Situation and Response
- Emphasizing the need for medical relief services, a report issued by Nepal’s Ministry of Health and Population noted that 375 of the 446 public health facilities and 16 private facilities in Nepal’s hardest hit regions were destroyed.
- Direct Relief has delivered 374,786 lbs. of requested emergency medicines and medical supplies with a wholesale value of $46 million to health facilities throughout the country.
Leveraging Connections and Equipping First Responders
From 2008 until when the earthquakes hit in 2015, Direct Relief had delivered more than $1 million worth of medicines and supplies to its charitable healthcare provider partners in Nepal, making connections across the country. After the temblors rocked Nepal, Direct Relief quickly coordinated with corporate partners such as Actavis/Teva Pharmaceutical Industries, and Mylan, as well as established local and emergency response partners, including fistula treatment centers and organizations focusing on maternal and child health, Doctors for You, Himalayan Healthcare, One Heart World-Wide, Patan Hospital, Possible Health, Reach Out WorldWide, Rescue Network Nepal, Sri Sathya Sai Central Trust, and Team Rubicon.
Within a week of the first earthquake, pallets full of relief supplies for survivors were readied at Direct Relief’s headquarters before being sent to Kathmandu, Nepal, via FedEx. Direct Relief additionally worked directly with Nepal’s Ministry of Health and Population to gather requests for specific items needed, then expedite their importation. At least half of a humanitarian charter plane’s capacity was secured for the initial airlift. At least 100 tons of materials worth $50 million were initially provided. On May 1, 2015, FedEx committed to deliver critical medical aid to Nepal, including supplies from Direct Relief, Heart to Heart International, and Water Mission.
Direct Relief equipped eight trained doctors, firefighters, and paramedics from Reach Out WorldWide with more than 350 pounds of antibiotics, wound-care items, IV solutions, and other medicines and supplies to operate a pop-up clinic in Kathmandu. The team would begin its work in Nepal on April 27, 2015. Additionally, the organization equipped four physicians and staffers from Mammoth Medical and World Wide Trekking with 250 pounds of antibiotics, wound-care supplies, and other needed medicines to support their work with Manmohan Memorial Teaching Hospital in Kathmandu.
On May 8, 2015, thanks to a generous donation by FedEx, a Nepal-bound airlift departed from the company’s Memphis World hub with $15 million in medical supplies from Direct Relief. This included 118,771 pounds of materials, with more than 6 million defined daily doses of medication and 20 hospital tents with solar lighting to facilitate safe births, designated to support 6 hospitals in and around Kathmandu, plus 5 emergency medical teams, One Heart World-Wide, and Nepal’s Ministry of Health and Population. The plane would land in Dubai, United Arab Emirates, to pick up additional relief supplies, then head into Kathmandu, where relief teams would offload and distribute the supplies. This plane would return to Dubai once more to reload another full flight’s worth of supplies bound for Kathmandu.
Additionally, Direct Relief purchased $260,000 worth of materials in India through Doctors for You, with supplies sent from Delhi, India, to Kathmandu, Nepal. Items delivered included five Siemens digital x-ray machines, five Dräger ventilators, implants and orthopedic supplies, and medicines and medical supplies. These were flown free of charge on Jet Airways, arriving on May 9, 2015. Direct Relief also procured 11,500 safe-birth kits, valued at nearly $54,000, from a company in India, supporting One Heart World-Wide’s work to ensure safe deliveries for women in two of the hardest-hit districts, Sindhupalchok and Dhading.
By the end of April 2015, Direct Relief’s emergency response team in Kathmandu had connected with partner organizations such as Doctors for You and One Heart World-Wide, which made its facilities in the area available as a temporary base of operations for the Direct Relief team. Additionally, Direct Relief attended U.N. Health and Logistics cluster meetings and met with the Nepal Ministry of Health and Population to ensure resources would be delivered appropriately, guided by local considerations.
The director of international partnership for Nepal’s Ministry of Health and Population, the director of the ministry’s Department of Health Services’ Logistics Management Division, and other government officials all helped fast-track Direct Relief donations through customs. Direct Relief received significant assistance from these officials in setting up secure storage and distribution of these medical resources as well. Damaged roadways and the already difficult topographical environment of the affected areas of Nepal necessitated using both trucks and helicopters for deliveries.
In Dhading, a three-hour drive from Kathmandu, teams from Direct Relief and One Heart World-Wide delivered emergency medical supplies to the local hospital. The hospital had suffered minor damage, but visits surged to 270 patients per day, nearly triple its usual rate. The hospital was undersupplied and underfunded before the quake and was extremely low on basic medications and supplies such as antibiotics, IV solutions, and bandages. Many patients were receiving care in the hospital’s halls and even outside.
By the end of April 2015, Direct Relief had sent several emergency medical deliveries along with teams bound for Nepal. More were underway soon thereafter.
Emphasizing the need for medical relief services, a June 10, 2015, report issued by Nepal’s Ministry of Health and Population noted that 375 of the 446 public health facilities and 16 private facilities in Nepal’s hardest-hit regions were destroyed in the earthquakes. The highest near-term priority was of health services resuming, including the provision of logistics to deliver drugs and supplies, enabling care for both injured individuals and the general population. As monsoon season raised the risk of waterborne and communicable diseases, Direct Relief continued its efforts in Nepal through close consultation with the Ministry of Health and Population and locally run institutions.
On June 16, 2015, a Direct Relief–chartered aircraft landed in Kathmandu carrying 55 tons of essential medications and emergency supplies to assist those affected by the earthquakes. The airlift included 5,350,173 defined daily doses of medications, prenatal vitamins for 10,000 women, 192 wheelchairs from Free Wheelchair Mission, 100 solar suitcases from We Care Solar, trauma- and wound-care supplies, and thousands of liters of Pedialyte oral rehydration solution, acutely needed with a heightened threat of cholera in affected areas. Companies that contributed supplies to the airlift included 3M, Abbott, AbbVie, Actavis/Teva Pharmaceutical Industries, Ansell, Baxter International, Bayer, BD, Bristol-Myers Squibb, Calmoseptine, Covidien/Medtronic Minimally Invasive Therapies, Ethicon, Hospira, Integra LifeSciences, Janssen Pharmaceuticals/Johnson & Johnson, Mountain Orthotic & Prosthetic Services, Mylan, Omron Healthcare, Sanofi Foundation for North America, and SoapBox Soaps.
Direct Relief’s initial round of cash grants to support local Nepalese health groups included $100,000 to the Midwifery Society of Nepal, to help address the increased risks faced by an estimated 126,000 pregnant women in earthquake-affected areas. Prior to the earthquakes, maternal mortality in Nepal had decreased by 70 percent in the 17 years between 1993 and 2010. A child in 2011 was twice as likely to live past age five as a child in 1996. But when the earthquakes hit, much of that progress was reversed.
It is thanks to the generous support of individuals, foundations, and corporate partners that Direct Relief was able to deliver critically needed medical products to assist thousands of earthquake survivors in Nepal. Without their generosity, this effort would not have been possible. In the first three months after the earthquakes, Direct Relief received more than 17,000 Nepal-designated financial contributions, totaling more than $6.6 million. One hundred percent of these contributions were used exclusively for assisting people affected by the earthquakes.
Early on in Direct Relief’s response, for instance, the Reddit community raised more than $130,000 for Direct Relief’s earthquake response, comprising more than 30 percent of the 10,000-plus donations for Nepal at that point. And in June 2015, gaming company Bungie presented Direct Relief with a check for more than $1 million, raised by 50,000 players of the game Destiny. This made the Seattle-based company the single largest financial donor to Direct Relief’s Nepal response.
Direct Relief was also able to tap into the network of NetHope members to develop a mobile app enabling easy assessments of facility status and health needs. The app allowed for offline data collection, which was important with spotty network connections in the quakes’ aftermath, as well as the collection of location information that could be shared when connectivity existed. This data was then automatically geotagged and published on the Esri platform.
On April 25, 2015, Direct Relief committed its entire available medical inventory, valued at more than $100 million wholesale, for response to the initial earthquake. On April 27, 2015, Direct Relief announced $500,000 in cash committed to the emergency response for the initial Nepal earthquake. In the first three months following the earthquakes, Direct Relief would grant more than $1,791,984 to organizations and health facilities in Nepal to provide urgently needed services and rebuild or expand essential services. Additionally, Direct Relief spent $710,699 in the first 3 months after the quakes to mobilize, transport, and deliver more than 144 tons of specifically requested medical materials, including more than 10 million defined daily doses of medication, valued at $28,982,827.
A border blockade with India in November 2015 resulted in severe shortages of medications and medical goods, intensifying an already difficult situation following the earthquakes. Direct Relief coordinated with Nepal’s Ministry of Health and Population, working off of a detailed list of the ministry’s highest-priority needs for the following three months, including HIV medication, pain medication, disinfectants, dermatological agents, cardiovascular drugs, respiratory medication, pain medication, disinfectants, dermatological agents, antifungal medication, anti-anxiety medication, and oral rehydration salts. An initial 15-pallet shipment containing approximately $3.5 million’s worth of requested medications and supplies would depart for Nepal in late November 2015, with an additional air shipment in December 2015. The initial shipment contained 2.6 million defined daily doses of medications and necessary supplies, provided by 10 health-care partners: Actavis/Teva Pharmaceutical Industries, Apotex, Bayer, BD, Bristol-Myers Squibb, Eli Lilly and Company, Janssen Pharmaceuticals/Johnson & Johnson Family of Consumer Companies, Hospira/Pfizer, Mylan, and Sun Pharmaceutical Industries.
Ultimately, medical resources were donated by more than 60 healthcare companies. Emergency airlifts donated by FedEx and in-country logistics coordinated by the World Food Programme and the U.N. Humanitarian Air Service helped to keep Direct Relief’s costs low. In the first year after the quakes, Direct Relief was able to deliver nearly 165 tons of requested emergency medicines and medical supplies, valued at almost $36.2 million wholesale. Cash expenditures to deliver this humanitarian medical material assistance were modest: just over $1.2 million in cash was spent to facilitate these activities. Extensive support through contributions of in-kind medical resources and air-transport and logistics services made a significant difference in Direct Relief’s ability to deliver needed resources without significant expenditures. Other donors included Boehringer Ingelheim Cares Foundation, Cera Products, Unilever, and ViiV Healthcare.
Building for the Future
The Nepal earthquakes caused traumatic injuries that resulted in lifelong disabling conditions for those injured. Direct Relief has sought to support institutions and services that will provide specialized care for these individuals for the decades to come. The organization provided medical materials and sustaining funding to organizations such as the Hospital & Rehabilitation Centre for Disabled Children and the Spinal Injury Rehabilitation Center.
In the Dhading and Sindhupalchok districts, between 65 percent and 75 percent of health facilities were destroyed. To support the approximately 16,000 women in the two districts who give birth each year, Direct Relief supported partner One Heart World-Wide with grants to renovate 5 damaged facilities into certified birthing centers, equip 35 birth centers, and build 45 health posts. The grants would also enable training for 80 skilled birth attendants and education for 1,300 community health volunteers on safe motherhood practices. Grants were also given to the Midwifery Society of Nepal to address increased risks to pregnant women and to Namche and Khunde Clinics for software to provide physicians with recent clinical guidelines and notes for patient care.
In the first year after the quakes, Direct Relief granted more than $2 million in cash to locally run organizations in Nepal for conducting medical outreach in quake-affected areas, reconstructing damaged and destroyed hospitals and health facilities, and extending maternal and child health services to rural communities. In addition to the organizations previously named, grants went to Clean up Nepal for a national awareness campaign, plus displaced-persons camp sanitation monitoring and hygiene-related health education; to Shakti Milan Samaj to provide blankets and warm clothing to families living in tent communities in earthquake-affected regions; to the Nepal Cancer Support Group for cervical- and breast-cancer education and screening programs; and to Western Regional Hospital in Pokhara to repair and replace damaged specialized medical equipment.
The remaining nearly $2.9 million in Nepal-designated funds would be used solely for Nepal relief and recovery activities, with emphasis on those that strengthened Nepal’s health-care infrastructure, expanded provision of services to the most vulnerable in society, and helped prepare the country for future disasters. Direct Relief’s subsequent efforts were organized around improving maternal and child health, providing Certified Midwife Kits developed in partnership with the International Confederation of Midwives; making financial resources available to local health-care partners; providing medical resources to community health-care facilities; and continuing to help Nepal improve disaster preparedness and build resiliency.