2009 Summer Newsletter

THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST

SPECIALREPORT:HELP FOR THE U.S.

UNINSURED

JESUSITA FIRE

RESPONSE

H1N1Flu

ResponsePAGE FIVE

GULF COAST HURRICANE PREPPAGE FOUR

UNINSUREDAND ASTHMATIC?BREATHING EASIERPAGE THREE

WWW.DIRECTRELIEF .ORG

STRENGTHENING THE SAFETY NET

for19 MILLION

PATIENTS NATIONWIDE

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2 WWW.DIRECTRELIEF.ORG PAID ADVERTISEMENT SUMMER 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST

The

HEALTH SAFETY NET

CRISIS IS REAL.

“ There’s not a single health center that doesn’t tell me that they have more patients coming in the door any given day than they can possibly handle.” – Dan Hawkins, National

Association of Community Health Centers Policy Director, as told to the Chronicle of Philanthropy

“ We reject the notion that if you’re poor and uninsured, it’s acceptable that you don’t get the care and medicine you and your child needs. We serve people who aren’t served by markets and government.”

– Thomas Tighe, Direct Relief President and CEO

Direct Relief USACHARITABLE CARE FOR 60 YEARS, TODAY, TOMORROW

THERE ARE MORE

UNINSURED PEOPLE IN LOS

ANGELES THAN

THERE ARE RESIDENTS

OF MONTANA.

NEARLY 46 MILLION AMERICANS LACK HEALTH INSURANCE, and that number grows daily as fi nancial pressures push many more people into a position of needing help

. But quietly, every day, more Americans are getting the care they need at their local nonprofi t community clinics and health centers

. Direct Relief USA is supporting more than 1,000 of these clinics in all 50 states. Since 2004, we’ve provided more than 10 million free prescriptions worth over $140 million for our neighbors who cannot afford them

. It’s a high-impact, low-cost program made increasingly important as the economy has faltered. The network and information systems built to run this program have aided fast and precise responses to emergencies that hit here at home, from fi res to hurricanes to the daily emergency of unmet need for medicines

. While we’re likely better known as an international and emergency response organization, Direct Relief has assisted U.S. partners for over 60 years. In 1948, our founders William Zimdin and Dennis Karczag

organized shipments of food, clothing, and medical aid out of a pantry

in Zimdin’s Santa Barbara home. While most attention was focused on postwar recovery in Europe, they kept a close eye on local needs, too. Just as a worldwide emergency was the impetus for our creation, local emergencies prompted the beginning of our programs domestically, largely in our home state of California, like the Northern California fl oods of 1956

and the local Coyote Canyon Fire of 1964. Later, when devastated parts of the nation needed help—the Bay Area after the earthquake of 1989, the Midwest during the fl oods of

1993, the Gulf Coast during Hurricanes Katrina and Rita in 2005

—Direct Relief drew rapid, effi cient responses from a long history of providing emergency aid.

Likewise, our everyday work with clinics and health centers was incubated over decades of support to the under-resourced medical safety net. In 1970, Direct Relief was instrumental in the launch of the Isla Vista Neighborhood Clinic near the University of California at Santa Barbara. Donated exam tables, surgical instruments, and pharmaceuticals helped outfi t the fl edgling clinic. Last year, the clinic and its two Santa Barbara affi liate clinics provided 48,000 low-income patient visits.

As the national healthcare crisis grew, we grew as well—to hold licenses that enable us to be a wholesale pharmacy distributor in all 50 states and the District of Columbia; to conduct massive responses to natural disasters and prepare the most vulnerable regions for future emergencies; to become

the largest nonprofi t program of its kind. In close partnership with these private nonprofi t safety-net clinics that are the healthcare “homes” for 19 million Americans throughout the country, Direct Relief USA is positioned, right now, to help ensure that the most desperate individuals and families have access to healthy lives

.

NEARLY 2/3 OF ALL BANKRUPTCIES STEM FROM INABILITY TO PAY MEDICAL BILLS.

– The American Journal of Medicine,June 2009

SPECIAL REPORT: Direct Relief USA

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WWW.DIRECTRELIEF.ORG PAID ADVERTISEMENT SUMMER 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST 3

Direct Relief USA and Teva Pharmaceuticalshelp 500,000 ASTHMA PATIENTS

ANGELS COMMUNITY CLINIC Murray, KY

“This is a prayeranswered. Thank you sovery much.”

RENITA CARTER, Executive Director

HEALTH CARE FOR THE HOMELESS, INC. Baltimore, MD

“We very much appreciate thegenerosity of Teva Pharmaceuticals in helping us serve our very vulnerable and indigent clients.”

JEFF SINGER, President & CEO

YORK COUNTY COMMUNITY ACTION CLINIC Sanford, ME

“Because we provide care at the homeless shelter, we were thrilled to get the inhalers. Many of these patients have no health insurance—not even Medicaid—and fi nding resources to buy medicine is a real challenge. Your contribution means a great deal to people who have very, very little. On theirbehalf, please accept our thanks!”

BARBARA CRIDER, Director, Health Services

GOasthmatic, uninsured, now what?Search

SINCE FEBRUARY, DIRECT RELIEF USA HAS SUPPORTED MORE THAN 500 CLINICS IN ALL 50 STATES WITH TEVA’S PROAIR® INHALERS.


ou just lost your low-income job and with it your health insurance, which was thin to begin with. You’re asthmatic—an often chronic condition—and you’ve tried enrolling in an inhaler manufacturer’s Patient Assistance Program but that requires access to a doctor and now

you can’t afford to see one. So what do you do? The local emergency room is an option, but those are stretched to capacity by the throngs of others also doing their best to access health care.

Where do you go to get help with your asthma?You are not nearly as hypothetical as we all wish you were. You, along with millions of other Americans weathering similar circumstances, will

most likely leap for the safety net—thousands of community based nonprofi t clinics and centers providing key points of access to health care. More than 16 million patients receive care at these clinics and health centers, and on average 40 percent of these patients have no health insurance.

The national associations that bring these independent healthcare facilities under one umbrella are at the forefront of assisting clinic efforts to reach patients facing diffi cult economic straits. So when the largest generic pharmaceutical manufacturer in the world sought Direct Relief USA’s help in distributing 500,000 ProAir® HFA

inhalers among asthma patients in need nationwide, Direct Relief gauged clinic demand through long-time partners the National Association of Community Health Centers and the National Association of Free Clinics. “On a daily basis, we work to get donated medicine in the hands of sick people,” explained Direct Relief USA Director Damon Taugher. “Working through the national health center and clinic associations, Teva Pharmaceutical’s extraordinary donation was aimed at those most in need.” In the heart of one of the poorest districts in California (over 40 percent of the 15th Congressional District’s children are uninsured—the highest percentage in the country), Harbor Community Clinic in San Pedro sees 1,800 patients each month. Sixty-three percent of Harbor Community’s patients live on less than $500 per month—well below the federal poverty level. Executive Director Michele Ruple believes that Harbor Community’s patients deserve the respect of quality healthcare. “There’s a misconception that the uninsured are not working individuals…they are,” says Ruple.

“They often perform some of the most dangerous jobs in the community or other essential services. We are a safety net so these hard working individuals can maintain their health and get needed medical care.”

Harbor Community treats 600 asthmatic patients each month. The clinic received 200 of Teva’s donated inhalers. Ruple was thrilled with the company’s generosity and Direct Relief ’s distribution model. “On behalf of the patients in the Harbor Area as well as our medical staff,” she said, “we thank you for this most generous donation to those in need!”


Hurricanes are an annual potential disaster for people living along the Gulf Coast, particularly those who are low income, have chronic medical conditions, or have limited access to transportation to evacuate. Of the 12 storms predicted between June 1 and November 30 this year, forecasters say six will become hurricanes and two will reach Category 3 or more. Last year’s devastating hurricane season produced a record number of storms. Five of the 16 storms were Category 3 or higher, and for the fi rst time on record, six consecutive storms made landfall in the U.S. The low-income, uninsured people who are disproportionately affected by damaging hurricanes are the same patient population seen at Direct Relief ’s partner clinics and health centers. To ready these clinics, Direct Relief USA and Abbott have engaged, expanded, and improved the three-year-old Hurricane Preparedness Program to healthcare providers in “hurricane alley.” In 2008, Direct Relief ’s HURRICANE PREP PACKS were indispensable to the physicians at the 18 U.S. clinics that received them, as well as to the evacuee patients these clinics treated. If an

emergency strikes this year, medical supplies will be on hand or close by, enabling providers to respond quickly to the medical needs of those affected.

FLORIDA, PUERTO RICO JOIN PROGRAMThis year, Direct Relief deployed 25 HURRICANE PREP PACKS to partner clinics and health centers in Alabama, Louisiana, Mississippi, and Texas, and expanded assistance to new partners in Florida and Puerto Rico. Five additional packs stand at the ready in Direct Relief ’s warehouse in case a hurricane strikes another area. Recipients were selected for their location, past experience with emergency response, patient population, and capacity to treat victims during an emergency. Each HURRICANE PREP PACK holds enough medical supplies to treat 100 patients for a variety of conditions, from injuries to chronic illnesses, for three to fi ve days. At a wholesale value of almost $12,000 for each pack, contents were informed by responses to Hurricanes Katrina and Rita in 2005, work with the Texas Blue Ribbon Commission on Emergency Preparedness and Response, and constant feedback from recipients since the program began in 2007. Prep Pack contents can be easily absorbed into regular clinic inventory to avoid waste if not needed in an emergency. The waterproof packs are designed for use in clinic settings or at alternate care sites, and are easily transported, as recipients demonstrated last year. Coastal Family Health Center in Gulfport, Mississippi, used the HURRICANE PREP PACK it received in 2008 aboard its mobile medical unit, which traveled to evacuation shelters in Texas and Louisiana during Hurricanes Gustav and Ike. Guadalupe Health Center in Texas received last year’s Prep Pack just a few days before hurricane Dolly struck and fl ooding destroyed the clinic. They were able to fl ee the clinic with the Prep Pack and use it to treat evacuees while the clinic was closed.

READY

TO LEARN MORE about hurricane preparedness in the U.S. and vulnerable Caribbean countries—and hear how Direct Relief’s Prep Packs came in handy last year—visit: DirectRelief.org/EmergencyResponse/2009/HurricanePrepProgram.aspx

Direct Relief PREPARES CLINICSALONG THE GULF COAST

FOR THE 2009 HURRICANE SEASON


HURRICANEPREP PACK PUERTO

RICO

DIRECT RELIEF’S EMERGENCY RESPONSE COORDINATOR BRETT WILLIAMS REVIEWS THE CONTENTS OF THE IMPROVED 2009 HURRICANE PREP PACK WITH JUDITH PEREZ, RN AT LAFAYETTE COMMUNITY HEALTH CARE CLINIC, LOUISIANA. THE PACK WILL HELP PREPARE THE CLINIC FOR WHAT IS PREDICTED TO BE AN ACTIVE HURRICANE SEASON. FOLLOWING HURRICANES KATRINA AND RITA, LAFAYETTE COMMUNITY HEALTH CARE CLINIC TREATED THOUSANDS OF DISPLACED EVACUEES.

Anti-infectives Biaxin and Omnicef from Abbott; FreeStyle Test Strips, FreeStyle Freedom System Kits, Sure Dose Syringes and FreeStyle Lancets for diabetes care, also all from Abbott

Atenolol, Metoprolol, to treat hypertension

Advil tablets for pain management from Wyeth

Albuterol for asthma

Povidine iodine for preventing wound infections

Anti-infl ammatory ibuprofen and Children’s Tylenol tablets

Epipens for emergency epinephrine doses

Carbamazepine, Depakote from Abbott, and Gabapentin for seizure control

Gentamicin and Sulfacetamide Opthalmic Solution for eye infections

Silver Sulfadiazine Cream for burns

Metformin for management of diabetes

Stethoscope, blood pressure cuffs and exam gloves

Gauze and elastic bandages for wound care

Clotrimazole and triple antibiotic ointment for skin infections

PREP PACKS provided to U.S. clinic partners CONTAINED MEDICAL ITEMS TO TREAT 100 PATIENTS FOR 3-5 DAYS:

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H1N1 Flu ResponseDirect Relief coordinated its response to the H1N1

infl uenza outbreak in March with responding partners and associations in the U.S. and Mexico for the most effective and targeted provision of medical aid. With the Centers for Disease Control and Prevention recommending that clinicians use protective supplies to prevent transmission of the new viral strain, Direct Relief immediately sent requested materials to clinics and community health centers in California and Texas. This provision included Tylenol to treat patients’ fever symptoms, N95 particulate respirators, and hand sanitizer products. N95 respirators, or protective masks, were specifi cally indicated by the U.S. Centers for Disease Control and Prevention to help prevent transmission of the virus. The National Institute of Pediatrics in Mexico City—a nonprofi t children’s hospital that provides care at low or no cost—received an emergency aid provision of 5,000 N95 particulate respirators, Tylenol, gloves, and hand sanitizer product. Direct Relief thanks BD, Cera Products, Inc., Henry Schein, and the Johnson & Johnson Family of Companies for their generous contributions to the H1N1 fl u emergency response.

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READ MORE AND WATCH A VIDEO OF THE MASK DISTRIBUTION at:www.DirectRelief.org/EmergencyResponse/2009/JesusitaFire.aspx

JESUSITA FIREJESUSITA FIRERESPONSE

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Jesusita by the NUMBERS30,500 PEOPLE EVACUATED8,733 ACRES BURNED24,000 N95 PARTICULATE RESPIRATORS

DISTRIBUTED

FOR MORE INFORMATION, VISIT THE WHO at:www.who.int/csr/disease/avian_infl uenza/phase/en/index.html

AWARDED HIGHEST GRADE FOR SECURITY, COMPLIANCE

The National Association of Boards of Pharmacy has approved Direct Relief as the nation’s fi rst nonprofi t recipient of Verifi ed-Accredited Wholesale Distributor (VAWD) certifi cation. This achievement means that we meet or exceed the highest security and compliance standards for the distribution and storage of medical goods, and have the strongest controls on materials of any nonprofi t. Other organizations with this high certifi cation include leading businesses like CVS, UPS, and Walmart, among others.

LICENSED TO HEAL

Direct Relief holds the licenses to distribute prescription drugs in all 50 states and the District of Columbia. This, on top of our federal registrations and certifi cations, lets us receive and deliver highly controlled materials, and allows us to reach any clinic, health center, and state or local government who require assistance in an emergency. Like our VAWD accreditation, Direct Relief is the only nonprofi t in the U.S. to hold this level of licensing.

PREPARING OURSELVES FOR EMERGENCIES

The best emergency preparedness begins at home, and Direct Relief’s home in Santa Barbara, California is no exception. We recently completed a 30-month project of planning, permitting, and installing an electric generator to ensure that our operations can continue to run in the event of a power failure for six days without refueling. This backup capacity is crucially important for medical materials in our warehouse that require strict temperature controls, and for ensuring our ability to respond in the event of a regional emergency.

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WAREHOUSECHATTER


watchvideo of the panel at

MilkenInstitute.org/events/gcprogram.taf?function=

etail&EvID=1637&eventid=GC09

HEALTH INITIATIVES SUPPORTING MOTHERS WORLDWIDEThe World Health Organization estimates that a woman dies each minute from complications during pregnancy and childbirth—more than 500,000 each year worldwide. In developing countries, pregnancy is a life-threatening condition, as pregnancy and childbirth are the second leading cause of death among women of reproductive age. Many of the risks for pregnant women and children in developing countries are related to general conditions of poverty, nutrition, and severely limited health resources and access that affect everyone. Direct Relief focuses on maternal and child

health—interventions that directly address the specifi c threats to women during pregnancy through childbirth: expanding access to care by bolstering

in-country health systems; ensuring safe delivery through midwife training and kits; addressing complications with emergency obstetric care; restoring health through obstetric fi stula prevention and care; and preventing mother to child transmission of HIV.

We interrupt this report to bring you…

THE REST OF THE WORLD

100% OF CONTRIBUTIONS ARE DEVOTED

TO OUR PROGRAMS. All overhead (non-program) expenses are covered by a generous bequest.

MILKEN INSTITUTE, GLOBAL CONFERENCE 2009Direct Relief President and CEO Thomas Tighe participated on a panel called “Global Aid Workers: Heroes on the Front Lines” at the Milken Institute’s Global Conference 2009.

FIND IT at

DIRECTRELIEF.ORG

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watchvideo from JFK Medical

Centre and meet the women whose health has been

restored through obstetric fi stula repair.

DirectRelief.org/ourfocus/mch/

obstetricfi stula.aspx

learn more DirectRelief.org/

EmergencyResponse/2009/CycloneAila.aspx

CYCLONE AILA RESPONSEAsia Program Offi cer Matt MacCalla was in Bangladesh when Cyclone Aila struck the country’s and India’s southern coasts on May 25. Matt was conducting a follow up assessment trip with partners who responded to 2007’s Cyclone Sidr, and was coordinating the placement of emergency cyclone and fl ood modules in anticipation of this upcoming cyclone season. In response to Cyclone Aila, Direct Relief shipped the critically needed cyclone and fl ood relief modules along with a provision of essential pharmaceuticals and supplies to partners who were already serving thousands of people injured and displaced by the storm. Four disaster preparedness and response modules have been air-shipped to partners in Bangladesh and India. Cyclone Aila affected more than 3.6 million people, left more than 750,000 people homeless, and took 300 lives.

learn more about mothers and children

living healthier lives at

DirectRelief.org


Who’s thinking of Direct Relief?Named Direct Relief the nation’s #1 Slam-dunk Charity, and recognized Direct Relief as “exceptional” for earning a Four-Star Charity rating fi ve years in a row.

YOUTH FOR DIRECT RELIEFA dynamic group of students from fi ve Santa Barbara high schools raised more than $25,000 for Direct Relief programs through their March fl ower sale. That’s an A+ to us.

The medical supply manufacturer and corporate supporter featured Direct Relief and its partner volunteer project in Ghana in the May issue of National Geographic Magazine.

The Santa Barbara County Medical Reserve CorpsDirect Relief committed to equipping volunteer emergency health professionals with custom-designed backpacks outfi tted with supplies appropriate for emergency-response.

3M Abbott Aearo Company Alcon Laboratories, Inc. Alkermes, Inc. Allergan, Inc. American CleanStat, LLC American Health Products Corporation Amgen Foundation, Inc. Amsino International Aramco Services Company AstraZeneca Baxter International Incorporated Bayer Consumer Care BD Beaumont Products Inc. Boehringer Ingelheim CARES Foundation Bristol-Myers Squibb Company Carlsbad Technology, Inc. Cera Products, Inc. Chattem Inc. Cobalt Laboratories Colgate-Palmolive Company ConMed Corporation Covidien Cumberland Pharmaceuticals

CVS CorporationCypress Medical Products Cypress Pharmaceutical, Inc. DAVA Pharmaceuticals, Inc. Den-Mat Corporation Dey Laboratories Dr. Reddy’s Laboratories LTD. E. Fougera & Company ETHICON Evo Medical Solutions Fenwal Inc. FNC Medical Corporation Forest Laboratories, Inc. Forest Pharmaceuticals, Inc. FSC Laboratories, Inc. GlaxoSmithKline Graham-Field, Inc. Henry Schein, Inc. Herban Essentials Hi-Tech Pharmacal Company, Inc. Hogil Pharmaceutical Housechem InstyMeds Corporation / RedPharm Drug Invacare Janssen Pharmaceutica, Inc. Jarrow Formulas, Inc.

Johnson & Johnson Johnson & Johnson Consumer Companies, Inc. King Pharmaceuticals, Inc. Marlex Pharmaceuticals, Inc. Matrixx Initiatives, Inc. McKesson Medical-Surgical McNeil Consumer & Specialty Pharms. McNeil Nutritionals, LLC Meda Pharmaceuticals Medical Action Industries Medline Industries Inc. MedVantx Incorporated Merck & Company, Inc. Merz Pharmaceuticals, LLC Microfl ex Midmark Corporation Miltex, Inc. Neutrogena Corporation Nexxus Beauty Products Nisim International North Safety Products OHM Laboratories, Inc. Omron Healthcare, Inc. Ossur Procter & GamblePfi zer Inc.

Pharma Medica Progressive Medical International Prometheus Laboratories Purdue Pharma, L.P. Quidel Corporation Inc. Redwood Bio Tech Reliant Pharmaceuticals, Inc. Rigel Pharmaceuticals, Inc. Rye Pharmaceuticals Pty Ltd Sage Products, Inc. Sandel Medical Industries, LLC Sanofi Pasteur sanofi -aventis Sappo Hill Soapworks Schering-Plough Corporation Sperian Protection Sunnight Solar Sunstar Americas, Inc. Tarascon Publishing Teva Pharmaceuticals USA The Harvard Drug Group Titan Corporation Tri-anim Zee Medical, Inc. Zooth, a Division of Gillette

WE EXTEND OUR DEEPEST THANKS TO ALL OF THE COMPANIES WHO HAVE SUPPORTED DIRECT RELIEF USA OVER THE LAST FIVE YEARS.

Emergency Preparedness SponsorsAbbott provided vision and generous contributions to support Direct Relief’s Hurricane Preparedness Program in 2009, resulting in expanded prepositioned aid to more sites in the U.S. and Caribbean. With P&G’s generous fi nancial support, Direct Relief was able to include PUR water purifi cation packets in the hurricane modules and strengthen the ability of our partners in the Caribbean to assist patients with their drinking water needs.

LEAVE A

LEGACY

Make a legacy gift to Direct Relief and extend your generosity beyond your lifetime. Your commitment and dedication will help Direct Relief continue its efforts to help people affected by poverty, emergencies, and civil unrest live better, healthier lives far into the future.

For more information, contact Jill Muchow Rode, CFRE, Director of Development

[email protected] or (805) 964-4767 x181

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The Boehringer Ingelheim CARES Foundation’s donations of medications are delivered nationwide to many low-income uninsured patients through Direct Relief USA’s work with U.S. free clinics and community health centers.


27 S. LA PATERA LANESANTA BARBARA, CA 93117TEL: 805.964.4767 TOLL FREE: 800.676.1638 FAX: 805.681.4838www.DirectRelief.org

BOARD OF DIRECTORS

CHAIR Dorothy F. Largay, Ph.D.VICE CHAIR Thomas J. CusackSECRETARY James H. SelbertTREASURER Kenneth J. Coates

Frederick Beckett • Jon E. Clark • Patty DeDominic • Ernest H. Drew, Ph.D. Patrick Enthoven • Gary Finefrock • Paul Flynn • Richard GodfreyBert Green, M.D. • Raye Haskell • Stanley C. Hatch • W. Scott HedrickPriscilla Higgins, Ph.D. • Brett Hodges • Ellen K. Johnson • Donald J. Lewis Robert A. McLalan • Rita Moya • Carmen Elena Palomo • John RomoAyesha Shaikh, M.D. • George Short • Ashley Parker SniderGary R. Tobey • Sherry Villanueva

INTERNATIONAL ADVISORY BOARDCHAIRMAN 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 BOARDPRESIDENT EMERITUS Sylvia KarczagCHAIR EMERITUS Jean HayDIRECTOR EMERITUS Dorothy Adams

NONPROFIT ORGANIZATIONU.S. POSTAGE PAID

SANTA BARBARA, CAPERMIT #756

O_

Get Connected with Direct Relief

LEARN MORE SPREAD THE WORD INTERACT WITH OTHER SUPPORTERS

EVEN RAISE MONEY!

facebook.com/directrelief

Become a fan and join with other supporters, get our updates, and share with your friends. Our page also links to the Causes application, where you can set up your own fundraisers.

twitter.com/directrelief

Follow our tweets and learn about what’s happening daily in our world—photos from the fi eld, updates on outgoing medicines, and more.

youtube.com/directrelief

Watch our videos (there are already 27) and subscribe so you’re notifi ed when new videos are live.

socialvibe.com/directrelief

Use your Facebook, MySpace and other social network profi les to support us by getting it sponsored by your favorite brands and putting a badge on your page. SocialVibe supporters have already earned us more than $15,000.

> MORE AT DIRECTRELIEF.ORG/SUPPORTUS/GETCONNECTED.ASPX

Follow the Leader. Bring your friends.

—Win a tote.Help us meet our $100,000 challenge

DirectRelief.org

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Economy & Finance

2009 Summer Newsletter