No Internet, No Scripts: How Drug Runners and Pharmacists Tackled Australia’s Flood Emergency

In the wake of flood-induced carnage, thousands of residents from across the northern rivers of NSW were forced to deliver solutions to problems they had never encountered before. Some became logisticians, and others, engineers. When the prescription drug shortage emerged shortly after, though, locals knew it was a job too complex to learn on the fly.

In the absence of government support, a paper thin healthcare workforce tried to fill the gap. 

After one-in-100-year flood waters rose close to 15 metres in parts of Lismore during the early hours of Monday, March 1, a local network of pharmacists took it upon themselves to try and meet the demands of what had quickly become a regional pharmaceutical shortage.

One of them was Caitlin McMahon, a Lismore-based pharmacist who told VICE that she headed to the nearby town of Goonellabah, about 5 kilometres east of Lismore, to work an emergency shift at the town’s local pharmacy. There, she said, there was still enough stock to meet a maelstrom of empty scripts that needed to be filled early in the week. 

Eventually, however, stock would run out. 

“Without the internet, it was impossible to order more. The stock that we had ordered couldn’t get in [to town], because the floodwaters were still so high, and we had started to take on all of Lismore’s methadone patients and I had no methadone,” McMahon said. 

“And these are people that need their dose, you know? A lot of people were very, very angry.”

Just days after the floods first struck, hundreds were still trapped by slow-receding floodwaters, while a stable internet connection remained off the cards for much of the region. There was no way for immunocompromised people living with conditions like diabetes, arthritis or heart disease to get the medicines they needed in order to live.

In a bid to broaden the region’s access, McMahon, along with a small group of other local pharmacists and doctors, took to evacuation centres across the region to assess the needs of communities left medically stranded. 

Their network liaised with doctors stationed on-site at evacuation centres from Lismore to Ballina, before heading back and retrieving the medicine needed to keep people alive. 

“We'd say, ‘Hey, do you have this person here? We’ve got his medication – medication he needs – he’s elderly, they’re chronic meds, he really needs these,” she said.

In other towns, like Ballina and Coraki, the opposite was true as well. Doctors stationed at evacuation centres worked to set up a system that allowed civilian volunteers to scout out a pharmacy with enough stock to fill a script and then run over with a doctor-signed approval sheet. This sheet would allow them to ferry medicines back and forth without taking pharmacists or doctors away from their work. 

“They would come in with approval sheets from the doctor to be like, ‘We’re collecting for so and so’, with ID, and a note from the doctor,” McMahon said. “Or, doctors would say, ‘I’m working out at this particular evacuation centre, I need to collect medicine on behalf of this person. Can you provide this and these people will collect it?”

The ad-hoc pharmacy network, however, couldn’t reach everyone who needed it, and in many ways wasn’t expected to. 

Where the network wasn’t able to make it, others tried to lend a hand. Eventually, people who grew up in the northern rivers - who had been watching the aftermath of the floods from their new homes in major cities like Sydney and Melbourne - saw the pharmaceutical gap and took it upon themselves to fill it.

“I was just seeing a lot of my old friends from home posting stuff on Instagram like, ‘We desperately need X or Y’, and they seemed desperate, so I tried to get as much as I could, packed a bag, and just jumped in the car,” Jen, who moved to Sydney from Mullumbimby about four years ago, told VICE.

“Most of what people seemed to be needing was insulin and antipsychotics, so I tried to get as much together as possible to get it up to them.”

The civilian-led drug-running effort offered pharmacists like McMahon – who along with her colleagues was going “above and beyond” to ensure that patients were getting their medicines in the correct dose – a major cause for concern.

From where she and her colleagues were sitting, efforts made by Jen and others like her could make the lives of local doctors more difficult, as nobody can really be sure that patients end up receiving correct dosages. The margin for error bloats tenfold. She feared an already-stretched healthcare workforce would be up against it in more ways than one.

“You’d be wanting to make sure that there’s continuity of care to make sure of the same dosage and active ingredients,” McMahon said. “It’s really concerning.”

Now, as the weeks roll on and scenes of sodden infrastructure recede well into the rearview mirror, McMahon and her colleagues continue to prioritise their community outreach efforts. Supply drops have, for the most part, resumed deliveries to the pharmacies that were spared from the worst of the region’s flood damage.

But scores of communities dotted across the region still don’t have cars, money, or anything else. McMahon said it’s those people that her network will continue to target, as much of the country turns its attention elsewhere. She doesn’t hold much hope for next time, though.

“Just in terms of healthcare, I'm scared about [what happens] if this frequency increases, and these climate disasters increase. We’re still opening coal plants, we're still encouraging them to operate, and we're not transitioning,” she said.

“What's the plan for the future?”

Follow John on Twitter.

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