This document provides 3 photos and captions that summarize Direct Relief's work focusing on maternal and child health in developing countries. The photos show: 1) An HIV counselor testing a couple for HIV in Kenya. 2) Facilities at Partners in Health's hospital in Haiti that Direct Relief has helped equip. 3) The facility and programs at Visitation Hospital in Haiti that serves 80-90 patients daily. The work aims to expand access to healthcare, ensure safe deliveries, address complications, restore health, and prevent mother-to-child transmission of HIV.

1. w w w . D i r e c t R e l i e f . o r g
Plus!
Our People of the Year (you are here) P/6
H1N1 Response Update P/5
Gift Guide Warm hearts with health, and babies with bassinets P/8
continue your legacy of giving P/8
This report was paid for by a generous bequest | photo by Vinit Satyavrata, www.purelightfoto.com

2. PHOTO ANNUAL
If pictures are worth a thousand of them, and actions speak louder than them, than the next few pages will convey our work and the work of
the healthcare leaders we support in 70 countries better than words can. (Not that we won’t also give the words a shot.)
Brett Williams
Focus on Moms and Kids about these initiatives and
read more
watch video of the women
A woman dies each minute from complications during pregnancy and childbirth, and while Direct Relief’s work has long been aimed at expanding the quality, whose health has been
availability, and access to health services for all people, a principal focus of this effort is on maternal and child health and, more specifically, interventions that restored through obstetric
directly address threats to women. These interventions include expanding access to care, ensuring safe deliveries through midwife training and kits, addressing fistula repair in Africa
complications through emergency obstetric care, restoring health through obstetric fistula repair, and preventing mother-to-child transmission of HIV.
D irect R elief . org
lindsey pollaczek
top 5 hiv rapid
test kit country
recipients in 2009 Defining the Big Problems: HIV Prevention and Testing
Kenya 976,000 Every 48 seconds, a child is infected with HIV, the virus that causes AIDS. It is essential to focus resources on where this infectious disease exists to save those who
Haiti 520,000 have contracted it and can transmit it and those who are most likely to contract it. Deciding who to treat requires knowing who is sick. In a village outside of Eldoret,
Congo, DR 483,000 western Kenya, Florence, an HIV counselor with AMPATH, explains to a young family the importance of HIV testing, and tests the couple for the virus using rapid tests
Cameroon 415,000 distributed by Direct Relief in partnership with Abbott. The test is quick—results take 15 minutes—and requires no electricity or water, making it ideal for areas that
Rwanda 281,000 may lack steady access to either resource. If a pregnant woman tests positive for HIV, the healthcare provider can take the necessary steps to help prevent the baby
from being infected with the virus.
2 www.directrelief.org winter 2009 This report was paid for by a generous bequest

3. photo annual
1
3
Brett Williams
Brett Williams
2
The Lottery
Brett Williams
By being born in the
U.S., you can expect
to live 27 years
longer than if you
were born in Haiti.
Haiti: Primary care where it’s most needed
According to the UN, Haiti is the poorest nation in the Western Hemisphere and has the lowest life expectancy: 51.5 years. Direct Relief has provided nearly $60 million in medical
assistance to Haiti since 2000, focusing on primary health care and basic medical supplies with groups like Partners in Health and Visitation Hospital.
Partners in Health’s Zanmi Lasante Sociomedical Complex ( 1 + 2) features a 104-bed, full-service hospital and a dozen schools, and the organization has expanded across Haiti’s
Central Plateau. Direct Relief recently helped equip the new hospital in Lacolline with beds, exam tables, sterilizers, and general hospital supplies.
Visitation Hospital (3) serves between 80 and 90 patients a day at its facility, which is designed to be environmentally sustainable. Its programs include a community health
initiative in nutrition and vitamin distribution to help alleviate malnourishment among children, as well as programs for deworming and water purification. The facility houses a lab
and pharmacy, seven exam rooms, two medical/dental procedure rooms, and a food bank.
kristin brown
King's Medical Center
see the video
about King’s Medical Center at
courtesy of bd
D irect R elief . org
randy olsen
The Bottom 5 in
Child Mortality
(probable deaths by age 5
per 1,000 live births)
BD and direct relief: Addressing Poverty Through Partnership in Ghana
Sierra Leone 269
Located in West Africa, Ghana has a population of over 22 million, with a life expectancy at birth of 49 years of age and child mortality at approximately 112 Angola 260
per 1,000 births, according to the World Health Organization. Afghanistan 257
Direct Relief and BD have played an active role in improving healthcare in Ghana through the BD/DRI Volunteer Service Trip (VST). The VST program
provides opportunities for BD associates to strengthen healthcare systems first-hand by working with Direct Relief’s local partners—supplying advanced lab
Niger 253
diagnostics, training midwives and traditional birth attendants, and infrastructure upgrades which put health facilities like King’s Medical Center in a Mali 217
stronger position to meet the needs of their communities, where the average wage is just $1 per day. - who
www.directrelief.org winter 2009 This report was paid for by a generous bequest 3

4. photo annual
Here at Home:
Helping People in All 50 States
Direct Relief USA is the country’s largest nonprofit program providing free medications to people who are uninsured and
have low incomes. This year, Direct Relief became the only nonprofit licensed to provide prescription medications in all 50
states. Working with more than 1,000 community clinics and health centers nationwide that provide access to care for people
in need, Direct Relief USA has provided more than 10 million free prescriptions worth over $170 million to our neighbors who
cannot afford them.
Direct Relief USA was
launched because we
Within a few miles of your home, you would probably find saw the same challenge
at least one of these locally run nonprofit clinics or health met by these nonprofit
centers that flank Direct Relief USA Director Damon Taugher clinics—uninsured
and Emergency patients unable
Preparedness and to obtain needed
Response Director medications—replicated
Brett Williams. in so many American
Collectively, these communities. We looked
facilities provide for an efficient, low-
care for over 20 cost way to address this
Vinit Satyavrata, www.purelightfoto.com
million people and common problem, but
are an essential we didn’t find one. So
part of the we built it.
healthcare
safety
net in the
country.
margaret molloy
In response to the economic
downturn that has affected
the ability of patients with
diabetes to afford medical
supplies to manage their
disease, medical supply
company BD and Direct Relief
USA teamed up to provide 5
million insulin syringes and
pen needles to Direct Relief’s
partner clinics and health
centers across the U.S.
As we learned during Katrina
and in every emergency since,
william vazquez
these nonprofit, community-
based health facilities also
play an essential role when
emergencies occur. Our day-
to-day work with these local Direct Relief Survey Cited in
partners has created an efficient, New England Journal of Medicine
proven way to respond fast to
emergencies—by pinpointing assistance directly to the frontline The survey Direct Relief conducted and wrote up earlier this year about the effect of
facilities where people go and focusing on preparedness. In 2009, the economic recession on America’s nonprofit safety net clinics and health centers
Hurricane Prep Packs were provided to 25 clinic partners in 5 Gulf was cited in a New England Journal of Medicine article published November 2.
States and Puerto Rico. The mobile, waterproof packs contain Direct Relief conducted the survey in connection with a partnership with BD, which
medical items to treat 100 patients for three to five days. donated 5 million needles and syringes to help newly unemployed people with
diabetes who are now seeking care at nonprofit clinics.
The article—“America’s Safety Net and Health Care Reform — What Lies Ahead?”—
is co-authored by Irwin Redliner, M.D., of the Children’s Health Fund, with which
Direct Relief partnered on our first 50-state distribution program of Schering-
Plough–donated inhalers in 2007.
4 www.directrelief.org winter 2009 This report was paid for by a generous bequest

5. ideo photo annual
Emergency Response
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Le mer ec
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Direct Relief is currently responding to 25 emergencies. Our global network of partners built over 61 years allows us to respond fast
when emergencies strike, as occurred recently when typhoons and earthquakes slammed Southeast Asia and devastating hurricanes hit
Central America. We get good information from people we know who live there, and we get them what they need.
Typhoon Ketsana
Philippines and Vietnam
The worst storm in 40 years made landfall in Manila on September 26, causing
severe flooding, killing more than 300 people, and leaving millions homeless.
Response: ONGOING
Direct Relief is coordinating with the medical arm of Gawad Kalinga, the
country’s largest nongovernmental organization, and other Philippine groups
responding to the emergency. Direct Relief also has joined with Singapore-
based Mercy Relief and Australian Aid International, both of which have
deployed specialized medical staff to the Philippines, on the relief effort.
www.AlertNet.org, Hoi An, Vietnam
matt maccalla
REUTERS/Kham, Courtesy of
H1N1 Influenza
Padang Pandemic
Earthquake
Response: ONGOING
Indonesia
Direct Relief USA is providing 478 clinics in 49 states with
In late September, West
needed H1N1 protective items to help clinic workers stay
Sumatra was rocked by two
healthy and on the job through flu season. The five tons of
large earthquakes less than
Hurricane Ida 24 hours apart that left more
supplies was delivered free by long time supporter FedEx.
Central America than 1,000 people dead and
The support was prompted by a nationwide survey
conducted by Direct Relief USA that showed that 80
On November 5, Category 2 Hurricane Ida caused severe flooding, mudslides, and thousands more trapped under
percent of clinics and health centers have less than a
displacement across the coastal zones of Central America, killing 124 people in El a city of rubble. Nearly every
one-month supply of key Personal Protective Equipment
Salvador alone. building taller than three stories
(PPE) like hand sanitizer, gowns, goggles, and masks,
in Padang suffered damage,
Response: ONGOING which are needed to protect staff from infection. The
and, tragically, all three main
Almost $3 million in emergency medical aid was airlifted via FedEx free of charge to survey represented over 30,000 healthcare workers who
hospitals collapsed and patients
Nicaragua, El Salvador, and U.S. partner clinics treating high-need patients affected treat over four million patients annually.
had to be evacuated.
by flooding and other damage caused by the hurricane.
Response: ONGOING
Most Vulnerable to H1N1 Flu*
Children under 5
Direct Relief is coordinating with People over 65
Muhammadiyah, Indonesia’s Pregnant Women
largest civic organization, which People with chronic respiratory and pulmonary
has requested assistance, and illnesses, including asthma and diabetes
Indonesia-based Yayasan Bumi People with immunosuppression caused by
medications and HIV
Sehat. The priority goal is to
Residents of nursing homes and other
bolster availability of medical chronic-care facilities * according to the CDC
items needed to treat a range
of traumatic injuries caused by
falling debris, crush injuries,
fractures, lacerations, and
nik wheeler
www.AlertNet.org, Verapaz, El Salvador
search and rescue activities.
REUTERS/Juan Carlos, Courtesy of
A continued flow of primary
care items to help keep peoples
with pre-existing health
problems and all other “normal
illness,” will also be necessary,
especially while local resources
are reallocated for emergency
response.
www.directrelief.org winter 2009 This report was paid for by a generous bequest 5

6. (Our)
Volunteers donated over
Volunt e e r s , Dono r s , an d
People
7,300 hours of work at Direct
Relief headquarters in 2009.
That’s over 180 40-hour work weeks donated by more than 50 volunteers
per month. And these numbers don’t include the thousands of hours
logged by the organization’s unpaid volunteer Board of Directors .
Ray Muñana has volunteered at Direct Relief since 2001, often putting in over 1,000
hours a year. A retired General Motors technical writer and editor, Ray repairs medical
equipment, prepares health shipments, and keeps the warehouse staff on their toes.
Ray’s wife, Dyane Muñana, also volunteers on a weekly basis.
Peter Sturken is the driving force behind Direct Relief’s video operations,
volunteering at least 18 hours every week. His projects range from editing field footage
shot by staff to producing videos for our Web site. A veteran ABC News cameraman who
worked with the late Peter Jennings out of the Beirut bureau, Peter filmed interviews
with Mother Theresa and King Hussein of Jordan.
Three years ago, Annie Villanueva, then a Santa
Barbara High student, founded Youth for Direct
Relief, which now fields chapters at all four Santa
Barbara high schools. These intrepid students–
like Annie’s sister, Katy Villanueva– raised
over $25,000 for Direct Relief in 2009, largely
through their annual Flowers for Relief bouquet
delivery service that benefits Direct Relief with
100 percent of its proceeds.
Each year, Direct Relief is privileged to receive
support from an average of 150 companies that
share their wealth and the source of their wealth—
such as Google for
online interaction,
FedEx for logistics,
and companies
who manufacture
medicines. This
provides enormous
energy and
efficiencies, and
leverages each dollar
we receive from
generous people to
help others.
Vinit Satyavrata, purelightfoto.com
andrew fletcher
nik wheeler
photos by:
6 www.directrelief.org winter 2009 This report was paid for by a generous bequest

7. of the Year
F r i e n d s o f Di r e c t R e li e f
Our supporters’ energy fuels Direct Relief, and that energy comes in a myriad of forms.
“Direct Relief is exceptional for its
combination of the values and mission
of a humanitarian organization with the
dynamism and agility of a Silicon Valley
start-up.” – Bruce Campbell, long time Direct Relief supporter
Direct Relief’s offices have been happily infiltrated by four of
15 GlaxoSmithKline (GSK) volunteers serving with Direct Relief.
The PULSE Volunteer Partnership empowers GSK’s high-
performing employees to act as catalysts for positive, sustainable, high-impact change
in impoverished communities, at home or abroad. PULSE is rooted in Charity Navigator
the notion that transformational change and capacity-building for named Direct Relief a
NGOs can occur by enabling employees to work full-time for three to Four-Star Charity for
six months with NGOs in order to use, share and pass on their specific the fifth consecutive
professional skills and knowledge. In short, volunteers address a clear year, something only
NGO need while developing their own leadership capabilities—a great four percent of charities
example of collaborating across sectors in order to build healthcare have accomplished,
solutions for the betterment of society, and particularly for communities and we earned our
most in need. eighth straight rating
of 99 percent or better
This past year has seen explosive growth in our donors’ and other fundraising efficiency
friends’ use of social media like Facebook, Twitter, and YouTube to learn
more about our work and support our programs. The number of fans
on the Direct Relief page on Facebook has surged to over 1,500. In
September, Twitter users in Santa Barbara held a “Twestival” party
that raised $10,000. And thousands viewed our online videos, from
those taken in Liberia to the middle of a blazing California wildfire.
A LEADER IN
We’re constantly updating our donors and other fans on Facebook, Twitter EFFICIENCY
and YouTube with new articles, photos, and videos, and asking them to send us
their ideas and feedback.
AND FISCAL
RESPONSIBILITY
interns are invaluable to every function of Direct Relief—such as program
research and analysis, administrative support, event coordination, and database
management. Right now, Direct Relief is supported by 11 unpaid interns from five
colleges, including UCSB, Santa Barbara City, Westmont, and Gordon College.
Amanda Shareghi , a recent graduate of Brown University, works with the from Forbes. The scale
communications team on media relations and public affairs. of Direct Relief’s work
also continues to be
notable; the Chronicle
of Philanthropy ranked
us as the largest
Get Connected with Direct Relief international charity
in California, and the
NonProfit Times graded
us as the 87th largest
charity in America.
Learn more. facebook facebook.com/directrelief
spread the word. twitter twitter.com/directrelief
interact with
other supporters. youtube youtube.com/directrelief
even raise money! social vibe socialvibe.com/directrelief
For $25, Direct Relief will send a beautiful tribute card
in your name to someone this holiday season.
To purchase cards, or for more information, please call (805) 964-4767
or visit D irect R elief . org
www.directrelief.org winter 2009 This report was paid for by a generous bequest 7

8. Gift
bryan watt
This year, give from a sampling of our
partners’ most critical needs in more
Catalog
than 70 countries around
the world, including the
United States.
Help a Person Fight AIDS with life-saving
antiretroviral drugs.................................................. $15
Provide clean comfort for new babies
with a hospital nursery bassinet.................................. $50
Enable a Midwife to assist
100 safe deliveries. ...................................... $250
Leave a Legacy Equip a medical reservist here at home
with a “grab ‘n go” med pack for emergencies................ $500
Provide medical aid for 10,000 people
Make a legacy gift to Direct Relief and extend your generosity during a flood when a tsunami, cyclone,
beyond your lifetime. Your commitment and dedication will help or typhoon hits........................................................ $6,000
people affected by poverty, emergencies, and civil unrest live Support care for 20,000 Afghan
better, healthier lives far into the future. women and kids by underwriting the annual
operating budget for the Maladan Clinic in Afghanistan.... $25,000
For more information, contact Jill Muchow Rode, CFRE, Director of
Development jrode@directrelief.org or (805) 964-4767 x181 See the full catalog at
www.dri.convio.net/GiftCatalog2009
100% of contributions are All overhead (non-program) expenses are
covered by a generous bequest.
devoted to our programs.
NONPROFIT ORGANIZATION
U.S. POSTAGE PAID
SANTA BARBARA, CA
PERMIT #756
27 S. LA PATERA LANE
SANTA BARBARA, CA 93117
TEL: 805.964.4767 TOLL FREE: 800.676.1638
FAX: 805.681.4838
www.DirectRelief.org
BOARD OF DIRECTORS
CHAIR Dorothy F. Largay, Ph.D.
VICE CHAIR Thomas J. Cusack
SECRETARY James H. Selbert
TREASURER Kenneth J. Coates
Frederick Beckett • Jon E. Clark • Patty DeDominic • Ernest H. Drew, Ph.D.
Patrick Enthoven • Gary Finefrock • Paul Flynn • Richard Godfrey
Bert Green, M.D. • Raye Haskell • Stanley C. Hatch • W. Scott Hedrick
Priscilla Higgins, Ph.D. • Brett Hodges • Ellen K. Johnson • Donald J. Lewis
Robert A. McLalan • Rita Moya • Carmen Elena Palomo • John Romo
Ayesha Shaikh, M.D. • George Short • Gary R. Tobey • Sherry Villanueva
INTERNATIONAL ADVISORY BOARD
CHAIRMAN Frank N. Magid
Lawrence R. Glenn • E. Carmack Holmes, M.D.
S. Roger Horchow • Stanley S. Hubbard • Jon B. Lovelace
Donald E. Petersen • Richard L. Schall • John W. Sweetland
PRESIDENT CEO Thomas Tighe
HONORARY BOARD
PRESIDENT EMERITUS Sylvia Karczag
Chair EMERITUS Jean Hay
DIRECTOR EMERITUS Dorothy Adams
8 www.directrelief.org winter 2009 This report was paid for by a generous bequest