I’m writing this from the flooded far north coast of New South Wales, where all around me people are contending with the awful and unexpected consequences of a catastrophic flood.
I have worked in rural health for a long time and this has been the worst I have experienced it. It is well established that those living in flood-prone areas often already have more financial and health issues than others.
Among those consequences is the need to manage medicines safely, and sometimes urgently find and acquire medicines you need to stay alive and healthy or keep pain at manageable levels.
The far north coast has a high population of older people, many of whom need daily medicines such as insulin to survive.
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While I was picking up medicines for a family member this morning, another older person turned up at the pharmacy with a script. She was running out of her medicine today but the pharmacy did not have the required medicines left. She continued her hunt for medicines at the last pharmacy in the area we have access to.
These are just some of the challenges people face when it comes to medicines in a disaster zone.
From ordinary errand to a life or death challenge
A week ago, if you needed to top up your medicine supplies, you could pop down to the local chemist. The script would be filled, and supplies plentiful. It would be an easy trip.
Today during floods, an errand like that means confronting challenges such as:
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many chemists being underwater or badly flooded
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the chemists that are open are contending with a surge of demand as people flock there to buy medicines
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power is down in many places, meaning online systems for managing scripts are impossible to access and fridges used to store medicines such as insulin at home are not working
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phone and internet is down or patchy in many places
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petrol is very hard to get and running out, so many people cannot drive to the chemist
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many people have lost their cars too or have water damaged cars
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some people cannot leave home due to landslides or floodwaters
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roads are being cut off and supply lines disrupted because the highway is blocked off
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getting a new script is not as easy as heading to the doctor’s office; some GPs are also flooded in, their practices inundated or not-operational and many are unable to get to work and/or stuck without power, phone or internet.
These challenges are not unique to our area nor are they unique to floods. People who have survived bushfires and other disasters have faced similar issues.
But with disasters predicted to become more frequent and more intense as the climate changes, it does raise the question what systems we can put in place to deal with these challenges in future without putting people at risk.
What can be done?
Firstly, if you are in an emergency, depending on your circumstances, please call 000 or contact the SES on 132 500.
When preparing your evacuation plan, ensure you have a list of all your medicines, care plans, scripts, Medicare and other health-care cards details and other important medical information ready.
If an evacuation warning is out for your area, ensure all your information and medicines are packed. Store medicines that need to remain cold in an esky with ice bricks, so you are ready when you need to evacuate. The esky is important; power may not be available for a while when you leave home.
Several apps are available to help in preparing for a disaster and taking your medicines safely, such as the Red Cross’ RediPlan emergency survival plan or the MedicineWise app.
If you know a flood is heading your way, it’s also handy to have extra cash at hand. During this flood disaster, electronic payment systems were not working in many places in the Northern Rivers. Having some cash can further reduce already very stressful circumstances.
If you’re flood-affected, in need of medicines and can get yourself to a pharmacy, it may be OK even if you have lost your scripts in the floods. The pharmacist may be able to call the GP on their mobile.
If you have internet access, use social media to see if others can help with transport or delivery of medicines. Many people feel powerless during disasters and will be keen to help.
And there may be some strictly limited circumstances under which a pharmacist can provide a small emergency supply of certain medicines without a script.
According to Queensland Health:
In an emergency situation where you are not able to reach a community pharmacy, your GP’s prescription can be filled by a Queensland Health public hospital pharmacy. However, please be aware that hospitals may not stock the full range of medicines prescribed by your GP, as the needs of hospital and community patients are different.
You can use My Health Record to get certain key details on your medicines and health details, if you’ve got internet access.
After the floods, it is important to look at replacing medicines that have been in contact with flood water or other contaminated water. This includes pills, liquids, injections, inhalers or creams. Contact your doctor or pharmacist as soon as possible and organise replacement medications.
You can also contact the NPS Medicines Line 1300 MEDICINE (1300 633 424) or the healthdirect helpline (1800 022 222 or Nurse on Call in Victoria) if you are unsure or have questions about your medicines.
More broadly, access to medicines during a natural disaster is complex, and we need to continue strong partnerships and collaboration between organisations to ensure access during disasters.
Having a good spread of chemists around different parts of a town or rural areas helps boost the chances that even if some are hit by disasters, others are able to operate and provide people with medicines (which is what we have seen in the 2022 floods in some areas).
Privately owned and hospital-run helicopters have been used to get medicines to residents in flood-affected areas of Brisbane; ensuring disaster-prone regions have the infrastructure and machines needed for this kind of help is important.
COVID forced us to think creatively about delivering medical supplies to people who need them but are unable to visit a pharmacy. This shows what’s possible when needs must be met.
Thinking carefully about people’s health during and after disaster is crucial to building disaster resilience. Ensuring uninterrupted supplies, extra support for vulnerable people and access to medicines is a core part of that goal.
Sabrina Pit, Honorary Senior Research Fellow at the University of Sydney, Honorary Adjunct Research Fellow, Western Sydney University