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.

Deadliest Phase of Hurricane Otis Likely Underway

Medical mission aims to reduce post-storm mortality.


Hurricane Otis

Mobile medical clinics take place in rural areas of Guerrerro state in Mexico, post-Hurricane Otis. (Photo courtesy of Medical Impact)

Hurricane Otis slammed into Acapulco, Mexico, in the early morning hours of October 25 with sustained winds of 165 miles per hour. The storm wrought catastrophic damage throughout the coastal city, known for its resorts, and at least 45 people were killed, and dozens remain missing. Local officials have said that 80% of hotels were seriously damaged.

Dr. Giorgio Franyuti, the founder and head of Medical Impact, a Mexico-based medical aid nonprofit that organizes monthly missions into underserved communities domestically and responds to disasters both at home and internationally, said the scale of devastation was well beyond anything he had seen in his career, which has spanned war zones, earthquakes, and volcano eruptions.

“This Category 5 storm was enormous… We didn’t even know where to start,” he said.

Determining that Acapulco would receive the most resources from the government and aid groups, Franyuti and his staff physicians organized a mission inland to the mountainous rural communities of Guerrero state and traveled to five different municipalities.

Before reaching the last one on their mission, Ejido Viejo, the Mexican military had to clear a path since existing roads were completely destroyed. The town had been cut off for over a week.

“It was horrendous. The houses were still drowning in mud. The cars were drowning in mud. Bodies were yet to be found,” he said. “We discovered a massacre.”

He plans to return next week with his team to continue treating survivors. Franyuti said that in his experience, which reflects the latest medical literature, the time after a natural disaster is oftentimes more deadly than the disaster itself.

Patient intake during a Medical Impact clinic in Guerrero. (Photo courtesy of Medical Impact)

“The secondary disaster is bigger than the first one. The earthquake or hurricane doesn’t kill as many people as the water shortages, for example, will. The cuts in basic services will cause major death among those affected by the hurricane,” he said.

The lack of refrigeration, combined with limited access to quality food, potable water, and gas for cooking food and boiling water, represents an extremely dangerous combination of challenges facing communities in rural Guerrero, which were vulnerable even before the storm, according to Franyuti, who said lack of clean water is the top priority.

He said he is concerned about the spread of a range of infectious diseases. Franyuti said diarrhea could kill more people than the hurricane due to the lack of oral rehydration salts and drinkable water in the area. Mosquitos, which could flourish in standing water near homes, also present a problem as some will likely vectorize diseases such as chikungunya, dengue fever, and zika. He predicts that the scarce local services will be oversaturated by these infections.

As is the case following most natural disasters, Medical Impact is working to address the shortages and barriers vulnerable communities have towards accessing chronic disease medication, particularly therapies that require being kept at cool temperatures, such as insulin. In Mexico, complications from diabetes are the second-leading cause of death.

Despite the level of need, Franyuti said the level of response has not been in line with the situation on the ground.

“I think what is worrisome compared to other disasters in the past is that while the media has given this wide attention, stakeholders have not,” he said.

Medical Impact is preparing for at least four more missions to address this crisis, each lasting for one week. Franyuti said his team has been the only one responding to these areas.

Direct Relief has been responding to Acapulco, equipping organizations with requested medical aid, including Medical Impact. The organization received a $25,000 emergency operating grant to deploy doctors to Acapulco to provide medical care in the area. Field medic packs and an emergency health kit, which contains medical essentials commonly requested after disasters, were also provided for medical providers from Direct Relief.

Giving is Good Medicine

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