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The Anatomy of a Disaster Response

From moving pre-staged emergency supplies to a dedicated charter flight of medical aid, Direct Relief’s response to the Haiti earthquake is multifaceted – and ongoing.


Haiti Earthquake 2021

Direct Relief's emergency response team in Puerto Rico prepares supplies for shipment to Haiti in the wake of the August 14 earthquake. (Photo by Jose Jimenez Tirado for Direct Relief)

It was early on a Saturday morning in August, but a Direct Relief WhatsApp chat thread was lighting up.

A staffer had seen emerging reports of a magnitude 7.2 earthquake striking in the south of Haiti, and raised the alarm. Emergency Response Director Dan Hovey, still drinking his morning coffee, began thinking quickly.

First and foremost, he feared an event as catastrophic as the 2010 earthquake that struck near Port-au-Prince, killing more than 220,000 people and triggering a series of secondary catastrophes that continue to affect Haiti to this day. “That was the first thought,” he said.

Direct Relief swung into action, reaching out to existing partners to see who was affected by the early morning earthquake, and what support they needed.

The earthquake was the most recent event in a long chain of instability affecting Haiti. In July of this year, the country’s president was assassinated. The summer had seen a deadly surge of Covid-19 and shortages of even the most basic medical supplies. Gang activity and economic instability were rife.

All these things meant that another catastrophe would be harder to respond to and recover from. But it also meant that Direct Relief was already working closely with organizations on the ground, from a hospital in the quake zone to maternal health care providers.

“Our response started before the earthquake, because Haiti’s been dealing with multiple and compounding crises that have had severe impacts on the local health care system,” Hovey said. “These are people we’ve been working with for more than a decade. We know them well and understand the issues they’re facing on a daily basis.”

Calls to existing partners yielded some good news. St. Boniface Hospital, a major health facility in the earthquake zone, was launching its response and had already seen an influx of patients injured during the quake. Locally Haiti, a community-based group near the epicenter, was responding as well. St. Luke Foundation for Haiti, another partner, had a team already in the area. Mobile medical teams were departing from the capital city of Port-au-Prince.

But there was bad news too. The one major road in and out of Haiti’s southern peninsula was all but blocked by damage and gang activity.

“We knew from our experience responding to Hurricane Matthew in 2016, which affected this same region, that road access out to the Haitian peninsula would be limited, making this a complicated response logistically,” Hovey recalled.

The first round

When a disaster strikes, Direct Relief has generally already begun responding. In anticipation of a calamity, the organization has caches of supplies that are designed for disaster response – containing PPE, wound care items, antibiotics, and much more – staged all over the world.

In this case, there were emergency medical modules in Port-au-Prince, which were quickly transported by medical teams to Haiti’s southern peninsula, and another at the UN Humanitarian Response Depot in Panama. Other supplies were nearby at Direct Relief’s Puerto Rico warehouse. And at the time of the earthquake, the organization had PPE and other medical supplies already en route to Haiti.

The emergency response team’s first priority was deploying the emergency response modules as quickly as possible, arranging for them to be shipped and for partners on the ground to receive them. Designed to treat up to 1,000 people for 1 month following a disaster, Direct Relief’s Emergency Health Kits were among the first supplies to arrive in Haiti following the earthquake.    

For Puerto Rico-based staffer Luis David Rodriguez, the earthquake brought another kind of challenge.

Direct Relief’s Puerto Rico warehouse is ideally positioned to serve as a disaster response hub for the Caribbean, which is at risk from hurricanes, earthquakes, and even volcanic eruptions. (The organization also responded to an eruption in St. Vincent and the Grenadines earlier this year.) In the immediate aftermath of the earthquake, the emergency response team decided to send out seven pallets of PPE and emergency medical backpacks, designed for in-the-field use, from Puerto Rico – and Rodriguez wanted to make sure it got safely to its destination.

“We always like to come in contact with the partner, make sure the shipment gets into the right hands. To me personally, it was important,” he said.

But with Covid-19 restrictions, he wasn’t sure he was going to be able to accompany the shipment: “I didn’t know I was flying out…until the day before.”

Rodriguez had never been to Haiti. As he helped to unpack the boxes, he noted the U.S. Coast Guard and military helicopters landing in force at the airport. “You have to get into Port-au-Prince and go through customs,” he said of the process. Once the supplies had cleared, a team from St. Boniface Hospital prepared to transport them to the quake zone.

Long-term strategy

The first round was on its way. But Hovey knew from experience that emergency response involves a long-term strategy, not a quick fix. He and other Direct Relief staff contacted on-the-ground partners with curated lists of the relevant medical supplies currently in stock in Direct Relief’s warehouses and asked what they needed. The organization began reaching out to corporate donors, asking for the supplies that would be needed in upcoming weeks – a list that included antibiotics, IV fluids, surgical supplies, anesthesia medications, and more.

Project MediShare staff organize medical donations from Direct Relief during medical outreach to communities in Haiti recovering from the 7.2-magnitude earthquake that occurred in August. (Project MediShare photo)

The organization’s corporate partners responded in force. Baxter provided a large donation of IV fluids. Pfizer sent requested antibiotics and other medications. Teva sent a range of essential and chronic disease medications; Merck provided pulmonary inhalers; and Eli Lilly supported Direct Relief’s Haiti response with a donation of much-needed human insulin.

In addition, three partners who were new to product donations with Direct Relief stepped up to help in the wake of the Haiti earthquake. Corza Medical offered sutures for orthopedic surgeries, which had been requested in the wake of the disaster. Integra contributed surgical supplies, and Organon offered medications for asthma and chronic disease.

Direct Relief staff started planning a large-scale charter flight, containing 164 double-stacked pallets of medical aid requested by partners working on the ground. The flight, donated by FedEx, contained multiple emergency medical modules, PPE, IV fluids, and a wide range of additional support. 

Haiti is a young country – more than half the population is under the age of 25, according to the World Population Review – so a number of antibiotics and other medications were intended for pediatric patients. Wound care and crush injuries were still major concerns. Because so many medical facilities had been damaged, Direct Relief also provided durable tents for providers to treat patients and store supplies.

On-the-ground response following a disaster is expensive, and it needs to be flexible and fast. With that in mind, Direct Relief provided approximately $800,000 in emergency funding to partners that included St. Boniface, St. Luke Foundation for Haiti, Locally Haiti, and the NGO GHESKIO.

“We committed undesignated emergency funds with the idea that more funding would follow from our donors, and fortunately it did,” Hovey said.

And finally, as donations poured in from corporate partners, Direct Relief staff opened a dedicated online ordering portal that partners responding to the earthquake could use to procure needed medical supplies. Antibiotics, surgical and anesthesia medications, injectable cardiac medications, steroids, PPE, and chronic disease treatments were all on the list.

As far as emergency response operations go, according to Hovey, this one was successful and smooth: “From our perspective, this is a pretty clean, ideal response,” he said.

Currently, he said, most of the acute care needs caused by the earthquake, such as crush wounds, have faded. The problem is now medication and supply shortages, caused by damaged medical infrastructure and ongoing economic and political instability.

But Hovey emphasized that, when a large-scale disaster takes place, Direct Relief’s emergency response team thinks in terms of months and even years – long after media attention has faded. As needs in Haiti have shifted in the three months since the earthquake, so too has the organization’s response. Most recently, Direct Relief has provided or committed shipments of insulin, midwife kits, and Covid-19 therapies and rapid tests to the country.

“It’s something we’re going to continue focus on, for sure,” Hovey said.

Since the earthquake struck, Direct Relief has provided more than $18 million worth of medical aid to organizations working in Haiti, with another $20.6 million committed. In addition, $795,000 in funding has been granted to on-the-ground groups.

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