Medical support arrived in Kingston, and the shipment contained a Direct Relief hurricane preparedness pack, a module containing critical medications, including antibiotics, wound care supplies, chronic disease management medication, protective gear, and more. The packs are staged in hurricane-prone areas across the Caribbean and U.S. Gulf Coast to support patient care if supply lines are damaged.

The pack contains enough medications to sustain care for up to 3,000 patients for 30 days. Monday’s shipment also included 10 Direct Relief field medic packs to Jamaica to aid in response efforts. The packs are specifically designed to equip first responders with medical essentials for triage care.

The shipment will be distributed by Jamaica’s Ministry of Health, which supports public health facilities in Jamaica, including hospitals and primary care clinics.

The shipment was dispatched from PAHO’s regional strategic stockpile in Panama and will be distributed to medical facilities serving patients. The infusion of support from Direct Relief is one in a series of air support shipments that have arrived or will continue to arrive in the country to support health services after Hurricane Melissa devastated portions of the island last month.

Direct Relief has worked with the Pan American Health Organization since 2018, to provide regional support to medical organizations in the Americas, including Caribbean countries, and will continue to assist with emergency response efforts in the region.

The post Critical Medications, Supplies Arrive in Jamaica with Coordination from Direct Relief, Pan American Health Organization appeared first on Direct Relief.

The Bahamas Minister of Health, Dr. Duane Sands, spoke to Direct Relief last week about the public health situation on Grand Bahamas and the Abacos Islands, his biggest concerns about the future, the impact of climate change, and his suggestions for how people can help the Bahamas recover.

Direct Relief: How would you describe the current situation in the Bahamas, from a public health standpoint?

Dr. Duane Sands: I think the situation from a public health standpoint is stable, but guardedly so. I think nobody is under any illusions. We are managing, but we have acknowledged that things can go sour, or can turn, without absolute vigilance.

So notwithstanding the massive blow, I think that we have, with the assistance of a number of international partners, managed to cobble together a pretty workable health system in both Abaco and Grand Bahama and it is holding.

It is actually holding well, and the perception on the ground is that things are okay and the surveillance data that we continue to get doesn’t show any worrisome themes or trends.

Let’s just say I’m keeping my fingers crossed.

Direct Relief: When you said that things can go sour without vigilance, what specific things are you most focused on? Or what specific things are you most vigilant towards at this point?

Dr. Sands: Well, there are a few things that we’re really concerned about.

One is the psychological stress, the risk of anxiety, depression, post-traumatic stress, that’s the major concern.

The second thing is obviously any waterborne or vector-borne illnesses that can crop up over time.

And then finally, the other big concern is the consequence or complication of unmet chronic care needs.

So what we find is that, you know, people are worried about rebuilding their houses and dealing with their losses. And the management of high blood pressure, diabetes, pregnancy, etcetera is a secondary issue. So, we’ve got to be very aggressive in terms of making people understand that, you know, yes, you’ve had a major blow, but you still need to take care of yourself.

Direct Relief: How is your office managing that (outreach campaign)? What is the most effective way of communicating that issue about chronic care in particular?

Dr. Sands: I think one of the best ways of communicating it is using social media. Being redundant, being repetitive being in your face, but also seizing opportunities to make captive populations feel comfortable. Hey, if I just take two minutes, I can get my pressure checked or I can get my blood sugar checked.

This is now very much about taking health care to the community. And community is loosely defined because a lot of the rudiments of community have been damaged or destroyed.

Direct Relief: You also referenced surveillance data that you’re looking at. I’m curious to learn a little bit more about that—what is this surveillance data in particular? Where is it sourced from and how are you using it?

Dr. Sands: We have our surveillance team augmented by a number of individuals from PAHO (Pan American Health Organization) and other agencies. For instance, we have entomologists on the ground specifically looking at mosquito populations. We are paying attention to prodromal or syndromal reports.

Today, for instance, I would have gotten a specific report or specific question about whether or not we were seeing any respiratory ailments due to mold exposure. So the response from my epidemiologic team was that (in Grand Bahama)… we have no evidence of an increase in fever or respiratory cases or influenza-like illnesses.

Now, that’s hard data that they are getting. What it is suggesting is that even though we are in tents, even though we are in field hospitals, the reporting mechanism is still working. So it is very reassuring to know that the rudiments of public health are still functioning even in makeshift infrastructure.

Direct Relief: And what do you credit for that?

Dr. Sands: Oh, I mean, I think it’s a multifactor thing. We have had the ability to resume services and we have partnered with organizations, teams, stakeholders that understand the importance of an holistic approach to health, not just simply the provision of health services, but careful monitoring, evidence-based decision making and interventions.

So you know, the behind the scenes management, surveillance, activity monitoring, reporting, etcetera has been critical in terms of people paying attention more to other aspects of the post-Dorian reality than health.

I think I can say that many of our participants in the health relief program, they get it. They understand that good health care is more than just giving injections or putting on band-aids or changing dressings. It is an holistic approach that that involves many things. But the surveillance and monitoring and evaluation aspect is as important as the actual delivery of healthcare.

Direct Relief: Are any other challenges or big-ticket items that you’re particularly focused on addressing, just in terms of general health concerns?

Dr. Sands: Right now, we have a massive challenge with the restoration of elective care, elective surgical care, for instance, particularly in Grand Bahama.

So, given the interruption of services at the RAND Memorial Hospital, we can perform emergency procedures at Samaritan’s Purse, but there are a number of elective things that have had to be postponed. Something as simple as dialysis access, maintaining, taking care of arterial-venous fistula and grafts and putting in catheters and dealing with gynecologic issues and cancer diagnoses and so on and so forth.

A lot of these things have been put on hold and I think we are getting to a mounting challenge that is going to have to be deliberately addressed by some strategic intervention.

But it’s getting increasingly more difficult to tell people, “Hey, look, you gotta wait.” And the option of transfer to New Providence, while it’s always a last resort, is not exactly a good solution because of the overcrowding in New Providence.

So we’ve got to find, fairly urgently, a solution to the problem of the types of diagnoses and interventions that have been put on hold as a result of Dorian.

Direct Relief: Is there is anything you want to address that you think has been misreported or misunderstood by the general public, especially here in the United States?

Dr. Sands: Well, you know, I think the narrative that the Bahamas has been decimated is certainly one that I’d like to rebut, debunk, throw away.

Abaco and Grand Bahama are important parts of the Bahamas, but they in no way encompass the entire Bahamas. The Bahamas is still open for business.

That said, while we still need the support, the love, the prayers of the rest of the world, we also need people to come to the Bahamas and allow us to entertain you, allow us to make a fuss over you, so that we are able to be self-sufficient in the repair and rebuilding of Grand Bahama and Abaco.

These things are inextricably connected.

Yes, we’ve had a devastating storm and yes, there’s massive destruction, but in order for us to be able to help ourselves, business has to go on and there are 14 other major islands and hundreds of other cays that are looking forward to welcoming persons, so that the ability to respond to Dorian is significantly a self-sufficient exercise.

We could not have done this without the tremendous outpouring of support from so many international agencies, countries, etcetera. And yet, we realize that at some point, we are going to have to shoulder a lot of this load ourselves. So that message, I think, which has to be carefully nuanced, and it’s a recognition of the gratitude that we wish people to feel.

But our acknowledgement is that, at some point, we’ve got to get up and shoulder a lot more of this load ourselves.

Direct Relief: If you were going to reflect at this point, in terms of lessons learned, what do you think they have been so far for you and for your office?

Dr. Sands: Oh, boy. That’s a huge question. At the end of the day, I think we have learned that we are now existing in a world where this is a new normal. And the way forward now, even in the medium-term, requires us to acknowledge the impact of climate change on all of the decisions that we make, and to understand the impact of climate change on health in particular. And we are having to make decisions rapidly, but they have to be educated and informed decisions.

So, how we rebuild, how we design, how we structure, how we organize, it’s all going to have to take into account the fact that Dorian was fed by, nourished by waters that are 2.7 degrees hotter than historical norms. And that is jet fuel for a hurricane. The marrying of health informatics and meteorology is an interesting, perhaps unwanted, reality, but it is a reality that we’ve got to face.

Direct Relief: How would you assess the government’s response to the hurricane in general?

Dr. Sands: I think we have done as best as we can. If we had an opportunity to do over, I think there may be some things that we would have prioritized differently, but overall, certainly, I’m very pleased with the effort, the rapidity and, given the damage to our capacity, I think it was acceptable, even though disappointing, even for us.

You know, when you have members of your response team who have lost possessions, homes loved ones, they find it almost impossible to respond greatly to the needs of others, and yet many of them did.

And so given the real picture, given the blow that the Bahamas suffered, and then the team members, the parts of government that were to respond, and did respond. Overall, I think when the when the die is cast, or when we are placed in the balance, I doubt that a fair person would say that we were found wanting.

The transcript has been lightly edited for clarity.

The post After Hurricane Dorian, What’s Next? A Conversation with Dr. Duane Sands, Minister of Health of the Bahamas appeared first on Direct Relief.

Nurtured by warm waters in the Atlantic Ocean, Dorian is gaining strength as it cuts a northwestern path, with winds threatening to reach 74 miles per hour by Monday evening. If dry air and wind shear fail to curb the storm, it is likely to become a category one hurricane.

Dorian is compressed in size – the radius of its strongest winds is about 45 miles – but not in potential force. Even before reaching full strength, it is likely to deluge the islands in its path with heavy rainfall – up to 10 inches in some locations.

While the storm will lose strength by the end of the week, if not earlier – the result, in part, of interacting with rough terrain of Puerto Rico and the Dominican Republic – its remains could reach the southeast of the U.S. mainland.

Islands throughout the Caribbean declared tropical storm warnings or watches during the weekend and on Monday. Crowds of people hurried to collect supplies before the arrival of wind and rain.

For Puerto Rico, the threat of a new, potentially destructive storm is particularly unwelcome. The U.S. territory still lives in the shadow of Hurricane Maria, which decimated the island in 2017, left some people without power for nearly a year, and caused the deaths of thousands. It’s rare that a conversation with one of the island’s residents makes no mention of the ruinous storm.

Another strong storm could shatter Puerto Rico’s fragile equilibrium and upend its delicate recovery process.

For the island of Dominica, too, Maria was devastating. Slammed full-force by the category five hurricane, the nation of roughly 70,000 lost the majority of its buildings, and its infrastructure was heavily damaged. It’s not clear how many ultimately died as a result of the storm.

Although the whipping winds of a hurricane making landfall can inflict immediate damage – it’s actually the accompanying water that causes the vast majority of a hurricane’s deaths.

In addition, a study in the New England Journal of Medicine revealed thousands of deaths occurred in the months after Hurricane Maria made landfall, roughly one-third of which were caused by lack of access to medical care.

To prevent similar deaths, Direct Relief has stationed Hurricane Preparation Packs throughout the Caribbean, from Jamaica to Grenada. The packs, which contain everything from first-aid supplies to vital medications for chronic diseases and allergic reactions, were developed with experts to save lives during and after a hurricane or similar event.

To track the hurricane and check the locations of pre-positioned modules, see the map below.

Direct Relief has worked to insulate Puerto Rico against future devastation by providing solar generators, medical refrigerators, satellite phones, and off-road-capable medical response vehicles to health centers throughout the island.

Direct Relief also works closely with the intergovernmental Caribbean Disaster Emergency Management Agency and the Organization of Eastern Caribbean States.

The organization’s status as a non-state actor and supplier of medical commodities to the Pan American Health Organization (the World Health Organization’s arm in the Americas) allows it to quickly and strategically distribute pivotal medications and supplies throughout the region in the event of an emergency.

Direct Relief has extended offers of aid to partner organizations throughout the region and will continue to monitor the storm as it progresses.

The post Hurricane Dorian Rakes Treacherous Path through the Caribbean appeared first on Direct Relief.

But it’s not every day that a shipment of Factor VIII – a protein that enables blood clotting, and that most people with hemophilia can’t produce – arrives in El Salvador. Injections of the vital protein aren’t always available in the country. And when it’s there, it frequently needs to be stored up for emergencies.

Hemophilia is a genetic mutation that prevents the body from producing enough of one of two vital proteins, Factor VIII and Factor IX, so blood can’t clot normally. (A Factor VIII deficiency is about four times more common.) It’s much more likely to affect males.

Wherever they live, a person with hemophilia is at much higher risk from bleeding too much, either internally or externally, after even a relatively minor injury. Major injuries can be fatal much more quickly than they would be for someone without the disease. Surgery is a particularly dangerous proposition.

Hemophilia is generally managed with injections of the missing protein.

And in privileged societies where injections of clotting factor are readily available, people with hemophilia can lead regular lives and have a normal life expectancy. Children with hemophilia are encouraged to run, climb, and play, because help is so quickly available.

When supplies grow scarce

That’s just not the case in El Salvador.

“A lot of [children] unfortunately even die because they do not have the medication available,” said Loli Sangiovanni, director of donor relations at the Salvadoran American Humanitarian Foundation. Overall, life expectancy for someone with hemophilia is about ten years shorter than average.

As a result, many children are forced to stay inside. An injury might mean an hours-long trip to the nearest hospital, only to find out that there’s no medication available.

“They’re children; they want to play, they want to run, they want to jump, and they just can’t,” said Melody Salinas, institutional relations manager at FUSAL, a Salvadoran foundation that works to provide essential healthcare in the country.

Because the disease is hereditary – and stigmatized – it’s often a source of tension in families. Mothers are especially likely to be blamed.

It’s not that hospitals don’t try to keep the medication on hand. It’s that keeping clotting factors on hand is complicated. They’re highly expensive, for one thing. For another, they need to be shipped and stored in cold, meticulously controlled conditions.

Dr. Hector Valencia works at Hospital Rosales, a facility in the capital city San Salvador where the majority of El Salvador’s adults with hemophilia are treated.

Through a translator, he explained that, when clotting factors are available, the hospital distributes them to patients to administer preventatively, in order to prevent bleeding before it starts. They’ve had good luck in reducing hemophilia-related deaths that way.

But when supplies grow scarce, the hospital stores what’s left in case of emergencies and shuts down the preventative aspect of the program until more clotting factor can be acquired.

In the past couple of years, Dr. Valencia said, the medication has become less available. There have been weeks-long periods when the hospital couldn’t get clotting factor at all. And patients have died as a result.

Rushing through customs

That’s why a shipment of Factor VIII that recently arrived in the country was widely celebrated.

The pharmaceutical company Bayer donated a large supply of Factor VIII to Direct Relief. Knowing it was badly needed in El Salvador, the organization worked with FUSAL and the Salvadoran American Humanitarian Foundation to deliver 430 vials – worth approximately $761,000 – to the country.

When the shipment arrived on Saturday, July 13, it was rushed through customs, which opened over the weekend just to receive and process it. Dr. Ana Orellana Bendek, El Salvador’s minister of health, was onsite. “All the media were already there,” Salinas said.

Dr. Bendek explained the reason for the rush. “It was necessary to clear out this donation urgently, since there was a shortage of more than three weeks of this product…which had already caused hemorrhagic complications in some patients,” she said in Spanish.

The president of El Salvador, Nayib Bukele, posted on Twitter to announce its arrival. “We had to sign a presidential exemption, move heaven and earth, overcome bureaucracy, open customs…to let [the shipment] out tonight and [the Ministry of Health] to enter today,” he wrote, in a post translated from Spanish.

The medication was rushed to both Hospital Rosales and Hospital Nacional de Niños Benjamin Bloom, a children’s hospital also in San Salvador.

“Even on the same day that the factor was received, there were two patients with severe hemarthrosis in the emergency room of the pediatric hospital,” Dr. Bendek said. Seventy-five vials of Factor VIII were immediately used in Benjamin Bloom’s emergency room.

A media presence, VIP treatment, and a presidential nod. “It speaks to the immense need that there was,” Sangiovanni said.

The post Vital Supplies for Hemophilia Patients Reach El Salvador appeared first on Direct Relief.

The World Health Organization works to lead and coordinate health responses globally, and works with governments as well as nongovernmental organizations during emergencies.

Direct Relief is an approved non-state actor to the Pan American Health Organization – the WHO’s regional office in the Americas – a status that allows Direct Relief to provide material and logistical support in times of sudden disaster. Trewin’s visit to Direct Relief was critical to expanding the partnership to the broader WHO network.

Direct Relief works in direct coordination with local health officials to ship only what is asked for, whether during an emergency or on an ongoing basis.

The post Direct Relief Hosts World Health Organization at New Headquarters appeared first on Direct Relief.

The Fuego Volcano erupted on June 3, sending a river of lava and debris plunging towards the town of San Miguel Los Lotes and other communities in southern Guatemala. More than 150 people perished, and nearly 200 are still listed as missing. Many who were displaced by the volcano are living in shelters, waiting to see whether they’ll be able to return to their homes or whether they’ll be forced to relocate.

Providing care in these evacuee centers is a critical need, and Direct Relief shipped 35 Emergency Medical Backpacks to the Pan American Health Organization this week to help do just that.

PAHO, the World Health Organization’s regional office of the Americas, is working in coordination with the Guatemala Ministry of Health, as well as with local health officials, to distribute the backpacks.

The packs are filled with essential first aid supplies that will equip community health workers. Five rugged tents, provided by Barebones, were also shipped, and will be used to set up temporary medical outposts near shelters so people can easily get the health care they need.

In the days following the volcano’s eruption, Direct Relief also issued emergency grants to local medical groups responding to the crisis, enabling medical outreach efforts as well as the purchase of equipment and supplies to local first responders.

Thick-soled boots, heat-resistant gloves, safety goggles and N-95 masks were all purchased to protect these workers as they responded. Emergency funds were also used to purchase personal hygiene products and other requested items needed by those living in evacuee shelters.

The post Medical Aid Bound for Those Displaced by Fuego Volcano appeared first on Direct Relief.

Direct Relief is currently coordinating with the Pan American Health Organization, local partners, and pharmaceutical companies with manufacturing capacity in the region.

Direct Relief is working with local partners, including Nuestros Ahijados, Presbiterio Kaqchikel, and Fundación Proemigrant, which are all responding to needs of those displaced and injured by the volcanic eruption.

Prior to Sunday’s blast, medicines and other critical supplies had been staged for emergency response, and medical staff had immediate access to that inventory.

In times of emergency, people forced to flee their homes are often left without access to the medications they need to manage chronic conditions, like diabetes or heart disease. Direct Relief has been sending regular shipments of essential medicines to Guatemala for over 30 years, and the current supply of these medicines is being used to meet the medical needs of those displaced.

As the volcano disaster response transitions from the emergency to the recovery phase, Direct Relief will work closely with local partners to ensure they have what they need to continue providing health care to affected communities.

Guatemala has a history of significant natural disasters, including other volcanoes, earthquakes, and hurricanes, and officials report that Sunday’s explosion is Fuego’s most devastating in over 40 years.
Direct Relief is funding the purchase of equipment for first responders, as well as sending other supplies needed to care for thousands of displaced people in the region.

The post Response Continues in Guatemala Following Deadly Volcano Blast appeared first on Direct Relief.

Direct Relief has long provided humanitarian support to each of the countries on both an ongoing basis and in response to emergencies.

In response to increased requests for assistance, Direct Relief’s privately funded humanitarian health assistance activities have expanded significantly over the past five years – both within the U.S. and globally – and has included more than $400 million to these five countries.

The delegation – initial members of a Direct Relief “Consulate Club” – also visited the site of Direct Relief’s new distribution facility and offices that are under construction, which are designed to meet both federal requirements related to the storage and handling of prescription medications and ensure that Direct Relief maintains its unique accreditation among charitable organizations to store and distribute such products in all 50 U.S. states.

The new 155,000-square-foot facility will serve as the distribution hub for prescription medications, vaccines, biologic therapies, supplies and over-the-counter health commodities that Direct Relief furnishes to colleague nonprofit health facilities and public health institutions in all 50 U.S. states and over 80 countries globally for people in need who otherwise lack access to essential resources for their health and well-being.

Direct Relief Chairman Dr. Angel Iscovich and Vice Chairman Mark Schwartz welcomed the delegation and led the briefing and discussions that covered a broad range of topics, emphasizing Direct Relief’s ongoing commitment to provide humanitarian assistance to those in need in the most efficient manner possible, to the highest standards of care and regulatory compliance, and consistent with the organization’s apolitical and secular character.

The post Latin American Diplomatic Delegation Visits Direct Relief, Tours New Distribution Facility appeared first on Direct Relief.