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Nepal Earthquake Anniversary: One Year Later

Relief, Recovery, and Rebuilding

April 21, 2016


Direct Relief

How much money has your charity raised for its Nepal Relief efforts?

$6,559,066 cash donations

Direct Relief is still accepting donations for this event. You can donate directly from our site:

How have you spent the donations you have received so far?

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events. For the Nepal earthquakes, Direct Relief received a total of $6,559,066 in designated cash contributions, and all of these funds have been and will continue to be used solely for relief and recovery efforts for the people of Nepal.

To date, $3,261,742 (50%) has been spent and committed on the response. Of that, $2,718,435 has been spent disbursed and an additional $543,307 has been committed and awaiting disbursement.

 As described in detail below, the Nepal-designated funds have been used in two basic ways:

  • to mobilize and deliver medicines, medical supplies, and durable medical equipment requested by partner organizations in Nepal and approved by the Government of Nepal, and
  • to provide locally run Nepalese organizations with financial assistance – in the form of cash grants – to support relief, recovery, and other essential health-related activities serving people affected by the earthquakes.

Medical Material Support: In the immediate aftermath of the earthquake, Direct Relief’s offers of assistance were met with requests from partner organizations, health facilities, and the Nepal government to provide extensive supplies of medications, medical supplies, and durable medical equipment.

In response, Direct Relief provided a series of emergency airlift deliveries from the U.S. of specifically requested and approved items, drawn from available inventories.   Simultaneously, Direct Relief purchased in India other specifically requested items, such as surgical instruments, orthopedic implant sets, and digital x-ray equipment, and arranged and managed the physical delivery of the products to the requesting facilities in Nepal via direct flights or overland transportation.

As of March 30, 2016, these efforts have resulted in the delivery to partners in Nepalof329,848 lbs. (164.9 tons, or 149.6 Metric Tons) of requested emergency medicines and medical supplies with a wholesale value of $36,180,530.55.  This humanitarian material assistance was furnished through 40 specific donations to requesting partner organizations and the government. Direct Relief arranged for and managed all logistics, transport, and physical delivery of these medical products to where they were needed throughout the affected regions.

Direct Relief’s humanitarian assistance to Nepal in the form of medical material has been among the largest response efforts the organization has ever conducted since the organization’s founding in 1948.  In relation to the sheer magnitude of the humanitarian medical material assistance that has been provided, related cash expenditures have been very modest – a total of $1,226,918 in cash has been spent to accomplish these activities.  This is due to the extensive support that Direct Relief has received from dozens of contributors of essential inkind medical material that was required and services related to air transport and logistics.

We note, with deep appreciation, that Direct Relief averted what would have been significant costs (and expenditure of donor funds) related to the first two airlift charters of 60 tons of humanitarian medical essentials from the U.S. to Nepal because FedEx donated its aircraft, flight crews, and tremendous logistics backbone and team for two full-plane charters.  Similarly, significant cash expenditures related to necessary in-country helicopter transport of goods to affected areas were averted because of the support provided to Direct Relief at no cost by the United Nations Humanitarian Air Service (UNHAS).

The following list outlines the specific recipients who received a donation from Direct Relief and includes the value of goods donated.


Recipient in Nepal

Value of Medical Resources Delivered (USD)

Number of Donations

United Mission Hospital, Tansen



Civil Service Hospital



Midwifery Society of Nepal



Himalayan HealthCare Nepal



Bayalpata Hospital



Manamohan Memorial Hospital



One Heart World-Wide - Nepal



Nepal Orthopaedic Hospital



Dhulikhel Hospital Nepal



Namche Clinic



Doctors For You Field Hospital



Spinal Injury Rehabilitation Centre



Department of Water Supply and Sewerage



Light of the Buddha Dharma Foundation



Maiti Nepal



Medical Teams International - Nepal



Mercy Relief Field Hospital



Sri Sathya Sai Seva Central Trust Nepal



Hospital and Rehabilitation Centre for Disabled Children



Team Rubicon Nepal



Ministry of Health and Population



Mobile Medical Team Nepal



Kathmandu Model Hospital/ Public Health Concern Trust-NEPAL



Patan Hospital







Financial Assistance to Nepalese Organizations:  In addition, Direct Relief has allocated more than $2 million USD in cash grants to locally-run organizations on the ground in Nepal to conduct medical outreach in earthquake-affected areas; to reconstruct damaged and destroyed health facilities and hospitals; and to provide maternal and child health support to rural earthquake-affected communities.  A list of cash grants awarded to Nepal-based organizations can be found below.


Partner Organization

Response Activities

Grant Amount (USD)

Doctors for You/Ministry of Health and Social Welfare

Emergency operations and medical supply

and equipment procurement and support for Nuwakot District healthcare services


Hospital & Rehabilitation Centre for Disabled Children (HRDC)

Emergency operations, medical and surgical outreach facility repair and expansion, and

post-earthquake patient services


Midwifery Society of Nepal


Addressing the increased risks posed

to pregnant women and newborns


Namche and Khunde Clinics

Provision of software that provides physicians with recent clinical guidelines and notes for patient care


One Heart World-Wide

Neonatal Health System Rebuilding in Sindhulpalchowk and Dhading Districts


Possible Health

Health Sector Rehabilitation and

Improvement in Dolakha District


Spinal Injury

Rehabilitation Centre


Emergency operations, facility expansion, post-earthquake patient medical and rehabilitation services, provision of specialized wheelchairs and other assistive devices, training sessions and workshops for staff members and medical professionals from district-level facilities


Clean up Nepal

Promotion and supplies for a national awareness campaign and IDP camp sanitation monitoring and hygiene-related health education


Shakti Milan Samaj

Providing blankets and warm clothing to families living in tent communities in earthquake-affected regions




Nepal Cancer Support Group

Cervical and Breast Cancer Education and Screening Programs


Western Regional Hospital

Repaired and replaced damaged specialized medical equipment at Pokhara, Western Regional Hospital



Total Grant Amounts Awarded To Date                                                                                   



What are your charity's plans to spend the money you have received, in the future?

Direct Relief is committed to spending the remaining funds to strengthen Nepal’s healthcare infrastructure, specifically focusing on the provision of services to the most vulnerable in society, and help to prepare the country for future disasters. Direct Relief’s efforts will focus on four areas:

1.       Improving maternal and child health

Pregnant mothers, newborns, and young children are the most vulnerable to the ongoing health impacts created by the earthquake. With a continued lack of adequate shelter and a lack of, or disrupted, access to government health services, there is a real need to maintain support to maternal and child health programs and facilities caring for pregnant and new mothers. To achieve this, Direct Relief will continue to provide cash grants to local organizations that are providing excellent maternal and child health care to earthquake victims. For instance, the Direct Relief partner One Heart World-Wide, which received a cash grant of $477,353, has been working with the Nepal government since before the earthquake to promote and implement safe maternal and child health programs in northern Nepal. In response to quake damage, One Heart World-Wide established temporary birthing facilities in the affected communities and is working with the government to rebuild damaged or destroyed health facilities. They are also conducting training of Skilled Birth Attendants and organizing community health outreach services.

Direct Relief is also supporting and empowering local midwives by providing specialized midwife kits developed in partnership with the International Confederation of Midwives (ICM). The Midwifery Society of Nepal (MIDSON) has been continuously providing midwifery services in affected areas since the earthquake. After the earthquake, MIDSON deployed midwives to provide support to pregnant mothers in the most affected districts. Since the earthquake, Direct Relief has been enabling the work of these midwives through the provision of the ICM certified Midwife Kits that each contain enough supplies for 50 safe births. Direct Relief will continue to support MIDSON as these midwives provide essential lifesaving care to pregnant and new mothers who have been displaced or isolated from adequate healthcare facilities as a result of the disaster.

2.       Providing critical cash grant funds to local healthcare partners.

The Nepal earthquakes caused a massive amount of damage to the existing healthcare system. Many hospitals and other health facilities were damaged or destroyed in both urban and rural areas. In many areas this has meant that earthquake survivors have either a reduced or no access to local healthcare facilities. This means that there is still an urgent need for both immediate health services – medical teams, outreach medical missions, temporary field medical facilities, financial assistance to hospitals, and health monitoring – as well as a profound need for the reconstruction, repair, and resupply of health clinics and hospitals across the affected districts in the medium- to long-term. Direct Relief has funded ongoing programs through cash grants, and is currently evaluating new grant requests from: Nepal Cancer Support Group, Children’s Hospital for Eye ENT (Ear, Nose & Throat) and Rehabilitation Services (CHEERS), and the Light of the Buddhadharma Foundation. All of these groups are providing critical care to patients in their respective service areas to ensure their health and wellbeing.

3.      Providing medical resource support to healthcare facilities

Direct Relief is committed to providing ongoing long-term support to its local partner network in Nepal. Public and private charitable health facilities, and medical agencies face many challenges in providing free or affordable medical care to low-income and indigent Nepalese people at the best of times. In the wake of the 2015 earthquakes, these groups face new challenges providing care to those who need it most. Direct Relief will continue to do whatever it can to support these local partners with ongoing donations of specifically requested medicines and medical supplies. Following the use of all disaster-designated funding, Direct Relief will work to integrate new partner facilities into its general medical assistance efforts.

4.      Preparing for the future: Disaster preparation and building resiliency

Before the 2015 earthquakes, Nepalese people talked about the ‘Big One’. The Big One refers to the feared cataclysmic earthquake that is predicted to strike Nepal and is well overdue: last year’s earthquake was not the Big One. There is a real need, therefore, to work with the Nepalese government and Direct Relief’s local partner network in order to prepare for any future calamity, whether it by an earthquake, landslide or flood.

By pre-positioning emergency medicines and supplies, expanding its partner network in Nepal, providing regular support through the donation of medicines and supplies, and assisting health partners to build back better, Direct Relief assists in fostering resiliency among at-risk communities and thus help reduce the impacts of future natural disasters. Direct Relief also stands ready to mobilize, at scale, if or when another disaster occurs.

Direct Relief’s experience responding to the Haiti earthquake, Typhoon Haiyan, the Nepal Earthquake and a myriad of other natural disasters has demonstrated the necessity of having pre-positioned and ready-to-ship supplies. Direct Relief will support more healthcare partners across the affected areas of Nepal to improve access to healthcare services and to increase the ability to rapidly respond in the event of another disaster. Direct Relief also is working with partners in Nepal on in-country plans to pre-position emergency medicines and medical supplies, an approach that has proven effective in many areas prone to natural disasters.

How did your charity come up with its plan for response in Nepal? And how long did that process take?

  • Direct Relief recognized immediately that a complex health emergency had occurred in Nepal similar to others in which Direct Relief has often been deeply involved. This allowed for certain elements of the plan – identifying international transport and in-country logistics options, protocols for information gathering and assessment – to be put in place immediately.
  • Direct Relief’s core expertise involves the provision of prescription medications and other health commodities, and clarity about that role also lends itself to specific planning about immediate assessments and information that will drive specific decisions – for example, which drugs or supplies may be required in what amounts and in which specific facilities will they be received, stored, and used.
  • The earthquake simultaneously caused a mass-trauma event that spiked demand for medical services while also diminishing the existing limited-capacity health infrastructure and inventories in the country, as well as the existing general infrastructure and distribution channels.
  • Those insights shaped the approach to the immediate response, as did Direct Relief’s longstanding basic approach – for emergencies and in ongoing programs – of identifying and supporting key local institutions and organizations.  In Nepal, Direct Relief already had ongoing partnerships with several such local organizations, so one obvious element of the immediate response plan was to address the needs of the already approved and existing partner organizations.
  • Direct Relief’s approach to disasters is to support the immediate needs of survivors by working with local partners best situated to assess, respond, and prepare for the long-term recovery. Each emergency has specific characteristics that are dependent upon local facts and circumstances. Direct Relief coordinates with local, national, and international responders to avoid duplication of efforts, logistical bottlenecks, and to ensure efficient use of resources. Disaster-relief efforts require rapid response, but the help must be of the right type.
  • Direct Relief’s response efforts are fast, yet they are always in direct response to specific requests from local partners and are coordinated with other international organizations and governmental authorities to ensure the most efficient use of resources. Experience has taught that the basic tenets of responding to specific needs and involving the local people are essential, particularly in an emergency setting.
  • Direct Relief’s main objective in any large-scale emergency response is to deliver emergency medicines and medical supplies – that are requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible. Because it works with organizations in 70+ countries, Direct Relief has existing relationships and vetted partnerships with health institutions that it supports on an ongoing basis. Nepal was no different. There were long-term existing partnerships and a Direct Relief staff member was on the ground in Kathmandu within 48 hours to start liaising with them as well as with UN agencies, the Nepal Ministry of Health and Population (MoHP), and with other national and international health organizations to quickly understand the needs and then respond appropriately.
  • Immediately after the news about the April 25th Nepal earthquake broke, Direct Relief started putting together lists of inventory of appropriate emergency medicines and supplies, allocating funds, and reaching out to partners on the ground. Based on the expressed needs of the MoHP, Direct Relief procured and supplied essential items such as: antibiotics, pain medications, IV solutions, wound care items, surgical supplies, pediatric medicines, and various orthopedic supplies. Direct Relief also used funds to replace damaged equipment such as portable x-ray machines, ventilators, equipment sterilizers, wheelchairs, orthopedic implants and hardware, and other essential items.

Have there been any specific programs, initiatives or services that you have provided towards your relief efforts in Nepal?

  • As noted above, Direct Relief has focused its response efforts to improve the healthcare infrastructure and increase access to maternal and child health services. Through cash grants and in-kind donations of medicines and supplies, Direct Relief will continue to support healthcare facilities throughout Nepal.
  • Direct Relief has signed an MOU with the Nepal MoHP. This unique agreement has enabled Direct Relief to provide local healthcare partners with medical support on an ongoing basis. It has also enabled Direct Relief to work with and fund other organizations to carry out their own initiatives, such as rebuilding and rehabilitating the entire health system of an earthquake-affected district. The MoHP then turned to Direct Relief for help during a nationwide drug shortage caused by a blockade at the India–Nepal border. Direct Relief responded by coordinating two shipments containing $7,157,763.54 of specifically requested medicines and supplies. The MoHP and the National Centre for AIDS and STD Control have also requested emergency donations of anti-retroviral drugs (ARVs) for patients whose regimens were disrupted by the earthquake, blockade, and/or drug manufacturer delays. Direct Relief delivered three donations of desperately needed ARVs, eliminating dangerous gaps in medication adherence.
  • Direct Relief, in consultation with experts from the International Confederation of Midwives (ICM), designed the first-ever Midwife Kit endorsed by ICM. Each Midwife Kit contains the 59 essential items a midwife needs to perform 50 facility-based deliveries.  Through the Midwifery Society of Nepal (MIDSON), Direct Relief has distributed 100 Midwife Kits to support midwives working throughout the earthquake-affected region of Nepal.

What do you believe is the most immediate necessity for the people of Nepal? Do you feel as though there has been significant enough progress in regards to such?

  • Consistent with Direct Relief’s basic characteristic as a support organization and partner to locally run health programs in Nepal, we would note respectfully that it is the judgment of the people of Nepal – not Direct Relief – that matters with regard to immediate necessities and priorities, as well as near- and longer-term ones. Direct Relief’s focus, partnerships, and activities relate primarily to health services in Nepal, and one year on from the earthquake, substantial unmet needs remain across the spectrum of health services. Direct Relief continues to work with and believe it important to direct designated funds towards activities that will provide essential care to those most affected by the earthquakes – such as persons who sustained long-term disabling injuries – and those, such as pregnant women and young children, who are generally more vulnerable and increasingly so in post-earthquake circumstances.  Direct Relief recognizes however, that the earthquake created many other critical needs in areas such as health, infrastructure, education, housing, and economic development in which the organization does not focus.
  • With regard to health services, Direct Relief remains committed to assisting as expansively as possible in the recovery and reconstruction efforts in Nepal with partner organizations.  Significant unmet needs remain in this area. Tens of thousands of families spent monsoon season and the winter months without adequate shelter which contributed to a number of deaths and exacerbated existing health problems. In addition, most of these at-risk and extremely vulnerable people have still not received any of the promised funds, construction materials, or information on the building of earthquake-resistant homes. The long-awaited National Reconstruction Campaign was finally launched on January 16th, 2016, but many of those whose homes were destroyed will continue to live in unsafe and unhealthy conditions for months.
  • The effects of disasters of the magnitude of the Nepal earthquake are long term, and significant humanitarian needs are likely to remain for several years. Direct Relief was providing humanitarian support to partners in Nepal before the earthquake and immediately responded to the emergency in Nepal, and is now supporting partners through assistance with recovery and rehabilitation efforts, which will continue.
  • Direct Relief also must help address disaster mitigation and preparation by working with partners to reduce potential risk and increase preparedness for a future emergency. 

Has your charity engaged in any joint collaborations with other charities or organizations with respect to your work in Nepal?

Direct Relief’s efforts are rooted in collaboration with locally-run healthcare organizations. Since the Nepal earthquakes, Direct Relief has worked with:

  • One Heart World-Wide on maternal and child health services
  • Possible Health on reconstruction and provision of health services in affected districts
  • The Midwifery Society of Nepal (MIDSON) on maternal and child health services
  • The Hospital and Rehabilitation Center for Disabled Children (HRDC) on health service provision for children and reconstruction of hospital facilities
  • The Spinal Injury Rehabilitation Centre (SIRC) on health service provision for indigent Nepalese with spinal injuries, and upgrading and renovation of hospital facilities
  • Doctors For You on medical team outreach to earthquake-affected communities
  • Nepal Ministry of Health and Population
  • Nepal Ministry of Health and Social Welfare
  • World Food Programme, LogsCluster, WHO and OCHA
  • Shakti Milan Samaj on providing warm blankets and clothing to families living in earthquake-affected tent communities 

Overall, what do you think have been the greatest successes of the philanthropic response to the Nepal earthquake?

Direct Relief has successfully delivered 329,848 lbs. (164.9 tons, or 149.6 Metric Tons) of specifically requested emergency medicines and medical supplies to support both public, and private nonprofit, healthcare facilities and programs.

Direct Relief has contributed $38,215,374.55 in financial and material aid to Nepal in the past year.

Some highlighted activities from this past year include:

  • One Heart World-Wide – Equipped 35 birthing centers with a complete set of birthing equipment and trained 172 health workers and 240 female community health volunteers.
  • Midwifery Society of Nepal – Supplied 100 Direct Relief Midwife Kits to ensure 5,000 safe deliveries. Purchased a 4x4 truck to safely deliver the kits and provide ongoing training and support to Midwives in the most remote regions of the country.
  • Namche and Khunde Health posts – Supplied two health posts in the remote Solukhumbu District with software to ensure they are up to date on medical advice and references.
  • Possible Health – Completed the construction of a fully equipped health center in the Dolakha District with 20 more underway.
  • Clean up Nepal – Conducted a nationwide cleanup event with 39,031 volunteers that resulted in the collection of 282,699 kilograms of waste collected at 106 locations in 38 cities throughout Nepal.
  • Spinal Injury Rehabilitation Centre – Increased the capacity of their facility by an additional 40 beds, provided medical and rehabilitation equipment to handle the large increase in patients after the earthquakes, and supported multiple training sessions and workshops for staff members.
  • The Hospital and Rehabilitation Center for Disabled Children – Broke ground on a hospital renovation project to build a new ward containing 30 beds, one nursing station, and a small management room. 

What else would you like donors to be aware of regarding your organization's efforts in Nepal?

Direct Relief’s activities in Nepal won’t end after a year or two; it will continue to offer assistance to local Nepali health partners on an ongoing basis.  The goal of Direct Relief is to help build a sustainable healthcare infrastructure in Nepal, which will be an ongoing, multi-year process.

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