We all do our best to be prepared in case of an emergency; however, unexpected events that we have no control over do occur. When disaster strikes, we frequently take medical care for granted. Hospitals and doctors are usually available when we need them, but what happens when a hospital is destroyed by a natural or man-made disaster?
Are you ready for that possibility? Do you have a strategy?
I asked our contributor James H. Redford MD, what advice he would give in a situation where a disaster has destroyed medical facilities.
Why is it critical to be medically prepared in the event of a disaster?
There is a widespread belief that if something bad happens, the federal government will step in and save everyone. Depending on the scope of the disaster, the government may be unable to assist.
Local disasters occur first. The feds may be too busy assisting others, and it may be some time before they can reach a smaller community.
Communities must know everything about their resources, how they are allocated, and how to respond if something goes wrong. Before the feds arrive, we need to take care of ourselves.
One of the issues is that, before outside help arrives, the hospital staff is likely to be affected by the disaster. They might not even be able to get to the hospital. The disaster has also harmed local service providers. They may also have home emergencies.
In the event of a major disaster, a hospital may have enough backup medical supplies and generators; however, the staff is a critical resource that may be unable to reach the hospital.
What is the mindset of people going through the initial stages of disaster recovery when disaster strikes?
Clearly, there is anxiety. Denial is another major factor in a disaster. Many people must overcome their denial. Bitterness could play a significant role as well.
You must remember the four basic survival principles: fire, water, food, and shelter. Most importantly, have a strategy.
You’re already behind the eight ball if you don’t have a plan. Having a plan puts you in the right frame of mind. There will be less confusion if you have a plan and know how to implement it.
What can folks do before a disaster to help improve their situation during one?
It depends on the type of disaster. The most important thing is that people should make sure they are up to date on the Tdap (tetanus vaccine).
People are attempting to become more self-sufficient, in my opinion. I believe that knowing some basic medical terminology will help them a lot.
Basic wound care is critical. Immunizations are critical. Dental health is also important, so obtain an emergency dental kit.
Have a book reference library. Look into home remedies because many of them work.
Bioenvironmental issues… how to clean water. How to use Bleach for disinfecting, and how to boil water to make it potable. Field hygiene is essential.
How will the bodies be disposed of in a long-term disaster where people are dying?
How are you planning to prepare for the old diseases which may come back?
What medical supplies do you always have on hand?
We have analgesics and basic antibiotics on hand (Azithromycin, Ciprofloxacin, and Metronidazole). Check to see if any of these medications have passed their expiration dates.
Many bandages, basic wound care, and dental care items are available (toothpaste, dental floss). Trash bags, condoms, feminine products, hydrogen peroxide, rubbing alcohol, basic suturing kits, and skin staplers. It’s also helpful if you know how to suture or staple.
Acetaminophen, Ibuprofen, and the availability of pediatric doses of these medications are also beneficial.
How frequently do you go through your med kit to ensure it’s up to date?
We usually do a quarterly inventory to ensure that nothing is out of date. If something expires during that quarter, I will pull it and purchase an inventory update.
How many days of supplies do you think people should stockpile?
FEMA tries hard to educate people that a three-day supply is adequate, but a larger-scale disaster may necessitate a much longer supply. Three days is a good starting point, but two to three weeks of supplies is more realistic.
Would there be any medical resources or facilities that would make sense as alternatives if a disaster struck and medical services were not immediately available?
During a disaster, emergency departments can quickly become overburdened. An emergency department has a certain amount of capacity. If a hospital has been destroyed, there are other options.
There are opportunities for assistance, whether through the Red Cross, churches, or universities. Nursing programs at some universities may be useful in a disaster situation.
We have open PODs, where people come for medical aid, when the health department has set up to care for people. There are closed PODs where nursing students from universities can assist. These relationships are already in place prior to the disaster. An urgent care center is another option.
Senior housing developments may be a viable option because they provide nurses and medications that may be beneficial. Before the disaster, medical reserve corps (MRCs) should be established. These are important to establish and consist of medical community volunteers.
When a disaster strikes, many people will want to help. Where should they go to be of most assistance?
You should contact the local emergency management agency. Check with the Red Cross, local churches, and walk-in clinics as well. Hospitals and public health agencies receive some funding and are required to have volunteer programs.
You can look for an incident command post. If you see a tent in a parking lot, someone is in charge. Inform them of your experience and credentials so that they can determine how you can best be used.
Another thing I would say is to not get your feelings hurt if that person does not immediately pay attention to you or put you to work. They must figure out how to safely integrate you into the plan.
What about the influx of volunteers who arrive to assist?
Although agencies have the best of intentions, their actions complicate the process of response recovery. When we go down to help, and it isn’t part of a coordinated effort, there are more people to feed and more places to stay.
This redirects efforts away from those who actually need assistance and toward those who are willing to assist. Now, healthcare must assist not only those affected by the disaster, but also those who are present to assist.
There are a lot of volunteers who just show up, and there’s no way to know what their backgrounds are or what equipment they have. As a result, the volunteers have the potential to overwhelm the system.
The person in charge on the scene must be responsible for both the people affected by the disaster and the volunteers assisting in the disaster. The last thing they want is to be responsible for the volunteer as well.
Not that assistance isn’t required, but the chaos must be managed. Find a company that has experience dealing with disaster services. Volunteer with them to gain experience.
Any final recommendations?
A disaster’s nature is to catch us off guard, so we must be prepared as a community. The community is the glue that holds us together, and we must remember that we are both a national and a local community.
You must be able to care for yourself. If you have a medical condition, you must understand how your body will react in that environment. You must stay in the game in order to assist as many people as possible.
The most important thing is to have a plan, but to be flexible. Don’t be so set in your ways that you can’t think outside the box. There are numerous shades of gray.
Make a plan. Carry your gear around for a while to see if it’s feasible. At the very least, you’re ahead of the guy who didn’t plan ahead of time. It is preferable to be proactive rather than reactive.
When a natural or man-made disaster strikes, it may take a long time for help to arrive. Prepare to be self-sufficient. This includes taking classes, honing skills, and devising a plan for surviving the disaster’s aftermath.
Make sure you know what you’re capable of doing in different situations, and practice with your gear. Understand the emotional components that emerge after a disaster and how you manage them in yourself and others.
Maintain flexibility in your thinking as both a survivor and a responder attempting to assist others.
“No one is coming to save you,” I keep telling people, and it is our responsibility to prepare and plan ahead of time.
You may also want to check this: