For weeks, Lavanya DJ watched as COVID-19 cases surged in India and began overwhelming the health care system. As calls for foreign aid and donations to non-profits and non-governmental organizations increased alongside the infection rate, she began compiling a list of smaller groups on the ground seeking help.

“I was seeing news coming through Twitter, just desperate cries for help. And immediately, my head was thinking, you know, this is people who have access to Twitter. Imagine the people who don't,” DJ said.

One reason DJ chose to highlight small organizations and mutual aid groups is that many are already working with marginalized people who lack access to basic medical care or even food. By donating directly to people who are already in the country and working with vulnerable communities, you can bypass roadblocks that larger international organizations may be facing.

“With large NGOs, they have to work through the government channels, and what we realized in the last month or so is the government has truly failed, especially in finding any kind of COVID relief or being responsible because they were, as we know, holding rallies as recent as two weeks ago,” DJ said. “Money will eventually get to the right places, but it's going to take some time because they have to navigate through all of these government hurdles and loopholes and departments and everything else.”

Emergency medicine for an infectious disease doesn’t typically call for cutting-edge gear. They just require the basics, said Dr. Rashad Massoud, senior vice president of the Connecticut-based Americares. The critical supplies needed in India right now are similar to what hospitals in the New York region desperately called for in spring 2020: straightforward equipment such as personal protective coverings, ventilators, oxygen concentrators and beds for hospital intensive care units.

“The health system is unable to cope, and that's why our actions are directed to helping the health system be able to cope with the increasing numbers,” said Massoud, whose organization provides medical care and relief during disasters around the world.

Americares India staff in Mumbai providing health care and information regarding COVID-19, March 30th, 2021

But acquiring those simple supplies—and then getting them where they need to go—is difficult. Intense demand for oxygen concentrators has driven prices through the roof. On Tuesday, the Biden administration suspended almost all travel from India, outside of U.S. citizens, permanent residents and some essential workers. Dr. Alex Kharazi, president of the New Jersey-based Razi Health Foundation, says these restrictions and similar ones implemented by other countries have made it harder to bring aid into the country via commercial flights.

“For example, we could buy some from Turkey, or we could buy from other countries, but there's no flights,” Kharazi said.

Despite these supply chain issues, governments and nonprofits are sending millions of dollars in cash and medical supplies as part of the collective global response to India’s crisis. But some are wary of what will happen to all this large-scale aid and wonder if it will be distributed effectively and equitably. Some of those emergency supplies have reportedly sat in airport hangars for days as medical workers continued to struggle under the onslaught of cases. For nearly a week, Indian health officials have reported more than 350,000 cases of COVID-19 every single day.

So far, DJ’s growing list includes volunteers operating an ad-hoc, free ambulance service; community initiatives that are providing free oxygen to those sick with COVID-19; and organizations providing basic food and medical supplies to transgender people. She is also raising the profile of similar lists as well as some volunteer opportunities for people who are outside of India.

“Communities know what they need best at this time and what are their most urgent needs,” DJ said. “So, Indians taking care of each other, finding ways to support each other, support their communities to volunteer efforts.”