As Barbados and other Caribbean countries are being warned to expect more powerful hurricanes and flooding if the challenges of climate change are not addressed, a local emergency physician is urging authorities to put systems in place to ensure that the Queen Elizabeth Hospital and other emergency services can run efficiently in the event of a natural disaster.

Dr. Charles notes that there were several issues from a health perspective, most notably the fact that those who were injured or ill had nowhere to seek medical assistance in the immediate aftermath of Hurricane Maria, as there was significant damage to the country’s main hospital and several of the other health care facilities were completely destroyed. He adds that the situation was compounded by the fact that there was no system in place to provide relief for those doctors and nurses at the Princess Margaret Hospital, who were on duty as the hurricane struck the island.

“For our health system, there needs to be some way of making your staff comfortable during and after the first few days of a hurricane. Our health sector needs to be able to have some way that those who are working for the community or the government, that they are fed, watered, rested and adequately taken care of during and after.”

Dr. Charles adds that while Dominica’s Emergency Operations Centre had plans in place for the emergency personnel to be relieved between eight and 10 hours following a hurricane, staff was not relived for days following the passage of Hurricane Maria.

The emergency physician is also suggesting the creation of a regional relief team. Dr. Charles notes that despite years of planning and training, it is often difficult for anyone to function immediately following a major disaster. He says the role of the regional team would be to provide an initial assessment of a country’s needs and provide relief until the National Emergency Organizations can take over. This advice also comes as the final Barbados Coast Guard contingent recently returned from Dominica following a three-month stint.

Dr. Charles adds that there also needs to be systems in place for the evacuation of seriously injured people to emergency points as well as off the island where necessary.

“In the aftermath (of the Hurricane) where persons were injured and needed health care, they could not get to the health care. We then had to rely on external agencies for medivac (services) as well as for direct transportation into the hospital. Now you can imagine that with the level of devastation, helicopter evacuation and arrival at the hospital, if you do not have a place prepared it is going to be a nightmare“.

Dr. Charles says arrangements must also be made as to where those who need medical attention off the island will go, how they will be cared for, as well as how they will be reintegrated into the island’s health care system upon their return.

Another key factor noted by the emergency physician is the need for meticulous planning and ‘backups’ when it comes to space, supplies and materials to rebuild. He says Barbados needs to look at where such supplies will be acquired, where they will be stored and secured as well as who will manage them. Dr. Charles stresses that ensuring stockpiles of portable water is essential to this plan.

As it relates to accessing and maintaining a steady power supply, Dr. Charles says individuals have an important part to play. He says residents should not rely on the government or a disaster organization for power relief in the immediate aftermath of a disaster. Therefore, he is urging individuals to invest in generators. Dr. Charles says that Barbados has been fortunate over the years, however, it is necessary for those on the island to learn from the misfortune of others.

Ms. McClean says the goal of the team was to provide some relief to the emergency staff who had been on the job from the time the hurricane struck the island. She notes that the loss of the operating theatre and laboratory facilities, along with other key services at the hospital added to the difficulty in diagnosing and treating may of the residents who came to the hospital. Ms. McClean says they also had to operate a 24-hour emergency room the first night they were there without any running water. She adds that a major challenge for the hospital staff was access to supplies.

“How the doctors and nurses (from Dominica) managed, I do not know. They were the most resilient people I have ever met. They were there morning, noon and night. The challenges in the hospital was supplies. It was really hard the first night that we were there, because they did not have syringes, they did not have needles, they did not have basic supplies that we needed to do our jobs. And then the chaos of not having a ward, because they did not have surgery wards, having to ward patients on the emergency room as well as deal with your emergency patients was chaotic. So there needs to be some organization, that even in the middle of the chaos that you can still find things and know where things are.”

Given her experience in Dominica, Ms. McClean is urging Barbadian to prepare in the event of a natural disaster. She says households cannot wait until June to start stocking up on Hurricane supplies, adding that they need to have enough food to last about two or three weeks.

“What people fail to realize is that after a Hurricane it takes the country a long time to recover. Supermarkets are not going to open the next day, sometimes it is going to take a couple of weeks. We need to look as a country at how we shop for Hurricane supplies.”