Climate chaos is here. So I’m posting questions or topics, one per week, about something every one of us is likely to face. Let’s see if we can work together to figure out ways to survive.
Week 1’s question was Do You Stay or Do You Go?
Week 2: What Is Your Timeline?
Week 3: What Skill Do You Need To Learn?
Week 4: How Will You Deal With Flooding?
Week 5: What About Potable Water?
Week 6: Got Energy?
Week 7 : What Are Your Preparations For A Food Emergency?
Week 8: Do You Have Enough Nutrients?
Week 9: What Are Your Plans For Fire?
This week the question is What will you do about medical care?
The covid pandemic has been an eye-opener
For a relatively small disruption (compared to climate chaos and a great extinction event), the extent and pervasiveness of disruptions caused by covid have been broad, deep, and long-lasting. The impacts on medicine are on-going, such as a decrease in the number of medical practitioners, funding cuts to community health and monitoring services, supply chain problems, and shortages of medicines.
What will the larger climate and biosphere disruptions bring? What are they already causing?
Increased medical needs
Humans are looking at a vast increase in medical needs as a result of climate chaos. Heat, pollution, and in some countries an aging population are already straining medical systems across the globe, and heat and pollution are increasing at accelerating rates. Heat stroke and heat death, and various pollutants (plastics, endocrine disrupting chems, forever molecules, and oldies like Pb, asbestos, Cr, etc.) are increasingly present in our lives and producing bad health outcomes.
Shortages
We already see shortages in medicine and caregivers. The WHO estimates that between 80,000 and 180,000 medical workers died from covid in the first 16 months of the pandemic. Additionally, huge numbers of nurses, doctors, and healthcare workers continue to leave the profession (the numbers vary depending on the study, but range between 20% and 50% in the United States).
Epidemics and bottlenecks have created medicine shortages before, but currently such shortages are at an all time high in the U.S. The reasons why vary, with corporate greed, supply chain issues, quotas, and increased use of drugs (sometimes off label) all being seen. But the manufacturing and supply chain for medicine is often so far from transparent that no one knows exactly why there is a drug shortage for any specific drug; often, there just is one.
Of course, the biggest drug shortages are in poorer countries where, in some cases, drugs are manufactured for export to richer countries, skipping the local population entirely.
Suppy chain disruptions
As we all saw at the start of the covid pandemic, modern supply chains are easily disrupted. The longer and more complex a supply chain, the easier it is to disrupt. The U.S. imports enormous amounts of our medical equipment and drugs from other countries. A drug can have a single manufacturer and the national supply of that drug can be knocked out by a power outage, spill, or fire at the single manufacturing site. A product recall, a hurricane, or a hostile takeover can impact supplies from a larger manufacturer. And political actions, tariffs, and wars can cut supplies across the globe.
Basically, our supply chains are strung out and fragile. And they are breaking.
So what are our options?
Southern Brazil is cut off from much of the world now and will be for weeks to come. We’ve seen what war can do to medical supplies and personnel. So what are out options if we need to source our own medical care?
- Make your own
- Alternative medicines
- Stockpiling
- Triage
- Expectations
- Community medicine
- Funding community docs
Make your own means just that. What medicines can you grow and/or make yourself? This means having a lot of good, tested, trustworthy reference books on hand, plus practical knowledge on what plants you can grow or collect and what procedures you can do in your kitchen (can you distill, can you set up vacuum extraction, are you able to test product purity, etc.) This option can be very botany and chem heavy, but everyone can make alcohol (and vinegar).
Alternatives means using non-western medicine as a real alternative to western medicine when you can. I’ve been seeing accupuncturists for most of my life, and have a fairly good understanding of what they do that works for me. I won’t bother going to an accupuncturist for skin issues but Bell’s palsy would get me through the door immediately.
Stockpiling medications that you can’t make or replace makes sense. True expiration dates becomes an issue. An epipen has a date of one year on it, but there’s also a window on the side that says to discard if the liquid looks colored or cloudy. So, at the end of one year, if the liquid is clear does that mean it’s still good? For how long? What are the problems if it’s no longer “good”? For each specific medicine, then, you’d need a lot of information. And what about medical equipment? A lot of equipment that had been stockpiled by the U.S. government that was released to hospitals during the first year of the pandemic was in non-working condition.
Triage might be needed if your resources are limited. Neighborhood Emergency Response Teams (NERTs, or CERTs for Community) are trained in mass disaster triage. If an injured person can walk over to a waiting area and isn’t talking nonsense in response to your questions, they can wait the longest for help and get a green classification. People are sorted into green, yellow, red, or black (dead) so you can send your limited resources to where they are needed and will do the most good.
This leads directly to Expectations. Without power, an MRI scanner won’t diagnose anything. Penicillin is a wonder medicine, but if all you have are sulfa drugs, you use those. Learning bush medicine, or studying health care practices of earlier times when there was less medical equipment and reduced access to drugs may be a useful course of study. There are lots of how-to books to help with this.
Community medicine is a way of pooling medical resources in one locality for use by the people in that place. Some cities and municipalities have functioning community clinics; some have good systems. Some communities depend on volunteer organizations for local medical care, and those organizations often are religious, many with a particular agenda to push (such as to increase cult memebership). It is easy for such systems to be inequitable, yet many have done a lot of good on very little money.
An extension of the community medicine idea is Community Docs, for a town to pool its resources to fund 1 or 2 students through med school with the proviso that they return to the town and set up their practice there.