Three Month Report

As of 11:55 a.m. local time on April 25, 2015, health indicators in Nepal were trending in the right direction. Maternal mortality had decreased in the country by 70 percent in the 17 years between 1993 and 2010. And compared to a child in 1996, a child in 2011 was twice as likely to live past the age of five.

Then, at 11:56 a.m., progress stalled. Upwards of 750,000 people lost their homes, 17,000 people suffered injuries, and 8,600 people died from what emerged as the most devastating earthquake in Nepal’s history.

Financial Summary

Direct Relief recognizes that the generous supporters who made financial contributions to Direct Relief following the earthquake in Nepal did so for the clear purpose of assisting people in Nepal. In accepting funds for Nepal, Direct Relief understands that both those who contributed and people in Nepal for whose benefit the contributions were made deserve to know, in detail, how Direct Relief is using these funds.

Three months into the response, this report offers a summary of Direct Relief’s activities to assist people in Nepal affected by the Earthquake and support ongoing recovery efforts.

Nepal Earthquake Donations

Direct Relief has received more than 17,000 Nepal-designated financial contributions totaling $5,508,005.

100 percent of contributions received for Nepal are restricted for the exclusive use of assisting people affected by the earthquake in Nepal.

Who donated to the response?

Of the total amount of Nepal-designated contributions —

$3,388,300 was contributed by 17,606 individuals,

$1,834,741 was contributed by 167 businesses,

$215,000 was contributed by 12 foundations, and

$69,963 was contributed by 67 other organizations.

Direct Relief does not rely on any funding from government grants.

How were donations accepted?

Of the total number of Nepal contributions, 92 percent (16,464) were made online. Online contributions totaled $2,084,605, or 38 percent of the total amount received.

Ensuring donors’ intent

Within 24 hours of the April 25 quake, Direct Relief modified its online donation page to ensure (1) that the organization’s policy regarding designated donations for the Nepal quake was prominently featured for all visitors and (2) that, before making a contribution, a person would be required to choose whether the donation was intended to be designated for Nepal or for another specified purpose or location.

This practice was adopted several years ago to avoid potential confusion about donors’ intentions, particularly following high-profile emergencies, which often spur spontaneous online financial contributions from the public wishing to help. Direct Relief is obligated to honor the intent of donors who make contributions, and this practice ensures that donors express their intent when making a gift.

Per Direct Relief’s Privacy Policy, Direct Relief does not disclose donor information to any outside party. Direct Relief also has a policy of not sending mail to donors on behalf of other organizations.

How and for what purposes are the funds being used?

Of the total Nepal-designated donations received to date, Direct Relief has spent $2,700,365 or 49 percent on the following earthquake response activities:

$710,699 to mobilize, transport, and deliver to health facilities more than 144 tons of specifically requested medical material valued at $28,982,827 – a ratio of $40 in medical aid for each $1 spent. This expense would be significantly higher, were it not for the emergency airlifts donated by FedEx and in-country logistics provided free-of-charge by the World Food Program and the UN Humanitarian Air Service.

to mobilize, transport, and deliver to health facilities more than of specifically requested medical material valued at – a ratio of $40 in medical aid for each $1 spent. This expense would be significantly higher, were it not for the emergency airlifts donated by FedEx and in-country logistics provided free-of-charge by the World Food Program and the UN Humanitarian Air Service. $197,682 to purchase urgently needed, specialized medical equipment and supplies (including ventilators, digital x-ray machines, and surgical kits for orthopedic repairs) requested by the Government of Nepal or individual facilities, and

to purchase urgently needed, specialized medical equipment and supplies (including ventilators, digital x-ray machines, and surgical kits for orthopedic repairs) requested by the Government of Nepal or individual facilities, and $1,791,984 to support – in the form of financial grants to organizations and health facilities in Nepal, outlined below — urgently needed services in the immediate term and to begin rebuilding or expanding essential services needed in the months and years ahead.

to support – in the form of financial grants to organizations and health facilities in Nepal, outlined below — urgently needed services in the immediate term and to begin rebuilding or expanding essential services needed in the months and years ahead. $0.00 spent on fundraising or marketing activities.

All medical donations to Nepal are tracked and visible on Direct Relief’s Nepal Relief Aid Map. The values for medical aid donations are tracked, calculated on a daily basis, and displayed on the map. This means that the value will increase to reflect each additional shipment of medical aid into Nepal.

Earthquake Recovery Priorities

Direct Relief’s programmatic activities are devoted to immediate relief and health-focused efforts in affected areas. Consistent with Direct Relief’s organizational capabilities and resources, the remaining Nepal-designated funds will continue to support the following activities:

Providing Medical Resources to Under-served Areas

Supporting Long-Term Medical and Rehabilitation Services for Earthquake Survivors

Rebuilding, Repairing, and Re-equipping Health Centers in High Risk Areas

1. Providing Medical Resources to Under-served Areas

The outpouring of generosity following the earthquake — combined with guidance from local organizations and support from Nepal’s National Drug Administrator, Director of International Partnership for the Ministry of Health and Population, and the Director of the Department of Health Services Logistics Management Division – has enabled Direct Relief to fast-track 288,118 lbs. — more than 10 million Defined Daily Doses (DDDs) — of high-priority medications, supplies, and medical equipment to 51 recipient health facilities and organizations in Nepal.

These medical resources were donated by more than 60 health care companies and transported, in large part, aboard humanitarian charter flights donated by FedEx.

2. Supporting Long-Term Medical and Rehabilitation Services for Earthquake Survivors

Earthquakes often cause traumatic injuries that, even if treated successfully, result in lifelong disabling conditions for the injured persons. Direct Relief’s experience in post-disaster situations has reinforced the importance of supporting the institutions and services that provide the specialized care for such persons – and will do so for decades. This has been a priority during the past three months, and Direct Relief believes this use of Nepal earthquake funds is important as it will provide essential long-term benefit to those left with disabling conditions from the quakes.

Direct Relief is supporting the Hospital & Rehabilitation Centre for Disabled Children (HRDC) and the Spinal Injury Rehabilitation Centre (SIRC) with medical materials and funding to sustain and expand these essential services. These dedicated rehabilitation departments and facilities are essential to the health outcomes and quality of life for people who have sustained traumatic injuries.

The Spinal Injury Rehabilitation Centre (SIRC) was established in 2002 by Nepali nonprofit Spinal Injury Sangha Nepal. Spinal cord injuries (SCI) require specialized treatment and life-long management. SIRC is the only facility in Nepal that specializes exclusively in the rehabilitative care, treatment, education, and disability management of patients with spinal cord injuries. Studies have shown that the mortality rates within the first year for patients who have sustained an SCI are dramatically reduced when access to a hospital-based rehabilitation department or national rehabilitation facility is established

Specializing in musculo-skeletal disorders, HRDC focuses its treatment and rehabilitation services on children below 18 years of age with priority given to those from disadvantaged backgrounds. HRDC also conducts medical outreach missions throughout Nepal. These missions target children living in remote and underprivileged communities, where medical care is inaccessible.

3. Rebuilding, Repairing, and Re-equipping Health Centers

The earthquake has severely impacted Nepal’s health infrastructure. A June 10th report on post-disaster needs by Nepal’s Health and Population Sector found that 462 of the country’s health facilities had been destroyed, while 765 were partially damaged.

In Nepal’s Dolakha District, 87 percent of healthcare facilities were damaged or destroyed, leaving 40 percent of the population without access to health services. To support the reconstruction and improvement of health infrastructure in Dolakha, Direct Relief is working with Possible Health and the Ministry of Health and Population of Nepal (MOHP).

Meanwhile, in Dhading and Sindhupalchok districts, between 65 and 75 percent of health facilities were destroyed completely. The consequences extend beyond those who suffered injuries in the quake. In post-disaster situations, pregnant women and children are often excluded from the immediate recovery plan. A combined 16,000 women in the two districts give birth each year. Without sufficient health services, many women have no alternative but to deliver their children in makeshift shelters or unsafe conditions.

To help restore maternal and neonatal health services in Sindhulpalchok and Dhading districts, Direct Relief is supporting its longtime partner One Heart World-Wide with grants to renovate five damaged facilities into certified birthing centers, equip 35 birth centers, and build 45 health posts. The grants will also enable training for 80 skilled birth attendants and educate 1,300 community health volunteers in safe motherhood practices.

Earthquake Recovery Grants: By the Numbers

Direct Relief has granted a total of $1,791,984 to the following local groups and organizations that are providing essential services for earthquake survivors:

Doctors for You $181,131 Emergency operations, equipment procurement, and support for Nuwakot District Healthcare Hospital & Rehabilitation Centre for Disabled Children (HRDC) $227,000 Emergency funding for post-earthquake patient services Midwifery Society of Nepal (MIDSON) $100,000 Address the increased risks posed to pregnant women Namche and Khunde Clinics $2,500 Software that provides physicians with recent clinical guidelines and notes for patient care One Heart Worldwide $477,353 Neonatal Health System Rebuild in Sindhulpalchok and Dhading* Possible Health $504,000 Health Sector Rehabilitation and Improvement in Dolakha District Spinal Injury Rehabilitation Centre (SIRC) $300,000 Emergency funding for post-earthquake patient services

*Direct Relief had committed $70,000 to support One Heart’s work, but the planned activities have been superseded by the profoundly changed circumstances caused by the earthquake. Direct Relief agreed with One Heart’s recommendation that those previously committed but not fully spent funds be redirected and used as part of the broader plan developed over the past three months for the same purposes of bolstering maternal health infrastructure in Dhading and Sindhupalchok districts.