If catastrophe calls, include these ‘musts’ in your plan

From 30 December to 7 January, 2020 this pharmacist-in-charge worked 24/7 with no support during unprecedented fires in a remote Victorian town.

Like everyone in Mallacoota, in the lead up to the fires that forced locals and tourists to the waterline early on New Year’s Eve 2019, I had to evacuate my home. I slept in my car for two nights at the back of the pharmacy.

After cold showers for a fortnight, three weeks later, I still had no power at home and lost everything in my fridge and deep freezer. Considering patients lost houses, I can’t complain. A loaned generator on 11 January was used only to charge my phones, as the town had no fuel. The first petrol tanker arrived on 14 January, escorted by emergency services, a welcome increase from the 4000 litres of petrol airlifted in by the Royal Australian Air Force (RAAF) that was used only for generators.

There was a massive increase in the use of puffers as the smoke intensified with the fire’s advance. Within one hour of opening on Monday 30 December, all my puffers were gone. I had ordered what I thought was enough based on our usual usage. P2 masks went quickly as well. Every patient was asking for salbutamol (Asmol/Ventolin) plus a mask. Initially we were selling our P2 masks. Then we got a donation so we now just hand them out – one per patient.

After reaching out to a local GP and connecting with various government agencies, an intervention from the Pharmacy Guild’s Victorian Branch Director, Allan Crosthwaite, helped secure a shipment of salbutamol, antibiotics and P2 masks from Sigma, brought by police barge the next day.

Suppliers have since sent deliveries to the RAAF Base in East Sale from where they are airlifted to Mallacoota. Initially, during confusion with stock delivery processes, suppliers sent orders normally, which caused holdups. By mid-January orders could be delivered via NSW, but only accompanied by emergency services or the army due to continued road closures. I preferred the RAAF.

It’s imperative that every pharmacy have a disaster plan, a clear written procedure on what to do. There must also be a standard procedure to follow that can be activated as soon as the ‘too late to leave’ order is issued.

We need a streamlined process to eliminate unnecessary delays getting deliveries to affected areas. Consider these:

• Communication: Who to call? Which government department? The Guild? PSA? While the pharmacy phone rang continuously with offers of help from people and organisations, it added to the confusion. A clear line of communication is helpful.
• Deliveries: All wholesalers must also have a clear procedure for emergencies. I am still reminding suppliers not to send stock in the usual way, but to the RAAF Base in East Sale – a waste of my time with waiting patients.
• Orders: What quantities? For a small pharmacy, ordering in anticipation can leave you with dead stock if a disaster does not eventuate. Ordering too little means no stock, as with Ventolin and Asmol running out – well before the fire even reached the town.
• 3-day supply: While addressed and too late for Mallacoota, governments should allow a month’s supply for any emergency – not necessarily only during a natural disaster.
• Mental health/support must be included in every disaster plan. I had a 3-day break in mid-January, but I needed help earlier. You become exhausted mentally and physically.

* In good news, Ballarat pharmacist Won Jun Chung arrived on a cargo plane on 14 January. He volunteered his services for a week, taking the pressure off me. Thanks!