Putting Your ‘Disaster Plan’ into Action

Although living in Santa Barbara is heaven on earth, over the last two decades vicious wildfires throughout the state have served as a painful reminder that we need to be prepared in the face of disaster. Just in the last two years, fires have started within minutes and spread in a few hours to wide areas of Santa Barbara County. After the Zaca fire in 2007 destroyed over 220,000 acres of land, our office, the Sansum Diabetes Research Institute, adopted the American Association of Clinical Endocrinologists’ (AACE) Diabetes Disaster Plan. The AACE “Diabetes Disaster Plan” is a checklist of 17 essential items to help patients prepare in case of an emergency.

We modified our plan to include a reverse 911 phone call message to patients’ homes that were in danger, to identify the Santa Barbara locations for meeting points, essential medicines to have packed, ready and checked for expiration dates on a monthly basis, and the statement in every plan- “If you have diabetes, take your insulin and needles with you.”

Santa Barbara is actually a very small county of only 425,000 people, but we estimate that there are 14,000 people with diabetes. Our shops and drug stores close at 7:00 p.m. and the city hospital does not have a public pharmacy. If 2,000 people in Santa Barbara were dependent on insulin for life support daily, the insulin supply in the hospital would not be sufficient to treat everyone.

Therefore, we also adopted a list of medicines that are essential for life support if not taken daily. The question is not how to maintain health or steady state serum concentrations of drug levels. If there is limited or no access to medications, the question is survival. Insulin is essential for life if one has type 1 diabetes mellitus and serious complications can occur if without insulin for longer than 24 hours. On November 13, 2008, at 6:18 p.m., a fire started in the hills above Montecito, a neighboring village immediately south of Santa Barbara. The hilltop was ablaze, and the fire could be seen moving quickly down the hills into the city. The winds were hot and ferocious, and thus the fire spread within minutes into Santa Barbara.

The residents were called by reverse 911 to immediately evacuate. The message was “You have less than 10 minutes to leave your home. If you have diabetes, take your insulin and needles.” By 7:00 p.m., the city was two-thirds evacuated into the high school gymnasium in a school north of Santa Barbara. The city was without electricity for 36 hours, but we had a sufficient insulin supply, thanks to the preparation and warnings by police and fire crews to be prepared! The AACE disaster plan brought sunshine to our community despite the loss of over 200 homes.

Here’s a sample of the checklist of activities that you can do to make sure you’re prepared when disaster strikes:

  • List of all medical conditions and prior surgeries.
  • List of all your health care professionals with their contact information.
  • Wear shoes at all times and examine your feet often for infection.
  • At least a three-day supply of bottled water.

Lois Jovanovič, MD, FACE, is CEO and Chief Scientific Officer of Sansum Diabetes Research Institute; Clinical Professor of Medicine, University of Southern California, Keck School of Medicine; and Adjunct Professor of Biomolecular Science and Engineering and Chemical Engineering at the University of California, Santa Barbara. Dr. Jovanovič has published over 490 articles in the fields of diabetes, metabolism, nutrition, obstetrics and gynecology, perinatology and engineering.