WATER EVERYWHERE AND NOT A DROP TO DRINK – DISASTER MANAGEMENT IN FAR NORTH QUEENSLAND
Dr Catherine Wilkinson1, Dr Murty Mantha1, Dr Carolyn Van Eps2, Ms Karen (Fred) Griffiths1, Ms Sally Cahill1, Ms Lorraine Davidson1, Ms Keri-Lu Equinox1
1Cairns Hospital, Cairns, Australia, 2Princess Alexandra Hospital, Woolloongabba, Australia
BACKGROUND: In December 2023, Far North Queensland experienced an extreme flooding event immediately following a cyclone; which threatened the integrity of water supply to the health district across several municipalities; and significantly impacted the provision of dialysis. We describe our reflection on problems and potential mitigation strategies.
CASE REPORT: During the cyclone event, usual disaster preparedness was undertaken, and patients were supplied with wet season ‘cyclone pack’ (patiromer) for hyperkalaemia. Unprecedented rainfall exceeding 1000 mm in a matter of hours resulted in widespread flooding damage to road and council water treatment plants. Provision of potable water to the entire region was threatened. We reflect upon the minimum standards for water quality; safe to use for dialysis (short and long term) depending on the source of water; the components of the pre-RO loop necessary to deal with changing water conditions; the limitations of water testing in a disaster area; the response of a local health network to timing of dialysis taking into account patient and staff safety in regards to access; considerations for water use after restoration of potable water to a town’s supply (chlorination); use of trucked water and a means for a state/nationwide coordination response to evacuation if required.
CONCLUSIONS: Large scale impacts from disasters require significant coordination to ensure safety. Our learning experience highlighted issues related to 1) access to medications from patients 2) advocacy for renal units in disaster management groups 3) necessary components of RO loops in disasters 4) understanding limitations of RO and optimising RO timings 5) dialysis options not dependent on town water supply 6) the difficulty of relocating large numbers of dialysis patients to others interstate facilities.
Biography:
Dr Catherine Wilkinson is an Interventional Nephrologist based at Cairns Hospital. She completed her training in both North Queensland (Townsville and then Cairns) as well as a year in Adelaide undertaking experience in transplant. She is clinical lead for transplant at Cairns Hospital; and co-lead of Kidney Supportive Care. She holds recognition from the RACS Conjoint Committee in Peripheral Endovascular Therapy. She is current Chair of the Australia/NZ Committee of Interventional Nephrology (subcommittee of ANZSN). She also is current Co-Chair of the Queensland Renal Clinical Network, representing the clinical priorities of delivering renal care in regional and northern Queensland.