, I think, actually driving towards that it’s a policy agenda and that it acknowledges that if half of the people that live by our laws have bodies that menstruate that acknowledging that within the framework of those laws is essential.

Period Equity is involved in several campaigns to pass policies that increase women’s access to period products. One of the organization’s main goals has been ending the tampon tax.

In 35 states, tampons, pads and menstrual cups are not exempt from sales tax. While other basic products, like toilet paper and soap, are also taxed by most states, activists argue taxing tampons—a product only half the population needs— is sex-based discrimination.

WEISS-WOLF: The tampon tax, sales tax, affects everybody. It wasn’t asking for any specific program or specific carve out, but to acknowledge that these products are a necessity and therefore deserving of this exemption. Slightly different questions if you can see what I’m getting at and it was a way to start that conversation.

In 2016, Weiss-Wolf led a class-action lawsuit to end the tampon tax in her home state of New York. The suit was successful in pressuring the governor to repeal the tax. But New York is an outlier. To date, only 5 states have passed a law ending the tampon tax.

WEISS-WOLF: The United States is just kind of scratching the surface right now. Kenya was the first nation to eliminate a national sales tax on menstrual products and did so in 2004. And has had policy ranging from menstrual product provision in schools to educational programs for the better half of the last decade.So yeah, I would say the United States is not ahead.

Thanks to activists like Weiss-Wolf, the United States is making incremental steps towards increasing women’s access to period products. This year, a bill that would make feminine hygiene products available for free in schools, shelters, and other public facilities was introduced into Congress. While other bills like it have been proposed in the past, the period equity movement has stimulated a national conversation that could give menstrual access laws unprecedented momentum.

WEISS-WOLF: Getting people to talk about menstruation, I would say, 500% improves their ability to be healthy in their menstruation. And that includes everything from helping to eradicate the shame, ensuring they are asking for what they need, in terms of information, in terms of medical support, in terms of product support. It’s a way to help live a healthier life and I don’t see why anyone would want to deny that.

RAFANELLI: While activists like Jennifer work to end the problem, women on the margins continue to deal with it on a regular basis. For many women, having a period without a tampon or pad to manage it is unimaginable. For women like Nancy, or the girls in Mississippi, it’s routine.

For Direct Relief, this is Amarica Rafanelli.

The post Rags Instead of Tampons. Here’s What Period Poverty Looks Like in the U.S. appeared first on Direct Relief.

In anticipation of the storm’s landfall on Saturday, emergency medical resources from Direct Relief are staged with healthcare providers in Louisiana and neighboring states, and additional shipments of medications and medical supplies are ready for rapid deployment from Direct Relief’s humanitarian distribution warehouse.

Tropical Storm Barry, the second named storm of 2019, is expected to bring major flooding and high winds to parts of Louisiana, Mississippi and Alabama.

Barry is expected to exacerbate the effects of recent rains that have swelled the Mississippi River, flooding streets and causing power outages in New Orleans and surrounding areas.

Before hurricane season started in June, Direct Relief strategically pre-positioned 75 “Hurricane Prep Modules” throughout hurricane-prone regions of the U.S., eight of which went to Louisiana.

Each module contains more than 200 medications and other health items requested most often by health providers during emergencies, including medicines and supplies for trauma as well as chronic health conditions like diabetes and hypertension that if unmanaged can cause acute crises.

The portable modules are created to address predictable risks during the immediate post-storm period when supply lines are often compromised and populations are displaced. Direct Relief initially designed the modules based on Hurricane Katrina after-action analyses that found medications and medical supplies, had they been available, would have averted health emergencies among evacuees.

To track Barry’s path and view the locations of Direct Relief’s hurricane prep modules, view the map below.

Direct Relief will continue to provide updates on Tropical Storm Barry as it approaches land.

The post Tropical Storm Barry: Emergency Aid Deployed as Gulf Braces for First Hurricane of 2019 appeared first on Direct Relief.

The series of storms led to the deaths of at least nine people, and the storm system also brought deadly flash flooding to northern Louisiana.

Over the weekend, Direct Relief staff reached out to staff at about 200 health facilities in Texas, Alabama, Mississippi and Arkansas to offer emergency assistance, opening the organization’s medical inventory that can support both acute and chronic health needs.

East Texas Community Health Services, located in Nacogdoches County, near the border of Texas and Louisiana, responded to Direct Relief and is working to meet medical needs in the community.

Storms passed through the area, health center staff reported, leaving a school and museum and civic center destroyed. Health center officials were working Monday to assess medical needs in the area.

Direct Relief is also coordinating with Hope Community Medicine in Center, Texas. A tornado touched down about an hour outside of the clinic, destroying homes in the community of Alto. In addition to individual clinics and health centers, Direct Relief is in contact with state associations, including the Texas Association of Community Health Centers, and will continue to offer support as requested.

The post Spate of Tornadoes Churns Through Southern U.S. appeared first on Direct Relief.

On Tuesday, Direct Relief reached out to more than 100 partner health facilities in Arkansas, Iowa, Illinois, Kansas, Louisiana, Missouri, Mississippi and Oklahoma to offer support, should those clinics and health centers need assistance in the storm’s wake.

Large amounts of rain, along with high winds and storm surges, are expected to batter the coast. The swath of coastline from Bay St. Louis, Mississippi, to Alabama and Florida’s shared state line are under hurricane warning, with a larger area of coast under tropical storm warning.

Remember that impacts from #Gordon will extend well beyond the “forecast cone” that we see as part of official forecasts. Consult your local forecast at https://t.co/VyWINDk3xP and heed advice from local authorities. pic.twitter.com/4MT21Kkbd2

— National Weather Service (@NWS) September 4, 2018

Governors of Alabama, Mississippi and Louisiana have all declared states of emergency in anticipation of the storm.

Direct Relief is ready to assist with immediate requests, and also operates a hurricane preparedness program throughout the region, which pre-positions caches of medicines and medical supplies in storm-prone areas.

Each pack contains enough medicines and supplies to treat 100 patients for three to five days after a hurricane hits, and includes medicines to manage chronic conditions like diabetes and high-blood pressure. Storm events like hurricanes often prompt evacuations, during which people often forget medications needed to maintain their health and stay out of medical crisis.

The program was formed after Hurricane Katrina devastated the region in 2005, and has been expanded and refined since.

The post U.S. Gulf Coast On Alert As Tropical Storm Gordon Nears Landfall appeared first on Direct Relief.

At least 29 tornadoes spanning six states were reported from Jan. 21 to 23, with 15 fatalities confirmed in three Georgia counties and four deaths reported in Mississippi. On Sunday, Direct Relief reached out to nearly 300 health care partners in Texas, Louisiana, Mississippi, Alabama, Georgia and Florida, making disaster relief inventory available to storm victims. Community health organizations in Georgia, Florida and Mississippi responded, and shipments to impacted communities went out Monday and have continued since.

One health facility responding to people recovering from the storms is the Southeast Mississippi Rural Health Initiative. The group, based in Hattiesburg, Mississippi, watched as 140-mph winds tore a ragged 25-mile path across the area on Saturday morning.

“It has been an overwhelming morning,” Pati Landrum, who works as the organization’s director of compliance, said on Monday. The group has 17 healthcare facilities in the area, which serve 36,000 patients, almost a third of which are uninsured. As her team strategized how to help people reeling from the storms, they learned that two of their own staff members had lost their homes. The tornado also decimated nearby William Carey University, where thousands of students were displaced after much of the campus was damaged.

The Southeast Mississippi Rural Health Initiative has requested over 300 hygiene kits, along with four emergency response backpacks, which include first aid and disaster relief supplies. Insulin was also included in the request, along with 500 doses of Tdap vaccine, which is used to immunize against diphtheria, pertussis and tetanus. The shipment will also help patients manage chronic conditions like diabetes. Diabetes medications are often lost during power outages because they must be refrigerated. Also, people often leave their medication behind when they evacuate their homes during a disaster.

The group also reported that they’ve opened a hurricane prep pack that Direct Relief prepositioned for such a situation. Each pack contains enough medicines and supplies to treat 100 patients for three to five days after a storm hits. The packs are prepositioned in coastal areas with a history of hurricane impacts, but can also be used in any natural disaster.

In Georgia, Gov. Nathan Deal declared a state of emergency for 16 counties in the southern half of the state. Direct Relief has been in communication with the Albany Area Community Health Care Center and stands ready to assist any facilities that make a request.

As tornadoes swept through the eastern United States, storms also pounded the West Coast, and California has seen significant rainfall and flash flooding as a result. In early January, Direct Relief reached out to all health care partners north of, and including, San Luis Obispo. No requests have been made for aid at this time, but Direct Relief stands ready to assist should that change.

Direct Relief has a long track record of responding to weather-related emergencies across the U.S. The organization supported more than 100 Gulf Coast health care partners as they worked to recover from devastating Hurricane Katrina in 2005, and has also been active in responding to tornadoes that the region experiences often, including the tornado that swept through Moore, Oklahoma, in May 2013.

The post As Deadly Tornadoes Ravage Gulf Coast, Direct Relief Sends Critical Shipments to Region appeared first on Direct Relief.

The floods follow a week-long wave of intense weather across the nation, including heavy rainfall, deadly tornadoes, and blizzard conditions.

Since December 23, more than 40 people have died from weather-related events.

Direct Relief’s Response

In response to tornadoes and floods across the U.S., Direct Relief has sent 24 emergency shipments of medical aid totaling $414,845 to community health centers and clinics throughout Arkansas, Mississippi, Missouri, and Texas.

Direct Relief’s response will continue to expand as the need for medical assistance increases.

Severe Weather Across the U.S.

Alabama

Major flooding threatens Alabama after Christmas cyclone https://t.co/zANRewuv0S pic.twitter.com/1ks2GWyAeP

— CBS News (@CBSNews) December 26, 2015

Arkansas

Storm damage in Bearden, #Arkansas – I’ll be running my own live shot with updated info at noon @THV11 #arwx pic.twitter.com/Aa7bddtkHI

— Phil Buck (@Phil_Buck) December 28, 2015

Georgia

More roads are closing in the Greenville County area. Red Cross is opening a shelter in Greenwood. https://t.co/u22zFHGCM4

— WSPA 7NEWS (@WSPA7) December 30, 2015

Missouri

“Major to historic river flooding” expected in Missouri after deadly storm https://t.co/WGintKbMzy pic.twitter.com/is72HtjfiO

— KTLA (@KTLA) December 30, 2015

Texas

Texas begins to clean up after devastating twisters https://t.co/NXOyvDOj6H pic.twitter.com/sTWbvFH1oN

— TIME (@TIME) December 29, 2015

The post Direct Relief Responds to Weather Emergencies Across U.S. appeared first on Direct Relief.

To date, Direct Relief has sent $270K in emergency medical aid to clinics and health centers in Mississipi, where tornadoes killed ten people and caused widespread damage to buildings. The emergency shipments were airlifted by FedEx — free-of-charge.

Among the recipients is North Mississippi Primary Health Care, Inc. (NMPCH), a community health center that operates in Northeast Mississippi. NMPHC staff reported tornado damage in three of the communities they serve and numerous patients with storm-related injuries.

Direct Relief is preparing to send another 2,000 lbs. of medical aid tomorrow for Mississippi. The shipment contains items such as insulin and antibiotics, as well as personal care supplies donated by CVS.

As a growing number of states face weather-related emergencies, Direct Relief is prepared to respond with additional medical resources.

Severe Weather Across the U.S.

Alabama

Alabama tornado adds to #Christmas storm woes: https://t.co/ZGK3WcUe8R pic.twitter.com/RRnh7pdmKx

— Tennessean (@Tennessean) December 26, 2015

Arkansas

11 counties were deemed disaster as of Monday morning, after at least four tornadoes were reported in Arkansas on Sunday, along with intense storms, high winds, and hail, ripping off roofs and uprooting trees. The state is expected to experience floods through Wednesday

https://twitter.com/rasorNET/status/681484028684427264

Georgia

At least one person died as a result of sustained rains and floods across Georgia.

Illinois

Flash floods and blizzard conditions in Illinois resulted in the deaths of five people Saturday.

Three adults, two children drown in car in Illinois flooding https://t.co/fxDKP07mMo #UniteBlue pic.twitter.com/amtz4iU4K1

— The Progressive Mind (@Libertea2012) December 28, 2015

Mississippi

A deadly tornado that struck Wednesday in Mississippi killed ten people and damaged numerous structures.

Missouri

Heavy rainfall and flooding has caused at least 10 deaths. Officials expect that number to rise.

Flooding closes numerous roads, bridges in Missouri https://t.co/9NZsQ1iP2H pic.twitter.com/c8ORtCs1R9

— KMBC (@kmbc) December 28, 2015

New Mexico

At least one person has died in New Mexico as a result of extreme weather and blizzard conditions. In response, the Governor has declared a state of emergency.

Texas

As many as nine tornadoes swept through the Dallas area Saturday, killing at least 11 people, injuring dozens, and damaging as many as 1,400 homes.

Updates will follow as the situation develops.

The post Emergency Update: Tornadoes, Storms Sweep Across U.S. appeared first on Direct Relief.

Tuesday’s bout of severe storms  – which included tornadoes – left at least four dead and hundreds of homes and businesses damaged across Georgia, Louisiana, and Mississippi, among other states. Areas of Georgia remain under flood watch, while thousands still lack power.

With storm-specific medical supplies pre-positioned throughout the affected region, Direct Relief is working to assess the full extent of the storms’ impact on health centers and clinics, and is ready to deploy additional resources upon request.

Further information and updates:

• National Weather Service: Active Alerts  
• NOAA Storm Prediction Center

The post Assessing Damage: Severe Storms Hit Southern States appeared first on Direct Relief.

Pati Landrum, Director of Corporate Compliance for SeMRHI, reported on the conditions of both the city and their health center sites.  According to Ms. Landrum, there were 80 people injured, but thankfully, no fatalities. More than 200 homes were damaged or lost.

One of their clinic locations experienced damage, but considering the impact of this level of tornado, Ms. Landrum says she “counts ourselves very lucky.”

SeMRHI is working to evaluate what they need to assist their community in recovering from this devastating disaster. Direct Relief is maintaining communication with Ms. Landrum to evaluate how best Direct Relief can support both their clinic and patients in the following days and weeks.

The post Evaluating Medical Needs After Tornado Hits Hattiesburg, Mississippi appeared first on Direct Relief.

Bringing winds of up to 188 miles per hour, the tornado destroyed homes and downed power lines and trees in seven counties in Mississippi, where the governor has declared a state of emergency today. Trauma injuries and lacerations from broken glass are likely consequences following a tornado.

Direct Relief’s longtime experience providing ongoing and emergency medical aid in the Gulf States, including Mississippi, facilitates an immediate response. In addition to the Safety Net Inventory Support program, which has provided clinics and health centers nationwide with more than $175 million (wholesale) in needed medicines and supplies for low-income patients, Direct Relief USA equips key partner facilities in the Gulf States with Hurricane Preparedness Packs each year. These programs have expanded during the long-term response to Hurricanes Katrina and Rita of 2005.

Direct Relief is prepared to tap its standing inventory to assist partners as needed to help the people injured in the tornado.

The post Direct Relief Offering Aid to Partners in Mississippi After Tornado Strikes appeared first on Direct Relief.

Ida makes landfall in the U.S. today, with winds of up to 70 mph expected to whip the coast of Alabama. Tropical storm watches are in effect along the Gulf Coast from Louisiana to Florida. Clinics in the U.S. are bracing for landfall; the governor of Alabama has declared a state of emergency there in anticipation of the storm.

A total of $271,548 (wholesale) in specifically requested medical material aid is being deployed to three partner health centers and clinics in the Gulf States: Bayou Clinic in Bayou La Batre, Alabama; Bethel Lutheran Medical Clinic in Biloxi, Mississippi; St. Thomas Clinic in New Orleans, Louisiana.

Ida displaced thousands in El Salvador and Nicaragua when it hit November 5, according to partner and news reports. Direct Relief is providing more than $590,000 (wholesale) in medical material aid to support two longtime partners’ responses in Central America.

In El Salvador, the storm killed 124 people and caused massive flooding and mudslides. Direct Relief is equipping FUSAL, a longtime partner in El Salvador, with medical material aid requested to assist storm survivors, where an estimated 7,500 people have been displaced. Direct Relief’s consignment includes nutritional products, oral rehydration solutions, medications to treat fungal infections, and antibiotics to treat general infections.

In Nicaragua, Ida caused major damage to infrastructure, including bridges, roads, and homes in coastal regions, requiring more than 3,000 people to be evacuated. Power and telephone service were out as well. Direct Relief is sending medical aid to its partner American Nicaraguan Foundation, which works with more than 300 health facilities and hospitals throughout Nicaragua and can apportion aid where it’s most needed.

Direct Relief continues to stay in close contact with partners in Central America and the U.S. to provide support for their emergency response efforts.

The post Direct Relief Extends Aid to Central America and Additional U.S. Partners as Ida Makes U.S. Landfall Today appeared first on Direct Relief.

Today, Direct Relief has also offered its reserve inventory of hurricane-targeted medical material to its network of partners along the Gulf Coast. This designated inventory includes products identified during years of hurricane response and has been donated by Direct Relief’s network of pharmaceutical and medical manufacturers, including Abbott and the Johnson & Johnson Family of Companies.

“This year, we expanded our Hurricane Prep Program into Florida, while also covering our partners in Texas, Louisiana, Alabama, and Mississippi,” explains Direct Relief’s Director of Emergency Response Brett Williams. “The best emergency response is smart preparation, which allows our partners to provide uninterrupted care to their patients when an emergency strikes. Support from Abbott since we started our hurricane preparedness program in 2007 has been a tremendous boost to our efforts.”

Designed to be portable, Hurricane Prep Packs contain enough materials to support care for 100 patients for three days, the time it usually takes to clear roads after an emergency. Contents include wound-care supplies as well as medicines to treat chronic conditions, and were informed by Direct Relief’s extended response to Hurricane Katrina as well as 2008’s Hurricanes Gustav and Ike. Caring for low-income, uninsured and vulnerable populations on a daily basis, Direct Relief’s clinic and community health centers partners see a surge in patients during emergencies, when hospital emergency rooms are overloaded.

From June to November each year, hurricane season is unpredictable. During an active season, like 2008, Hurricane Prep Packs ensure that clinics and health centers have the materials they need to support patient care. The packs’ contents can be absorbed into the facility’s regular inventory if not needed during an emergency.

Emergency preparedness and response is one aspect of the assistance Direct Relief USA provides. Since 2004, more than $150 million in aid has been delivered to clinics and health centers across the country. Direct Relief is the only nonprofit with the licensing and accreditation necessary to provide pharmaceutical and medical material aid in all 50 states.

Direct Relief USA program staff is monitoring the situation with partners in the Gulf States preparing for Hurricane Ida and will apportion additional aid as needs arise.

The post Direct Relief USA’s Pre-Positioned Aid Readies Gulf State Partners for Hurricane Ida appeared first on Direct Relief.

In Texas and Louisiana, more than 20,000 evacuees remain in shelters, as debris clogs roads, homes have been destroyed, and infrastructure is being repaired. Interrupted water service and nonfunctioning sewer systems have caused health concerns, especially in Galveston and the greater Houston area. In Louisiana, almost 25,000 homes have been flooded, and Gov. Bobby Jindal reported last Wednesday in a letter to President Bush that the state’s infrastructure had sustained $1 billion in damage.

To help those affected by the hurricanes, Direct Relief has provided ongoing shipments—a total of 30 since August 29—of urgently needed medicines and supplies such as antibiotics, analgesics, chronic medications, wound-care supplies, and personal care products. For people living in a shelter, even shampoo and soap can bring comfort, and good hygiene helps prevent disease transmission.

“These are 24- to 48-hour shelters,” said Lori Hooks of the Texas Association of Community Health Centers, “but people will be staying there for weeks.” Hooks reported that clinics and health centers are providing services at shelters and assessing damage to their own facilities, 12 of which were closed as of Friday. TACHC’s goal is to reinstate care at clinics as fast as possible; generators and mobile units are being brought in to help bring facilities back to operation.

In Galveston, a mobile unit clinic opening Monday will help take pressure off the crowded local hospital emergency room, though all pharmaceuticals will need to be replaced, and water, sewer, and power services are not up yet. The executive director of three clinic sites in Port Arthur—an East Texas town closed due to massive damage—has been allowed to tour her locations to assess damage this weekend.

“The biggest problems are standing water and no electricity,” said Hooks. “Mosquitoes are an issue, and it’s going to get really bad in the next few days as the weather heats up. People run out of medications when health centers are closed. And the longer people go without refrigeration, the more likely they are to eat spoiled food, which causes illness.”

Direct Relief also made a cash grant of $150,000 earlier this month to the National Association of Community Health Centers to help clinics buy emergency medicines to treat hurricane-affected populations. Health center needs range from medicines and supplies to funds to replace computer systems damaged by flooding.

At the start of hurricane season, Direct Relief positioned 18 hurricane preparedness packs throughout the Gulf Coast. These packs contain enough medical material for one site to treat 100 people for a 72-hour period.

The post While Need Continues, Direct Relief Emergency Aid to Gulf States Tops $1 Million appeared first on Direct Relief.

With widespread power outages and residents encouraged to stay in shelters due to extreme flooding and other damage, health centers in Louisiana and Texas are working around significant challenges following the two hurricanes. Direct Relief’s emergency response team expects to send several more shipments of specifically requested critical medical aid this week.

Health centers are treating evacuees for chronic conditions like asthma, diabetes, and hypertension. Clinicians are also seeing a notable increase in patients being treated for mental health issues, understandable in the face of great personal loss.

According to U.S. Census data released August 2008, 24.4 percent of people in Texas are uninsured—the highest percentage in the U.S. Health centers and community clinics serve this vulnerable population, and are a key resource in emergency response.

Two members of Direct Relief’s Domestic Programs staff are visiting Gulf State clinics this week to help assess needs and coordinate response efforts along with the Texas Association of Community Health Centers. Direct Relief is licensed by the Texas Department of State Health Services as a “Wholesale Distributor of Prescription Drugs,” which means it can provide safety-net clinics with needed resources in emergencies and on an ongoing basis.

Direct Relief partners in the region have weathered the storms to varying degrees. Clinic director Clark Moore of Ubi Caritas in Beaumont, Texas, had to evacuate to Austin during Ike, and returned to assess damage yesterday. “Other than the drugs we have lost, we are OK,” Moore reported. “Our new clinic, which was built to with stand 150 mph winds, actually did.” Ubi Caritas plans to reopen this coming Monday, though, like much of the state, it is currently without power or sewer services.

“We have 5,000 to 6,000 Hurricane Ike folks from Beaumont here in town,” said John English of Bethesda Clinic in Tyler, Texas. “Looks like they will be here for the next several weeks. Many are at shelters but they send them out for care, or call for supplies when needed.”

In July, 18 hurricane preparedness packs were sent to qualified health centers in the Gulf States; they have proven useful during this active hurricane season.

“We are using the medications and supplies that you sent for hurricane season,” reported Janet Mentesane, of Martin Luther King Health Center in Shreveport, Louisiana, as Ike was bearing down last Saturday. “The government-run shelter calls in or emails medication orders, we fill them at the clinic, and then take them to the shelter. So far, it is running smoothly.”

The post Next Wave of Emergency Aid Sent to Gulf Coast Health Centers appeared first on Direct Relief.

Four sites will each receive specifically requested materials on Tuesday via overnight airfreight, generously donated by FedEx:

• Amistad Community Health Center, Corpus Christi, TX
• Texas Association of Community Health Centers (TACHC) Distribution Center, Austin, TX
• Primary Health Services Center, Monroe, LA
• United Community Health Center, Eunice, LA

Longtime corporate donors Abbott, BD, Boehringer Ingelheim, Bristol-Myers Squibb, Covidien, CVS, GlaxoSmithKline, Henry Schein, Johnson & Johnson Family of Companies, Matrixx, Merck, Miltex, Nexxus, sanofi-aventis, and Schering-Plough have given their product for use at these sites.

In addition to continued coordination with TACHC and the National Association of Community Health Centers, Direct Relief is working with the Lone Star Association of Charitable Clinics (LSACC), which represents 57 clinics throughout the state. LSACC is assisting Direct Relief in obtaining the medical material needs of its membership.

Since September 1, Direct Relief has supplied its medical safety-net partners in Texas and Louisiana with nearly $400,000 in medical material aid to assist their response to Hurricanes Gustav and Ike.

Two members of Direct Relief’s domestic programs team will arrive in Louisiana on Sunday, and will be surveying clinic sites and evacuation centers throughout the week. Many evacuation shelters set up for Gustav are now serving those affected by Ike.

One such shelter in Shreveport, Louisiana, is being served by the Martin Luther King Health Center, a recipient of one of the 18 hurricane preparedness packs Direct Relief sent to safety-net clinics throughout the Gulf in July.  According to e-mail messages from Janet Mentesane, executive director of the center, “The shelter calls in or emails medication orders, we fill them at the clinic, and then take them to the shelter.  So far it is running smoothly with what we are doing.”

The post Additional Medical Aid Set for Arrival at Clinics, Shelters appeared first on Direct Relief.

Tapping its $45 million medical inventory and emergency funds, Direct Relief today allocated additional prescription medicines and supplies to Texas’s nonprofit community clinics and health centers that serve as the medical safety net.  Direct Relief is coordinating with the Texas Association of Community Health Centers, the statewide organization with which Direct Relief formed a partnership three years ago following Hurricanes Katrina and Rita.

Direct Relief is licensed by the Texas Department of State Health Services as a “Wholesale Distributor of Prescription Drugs,” which allows the organization to provide safety net clinics with needed resources in emergencies and on an ongoing basis to assist their low-income patients without insurance for medicines.

Three shipments going out tomorrow follow on the recent delivery of 18 “hurricane packs” that were pre-positioned throughout Gulf State clinics in anticipation of hurricane evacuations and the Katrina/Rita scenario in which many evacuees sought care at clinics after being unable to obtain needed medications.

While undertaking preparatory efforts in Texas, Direct Relief is also responding to the storm’s devastating effects in Haiti. Ike’s 135-mph winds and drenching rain pummeled the Caribbean nation on September 7, killing 65 people and leaving 240,000 in Gonaives homeless with most of the city under more than six feet of water. The death toll in Haiti stands at more than 600, with numbers climbing as floodwaters recede.

Direct Relief is providing urgently needed antibiotics, vaccines, oral rehydration solutions, and personal care products to treat and prevent a variety of waterborne diseases through its existing partner network in the country.

Waterborne diseases pose the greatest threat during flooding and torrential rains. Flooded sewer systems create dangerous sanitation issues, including the spread of cholera, hepatitis A, and rotavirus. Parasitic diseases, malaria, dysentery, and dengue fever thrive in standing water.

Displaced people living in shelters are particularly at risk for a variety of waterborne diseases, due to their close proximity and stress-compromised immune systems. Direct Relief is carefully compiling appropriate medicines and supplies to treat people affected by flooding in Haiti.

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Throughout the state, particularly in New Orleans, staffing shortages have significantly hindered the ability of healthcare providers to meet the needs of the populations they serve. From our conversations, it is clear that there is a specific shortage of registered nurses, many of whom evacuated New Orleans and have yet to return. With fewer nurses and healthcare professionals to service increased populations, patients often wait weeks to see a doctor and receive needed medications. Direct Relief partner, East Jefferson General Hospital, a facility which is renowned for its Nurse Magnet status, is suffering from a shortage of 100 nurses, a need so great they are reviewing recruitment options of nurses from other countries.

Access to medications, particularly at community health clinics, remains a critical issue. In our meetings with Algiers Community Health Center in New Orleans, Lafayette Community Health Care Clinic, and Capitol City Family Health Center in East Baton Rouge Parish, nurses and doctors work with a limited stock of medicines to provide care to medically underserved and uninsured residents. We were amazed at the extent of health services these clinics were continuing to offer with such limited resources. We were also acutely aware of how valuable shipments of medicines and supplies from Direct Relief are and how continued support is needed to strengthen the capacity of these organizations to meet the needs of their community.

An additional concern of the healthcare professionals we met is access to transportation. The thousands of people that fled New Orleans since the storm have relocated to other cities, where they reside in FEMA trailer parks that often lack sufficient public transportation. Many providers have been forced to invest already tight resources into mobile medical units and patient vans to meet the needs of patients living out of reach of public transportation. Without such measures, many patients would go without healthcare.
The population continues to ebb and flow throughout Louisiana; many people are returning to New Orleans, while other evacuees have become permanent residents in new homes and cities. Many of the facilities we spoke with are still treating an increased number of patients compared to pre-Katrina levels, which makes the need for medical professionals, medication, and transportation services even more critical.

The situation remains complicated for health care providers. One year later, there is a still an enormous amount of work left to be done. The partners we have met with are all incredibly dedicated, passionate, and hardworking; with limited means they will continue to provide health care to their communities in every shape and form possible, but they recognize the challenges that lie ahead. Direct Relief remains committed in its support throughout Louisiana both through increased material support and cash grant program.

The post Hurricane Katrina Response appeared first on Direct Relief.

The objective of the trip was to meet with current and prospective Direct Relief International partners in the Mississippi Gulf area. Overall I was extremely impressed by the commitment of the people I met there, and the quality of their work post Katrina. As expected the most marginalized groups have been hit the hardest. Geographically, from what I saw in Mississippi, Gulfport, Biloxi and Waveland were the most affected towns. The bulk of the recovery work has fallen on individuals and smaller groups. The churches have been particularly effective getting aid to people who really need it.

The devastation along the Gulfport coast reminded me of what I saw on the southern coast of Sri Lanka following the tsunami. Up to two miles inland was practically flattened. All that remained in some sections were the foundations of homes and businesses. Also like Sri Lanka, it will be some time before they sort out land ownership issues. These upcoming land disputes are bound to hold up significant reconstruction efforts.

Dr. McNair is a fantastic leader in his community. His wife is another tireless worker determined to do whatever it takes to fill the gaps. He is the President of the local African American Physicians Association. As with many of the people I spoke with the question of whether medical professionals will move away is a serious concern. Dr. McNair said that 35 of his medical professional friends have already decided to leave the area. Approximately one third of Dr. McNair’s staff are homeless (he runs a newly constructed Surgery center and a Digestive Care facility).

While they feel that the “crisis mode” has subsided, the future is anything but clear. They talk of a general diaspora of talent from the area. Dr. McNair would like to do whatever it takes to get nurses and doctors from relocating. In this vein he sent a letter to the Biloxi Regional Medical Center asking for special consideration to help physicians on the Gulf get on their feet. The Medical Center is planning to use this appeal to bolster their case in the US Congress.

Despite the fact that Gulfport Memorial hospital is located right next to one of the hardest hit coastlines it was able stay operational throughout the crisis (it is probably 80% + operational at the moment). The main entrance is closed, but most of the services are functioning. The hospital was extremely fortunate to have water and some electricity following the hurricane. It should be noted however that m ost of the employees have suffered some degree of personal trauma. As such it is very common to see skeleton staffing and truancies (people attending to their personal business).

The special needs shelter GMH set up was a great success. The hospital administrators immediately designated the cafeteria as a shelter and brought in 800 to 1000 individuals & families. It was called “the Village” and was also charged with dispensing drugs. In fact they provided over 1,500 individuals with free prescription drugs between the hurricane (Aug. 30 th) and the 15 th of September (the village closed just before I arrived).

I was fortunate to have had the opportunity to spend an hour with the CEO and two administrators to discuss the situation. As mentioned above, homelessness is one of the biggest issues for the hospital. Out of 2,220 staff almost 500 of them lost their houses. Our shipment was critical and supplemented their existing stock (which mainly consisted of a wide range of pharmaceutical samples). Once the shelter closed the surplus stock was passed on to other clinics in the area. It was clear that the hospital was very responsive to the needs of the community. They opened their one water spigot (from a well) to the public and even established a gas station immediately following the hurricane. The CEO reported that their medical supplies have stabilized. The regular supply channels are back up and running and capable of satisfying their current needs. The hospital spent approximately $100,000 to run the temporary shelter, and the $50,000 provided by Direct Relief International will go towards that debt. The hospital has created a fund for homeless employees. They are considering giving each of these victims with $1,000. The fund is at @ $250,000 now. We talked about how Direct Relief International could contribute to this fund, or support other hurricane related activities (such as establishing a phone bank).I met with Arthur Keys (CEO) and the IRD health staff (Bridget and Dr. Lisa). Their seven person team had spent the last week assessing the situation. IRD seems intent on committing a significant amount of resources to the redevelopment of communities in the Biloxi and Gulfport areas. Arthur was clear that supporting healthcare initiatives would be a priority. They have already tied in with the Backbay Mission and several Vietnamese groups living in Gulfport. In terms of material aid Heart to Heart has already sent IRD several shipments of personal care products to pass out as they see fit.

Prior to staging this assessment IRD’s board of directors signed off on a plan to establish a satellite office in Biloxi. They intend to share an office building with Oxfam and the Gulf Coast Community Center. The commitment is to operate in the Biloxi/Gulfport area for at least one year.

Apparently Gulfport is planning to set up a tent city for 10,000 homeless in the area. Estimates are that 70% of the housing was damaged in these two areas. Several people mentioned that the numbers of homeless is impossible to gauge. This is because of the “invisible homelessness” – people living/staying with others.

I spent several hours at the centralized command center for the State and Federal emergency assistance in the Gulfport area. FEMA, US and State Public Health Services, Homeland Security, the National Guard and a variety of other military branches were represented (plus the press). I spoke with the US Health Services pharmacist about their short-term plans. He described their intention of setting up a centralized distribution system. These plans have been put on hold due to their inability to find warehouse space. In addition, there were few local medical professionals willing or able to staff the center and pharmacy on a permanent basis. Almost all of the people I met were from out-of-state, on one to two week assignments. They did provide me with an extensive needs list collected from various facilities in the area.

Driving through Slidell’s business district was like going through a ghost town. Most of the businesses were either shut up or in pieces. I had scheduled an 8AM meeting with the chief pharmacist of the hospital, Bruce Clements. He called at the last minute saying he could not make the appointment. Clement’s explained that he could not make due to personal issues. I found this to be a common refrain during my trip. His assistant, Liz Edwards, showed me around the pharmacy and answered questions. The pharmacy was quite disorganized. The person in charge was unable to provide me with information on their current stock situation. Clearly they did not have an idea of the true inventory status due to the overwhelming influx of donations. The medical supply situation was in a similar state of disarray.

Slidell hospital is operating a successful immunization station outside the main entrance. There was a long line going up the street and they claim to be immunizing 1,000 people each day with Tetanus and Hepatitis A.

Like GMA, almost half of Slidel Memorial staff lost their homes. The hospital has established a fund to help these families. Arriving at a monetary figure to distribute to affected staff has been an extremely challenging exercise for the administrators. Most of the hospitals have committed to keeping all staff on payroll for at least three months.

Liz described their plans to purchase a van to shuttle patients to and from their homes. A large number of people had lost their vehicles and are in need of this type of assistance. They plan to submit a grant request to Direct Relief International next week.

Bill Bynum is the CEO of Enterprise Corporation of the Delta (ECD) in Jackson, Mississipi. Bill has played a key role in connecting Direct Relief with several of our key Mississippi partners (Doctors McNair and Rigsby). ECD is a private, nonprofit community development financial institution that provides commercial financing, mortgage loans and technical assistance to support businesses, entrepreneurs, home buyers, community development projects, and health care infrastructure including community health centers. ECD also sponsors Hope Community Credit Union, which provides a range of financial products and services that meet the needs of low- and moderate-income residents in its three-state service area.

In response to Hurricane Katrina, ECD established a fund to target financial assistance to churches and other community groups that are providing extensive support to displaced persons during this emergency phase.  Bynum and two of his staff discussed how we can support ECD’s immediate and longer-term efforts. In particular they are interested helping community clinics get back on their feet financially. They are set up to provide bridge loans to non-profits and help these institutions shortcut the traditional lending process.

I visited Mississippi Emergency Management Agency’s donation coordination center in Jackson and the 320,000 square foot warehouse on the outskirts of the city. An Emergency Management Volunteer accompanied me to the warehouse and shared her experiences. I was able to locate the 24 pallets of CeraLyte we had sent that week. The warehouse coordinator was more than willing to allocate 4 pallets to Dr. McNair. In fact Dr. McNair can ask for an entire truckload of materials (approx. 24 pallets) if he gives them a needs list. Obviously this is the type of information that should be shared among the healthcare community on the Gulf.

Mississippi’s Lieutenant Governor, Amy Tuck, was touring the MEMA warehouse at the same time. We briefly discussed the overall recovery effort and she thanked us profusely for our support.

The post Staff Story: Mississippi Clinic Visits appeared first on Direct Relief.