I'm Thomas Tighe, CEO of Direct Relief, one of the aid organizations on the ground in Nepal, currently being supported by the reddit community and deeply thankful. AMA!

Hi there Thomas, I am one of the attendees of Zeldathon, a charity marathon that raised money for Direct Relief back in December 2014. I was wondering what you initially thought about charity fundraisers such as Zeldathon, and the one currently hosted here on Reddit, and if you were surprised by the amount of support they received?

Hi, WaluiJ. Zeldathon was such a wonderful surprise to me and, more importantly, for the organization. I was stunned how much attention it received and how long you all kept at it. I was transfixed, actually, even though I'm not a gamer of note. Sadly, I'm old enough to have played Pong, in its original format at an arcade. Thank you again for spending your New Year's eve making it happen on Zeldathon. #dontgetblasted was my first, unwitting, hashtag!

Hi Thomas. Thanks for doing this. How's government responding to the relief teams? Are they co-ordinating well with you? Also any comments on this regarding the necessity of relief team.

Hi, sunzoje. My pleasure. Our colleague, Gordo, was with the Ministry of Health and at the UN "cluster" meeting today, and he shared that the government obviously wants and has requested help but are being careful to ensure that they can understand who and what is being brought into their country. We always respect that, so we're being careful to explain what we can do and that, of course, we respect that we're only there to help -- it's their country, as is always the case. Direct Relief is a support organization, which is why we think it works.

what is the biggest thing we can do to help nepal??

Hi, rootbeerghost. I wish I could answer that succinctly, but I think the best thing I can say is that, if you're concerned, track the news and look for an organization that does what you care about and understand and support it if you can. In Nepal, the tragedy is so extensive -- and the full extent isn't even fully known -- I think there's a risk of getting so caught in the news reports that we all fail to recognize the enormous human tragedy that has occurred. All in one instant. In general, the main concerns are food, water, sanitation, and health services. Direct Relief focuses on the health services, but we recognize that other groups do other things are also essential. Supporting organizations is important, but so is expressing concern. It means a lot when people know others are pulling for them. Reddit is an example of that. And sorry that was such a long-winded answer to a very short question.

Where do the donated finances go when you recieve them? E.g. food, shelter etc. I'm curious to see what exactly is being done to help.

Hi, soupzYT. We will spend the funds received for Nepal to provide medications, medical supplies, and other medical equipment to local partners in Nepal. Over the past few days, we've been in contact with many of them to understand what exactly they need that we can deliver. It's important to get that nailed down, since the rush to send "stuff" in without a plan often results in a logjam of that material at the airport with no one quite sure what to do with it. It's not only wasteful, it clogs up the distribution channels. That's why a lot of our time and effort and expenses are related to getting the logistics and transportation and storage nailed down. We also will be providing direct financial support to the partner organizations in Nepal -- in the form of cash grants, depending on how much we might have -- so that they can rebuild facilities and cover other losses or increased expenses related to the earthquake. We have offered our entire medical inventory -- which includes large volumes of things like saline solution, antibiotics, and surgical supplies -- to partner organizations in Nepal. The funds we receive will be spent on transporting the items -- IF they are requested, approved for importation, and we are confident they will be properly used -- and the costs of distributing them in country. That's Direct Relief's basic program model: providing essential medical material assistance to locally run health projects (free of charge, I should add). You can see the partners we work with in Nepal, and what we've provided over the past several years, on https://www.directrelief.org/aidmap We're fortunate to work closely with many of the world's healthcare manufacturers, which provide donations of their products to us for humanitarian uses we identify. We don't spend any donors' money on fundraising expenses. I tried to explain in another answer (and I'm sorry I missed this question while typing another answer) that, although Direct Relief has a focus on health and the specific medical material, we certainly recognize that other areas we don't address are critically important. Also, it's important to note that if a donor gives a contribution for Nepal, 100% of that contribution is used only for activities and expenses directly related to helping in Nepal.

Just concerned where your working area [location] is? Are you, like number of other team, focusing on headquarters or on the remote villages?

We're working with One Heart Worldwide -- a group we've been suupporting for several years that focuses on safe deliveries for women -- as well as number of other groups that provide specialized care for women with obstetric fistula and general health services. One Heart works in 5 districts, and our colleagues are travelling tomorrow (today local time) to Dhading Besi, where One Heart trains healthworkers and staffs birthing centers. The initial reports are that 18 of the 20 facilities in Dhading were destroyed or damaged, so that will be a priority area for us and where we will channel funds and material support. We're also seeing what the other groups in Nepal need, particularly in the area of medications, supplies, and medical equipment, since that's what Direct Relief does extensively. Fortunately, we have a large current inventory that includes large quantities of things like saline solution, antibiotics, surgical and wound care supplies -- all of which have been offered. We have to make sure the government approves each and every item before it arrives, which is what our colleagues are doing in Kathmandu.

Other than financial donations, is there anything we can do to help in Nepal?

One of the really helpful things that people are doing is engaging to assist in gathering information. OpenStreetMap.org has had more people helping map out Nepal -- which is important for a lot of reasons in the response -- than did during the Ebola crisis, Haiti, etc. That is a big help. Good information allows for good decisions and more efficient use of resources -- it's got to be targeted to specific places, not just "to Nepal." We've developed a mobile app that we're sharing with partners so they can do assessments of structural damage and specific needs for medications and other supplies. It doesn't require connectivity to use the app, but the information can be stored and shared when there's connectivity. This is just one example of things that people can do other than give money. I hope that folks figure out other things, like how to enable all the small businesses that have been wrecked to back on their feet. Money, ultimately, is good only to convert into other goods and services. Some people find it easier to provide goods and services directly, and things that can be done online to support, encourage, teach, purchase, etc. with or from people in Nepal would seem to me to be very good things to consider.

Hi, everyone. Thank you for your questions and to all redditors for their amazing support today! I'm signing off, but you can reach us through our contact information on www.directrelief.org Thanks again.

Thomas

Hi Thomas. Is there any data collection being done by your team too. We are trying to use Sahana eden software used in Haitin Earthquake for data collection so that we can have at least one central data entry and viewing system. What are your ideas on this? The data will help decentralizing volunteer efforts and resource management.

Hi, mineshjoc. Great question. It's in everyone's interest to have good data shared broadly. We work with a bunch of other organizations and companies that are members of NetHope, trying to solve this always frustrating situation of information being gathered and not shared, or bad information being shared. We haven't worked with Sahana eden, so I can't comment on that. Our team developed a mobile app based on xls forms, and the data collected can be shared and used in various software programs that interpret this format. ODK (open data kit) is an example of a platform that can incorporate information on xls forms. (Full disclosure, I had to phone a friend here on staff so I didn't garble this answer!) You should check out NetHope, whose data expert, Gisli, is in Kathmandu.

What are some short-term and long-term challenges that arises after a disaster of this magnitude?

Thanks, not_god_grodd. The immediate concerns are just finding and caring for the people who are injured or sick. Tragically, for the lives that have been lost, one can only provide a proper, respectful burial, which also is very important. The basics of food, water, shelter, health services, sanitation are the essential "immediate" needs. Looking forward, the larger issues of rebuilding infrastructure, kickstarting the economy, and generally enabling the structures of society to be rebuilt are huge challenges. Direct Relief likes to work with and be guided by the people who will live in these communities the rest of their lives. No one from outside has lost more, has a higher stake in rebuilding properly, or knows more than the people who have suffered this tragedy. From our perspective, the funds that are coming to Direct Relief are, unquestionably, not really for Direct Relief but are really for the benefit of people in Nepal. We sort of receive the funds as trustees, and we will make sure that they're used in Nepal, for the benefit of the people in Nepal, and how they think the funds will be best used.

Recently saw VICE's report on Haiti regarding the mismanagement of disaster fund, what can be done to avoid similar scenario?

I saw the VICE piece too, and it was terribly disturbing. It seems the best way to avoid it is to just tell everyone -- donors, the public, and most importantly the people of the affected country -- here's how much money we've received, here's what we spent it on, and why. I think that's what "transparency" means, and it's pretty basic. We're very conscious of this, and I hope we're doing it well. If you look at the maps on our website, we literally track everything that we provide -- we have to do this, because of the nature of medications (if there's a recall or something, we have to contact anyone who might have received it.) In Haiti, for example, we received a total of $7.1 million five and half years ago. We gave $900,000 to one Haitian group, Healing Hands for Haiti, which was and still is providing specialized services for those who lost limbs or suffered disabling injuries. Another $750,000 was granted to local Haitian groups that hadn't received any international support, but were doing very good, imporant work. $500,000 went to upgrade 9 hospitals' labor and delivery rooms. $200,000 was spent to conduct a cervical cancer screening and training program. All those funds were invested directly in Haiti. We also used the funds to bring in and provide what has now been over $125 million in medications and supplies, and the costs of doing that -- warehousing and trucking things in Haiti, have put the funds into the Haitian economy, which we think is important and the point. It's not hard to do it -- every organization knows what it spends money on -- so I think it's a matter of asking. I should also note that our funding comes from private people, like the nice people today on Reddit, not from governments. I think that's a different dynamic, and causes one to be more accountable. It's always exceedingly humbling to all of us when, like today, people send their own money to our organization. It was very moving, and inspiring, yesterday when I saw a $25 contribution come in online from a person in Nepal. That's a very high level of trust -- on a personal level -- and it's very important to honor that. I think governments and all groups can do a better job in this regard, and we should keep at it.

Hey Thomas,

Thank you for all of the work that youre doing in Nepal.

As rebuilding moves forward, how long do you think it will take for the Nepal crisis to be over in terms of rescues, rebuilding etc. And how long do you plan to have DirectRelief on the ground in the country?

Hi, ZineZ. Thank you for your kind comment and question. It's tough to make an informed guess about how long the crisis will last, since the information is still being developed about the full extent of damage, loss of life, and the numbers and locations of people who have been hurt. The search and rescue phase itself, which is usually said to be 72 hours, has already passed, but that remains the immediate, post-incident priority and I believe people are still being found alive. The cruel effect of this quake is that, even the day before, Nepal was working hard to deliver health services for people who need it, and it was a stretch. Now, the needs are immediately much greater, and the system to provide the care is diminished. It will be a long time, but it's important to do everything possible in this immediate phase to support the people and facilities that will be there 5 years from now. Our model is not to have our staff on the ground for extended periods -- it's really to help bring resources that we have access to but our partner groups don't. But, in this immediate aftermath, we'll be rotating staff just to help manage the infusion of help that is needed and difficult to deal with logistically. Our support will continue for as long as needed -- basically, indefinitely, since we've been helping in Nepal for a long time as a supporting organization to the locally run efforts. Those, ultimately, are always the most important.

Look, if you had, one shot, or one opportunity To seize everything you ever wanted in one moment Would you capture it, or just let it slip?

All I can say in response to this, is... You better lose yourself in the music, the moment. Don't let it slip.

AS an American who just watched one of his own cities burn last night, why should I care about a disaster half the world away?

(I know this sounds blunt, but frankly a LOT of Americans think this way.)

Hi, dri123. I understand your question. Direct Relief works extensively throughout the US -- we are the only US nonprofit that has received VAWD accreditation and is licensed to distribute prescription medications in all 50 states. (It's a complex federal system to do anything nationally.) But, we did this for the same reason we're helping in Nepal -- it's a humanitarian matter, and groups like Direct Relief exist to do things that are worth doing to help those who are less fortunate, even though it often doesn't make a lot of "business" sense. The fact that people in the US do not have access to care that they need and deserve makes no sense -- it's the richest country in the world. Our extensive US program to help people get access things that they need for their health and lives is just a humanitarian program -- not political or anything else. It's the same in Nepal. We do it because we can, it's important, and in the long run, it's a very good thing to do in this life. I feel the same way about the work we did after Katrina, after the tornadoes in Joplin, after Hurricane Sandy, and every other situation. I remember after Hurricane Sandy, when a group we'd supported in Haiti sent us a small contribution to help people in NJ and NY. When we called to ask why they would do this, they said they remembered how much people in the US had helped them, and they wanted to do something to help in return. Not sure this is the answer to world peace or international stablility or much else, but I'm pretty sure it's a good thing that counts for something. And we've certainly seen that emergencies hit hardest those who were the least fortunate the day before. They have the least cushion and the hardest time bouncing back.