I first began prepping about two years ago so I am fairly new to this. In those two years I have been fairly aggressive with my education and training on the topic with much of my real world education coming from reading blogs. I have found an area where there is a great deal of misinformation and limited preparedness so it has prompted me to address this topic since it is the one area where I possess a skill set that I can share. The topic is healthcare after the SHTF. I think it is difficult for any of us, especially in America, to understand how so many aspects of our health we may be taking for granted. I can honestly say that I was in the same boat which is a sad statement considering the fact that I am a physician.
To give a little background as a lead in; I worked as a general and vascular surgeon for about 10 years after I finished residency. A little over two years ago I walked away from that to focus on nutrition, fitness, and wellness counseling. There were many reasons for this change, lifestyle being a big one but more importantly I came to understand that we were no longer practicing medicine but rather pharmacology and surgery. I found that training people to modify lifestyle was the best defense and prevention strategy and this certainly applies to prepping.
I will be focusing on four topics:
- Optimizing your health
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- Nutrition
- Fitness
- Healthcare skill sets
- Water and hygiene
- Healthcare supplies
Optimizing your Health
Health should be viewed as a spectrum with chronic disease at one end, disease-free in the middle, and optimized health at the other end. Think about where you would want to be and whom you would want in your survival group should the SHTF.
In reading through the various prepper and survival blogs, I see so many people that are unhealthy and they do not hesitate to talk about it. I would be worried if I were in this situation or if I had to rely on this person as an essential link in my support group. Stocking up on medications may help but what happens when they run out or expire? Will you live to take advantage of all your amazing preparations or will they be taken from you? The solution is to get out of the chronic disease end of the spectrum and get as close to optimal health as possible. I treat and resolve chronic disease every day by basically changing one thing: lifestyle. This means nutrition and fitness. You just have to understand that chronic diseases such as Type II diabetes, high blood pressure, and most high cholesterol are actually just symptoms of a poor lifestyle, you fix that, and you fix the problem without medication.
Nutrition is the key to good health; the problem is there is way too much misinformation out there as to what constitutes good nutrition. What I am about to say will make most prepper gasp, but let me explain. Get rid of all grains from the diet! Now, that said, I do store grains but I do not currently eat them, they are reserved as emergency foods only. You may now be asking, “where does this insanity come from?” Well the answer is biochemistry and anthropology. We are and always have been physiologically hunter/gatherers and grains were not a part of our natural diet. Our bodies function best and experience the most positive effects from a hunter/gatherer style diet. I am not asking you to immediately take my word for it just because I have a few initials at the end of my name, but I do ask that you try this challenge – give up all grain, bread, pasta, rice, crackers, chips, pretzels, popcorn, sweets, etc., for one month and see how you feel. You will eat only meats, eggs, vegetables, fruits, and nuts during this time and eat all you want. You will experience amazing results. Since I do have limited space here to go into all the details, I have provided a link to a video on Vimeo to help explain my approach to this diet: Functional Nutrition.
Other good sources of information are the books The Paleo Solution: The Original Human Diet
Another aspect of optimal health is fitness. It is a necessity in survival and should be an integral part of any preparation regimen. Everyone seems to prep for food, medical and self defense but another aspect of preparation is your body. I would like to see the 3 Bs change to the 4 Bs: Beans, Bullets, Band-Aids, and Body. Your level of fitness will be directly proportional to your chances of survival so you need to train the right way. Bottom line – lift heavy stuff and run fast. What I recommend is functional fitness and you do not need a gym for this. Functional fitness means training the body to be able to do the necessary things in life well and remember, life will be substantially different if society fails. If you have weights available, then lift heavy – squats, cleans, military press, rows. Add push-ups and pull-ups. Chop and carry wood, dig ditches, and run sprints. The book The Primal Blueprint that I mentioned has some good functional training advice and workouts.
Healthcare Skillsets
The practice of medical care could change dramatically in this scenario. Physicians and nurses currently practice with the aid of technology, sterile environments, a slew of available instruments and specialist referrals. EMTs and paramedics are trained in stabilization and transport. Despite my surgical training and experience, my experience in a level 4 trauma center and having been an Advanced Trauma Life Support instructor, I would have little skills to care for people in a post-apocalyptic scenario. That was until I began studying wilderness medicine. Wilderness medicine training is available for health care providers (EMTs, paramedics, nurses, and physicians) and what makes this different is that you have to diagnose and more importantly TREAT in the field without the benefit of technology and transport. In TEOTWAWKI scenario things like minor wounds, burns, blisters, and fractures become potentially life-threatening emergencies. I never realized all this until I took a Wilderness First Responder course offered by NOLS (National Outdoor Leadership School) and I feel that this is an absolute necessity for someone in your group. We should all know how to properly clean and care for wounds, close lacerations, treat a burn, splint and reduce fractures and dislocations in situations where we do not have the luxury of modern technology. Now this course will not make you the Dr. House of the TEOTWAWKI but it will give you the basis to build from and a level of comfort in dealing with many of the issues you may encounter. You should still have access to someone with advanced medical training.
Water and Hygiene
Wilderness medicine gets you thinking about things we take for granted like water or hygiene. In the wilderness, clean water is your best friend. Even sparkling clear mountain spring water can be full of protozoa and bacteria so boiling or filtration is essential. What kills more people worldwide? Infectious diarrhea. This is also one of the number one debilitations in the wilderness along with food poisoning related to poor food prep hygiene. It is also important to remember that filtration will not get rid of viruses, so in the face of a viral outbreak if the water supply gets contaminated, you will need a chemical disinfectant as well. Iodine and/or chlorine will work well for this added safety. We need to look at the health care issues faced in the third world countries in order to fully understand what we need to prepare for should the worst case scenario occur.
Healthcare Supplies
First thing to remember here is that it will do you no good to stock up on supplies that you have no skill or knowledge to use. When I design and stock kits for people, I always find out what abilities they possess first. You also have to determine what size group you want to prepare for and the environment where the kit will be needed. I typically see a need for three types of kits and a stock of supplies on top.
Kit #1: Basic field kit. This kit needs to be compact and lightweight but still be supplied to cover you for a 1-5 day trip away from your Bugout Location (BOL) for 3-4 people. This should cover everything for stabilizing illness or injury long enough to get you back to your BOL. This is the kit that I keep in my Bugout Bag (BoB) and I take hiking or camping.
Basic contents:
- Sterile and non-sterile gloves
- Facemasks with eye protecting, also antiviral mask
- Thermometer
- Ace bandage and scissors
- Various quantities of different size sterile gauze and gauze rolls
- Field surgical kit and sutures
- Variety of medical and athletic tape
- Moleskin for blisters and second skin for burns
- Opsite or other occlusive dressing
- Steristrips and benzoin for wound closure
- Small vial of povidone iodine or betadine
- Bacitracin and Cortisone
- Thermal reflective blanket
- SAM splint
- Eye pad
- Large irrigation syringe
- Several cravats
- Quikclot or Celox trauma bandage
- Pen light
- Emergency resuscitator pocket facemask
- Ibuprofen, aspirin, Benadryl, and various antibiotics
Kit #2: Advanced Home Kit. This is an advanced medical kit for the home or BOL. It contains all the above items from Kit #1 just larger quantities, plus:
- Stethoscope and BP cuff
- Fiberglass casting wrap
- Greater variety of surgical items
- Lidocaine, needles, and syringes
- Battery operated cautery device
- Skin stapler
- Greater variety of antibiotics and other prescription meds
- Emergency cricothyrotomy kit
Kit #3: Advanced Trauma Kit. Now this kit would be mainly for people with advanced medical training or military field medics. I keep this is a STOMP bag and it weighs about 40 pounds. It is basically a portable trauma bay with advanced surgical instrumentation, major wound treatments, airway control, etc.
My recommendation is to train each person in your group in the basic medical skills and have each carry a basic kit. Many prep groups run drills for defense and bug-out but few run through medical scenarios and these are the most likely issues that they would encounter. Each group or family should have someone in charge of medical and it should be their responsibility to train the others.
So our best course of action is prepare and prevent. Prepare by optimizing each individuals health, have the training necessary for your environment, and have the appropriate tools and knowledge in order to act. Prevent by obtaining/maintaining optimal health, recognizing and understanding the risks of your environment, practice good hygiene, and utilize adequately filtered water.