Responding to the Call: The Pharmacist’s Role in Disaster Responses and Medical Missions

Stephanie L. Conway-Allen, PharmD, RPh Sheila M. Seed, PharmD, MPH, CTH®, RCPS AFTM (Glasg), RPh

Volunteerism is embedded in the makeup of a healthcare professional; we desire to assist others in times of need. Many healthcare professionals volunteer their services in response to a natural disaster or on medical mission trips. Pharmacists have long had a role in disaster response teams and medical missions. The International Pharmaceutical Federation (FIP) issued a Statement of Professional Standards on the role of the pharmacist on humanmade and natural disasters in 2006 (1) and developed the Responding to Disaster Guidelines for Pharmacy in 2016. (2)

Pharmacists have been involved for several years in the response to public health emergencies and disasters, such as pandemics, medical missions, serving on Disaster Medical Assistance Teams (DMAT), or as part of the Medical Reserve Corps (MRC). Proper training is essential and is provided for both DMAT and MRC response team members. The role of the pharmacist in these settings has traditionally consisted of dispensing medications and ensuring individuals have access to safe products, providing continuity of medical care. In addition to dispensing, pharmacists often need to review treatment plans and appropriate medication substitutions if a particular drug is not available. They are responsible for the proper storage of medications and must ensure a level of quality assurance for medications purchased locally. Recently, pharmacists have expanded their traditional roles to include screening patients for triage purposes, point-of-care testing, administering first aid, and providing immunizations. (1,2,3) When providing clinical pharmacy services, it is important to consider the needs of the local population and the available resources. This is true when responding to a disaster situation or while on a medical mission.

Responding to a natural disaster or public health emergency can either be either a local response with organizations such as the Worcester Regional Medical Reserve Corps (MRC) (https:// worcesterregionalmrc. org), or a federal response, such as with a DMAT unit when local resources are overwhelmed. The MRC is composed of both non-medical and healthcare profes- sional volunteers, including pharmacists. During Hurricane Katrina, the response required both federal and local assistance to aid victims. In a combined effort of federal resources, chain pharmacies, and drug companies, a pharmacy was set up in the Houston Astrodome. The pharmaceutical needs for approximately 7,000 victims were met as hundreds of volunteer pharmacists filled more than 20,000 prescriptions. (4) In addition to responding to disasters, many healthcare professionals volunteer to assist on medical missions. One of the many advantages to volunteering for a medical mission is the opportunity to assist and implement healthcare needs in underserved communities, both domestically and internationally. You are able to provide care to individuals that may not have access to medical care, or it may be beyond their means to get medical care. There are a number of logistical issues with planning a medical mission, such as transportation of medications and supplies out of the country, lodging, proper travel documentation, and safety.

Both of us have had the opportunity to participate on mission trips. One mission trip was to the village of Roche-a-Bateau, located on the southwest coast of Haiti. There, we assisted a clinic run by the Sisters of Saint Anne. The mission team contacted the Sisters ahead of the trip to determine which medications and supplies the clinic needed the most. The greatest needs were over-the-counter medications for children and adults, including vitamins, analgesics, heartburn medications, basic first aid supplies, nebulizers, and a centrifuge. Donation bins were set up and five full suitcases were brought to Haiti--retrieving all the bags at the airport was an adventure in itself.

The clinic provided service to those within the village and the surrounding mountainous villages. Travel from some communities required over a two-hour walk down a mountainside and across rivers to reach the clinic. Access was limited to the remote mountainside village, so we brought the supplies to the village by donkey. The supplies allowed for a nurse in the village to administer over-the-counter medications for mild ailments. Luckily, Haiti has the same electrical current as the United States, so the equipment was immediately operational in the clinic. The trip was a success! It filled up the empty medicine cabinets, allowed the nuns to provide some medical treatments, and for many individuals, prevented the need for travel to the nearest city for a breathing treatment that was well over an hour away by car.

In Honduras, the need for medical missions is extensive and year-round. Many communities exist in rural or mountain areas where access to healthcare is limited while the need is great. Through the Cape Cod, Massachusetts-based Central American Relief Efforts (Cape CARES) organization (https://capecares.org), several trips are made each year to areas of Honduras where medical services are not readily available. Los Encinitos sits far into the mountains of Honduras and is at least an hour drive (through the mountains and only with the assistance of very experienced drivers) from the country’s capital, Tegucigalpa. Each year, three teams set up both adult and pediatric medical and dental clinics for one week. The work required to prepare for each trip is extensive, and the role of the pharmacist is especially imperative in the preparation. Inventories are pertinent in both the medical and dental clinics to ensure that the adequate amount of medicine, supplies, and maintenance materials are available to those unable to journey to the nearest clinic (which for many is a day or more on foot). Pharmacists work with the team to obtain donated and purchased medications for various health issues such as blood pressure, diabetes, cardiovascular health, pain, gastrointestinal-related ailments, allergies, and numerous types of infections. The pharmacist works to prepare medication orders with complete Spanish-language label instructions and conducts medication patient counseling. The pharmacist is responsible for maintaining a running inventory of medications, making recommendations and adjustments to treatment plans based on evidence-based medicine and supply, and assisting in blood glucose and other point-ofcare testing. In Honduras, the pharmacist’s role is substantial and an absolute necessity.

While volunteering in response to either a disaster situation or a medical mission has its r own unique challenges and opportunities, both are professionally and personally fulfilling. +

Stephanie L. Conway-Allen, PharmD, RPh is Associate Professor of Pharmacy Practice at Massachusetts College of Pharmacy and Health Sciences School of Pharmacy.

Sheila M. Seed, PharmD, MPH, CTH®, RCPS AFTM (Glasg), RPh is Professor and Chair of Pharmacy Practice at Massachusetts College of Pharmacy School of Pharmacy.

References:

1. International Pharmaceutical Federation. FIP Statement of Professional Standards: The Role of the Pharmacist in Crisis Management: Including Manmade and Natural Disasters and Pandemics. Available at: https://www.fip.org/file/1472 Accessed October 20, 2022

2. International Pharmaceutical Federation. FIP Responding to Disasters: Guidelines for Pharmacy 2016. Available at https://www.fip.org/files/content/pharmacy-practice/militaryemergency-pharmacy/emergency-activities/2016-07-respondingto-disasters-guideline.pdf. Accessed October 20, 2022.

3. Ahmer Raza M, Aziz S, Noreen M, Masood Raza S. Role of Pharmacist in Disaster Management: A Quantitative Content Analysis Approach. Innov Pharm. 2021 Sep 22;12(4):10.24926/ iip.v12i4.4359. doi: 10.24926/iip.v12i4.4359. PMID: 36033125; PMCID: PMC9401375.

4. Koutnik-Fotopoulou, E. In the Wake of Katrina, Chain Pharmacies and Drug Companies Join Forces. Pharmacy Times, Oct 1, 2005. Available at: https://www.pharmacytimes.com/ view/2005-10-9919 Accessed October 20,2022.