Connecting and Equipping First Responders
As the Mexican states of Oaxaca and Chiapas recorded fatalities and massive infrastructure damage from the first quake, Direct Relief staff already in Mexico City quickly responded. The organization had been preparing for Hurricane Katia’s landfall when the initial earthquake struck, thus staff in-country were able to coordinate responses to both disaster situations. Direct Relief has many connections and partners in the country from previous relief efforts: sending medical supplies in the wake of Hurricane John in 2006, providing aid to a pediatric hospital and clinics in response to a 2009 H1N1 flu outbreak, airlifting medical supplies again in 2009 in the wake of Hurricane Jimena, organizing flood-relief efforts in 2013, helping cities prep for subsequent years’ hurricane seasons, and working with organizations such as Partners In Health and the Baxter International Foundation and Asociación Gilberto on mobile health initiatives supporting preventative care.
On September 10, 2017, Direct Relief arrived in Juchitán de Zaragoza, Oaxaca, with shipments of medication, gauze, surgical gloves, and other needed supplies, and began working with state and federal governments to bring large-scale shipments of medication and medical supplies to hospitals in the region. A gym became a makeshift hospital, with doctors in need of surgical supplies, sterile dressing gowns, catheters, sutures, and medication for chronic conditions. Direct Relief worked with Mexican government officials who could facilitate gathering lists of needs from local medical centers and get permits in place for large-scale medical shipments from the U.S.
Responding to the Second Earthquake
A second quake struck Central Mexico with 7.1 magnitude force on September 19, 2017, the anniversary of a devastating earthquake in 1985 that had left 10,000 people dead. Ultimately, more than 370 deaths were reported in the aftermath of the second 2017 quake, with an epicenter in the state of Puebla. Students had been practicing earthquake drills just hours before the second quake struck.
Direct Relief’s response to the crisis caused by the initial quake was already well underway at that point, in coordination with Mexican and local governments. Contacts reported major concerns after the second quake in the state of Morelos, where a number of hospitals had collapsed in high-density urban areas. In at least one case, patients were moved to a nearby park, lying on stretchers beneath the trees with IV bags at their side. At temporary neighborhood aid stations, handwritten lists of needs were compiled on butcher paper taped to walls. Direct Relief offered support and an Emergency Health Kit to Mexico’s operational-response officials. The organization has Donataria Autorizada status from the Mexican government, allowing Mexican companies to receive tax benefits for donations. FedEx and Baxter made significant early contributions.
On September 23, 2017, Direct Relief volunteers began distributing bags of personal care items in Hueyapan, Morelos. The aid effort, made in partnership with the Centro de Investigación y Docencia Económicas, included 10 vehicles and more than 30 volunteers, who distributed nearly 450 individual hygiene kits to 13 towns and villages that had been affected by the earthquakes.
Many families ended up sleeping outside, on sidewalks and in parks, with only tarps for protection from blazing sun and torrential rain. On October 25, 2017, representatives from Direct Relief partner organization Mexfam drove into the fishing village of Santa María Xadani in Oaxaca to deliver 10 large tents to families who lost their homes in the earthquakes. Providing temporary shelter, while not historically one of Mexfam’s primary directives, became a priority in the days after the quakes. Full recovery of homes could take years in some cases, as the owners must salvage what they can from the ruins and set aside materials to rebuild bit by bit. Direct Relief assisted in sourcing tents, food, and hard-to-find medications, coordinating on the distribution of goods via Mexfam’s fleet of vans.
Assessing Impact and Building for the Future
In municipalities such as Juchitán de Zaragoza, catastrophic damage struck half of the Municipal Palace, nearly all of the main market, nearly every religious structure, at least 30 percent of residential structures, and 90 percent of the city’s largest hospital. The hospital’s primary storage facility collapsed in the first earthquake, taking a month’s worth of medications with it. In the relocated hospital, temporarily staged in a local school’s gymnasium/auditorium, medications were stored in the bleachers. A temporary hospital was up and running on an empty baseball field near the city’s northern edge by the time the second quake hit, but stocking medications for the hospital and 118 health centers around the region remained a critical issue.
Direct Relief’s Mexico team worked in conjunction with the state government to find a new storage facility, a large warehouse not far from the temporary hospital in Juchitán. Mexican health officials immediately began using the space to store and organize medications from individual donors, pharmaceutical companies, and non-governmental organizations. Within a few weeks of the first quake, about half of the floor space in the cavernous, hangar-like space was filled with donations.
Medications gathered at the warehouse would be used to serve not only the temporary hospital in town, but also regional hospitals across 5 towns, health centers, and traveling medical teams headed to smaller municipalities, where daily tremors continued more than a month after the first quake. As plans were made to rebuild the general hospital with 30 more beds, this facility provided a way to channel medical resources to patients scattered around the region. Direct Relief worked closely with pharmaceutical companies and Mexico’s medical service to see that medical workers on the ground had timely access to needed medications such as IV antibiotics and analgesics.
Moving From Acute Care to Preventive Health
As conditions evolved after the earthquakes struck, doctors informed Direct Relief, medical needs did as well, moving from trauma injuries such as fractures to minor problems, such as skin irritation, swelling, and lacerations from exposure to damaged structures and stagnant water. Epidemiological issues would follow, with flare-ups of untreated chronic illnesses such as hypertension and diabetes becoming a concern. Direct Relief and Mexfam worked together to assess new ways to balance day-to-day work toward Mexfam’s organizational goals—including sex education, STD testing, and pre- and post-natal care—with imperatives of disaster relief. Mexfam stepped in to perform procedures such as appendectomies and cesarean sections through its Ixtaltepec clinic while continuing to address its reproductive health mission.
On November 9, 2017, the Baxter International Foundation, Asociación Gilberto, and Direct Relief sponsored a dental clinic for dozens of children in Zacazonapan. Schools distributed information and divided visit days by age, helping avoid confusion, overcrowding, or the need to turn anyone away. Each day, numbered tickets were distributed to 120 families, some of whom traveled from smaller villages up to 2 hours away. This clinic was part of a larger 3-year effort, Driving Your Health, aimed at connecting residents in and around Mexico City with health care. Most of the children would be seeing a dentist for the first time. This was one of 72-plus communities in Mexico state that Asociación Gilberto was able to reach in 2017 using funds from Baxter International Foundation, channeled through Direct Relief.
The Driving Your Health program was established in 2015 to help expand access to health care, provide health education, and increase early detection of potentially serious health conditions. The Mexican Diabetes Association, for instance, directed funding toward establishing mobile glucose test sites in Mexico City, raising awareness and providing a pathway for diagnosis. Casa de la Amistad, a center for pediatric cancer that has helped more than 9,000 children with limited resources, used its funding to purchase a bus to transport patients from its center in southern Mexico City to hospitals around the city.