In a Wealthy County, Uninsured Patients Struggle with Grief and Trauma. This Therapist Helps Them Heal.

The father of three was finding it difficult to manage without his wife.
 

He and his children were grieving her recent death. But on top of that, she had been the one who did the cooking, who helped the kids get ready in the morning.
 

For marriage and family therapist Virginia Moreno, who treats people experiencing bereavement and trauma in Santa Barbara County, California, this wasn’t a problem that could be solved in the clinic. So she did what she so often does: She took extra steps to help her patient cope, in this case teaching the widowed father how to cook a few simple dishes, brush his daughter’s hair, and make the beds.
 

“You just go that extra mile, because there were three surviving children,” Moreno said. “We did all the survival skills.”
 

For nearly 14 years, Moreno has worked as a clinical therapist at the nonprofit Hospice of Santa Barbara, working with patients who have lost loved ones. The care she provides is often relatively short-term, focused on helping patients process their grief and build coping skills to help them continue on.
 

Now Moreno will be providing bereavement therapy at the Savie Clinic, a free clinic in north Santa Barbara County, in addition to her work for Hospice of Santa Barbara. There, she’ll work with as many as 50 patients confronting trauma or grief. The expansion of her work was funded through the Community Routes: Access to Mental Health Care program, a partnership with Teva Pharmaceuticals, the National Association of Free and Charitable Clinics, and Direct Relief. Savie Clinic received $150,000 over two years to expand their mental health services and outreach.

Outreach to their local community is a significant part of Savie’s work. (Photo courtesy of Savie Clinic)

“It’s being able to provide a safe place for clients to share their stories, without judgment, without added stress,” she said. “You’re creating a safety net and [they know] that there’s someone who’s interested in walking this path with them.”
 

Moreno didn’t always plan on being a bereavement therapist. She went to college expecting to become a private investigator. But then she took a psychology class, and fell in love. She also saw a high need for mental health services in her Latino community, and was concerned about the stigma she saw community members holding toward psychology and mental health care.
 

“I thought, ‘Maybe if I look like them and talk like them, I can help them,’” she recalled. “I felt a yearning and a calling for that.”

Moreno became a marriage and family therapist after she fell in love with psychology and began to think about the extraordinary needs in her community. (Photo courtesy of Virginia Moreno)

Santa Barbara County is famous for its natural beauty and elaborate mansions, but the area is rife with inequity and income disparities, particularly in the northern part of the county, which has historically had little in the way of affordable health care.
 

That changed in 2022, when physician Ahmad Nooristani saw the extraordinary need for medical services in north Santa Barbara County, and founded Savie Clinic in the city of Lompoc, to provide free health care for uninsured patients.
 

Savie’s leaders first became aware of the urgent need for bereavement therapy in their community when a young patient died suddenly from an illness last year. As Savie’s staff worked to organize support for the boy’s family, they began to hear other stories of patients losing family members suddenly, whether from murder, suicide, car accidents, or natural causes.
 

“Hearing more of these stories made my hope to partner with Hospice increase,” said former Savie executive director Eryn Shugart, who is now a grant writer, in an email to Direct Relief.

Shugart said Moreno was a natural choice to provide the expanded services: “She is bilingual and bicultural, and 90% of our patients speak Spanish only. She is also an excellent and experienced clinician.”
 

For Moreno, it was an opportunity to bring an essential treatment to an underserved population.‹“I was excited because I know that north county doesn’t get a lot of services,” she explained. “We don’t turn anyone away.”
 

But the care itself is familiar. “The subject is the same. It’s death and dying,” Moreno said. “This is what grief looks like
They’re brave enough to come in and fall apart, and then pull themselves together again.”

Savie Clinic, founded in 2022, met a significant need for medical services in north Santa Barbara County. (Photo courtesy of Savie Clinic)

In Moreno’s experience, many members of Santa Barbara County’s Spanish-speaking population need mental health care, but they’re afraid of reaching out, and aware of the stigma. Part of her work is helping her patients understand and process the fear they’re feeling. “Whatever emotions you’re feeling, it’s normal,” she tells patients.
 

Ultimately, Moreno’s goal is to give the people who seek her help the tools they need to work through grief, trauma, and other emotional pain in their lives.
 

“They’re going to learn coping skills,” she said. “So when they get triggered, or they feel like the world is falling apart, they’re going to draw on their coping skills.”

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2024-08-08

Maui Wildfire Response: One Year Later

One year ago, devastating wildfires ravaged the town of Lahaina, destroying hundreds of structures and tragically claiming at least one hundred lives.

The recovery process is ongoing, with many residents still residing in temporary housing and receiving medical care at health facilities operating in temporary or mobile settings.

Since the fires ignited on August 8, 2023, Direct Relief has provided more than $5 million in aid to support 33 local organizations involved in recovery efforts on the island. That includes $3 million in financial aid to organizations serving the Maui community and $2 million in requested medicines and medical supplies like vaccines, insulin, inhalers, emergency medical backpacks for first responders, and personal protective equipment for individuals returning to burn areas–totaling 26 tons.

Direct Relief’s main objective in any large-scale disaster response is to deliver emergency medical resources safely and securely – specifically requested and appropriate for the circumstances – where they are most needed, as rapidly and efficiently as possible.

Direct Relief began working with local organizations to determine needs and requests for aid. Direct Relief leaned into its existing relationships with organizations that have long worked in Hawaiʻi and have trusted relationships with the communities they serve.

Just hours after the fires began, midwives from Healthy Mothers, Healthy Babies Coalition of Hawaiʻi arrived in the burn zone via jet ski and began treating patients.

Direct Relief provided the group with field medic packs, containing first aid essentials, and also additional requested medicines for patient care.

As needs became clearer, Direct Relief began to channel aid via ongoing shipments to Maui, including specifically requested antibiotics, respiratory medications, vitamins for children and adults, personal protective equipment for people returning to their properties to begin clean-up, hygiene items for people displaced from their homes, and other needed medical products.

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Aug. 8, 2024.

As of Aug. 8, 2024, Direct Relief’s Maui Wildfire response efforts have resulted in financial support totaling $3,055,000 and more than 26 tons of medical aid, valued at $2.4 million wholesale, to support the work of health workers and local organizations in the aftermath of the wildfires.

Healthcare facilities and organizations that have received medicines and/or supplies include:

Direct Relief also coordinated the distribution of vaccines including protection against Covid-19, influenza, RSV, and pneumococcal infections with the state Department of Health’s immunization branch to these additional healthcare facilities:

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the in-kind donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation, including the following:

FedEx also provided funding for many of the emergency medical backpacks sent by Direct Relief.

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of people impacted by Maui wildfires.

To date, Direct Relief has identified, vetted, and committed emergency financial support totaling $3,055,000 for groups responding to community needs related to the wildfires.

Direct Relief received contributions from 13,520 donors totaling $5,507,260 from individuals, foundations, businesses, and organizations located in all 50 U.S. states and twenty-two countries.

Of the total amount of Maui wildfire-designated contributions —

Among the companies and campaigns that supported Direct Relief’s response are the following:

Of the total Maui wildfire response-designated cash contributions received to date, Direct Relief has expended or committed $4.479 million to improve the health and lives of people affected by the disaster.

This includes:

  • $3,055,005 on financial assistance to organizations supporting emergency response
  • $136,263 on transportation (paid and pending)
  • $513,949 on emergency personnel costs and other organizational response management expenses
  • $781,556 on procurement of medical supplies and products, field medic packs, and other supplies

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for Maui wildfire response have been used for fundraising.

(As explained here, all Direct Relief’s fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

As long-term recovery continues, Direct Relief remains able to provide support because of its existing strong relationships with local groups that were already receiving ongoing support from Direct Relief through medical material aid and/or grant funding, and new relationships formed following the fire.

Each of these groups has an unwavering commitment to their communities – before, during, and in the recovery phase of the wildfires – and Direct Relief will support their work as Maui continues to recover.

  • Groups like Healthy Mothers, Healthy Babies Coalition of Hawai’i have received emergency medical backpacks from Direct Relief for triage care. (Brea Burkholz/Direct Relief)
  • Burn zone on Maui, August 12, 2023. (Photo courtesy of Mālia Purdy/ Hui No Ke Ola Pono)
  • Burn zone on Maui, August 12, 2023. (Photo courtesy of Mālia Purdy/ Hui No Ke Ola Pono)
  • Healthy Mothers Health Babies Coalition of Hawai’i visits Royal Lahaina Hotel, one of many sites used as temporary housing for displaced residents after the Maui wildfires. (Brea Burkholz/Direct Relief)
  • Residents sift through properties in Maui as re-entry occurs in burn zones from last month’s devastating fires. Direct Relief-provided protective gear, including body suits, gloves, masks, goggles and more was distributed to residents to protect them from ash and chemicals resulting from melted plastic, drywall and more. (County of Maui photo)
  • Direct Relief Responds to the Maui Wildfires of August 8, 2023.
  • Scenes from Maui, where a wind-driven wildfire raged through, destroying lives and property. (Brea Burkholz/Direct Relief)
  • Doctors and providers at a local health fair to support survivors of the wildfires. Direct Relief provided vaccines for children and adults at the event, as well as other medical supplies. (Photo by Dr. Felicitas Livaudais)
  • Direct Relief ships out cold chain vaccines to Maui for the upcoming health fair, all part of the organization’s ongoing wildfire response efforts. (Brea Burkholz/Direct Relief)
  • Direct Relief Responds to the Maui Wildfires of August 8, 2023.
  • Banyan Court, home to a 150-year-old historic landmark Banyan tree, is seen on Aug. 11, 2023. More than 80 percent of the surrounding town has been destroyed. (Photo courtesy of County of Maui)
  • Wife of Lahaina Mayor, Isabelle Bissen, recieving a donated vaccine from Direct Relief (Photo by Dr. Felicitas Livaudais).
  • Boy scout troops in Maui assemble kits of personal protective equipment for residents returning to their homes after fires destroyed the Lahaina area last month. (Courtesy photo)
  • Staff from Healthy Mothers, Healthy Babies Coalition of Hawai’i arrive in the harbor at Lahaina with an emergency medical backpacks for care. (Brea Burkholz/Direct Relief)
  • Community partners involved in the creation of the Lahaina Comprehensive Health Center on August 12, 2023. Picturedis Hui No Ke Ola Pono Executive Director Mālia Purdy (far R), along with representatives from the Department of Health, Mālama I Ke Ola Health Center, and Mauliola Pharmacy. (Photo courtesy of Mālia Purdy/ Hui No Ke Ola)
  • Last week, volunteers packed 5,000 kits of personal protective equipment, including gloves and boot covers, at Direct Relief’s headquarters in Santa Barbara. These kits will be shipped to Maui and provided for free to people re-entering Lahaina after fires swept through the area in August. (Brianna Newport/Direct Relief)
  • The road to Pohaku Park, Maui.

Go Deeper

Prioritizing Health of Body and Mind for Maui Wildfire Survivors

Support for mental and behavioral health needs have skyrocketed in Maui following the wildfires. Doctors on the island say everyone is working to provide solutions.

‘Aloha and Trust.’ Native Hawaiʻian Health Care’s Response to Maui Fires

“It was our first natural disaster, so we were just trying to learn the protocol, what services were expected and if we could contribute to what was going on.”

After the Fires, Providing Community Care in Maui

Prenatal care was limited on Maui before the fires, but groups like Healthy Mothers, Healthy Babies Coalition of Hawai’i are stepping up to fill the gap.

2024-08-09

Hurricane Debby, California Wildfire Responses Remain at the Forefront

In the past week, Direct Relief delivered 484 shipments of requested medical aid to 45 U.S. states and territories and 21 countries worldwide. Included is support for communities impacted by Hurricane Debby in Florida and continued wildfire response in California.

These shipments contained 12 million defined daily doses of medication and supplies, including prenatal vitamins, diabetes therapies, rare disease treatments, oncology medications, field medic packs for first responders, and more.

Waters Rise After Hurricane Debby

Waterways in Sarasota, Florida, overflow into adjacent residential neighborhoods after Hurricane Debby moved through the region. (Photo courtesy of the Sarasota Sheriff’s Department)

After Debby’s landfall in Florida’s Big Bend region on Monday, the storm was downgraded from a Category 1 hurricane to a tropical storm, and then had a second landfall early Thursday, bringing tornadoes, flooding, and power outages.

On Monday, the Florida Association of Community Health Centers reported at least 71 health centers experienced partial or full closure due to Hurricane Debby. In response to Debby, Virgina B. Andes Volunteer Community Clinic, a free clinic in Port Charlotte, Florida, reported opening their Hurricane Preparedness Pack to access chronic disease medications for impacted patients.

The packs are staged in hurricane-prone areas across the U.S. Gulf Coast in advance of Atlantic Hurricane season at the start of each year and contain medical essentials commonly requested after storms.

Health workers at the Virginia B. Andes Volunteer Health Clinic in Port Charlotte, Florida, open an emergency medical backpack from Direct Relief in 2022 after Hurricane Ian. This week, the clinic was impacted by Hurricane Debby and opened a hurricane preparedness pack, prepositioned before hurricane season, and used medical supplies inside to support patient care. (Photo by Zack Wittman for Direct Relief)

Direct Relief also recently supported Virginia B. Andes in 2022, after the clinic was hit by Hurricane Ian. This week, Direct Relief shipped requested chronic disease medications and personal care items to the clinic to support their work with patients.

Shipments also departed this week to the University of Florida Mobile Outreach Clinic, which has been providing care for agricultural workers and other community members impacted by the storm in the Gainesville area. The Way Free Medical Clinic in the Jacksonville area also received Direct Relief support, and the Neighborhood Medical Center in the Tallahassee area received diabetes management supplies, medical consumables, and other requested items this week.

As more health facilities come online, Direct Relief expects more requests for support and will continue to respond.

Park Fire One-Third Contained in Northern California

Direct Relief staff deliver medical aid to a mobile outpost of Ampla Health in Northern California. (Aaron Rabinowitz/Direct Relief)

Wildfire response in Northern California is ongoing as the Park Fire, which is currently about one-third contained, continues to rage north of Sacramento.

Last weekend, Direct Relief staff traveled to the region to deliver requested medical aid, including to facilities in Butte County, where the 2018 Camp Fire killed 85 people and destroyed thousands of structures in the Paradise area. Direct Relief staff delivered aid last week to Butte County Public Health’s warehouse, partly funded by Direct Relief, which will eventually be used to consolidate medical supplies in a single location to increase efficiency.

Direct Relief staff deliver medical aid to the Butte County Public Health warehouse in Northern California. The warehouse, partially funded by Direct Relief after the 2018 Camp Fire, will consolidate medical supplies used by the county during disaster response. (Aaron Rabinowitz/Direct Relief)

Staff also met with Butte County Search and Rescue, an all-volunteer team that provided door-to-door evacuation notices, mapping support, and coordination efforts with the sheriff’s office during the Park Fire. They also housed 20 firefighters in their training center during the Park Fire response.

Their Rescue 3 vehicle was funded by Direct Relief and has been used as a model for other SAR teams across the state. Each of their response vehicles will now have an emergency medical backpack with medical essentials for triage care.

A vehicle purchased by Direct Relief for Butte County Search and Rescue after the deadly 2018 Camp Fire is now being used to facilitate evacuations during the Park Fire burning in Northern California. (Aaron Rabinowitz/Direct Relief)

Medical supplies were also delivered to Shingletown Medical Center and Ampla Health’s health centers in Magalia, Gridley, and Los Molinos.

More wildfire response kits, which contain medical essentials commonly requested during fires, including respiratory and ophthalmic medications and N95 masks, are currently being built and will ship out next week for Butte County Public Health and community health centers in the area.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 10.9 million defined daily doses of medication to countries outside the U.S. that include the following:

  • Ukraine
  • Iraq
  • India
  • Cuba
  • Togo
  • Peru
  • Uganda
  • Burkina Faso
  • Armenia
  • Kenya

UNITED STATES

Direct Relief delivered 449 shipments containing 1.1 million doses of medication during the past seven days to organizations, including the following:

  • Community Health of East Tennessee, Tennessee
  • Samaritans Touch Care Center, Inc., Florida
  • Pasadena Health Center, Texas
  • Mercy and Truth Medical Missions, Kansas
  • AAHC DBA HOPE Health Pharmacy, Texas
  • St. Vincent de Paul Charitable Pharmacy Cincinnati, Ohio
  • Clinica Esperanza/ Hope Clinic, Rhode Island
  • Good News Clinics, Georgia
  • Community Volunteers in Medicine, Pennsylvania
  • Martin Luther King Health Center, Louisiana

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 15,300 shipments to 2,068 partner organizations in 54 U.S. states and territories and 83 countries.

These shipments contained 281.9 million defined daily doses of medication valued at $911.7 million (wholesale) and totaled 3.5 million pounds.

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