Impacts of the Quakes on Type 1 and 2 Diabetes
The Diabetes Centre caters for people with diabetes who are over the age of 14 years and live within the Canterbury District Health Board area. The Centre offers individual appointments, on-going specialist follow-up, and group education for people with all types of diabetes, with the exception of diabetes in pregnancy which is managed at Christchurch Women’s Hospital. They also participate in research programmes studying the causes and treatment of diabetes.
A photograph of the Diabetes Centre on Hagley Avenue, taken from the car park.
Like many other health professionals, the staff at the Diabetes Centre responded with urgency to the 22 February 2011 earthquake. They were aware that the widespread loss of domestic power, water, and sewerage would means that many diabetes patients would have to abandon their homes, often without their medications, belongings, or food. The Diabetes Centre building on Hagley Avenue, which is home to both clinical staff and also the lay society Diabetes Christchurch, was also damaged. The building needed assessment by structural engineers before it could be used again.
A photograph of a yellow sticker on the window of the Diabetes Centre on Hagley Avenue.
Thankfully the staff were able to set up a diabetes emergency triage unit at the Christchurch Hospital where they could treat patients, as well as organise the delivery of medical supplies, including diabetes gear such as glucose meters, to key sites such as the 24 Hour Surgery on Bealey Ave, the temporary hospital situated at Cowles Stadium and also to Civil Defence Emergency shelters throughout Christchurch. Managers Kit Hoeben (Diabetes Centre) and Lynne Taylor (Diabetes Christchurch) were also able to re-enter the Diabetes Centre building and secure insulin supplies from their fridge. The Maori diabetes team distributed supplies to the most vulnerable individuals with diabetes, living in the Eastern suburbs. New Zealand diabetes pharmaceutical companies also provided medications and diabetes gear free of charge, for one on one distribution by local health professionals and the diabetes lay society, Diabetes Christchurch.
The Canterbury District Health Board provided free prescriptions in the immediate post quake period and Diabetes Christchurch lobbied for an extension of these free prescriptions. The availability of free prescriptions ensured that the most vulnerable diabetic patients had adequate supplies of insulin, glucagon, glucose meters, and other diabetes management supplies. This relieved the pressure on the Civil Defence Emergency Shelters. It also allowed patients with ‘spoiled’ insulin supplies, which occurred because they could not keep their stock of insulin cold in their fridge, to restock at no extra charge.
Diabetes supplies at CWH (Christchurch Women’s Hospital) were unaffected by the quake. In the first couple of days after the February quake, stock became low at the local pharmacies and CWH kindly allowed Diabetes Centre staff access to some of their supplies.
After the immediate risks were over, the diabetes team distributed information sheets about post-disaster diabetes management, explaining how stress can alter sugar levels, the importance of testing more often, the shelf-life of insulin without refrigeration, and how to dispose of sharps. They also called well over 200 members to assess their needs and provide sympathy and compassion.
A patient information sheet outlining practical issues affecting members of the diabetes community in Christchurch after the 22 February 2011 earthquake.
One of the things that the material in the Diabetes Centre collection best demonstrates is the need for emergency management organisations to expand their view of who is affected by natural disasters. As Nurse Specialist Marianne Wilson explains in her earthquake story:
the most important lesson we learnt was that, during a disaster, hospital managers don’t view diabetes care as a priority and it is vital to have a strong advocate for patients’ welfare and for diabetes services. It was also important to maintain a high profile and to ensure hospital staff, Medical Centres and Relief Centres were aware that we were available to assist with any diabetes related problems.
Immediately after the earthquakes, it is natural for emergency-response organisations to focus on the most immediate, life-threatening injuries, but as time passes, they need to be aware of the risks to those with conditions which require long-term management, such as diabetes.
A presentation by Dr Heidi Su, Kit Hoeben, and Helen Lunt from the Diabetes Centre.
The material also reveals the need for organisations, particularly those that deal with public health, to develop emergency-response plans so that they have the resources, skills, and information they need when disasters strike. Again, Marianne Wilson comments:
We were fortunate that we were able to gain access to our building and to get some equipment out, but I believe that if the building hadn’t been accessible we could have had insufficient stock to meet patient’s needs within two days. We now have a small stock of equipment and education material in one of the hospital wards and that would be enough to start with if we weren’t able to access our building in the future.
The manager of Diabetes Christchurch, Lynne Taylor also commented on this in her own earthquake story:
Already future preparations to stockpile more diabetes supplies and the making of diabetes emergency kits for direct access for Civil Defence shelters, will help provide essential immediate relief, as well as optimal diabetes care and support. These supplies and specialised medical kits will help resolve any supply issues through easier access and distribution in the future.
The Diabetes Centre staff responded to the 2010 and 2011 earthquakes with skill and perseverance, ensuring that diabetes patients had adequate supplies, information, and care. The material in this collection reveals both their tenacity during challenging times, and the lessons they learned in the process. It is our hope at CEISMIC that the Diabetes Centre collection will be used by many healthcare providers and emergency-management organisations as a valuable resource in their own emergency-response planning.