Disaster recovery from a health perspective

Hurricane season 2013, which runs from 1 June until 30 November, has already arrived and this means disaster preparations should have been completed, or at least well underway. While we may all have secured our homes with the installation of hurricane shutters, filled our cupboards with non-perishable food and drink and cut down our trees and branches in readiness for the season, health-related disaster planning should be just as integral to the overall disaster plan and that goes for individuals and health service providers alike.  

In recent times the Cayman Islands has thankfully been spared extensive injuries or loss of life of its residents as a consequence of a disaster such as a hurricane. While the Island was saved from substantial loss of life as a result of Hurricane Ivan, Grand Cayman’s worst hurricane in living memory that hit in 2004, other countries have not been so lucky. Severe storms of recent years that have caused loss of life include Hurricane Katrina in 2005, during which over 1,830 people lost their lives in America alone, Hurricane Irene which caused 56 deaths in 2011 and Hurricane Sandy, last year’s “super storm” that killed 125 people in America and 71 in the Caribbean. With the intensity and frequency of hurricanes seemingly on the increase, this is certainly not a time for complacency and everyone who lives within the hurricane belt ought to ensure that they have done all they can to prepare for the season. 


Vital preparations before a storm hits  

It is essential to be prepared before a storm hits to make recovery as smooth as possible. There are many ways in which we can prepare for medical emergencies, should a hurricane cause severe disruption to medical services, many of which depend on a regular supply of electricity to keep supplies and equipment up and running. 

Just as important as being prepared for a hurricane or similar disaster, it is equally important for healthcare entities, just like all other organisations, to place an emphasis on disaster recovery planning and business continuity. Disaster recovery planning is especially important in today’s healthcare organisations as they become increasingly dependent on information systems. With the adoption of electronic medical records and various types of electronic documentation and imaging applications it is imperative that plans and solutions are in place to ensure that data can be securely stored and recovered so that business can resume following a disaster.  

The Cayman Islands Health Services Authority has developed a robust disaster recovery plan which includes their IT infrastructure, by ensuring data, which includes electronic medical records, are secure and hosted off-site. 


Electrical outages  

Lack of electricity and power outages are a possibility following a hurricane or any other disaster. On a personal level, if constant electrical power is a requirement for your medical needs, consideration should be given to staying somewhere that has back-up electrical power from a generator. This may mean leaving the area in the path of the storm.  

For a healthcare organisation, an alternate source of electricity is essential to ensure a resumption of operations. Back-up generators provide power essential for the use of medical equipment, electronic devices and access to medical records which are vital components in providing continuity of care. As a part of the plan for recovery, regular testing and maintenance of back-up generators as well as appropriate placement is necessary to ensure that this vital resource is available following a disaster.  


Ensure adequate medical supplies  

When a hurricane threatens, it is very important to have a supply of prescription medications on hand, so it is worth working with your doctor, insurance company and pharmacy to obtain extra medication should healthcare facilities not be up and running immediately after a storm. 

Assembling basic first-aid items is another important way to prepare. Ensuring an adequate supply of medical necessities such as contact lens supplies, other personal supplies, hearing-aid batteries, denture care products, dietary food supplements, adult diapers, feminine hygiene supplies, baby supplies as well as pet medication and supplies are vital steps that will allow individuals to get through the period immediately following any disaster. 

It is also useful to have a list of all prescription medications with dosages, dosing schedules, doctors’ names and phone numbers, and pharmacy phone numbers. Include the names and phone numbers of people to contact in an emergency. For persons with chronic ailments another consideration is to request copies of health records in an electronic format. Information should be kept with important papers in a plastic zip-top bag. Originals documents should be placed in a safety deposit box. Documents can also be scanned into a computer and stored remotely for safe-keeping. Paper copies or printouts of the documents should be in a sealed, waterproof pouch. 


Emergency overseas healthcare treatment  

If a storm were to cause serious injury within the Cayman Islands, it is likely that there would be a need for individuals to be airlifted to another jurisdiction, such as the United States, Jamaica or even the United Kingdom.  

Travelling for medical reasons via either air ambulance or a charter flight means you must have the proper documentation in order to enter the country to which you are travelling, even in an emergency. Even when urgent medical care is needed, immigration authorities still require proper documentation. Without it, most countries will refuse admission. 

It is therefore vital that travel documents for yourself and your family are always in order, this may be critical to saving your life and the lives of your loved ones. 

Cayman Islands residents need to ensure that their documentation into the United States is in order, as this is the primary source of emergency healthcare in such a situation. It should be noted that the US Visa Waiver Programme applies only to arrivals on a commercial airline; persons entering the US on a charter or air ambulance will need a visa. The Cayman Islands Passport Office can issue waivers for Cayman passport holders but cannot issue waivers for UK passport holders. 


Check your documents  

Well before the start of hurricane season and to remain prepared in the event of any disaster it is wise to take the following necessary precautions travel is not hampered:  

Ensure travel documents are correct and valid: passport and visa to enter the US, UK, Jamaica or any other likely destination.  

Check expiration dates of passport(s) and visa(s) – there should be at least six months left before the expiration date; 

Holders of Caymanian passports – contact the Passport Office to have passport validated as necessary. 


Examine health insurance  

Health insurance is an absolute necessity should healthcare be required overseas. The cost of healthcare, particularly in the United States, is usually prohibitive, so ensure that health insurance premiums are paid and current.  

Forward planning that includes a well thought-out disaster recovery plan means organisations such as the Health Services Authority are well-placed to retain a continual service for its patients, providing peace of mind, even when a storm hits. 


Cayman Islands Hospital