“We were very worried about the intensity of the storm that was predicted, so we took on preparation,” said Dr. Iftikher Mahmood, Director and Founder of HOPE Foundation. “We secured our hospital as much as possible. We put together teams of doctors, nurses, midwives, support staff – and they all stayed during the storm to assist with patient care.”

Since August 2017, an unprecedented humanitarian emergency has unfolded in the region as hundreds of thousands of Rohingya refugees have crossed the Myanmar border into neighboring Bangladesh. This mass migration has created what is now the world’s largest refugee camp forming in southern Bangladesh, between the Myanmar border and the Bay of Bengal.

Direct Relief’s long-time partner the HOPE Foundation, which is based in Cox’s Bazar and specializes in maternal and child health care, has established itself in the refugee camps of southern Bangladesh to provide care for expectant mothers using mobile clinics and the 24-hour field hospital, which has expanded HOPE’s capacity for care.

Sexual and reproductive health services are scarce, given the disproportionate number of women and expectant mothers in the camps. Obstetric surgery in these conditions is limited, so most women must be transported to local hospitals, but in the face of a catastrophic storm, such transport is highly unlikely, if even possible at all.

As the storm raged on, pregnant women arrived at the hospital in labor. The emergency team of staff were on hand to provide the care and support the mothers needed to deliver their babies safely.

“Between our two hospitals, we had several deliveries, including surgical c-sections,” Dr. Mahmood continued. “If we had shut down operations due to fear of the storm, these women could have been at major risk.”

Despite the challenging conditions, the hospital’s team of doctors, nurses, and support staff worked throughout to ensure that patient care continued despite the threat of the storm.

“Direct Relief has provided us emergency response packs for the past four or five years, so we have them as a resource,” said Dr. Mahmood. “Luckily, the storm diverted, and we did not sustain any major damage.”

In addition to the emergency response packs, Direct Relief has sent five shipments to Bangladesh over the last six months, which included 10 tons worth of insulin, prescription drugs, and medical supplies, as well as a shipment of requested medications to Myanmar.

HOPE Foundation will open their new hospital, a six-story facility that has served as a location for patient quarantine during the Covid-19 pandemic, and recently as a safe haven for critical patients in dangerous weather conditions.

Direct Relief has provided Hope Hospital for Women and Children with $6.6 million in medical aid, including medical essentials to equip midwives for healthy births, and provided more than $660,000 in grant funding.

The post With Cyclone Mocha Raging, Life Carries on at HOPE Hospital appeared first on Direct Relief.

Flooding has killed 68 people in Bangladesh, the majority of them in the country’s Sylhet region, and left approximately 4.5 million stranded, according to Reuters. Houses and livelihoods have been swept away. Waterborne illnesses, including skin infections and diarrheal disease, quickly spread.

The HOPE staff have responded to mudslides and other disasters before in the Cox’s Bazar area where their field hospital is located. They’ve been training emergency response teams since 2017. But this was their first time responding to an emergency far from home, said founder Dr. Iftikher Mahmood.

Thus far, the team has treated more than 500 people a day via a mobile medical clinic stocked with emergency medical packs and medicines from Direct Relief and has distributed hot meals and dried food to more than 1,000 a day. They continue to travel through flooded areas, providing free medical care, food, and water to people affected by the floods.

Mahmood talked with Direct Relief about his team’s response, what it’s like on the ground for those affected by flooding, and what he anticipates seeing in the weeks and months to come.

Direct Relief: What is the situation like in Sylhet now?

Mahmood: The Sylhet division has multiple districts, and several districts got flooded. The water is actually receding now, but the water level is rising in some other areas. So it’s better in terms of the flood, but it is still unpredictable.

It was a big event. A number of people lost their lives, unfortunately. At the same time, many people have been displaced, properties have been damaged, and livestock has been damaged. [People] became homeless.

But support from all over the country actually poured in: social organizations, non-governmental organizations, private individuals, also the government. A lot of people came to help.

Direct Relief: And a HOPE for Bangladesh team responded as well. Can you talk a little bit about your response?

Mahmood: We are far from that area, definitely a few hundred miles. In Bangladesh, a few hundred miles is a long way.

But because we are a humanitarian organization, and we have experience working with the refugees in Cox’s Bazar, we have teams of people who can respond quickly. Also, we have some supplies from Direct Relief, and when it happened, we quickly decided to send a team [that included two paramedics] with dry food and medicines.

And the next day, we sent four more, and the following day we sent a six-person medical team. So in total, 14 people are in Sylhet right now, and also we recruited volunteers locally. They are cooking food because we are distributing hot meals, and also dried food.

Since we had the medical team arrive, we set up a mobile medical clinic, so we went to different locations.

Direct Relief: What is your staff seeing on the ground as they respond?

Mahmood: Now, our people are serving in areas where it’s still flooded.

When the flood water receded, a lot of people are homeless so they’re still in shelters. And there are some outbreaks of intestinal infection, skin infection, respiratory infection. But we are serving them, giving them treatment: medical examinations, free medication. And also, we are giving them clean water.

The support is coming, but some places probably got good support and some places probably still need support.

Direct Relief: Tell me about your disaster response training.

Mahmood: We got training locally in Cox’s Bazar. We’ve been training for these kinds of emergencies because, in our area, there are a lot of natural disasters like cyclones, mudslides. So we get trained agencies every year through the UN agencies and through our own training.

We’ve had an emergency response team since 2017.

This is a good exercise for us, away from home. That tells us that we can actually mobilize our team to many other places whenever it’s needed. And also, we can increase [our] capacity; we can expand the team. In case we need thirty people or forty people, we have the experience of traveling to a distant place and giving service without any trouble.

It went extremely well. I was not only surprised; I was very pleased.

Direct Relief: What were the greatest needs when your team arrived, both medical and otherwise?

Mahmood: When they arrived, what they needed most was food. Now that water is receding, the greatest need is medical support. And next will be rehabilitation. Many people lost their homes. Some areas are very poor areas, so their homes are small and fragile, and the flood washed them away.

Direct Relief: You had some existing medical support from Direct Relief that you mentioned was helpful. What supplies did you have, and how did they help your team?

Mahmood: We have been getting emergency response supplies from Direct Relief since 2017. We had emergency [medic] packs; we have water purification tablets; we have small procedural equipment. We have antibiotics, antibacterial cream, many ointments. We have a range of things.

Direct Relief: How did these floods compare to other disasters you’ve responded to in the past?

Mahmood: We’ve responded to several floods locally. The difference is in our area, many times, there are mudslides, which can be acute and dangerous. It sometimes happens unnoticed. But this is a big area, so it was different. But both are dangerous. It gave us a good lesson on how to respond in different circumstances. It made our team really strong.

Direct Relief: Financial inflation has been a major problem in Bangladesh, as in the U.S. Has that affected this disaster or its response?

Mahmood: Yes, prices are higher.

There are always people who, even aside from inflation, when things like this happen, try to take advantage and raise the prices for services and goods. That’s always there. But as a humanitarian organization, we only focus at this time on people and what they need. So we pull resources together from different places and try to do a job to save lives.

And also, we got support from good people and organizations, who gave money and other supplies.

So inflation is a problem, but we did what we had to do.

Direct Relief: People are still in the immediate aftermath of this disaster. What concerns do you have for affected people going forward in the coming weeks or months?

Mahmood: We’ll be watching out for different kinds of illnesses. Especially small children, especially elderly people, I think they’ll have respiratory problems. Asthma, bronchitis, pneumonia. And people who have chronic conditions, if they have diabetes or hypertension, if they’ve lost their medication, they will have problems. Diarrheal diseases. Some will need hospitalization.

I worry about the kids, pregnant women, and elderly people. Because they will have problems that they won’t expect.

And of course, after that, they have to find a place to live. In this kind of area, there are a lot of financial issues, so now they will need help to rebuild their houses.

The government has provided a lot of support already, and there is good coordination in that administration, so I think a lot of people will get help from the government, and also NGOs and other organizations and individuals will come together and try to help these people.

A shipment containing over 4,000 pounds of medical aid, valued at $81,000, left Direct Relief’s warehouse on June 29, bound for HOPE Foundation for Women and Children of Bangladesh. The shipment contains wound care products, surgical instruments, vitamins, IV fluids, and other medical supplies. Additional support is currently being coordinated.

The post Responding Amid Bangladesh’s Devastating Floods appeared first on Direct Relief.

Dr. Iftikher Mahmood, HOPE’s founder, explained that health care providers around the country were refusing to work as the virus appeared. “They’re scared they will be Covid patients,” he said. “They’re trying to stay alive, basically.”

At the same time, Mahmood said, a number of international health care providers working in Bangladesh were sent home.

HOPE quickly became the only 24-hour emergency obstetric health care provider in the Rohingya camps, Mahmood said. Their workload increased to somewhere between double and triple its usual amount.

“That puts a lot of pressure on us,” Mahmood said. But he was sanguine about HOPE for Bangladesh’s ability to meet the needs of maternal health patients. “We don’t get afraid, and we don’t get worried. We try to manage it.”

Maternal health care providers around the world felt the effects of Covid-19. Even as researchers find evidence of increased maternal mortalities, stillbirths, and other indicators of interrupted maternal health care, the organizations that care for some the world’s most vulnerable communities report everything from difficulties procuring PPE – one midwifery organization in Indonesia reported having to use plastic raincoats when gowns ran out – to malnourished mothers and infants.

Pandemic Costs

Dr. Victoria Chou, a researcher at Johns Hopkins Bloomberg School of Public Health and co-author of an early modeling study examining the pandemic’s effects on maternal and child health, said that, in the pandemic’s earlier phases, maternal health services were significantly disrupted by lockdown measures, supply chain interruptions, disruptions in the availability of health care workers, and other measures.

“Country-specific analyses have suggested that there was a disruption that lasted weeks and months, but a lot of those services have been restored,” she said.

At this point, researchers are particularly concerned about food insecurity and other economic consequences of the pandemic – along with mental health concerns.

Like their patients, maternal health care providers that care for vulnerable patients are feeling the economic consequences of the pandemic. Many kept their doors open even when other organizations weren’t able to provide maternal health services.

To help defray the costs of the Covid-19 pandemic – and help on-the-ground organizations continue to provide vital health services – Direct Relief is dispensing $2.5 million in grants to international partners. Nine of those partners focus specifically on reproductive and maternal health.

For example, the Indonesian midwifery group, Bumi Sehat, quickly began burning through the PPE required to safely see patients through their deliveries, said founder Robin Lim. A senior midwife died of Covid-19.

Maternal health organizations have also reported high costs of PPE, staffing and sick leave; economic downturn; and other financial consequences.

“The economy shut down; there were shortages of everything,” said Jane Drichta, executive director of Midwives for Haiti. “We still have a massive PPE shortage, and the thing with PPE is you’ve got to keep buying it.”

Midwives for Haiti, which staffs a government hospital with qualified maternal health providers, didn’t see the upward swing in patients that HOPE for Bangladesh did.

Instead, “there was a lot of stigma…there was a lot of fear, there was a lot of evocation of indigenous knowledge,” Drichta said. “Our census at the hospital went way down, because people were afraid to come in to deliver their babies.”

In lieu of hospital births, women whom Midwives for Haiti would ordinarily have served were relying on traditional birth attendants, called matrons. The organization responded by providing the matrons with education and midwife kits.

The matrons, whom Drichta described delivering babies on dirt floors without electricity in some cases, “are our real eyes and ears out in the villages,” she said. “If they run into a problem, they will call and we can give them advice over the phone.”

Indirect Consequences

Edna Adan, founder of the Edna Adan University Hospital in Somaliland, said that a number of colleagues had come down with Covid-19, further straining the hospital’s resources. She described gloves being washed and reused – fresh, sterile ones are reserved for surgeries.

But her greatest worry is for her patients. Food insecurity was always a concern in Somaliland, where a large number of people earn their incomes by raising animals for export, but when international demand for the animals decreased, women’s health suffered.

“There were always women who were weak and who were anemic, but now we’re seeing an upsurge of malnutrition,” Adan said. For a woman about to give birth, “the only thing we can do is try to give her a blood transfusion…so if she loses blood, she won’t die from it.”

Adan has also seen an increase in the number of babies weighing less than two kilos – about four and a half pounds. “This is something we are seeing repeatedly. This is not something I can attribute to anything other than acute malnutrition and Covid,” she said.

In Bali, where Bumi Sehat has a birthing center, a significant majority of people were dependent on the tourism industry, which has been curtailed by Covid-19. “Lots of people are back in the garden growing food because they don’t have jobs,” Lim said.

Bumi Sehat has been attempting to bolster the local economy – and feed patients – by buying fruits and vegetables from local farmers and giving them to families who need food.

Vital Support

External support has played an essential role in helping these organizations continue to provide uninterrupted maternal health services.

“It really helped to keep our focus on work,” Mahmood said. Without funding, PPE, and other essential resources, “we would be broken as an organization.”

Mahmood described his staff as passionate and dedicated – only one non-clinical staff member opted not to continue their work during the pandemic. “We like to help people,” he said.

And all stressed the importance of continuing to provide these services. Bumi Sehat, for example, had recently opened up a new health center on the Indonesian island of Lombok. Bumi Sehat purchased the land and Direct Relief funded construction of the center.

During the pandemic, the facility stayed open, providing both maternal and community care despite the difficulties.

“People needed a birthing center that was kind and compassionate so badly. And free,” Lim said. “They needed free.”

The post Covid-19 Threatened Maternal Health Care Around the World. These Groups Fought Back. appeared first on Direct Relief.

“This is where we can offer labor and delivery for the Covid-positive mothers, where other isolation centers in the camp nearby don’t have that kind of service,” explained Iftikher Mahmood, a Miami-based physician who oversees the Bangladeshi organization.

The isolation center is located inside the Rohingya camp near Cox’s Bazar, where more than 800,000 refugees currently live, and where the HOPE Foundation for Women and Children of Bangladesh already has a dedicated field hospital.

Covid-19 has been slow to gain a foothold there, even as cases in Bangladesh have topped 175,000. Dr. Mahmood attributes the relatively low number of cases among Rohingya refugees both to the presence of the World Health Organization and NGOs working fervently in the area and to restricted mobility into and among different areas of the camp.

But it’s arrived nonetheless. There’s been at least one Covid-19-related death, and a number of confirmed cases.

And the HOPE isolation center has risen to the occasion, working quickly to acquire medical materials, establish clinical procedures, and train staff.

The center currently has 16 admitted patients, and treats an additional 50 per day on an outpatient basis. They’re swabbing people who show up with symptoms of the coronavirus, and reaching out to a contact-tracing team in the event that one shows up positive, according to chief medical officer Dr. Ismail Idris.

Thus far, they’ve placed patients with respiratory distress on oxygen support, provided antibiotics and other medications, and, in one case, delivered a baby for a mother with Covid-19 symptoms in a dedicated labor room.

Direct Relief has provided funding, personal protective equipment, and supplies for the isolation center, as well as connecting Dr. Mahmood with two physicians with experience addressing major public health concerns in low-resource settings.

One of them. Dr. Larry Stock, has worked in international emergency medicine and global public health for 30 years, including a stint in Liberia during the West Africa Ebola outbreak.

“The building is beautiful, and I think they built something which is really special,” he said. “They’re giving people a place to rest and heal up.”

In addition to building a sophisticated facility, Dr. Stock said, HOPE for Bangladesh has a vital tool in its belt: trust. “We saw this with Ebola,” when people were much more likely to consent to treatment and to participate willingly in containment measures if they trusted public health organizations and NGOs, he said. “I think HOPE…[has] several years now of building a relationship with the community.”

In addition to the isolation center and field hospital, which are located in the camp itself, HOPE operates a separate hospital in the district of Cox’s Bazar. The organization also trains between 20 and 30 midwives each year.

According to Dr. Idris, Covid-19 has profoundly changed life in the camp. “Now people are becoming conscious day by day about their personal hygiene, lifestyle, avoiding social gatherings and [receiving] services if someone is having symptoms,” he said.

But social distancing continues to be a challenge. Many of the refugees live in small structures with several family members.

“We don’t have hotels. We don’t have community centers. We don’t have any place where they can be separated,” Dr. Mahmood said. The isolation center allows symptomatic patients to receive care while also preventing transmission.

Asked if he anticipates seeing the disease spread through the camp, Dr. Mahmood was thoughtful. “The way that the people are living there – it’s so unpredictable. No one can predict what can happen,” he said. “Everybody is…getting ready for the worst. Hoping for the best, but getting ready for the worst.”

The fact that the camp has seen relatively few cases compared to the country at large reassures its residents, Dr. Mahmood explained. “They used to be very, very afraid before, but now I think they feel reassured,” he said. “They know that in their community, the damage has not been the same.”

He hopes that the isolation center will make a difference. “This is the best we can do: set up 50 beds in addition to our original 50 beds” in the field hospital, he said.

The staff at the isolation center are uniquely positioned to provide Covid-19 treatment to pregnant women, Dr. Mahmood said, precisely because they are locals with an established history of working among this population.

“We don’t promote this job. We promote our organization as…something we do to serve the community,” he explained.

And when it comes to having providers who are willing to stick it out even in the face of the pandemic, that feeling of wanting to serve makes a difference.

“This is the time to serve, so they are not questioning,” Dr. Mahmood said. “And they are not afraid or anything like that.”

The post Inside a Covid-19 Isolation Unit in Bangladesh’s Rohingya Refugee Camp appeared first on Direct Relief.

The Miami-based pediatrician oversees a field hospital in the refugee camp in Cox’s Bazar, Bangladesh, where more than 1 million Rohingya people live in makeshift structures clustered closely together. Most arrived in 2017, but some have been there for as long as 30 years, Dr. Mahmood said.

On May 14, the first two confirmed cases of Covid-19 within the Rohingya camp were announced. Since then, there have been more – but not many, thanks in part to measures taken to prevent movement both into and within the camp.

Cyclone Amphan, which posed a devastating threat to the refugee settlement, caused some flooding, but vented the worst of its fury elsewhere. (While more than 100 have been killed, and hundreds of thousands displaced, the full impact of the storm is not yet fully understood.)

During a recent interview with Direct Relief, the physician spoke about the collaborative work being done to keep Covid-19 at bay and treat those affected; the continuation of medical services after the cyclone; and his concerns looking ahead to a season of heavy rains.

Direct Relief: Covid-19 was recently detected in the Rohingya camp in Cox’s Bazar. Tell me a little bit about the conditions in the camp and how they might intersect with Covid-19.

Dr. Mahmood: The camp is in the southern part of Bangladesh, and it’s a very small area, and currently, over a million refugees live there.

And they live in makeshift structures. There is no permanent, solid structure for them. There are the same issues with structure, and the same issues with hygiene, same issues with space. Their condition has not much changed since the time they came.

So that makes the Covid-19 issue a little bit difficult for them. But luckily, fortunately, the first case was diagnosed inside the camp long after cases had been diagnosed in the country. It took time to reach the camp.

It was primarily because the local administration has taken some strict measures in terms of people’s movement. There were a lot of restrictions [around] going inside the camp or going outside.

And also, the numbers are not yet that high. The first case was diagnosed about a week ago. So far, I think they have fewer than 20 cases. There is no case fatality. For some reason, so far it has been very slow.

But the tension is extremely high. They live very close to each other, the Rohingya people. So if there is a bad strain or people get seriously ill, that can spread very quickly.

Direct Relief: What did people who live in the camp and take care of the camp start doing differently when Covid-19 appeared?

Dr. Mahmood: As soon as this thing happened, people got engaged in the discussion about it in Bangladesh itself. Everywhere, there were high tensions and people trying to figure out what to do. And especially in the Rohingya camp, tension was highest because we knew that this could be a very bad situation if it comes here.

So along with other organizations that are involved, including the health sector [and] the World Health Organization, we did the best we could in terms of [establishing] handwashing practices and social distancing practices – within the limitations – and using masks for the people. All the common public health measures, we have been practicing even a long time before Covid came there.

The camp is divided into small subcamps. In every subcamp, there are some offices or there are some organizations that were working there for the past two or three years, and they know that community.

As I said, they restricted movement in and out of the camp. Also, they restricted movement inside the camp. [People] cannot go from one subcamp to another subcamp just like that.

As soon as the first case was diagnosed, and they tried to find that case, and contact tracing and all of this, some of the areas inside the camp were locked down.

[The health sector, working with a number of different organizations] has a plan to set up a number of isolation units. I was told, I’m not 100% sure, [there would be] at least 1,000 beds inside the camp so they can take care of those patients.

[Camp residents] are pretty worried about it themselves as well.

Direct Relief: What is their access to running water? How much are they able to maintain social distancing?

Dr. Mahmood: Limited. The scope is limited.

We have set up, in our hospital and around our hospital, some handwashing stations. Soap, water’s available, also sanitizers. And inside the camp also, they have set up different handwashing places. But it’s limited.

It’s like a small village, but a lot of people.

Say I have a family of five, six people. They’re staying within themselves, not doing things with others, going around to the shops or to gatherings or things like that. These are the best they can do. And they’re using masks.

Direct Relief: You run a field hospital in the camp that particularly focuses on women’s health. Can you talk about the services that you provide and how those will be affected by Covid-19?

Dr. Mahmood: We have a 50-bed hospital for women and babies. We have an outpatient department. We have a labor and delivery room. We have a maternity unit to admit patients after delivery or any maternal health conditions. We have an operation theater.

We have an isolation unit inside the hospital, so if they have an infectious disease, we isolate them. We also have the pediatric unit, and we have a neonatal unit. We provide around-the-clock emergency obstetric care.

The impact of Covid-19 is that, first of all, we have seen a decrease in the number of patients. Now that [there is] social distancing, they are not coming for minor things. They’re coming for major things, of course, important things.

Before, we used to have a lot of field workers who would go from home to home to follow up on patients. That has reduced because of the limited movement and also staff issues, of bringing staff from outside the camp.

But our deliveries and the emergency C-sections remain pretty much the same. And caseloads are still there.

We started a fever and flu corner, so people don’t come directly to the hospital, because upper respiratory infection is very common in the camp, because of the close proximity and hygienic issues.

Our staff, they have protective equipment themselves, so they don’t get infected. We have conducted many trainings for our staff so they know what to do. And we have put together a team of doctors, nurses, and midwives specifically to treat patients with suspected infection.

We have a plan to set up a special unit, a separate unit of 50 beds to treat patients with Covid or suspected Covid, because it seems like the infection is going to be with us for a long time. We want to make sure that we prepare for it. And we are a part of that 1,000-bed plan.

Direct Relief: So you’ve doubled your beds and taken on a whole new area of medicine – from maternal and child health to infectious disease. What did you have to do to make that happen?

Dr. Mahmood: We did it even before we got any funding support because we knew that it was important and necessary. I knew support would be coming.

I have been following this since it started, and I did a lot of studying of how to set up a unit like this. I spent a lot of time to understand the mechanics, the setups.

I consulted a lot of top-level infectious disease specialists. And I have involved many Bangladeshi specialists that worked in the U.S. on infectious disease and pulmonary care and Covid infections, and sought their help and guidance.

The information is out there. It’s been happening since November [in other countries]. So we had all this time to prepare and understand the disease, the process for response.

I want to mention that Direct Relief, we already had several training sessions, discussions, consultations, and support. The Covid supplies [donated by Direct Relief] already arrived.

Direct Relief: Cyclone Amphan recently made landfall in Bangladesh, and it wasn’t as bad in Cox’s Bazar as people were fearing it would be, but it did cause flooding. Has the cyclone complicated Covid-19 response or medical care in the camp?

Dr. Mahmood: Honestly, very little. We were ready to respond, but the cyclone kind of diverted and went to northern Bangladesh and India. So we had very little happen, luckily, because this kind of hurricane can devastate a camp like the Rohingya camp.

Direct Relief: Are you concerned about any other consequences related to Covid-19 or the cyclone?

Dr. Mahmood: I’m very concerned because of the monsoon time.

Next June, July, August, these are high times for monsoon. Lots of rain, lots of floods, can happen. And now Covid, where you have to keep people separate. Whenever you evacuate people, you have to be together, right?

I mean, this is a mess. Hopefully we don’t have to be subjected to natural calamities. And hopefully, the Covid situation will be mild. We are hoping for a lot of things, but we are worried.

Direct Relief has provided Dr. Mahmood’s organization, HOPE Foundation Hospital for Women and Children of Bangladesh, with financial support and medical aid, including protective gear, to equip workers responding to the pandemic and cyclone. The latest shipment arrived last week.

The post As Covid-19 Gains a Foothold, a Q&A with the Director of a Rohingya Camp Field Hospital appeared first on Direct Relief.

More than 670 deaths have been reported thus far, and millions have been displaced or significantly affected. Many are still missing, including children.

Dr. Ravikant Singh, founder of the nonprofit Doctors for You, recalls making his way to a village in Bihar, one of the poorest states in India. A baby who had been delivered that morning had spent hours still attached to the placenta – there was simply no one available to care for mother and child.

Throughout the region, houses and even entire villages have been submerged. “Even in higher-up places, many villages in Bangladesh are underwater,” said Iftikher Mahmood, founder of the HOPE Foundation for Women and Children of Bangladesh.

For people living in affected areas in India, Nepal, Bangladesh, and Pakistan, the difficulties have just begun.

Immediate dangers

It’s the start of monsoon season, a yearly seasonal change that causes the majority of South Asia’s rainfall to occur over just three months in the summertime. A new storm arriving Thursday is expected to blanket 90% of India with rainfall – which could, in turn, cause additional flooding, rising rivers, and landslides.

Each major storm can have devastating effects that continue for months or even years after the initial burst of rain and flooding – long after the news cycle has forgotten it.

More immediately, many people in flood-affected areas, particularly in India, are still cut off from most contact with the outside world, making it difficult to deliver aid.

Food supplies have been damaged and water in flood-affected areas has been contaminated with sewage and other unsanitary material. That means many people are currently going without food, clean water, or access to medicines. If they get sick or are already dealing with chronic conditions, there’s no one to care for them.

Organizations like the HOPE Foundation’s field hospital, Mountain Heart Nepal, and Doctors for You have responded by setting up medical camps in flood-affected regions, making their way to isolated villages to treat patients, and providing everything from clean water to soap to people living in overcrowded facilities and makeshift shelters.

They’re already treating injuries and snakebites, along with diarrhea and skin diseases – both complications from contact with contaminated water.

Looking ahead

They’re also gearing up to address the serious, often deadly diseases that can follow a storm or flood. Cholera, which spreads rapidly when people drink water contaminated by the disease, is a visceral fear.

“After the flooding…we saw lots of standing water,” said Dr. Aban Gautam, president of the aid group Mountain Heart Nepal. Standing water attracts mosquitoes, greatly increasing the potential for malaria, dengue, and other vector-borne diseases.

Crowded conditions in shelters and camps can cause respiratory diseases like pneumonia to spread quickly. And people with chronic conditions like diabetes and hypertension are less likely to have access to the vital medications needed to manage their conditions.

All of these are compounded by malnutrition, already a risk for the largely poor population affected by the storm. “Since they belong to low socioeconomic groups, they are vulnerable,” Dr. Gautam said.

He explained that many of the people affected are subsistence farmers and members of lower castes. (Indian society is stratified into strict layers determined by status and occupation. Members of some low castes, as well as those outside the caste system, have famously been called “untouchables.”)

In Nepal, Dr. Gautam said, people are slowly returning to their homes. “People are starting to rebuild,” he said. But that doesn’t mean that life will return to normal anytime soon.

For one thing, the threat of disease won’t disappear. Dr. Gautam is concerned that he’ll see outbreaks of cholera, diarrhea, and vector-borne diseases in Nepal in the coming weeks.

Economic impacts

But in addition, monsoon season has a profound impact on South Asia’s agriculture and, by extension, its economy. “Such a large number of people are so dependent on this intensively seasonal rainfall,” said Sunil Amrith, a professor of South Asian studies at Harvard University.

“If the monsoons are late, or if they fall short of normal expectations, or they are in excess, they can ruin a harvest, and in a predominantly rural country, that really matters.”

Many of the people in this region are rural farmers for whom a bad harvest is devastating. “The whole family depends on income from livestock and from farming,” Dr. Gautam said. In the wake of the storm, livestock have been drowned and paddy fields destroyed.

Highlighting the situation

Direct Relief has responded by providing requested medical supplies and an emergency cash grant, helping aid organizations in the region set up medical camps, travel to flood-affected areas to provide services, and distribute urgently needed medical supplies.

The organization has aided in other disasters in the region, including Cyclone Fani, which hit northeastern India earlier this year, as well as heavy floods in Nepal in 2017 and in Kerala, India in 2018.

Dr. Singh explained that frequent disasters cause “donor fatigue,” in which people are less likely to help out when faced with repeated requests for donation.

To compound matters, Dr. Singh said, “the local media is not giving much attention, or maybe they don’t want to highlight the situation on the ground.”

There may be an explanation for the relative lack of media coverage in the region and elsewhere. “In some sense, I suppose, one might call it an ordinary disaster,” said Amrith. “It’s almost as if these things are expected in South Asia, under the radar.”

“A force that governs the world”

And the future may be more volatile – in part because of climate change. “The monsoon has become more prone to extremes,” Amrith said. Both the where and when have become less predictable: monsoon rains have been falling in unexpected places, and heavy rains are interspersed with longer dry periods.

Amrith said that monsoon seasons have always had a profound – and variable effect – on South Asian economic and cultural life. “The monsoon is portrayed as a force that governs the world” even in centuries-old literature.

“But they really are changing,” he added. “They’re becoming much more unpredictable and much more dangerous.”

The post Widespread Flooding Has Devastated South Asia. It’s Only the Beginning. appeared first on Direct Relief.

On Tuesday, Nepal’s death toll was most severe, at 78. But the extreme weather has also killed people in India, Pakistan, and Bangladesh, and millions of individuals throughout the region have fled or been evacuated.

Damage has been considerable. Homes and buildings were extensively damaged or even submerged, cropland flooded, and livestock lost.

First responders have had to carry people through floodwaters and rescue others in inflatable boats. And access to vital supplies – everything from medication to clean drinking water – has been severely compromised.

The severe downpour is part of the monsoon season, which affects the region from June to September every year, often causing hundreds of casualties. Monsoon-related flooding killed more than 1,000 people in South Asia in 2017.

The flooding has also made its way to Cox’s Bazar in Bangladesh, where hundreds of thousands of Rohingya refugees who fled persecution in Myanmar are currently living.

While the rainfall has temporarily eased, more is expected over the next few days, and flooding continues to be a problem throughout the region.

Monsoon season is an integral part of life in the region, providing much of the water that the people of South Asia rely on for everything from agriculture to hydroelectric power.

In recent years, however, monsoons have become more erratic, causing everything from food shortages, when weaker monsoons lead to inadequate rain, to extreme flash flooding due to acute, severe rainfalls.

Flooding can be responsible for a wide range of health problems. Most immediately, people can be sickened by contaminated water, which frequently contains germs that cause tetanus in open wounds and cholera or E. coli when ingested.

But in addition, conditions in overcrowded shelters – especially when reliable aid isn’t accessible – can be breeding grounds for disease, which can lead to outbreaks of contagious diseases, including influenza, tuberculosis, and meningitis. When compromised supply lines or damaged food storage make it difficult to provide displaced people with basic nutrition, the problem compounds.

To put it simply: unhealthy people are more likely to get sick.

Direct Relief is currently in contact with partners throughout the region to coordinate the shipment of essential medical items. A shipment containing wound dressings, medicines for respiratory disease, supplies for dehydration and water purification, and other supplies will depart the organization’s warehouse this week.

The post Floods, Landslides Batter South Asia appeared first on Direct Relief.

Its prevalence, concentrated in the developing world, signals deep-seated inequities in health systems and little access to timely emergency obstetric services.

And its consequences are tragic.

Take Gajara, a 35-year-old woman living outside of Cox’s Bazar in Bangladesh. After three days of obstructed labor, Gajara gave birth to a stillborn baby. She developed a fistula in the process that left her incontinent.

That was 12 years ago.

Gajara endured her debilitating birth injury for more than a decade before learning that she could access life-restoring surgery, free-of-charge, at the nearby HOPE Hospital.

Doctors at the hospital told Gajara that her case was particularly complex due to the large size of the fistula as well as the fact that she had developed bladder stones. She underwent four operations to fix the extensive damage to her bladder and urinary system. Her treatment was ultimately successful. She got her life back. Every so often, she calls the hospital to express her gratitude.

Fistula also occurs where social norms related to child marriage and female genital mutilation exist, as was the case with Siyan.

At 13, Siyan underwent what is referred to locally as “traditional initiation” or female genital mutilation. Before the wound had healed, she was married to a 25-year-old man and became pregnant.

Siyan went into labor at home. Two days passed before a birth attendant arrived to assist. She gave birth to a healthy baby but suffered a vaginal tear that didn’t heal and left her incontinent.

A short time later, her husband left. Siyan moved back with her mother where she lived for more than a year before a local hospital referred her to the Gynocare Fistula Hospital in Eldoret, Kenya. There she underwent successful surgery to repair her rectovaginal fistula. After her recovery, Siyan was able to go back to school. After her surgery, Siyan said she hopes to study medicine in college. She wants to be a fistula surgeon.

The Fistula Repair Module

These stories are representative of thousands of women in the developing world who are living with obstetric fistula. To help ensure they can access care as Gajara and Siyan were able to, Direct Relief developed the Fistula Repair Module.

The module, endorsed by the Federation of Gynecology and Obstetrics, contains 55 surgical and medical items, including highly specialized sutures generously donated by Ethicon (part of Johnson & Johnson Medical Devices Companies), to perform 50 surgeries.

By the end of this fiscal year, Direct Relief will have shipped 100 Fistula Repair Modules to 17 countries — enough surgical supplies to enable 5,000 surgeries.

Partnering to End Fistula

While surgery and surgical tools are essential to ending fistula, they comprise only part of the equation.

That’s why Direct Relief is privileged to partner with dozens of healthcare facilities and advocacy groups around the world that work tirelessly to not only address obstetric fistula as a physical injury but as psycho-social trauma, helping women overcome the associated stigma and successfully reintegrate into their families and communities.

For a comprehensive list of organizations working to end obstetric fistula, visit the “Find a Fistula Repair Center” application.

Editor’s note: Names were changed to protect patient privacy.

The post Equipping Surgeons to End Obstetric Fistula appeared first on Direct Relief.

Midwives are the first line of assistance, providing high-quality care during routine deliveries and managing basic complications. They’re also trained to recognize when to refer a mother to emergency obstetric care.

Most obstetric complications could be prevented or managed if women had access to a doctor, nurse or midwife during childbirth, according to the World Health Organization.

But midwives can only do their work if they have the right tools.

Direct Relief’s Midwife Kit contains everything a midwife needs to deliver babies safely in almost any environment. Surgical instruments, sutures, IV sets, gloves, cord clamps, and more. Endorsed by the International Confederation of Midwives, the kit contains the 59 essential items a midwife needs to perform 50 facility-based safe births.

Indonesia

In addition to the bringing more than 600 newborns into the world each year, the midwives of Bumi Sehat are often first responders after disasters occur in Indonesia. After Indonesia’s succession of devastating earthquakes in 2018, the team care for mothers and babies outside of hospital walls in the devastated communities of Palu and Lombok.

Syria

In a country where facility-based births are becoming less common due to internal conflict, the Syrian American Medical Society operates midwifery schools that offer the resources to perform safe births virtually anywhere.

Haiti

Haiti has the highest rates of maternal mortality in the Western Hemisphere, but groups like Midwives for Haiti are working to ensure that the country has a trained workforce of skilled birth attendants to oversee deliveries in the healthcare facility setting.

Bangladesh

Medical care for Rohingya refugees in Bangladesh is extremely limited, with few places for women and children to receive medical treatment. That’s why Hope Foundation Hospital for Women and Children of Bangladesh is training local midwives to serve as the epicenter of maternal health in underserved communities.

Somaliland

With a mission to ensure mothers have access to a skilled birth attendant, Edna Adan University Hospital is working to train and dispatch 1,000 midwives throughout Somaliland.

The post Celebrating Moms and Midwives Around the World appeared first on Direct Relief.

Damage reports are still emerging, but more than 1 million people were evacuated from coastal areas of India as a precaution.

As the storm moves along India’s eastern coastline, neighboring Bangladesh is also bracing for impacts, and officials were working to evacuate 2.1 million people from coastal areas on Friday.

Even though the flood-prone country isn’t in the direct path of the storm, rain bands and high winds could inundate low-lying areas of Bangladesh quickly.

Those at increased risk include Rohingya refugees living in settlements outside of Cox’s Bazar. Many reside in homes built without permanent foundations, placing them at risk of landslides and flash flooding.

Direct Relief is working with local staff inside India and with health provider networks in India and Bangladesh.

One of those groups is Doctors for You, an  organization that rapidly dispatched a medical team to Odisha, India, which was badly impacted by the cyclone.

The medical team will be focusing on care for vulnerable people, including women, children and adolescents, the group reported. They’ll be providing primary healthcare and reproductive health services with mobile health units and medical outposts.

Another organization Direct Relief is coordinating with is Calcutta Rescue, an organization responding with a medical team in the Kolkata area.

In Bangladesh, Direct Relief is coordinating with HOPE Hospital Foundation for Women and Children in Cox’s Bazar, Bangladesh. The group has conducted extensive disaster response training for medical staff and is ready to respond if needed. Direct Relief has supported the organization with medical and financial support as they’ve expanded services to care for Rohingya refugees living in the area.

The post Millions Evacuate as Deadly Cyclone Fani Lashes India, Churns Towards Bangladesh appeared first on Direct Relief.

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.

The post India, Bangladesh Facing Strongest Cyclone in Decades appeared first on Direct Relief.

Dr. Ifthikher Mahmood, founder of HOPE Foundation for Women & Children of Bangladesh, and Dr. Steve Arrowsmith, medical director of the Fistula Foundation and consulting medical director for Direct Relief, spoke to staff and a small group of supporters.

The doctors have traveled the world to bring care to the most vulnerable women.

Dr. Mahmood was born in Southern Bangladesh in Cox’s Bazar, and knew from a young age he wanted to help his community.

“Our destiny [as humans] is in our childhood,”  the doctor said. “All that we see and do as young children impacts our path through life.”

He wanted a way to give back to those in his community. In 1999, he founded HOPE Foundation for Women and Children of Bangladesh.  The foundation operates a 40-bed hospital in Ramu Cox’s Bazar, as well as eight medical centers in rural areas.

Many women in Bangladesh lack access to a skilled birth attendant, and the country’s maternal mortality rate remains high. The hospital allows women a safe place to give birth and also facilitates training of local midwives.

In 2007, a deadly cyclone struck the region, and HOPE staff connected with Direct Relief  to coordinate shipments of medical aid.

“HOPE depended on Direct Relief so much it was unbelievable,” said Mahmood.

The hospital’s mission became even more critical when nearly 1 million Rohingya refugees fled from neighboring Myanmar into Southern Bangladesh, just miles away from HOPE’s front doors. The hospital was suddenly confronted with a massive humanitarian crisis, and began to work with patients, one at a time and eventually expanded to providing care in the Rohingya camps.

The hospital provided  treatment like fistula repair, during which a surgeon repairs a fistula, or opening, that results from obstructed labor and can have devastating consequences. The hospital has been able to offer the surgery, sometimes to patients who have lived with the condition for decades. “Without Direct Relief supplies, like wound sutures, HOPE couldn’t have done the fistula surgery,” said Mahmood.

Arrowsmith, a surgeon has provided countless surgeries for women with fistula over the past 25 years, also spoke. Arrowsmith started the Fistula Repair Center in Jos, Nigeria, and also conducted surgeries at the Addis Ababa Fistula Hospital.

He trains surgeons on how to do the surgeries, and said that he’s depended on Direct Relief surgical supplies for many surgeries.

When asked about identifying where and how to help, Arrowsmith encouraged organizations to continue supporting people on the frontlines of healthcare, like Dr. Mahmood.

“Find people with passion and a heart for what they do, and grab onto those who have that calling,” he said.

The post Maternal Health, from Nigeria to Bangladesh appeared first on Direct Relief.

Immediate trauma and illness accompany such catastrophe, and in the long-run, when ambulances can’t maneuver muddy roads or facilities remain without power, disrupted health care endangers lives. At particular risk are women in need of reproductive health care.

Direct Relief’s long-time partner the HOPE Foundation, which is based in Cox’s Bazar and specializes in maternal and child health care, has established itself in the camps to provide for expectant mothers and the Rohingya at-large. When the Government of Bangladesh opened their borders to the Rohingya, the HOPE Foundation opened their doors.

The one-hour drive from HOPE Hospital (the northernmost site) to Kutupalong Balukhali Expansion Site’s northern border is over 20 miles. HOPE strives to offer continuous care for patients by operating a range of facilities within the camps, including mobile clinics and the new 24-hour field hospital.

Providers treat most patients at one of these various facilities. The new field hospital expands HOPE’s capacity for care, and sound construction means its doors will stay open.

“The drainage network of the HOPE Field Hospital for Women was found to be very efficient,” reported HOPE Country Director and Commander (Ret.) Ferdous Muhammed. “I am happy to report there was no waterlogging in, or outside, the hospital.”

The post HOPE for Rohingya Women and Children appeared first on Direct Relief.

While striving to secure shelter and sustenance, their already precarious situation is compounded by threats of extreme weather, including monsoonal rains and cyclones that pound Bangladesh every year.

What’s more, medical care for the Rohingya is extremely limited, with few places for women and children to receive medical treatment.

Though the Rohingya are fighting back against these overwhelming odds, parents need health facilities to receive their children when they are sick and soon-to-be mothers need regular care and potential life-saving treatment when giving birth.

That’s why Direct Relief is raising support for the Hope Foundation, a local health organization providing critical care to the Rohingya.

When Rohingya communities began fleeing into Bangladesh, Hope Foundation was already providing free health care at its established maternity hospital on the outskirts of Cox’s Bazar, more than an hour’s drive from the nearest refugee camp.

Seeing the urgent medical needs among the newly arrived refugees, Hope Foundation rapidly scaled up its operation, establishing maternal health clinics across the camp as well as a field hospital.

Hope foundation is continuing to provide basic care and maternal health services across its healthcare facilities, but funds are urgently needed to complete construction on the field hospital, purchase medical equipment, and maintain and expand services to Rohingya families in Bangladesh.

It’s important to note that several international groups are providing health services to the Rohingya community and doing a great job; however, donations to the Hope Foundation support a local solution and will help ensure access to health care for Rohingya and Bangladeshi long into the future.

Over the next several weeks, Direct Relief will match every donation made to Hope Hospital on Facebook, up to $100,000.

The goal of hosting the fundraiser on Facebook is to leverage Direct Relief’s initial commitment into additional support for Hope Hospital.

Facebook has waived all processing fees for fundraisers hosted on the platform, meaning Hope Hospital will receive 100 percent of the donations made to the fundraiser.

The post A Facebook Fundraiser for Rohingya Mothers and Children appeared first on Direct Relief.

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The Rohingya refugee situation is among the world’s most urgent humanitarian crises. With more than 800,000 individuals living in densely populated camps and packed in makeshift shelters with minimal infrastructure, the risks to human health and safety abound. Outbreaks of diphtheria and measles have already occurred in the camps, and concerns are mounting from upcoming rains and the potential for cholera and other water-borne disease that follow.

“Direct Relief is deeply concerned about the unfolding crisis surrounding the Rohingya people in Bangladesh and understands from experience how the massive and rapid influx of people into a densely populated area can rapidly escalate into a massive humanitarian crisis,” said Direct Relief President and CEO Thomas Tighe. “As always, the priority is to support local partners who live and work in Cox’s Bazar and have the established systems to best care for the influx of people.”

Since the refugee crisis began, Direct Relief has sent $2.7 million in requested medical supplies to health providers in Bangladesh. Recipients of medical assistance include Hope Hospital and other providers in Cox’s Bazar.

Among the supplies delivered to date are 18 field clinic tents, solar panels and battery systems to provide power and lighting within healthcare clinics and delivery rooms, diagnostic equipment, water purification systems, personal protective gear for medical staff, wound care materials, hygiene items and oral rehydration salts.

Additionally, Direct Relief is prepositioning emergency medical supplies in advance of monsoon season and has already delivered an Emergency Health Kit comprised of the medical materials needed to care for 1,000 patients in low-resource settings, in accordance with World Health Organization guidelines.

The post Direct Relief Commits $250,000 in Funds to Assist Rohingya Refugees, Makes Full Medical Inventory Available for Relief Efforts appeared first on Direct Relief.

Many refugees have recounted horrifying experiences of sexual violence and physical abuse, and immediately following the escalation of violence in the region, Direct Relief contacted longstanding partner, HOPE Foundation for Women and Children of Bangladesh. The Foundation manages HOPE Hospital in Cox’s Bazar and now, in response to the sudden influx of refugees, operates field clinics in refugee camps and informal tent settlements.

Sixty percent of new Rohingya refugee arrivals are children. And with tens of thousands of pregnant and lactating mothers now residing near Cox’s Bazar, HOPE focuses on antenatal and postnatal care, safe deliveries, and child health and nutrition.  In addition to their focus on maternal and child health, HOPE is building a field hospital where Rohingya patients can receive more comprehensive care.

On Friday, Oct. 13, Direct Relief dispatched a 5-ton donation of medical supplies specifically requested by the medical team at HOPE Hospital. The goods are due to arrive in Cox’s Bazar within days.

The donation includes:

• 18 durable, medical-grade, all-weather tents – The Rohingya are restricted from traveling outside their camp for medical care, so HOPE Hospital is bringing medical care to the camp. These tents will serve as reproductive health units, birthing centers, and primary care clinics.
• Oral rehydration salts – Many refugees walk for 10 days or more before reaching a settlement and most are severely dehydrated when they arrive. Oral rehydration salts help to replace essential fluids and electrolytes.
• Water filtration units – A refugee camp of well over half a million people that develops so quickly has little to no infrastructure. Clean drinking water is almost impossible to find.
• Solar lighting – No infrastructure also means no electricity. Medical care must be provided 24/7 and light is required to provide safe, effective care.
• Prenatal vitamins – Most pregnant women arrive in Bangladesh malnourished. The small, limited, food rations provided to them do not supply all of the vitamins and minerals needed for a healthy delivery.
• Personal protective gear for medical professionals – Doctors, nurses and midwives need supplies like gloves to ensure they can safely tend to the medical needs of their patients.
• Sutures, surgical instruments and instrument sterilizers – HOPE Hospital can transport patients to their facility in Cox’s Bazar to conduct surgery if necessary. When their field hospital is in operation (most likely before the end of the month), they will be able to perform minor surgeries there as well.
• Personal care items – Good personal hygiene is integral to good health, however, items as basic as soap are oftentimes hard to find in refugee situations.
• Diagnostic supplies, needles and syringes, IV sets – Medical supplies are needed for a wide array of issues, ranging from respiratory infections to dermatitis to traumatic physical injuries.

Thousands of Rohingya refugees continue to pour into Bangladesh every day. Many have lost absolutely everything.  As camps become increasingly crowded the situation only worsens.  Rohingya with non-communicable diseases such as diabetes or asthma will need their daily medication.  New arrivals with trauma-related injuries will need immediate medical attention and follow-up care.  Malnourished mothers and children will need nutritional supplements.  Mental health issues such as anxiety and depression will be exacerbated by the ongoing stress.

Direct Relief will continue to collaborate with local partners in Bangladesh that are providing services to Rohingya refugees and will do everything possible to deliver critically needed medicines and medical supplies to a population that is facing incredible uncertainty and hardship.

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As reported on Friday, two shipments that were intended for regular ongoing support of local partners will be redirected for emergency response as needed, and Direct Relief is working with local groups to learn of specific needs in connection with the cyclone response.

Direct Relief staff members have been in touch with the Bangladeshi consulate in Los Angeles to offer the organization’s support and discuss ways to expedite clearance of medical material aid into the country.

Additionally, Direct Relief has approached several of its corporate donors about donations of antibiotics, personal care items, and water purification systems, among other items, specifically for the cyclone recovery.

According to Direct Relief’s partners in Bangladesh, the severity of the impact, and thus the appropriate response, has not yet been fully realized. “The scale of devastation is so severe [but] it is not yet clear as many areas are inaccessible,” said Dr. Iftkher Mahmood of Hope Foundation via e-mail.

Communications with these partners has been challenging; the cyclone destroyed much of the country’s communications and electrical infrastructure, making phone calls and e-mail correspondence difficult.

Though Direct Relief does not have a specific campaign for cash contributions to the cyclone recovery, we will honor any requests for donations to be directed to the response in Bangladesh. Due to a recent bequest, Direct Relief pays for all of its own overhead administrative and fundraising expenses, and 100 percent of all donations we receive are applied for programmatic expenses.

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A 20-foot container of medical material aid for the Hope Foundation’s hospital is currently at sea, and an air freight shipment containing 46,000 sachets of oral rehydration solution to SSS recently cleared customs. The materials in both shipments will be redirected to help those affected by the cyclone if needed.

Direct Relief has contacted Hope Foundation’s Hospital for Women and Children in Cox’s Bazar (150km south of Chittagong and Southeast of the Bangladesh’s capital, Dhaka), Marie Stopes International’s Clinic in Dhaka, and Shidhulai Swanirvar Sangstha (SSS), also located in Dhaka, to gauge their needs. All are still assessing the situation, and will report back with specific needs once a clearer picture of the impact emerges.

Based on past experience responding to cyclones, Direct Relief expects that the medical needs of the affected population will be supplies to help treat traumatic injuries, antibiotics to help treat water-borne illness, and antifungal medications for skin infections.

According to Reuters, Cyclone Sidr has caused 587 deaths and thousands of injuries, numbers that are feared to soar higher as response efforts continue. An estimated 3.2 million people have been displaced from their homes.

A cyclone, called a hurricane or typhoon in other world regions, is a low pressure system with high velocity spiraling winds. In the case of Sidr, these winds triggered a 15-foot tidal surge that violently struck populated areas and easily flooded Bangladesh’s low topography.

Direct Relief has had relationships with partners in Bangladesh since 1972. Earlier this year, Direct Relief answered requests for an emergency response to the severe flooding that was triggered by intense monsoons across Southeast Asia.

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