Direct ReliefI N T E R NAT I O NAL 2000 Annual Report
COVER PHOTO: Mother and child after receiving care at DRI project Rurrenabaque, Boliva Jill Reardon Direct Relief Dedication . . . International wishes to thank the many photographers who This report is dedicated contributed their work to the cadre of 400 local Volunteers for the 2000 annual who contribute their time, talents, and energy report. to the mission of Direct Relief International. They are high school and college PHOTO CREDITS: students, retirees, stay-at-home 1. File, Santa Barbara; moms, practicing physicians and lawyers, and business people from 2. (a) Chris Centrella many fields. Each brings & (b) File; 4. Jill extraordinary enthusiasm and a sense of service to the Direct Relief Reardon, Bolivia; 6. mission. File, Guyana; 7. File, Their involvement - whether Honduras; 8. (a) & (b) refurbishing medical equipment, Linda Jo Stern, assisting with physical inventory, rolling bandages, conducting Honduras; 9. File, research, or writing thank you Uganda; 10. (a) Dick notes to our supporters - is essential to the character and Mathews, Ghana, & (b) success of the organization. File, Santa Barbara; 12. For 53 years, Direct Relief Ted Savage, Tibet; 13. International has been able to help (a) & (b) Jay Farbman, people trying to overcome enormous challenges because great India; 14. File, Uganda; people have been willing to put 15. (a) & (b) Kathy their shoulder into any task necessary. Our low overhead is Poma, Bulgaria; 16. due, in large part, to their big Gerry Melendez, hearts and helpful hands. Turkey; 17. Ken Esther Smith, volunteer, packing supplies at DRI We salute you. Grimwood, Santa Barbara; 18. Jill Reardon, Mexico1.
FROM THE PRESIDENT & CEO FROM THE CHAIRAs a newcomer to Direct Relief 2000 was another record year forInternational in 2000, I am honored Direct Relief International, duringto report on the organization’s which we shipped pharmaceuticals,activities for the year. As the facts medical supplies, and equipmentnoted by Chairman Dick Godfrey worth over $67 million at wholesalereflect, the year was highly produc- values to assist over 9.7 milliontive. We expanded our assistance- people in developing countries. Weprogram by more than 27% to a did this with remarkable productivity,record $67 million, providing which Forbes Magazine noted in theirassistance to almost 10 million people. The people we serve December 11th issue when they named DRI one of the mosttypically are outside the reach of even minimal health safety nets efficient charities in the country!and these resources make a profound, positive difference in theirlives. Last year was also noteworthy for our success in attracting Thomas Tighe to be our new President and CEO. Thomas was previouslyBut underlying these numbers are millions of personal stories that Chief of Staff and Chief Operating Officer of the Peace Corpsprovide the motivation and hope that fuels our work. In El where he served with great distinction for the past seven years.Salvador, a local dentist was overjoyed with basic dental hand He has outstanding credentials as well as the vision and compas-tools and supplies that allowed her to repair children’s damaged sion to lead this organization successfully into the 21st century.teeth, not simply pull them. A shipment to Kenya of pain reliefand antibiotic medicines allowed people living with HIV/AIDS With the splendid efforts of a small, immensely talented and hardto combat opportunistic infection and spend more quality time working staff, a dedicated Board, and a host of remarkablewith their families in an unimaginably tragic situation. In volunteers, we have almost tripled our shipments over the pastEthiopia, displaced persons from the Ethiopia-Eritrea conflict three years. As we continue to grow, we need to attract financialwere able to receive health services – in outdoor hospitals and support from outside the Santa Barbara community. As one of theclinics set up in caves – because of essential medicines and oldest humanitarian aid agencies in the country with a sterling 53supplies that we were able to provide. And through a Direct year history, we should be able to expand our constituency. As aRelief International program in the Bolivian rainforest, thou- first step, we have formed an impressive Advisory Board under thesands of indigenous people received medical care and health leadership of Frank Magid to guide us on this path.education. With the assistance of the well-known actor, John Forsythe, ourIn our 53rd year, the people who comprise Direct Relief Interna- endowment fund will secure the financial future of the agency.tional remain committed to its longstanding model of strength- With a pace-setting gift from a loyal Board member, we haveening local efforts and working directly with local people. We do grown these assets 480% since 1998 to a present value of $3.5this by supporting the talented, ethical, committed, and often million.unsung local heroes who, confronted with tremendous challengesof poverty and health risks, devote their lives to improving the Today, over two thirds of the world’s population lives in poverty,quality of life for people in their communities and countries. just trying to exist from day to day. Good health is fundamental toSeveral of these people are highlighted in the following report. earning a living and having the ability to get ahead. We are thankful for your support of our work.Recognizing the enormity of the challenge, we remain commit-ted to making every dollar count. We are deeply appreciative ofour supporters, who make our work possible. Richard Godfrey 2. Thomas Tighe
Local Solutions . . . Worldwide The year 2000 was the 52nd year of operations for Over the course of the year, Direct Relief Interna- Direct Relief International. The year was marked by tional provided 24.3 million discrete courses of significantly expanded efforts to help people in the treatment, sufficient to reach an estimated 9.7 developing world achieve healthier, more productive million people living in impoverished or medically lives by strengthening local health facilities and under-served areas of the world. In addition to programs. Direct Relief International provided supporting our worldwide network of health institu- material assistance of critically needed medical tions and programs, Direct Relief also responded to a resources donated by manufacturers. These products, number of new emergency situations and continued with a wholesale value of more than $67 million, efforts to assist countries still struggling with the were furnished to over 500 locally managed health effects of devastating natural disasters such as care facilities and organizations in 53 countries Hurricane Mitch, flooding in Venezuela, and around the world. These hospitals, clinics, dispensa- earthquakes in Turkey. ries, and health care programs are run by trained, ethical, and committed local people who seek our Direct Relief International’s heightened level of assistance and complete a thorough screening and assistance in 2000 was possible because of increased reference-check process. Many of them are support from the extensive network of corporate, longstanding partners of Direct Relief, and some of foundation, and individual donors who provide the their extraordinary efforts in the face of tremendous organization with medical products, services, and challenges are highlighted in this report. financial support.3.
Latin America and the CaribbeanIn 2000, Direct Relief International provided material assistance to strengthen local efforts in 18 countries in LatinAmerica and the Caribbean: Bahamas, Bolivia, Brazil, Colombia, Cuba, Dominican Republic, Ecuador, El Salvador,Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Peru, and Venezuela.Although health care is and Tacana Indians living inimproving in some countries isolated villages and settlementsin the Latin America and along the Beni River in north-Caribbean region, many western Bolivia. This remotehospitals and clinics still area, at the base of the Andessuffer significantly from Mountains where the Amazoninadequate resources to Jungle begins to form, is one ofaddress the basic health needs the poorest and least accessibleof poor people in the region. in the country. Lack of cleanHighly uneven income water and inadequate sanitationdistribution has resulted in render inhabitants vulnerable tomore than a third of the various debilitating tropicalpopulation living below the diseases. Annual floodingpoverty line. The region’s 40 during the rainy season prohib-million indigenous people, its travel and leaves villagerswho constitute the bulk of without emergency care forthe “absolute poor,” are acute medical conditions andexcluded from the develop- injuries.ment process and deprived ofincome opportunities and Three years ago, the Rio Benibasic public services such as Health Project began offeringeducation, health care, and regular health care in the region DRI training program,Rurrenabaque, Boliviahousing. Historically, the providing communities withLatin America and Caribbean region has been a consistent and reliable health services for the firstmajor focus for Direct Relief, a tradition that time. The project consists of a mobile health teamcontinued in 2000 with 93 shipments to 18 coun- which conducts clinics on a regular basis, travellingtries. by motorized launch or 4-wheel drive vehicle to 19 villages in the surrounding countryside. Over 5,000Bolivia people that inhabit this isolated region have beenRio Beni Health Project treated at scheduled clinics which often extendThe Rio Beni Health Project strives to improve through the night in order to complete all of theaccess to primary health care for Chimane, Quechua, consultations. (continued) 4.
PROFILE: Dr. Carl Niamatali GuyanaDr. Carl Niamatali is Consultant Physi- Direct Relief International: Who does your clinic serve?cian, Hematologist-Oncologist to theMedical Diagnostic Centre in Guyana. Dr.Niamatali was born in Guyana, SouthAmerica. He received his medical trainingat the University College Galway, Ireland.He was also trained at the HammersmithHospital, Royal Postgraduate Medical “ I cannot emphasize Carl Niamatali: We see patients turned away at the hospital because they can’t afford to pay. If they go to the free public hospitals, they may be seen by a doctor and receive a diagno- sis, but the hospital may not have any medicine. I am the only doctor at the Clinic but I have a good experienced staff.School, and the Westminster Hospital in We provide all types of general medical services, includingLondon. He specialized in Hematology- enough how basic lab tests, blood sugars, urinalysis, blood counts, etc., andOncology and was a consultant Hematolo- critical take care of 300 children who are in various orphanages in thegist-Oncologist at the Regional Hospital in town and the students at the handicapped school. it is forGalway. He has published several papersand was involved in clinical cancer studies Direct Relief On weekends we go to remote areas of the rain forest and doand research in Europe. Dr. Niamatali is to continue outreach, providing services and bringing anyone who needsan Executive member and Secretary of the the lifeline specialized care back to the clinic. In those areas, poverty isMedical Association of Guyana and headsits Medical Education Program. He is a greatest and few health services are available. We are doing of supplies health education because we believe it is a very critical part ofmember of the Cancer Board and a formerRotarian. because that delivering health care. is what theyThe Medical Diagnostic & Therapeutic DRI: What is the status of health in Guyana?Centre primarily serves the scattered and are doing.impoverished communities surrounding the CN: For children, the most common childhood illnesses arecity of New Amsterdam. The Centre diarrhea and other gastrointestinal problems. Because of poorprovides general medical services, emer- sanitation and water, antibiotics and oral rehydration salts aregency and acute care, as well as very basic That is what important. Direct Relief has provided Vermox and drugs likelaboratory services. The Centre alsoprovides outreach clinics to the remote rural Direct Relief that for worm infestation. These are extremely useful. Wevillages, most of which have no access to literally is, also see a lot of kids who suffer from malnutrition, so theregular medical care and are extremely poor. Direct Relief vitamin supplements are great.Malaria is endemic to the area. Frequent a lifeline tooutbreaks of dengue fever, seasonal droughts the people in For women, maternal mortality is high and so is neonataland flooding, and poor sanitation and water such great mortality. Education is important, to encourage and remindalso exacerbate the fragile health of these women to understand signs and seek checkups — hyperten-vulnerable communities. Hypertension, need in sion and diabetes during pregnancy is dangerous.pelvic inflammatory disease and cervicalcancer among women, diabetes and Guyana.cardiovascular disease are the most common Malaria is endemic in the rainforest and remote areas where there is not ready access to diagnostics, microscopes, and “conditions among the people served. testing. Sometimes there is a shortage of basic treatment as 5.
Latin America continuedwell. Unfortunately quite a few people die every year frommalaria for lack of treatment or misdiagnosis. Direct Relief, with the support of corporate partners such as Janssen Pharmaceutica, Glaxo Wellcome,DRI: How does Direct Relief International work with you? and Bausch & Lomb, has been supplying pharma- ceuticals, medical supplies, and medical equipment to the project since its initiation, and is now expanding its role to include preventive health education and training. A feasibility study com- pleted in May of 2000 identified the project as an excellent candidate for a health-promoter training program. The new training component is a five-year initiative to promote an integrated approach to health care, one that combines primary health care with essential health education and training. By November 2000, two volunteers from each of 10 local communities had been selected by their villages to participate in long-term training. The promoters will learn how to diagnose and treat a significant percentage of common health problems as well as promote important preventive health Dr. Carl Niamatali (right) practices. Direct Relief will design and supply medical kits comprised of basic medications, supplies, diagnostic equipment, and educational materials, for each of the health promoters.CN: The assistance that Direct Relief International has givento various institutions in the country has been invaluable. HondurasThey provide medical goods for the clinic and outreach Comite De Emergencia Garifunaprogram which have been enormously helpful. Because of Located on the sparsely populated northern coast ofwhat Direct Relief provides, we are able to go out into areas Honduras, the Comite De Emergencia Garifunaand provide health care where there is nothing. The equip- works with local public health facilities throughoutment that Direct Relief has given us, such as Midmark the region in an effort to improve the quality of lifeautoclaves and patient monitors, have enabled us to do for the indigenous Garifuna population. Numberingsurgery. Stretchers, patient gurneys, again, immensely useful. about 400,000, the Garifuna are an ethnic mix ofI got a spinal board from Direct Relief that has been helpful in black and indigenous people that have inhabited this remote area since colonial times. Since then,taxiing and immobilizing patients. and in spite of over 200 years of continued racial discrimination and isolation, the Garifuna haveWithout this support, I am not certain that I would be able to managed to maintain aspects of African culturedo the medical outreach programs or provide certain services through their unique language, music, dance, oralat the clinic. Resources are very scarce or unaffordable. traditions, and religious beliefs. (continued) 6.
Latin America continued PROFILE: Direct Relief has supported the Emergency Linda Jo Stern, MPH Committee for the Garifuna since it was formed Linda Jo Stern, MPH, is in response to the devastation caused by Director of PROMESA, a Hurricane Mitch in 1998. Despite the fact that service, training and the northern coast of Honduras was heavily “ education project in Hondu- damaged in this disaster, little national or ras. Ms. Stern holds a international assistance became available to the degree in Nutritional Garifuna due to their remote location and to Science and earned her other geographic and political concerns. Masters in Public Health at Boston University School of Training is Suzanne Shende, Coordinator for the Commit- tee, writes: “DRI donated medicines and equipment Public Health. She has essential to have been sent to the regional hospital in Trujillo, as devoted her work specifically self-sufficiency. well as small village health centers, such as that in to the communities of the Cusana, a small agricultural town without electric- Yeguare region of Honduras ity, phones, or year-round accessibility. Your since 1994. But training assistance even extends to the most marginalized of alone doesn’t towns where there isn’t even a health center, as first The goal of PROMESA is aid supplies are sent to trained health workers in to improve the health status, solve the villages like Punta Piedra and Iriona Viejo.” knowledge, and self-reliance problem. of the Yeguare Region of Honduras by developing partner projects with Direct Relief’s families, communities, and material community-based organiza- assistance is Asusena Garcia tions in the region. sets off before PROMESA provides health an essential part dawn with the assessment, diagnosis, and of the overall first aid treatment through the use of program plan supplies for the Health Brigades to the 72 town of Iriona remote villages of the to achieve a Viejo, on the Yeguare River basin. sustainable remote northern Medical supplies, pharma- health program. coast of ceuticals, and medical Honduras. equipment provided by Asusena is a Direct Relief International native7. Garifuna. help make these Health Brigades possible. (continued) “
Linda Jo Stern continuedPROMESA also supports 16 health centers have to train them how to use them. Itscattered throughout the river basin. doesn’t come naturally. The basics of what we call first aid must be taught.Direct Relief International: The The second level is prevention. OftenPROMESA project is a health component children have severe conditions likeof the rural development work at Zamorano parasites or respiratory infections. OneCollege in Honduras. How did it come must first help the family cure the illnessesabout? and then there’s space and time and quiet to learn the preventive part.Linda Jo Stern: Zamorano College identi-fied a catchment area called the Yeguare The third level involves training existingRiver basin. They recognized that water, community leaders and community healthsanitation, etc. is important, but health workers. These are people who have amust be addressed concurrently with rural leadership role, have been chosen by theirdevelopment so health services and health communities as leaders— maybe they knowassessment are included. Direct Relief how to read and write— and they are theprovides the material resources they need ones that are available and accessible to theand we help provide the training so that villagers.they can do the work that they are supposedto do. The goal is to help these clinics DRI: What are the greatest needs in thesebecome self-sufficient. villages?DRI: Train- LJS: Theseing is such an health These boxes, in transit to a rural clinic in Honduras,important contain supplies provided by DRI. workers arecomponent to desperately inthe process of need of needed item is mebendazole which we usebuilding local materials. for parasites, and Biaxin, an antibiotic. Soleadership Basic first aid everybody now knows how to deparasitizeand develop- items are their children and themselves. We leaveing real, really most them with that. Other things we couldsustainable needed. We leave them with if we had them are prenatalchange in the see people supplements and birth control.health status walkingof communi- around with Health workers in these villages know whatties. gaping they need. They may not recognize an wounds, no opportunity or know of ways of gainingLJS: Yes, bandages. resources - that’s where organizations liketraining is the Now Johnson PROMESA and Direct Relief come in. Weway to go, & Johnson can bring technology or knowledge or waysespecially if products are of providing information or care to them,you believe in the concept of self-determi- the best, especially the first aid products like especially if they don’t have access tonation. I believe there are a number of bandages. I mean this sounds ridiculously information.levels of training. The first is just teaching simple but you wouldn’t believe howthe families how to use the materials; this important it is down there to have asometimes involves the Direct Relief bandage that sticks. Johnson & Johnsoncommodities. If you bring materials in you bandages stick. Another example of a 8.
Africa In 2000, Direct Relief International provided material assistance to local facilities, programs, and organizations in 12 African Countries: Congo, Eritrea, Ghana, Guinea-Bissau, Kenya, Malawi, Mozambique, Nigeria , Sierra Leone, Tanzania, Uganda, and Zambia Rich in natural resources but beset by ethnic and tribal violence, political instability, poverty, disease and famine, Africa presents what many consider to be the greatest challenge to global development. Out of the 25 countries that the U.N. describes as “low human development” countries, 22 are in Africa; 33 of the 47 “Least Developed Countries” are in Africa. The devastating effect of HIV/ AIDS has led to a major drop in life expectancy in many countries and resulted in millions of orphans, many of whom must fend for themselves because of scarce to non- existent social- and health-support services. In 2000, Direct Relief identified several new partner institutions and health programs, and increased assistance levels to Africa 2000 DRI shipment being received in Uganda through 33 medical donations. An average 100 women and children come to a clinic each day, but in the past the staff has had few or none of the critical Ghana medicines and supplies needed for treatment. In 2000, with Jehovah Rapha Health Care Foundation funding from the Carsey-Werner Company, Direct Relief was The Jehovah Rapha Health Care Foundation supports 30 able to provide its second shipment to Jehovah Rapha. The community health clinics in the southwest region of Ghana shipment included antibiotics, prenatal vitamins, children’s with supplies, guidance and technical training. The chewable vitamins, oral contraceptives, baby scales, oral Foundation’s Director, Madam Oku, is a registered nurse rehydration salts, exam gloves, needles and syringes, pediatric and third generation midwife. blood pressure cuffs, and other primary care supplies. Corpo- rate donors including Becton-Dickinson, Ethicon and Ortho- The focus of each clinic is to serve the needs of women and McNeil provided major material support for this project. children by providing pre- and post-natal care, immuniza- tions, well-baby exams, family planning, and other primary Tanzania care services. In addition, the Foundation promotes Nyakato AIDS Outreach Project preventive health care through community talks on topics “I hope that Direct Relief will be able to help us! We have 190 such as health during pregnancy, early symptoms of AIDS patients in the Nyakato area, and that number is growing all childhood diseases, nutrition, and safe sexual practices. the time. We know that any help you can give us will be very Each clinic is staffed with one nurse, two midwives, and greatly appreciated by these AIDS patients. We don’t have access several health assistants, all of whom reside in the commu- to the new ‘therapies’ but the antibiotics, etc. are very helpful to us nity they serve. in treating the opportunistic infections that people get.” - Sister Veronica, Project Director9..
PROFILE: John Ganda Sierra Leone Against the overwhelming statistics and enormity of the AIDS pandemic, Sister Veronica’s outreach John Ganda, Ph.D., is Founder and Director of the program may seem insignificant. Yet it is exactly Ndegbormei Development Organization in Sierra Leone. A these local, community based services that will native of Sierra Leone, Dr. Ganda has dedicated his life and eventually prove effective in changing behavior career to aiding the people of this war torn nation. His and African societal attitudes toward this terrible experience includes disease. In the meantime, the project provides comfort and support to individuals suffering both working with the physically from the virus, and emotionally from the Peace Corps in stigma of having AIDS. Sierra Leone, recruiting, training, According to the UNAIDS Report on the Global placing, and HIV/AIDS Epidemic, the “essential package” of supervising both testing, counseling, psychosocial support, palliative volunteers and staff. care, prevention and community activism, is the minimal level of care and outreach required for Sierra Leone has assistance to AIDS affected communities when been rated last in more comprehensive resources are not available. the Human Devel- Following these guidelines, Direct Relief supports John Ganda opment Index as the HIV/AIDS programs such as the Nyakato AIDS poorest country in Outreach Project that are providing medical the world. The social and political fabric of the country has services, education, and outreach. been torn by a protracted civil war that, though there has been a cease fire, continues to impact every aspect of life. There are no proper medical facilities nor education facilities in the country. Agriculture has come to a standstill. Established in 1982, Ndegbormei Development Organization was founded as a network of non-governmental organizations within Sierra Leone. Through cooperation and the sharing of resources and expertise, the network is slowly addressingDRI program various social development issues -- primarily the health careofficer Kelly needs of women and children. Their plans include theDarnell in Ghanawith Madame construction, supply, and staffing of a children’s hospital to beOku, Director of located on the outskirts of Freetown where access to qualitythe Jehovah medical care is scarce.Rapha Health (continued)Care Foundation 10.
John Ganda continuedDirect Relief International: Help us understand life in damaged during the war— with beds, with They need a lot more wheelchairs, crutches,Sierra Leone. medicines. orthopedic supplies— the rural areas have received very little. The lack of clean water is one of theJohn Ganda: Sierra Leone has been rated in the DRI: What are the major health issues in Sierra major problems. During the war a lot of the villageHuman Development Index as the poorest country in Leone? wells were polluted. The rebels killed people andthe world. There are no proper medical facilities, no dumped them in the wells. The rivers and streamsproper education facilities. Agriculture has come to a JG: Many amputees and people maimed by war. upon which people rely have also been polluted.standstill. The war that started in 1991 has devastated Typhoid, cholera, diarrhea, and dysentery are majoreverything. Young men— who were able-bodied problems. Diarrhea and dysentery affect childrenagricultural workers— have either been killed, hadtheir arms amputated, or they’ve been recruited by therebels to fight and cannot go back home.DRI: How do you operate under these conditions? “ Many have particularly. HIV is another. It was heightened by the war because a lot of girls were raped and many of them have come up with this virus. But we don’t have the medical facility to properly diagnose them, no proper laboratory facility. Some are dying without having been properly diagnosed. And weJG: We are working with the amputees and with forgotten do not know if it is something else.internally displaced persons. We give amputees Sierra Leone,wheelchairs and provide them with food. In the Bo DRI: Where do you focus, and what are your goalsDistrict, we have a whole chiefdom of about 60,000 or offer for the organization and for Sierra Leone generally?persons that we are trying to support with medicines, onlyfood, clothing, wheelchairs— everything we can get. JG: The youth have been silent for a long time.But we want to go beyond looking at just the victims of commentary This rebel war was the only thing that brought themthe war. We want to look at the families, because at and advice. out. Because they have the guns we listen to them.the end of the day those victims will have to rely on But when they put the guns down we still need totheir families for support. listen to them. Why did they fight? What were Direct Relief they fighting for? And where did we go wrong? We need to empower these people toward positive ends.Last January we started working with an orphanage for is a One very important tool of empowerment isstreet children, abandoned children or those affectedby the war. We also have set up home care centers. respectful education. And for education we need learning materials.We have two nurses and three volunteer doctors who partner.work with us, and they require the supplies from DirectRelief. There is only one children’s hospital in the We are also working with the women. We are training them in dressmaking, growing andcountry. It is poorly staffed, under-supplied, and under- We are very processing different foods, and as traditional birthequipped. We want to build another. grateful attendants. We want to help them become leadersDRI: How has Direct Relief International supported for the in the community. It is good to ask for help but it isthese efforts? good to see what you can do for yourself. That is assistance what our five-year program with Direct Relief is allJG: Direct Relief’s partnership has helped tremen- to help about. What we are looking at is a whole approach.dously. The material has allowed us to expand and The hospital and health program is an introductionassist other district hospitals and the children’s hospital save lives. into community development programs. We are very grateful to DRI for all the support we are 11. getting.
Asia and the PacificIn 2000, Direct Relief International provided material assistance to strengthen local efforts in 9 countriesin Asia and the Pacific: Afghanistan, Cambodia, India, Indonesia, North Korea, Pakistan, Philippines,South Korea, and Sri LankaHome to two-thirds of humanity, much of the Asia and hospital performs an average of 2,000 sight restoringPacific region is undergoing enormous change as it operations free of charge each year. In addition,grows rapidly and industrializes. Along with economic 50,000 outpatients receive screenings and treatmentgrowth, industrialization creates more transient at a nearby satellite clinic, and 22 mobile “eyepopulations which can fuel such epidemics as HIV/ camps” are conducted throughout the state. TheAIDS. Many epidemiologists fear that India will Association also distributes high-dose vitamin A tobecome the children andnext major lactating mothersbattleground of in 14 localthe AIDS villages. Thepandemic. vitamin preventsEconomic blindness andprogress has strengthensbrought better resistance toliving condi- infectioustions for much diseases.of the region,but most of the In May 2000,population is with fundingstill living in from Thepoverty and Allergan Founda-without tion, Directadequate Relief Interna-health care. In 2000, Direct Relief made 35 shipments tional provided a large shipment of exam and surgicalto 9 countries in the Asia and Pacific region. equipment to the Gujarat Blind Relief Association. The assistance package included a phacoemulsifierIndia (cataract extraction unit), an operating microscope,Gujarat Blind Relief Association and ophthalmic gurneys, chairs, stands, instruments,One third of all of the blind people on earth live in and supplies; medicines donated by Alcon Laborato-India. Even more astonishing is that the vast majority ries and other corporate donors were also provided.of these cases of blindness are completely preventable Special training in the use of the phaco machineor easily treatable. The Shri R.M. Eye Hospital was conducted by the manufacturer was arranged andfounded in the 1950’s and is operated by the Gujarat took place in Bombay. Dr. Doshi, an 82-year oldBlind Relief and Health Association. The 100-bed ophthalmic surgeon who has dedicated his life to (continued) 12.
Asia and the Pacific continued restoring sight and continues to perform hundreds of further contaminating the floodwaters. The most operations at the eye hospital each year, was thrilled needed commodities were safe water to drink, rice to upon receiving the shipment. eat, and medicine to cure In a letter sent to Direct diarrhea and bacterial Relief, Dr. Doshi stated, “So infections from contaminated many grandparents will see their floodwater and to treat grandchildren for the first time communicable diseases, such and be able to perform their as pneumonia, acquired from family and village responsibilities the overcrowded living again due to the use of this conditions. incredible equipment. Thanks so much for remembering us.” The Sihanouk Hospital Center of Hope sent special Cambodia outreach teams to deliver food Sihanouk Hospital and shelter materials to Severe rains during the early communities in desperate monsoon season filled the need of relief. Physicians and lower Mekong River in nurses from the hospital set up Cambodia and Vietnam makeshift clinics to treat beyond capacity in the villagers. With the support of autumn of 2000. In many of McNeil Consumer, Direct the flooded areas, entire Relief was able to provide villages of people and animals were living in the needed medicines. Medical donations were also local pagoda, the only building remaining above provided to four area health facilities including water, on bamboo platforms built in trees, or in the district hospitals and health centers. Team members rafters of their houses. All of the affected villages commented that, “it was so gratifying to see the trail of lost their rice crop. The lack of dry land resulted in villagers returning to their homes after being treated at the the water surrounding these village islands being clinics, wading through water thigh deep with large sacks used for drinking, cooking, bathing, washing clothes of rice on their heads, their children trailing behind. You and dishes, and as the garbage dump and toilet. The could see in their grateful eyes a little bit of relief for their animals were drowning or dying from lack of food, hearts and some food for their hungry stomachs.”13.
Biomedical Equipment: Essential Tools for Health Care You’re sick or injured. You go to a hospital or clinic, enced staff and volunteers refurbish used, donated but the doctor has no diagnostic medical equipment, equipment suitable for use in partner facilities sterile instruments, or medicines to provide. It is a throughout the developing world. Necessary power frightening thought, yet a daily occurrence for people conversions and plug configurations are completed living in developing countries. prior to shipment, and each item is shipped with a technical manual. These tools have sustaining value Appropriate medical equipment is essential for to health facilities and enable doctors and nurses to health-care providers to help patients. provide better care to sick and injured people. For 25 years, In 2000, Direct Relief Direct Relief International provided International has more than 5,000 provided a broad individual biomedical range of equip- items to facilities in 36 ment to indig- countries, including enous facilities to more than 400 help strengthen autoclaves, 25 dialysis local health units, 85 wheelchairs, efforts. The 350 blood pressure kits, equipment ranges 100 operating and from basic items exam tables, dozens of such as stethoscopes and dental hand instruments to dental chairs and related equipment, and hundreds of more advanced, if far from cutting edge, electronic pediatric-care items including ambu (respiratory) devices such as ventilators, defibrillators, electrocar- bags, nebulizers, and ventilators. diograph (EKG) machines and autoclaves (which sterilize medical instruments). Wheelchairs, walkers, The wholesale market value of these products dental chairs, and other assistive devices are also exceeded $3.1 million. However, to the recipients, furnished to resource-poor facilities. these items are priceless. A qualified Biomedical Engineer oversees the Direct Relief International biomedical program. Experi- 14.(Background: Refurbished Sterilizers)
Eastern Europe,Russia and the NIS In 2000, Direct Relief International provided assistance to local organizations in 9 countries in the region: Albania, Armenia, Bulgaria, Croatia, Estonia, Lithuania, Romania, Ukraine and Yugoslavia The collapse of the Soviet Union provided some East medical equipment is in dire need of updating. In European countries the opportunity to thrive, while some hospitals, they witnessed patients being carried others are still struggling through economic and social up stairs in the arms of a family member, because there upheaval. With the end of the highly centralized were no wheelchairs or stretchers and the aging Soviet distribution system, medical supplies are no facilities lack elevators. longer available from neighboring Eastern bloc countries and must be purchased from Western In spite of these difficult conditions, most physicians European companies using scarce hard currency believe the current situation is temporary. Dr. Stefan reserves. In Zerovski, Deputy 2000, Direct Director of the Relief was able municipal to ease some of hospital in Pernik the shortages this sums up the situation has prevailing mood, created by “We believe that making 29 in a few years we shipments to 9 will be able to countries. take care of ourselves. In the Bulgaria Bulgaria’s rich history, and empty pharmacy shelves meantime, Direct Hospital Support Relief’s help has Bulgaria has suffered an enormous financial crisis made an incredible difference.” resulting in the deterioration of the health care system and other infrastructures. In September, 2000, Direct In 2000, Direct Relief sent 10 medical donations to Relief senior program officer Katherine Poma and seven hospitals located throughout Bulgaria. Recipi- pharmacist Cathleen Grabowski conducted an ents included five general hospitals, a respiratory assessment trip, visiting a number of hospitals facility which specializes in treating adult and pediatric throughout Bulgaria. They reported that many health asthma, and the country’s main cardiology institute. facilities lack even the most basic medicines and that15.
Middle EastIn 2000, Direct Relief International provided assistance to local organizations in: Iraq, Gaza,Lebanon and TurkeyConditions improved in 2000 in some parts of organization for 18 tent cities that continued tothe Middle East, such as Lebanon, but deterio- house hundreds of thousands of homeless citizens,rated in others, such as the Gaza Strip in Israel. was selected to receive additional general supportThe civil strife that has long plagued much of including large quantities of personal carethe Middle East increases patient loads at already products. Abant Izzet Baysal University Hospital,overtaxed hospitals and contributes to the a teaching facility in Duzce that treated overoverall deterioration of public health. In the fallof 1999, massive earthquakes struck Turkey andrebuilding efforts became the focus of ourassistance there throughout 2000. Direct Reliefmade 9 shipments in 2000 to 4 countries in theMiddle East.TurkeyEarthquake RehabilitationThe earthquakes that struck Turkey in Augustand November of 1999 totally devastated thenorthwestern region of the country. Tens of Temporary shelter for earthquake victims, Turkeythousands of lives were lost, with greaternumbers of people injured and families left 2,000 injured patients after the second earth-homeless. Direct Relief International responded quake, was chosen to receive a series of donationswithin 72 hours with its first major shipment and of medical equipment. Until new medical clinicsfollowed up with nine more through the end of as well as a general hospital are constructed to1999. In January of 2000, program officer Mike replace those destroyed, this facility will beHayes visited Turkey to evaluate the distribution providing the bulk of all secondary and tertiaryand use of the emergency shipments and to assess care services to the local population. In 2000,the intermediate and long-term rehabilitation Direct Relief sent two shipments of medicalneeds of the affected areas. equipment including patient monitoring and other devices to complete a new intensive careLojistik Destek Koordinasyon, the coordinating unit. 16.
United States Direct Relief’s on- target homeless going work in the children in Santa United States Barbara with dental focuses on respond- education and care. ing to the needs of Dental care has been under-served, low- identified as the income families as number one unmet well as the chal- health care need by a lenges faced by number of health care Native American authorities in Califor- populations. In nia and Santa Barbara 2000, 20 shipments County, but there have were made to health been no programs that care organizations in DRI program officer Martha Angeles provides dental education specifically targeted the U.S. In addition the dental needs of to donating medical commodities to local health homeless children. Dental care is often ne- facilities and programs, Direct Relief provides glected because of the many overwhelming personal care products to social service agencies problems that homelessness creates, but inter- and shelters, equips schools with containers and vention with education and care at a young age emergency first aid supplies for disaster prepared- can impact the health and self-esteem of these ness, screens high-risk seniors for osteoporosis, children for the rest of their lives. “Healthy and provides children with dental education, Smiles” offers bilingual dental hygiene work- services and supplies. shops for children living at a local homeless shelter, provides dental supplies for the entire “Healthy Smiles” is Direct Relief’s newest family, and follows up with dental appointments domestic program and it has been designed to as needed.17.
Special Thanks for Extraordinary Support We extend specialDirect Relief International is honored by every contribution we receive - from individual people, from corporations and businesses, from thanks:foundations, service organizations, church groups, and classrooms. Each contribution represents a judgment and a trust in our efforts to assist To the Santa Barbara County those without means and facing enormous health challenges to have a Vintners Association, whobetter chance at a better life. Our commitment, both to those who have dedicated to us the proceeds from honored us with their trust and to those whom we strive to serve, is to the Harvest Moon Wine make every dollar count toward advancing this important mission. Auction. Their first-ever charity gala raised more than $250,000, enabling us to provide approximately 20 shipments of critically needed medicines, supplies, and equipment. To our largest corporate partners, who contributed generously to the total of more than $75 million in product we received in 2000. Many thanks to Abbott Laboratories, Johnson & Johnson, Merck & Co., Becton- Dickinson, Midmark, Ortho- McNeil, TEVA USA, and Watson Pharmaceuticals. To the several persons who made significant financial contributions and requested anonymity.
STATEMENT OF ACTIVITIES Direct Relief’s Expanding Assistance PUBLIC SUPPORT & REVENUE Public Support (medical assistance wholesale values 1996-2000) Contributions in-kind $76,886,255 Contributed freight 234,411 Contributions in cash and securities 3,887,563 1996 $25,228,933 81,008,229 Revenue Earnings from investments and miscellaneous income 209,269 TOTAL PUBLIC SUPPORT AND REVENUE 81,217,498 1997 $25,074,167 EXPENSES Program Services Value of medical donations shipped by Direct Relief 67,849,831 Freight provided to Direct Relief 234,411 Operations and shipping 1,764,439 Contributed services 48,262 69,896,943 1998 $27,852,382 Supporting Services Resource acquisition 532,343 Administration 396,699 TOTAL EXPENSES 70,825,985 INCREASE IN NET ASSETS $10,391,513 1999 $52,931,445 STATEMENT OF CASH FLOW Cash flows from operating activities Increase in net assets $10,391,513 Adjustments to reconcile change in net asset to net cash (used) provided by operating activities In-kind receipt of inventory (76,811,999) In-kind shipment of inventory 67,849,831 2000 $67,849,831 Depreciation 74,568 Investment adjustments 0 Changes in operating assets and liabilities (109,855) Net cash provided by operating activities 1,394,058 Net cash used by investing activities (1,526,803) Net cash used by financing activities (34,437) 10 20 30 40 50 60 70 Net decrease in cash ($167,182)19.
STATEMENT OF FINANCIAL POSITION Maintaining Low Fundraising andASSETS Current Assets Administrative Expenses (as a percent of Total Public Support and Revenue) Cash and cash equivalents $2,174,816 Receivables 170,596 Inventories 27,280,404 Prepaid expenses 23,793 2.45% 1996 29,649,609 Other Assets Future interest in Unitrust 2.68% 1997 1,227,563 Investments 163,434 Receivables 10,000 2.07% 1998 Property and equipment 3,609,893 Miscellaneous 15,160 TOTAL ASSETS $34,675,659 .94% 1999LIABILITIES AND NET ASSETS 1.14% 2000 Current Liabilities Payables $105,060 Current portion of long-term debt 25,219 Other liabilities 8,710 % 1 2 3 138,989 Other Liabilities Long-term debt 1,694,159 Distribution payable Capital lease obligation 63,667 Growing Support from 0 TOTAL LIABILITIES 1,896,815 Product Donors Net Assets Unrestricted net assets 28,670,438 Temporarily restricted 4,108,315 TOTAL NET ASSETS 32,778,753 1996 $17,005,338 TOTAL LIABILITIES 1997 $19,562,191 AND NET ASSETS $34,675,568 1998 $32,812,605 1999 $58,192,096 2000 $76,811,999 10 20 30 40 50 60 70 80 20.
DonationsCorporations providing medical Warner Lambert Consumer Healthcare Hanvit America Bankin-kind contributions Watson Pharmaceuticals, Inc. Thank you to the individual donors who donated Haskell FundAbbott Laboratories medical equipment and supplies for the clinics and Help Diocese of Kikwit in ZaireAlcon Laboratories, Inc. hospitals overseas. Conrad N. Hilton FoundationAllergan, Inc. Medical facilities, organizations and Organizations, including corporations and Hitching Post WinesBausch & Lomb Pharmaceuticals, Inc. institutions providing medical in-kind foundations, providing cash or non-medical Home DepotBayer Diagnostic contributions valued at $5,000 or more in-kind contributions of $1,000 or more H.H. Horton Philanthropic TrustBecton Dickinson & Company AmeriCares African Poverty Eradication Commission Hosford Family FoundationBiotrol International Cancer Center of Santa Barbara Allergan Foundation Human Dignity ProgramCarlsbad Technology, Inc. Carrillo Community Medical Clinic Alpha Development Agency Inc. Hutton FoundationCiba Vision Corporation Casa Dorinda Retirement Community American Jewish World Service Independent Charities of AmericaDCI International The Church of Jesus Christ of American Nicaraguan Foundation, Inc. Independent Givers of AmericaDen-Mat Corporation Latter Day Saints American Society of the Most Venerable Indian Student Association at UICDentsply International Church World Service Amgen Foundation, Inc. Indo American Institute, Inc.DeRoyal Industries Coram Health Care A.N.E.R.A. Indo-American Eye Care Society Inc.Diamond Polyethylene Products East West Associates The Anschutz Foundation The International FoundationDupont Pharmaceutical Company Foodbank of Santa Barbara County Aveda Corporation The Ann Jackson Family FoundationEli Lilly & Company Forex Cargo B & B Foundation John Paul Mitchell SystemsEthex Friends of the Poor BankAmerica Foundation Johnson & Johnson Family of CompaniesEthicon Endo-Surgery Global Links Barnwood Vineyards JP MorganEthicon, Inc. Goleta Valley Cottage Hospital Beckmen Vineyards Junior League of Santa Barbara, Inc.Fine Science Tools Handpiece Trading Post Bien Nacido Vineyards Nancy Katayama Foundation, Inc.FNC Medical Corporation Healthsouth Reno Medical Plaza Bistra Balabanova W.M. Keck FoundationGlaxo Wellcome Inc. Home Depot The Lynde and Harry Bradley Foundation Nancy K. Ketcham FoundationHardwood Products Company Human Performance Center Conley and Marney Brooks Fund Liselotte Kuttler TrustHudson Oxygen Therapy Sales Interchurch Medical Assistance The Sheila Johnson Brutsch Charitable Trust La Centra-Sumerlin FoundationHu-Friedy Mfg. Co., Inc. International Aid, Incorporated Burch Plumbing La Santa Casa De MisericordiaJanssen Pharmceutica, Inc. Kaiser Permanente Andrew H. Burnett Foundation Life Enrichment FoundationJohn O. Butler Co. Keckler Medical Bush Hospital Foundation L.S. Research, Inc.Johnson & Johnson Consumer Products LA Multi-purpose Program Cali USA Acoustics, Inc. The Laurel FoundationJohnson & Johnson Corporate Lompoc Hospital District California Community Foundation Luxury PerfumesJohnson & Johnson Health Care National Pediculosis Association Cambria Winery & Vineyard MacDonald Family FoundationJohnson & Johnson Medical Ojai Valley Community Hospital Cameron Brown Foundation MADREJohnson & Johnson Professional Operation USA Capital Group Co. Charitable Fnd. Magellan’sKarl Storz Endoscopy Oriental Mission Church The Carsey-Werner Company Marbrook FoundationMaxxim Medical, Inc. Partners in Health Casa Provincial de las Hijas de Caridad The G. Harold &McKesson-General Medical Phelps Medical Center Channel Islands Equity Leila Y. Mathers FoundationMcNeil Consumer Healthcare Power Equipment Company Christian Relief Services Fred Maytag Family FoundationMedical Innovations, Inc. Pruner Medical Church World Service, Inc. McGraw-Hill CompaniesMedline Industries, Inc. Rapid City Regional Hospital Ciba Vision Corporation R. K. Mellon Family FoundationMedPharm, Inc. Rehabilitation Institute Coast Village Business Association, Inc. Mercy Corps InternationalMencar Pharmaceutical Corporation Saint Francis Medical Center Cold Heaven Meridian VineyardsMentor Corporation Sansum Medical Clinic Conservation, Food & Health Foundation Seeley W. Mudd FoundationMerck & Company, Inc. Santa Barbara City College Willametta K. Day Foundation Midwest Chapter of Peruvian InstitutionsMidmark Corporation Santa Barbara Cottage Hospital The Disarm Education Fund, Inc. Mostyn Foundation Inc3M Pharmaceuticals Santa Barbara Internal Medicine Group The Doehring Foundation Motion Engineering, Inc.Nexxus Products Company Santa Barbara Medical Foundation Clinic Dos Pueblos High School The Myers Family FoundationNihon Khoden Santa Barbara Visiting Nurses Association The James R. Dougherty, Jr., Foundation New Horizons Outreach, Inc.Nordent Manufacturing, Inc. Santa Ynez Valley Hospital The Grant C. Ehrlich Trust OEF De El SalvadorNorth Safety Products SEE International Emmanuel Presbyterian Church The Pacer FoundationNutrex Hawaii, Inc. St John’s Hospital The Entertainment Industry Foundation Packers, LTDOlympus America Inc. St. Joseph’s Hospital Library Estonian Am. Fund for Economic Edu., Inc. The Peebles Sheen FoundationOnyx Medical St. Vincent Hospital Family Unity International Peruvian American Medical SocietyOrtho-McNeil Pharmaceutical Corporation Tarzana Pediatric Medical Group Federal Express Corporation Pfizer Foundation, Inc.Physio-Control Corporation Tulare District Hospital Fess Parker Winery & Vineyard Philippine National BankPrecision Medical VacuMed Firestone Vineyard Precision StripSearle Valle Verde Retirement Community Flying Doctors of Mercy The Quinn Family Foundation, Inc.Shaman Botanicals Ventura County Medical Center Foley Estates Vineyard & Winery Robert N. Lindquist & AssociatesSmith & Nephew - Orthopedic Veterans Administration Outpatient Food for the Poor, Inc. The Roberts Bros. FoundationSultan Dental Products WESCO Fox Point LTD. Robinson-MaySurgin, Inc. Westhills Regional Medical Center Foxen Vineyard, Inc. The Dorothea Haus Ross FoundationSwibco Wheelchairs for the World Foundation Frey Farming Rotary Club of BishopTagg Industries WW Patterson Committee Fundacion Pro-Vista, A.C. Rotary Club Of FillmoreTEVA Pharmaceuticals USA The Leo and Eva Gans Foundation Inc. Rotary Club of Santa Barbara SunriseTillotson Healthcare Corporation Glens Falls Medical Missionary Fnd. Rotary Club of Santa YnezTissue Banks International Thank you to each member of the Kiwanis Clubs, Global Partners for Development Rotary Club of WestlakeVisticon Emblem Clubs and Lions Clubs for supporting our Godric Foundation Rusack VineyardWalgreens Save Our Sight Program through donations of The Griggs Family Foundation Samaritan’s Purse thousands of pairs of eyeglasses. Guyana Medical Relief Santa Barbara Bank & Trust 21.