News publications and other organizations are encouraged to reuse Direct Relief-published content for free under a Creative Commons License (Attribution-Non-Commercial-No Derivatives 4.0 International), given the republisher complies with the requirements identified below.

When republishing:

  • Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
  • If publishing online, please link to the original URL of the story.
  • Maintain any tagline at the bottom of the story.
  • With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
  • If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
  • If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
    • Twitter (@DirectRelief)
    • Facebook (@DirectRelief)
    • Instagram (@DirectRelief)

Republishing Images:

Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.

  • Maintain correct caption information.
  • Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
  • Do not digitally alter images.

Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.

Other Requirements:

  • Do not state or imply that donations to any third-party organization support Direct Relief's work.
  • Republishers may not sell Direct Relief's content.
  • Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
  • Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
  • If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.

For any additional questions about republishing Direct Relief content, please email the team here.

For People Living with Chernobyl’s Effects, A Medication Shortage Threatens

Direct Relief has shipped 14 million doses of levothyroxine, a drug used to treat impaired thyroid function, to Ukraine’s Ministry of Health and a Ukrainian NGO in response to increased need.


Ukraine Relief

Charity Fund Modern Village and Town, a Ukrainian NGO, receives a shipment containing levothyroxine for distribution to people affected by the war. (Photo courtesy of Charity Fund Modern Village and Town)

In the days after the Russian invasion of Ukraine, a local nonprofit began receiving an unusual request.

Many people were calling the NGO, Charity Fund Modern Village and Town, searching for insulin and other typical drugs – increasingly difficult to find as the war caused logistical issues throughout Ukraine, and even basic medications were made scarce in the areas under attack.

In addition to supplying hospitals and other health facilities with medical aid, the organization responds by searching for requested medications, and letting patients know where they can access them. In some cases, they’ll even acquire a medication for a specific patient.

But some people were searching for something more unusual: levothyroxine – a hormone replacement used by people whose thyroid glands have been removed or whose thyroid function is impaired. Before the war in Ukraine, it was inexpensive and highly available, said Dr. Robert McConnell, a physician at the Columbia University Irving Medical Center and expert in radiation-caused thyroid disease, which he has studied in Ukraine since the aftermath of the 1986 Chernobyl nuclear power plant disaster.

It was also widely needed. For the past 25 years, working with the National Cancer Institute and in partnership with the government of Ukraine, McConnell and his colleagues have studied a cohort of 12,000 people who were under the age of 18 when they were exposed to the effects of Chernobyl’s fallout.

Even among their cohort, approximately 300 people had thyroidectomies, about half of them due to cancer. Even decades later, “we’re finding an excess number of cancers, beyond what you would expect from screening. And the cancers have a unique genetic signature…they are radiation induced,” McConnell said.

Many of the people affected by thyroid disease rely on the medication levothyroxine.

According to McConnell, a pharmaceutical manufacturer of the medication was destroyed by artillery fire. Ukrainians “haven’t had any levothyroxine available locally since the second week of the war,” he said. “Now we have these young adults who were exposed to Chernobyl, and they’re without thyroid hormone.”

In addition, there have been reports of people wanting levothyroxine to protect them from the effects of radiation caused by a nuclear attack.

However, it works differently than something preventative like potassium iodide, said Alycia Clark, Direct Relief’s director of pharmacy and clinical affairs. “As a hormone replacement, it’s really meant for people who already have experienced impaired thyroid function,” she said.

Going without the medication is dangerous. McConnell explained that withdrawal symptoms – including low blood pressure, extreme fatigue, muscle cramps, depression, and sensitivity to cold (“and it’s winter,” he pointed out) – begin after about two weeks without treatment. After three months without it, people’s conditions can become life-threatening.

Complicating matters is the fact that the subjects McConnell and his colleagues are tracking have scattered because of the war. “It’s just a big, big question mark. We don’t know how many have gotten out,” he said. “It’s heartbreaking and sickening.”

Even before the war began, Direct Relief had a shipment containing levothyroxine packed and ready for shipment to Ukraine. “We almost always have levothyroxine in our inventory,” Clark said.

In the days immediately after the invasion, “the first requests were [for] all the wound care and trauma,” she said. But as the war has dragged on, the drugs required for routine care – including levothyroxine – are increasingly requested.

Direct Relief has shipped more than 14 million defined daily doses – totaling above 30,000 pounds – of levothyroxine to Ukraine’s Ministry of Health at their request, and to Charity Fund Modern Village and Town, for distribution to health facilities serving people affected by the conflict.

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.