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Medical Caches Shore Up Critical Health Facilities Ahead of Hurricane Season

As bigger storms hit small countries and territories, Direct Relief’s 2023 hurricane strategy is region-wide.



Hurricane preparedness packs are delivered to Vieques, Puerto Rico, on May 19, 2023, in advance of hurricane season starting on June 1. The packs are currently being staged across Central America, the Caribbean and the U.S. Gulf Coast in advance of the 2023 Atlantic hurricane season. (Photo by Xavier Garcia for Direct Relief)

While Hurricanes Eta and Iota both landed along Nicaragua’s coast in November 2020, the destruction they wreaked spanned all seven Central American countries. Increasingly, the larger and more dangerous storms spawned from warming oceans are crossing international borders and threatening entire regions.

In response, Direct Relief is taking a regional approach to help countries in the Caribbean and Central America prepare for hurricane season. This includes pre-positioning medical aid in depots across the region, close coordination with a set of intergovernmental organizations, and on-the-ground staffing in Direct Relief’s Puerto Rico response hub.

2023’s Atlantic hurricane season officially begins June 1, but Direct Relief has been preparing for months, assembling and staging large caches of emergency medical supplies, and collaborating with national health care and emergency response authorities in countries across the storm-prone region.

Direct Relief is pre-positioning emergency medical supplies in every southeastern and Gulf Coast U.S. state from Virginia to Texas, as well as throughout the Caribbean and Central America. The caches, called hurricane prep packs, or HPPs, contain the medical items most commonly needed in the wake of a disaster, including trauma supplies, antibiotics and wound care supplies, as well as medications for diabetes, hypertension, and respiratory, psychological and gastrointestinal ailments.

Internationally, Direct Relief is shipping 18 HPPs to countries in the Northern Hemisphere including Anguilla, Bahamas, Barbados, British Virgin Islands, Cuba, Dominica, Dominican Republic, El Salvador, Haiti, Honduras, Panama and St. Lucia. It will ship additional packs in November to Fiji and Vanuatu ahead of their cyclone season. These international HPPs weigh 1,470 lbs., designed to provide enough medical supplies to care for 1,000 people for 30 days.

Direct Relief is shipping 70 smaller versions of the pack to health partners in 12 U.S. states and territories. Each of these packs weighs 180 lbs., is sized to accommodate a small clinic’s operations, and is staged with a higher number of health clinics than the mid-sized HPPs used in previous years. Packed into each HPP are 220 types of medicine and medical supplies, designed to provide enough medical supplies to care for 100 people for 72 hours.

The HPPs are designed to be opened in case of emergency. If they haven’t been opened by the end of hurricane season, the health partners storing the stockpiles open them and distribute the material for ongoing healthcare operations.

Currently, Direct Relief has 25 tons of emergency medical supplies staged in Puerto Rico and three tons at a hub in Panama.

“We launched our Hurricane Preparedness Program in response to Hurricane Katrina in 2005, and it’s grown to become the largest medical hurricane pre-positioning program in the world,” said Daniel Hovey, Direct Relief’s Director of Emergency Response and New Initiatives.

2022’s hurricane season saw the highest-ever number of hurricane preparation packs opened, deployed and utilized in the Caribbean and Central America. These included six HPPs in Puerto Rico, two in the Dominican Republic, one in Cuba (plus another one transported to Cuba from Panama), one in Honduras and one in Nicaragua, along with more than 100 emergency medical backpacks packed with supplies.

In the Dominican Republic, Direct Relief Medical Aid Helps Thousands after Hurricane Fiona

As part of its Hurricane Fiona response last September, Direct Relief sent 30 medical backpacks to the Dominican Republic from its Puerto Rico hub.

A health worker with Patronato Benefico Oriental measures a patient’s blood pressure at a medical clinic in Caciquillo, Dominican Republic, after Hurricane Fiona impacted the community in Sept. 2022. The group was able to use pre-positioned medications to treat patients. (Courtesy photo)

“We carried out a medical operation in the community of Caciquillo in El Seibo, where with only the medicines donated by you [Direct Relief] we were able to impact more than two thousand people,” said Sanil Garcia, a staff member at Patronato Benefico Oriental, a children-focused social services nonprofit in La Romana, Dominican Republic. In all, “some 6,854 people have been impacted with the prep pack medications.”

Regional Partners

Direct Relief is increasingly working closely with intergovernmental organizations to prepare for disasters and to coordinate disaster aid. These organizations have strong ties to national healthcare systems and also provide regional disaster response coordination.

Direct Relief has been working closely with the Pan American Health Organization, or PAHO, a United Nations agency focused on public health in the Americas. PAHO has representatives working with every country in the Western Hemisphere, easing international cooperation.

In Nicaragua during 2022’s Hurricane Julia, emergency responders tapped into an HPP that Direct Relief had pre-positioned at a PAHO hub there. As Hurricane Ian hit Cuba last year, an HPP packed with emergency medical supplies that had been positioned by Direct Relief and PAHO at the U. N. Humanitarian Response Depot in Panama was quickly transported to Cuba.

Late last year, Direct Relief renewed its partnership with the Organisation of Eastern Caribbean States, which represents 11 small countries in the Leeward and Windward Islands, the chain extending north to south from the British Virgin Islands to Grenada. Other regional organizations Direct Relief works with during disasters include the Caribbean Disaster Emergency Management Agency.

Direct Relief’s Puerto Rico Hub Enables Rapid Regional Response

Direct Relief’s Puerto Rico regional hub keeps large stocks of medical supplies on hand for rapid delivery to the Caribbean or Central American nations struck by hurricanes, while emergency response personnel stationed in Puerto Rico are ready to respond immediately to regional emergencies.

When a 7.2-magnitude earthquake struck Haiti in 2021, killing more than 2,000 people and injuring more than 12,000, Direct Relief’s Puerto Rico team quickly dispatched seven pallets of emergency medical backpacks and PPE to equip Haitian health workers, accompanied by a Puerto Rico-based staff member. The regional hub in Puerto Rico also enabled a fast response to the 2021 eruption of a volcano on St. Vincent and to the 2020 Covid outbreak in Dominica.

The Puerto Rico hub was an outgrowth of Direct Relief’s intensive response to 2017’s Hurricane Maria, which is estimated to have led to nearly 3,000 deaths in the U.S. territory and left much of the island without power for months.

In addition to staging medical supplies in regions vulnerable to hurricanes, Direct Relief has also increased its ability to deliver hurricane relief supplies directly from its Santa Barbara, California, headquarters. This includes the ability to get emergency shipments, even into areas cut off from normal services, by working with its disaster response transportation provider FedEx.

Improving Coordination Through Data Sharing

Ultimately, hurricanes are only one of the often-interrelated environmental challenges people are facing.

“Everywhere in the world, the problem is really this alternation between deep drought and intense storms,” said Andrew Schroeder, Direct Relief’s VP of research & analysis. Other problems associated with intense storms include damage to crops, trees and topsoil, adding economic stress to local people. “These are complicated, really tough issues.”

Direct Relief has continued extending the availability of data systems that inform the actions of health and emergency response agencies, working through partnerships like CrisisReady, a collaboration of Harvard University and Direct Relief. Last week, CrisisReady was using anonymized Facebook mobility data to report on a large movement of people from the giant refugee camp in Bangladesh’s Cox’s Bazar as Cyclone Mocha made landfall.

“You have displacement being driven by drought and food security crisis, and then you have these large-scale storms that hit communities already vulnerable for reasons related to poverty,” Schroeder said. “We need better responsive coordination structures in order to be able to effectively manage through them.”

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