Fall newsletter-2009
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This document summarizes initiatives that are improving healthcare access and outcomes. It discusses increasing healthcare access through mobile clinics, telemedicine, and nurse training programs. It also covers improving maternal and child health by focusing on safe deliveries, obstetric care, and preventing mother-to-child transmission of HIV. The document advocates that basic training can expand basic healthcare provision and addresses scarcity of resources through clinical officer programs in places like Southern Sudan.
Fall newsletter-2009
- 1. THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST Vi ACY E 8 Gi R LETGINU P/ NG OF OU N CO Y W W W . D I R E C T R E L I E F . O R G THINGS THAT ARE WORKING NOW (in the U.S. and around the world) P / 2 1/ Increasing Access 2/ Primary Care 3/ Focus on Moms & Kids 4/ HIV Prevention & Testing 5/ Basic Training for Basic Care HELP ‘ROUND THE CORNER FREE CARE IN SB P/7 SMARTER SWINE FLU CALIFORNIA SPECIAL SUBVERTING EMERGENCY DR.MIKE PREP P/7 MARKS your WILL NOW take REPORT P/6 THE # OF F 1 CAUSE DEATH IN FIJI P / 6 QUESTIONS P/4
- 2. T H E S O LUTIONS ISSUE / 5 THINGS WOR K I N G N OW I N H E A L T H CA R E What’s Working Now. Healthcare challenges are daunting. They are easy to see in developing countries and being vigorously debated in the U.S. The elusive trifecta solution involves: ACCESS, QUALITY, and AFFORDABILITY. Working with great partners in all 50 states and in 60 countries, we get to see great examples of each at Direct Relief. For more on the 1/ Elusive Formula see P/4 Increasing Access M any factors limit people’s access to care. Scarcity of resources—human, financial, technological, and medical material—and limited access to education and physical proximity to care are among the many challenges. Consider the Liberian family in the Temor Cheifdom of Grand Bassa County who walk ten hours to cross a river in a dugout canoe to get to the nearest hospital in Kakata. Or the Quechuan man in Cochabamba, Bolivia, unaware that his advancing blindness is a result of diabetes. Or the expectant Latino mother in the Lower Ninth Ward of New Orleans, Louisiana, anxious for prenatal care, but having difficulty understanding her options because of language barriers. The healthcare providers Direct Relief supports in the U.S. and abroad are constantly IRMA TURTLE looking for pragmatic, innovative ways to bridge such obstacles to access. Be it through mobile clinics, telemedicine, or medical training, Direct Relief has worked, for over 60 years and in over 60 countries, to infuse essential medical resources into in-country systems so more Direct Relief USA supports the people can receive better quality care. creative efforts of community-based clinics and health centers expanding access for In Niger, the Nomad Foundation has brought health care millions of uninsured and working-poor to nomadic populations by establishing a medical center on a Americans… well-traveled migratory route. A Nigerien woman has a one in seven lifetime risk of dying in childbirth—the worst reported ratio in the world. At and near the health center, the Tuareg and TRANSPORTATION Wodaabe peoples of the isolated Sahel and Sahara regions can Direct Relief purchased vans to shuttle patients now access essential medicines, patient services, clean water, to U.S. Surgeon General Nominee Dr. Regina Benjamin’s clinic in Bayou La Batre, Alabama, and Common Ground food, education, and skills training—without compromising Clinic’s outreach program for Latino workers in the Lower their traditional herding cultures. Ninth Ward of New Orleans. In Los Angeles, multiple The U.S.-based nonprofit TurtleWill works with nomads providers run mobile clinics to homeless shelters and in Niger, Mali, and Ethiopia—populations particularly afflicted IRMA TURTLE gathering sites. by malaria, respiratory infections, and parasites—by conducting annual medical camps along migratory routes, providing primary care to over 20,000 people since 2004. TELEMEDICINE b In Southwestern India, the Amrita Institute of Medical Sciences (AIMS) Direct Relief and FedEx established video conferencing for clinic associations and their members in California, and operates a cutting-edge telemedicine van to bring care to the many people Venice Family Clinic—the largest free clinic in the U.S.— who are too remote, sick, or poor to get to a hospital. Direct Relief funded the MATT MACCALLA transmits images of retinal screenings to ophthalmologists van and provides the medical material for everything from its ongoing health at UCLA’s Jules Stein Eye Institute for interpretation. clinics in nearby villages, to its broad excursions to the sites of natural disasters b and health emergencies where there is little other access to care. The van EMERGENCY RESPONSE has brought state-of-the-art care to more than 30,000 people using live-video conferencing and real-time transmission Direct Relief’s Hurricane Prep Pack Program of medical information to expert medical providers at AIMS hospital. Earlier this year, a second Direct Relief-funded provides easy access to medicines and continuity telemedicine van was set up with another specialty hospital in South India. of care in emergencies. This year, 25 packs were deployed In India’s southeastern port-city of Chennai, Ramakrishna Math runs a Direct Relief-sponsored nurse assistant to clinic partners in five Gulf States and Puerto Rico. Each training program that has graduated 1,200 nurse assistants in four years to work in regions suffering from a shortage of pack contains medical supplies to treat 100 patients for professional medical personnel. The graduates have a 100 percent employment rate, bringing needed financial help three to five days. to the young women, their families, and the villages they come from. To learn more about our partners’ innovative approaches to broadening access to care, visit www. D I R E C T R E L I E F . O R G 2 WWW.DIRECTRELIEF.ORG FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST
- 4. T H E S O L UTIONS ISSUE / 5 THINGS WOR K I N G N OW I N H E A L T H CA R E BONKWASO OUTREACH CLINIC, GHANA The CRAIG BENDER Elusive E Formula KRISTIN BROWN very 48 seconds, a child is infected with HIV, the virus THE TRIFECTA FOR that causes AIDS. This IMPROVED HEALTH Focus on is a profound human CARE DELIVERY tragedy, the primary 3/ cause of which is Access preventable. Without Moms & Quality medical intervention, the chance that a mother will pass along the virus to her child during birth is as high as 30 percent, but with Kids Affordability proper testing and therapy, this chance can be nearly eliminated. Stating the staggering numbers of HIV or any other health crises does not in Prevention is always itself tell us what to do about it. A vaccine key, but when care may someday protect humans against this is needed, it must be and other deadly viruses, and aggressive others are the cornerstones of families, communities, economies, and societies worldwide. That’s why accesible, of high quality, education and prevention campaigns are essential. Also essential is to focus resources it’s staggering that the World Health Organization estimates and affordable. on where this infectious disease exists to that a woman dies each minute from complications during save those who have contracted it and can pregnancy and childbirth—more than 500,000 each year transmit it and those who are most likely to worldwide. Pregnancy is often a time of joy and trepidation, but in developing countries, contract it. As Paul Farmer says, with HIV pregnancy is a life-threatening condition, as pregnancy and childbirth are the second- leading cause of death among women of reproductive age. In 2007, more than nine million children Give it to us died worldwide under the age of five from In Sub-Saharan Africa, largely preventable causes—illnesses such as only 40% of women are straight, Doc… pneumonia, diarrhea, and malaria, and indirect attended by a health causes including conflict and HIV/AIDS. professional during Malnutrition, poor hygiene, and lack of access to childbirth. Direct Relief has safe water and adequate sanitation contributed financed and equipped 4 to more than half of these deaths. Nearly one- surgical theaters costing up third of children in the developing world are Mike Marks, M.D., Direct Relief’s to $50,000 each in Malawi, Tanzania, and Zimbabwe chronically malnourished. Broadening access to care and maintaining good nutritional status are International Medical Advisor to enable safe C-section integral to improving child survival. “Every day, three deliveries and other Many of the risks for pregnant women and jumbo jets full of Q What are kids dying of in Africa? surgeries children in developing countries are related to pregnant women A The most common causes of death in children are general conditions of poverty, nutrition, and not tropical diseases but rather diarrheal illnesses crashes...and it severely limited health resources and access that and chest infections—things kids get everywhere. doesn’t get on READ affect everyone. Direct Relief ’s core activities have long been aimed at expanding the quality, availability, and access to health services the news.” Antibiotics and clean water, if they were universally available, could prevent most of these deaths; MORE unfortunately they are not. about these initiatives for all people. But a principal focus of this effort is on maternal and and watch video of the child health and, more specifically, interventions that directly address women whose health the specific threats to women during pregnancy through childbirth. has been restored Q How dangerous is pregnancy and childbirth in the through obstetric These interventions include expanding access to care, ensuring developing world? fistula repair in Africa safe deliveries through midwife training and kits, addressing D IRECT R ELIEF . ORG complications through emergency obstetric care, A Let me put it this way: Every day, three jumbo jets full of pregnant women crashes, killing every last passenger, and it doesn’t get on restoring health through obstetric fistula the news. repair, and preventing mother-to-child transmission of HIV. Q Can we beat AIDS? A History has shown that we can overcome anything viral, like Every Day is Mother’s Day smallpox or polio, by severing the connection between virus and host. Help us ensure safe pregnancy and delivery—donate online So yes, someday AIDS will be eradicated. and create a tribute page for your mom D IRECT R ELIEF . ORG 4 WWW.DIRECTRELIEF.ORG FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST
- 5. Tools for Midwives Defining the 4/ Big Problems HIV Prevention and Testing and other infectious diseases “treatment is prevention.” And deciding who to treat requires knowing who is sick. Training and equipping midwives saves lives and significantly increases and improves the chance for safe delivery. Based on input from partners in the field, and with support from the Steinmetz Foundation, Direct Relief designed and provided more than 700 medical kits to midwives in 14 countries: AFRICA: Cameroon, Ethiopia, Ghana, Uganda In 2007, Direct Relief began supporting Abbott’s efforts to distribute free, HIV rapid test kits. Sixty-nine ASIA: Afghanistan, China (Tibet), India, Indonesia, developing countries are eligible for the program, including all countries in Africa, where the burden of HIV is heaviest. Laos, Philippines Direct Relief and Abbott are working to eliminate barriers to the testing of pregnant women for HIV in countries where LATIN AMERICA AND THE CARIBBEAN: mothers and their children face the greatest threat. El Salvador, Haiti, Honduras The Abbott-donated Determine® test is quick—results take 15 minutes—and requires no electricity or water, PACIFIC: Fiji making it ideal for areas that 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. The $50 kit is designed to handle 100 deliveries, Between 2002 and 2008, Abbott donated more than 11.2 million rapid HIV tests to prevention programs with equipment that is sterilized after each use and throughout the developing world. Through 2008, more than 9.5 million pregnant women have been tested and supplies that can be restocked by Direct Relief. 980,000 of those women tested positive for HIV. Rapid tests have also have been provided for more than two million spouses and children of pregnant women who have tested positive. In many developing countries, Abbott and Direct Relief work closely with ministries of health and other major AN AFGAN healthcare networks running prevention of mother-to-child transmission (PMTCT) programs to distribute the test kits. INSTITUTE The Rwandan Ministry of Health, one of the first to subscribe to the program, has tested more than 860,000 pregnant OF LEARNING NURSE- women. In Kenya, where UNAIDS estimates 8.3 percent of adult females are HIV-positive and 117,000 children under MIDWIFE the age of 14 are infected, Direct Relief partner Elizabeth Glaser Pediatric Aids Foundation has tested 350,000 TRAINING expectant mothers, more than 15,000 of whom were HIV-positive. COURSE Basic Training for Basic Care 5/ S carce resources, high demand, clinical officers conduct basic surgical and the high costs of training procedures in the absence of a doctor. specialists create huge obstacles WILLIAM VAZQUEZ The need for trained health workers in to people seeking care. These Southern Sudan is great: Almost 20 years pressures are magnified by economic of war has led most of the surviving health professionals to flee forces that inspire the “brain drain” (or the country. It is estimated that there is only one doctor for “human capital flight”) of trained health every 220,000 people. Direct Relief joined with AMREF to professionals to places where their skills address Southern Sudan’s priority healthcare infrastructure by Sakena Yacoobi in 1995, AIL provides healthcare services, are better compensated. needs. This year, Direct Relief committed $192,000 to preschool through university-level education, and training to The poorest parts of the sponsor 30 clinical officer students at the National Health women and girls at four sites in Afghanistan. With support world have long been Training Institute (NHTI) in Maridi. Students began from the Abbott Fund and Direct Relief, AIL has operated compromised by the flight their coursework in January 2008. The program is open to a successful nurse-midwife training course since 2005. To of health professionals Sudanese nationals who have met preliminary health worker date, 78 women have completed their training, with most now in whom scarce training qualifications. Students from different ethnic groups and employed in clinics and hospitals. An additional 25 students AMREF has been invested. But remote areas are actively recruited for the program, which pays are expected to graduate in 2010. some groups, like the for tuition, room and board, insurance, a personal stipend, Trainees study a comprehensive curriculum of medical “In the next five years African Medical Research and transportation. After completing the three-year course, subjects during the 18-month program and after graduation Southern Sudan will Foundation (AMREF) graduates intern for a year at one of seven hospitals, and are are able to treat an estimated 11,000 patients a year. Because need 1,500 clinical are filling these voids by then required to work in their home communities for three it is culturally preferred that Afghan women receive health officers—a tenfold analyzing what can be years. care from a female provider, highly skilled nurse-midwives increase of the current done by paraprofessionals, To provide better maternal and child health care, many represent greater access to care and are highly sought production of NHTI, technicians, community- groups are addressing the absence of health professionals after. The Abbott Fund has funded nurse-midwife training the only clinical based educators, and other by putting resources behind midwives, traditional birth programs since 2005; together, Direct Relief and the Abbott officer training school. levels of health workers— attendants, and skilled birth attendants. Pregnancy and Fund have provided AIL with more than $7 million in cash With the generous and then developing childbirth are the leading causes of death and disability among grants and medical material assistance. support of Direct training to enable more women in developing countries. Having a skilled attendant Relief we will double the production of NHTI basic essential care to be present during delivery is considered the single most critical FACT: provided at lower costs, intervention for ensuring safe motherhood. in the next two years.” allowing for the more Direct Relief supports midwife training programs in 12 efficient use of scarce In Afghanistan, – Dr. Peter Ngatia, AMREF countries, including Afghanistan, which has one of the highest Director of Capacity of Building high-level skills. In many maternal mortality rates in the world. The Afghan Institute of only 14% of births are attended and Human Resources for Health Development countries, non-physician Learning (AIL) is working to reverse that statistic. Founded by a skilled healthcare worker. WWW.DIRECTRELIEF.ORG FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST 5
- 6. On the “U.S. health centers’ expertise Brink of Flu in providing comprehensive Season primary and preventative health services to low- income, ethnically diverse patients makes them uniquely PREPARING FOR SWINE FLU positioned to participate in IN THE U.S. AND MEXICO community response to an influenza pandemic.” As the fall/winter flu season approaches, Direct – Mollie Melbourne, Director of Emergency Management, National Relief has been building an effective response plan Association of Community Health Centers to a widespread outbreak of the H1N1 Influenza- A strain. Working closely with the emergency response agencies at the national and state level, ethnically diverse patients makes them uniquely Direct Relief staff has identified key items designed positioned to participate in community response to help healthcare workers avoid infection so they to an influenza pandemic,” says Mollie Melbourne, can continue to treat patients. director of emergency management for the With the support of major healthcare company National Association of Community Health donors and funds designated for emergency Centers. response, Direct Relief is sourcing the materials During the first phase of the new flu strain, U.S. clinics will need to address H1N1 flu Direct Relief activated its emergency response prevention and infection. The Johnson & team to provide medical supplies to clinics in Johnson Family of Companies provided a large California and Texas, states where the infection donation of flu-fighting products in support of the rates were highest. Aid was also sent to the Most Vulnerable to H1N1 Flu* H1N1 response, including Tylenol for adults and National Institute of Pediatrics in Mexico City, a Children under 5 children, Imodium, hand sanitizer, and soap. As 500-bed hospital that cares for children age 17 and REUTERS/JORGE DAN, COURTESY OF WWW.ALERTNET.ORG People over 65 the Centers for Disease Control and Prevention younger, regardless of their ability to pay. Pregnant Women has indicated, good personal hygiene provides While H1N1 is proving to be less virulent People with chronic respiratory and protection against the flu virus. than previously thought, the Centers for Disease pulmonary illnesses, including asthma and Direct Relief ’s unique nationwide partner Control and Prevention indicates that several diabetes network will play a crucial role in a large- groups are advised to take precaution against People with immunosuppression caused by scale H1N1 response, taking the burden off infection, including children under the age of 5; medications and HIV crowded emergency rooms. “U.S. health centers’ adults 65 and older; pregnant women; people with Residents of nursing homes and other expertise in providing comprehensive primary chronic conditions such as asthma and diabetes; chronic-care facilities and preventative health services to low-income, and people with suppressed immune systems. * according to the CDC Fighting Heart Disease in Fiji INFUSING RESOURCES WHERE THEY’RE NEEDED MOST T FACT: hanks to Direct Relief and Merck & Co, Inc., 400 patients at Fiji’s DR. ERIC Savusavu Hospital will receive KLEERUP, medication to treat their high cholesterol, CLINICAL one of the population’s gravest chronic conditions, free of charge for one year. Ischaemic heart disease, PROFESSOR OF “Many people think of Fiji only as brought on by high PULMONARY white-sand beaches, turquoise waters with cholesterol, diabetes, MEDICINE colorful fish and magnificent coral, and AT UCLA and hypertension, is Fiji’s SCHOOL OF the friendliest people on earth,” noted Dr. Mohammed Ishaque, director of Savusavu leading cause of death. MEDICINE, EXAMINES A Hospital and Sub-Divisional Medical – WHO, 2006 PATIENT AT Officer for Cakaudrove Province on Vanua SAVUSAVU Levu. “But unfortunate medical conditions HOSPITAL dampen this idyllic place. Diets often high IN FIJI in saturated fats, starch, and sugar lead to education guides to accompany their drug KEN BARASCH cases of high cholesterol and heart disease.” treatment regimen. The donation was made possible Merck & Co., Inc. also donated 25 through a collaboration between copies of the 18th edition of the Merck Merck, Direct Relief, and the Savusavu Manual for use at Savusavu and Labasa Community Foundation, a nonprofit Hospitals, in addition to nursing stations corporation operating in the U.S. and and medical centers throughout the region. “Unfortunate medical conditions Fiji to provide medical, education, and The Merck Manual is a widely used guide dampen this idyllic place. Diets environmental support to Savusavu and to assist doctors and nurses in diagnosing other areas throughout Fiji. The Jean- and treating medical problems, from simple often high in saturated fats, Michel Cousteau Fiji Islands Resort ailments to complex diseases. Dr. Neil starch, and sugar lead to cases handled the consignment and physical Sharma, Fiji’s Minister of Health stated, of high cholesterol and heart delivery of the donation to Savusavu “I find these manuals invaluable and hope disease.” KEN BARASCH Hospital. to eventually have copies at all of Fiji’s Patients will also receive nutrition medical locations.” – Dr. Mohammed Ishaque, Director of Savusavu Hospital 6 WWW.DIRECTRELIEF.ORG FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST
- 7. Equipping Medical Reservists Here at Home EMERGENCY PREPAREDNESS BACKPACKS START AT »» THE BASIC LEVEL FOR AN AUSTERE MEDICINE FOR LOCAL EMERGENCY RESPONSE VOLUNTEERS EMERGENCY MEDICAL TECHNICIAN, T AND INCLUDE MORE he Santa Barbara County Medical Reserve Corps (MRC) advanced products and supplies for nurses and physicians. ADVANCED PRODUCTS was founded in 2007 to ensure that medical volunteers Contents include first-aid supplies, medications, and diagnostic AND SUPPLIES FOR would be ready and able to help during a public health tools. The kits enable MRC members—trained, credentialed NURSES AND PHYSICIANS emergency. Like other MRCs around the country, the Santa medical personnel—to support the work of first responders Barbara County MRC is completely volunteer and members when an emergency strikes. must provide their own supplies and equipment for use during Designed to “grab and go,” the preparedness kits were INFECTION CONTROL, critical in emergencies. created with input from other experienced emergency any emergency, particularly hurricanes and At the request of the Public Health Department’s Office responders, including physicians from the UCLA School floods, during which waterborne illnesses are of Emergency Services, Direct Relief designed and provided of Medicine, the University of Pittsburgh, emergency prevalent 90 members of the Santa Barbara County MRC with custom field physicians from Australian Aid International, and N95 PARTICULATE MASKS preparedness kits. The streamlined backpacks start at the basic representatives from the Santa Barbara Public Health EXAM GLOVES level for an emergency medical technician, and include more Department. HAND SANITIZER ANTIBIOTICS ANTIFUNGAL OINTMENT What is austere HYDROCORTISONE CREAM medicine? DIAGNOSTICS to quickly and accurately “It’s a phrase for the practical, assess the condition of affected people on- universal applicability scene of care we’re trying to accomplish through the STETHOSCOPE packs—optimizing emergency BLOOD PRESSURE CUFF medicine with the most OPHTHALMOSCOPE critical components in the THERMOMETERS fewest number of moving parts. The packs are streamlined for mobility, TRAUMA CARE for open wounds most but each unit’s versatile frequently associated with earthquakes medical functionality belies its GAUZE PADS AND BANDAGES 37.2 c compact size.” SCALPELS AND SHARPS CONTAINER – Brett Williams, Direct Relief SUTURE KIT Emergency Response Coordinator IODINE PERSONAL PROTECTION + TOOLS to help first responders get to people trapped under debris after an earthquake or keep people warm and dry through a hurricane HEADLAMP AND WORK GLOVES EMERGENCY BLANKETS PONCHOS COLD AND HEAT PACKS MULTI-TOOL AND DUCT TAPE Healthy Smiles FREE DENTAL CARE FOR LOCAL KIDS The number one unmet health need in Santa Barbara County is FACTS: Healthy Smiles focuses on preventing dental disease and tooth undertaking with many community members sharing in the project of dental care for children. decay. Working in partnership with more making oral health information and Direct Relief started Healthy Smiles in than 40 local agencies and hundreds services accessible and fun for children 1994 to provide free oral health services 33.9% of kids in of community volunteers, including and families who otherwise cannot to thousands of the county’s low-income Santa Barbara 25 dentists who donate their time and afford a visit to the dentist office. Pre- kids who would otherwise go without. County are without expertise, Healthy Smiles has provided dental and pre-medical students from According to the Surgeon General dental hygiene kits serving over 265,000 UCSB, dental hygiene students from JOEY SCHAFFER and the Henry J. Kaiser Family dental insurance. kids and parents since 2003. The kits are Allan Hancock College, Santa Maria Foundation, oral diseases have been – UCLA Center for Health Policy part of a broad effort to bring bilingual High School’s Key Club, dentists who linked to weakened immune systems, Research oral health and nutrition education to are members of the Central Coast Dental diabetes, and heart and lung disease. A children in need and their families. Society and the Santa Barbara-Ventura A YOUNG PATIENT RECEIVES lack of dental treatment has the potential 24% of children under Since 2002, Healthy Smiles has Counties Dental Society, the staff of each to affect speech, nutrition, growth, and 11 in California helped more than 600 low-income, host dental office, and the Santa Barbara FREE DENTAL CARE AT A social development. Children with oral uninsured and highly affected children County Dental Disease Program’s Tooth HEALTHY SMILES DENTAL CLINIC diseases are estimated to miss over 51 have never been to a receive critically needed dental Fairies all volunteer their time to make IN GUADALUPE, CALIFORNIA million hours of school each year. In dentist. treatment at no cost to families through the day a success, put the parents at ease, rare cases, untreated dental disease in – California Healthcare one- and two-day dental clinics. Each and ensure that each child is treated with children leads to death. Foundation Healthy Smiles Dental Clinic is a major care and a smile. WWW.DIRECTRELIEF.ORG FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST 7
- 8. Leave a THE $5 Difference Legacy Does a $5 donation make a difference? The answer is a resounding yes when it comes to the Make a legacy gift medical aid Direct Relief can provide. We put needed materials, supplies, BRYAN WATT to Direct Relief and medicines into the hands of and extend your healthcare providers caring for the generosity beyond most vulnerable people in their communities, including the U.S. your lifetime. Your commitment and dedication will help people affected by poverty, emergencies, and civil unrest live better, See some examples of the support that donations provide— healthier lives far into the future. and make a $5 difference—at For more information, contact Jill Muchow Rode, CFRE, Director of Development HTTP://DRI.CONVIO.NET/5DOLLARDIFFERENCE jrode@directrelief.org or (805) 964-4767 x181 100% OF CONTRIBUTIONS ARE DEVOTED TO OUR PROGRAMS. All overhead (non-program) expenses are covered by a generous bequest. LEARN MORE. FACEBOOK facebook.com/directrelief Get Connected with Direct Relief SPREAD THE WORD. INTERACT WITH TWITTER twitter.com/directrelief OTHER SUPPORTERS. YOUTUBE youtube.com/directrelief EVEN RAISE MONEY! SOCIAL VIBE socialvibe.com/directrelief 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 FALL 2009 THIS REPORT WAS PAID FOR BY A GENEROUS BEQUEST