Nepal Earthquake Response Update

Nepal Earthquake: Child receives medical care
Image courtesy of Patrick Adams
By Tony Morain
Update: 4/30

Humanitarian charter a go:  Direct Relief has confirmed the donation of a humanitarian charter for Nepal. At this point, Direct Relief will use at least one-half of the plane’s capacity (102 “skids”), which may increase depending the space needed by a colleague nonprofit.

Emergency procurement of medical equipment:  As noted yesterday, when the Ministry of Health requested specific items and approved and pre-cleared their importation, they also asked for specific items that Direct Relief does not have in inventory (ventilators, fixation devices for fracture repair, imaging equipment, etc.)  Given the inflow of financial contributions, Direct Relief is procuring these items with a portion of the available funds and advised the MOHP of this.

Direct Relief’s team in Nepal met again with Ministry of Health officials to inquire if they had specific, pre-approved in-country vendors or suppliers, and if that is a more straightforward path. (We want to ensure that, if any equipment is procured, it is approved for use in the country and has a service contract and authorized techs in Nepal. This is to ensure the equipment can be repaired and serviced, if the need arises.)

Scaling plans to meet the health care needs in Nepal:  At this point, Direct Relief has revised its budgeting scenarios with the assumption of at least $1.5 million in designated funding. Direct Relief has begun an initial allocation for how these funds will be best used to assist Nepal in the most productive manner.

The availability of the charter is a huge force-multiplier. It allows Direct Relief to plan around transport costs, which are often among the largest expenses.

Direct Relief’s immediate focus includes:

Funding: The reddit community has raised more than $130,000 for Direct Relief’s earthquake response and comprises more than 30 percent of the 10,000-plus donations for Nepal.

Direct Relief’s response is only possible thanks to the generosity redditors and each person who’s lent their support.

Thank you.

Update: 4/29

Direct Relief staff met today with the Ministry of Health (M0H) in Nepal, which requested more than 320,000 lbs. (approx. 500 4x4x4 skid spaces) of medical items from Direct Relief’s available inventory. The MoH confirmed both the need for the specific items and a willingness to fast-track pre-approved items through customs. Direct Relief also met with the National Drug Administrator and the Director of International Partnership for the MoH, who both affirmed the Ministry’s need for such items and confirmed their importation requirements.

These approvals are essential at this stage of the response, as the typical bottle-necking that occurs post-disaster is occurring, and the offloading capacity at the airport, limited storage, and damaged roadways – as well as the unique topographical environment in Nepal – create significant challenges for in-country distribution.

Meanwhile in Dhading, a three-hour drive from Kathmandu, teams from Direct Relief and One Heart delivered emergency medical supplies to Besi District Hospital. While the hospital suffered only minor damage, it faces an average surge of 270 patients a day, up from 100. Undersupplied and underfunded even before the quake, the hospital is extremely low on basic medications and supplies such as antibiotics, IV solutions, and bandages. Patients, who before sought treatment for fractures and orthopedic surgeries in Kathmandu, now receive care in the hospital’s halls and outside.

With a large proportion of homes collapsed or visibly cracked, and people forced to sleep on the street for a lack of safe shelter, the team noted little improvement outside the hospital. People in remote areas are unable to reach hospitals for needed medical care, which makes doctors wary that more serious complications or outbreaks of cholera or other infections could take root.

Infusing essential medical material. Direct Relief, as one of the main channels for humanitarian medicines and supplies, is in discussions with the Ministry of Health and other agencies to provide medical material support at a national level. Meanwhile, Direct Relief has sent several emergency medical deliveries with teams bound for Nepal, with several more planned in the coming week.

Supporting local organizations. Direct Relief supports local organizations that focus on Maternal Child Health, specifically safe deliveries, and fistula repair.  Depending on the availability of funds, Direct Relief will provide the direct financial support necessary for rebuilding damaged/destroyed delivery centers and facilities.

Information gathering, sharing, coordination.  Working with NetHope members, Direct Relief developed a mobile app to conduct assessments of general facility status and capture specific health needs (screenshots below).  The app enables offline data collection (i.e. when a device is not connected to a network) and location information, which can be subsequently shared when connectivity exists.  Data will be automatically geo-tagged and published on the Esri platform.  The app and all information collected will be publically available and broadly shared.

For more information, visit reddit to read Direct Relief CEO Thomas Tighe’s candid “Ask Me Anything” on the response.

Direct Relief extends its deepest thanks to everyone who has supported the effort thus far.  Your support is critical to the many thousands of survivors of this devastating tragedy.

Update: 4/28
Thousands living on the streets because of damaged or destroyed houses or fear of aftershocks. 

In Nepal: Direct Relief’s emergency response team is in and around Kathmandu.  They are connecting today with Doctors for You, a highly regarded partner organization that Direct Relief funded to deploy to the region.

The UN has activated its “cluster” system, which serves as the convening mechanism to (attempt to) coordinate information sharing and activities among various UN agencies with different responsibilities and assets as well as international organizations.  Direct Relief attended yesterday’s Health and Logistics cluster meetings, and then were scheduled to with the Ministry of Health to ensure Direct Relief’s resources and activities are delivered and conducted appropriately and guided by the local considerations.

Direct Relief is in regular communication with long-time partner One Heart Worldwide, a group with a strong presence in Nepal. One Heart has generously made available their facilities in Kathmandu as a temporary base of operations for the Direct Relief team.

One Heart Worldwide works in two districts of Nepal. In one area, 10 of the 20 birthing centers they staff (at Ministry of Health facilities) are utterly destroyed, and the other 10 are significantly damaged.  Overall, more than 70% of the structures in the 400,000 district had been destroyed, according to One Heart staff.

Emergency Shipments for Medical Teams En-route:  Direct Relief packed and delivered emergency shipments for two Nepal-bound medical teams yesterday, with several more in the works.  The two groups include:

Other activity: Direct Relief is in regular communication with roughly one dozen partner organizations based in Nepal, many of which are working to collect complete information, and other international organizations with which Direct Relief  often works such as NetHope, the consortium of Tech Companies and colleague nonprofits.

Medical Resources: Current, available inventory includes 300 pallets of materials that are likely to be needed and are being made available, include:

IV solutions (60 4x4x4 pallets total, estimated weight 108 – 120,000 lbs.):

Hospital supplies (50 Pallets total):

Rx Medications (primary care):

Rx Medications (chronic care):

OTC pain relief medications:

Hygiene/personal care items:

Healthcare Company Support: Direct Relief is in discussions with healthcare companies to mobilize wound care, sterile gauze, sutures and other items based on an initial assumption of 20,000 injured with an injury pattern consistent with prior earthquake events. This estimate will be refined as local partners make specific requests and a complete information becomes available, in addition to the obvious concerns about traumatic injury, infrastructure, contaminated water, power, fuel supply lines, etc.

Thank you to everyone who’s helped the effort thus far. Your support is critical, and it makes a difference.

Update: 4/27 – Direct Relief ups Commitment to $500,000 Cash for Nepal Earthquake Response
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Direct Relief announced today an increase to $500,000 cash committed to the emergency response for the Nepal earthquake, up from the $50,000 announced initially on Saturday.

The increase reflects the urgency of the situation based on the still-unfolding information available, requests from longstanding partner organizations in Nepal, and the generous support that has been forthcoming from the public since Saturday’s quake.

As always, Direct Relief will use 100 percent of gifts designated for Nepal only for the response in Nepal.

Update: 4/26
Displaced and shell-shocked Nepalese residents set up tents in an open field in the Chuchepati area of Kathmandu, Nepal, Sunday, April 26, 2015, a day after a massive earthquake devastated the Himalayan region. (AP Photo/Tashi Sherpa)

While the situation in Nepal is still unfolding, initial assessments report more than 2,500 people killed, thousands injured, and hospitals and other medical facilities overwhelmed.

As has occurred in other major earthquakes to which Direct Relief has responded (Pakistan, Haiti, Indonesia), this quake has simultaneously created an enormous spike in need for emergency health services while destroying much of the already-inadequate health infrastructure through which such services are provided. The quake also has diminished the country’s general infrastructure (roads, power, water), which are needed to accommodate a much-needed surge in the support.

With news of the Nepal earthquake and in the subsequent hours, Direct Relief activated its emergency response effort and began contacting Nepal- and India-based healthcare partners to mobilize the resources needed to care for people in affected areas.

Direct Relief has a substantial medical inventory valued at over $100 million (wholesale), and yesterday made all of it available as needed for the response. Also, Direct Relief committed an initial $50,000 in cash — regardless of whether any specific Nepal-designated contributions are received — to jumpstart the response.

Direct Relief’s emergency response manager, Gordon Willcock, will be coordinating Direct Relief’s activities from Nepal, in concert with partner organizations and other international actors that also are responding. The general needs are evident and extreme, but on-the-ground coordination is essential to ensure that the resources being mobilized and delivered are targeted, well managed, and distributed efficiently within the very dynamic situation.

Since 2008, Direct Relief has delivered more than $1,000,000 of medicines and supplies to excellent, committed healthcare provider partners in Nepal, primarily those working to improve maternal and child health. The support has been ongoing, but also last year involved responding to massive flooding in the region.

With profound sadness for the tragedy that occurred in an instant yesterday, Direct Relief is responding as fast and expansively as possible to ensure that the effects of this disaster do not claim additional lives and to help those who have survived overcome the enormous challenges that exist and will remain for an extended period.

Those wanting to support the response can do so by making a donation here: http://bit.ly/nepal_quake

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100 percent of donations for Nepal are used exclusively to help people in Nepal.

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