Nearly 1 million people are being evacuated from coastal communities in India, ahead of a powerful cyclone expected to make landfall Friday.

Cyclone Fani is churning through the Bay of Bengal and meteorologists predict the storm will make landfall on India’s eastern coastline with winds of up to 124 miles per hour, speeds equivalent to a Category 4 hurricane. Heavy rainfall is also expected in the states of Odisha and Andhra Pradesh, and a storm surge of at least five feet is expected in low-lying areas. Several hundred shelters have been opened in the country to accommodate evacuees.

More than 100 million people are in the storm’s path, and the cyclone is expected to be the strongest to hit India in two decades.

Direct Relief has staff members in country working on response activities, and is also in communication with local health organizations as they prepare for the storm’s impacts. Direct Relief is ready to respond with support, if requested.

HOPE Foundation Hospital for Women and Children of Bangladesh was one of the group’s readying for Fani’s impacts. The storm could send large amounts of rain into Cox’s Bazar, where the hospital serves Rohingya refugees residing in the flood-prone area.

Dr. Iftikher Mahmood, founder of HOPE Foundation, said Tuesday that the HOPE Emergency Response Team had been activated and was ready to provide care if needed.

In addition to ongoing medical aid support, Direct Relief has shipped Emergency Medical Backpacks to hospital staff so they’re equipped to provide care outside of hospital walls, if needed. The packs contain supplies and equipment to meet a variety of prevalent disaster-related medical issues, including infection control, diagnostics, trauma care, and personal protection tools.

Emergency first responder training was also held last year, spearheaded by Dr. Neena Jain, who worked with HOPE Hospital staff on their disaster response plan, including scenarios of triage care. The hospital has also conducted more emergency response training since and has an emergency response team ready to deploy in case of emergency.

Direct Relief will continue to monitor Cyclone Fani as it approaches the coast and respond as needed as the situation evolves.