YOUR HOUSEHOLD’S SPECIAL NEEDS
Members of your household may have needs that will be difficult to meet after the earthquake. Children, pregnant and nursing women, frail older people, and those with chronic illness or physical or mental challenges are more vulnerable to problems caused by post-earthquake conditions. Households with pets need to be ready to care for them.
The information in this chapter doesn’t cover every situation, but it will help you think about the special needs in your household and how you might adjust your preparations accordingly.
People with compromised immune systems, those who need frequent medical procedures, and those with serious chronic health conditions will likely face an interruption in their usual care.
Every year, hospitals and medical facilities make progress toward being more prepared for continued operation after a major emergency such as a mega-earthquake. As more patients push for answers, preparation for the Cascadia earthquake will be given the focus it deserves in health-care circles. Keep asking the questions, and hopefully the answers will become more satisfactory over time. But do whatever you can to prepare now; don’t wait for health-care providers to come up with the perfect answer to your issues.
There aren’t easy answers for how households should address complicated physical or mental needs without the expert help they rely on. Talk to your doctor about what to do in case of an interruption in care. Some doctors may assume that emergency responders will be able to restore supply lines and roads much more quickly than official estimates—if your doctor believes that there will be a break of only a few days in critical services, you probably know more about a 9.0 Cascadia earthquake than they do.
Many medical devices require power to operate. An extra battery pack for your device may suffice; check expected battery life against your typical use. Generators are an option for power but require fuel, which is difficult to store safely and may be impossible to get after a mega-earthquake. Solar-powered generators are a safer option, but reliability could be an issue depending on weather conditions. Talk with your doctor to sort out which options might be best for you.
For many prescription drugs, it is dangerous to suddenly stop taking the medication. Talk to your doctor about your medications, and whether you can safely reduce or stop if needed in an emergency. Discuss how to ensure you have an emergency supply of your drugs or what might substitute for the medication in question. Insurance generally won’t cover the cost of a prescription to be used in case of emergency. Some drugs have relatively modest retail prices, but others are shockingly expensive. Work with your doctor and pharmacist to come up with the most reasonable option—medically and financially—for your situation.
While refrigeration for insulin is recommended, most types can be kept safely for up to two weeks if the temperature is kept below 82 degrees F. Some insulin will last for up to a month without refrigeration. The resource section at the back of this book includes a link to a summary table of insulin products with safe storage notes. Again, talk with your doctor or pharmacist about your situation.
A conversation with your doctor may not provide a satisfactory solution to every challenge. There may be complex things you can’t do, but there may also be simple things you can. Look for what is possible. If your doctor can’t offer practical suggestions to address the special needs in your household, try reaching out to online forums. There are online groups for people with a wide variety of chronic illnesses or physical or mental challenges. Post a question to others about whether anyone has had to manage their condition during a natural disaster. You may find good insights or suggestions.
Recognize that people often do much better in life-threatening situations than anyone would have expected. Studies of dire situations suggest that the decision to survive can be more critical than other factors in determining who overcomes impossible odds. This isn’t to suggest, of course, that someone dependent on insulin can somehow “decide” to survive without it, but simply a reminder not to be overly pessimistic about what is survivable. Thousands of people around today have experienced conditions they never thought they could survive, many contrary to all expert predictions of what it is possible to survive.
Children are more vulnerable to dehydration, food- and waterborne illness, and other post-earthquake risks than adults, but you’ll want to make sure to look beyond their physical needs. Emotions are contagious, and children are especially susceptible to “catching” the feelings of their parents. The most important thing parents can do for their children in a natural disaster is to keep themselves as calm as possible.
There is a reason that every airline safety talk recommends that parents put on their own oxygen mask before they try to put masks on their children. In an earthquake, making sure you address your own safety and health will be like putting on that oxygen mask—something you must do to better care for your children.
The ways your family usually copes with stress may be amplified by the disaster. You know how family members respond to ordinary problems and conflicts; expect the typical behavior to intensify.
Remember that children are often able to suggest creative solutions to problems, because their life experience hasn’t narrowed their views on what is possible. Some of their ideas won’t be practical, but others may be. In post-earthquake conditions, many problems will need to be solved in novel ways. Including children in thinking through options may be helpful to them and to you too.
Effect |
Solution |
Child assumes the earthquake and aftershocks are caused by a person or group as a punishment for some transgression |
Explain repeatedly that no one can cause or stop earthquakes: they are due to natural forces |
Child begins to act younger than their age |
Understand that regression is common and nothing to be alarmed about—don’t try to force the child to return to “acting their age”; they will “catch up” as things calm down |
Child is frightened of being away from their parent(s) |
Accommodate their need, as much as possible, to have those they love nearby |
Older child becomes defiant, withdrawn, or tries to take on the responsibilities of an adult |
Try not to let them overextend themselves while still honoring their desire to be of help |
Child is anxious |
Understand that action reduces anxiety; find genuinely helpful jobs that a child can do (see this page). Give the child control over something; for example, give them their own flashlight so they can control having light. |
Children can also be a resource to help accomplish tasks after the earthquake. Just as before the earthquake, it will probably be easier to do it yourself than to have their “help.” But as noted in the accompanying chart, staying busy and feeling capable are both powerful antidotes to the anxiety many children will feel. Find ways that children can help, even if it does slow you down.
Reading aloud to younger children or playing games with them
Sitting with older adults who can’t help with post-earthquake tasks
Covering any animal waste they see with sand or dirt
Counting the number of aftershocks and writing them down—so they can see that they are diminishing with time
Walking with a parent to check on neighbors
Counting the cups of water they drink to make sure they are getting enough liquid
Rolling up sleeping bags each morning
Feeding pets and making sure they have water
“Interviewing” people if the family is sheltering with others in a park or open area and writing down what they say in response to questions such as these:
What has surprised you about life since the earthquake?
Are there skills you have that you are willing to use to help others?
Are there needs you have that you’d like help with?
Pregnant and nursing women can be more vulnerable to dehydration, hunger, cold, and other post-disaster conditions than other adults. Prioritize their needs above those who will weather shortages more easily.
If a woman is close to her delivery date, know that the challenges of getting to medical care could be a problem, and even if she can get to a hospital, the facility may be trying to evacuate. Begin making backup plans and looking for knowledgeable help immediately. Identify anyone in the workplace or neighborhood who might be equipped to deliver a baby—a doctor, nurse, midwife, or military medic might all be options in an emergency.
The reality is that infants and small children survive every day in the kinds of conditions we’ll face—but the reality also is that little ones die of diarrheal illness in large numbers in countries without running water and sanitation systems. The main dangers are dehydration, hypothermia, hyperthermia, and food- and waterborne illness; be on high alert for signs of these (see relevant chapters on preparing for and dealing with each of these issues).
Some older people will be especially resilient, an advantage gained from living through many types of crises in their lives. These elders can be a valuable resource for keeping others calm and hopeful.
However, some older people may have more difficulty caring for themselves in the extreme conditions following an earthquake. Their lessened ability to regulate their body temperature makes hypothermia or hyperthermia a greater risk, and since signals of thirst usually diminish with age, dehydration is a bigger danger. If older people are alone or isolated, it may be even harder for them to summon the important will to survive.
As with children, provide care to those older people who can’t care for themselves, but work to find ways they can contribute. Keeping busy will reduce their anxiety and may make it easier for them to accept help from others.
Many of us are dependent on substances. If you are a daily user of caffeine, nicotine, alcohol, or cannabis, you may experience mild to significant symptoms if you miss your daily dosing. Even a headache from caffeine withdrawal will be more uncomfortable than usual given other stresses you’ll be dealing with. Being distracted by a need for substances can also interfere with your ability to stay aware of your surroundings and make good decisions. Look honestly at your physical dependencies and prepare for your needs.
Your challenge is greater if you are dependent on legal or illegal drugs. The earthquake will disrupt both legitimate and criminal drug supply lines. See the Complex Medical Needs section on this page for more information about prescription drugs.
If you are at risk for experiencing withdrawal from legal or illegal drugs, be honest with the people around you so they can try to help you; otherwise, your symptoms might seem to come from illness or food poisoning, resulting in misguided treatments. If you have been through withdrawal before, tell them what to expect. If you haven’t, find out what you’ll need to do to best weather it. Again, a conversation with your doctor may not result in a solution but could provide ideas to prevent unnecessary suffering.
While outdoor cats with well-practiced hunting skills may survive an earthquake with little human help, most domesticated pets are entirely dependent on their human families for food and water. According to Ryan Scholz, district veterinarian for western Oregon, a general rule of thumb is that pets shouldn’t eat food or drink water that isn’t safe for humans. Your dog may happily drink from the toilet bowl every day without ill effects; however, there won’t be an easy way to know what a pet can eat without getting sick, so this is a “better safe than sorry” situation.
Pets may also suffer from the most common earthquake injuries, including lacerations. Treat their injuries as you would the same injury in a person (see Chapter Seven, this page). Veterinary care will be as difficult to access as other medical services, and you may have to provide treatment yourself.
Talk to your vet about the possibility of a pet first-aid kit, pet tranquilizers, or other supplies that might help you keep your pet healthy and safe after a mega-earthquake. Frequent aftershocks may upset your pet. Searching for a lost animal in the aftermath of the earthquake will be difficult and dangerous; at a minimum, make sure you have more than one way to secure your pet—leashes, crates, portable fencing.
If you use dried pet food, make sure that you always have more than a two-week supply on hand—whether that means buying more when it gets below a certain level in a large bag, or purchasing a second bag and implementing a rotation system similar to the one for canned food in Chapter Eleven (this page).
If you use canned pet food, remember that the date on the can relates to quality rather than safety. You can implement a rotation system similar to the one for canned people food, though canned pet food stored in a cool, dry place should be safe for your pet long after the date shown.
You’ll need water for your pet, about an ounce for every pound of weight per day. Even though aftershocks may spill water in a pet dish, you’ll still want to make sure pets have easy access, so they don’t get dehydrated. An especially deep bowl may help, but you’ll still want to store double the minimum amount of water per pet.
Even mild-mannered pets may be so stressed they snap, scratch, or bite when you try to help them or crate them. Children may want to carry or hug their pets, but this could be dangerous until you know how your animal will react. Be cautious. Have a muzzle that allows your dog to eat and drink but prevents biting just in case its behavior turns aggressive.
□ Written plan, including both best-case and worst-case scenarios, for care of any medically dependent family members
□ Backup plan for any power needs for devices or refrigeration of medicine, and any necessary tools or batteries
□ Extra glasses, hearing-aid batteries, cane, or other frequently used medical devices
□ Two-week supply of child or adult diapers for each person who uses them
□ Emergency supply of medication
□ Extra flashlights for children
□ Any substance on which you regularly depend—caffeine, alcohol, legal and illegal drugs—and/or a plan for potential withdrawal
□ Two weeks’ worth of food for each pet
□ Multiple restraints and/or enclosures for animals
□ Two ounces of water per pound of each pet’s weight per day