Nepal Earthquake: One Year Accountability Report on Use of Funds, Activities, and Results

One year ago, on April 25, 2015, a tragedy struck Nepal in the form of a 7.8-magnitude earthquake. The devastation was immediate and far-reaching. More than 2 million people lost their homes, more than 17,000 people suffered injuries, and more than 8,700 people died.

The weeks and months that followed gave way to new difficulties. Powerful aftershocks rattled the already anxious population, monsoon rains poured on thousands of families that were still without shelter, and a border blockade starved the country of much-needed medical resources.

One year later, Direct Relief remains committed to supporting the people of Nepal as they rebuild their lives.

For an overview of Direct Relief’s activities in response to the Nepal Earthquake, including its use of donated funds, please continue reading.

Financial Summary

Nepal Earthquake Donations

Direct Relief recognizes that the generous supporters who made financial contributions following the earthquakes in Nepal did so with the express intent that their contributions benefit people in Nepal. In accepting funds for Nepal, Direct Relief understands that both those who contributed and the Nepali people — for whose benefit the contributions were made — deserve to know, in detail, how Direct Relief is using these funds.

How Were Funds Used?

In response to the earthquake, Direct Relief received more than 17,000 Nepal-designated financial contributions totaling $6,559,066.

To date, Direct Relief has spent and committed a total of $3,681,040 (56%) on the response. Of that, $3,061,840 has been disbursed, and $619,200 has been committed.

Medical Material Support

In the immediate aftermath of the earthquake, Direct Relief’s offers of assistance were met with requests from partner organizations, health facilities, and the Nepal government to provide extensive supplies of medications, medical supplies, and durable medical equipment.

Direct Relief provided a series of emergency airlift deliveries from the US of specifically requested and approved items drawn from available inventories. Simultaneously, Direct Relief purchased in India other specifically requested items, such as surgical instruments, orthopedic implant sets, and digital x-ray equipment, and arranged and managed the physical delivery of the products to the requesting facilities in Nepal via direct flights or overland transportation.

As of April 19, 2016, these efforts have resulted in the delivery of 329,848 lbs. of requested emergency medicines and medical supplies with a wholesale value of $36,180,530. This humanitarian material assistance was furnished to requesting partner organizations and the government. Direct Relief arranged for and managed all logistics, transport, and physical delivery of these medical products to where they were needed throughout the affected regions.

Healthcare facilities and organizations in Nepal that have received emergency shipments of medical material resources from Direct Relief include:

Compared to the magnitude of the humanitarian medical material assistance provided by Direct Relief, related cash expenditures have been modest – a total of $1,226,918 in cash has been spent to accomplish these activities. This is due to the extensive support that Direct Relief received from dozens of contributors of essential in-kind medical resources and services related to air transport and logistics.

We note, with deep appreciation, that Direct Relief averted what would have been significant costs (and expenditure of donor funds) related to the first two airlift charters of 60 tons of humanitarian medical essentials from the US to Nepal because FedEx donated its aircraft, flight crews, and tremendous logistics backbone and team for two full-plane charters. Similarly, significant cash expenditures related to necessary in-country helicopter transport of goods to affected areas were averted because of the support provided to Direct Relief at no cost by the United Nations Humanitarian Air Service (UNHAS).

And, of course, Direct Relief’s ability to furnish all the extensive medical material support without the expenditure of donor’s funds was due to the in-kind donations from many companies, with which Direct Relief works on an ongoing basis on humanitarian health activities and responded expansively to requests for their participation in the relief and recovery efforts. Included among them are Abbott, AbbVie, Actavis Pharma, Inc., Allergan, Inc., Baxter International Inc., Bayer, BD, Boehringer Ingelheim Cares, Bristol-Myers Squibb, Cera Products Inc., Covidien, Eli Lilly & Company, Hospira, Inc., Johnson and Johnson, Mylan, Pfizer, Inc., Sun Pharmaceutical Industries Ltd., Teva Pharmaceutical Industries Ltd., Unilever, and Viiv Healthcare.

Financial Assistance to Nepali Organizations

While the type of resource Direct Relief typically provides is medical material, the availability of designated contributions for disasters sometimes enables Direct Relief to also provide cash grants to locally-run organizations.

Thanks to the outpouring of financial support from donors after the quake, Direct Relief has granted more than $2 million USD in cash to locally-run organizations in Nepal for conducting medical outreach in earthquake-affected areas, reconstructing damaged and destroyed health facilities and hospitals, and extending maternal and child health services to rural communities.

To date, Direct Relief has identified, vetted, and supported with cash grants the following locally-run organizations to help strengthen and rebuild the healthcare system:

Partner Organization	Description of Activities	Grant Amount
Doctors for You	Emergency operations and medical supply and equipment procurement and support for Nuwakot District health care services	$181,131
Hospital & Rehabilitation Centre for Disabled Children (HRDC)	Emergency operations, medical and surgical outreach facility repair and expansion, and post-earthquake patient services	$707,200
Midwifery Society of Nepal	Addressing the increased risks posed to pregnant women and newborns	$120,000
Namche and Khunde Clinics	Provision of software that provides physicians with recent clinical guidelines and notes for patient care	$2,500
One Heart World-Wide	Neonatal Health System Rebuilding in Sindhulpalchowk and Dhading Districts	$477,353
Possible Health	Health Sector Rehabilitation and Improvement in Dolakha District	$498,948
Spinal Injury Rehabilitation Centre (SIRC)	Emergency operations, facility expansion, post-earthquake patient medical and rehabilitation services, provision of specialized wheelchairs and other assistive devices, training sessions and workshops for staff members and medical professionals from district-level facilities	$300,000
Clean up Nepal	Promotion and supplies for a national awareness campaign and IDP camp sanitation monitoring and hygiene-related health education	$30,793
Shakti Milan Samaj	Providing blankets and warm clothing to families living in tent communities in earthquake-affected regions	$4,138
Nepal Cancer Support Group	Cervical and Breast Cancer Education and Screening Programs	$50,000
Western Regional Hospital	Repaired and replaced damaged specialized medical equipment at Pokhara, Western Regional Hospital	$137,969
Total Grant Amounts Awarded To Date	$2,510,032

Looking Forward

The remaining $2,878,026 in Nepal-designated funds will focus solely on Nepal relief and recovery activities, with particular emphasis on those that strengthen Nepal’s healthcare infrastructure, expand the provision of services to the most vulnerable in society, and help prepare Nepal for future disasters.

Specifically, Direct Relief’s efforts will organize around the following areas:

1. Improving maternal and child health

Pregnant mothers, newborns, and young children are extremely vulnerable to the ongoing health impacts created by the earthquake. With a continued lack of adequate shelter and a lack of or disrupted access to government health services, there is a real need to maintain support for maternal and child health programs and facilities caring for pregnant and new mothers. To achieve this, Direct Relief will continue to provide cash grants to local organizations that provide high-quality maternal and child health care to earthquake survivors.

Direct Relief is also supporting and empowering local midwives by providing specialized midwife kits developed in partnership with the International Confederation of Midwives (ICM). The Midwifery Society of Nepal (MIDSON) has been continuously providing midwifery services in affected areas since the earthquake, deploying midwives to provide support to pregnant mothers in the most affected districts. Since the earthquake, Direct Relief has been enabling the work of these midwives through the provision of the ICM Certified Midwife Kits that each contains enough supplies for 50 safe births. Direct Relief will continue to support MIDSON as these midwives provide essential lifesaving care to pregnant and new mothers.

2. Providing financial resources to local healthcare partners

The earthquakes caused massive damage to the existing healthcare system, with medical facilities at all levels damaged or destroyed. In many areas, this has meant that earthquake survivors have either reduced or no access to local healthcare services. This means that there is still an urgent need for both immediate health services – specialty medical teams, medical outreach, temporary field facilities, financial assistance to hospitals, and health monitoring – as well as a profound need for the reconstruction, repair, and resupply of health clinics and hospitals across the affected districts in the medium- to long-term. Direct Relief has funded ongoing programs through cash grants and is currently evaluating new grant requests from local groups providing critical care to patients in their respective service areas.

3. Providing medical resources to healthcare facilities

Direct Relief is committed to providing ongoing support to its local partner network in Nepal for the long term. Public and private charitable health facilities and organizations face many challenges in providing free or affordable medical care to people in need at the best of times. In the wake of the 2015 earthquakes, these groups face new challenges in providing care to those who need it most. Direct Relief will continue to support local partners with ongoing donations of specifically requested medicines and medical supplies. Following the use of all disaster-designated funding, Direct Relief will work to integrate new partner facilities into its general assistance efforts.

4. Disaster preparation and building resiliency

Before April 2015, many geologists were very concerned about a cataclysmic earthquake, often referred to as the “Big One,” that is predicted to strike Nepal and is well overdue. The 2015 earthquakes were not of the magnitude or intensity of the feared “Big One,” and there is a real need to work with the Nepali government and Direct Relief’s local partner network to prepare for any future calamity, whether it by an earthquake, flood, or landslide.

Direct Relief’s experience responding to the Haiti earthquake, Typhoon Haiyan, the Nepal Earthquake and a myriad of other natural disasters have demonstrated the necessity of having pre-positioned and ready-to-ship supplies. Direct Relief will support more healthcare partners across the affected areas of Nepal to improve access to healthcare services and to increase the ability to rapidly respond in the event of another disaster. Direct Relief also is working with partners in Nepal on in-country plans to pre-position emergency medicines and medical supplies, an approach that has proven effective in many areas prone to natural disasters.

By pre-positioning emergency medicines and supplies, expanding its partner network in Nepal, providing regular support through the donation of medicines and supplies, and assisting health partners in building back better, Direct Relief assists in fostering resilience among at-risk communities and thus, helping reduce the impacts of future natural disasters. Direct Relief also stands ready to mobilize, at scale, if or when another disaster occurs.

Long-Term Recovery

The effects of disasters of the magnitude of the Nepal earthquakes are long-term, and significant humanitarian needs are likely to remain for years. Direct Relief provided humanitarian support to partners in Nepal before the earthquake, immediately responded to the emergency in Nepal, and is now supporting partners through assistance with recovery and rehabilitation efforts which will continue. Direct Relief also must help address disaster mitigation and preparation by working with partners to reduce potential risk and increase preparedness for a future emergency.

Disaster recovery can provide an opportunity to expand long-term healthcare capacity and services and to introduce sustainability into a region. The dramatic and tragic nature of disasters, the need to reinstate services and rebuild damaged and destroyed structures, and the support of the international community are all factors that can lead to establishing a more equitable healthcare system. Direct Relief is committed to working with healthcare facilities and public health agencies in Nepal to provide intermediate and ongoing health care for earthquake-affected families and communities and to rebuild and strengthen the country’s healthcare infrastructure.

Thank you