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Operational Update: Medical Support for Nepal, Acapulco, Turkey, and More



Direct Relief has been supporting primary healthcare centers and doctors with needed medical equipment, as earthquakes caused massive damage to healthcare infrastructure. (Photo by Ali Saltan for Direct Relief)

Over the past seven days, Direct Relief has delivered 520 shipments of requested medical aid to 47 U.S. states and territories and 19 countries worldwide.

The shipments contained 25.4 million defined daily doses of medication, including insulin, cardiovascular medications, antibiotics, chronic disease medications, PPE, and more.

Support for Nepal After Deadly Earthquake

A 5.4-magnitude earthquake shook northwestern Nepal last week, and at least 153 people have been killed, with 345 injured and about 12,000 families left homeless across seven districts, according to a preliminary report from the Nepal Red Cross Society.

The staff at Dhulikhel Hospital, which Direct Relief has supported since 2015, have already been deployed to support earthquake-affected regions in western Nepal. Dhulikhel Hospital is an independent, not-for-profit, non-government institution that operates a 475-bed hospital in addition to community health programs and 18 outreach centers that cover populations from at least 50 out of 75 districts in Nepal.

The staff at Dhulikhel Hospital brings DIrect Relief medical items to a rural healthcare facility in the earthquake-affected area in western Nepal. (Courtesy Photo)

Over the past three months, Direct Relief has sent two large shipments of medical products to Dhulikhel Hospital, totaling 35 pallets, which contained surgical instruments, diagnostic equipment, PPE, nutritional products, vitamins, and ICU consumables.

Direct Relief continues to monitor the situation and is ready to respond to requests.

Hurricane Otis Response Continues in Acapulco

Two weeks have passed since deadly Hurricane Otis, a powerful Category 5 storm, made landfall in Acapulco, Mexico, but the risks from infrastructure damage may make this week and those following the deadliest phase of the hurricane yet.

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 that “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.”

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.

Mexico’s BREIM (Brigada de Rescate Especializado de Intervención en Montaña – Specialized Mountain Intervention Rescue Brigade) open emergency medical packs sent by Direct Relief. (Courtesy Photo)

So far, Direct Relief has allocated $500,000 for emergency response assistance, which is being used to support local NGOs and first responders like Medical Impact assisting individuals affected by the hurricane. The organization has also delivered 83 field medic packs, which contain first aid items for care outside of clinic walls. Thirteen emergency health kits, which contain medicines and supplies commonly requested after disasters, were shipped to the area, as well as 20,000 liters of diesel to power the backup generators at Acapulco’s general hospital, which were running out of fuel.

Direct Relief will continue to respond to Hurricane Otis throughout the coming days.

Turkey Continues to Recover from February Earthquakes

Recovery from the devastating February earthquakes in Turkey continues, albeit slowly. In the province of Hatay alone, 23,453 people died, and over 75,000 buildings were damaged beyond repair. Debris removal is still in process, and as rebuilding has not yet begun, cities in the region have become acres of unrecognizable rubble.

Over 150,000 people still reside in containers, and many Syrian refugees live in formal and informal tent camps. These crowded temporary living situations, which lack access to reliable water sources due to infrastructure damage, leave the population constantly vulnerable to public health risks.

Direct Relief staff recently visited Hatay and met with many of the non-profits that have received medical aid and support from Direct Relief, including a primary health center providing care out of the container pictured below.

A primary healthcare center and physician in Samandağ. Hatay, Turkey, on Oct. 25, 2023. (Photo by Ali Saltan for Direct Relief)

This facility, located in Samandağ, Hatay, is typical in the earthquake zone, consisting of a container supplied by the Ministry of Health. Doctors are solely responsible for furnishing and outfitting the temporary clinics with required medical equipment. As doctors are also EQ survivors, purchasing these items has proved challenging.

Direct Relief’s recent $300,000 commitment to medical equipment procurement is supporting 58 primary health centers to locally purchase needed items to better serve the earthquake survivor population and ease the burden on healthcare professionals throughout the region.

A primary healthcare center and physician in Samandağ. Hatay, Turkey, on Oct. 25, 2023. (Photo by Ali Saltan for Direct Relief)



This week, Direct Relief shipped 22.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

  • Ukraine
  • Morocco
  • Pakistan
  • India
  • Uganda
  • Fiji
  • Malawi
  • Mali
  • Madagascar
  • Honduras
  • Turkey
  • Colombia
  • Liberia
  • Lebanon
  • Guatemala
  • Cambodia
  • Israel
  • Tanzania


Direct Relief delivered 476 shipments containing more than 16.1 tons of medications over the past week to organizations, including the following:

  • Mission Arlington Medical Clinic, Texas
  • GAIN, Inc, Arkansas
  • Family Health & Birth Center, District of Columbia
  • Riverside Health Center, West Virginia
  • Phoenix Allies for Community Health, Arizona
  • Charis Health Center, Tennessee
  • Amistad Community Health Center, Texas
  • Southeast Community Health Systems, Louisiana
  • Faith Family Medical Clinic, Tennessee
  • Community Care Clinic of Highlands-Cashiers, North Carolina

Direct Relief also issued a $150,000 grant to One805, an organization that provides needed resources to Santa Barbara County’s first responding agencies, such as safety items or equipment, assistance to support their mental health, or help in strengthening emergency and disaster preparedness in local communities. This grant will support mental health services for firefighters in Santa Barbara County.


Since January 1, 2023, Direct Relief has delivered 18,700 shipments to 2,402 healthcare providers in 55 U.S. states and territories and 86 countries.

These shipments contained 484.1 million defined daily doses of medication valued at $1.8 billion (wholesale), totaling 5.7 million lbs.

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