Category Archives: emergency preparedness

Will you die in an Emergency?

30 Saturday Sep 2017

Posted by in Disaster, emergency preparedness, Nature, Uncategorized

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If you have diabetes, heart disease or another chronic illness (like me), your chances are higher.

A 2008 study titled Chronic disease and natural hazards: impact of disasters on diabetic, renal and cardiac patients found that chronic diseases are exacerbated during and immediately following natural disasters (Miller & Arquilla, 2008). That means, if you have diabetes before a disaster strikes your symptoms will probably get worse.

In the regions affected by Hurricanes Katrina and Rita, up to 40% of the people lived with at least one chronic disease like diabetes (Jhung et, al., 2007). Chronic disease can also be heart disease, Chronic Obstructive Pulmonary Disease (COPH), cancer, asthma, arthritis, autoimmune diseases and addictions. For more information on chronic diseases in general, visit CDC.gov https://www.cdc.gov/chronicdisease/index.htm

Nationwide 1 in 2 adults has a chronic disease and 1 in 4 have more than 1. What does that have to do with disasters and emergency response? A great deal.

The people (like myself) with chronic disease usually see their symptoms get worse during disasters. This is what that exacerbation word up top means. Sometimes those symptoms get so bad that people end up in the hospital or seeking care for their symptoms. Sometimes, the symptoms are so bad that people die.  A study from Tulane University School of Medicine found that hospital admissions for heart attacks are three times higher in New Orleans up to 10 years post hurricane Katrina (Chronic disease post Hurricane Katrina, 2016). This data was compared to pre-Katrina rates and controlled for typical population factors. In that same study, post-Katrina patients had significantly higher risk factors for heart attacks because their heart disease, diabetes and high blood pressure was not being well managed.

Why do these symptoms get worse during disasters?

The first reason is the disaster itself. Earthquakes, wildfires, hurricanes, floods, mudslides, tornadoes, even Arizona Haboobs cause major disruptions in the environment and our lives. Haboobs stir up dust that increases symptoms of asthma and COPD (not to mention Valley Fever). Floods expose diabetics to nasty sewage water that can increase the chances of skin infections. So if you outlive the actual disaster and don’t get crushed by the earthquake, you are probably going to have a really hard time managing your asthma and you might die from it.

The second reason is exposure to temperature extremes, lack of food and water and they physical and emotional trauma. Many of the medications we take to control chronic diseases make dealing with extreme temperatures very difficult. A lack of food or water for someone with diabetes usually means low blood sugar and a trip to the emergency room. If that emergency room is unavailable or you are stuck in an inaccessible area, you might die.  The stress of the emergency leads to anxiety, forgetfulness, depression, increased blood pressure and increased exacerbation of chronic disease illness.

disaster

The third reason is lack of medications. Many evacuees forget (or don’t have time) to bring their medications with them. In Houston and Florida, many evacuees didn’t even know what medications they took for their conditions. During hurricane Katrina, local and federal responders set up emergency pharmaceutical dispensing areas where evacuees could get over the counter and prescription medications. 73% of the medications dispensed were for chronic care in general with 39% of that being for people with heart disease (Jhung et. all., 2007). So if you survive the tornado itself and you are now trapped in your underground bunker for a week and you didn’t bring your heart medications with you… well you see where I’m going.

What can we do about it?

Be the healthiest version you can be.

I’m not saying you need to be super thin or compete in American Ninja Warrior training. I’m saying, take care of yourself. Manage your chronic condition to the best of your ability. Manage your symptoms well now so that when disaster strikes, you have a greater chance of survival.

  • Take your medication as prescribed
  • Talk to your doctor about everyday management
  • Sign up for Chronic Disease Self-Management Classes http://azlwi.org/
  • Know your nutrition needs and try to live that everyday
  • Find ways to reduce stress: practice meditation, prayer, yoga, whatever appeals to you

Be the preparedest (not a word) version you can be.

I’m not saying you need to build a bunker (unless you live in a tornado infested area). I’m saying, take some time to build an emergency preparedness kit. Prepare for the management of your chronic illness away from home by including:

  • At least a seven day supply of all your medications
  • A cooler with those insta cool packs for medications that need refrigeration
  • A list of medications and dosages you normally take or
  • Empty bottles of your medications stored in your kit
  • Add special equipment for disease monitoring (glucose machine, blood pressure cuff)
  • Instructions on how to take your medication in case you need help with dispensing
  • Over the counter medications you normally take
  • Comfort foods or special diet foods
  • A list of physicians with their contact information
  • A list of facilities with their addresses that you receive regular care at (cancer and dialysis treatment)

Be the championingest (I’m gonna make this work) version you can be.

I’m not saying you need to lead the charge in your neighborhood. I’m saying, since 1 in 2 Americans have a chronic disease, it’s smart to build a network of support:

  • Ask neighbors if they need help building emergency preparedness kits
  • Advocate chronic disease self-management
  • Encourage others to eat for their health and know their nutrition needs
  • Find trustworthy people to help with medication dispensing during emergencies
  • If you have other family members with chronic disease needs, plan together

How I’m going to start

The one thing that really hit home with me was how evacuees didn’t know their own medications. I’m lucky and I only need to take one medication on a regular basis so it’s easy for me to remember the name and dose but I couldn’t tell you the names and doses of medications my family takes. Something with an A? Something that sounds like propanol? That one that causes massive diarrhea? My husband probably doesn’t know what I take. The first thing I’m going to do this weekend is to take our old bottles and put them in the go kit. It’s a first step for me and it can be a first step for you too.

blog post 2

Disclaimer: I’m obviously not a physician of any kind. Just a public health emergency planner who thinks about disasters a lot.

References if you really want them:

Miller, A., and Arquilla, B. (2008). Chronic disease and natural hazards: impact of disasters on diabetic, renal, and cardiac patients. Prehosp Disaster Med. 2008 Mar-Apr;23(2):185-94.

Jhung, M. A., Shehab, N., Rohr-Allegrini, C., Pollock, D. A., Sanchez, R., Guerra, F., & Jernigan, D. B. (2007). Chronic disease and disasters medication demands of Hurricane Katrina evacuees. American Journal Of Preventive Medicine, 33(3), 207-210.

Chronic disease post Hurricane Katrina. (2016). Australian Nursing & Midwifery Journal, 24(6), 15.

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It Wasn’t my Storm!

05 Tuesday May 2015

Posted by in emergency preparedness, monsoon, weather

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Wash overflowing in Bouse, Arizona

Wash overflowing in Bouse, Arizona

It wasn’t my storm!

The storm wasn’t anywhere near us. It was, in fact, over 35 miles across the dry hot desert hovering over the small town of Quartzsite, Arizona. Quartzsite sits along Interstate 10. It’s that little town you drive through about 10 miles east of the California border. If you were to stop you would find a friendly community of retirees who spend their time exploring the desert, organizing community events, dabbling in politics and prepping for disasters. Maybe that’s why storms always hit Quartzsite but never traveled north to the town I was living in at the time, Parker, Arizona. The storms were testing…

I had just finished putting my kids to bed when I saw the first flash of lightening. Excited, I rushed to the window, expecting to see dark Monsoon clouds looming overhead. Nope. Nothing.

You can’t touch me!

The dark clouds were nothing but a wall of disappointment stretched across the horizon, mocking me. “You can’t touch me.” Sure, they were spewing bright flashes of lightning like an angry mother whose children won’t go to sleep but they were too far away to bring cool relief. With a turned down mouth I settled into my own bed and pouted about the unfairness of how Quartzsite always gets the rain but Parker never gets anything (you have to whine aaaaannnythiiiing like a 5 year old would. It really helps to set the mood).

"You can't touch me," says the cloud.

“You can’t touch me,” says the cloud.

 

 

 

 

 

 

 

There I was, just about to fall asleep to the sound of my nice, cool air conditioning when I noticed a little flicker of the hall light. Just a little. Just enough to make me think about replacing the bulb in the morning because it was probably just the bulb going out and not the storm (say it with a snicker. It’s fun that way) coming in.

A few minutes later, I wake up to the stifling heat of a low insulated house that’s gone minutes without cool air. It’s like the great desert saw weakness and sucked every last drop of cool conditioned air out of the smallest cracks in my weather proofed doors within seconds. It was hot. It was sticky. I was miserable. Grudgingly I walked to the window, expecting to see the progression of the storm at my doorstep. What? It’s still in Quartzsite? The Monsoon settled over the small town and unleashed its mighty fury without moving. Then why is my power out?

I did the only thing a girl could do, I turned on my scanner and opened Twitter and Facebook to see if there were clues about what was going on. Twitter was quiet and Facebook had a couple of “Why is the power out” posts but the scanner was chirping with activity.

“Yeeeeaaaaah, uuuh, looks like we have a couple of poles down along the 95 (highway connecting Parker to Quartzsite).” “We are getting calls of localized flooding and running washes along Tyson. Can you send someone over to check that out?” “(Fire Department call tones…) Station 33, possible car in a wash, cross streets of Tyson and Wells Rd.” “Dispatch can you notify APS that it looks like 15 poles are down along 95. Half of them are after Tyson Rd and it is completely flooded so let them know accessibility will be an issue.”

You get the picture.

What started out as a disappointing storm for me was turning into a real emergency for the people of Quartzsite. The calls kept coming in. Trailers had damaged roofs, cars had broken windows, travelers were stranded in the night, medical calls, assistance calls; the town of Quartzsite quickly became overwhelmed.

This went on for a couple of hours. I was still hot, I was still sticky but my kids remained asleep and I was safe from flooding and wind, unlike the residents of Quartzsite. I thought of them and what they would wake up to in the next few hours. Not many people outside of Arizona realize how destructive Monsoon storms can be. Microbursts (wind that quickly bursts downwards from a Monsoon cloud) can generate wind speeds higher than 170 mph. The typically hit a small area, less than 2.5 miles in diameter. Anything more than that is a Macroburst. What hit Quartzsite was a Microburst and it dumped a lot of water. I wish I had kept the clippings of the storm damage when I moved from Parker to Phoenix. I remember pictures of trailer roofs being torn off, power poles laying in the street, washes that overflowed into yards and undermined foundations, a car still stuck in a wash, covered in mud and desert debris. Some residents posted pictures on Facebook.

Over the next few days, APS worked long hours to repair the downed poles and restore power to the community. For 48 hours, some parts of the town were without power while I only had to suffer through 12 hours before my power was restored. In Parker, local government agencies got themselves ready to support the town. We thought of shelters, food supplies, games for kids, generators for emergency power for people on medical equipment. The call never came. Why? Because the small community of Quartzsite was prepared. They were resilient! These storms don’t phase them! They already had shelters set up in a couple of churches with back-up generators. Residents with medical needs that required power either self-evacuated or had community help getting to their shelters. They cooked for each other, played games with the kids, entertained and told stories and made plans to clean up after the power was restored and roads were cleared.

I realized the storms don’t come to Quartzsite because the residents are prepared; the residents are prepared BECAUSE THE STORMS COME TO QUARTZSITE!

Talk about an Ah-HA moment (you are probably saying, well duh!). A small community of less than 4,000 people came together to prepare, respond and recover. It didn’t take a major emergency preparedness campaign; it took their own personal experience and community mindedness. First responders, emergency management, public health, public works and town and county officials were freed up to assist with recovery, clean up and mitigation for the next storm.

The residents of Quartzsite taught me a few lessons.

  1. Monsoon storms can be very destructive. Don’t underestimate their power.
  2. Personal preparedness starts with experience. I admit that I am not all that prepared. I still have that “it won’t happen in Arizona” mindset because I’ve never personally been in an emergency that stressed my preparedness supplies (I have about a day or two but often run out of stuff before restocking).
  3. Emergencies don’t have to happen to you directly for you to be affected. If the power restoration took more than 12 hours, I would have been in a pickle.
  4. Community resiliency (ability to bounce back) starts with and is dependent upon community, not government. Yes, governmental agencies play an important role but the community heals faster when it comes together.

Resiliency starts at home with you, me and our community. Next month is Arizona’s Monsoon Awareness Week. Watch for tips on being prepared and increasing your disaster resiliency.

http://monsoonsafety.org/