In Times of Distress, Insulin for Life Is a Beacon of Hope

By Mary Green, AACE Staff

Carol Atkinson received the desperate call for help not long after Hurricane Harvey made landfall in Texas as a Category 4 storm, bringing winds of 130 mph, heavy rains and a massive storm surge that caused catastrophic flooding throughout the Houston area.

It’s the type of call she’s becoming accustomed to.

As Executive Director of Gainesville, Florida-based Insulin for Life USA (IFL-USA) Atkinson – with the help of two fulltime employees and a cadre of volunteers – coordinates aid to persons with diabetes who are in desperate need of disease management supplies ranging from insulin and syringes to lancets, test strips, meters, glucagon kits and more. IFL-USA is one of nine worldwide affiliates of relief organization Insulin for Life Global, which was founded in Australia 20 years ago.

The organization’s mission is deceptively simple…and utterly brilliant: In countries where diabetes products are readily available, the organization solicits donations of unneeded or unused insulin and other supplies that would otherwise go to waste (e.g., in-date insulin from a patient whose treatment regimen has changed) and ship them to developing countries where the donations are distributed, free of charge, to children and adults with diabetes who either simply can’t afford or don’t have access to the life-saving resources. Additionally, IFL-USA provides emergency aid domestically in times of disaster.

Atkinson and her diminutive team had their work cut out for them during the 2017 Atlantic hurricane season. The fallout caused by Hurricane Harvey, then Category 5 Hurricane Irma, followed by Hurricane Maria, put them to the test like no other prior disaster scenario.

Working in tandem with a Diabetes Emergency Relief Coalition assembled in response to the storms and composed of representatives from the American Diabetes Association, the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators, JDRF, The Endocrine Society and other related organizations, Atkinson sprang into action, putting her considerable donor solicitation/fundraising/logistics/grassroots community relations skills to work.

The activities were complemented by the additional efforts of Insulet, Dexcom, Lilly Diabetes, Merck, Medtronic, Novo Nordisk, Sanofi-Aventis and Pfizer

In Texas, IFL-USA began with shipments directly to shelters and different agencies caring for displaced citizens and moved on to individual physicians. “Each situation calls for a different way of doing things,” notes Atkinson. “We do whatever works and where we can achieve good coverage, which all comes down to establishing good communication.

“In the midst of these natural disasters, people are thrust into conditions where they’re asking, ‘Where am I going to get my insulin? How am I going to keep it cool? My meals aren’t on time, and I can’t eat what I would normally eat, so what should I do?’” she adds. “All of a sudden, they find themselves in a similar life-or-death situation as the people we service every day. Those people live constantly in what we would say is the outfall of disaster relief, having no hope of getting what they need to sustain, manage and control their diabetes.”

Meanwhile, as IFL-USA’S relief efforts in Texas continued, Hurricane Irma was gaining momentum and was heading toward the Caribbean Islands before moving striking in the U.S. mainland.

“We expected Puerto Rico to take a hard hit from Irma, and what we learned during Hurricane Harvey is that part of the challenge was having certain paperwork in order before supplies could be shipped and delivered,” Atkinson says. “So we began reaching out and establishing relationships before the storm hit. We connected with a physician in San Juan, and he ‘virtually’ introduced us to additional people who we thought could be helpful after the storm passed.”

Even though Puerto Rico sustained minimal damage from Irma, the advance groundwork paid off, as evacuees from neighboring islands in need of medical supplies were descending upon the U.S. territory. Then, less than two weeks later, Hurricane Maria decimated Puerto Rico, wiping out the island’s infrastructure and creating a disaster relief logistical nightmare.

“We tried to get some supplies pre-positioned before the storm, but you have to hope that the location you’re sending supplies to is going to be secure and accessible after the storm,” Atkinson notes. “Because of the damage done, there was a lag time while we awaited word regarding what was needed and how we could get resources there. And even though it’s only a day or so, one day feels like a very long time because people’s lives are in the balance.”

Fortunately, Atkinson received a post-storm call from the San Juan physician she had spoken to previously – who helped her with necessary logistical workarounds – as well as another healthcare professional that she had worked with during Texas recovery efforts. He, in turn, reached out to private pilots and asked for their help in transporting supplies to the island, even going so far as to meet pilots on the tarmac who had flown to Insulin for Life’s home base to collect supplies, since he knew what a difficult task they had ahead of them.

All told, from August through October, Insulin for Life collected, processed and shipped well over two TONS of hurricane-related diabetes relief supplies, including 450,000 syringes, 23,000 milliliters of insulin, 61,000 test strips and more, with requests still being fulfilled.

“When I look at how much has been accomplished, it’s amazing that this is a simple, grassroots effort of people helping people,” Atkinson says. “Up until very recently, the foundation of what we’ve been doing has been a single donation at a time from one person with diabetes, or one family of a person with diabetes, knowing the value of what they have, knowing the lifesustaining capabilities of what they have, and refusing to discard what they can’t use, instead donating it to be given to someone else who has no access. And that’s exciting. When you put all of that together, it’s a great example of how, with enough people joining together as a team, you can make anything happen.”

To learn more about Insulin for Life’s mission or how to support its operations, visit: www.ifl-usa.org.

American Association of Clinical Endocrinologists Member Physicians Join Forces with Others to Bring Relief

By Joy Batteh-Freiha, AACE Staff

Many people live along coastal regions for a reason – the natural beauty of being surrounded by water is one of them. However, there is a price to pay at times, as these coastal communities are prone to natural disasters like hurricanes.

The people of Puerto Rico know this all too well. The island was hit earlier this fall by two devastating hurricanes – Irma and Maria, within a month of each other.

“We are used to hurricane warnings, and like every time, we thought we were prepared,” said Dr. Myriam Allende-Vigo, an endocrinologist practicing in Humacao, Puerto Rico and who was instrumental in spearheading a local group of physicians to work with others in getting help to patients. “We had a generator, plenty of batteries, lanterns, a gas stove, plenty of gas in our vehicles, food and bottled water to last a few days, but we never thought of not having power, water and no communications for more than a few days.”

“As a practicing endocrinologist, I did my best to prepare my patients with diabetes, including giving them information on how to maintain good health in a time of disaster,” said Dr. Allende-Vigo. “And, I took home all the insulin/GLP1 samples that I had in the office to keep them refrigerated in the event we lost power.”

As media outlets reported daily, Puerto Rico not only lost power, but was isolated from what seemed the rest of the world for weeks, stranded without necessities such as food, medicines, gasoline, safe infrastructure and even communications.

The American Association of Clinical Endocrinologists (AACE) had, just weeks earlier, joined other diabetes-related organizations including the American Diabetes Association, JDRF and the American Association of Diabetes Educators in forming the Diabetes Emergency Relief Coalition to provide resources to victims of Hurricane Harvey that devastated Texas in early September and Hurricanes Irma and Maria.

Representatives from AACE headquarters in Jacksonville, Florida contacted Dr. Allende-Vigo to determine the most urgent needs in Puerto Rico and worked with the Coalition partners in coordinating assistance to patients.

“While communications were literally null and void in Puerto Rico, we did our best to get the word out that we were in dire need of help – it was an emergency,” said Dr. AllendeVigo. “After Hurricane Maria hit, a group of endocrinologists convened over the phone and created a volunteer group to help meet the needs of our patients and others. We learned the Coalition was formed to help with disasters such as ours in Puerto Rico. AACE was heavily involved in this Coalition and contacted me to help coordinate the efforts.”

Dr. Leticia Hernández, an endocrinologist also from Puerto Rico and part of the volunteer group of physicians working to help keep patients safe in the aftermath of the hurricane, said it was without question that she be part of this group.

“The day after the hurricane, we found ourselves without power or communications,” said Dr. Hernández. “Many people lost their home, belongings, jobs and I knew that it meant they had probably lost their medications, too. Most clinical offices and pharmacies were unable to open, and in addition to their economic losses, people had no access to their doctors or vital medicines.”

This new scenario, explained Dr. Hernández, put the health and quality of life of her patients and others at risk and was the impetus to do something.

“We knew that our patients would be faced with limited access to medications, increased stress, forced changes in their dietary habits and limited to or no access to water,” she said. “People with diabetes and especially those on insulin therapy would be the most vulnerable.”

Even though traveling throughout the island was difficult due to downed trees and limited accessible roads, the group of physicians and other healthcare professionals worked diligently for the sake of their patients.

“Volunteer endocrinologists met with insulin suppliers, drove to the airport to pick up packages of insulin brought into Puerto Rico by relief agencies, and set up several insulin distribution centers where patients could get their supplies,” added Dr. AllendeVigo. “They gave direction to people on local radio stations on proper insulin storage, nutrition, hypoglycemia, blood sugar monitoring, and more. They also evaluated patients, prescribed treatment, and traveled to remote areas to get needed medications to people.”

“As doctors, we felt the need to take an active role in helping our patients get access to healthcare, medications, and to make all possible effort to educate them so they could stay in control of their conditions as much as possible,” said Dr. Hernández.

Five weeks after Hurricane Maria hit Puerto Rico, power was still out on most of the island but things are slowly getting back to normal, says lead physician volunteer, Dr. Angel L. Comulada-Rivera.

“Pharmacies are opening and dispensing insulin, medications and other diabetes supplies to patients, and every day more physicians are opening their offices and seeing patients and writing prescriptions,” said Dr. Comulada-Rivera. “Still, there are municipalities requiring clinical services, medications, insulin, and diabetes supplies as well as food and water. We will continue to work with the Puerto Rico College of Physicians and Surgeons and all the volunteers to provide these services.”