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Tuesday Oct 11, 2016

Will You Be Prepared When Disaster Strikes?

As Hurricane Matthew swept along the coast of the southeastern United States last week, it caused catastrophic flooding, left more than 2 million homes and business without power, claimed the lives of more than two dozen people in five states and displaced thousands of others.

Whenever a natural disaster strikes, I imagine how I would respond if it happened in my community. If I needed to evacuate like those in South Carolina, would I be ready to leave? If I stayed, would I have the necessary supplies to take care of my family? Could I keep working at my clinic to help my patients? Am I able to advise my patients on preparedness issues?

 U.S. Department of Defense

Hurricane Matthew covers parts of Florida, Georgia and South Carolina. More than 30 Americans died in five states as a result of the storm in early October.

In the last year, my answer to all these questions has changed from no to yes, and I want to share why.

Reports were published last year about the probability of a major earthquake striking the Pacific Northwest, one large enough that most Portlanders could go weeks without basic city services or access to emergency support. In fact, one in-depth piece in The New Yorker(www.newyorker.com) projected that a major quake in the Cascadia subduction zone would be "the worst natural disaster in the history of North America."

Oregon averages more than 60 earthquakes per year, and because I've lived here all my life, I've felt a few. But the potential scope of a Cascadia subduction zone earthquake was the wakeup call that spurred me to take action, prepare myself and learn how I could assist my community.

In May, I completed training to become a member of a Neighborhood Emergency Team(www.portlandoregon.gov), or NET (known as Community Emergency Response Teams(www.fema.gov), or CERT, elsewhere in the nation).

NETs are city-sponsored, all-volunteer disaster response units, tasked to fill the gap when professional first-responders are overwhelmed by a major disaster. My city's NET program provided 28 hours of free training during the course of a few weeks, taught by local first responders and city employees. They taught us practical skills to provide emergency assistance in the event of a disaster. For example, we learned search-and-rescue techniques, carried victims using chairs and blankets, used wooden debris to rescue trapped victims, and practiced radio communication.

Our final exercise was conducted in Portland's "Scenario Village," a warehouse that held a realistic city block filled with volunteer actors with simulated injuries who were waiting to be found, triaged and treated. Although NET training is aimed at the general public, I learned a lot as a physician even in the medical triage and first aid sections.

I also took additional training courses on Federal Emergency Management Agency (FEMA) operations, emergency communications systems and advanced wilderness first aid, and I assembled my own home emergency kit. (NET suggests members be able to be self-sufficient for at least two weeks after a disaster.) I now feel prepared for even a major disaster.

Working with my city's NET program has been a great way to connect with my community. I talked with neighbors about emergency kits at a booth at my local farmers market, and I discussed medical preparedness at a community fair on earthquake preparedness. I attend monthly meetings with my neighborhood team members. I joined my clinic's safety committee, and we help organize safety drills at work.

Disaster readiness has become a common topic with interested patients who ask me what I think they should do to get ready. When the subject arises, I tell them a few key things:

  • Have a plan. Designate an emergency contact outside the city for everyone to call or text. Set a meeting place at which loved ones will gather.
  • Set aside clean water, at least one gallon per person per day for a week. Keep fresh bleach on hand to purify water. Store non-perishable and canned food with an extra can opener.
  • Have at least a one-week supply of important medications.

Emergency preparedness takes a lot more than these things, but I find that patients respond well to this advice coming from a physician. I have a patient handout I can use for after-visit summaries, and there are great community resources for patients who want to put together a home kit(www.ready.gov) that includes more than food, water and medications.

As family doctors, our patients trust us as healers who care for them and their families. Patients rely on us to advocate for their needs. In medical school and residency, this meant managing the health problems of individual patients. In practice, this means knowing and caring for entire communities. Primary care doctors can be an important voice in helping patients be prepared for disasters.

Whether we live in a seismic hot spot, Tornado Alley, a flood-prone region, or an area that is vulnerable to hurricanes or other natural disasters, there are steps we can take to help prepare our families, practices, patients and communities. The AAFP has comprehensive disaster preparedness resources  that include instructions for our homes, practices and communities. FEMA also offers an in-depth preparedness guide(www.fema.gov).

Melissa Hemphill, M.D., is faculty at Providence Oregon Family Medicine Residency and practices in an urban underserved clinic in Portland, Ore. You can follow her on Twitter at @MhemphillMD(twitter.com).

Posted at 04:52PM Oct 11, 2016 by Melissa Hemphill, M.D.

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