Thursday, August 2, 2012

Chapter Seven: Medical


Afghan National Army Soldiers Receive Medical Treatment
from the Farah Forward Surgical Team
and Provincial Reconstruction Team Farah medics
at Forward Operating Base Farah (ca 2010)
source
United States Army


In all the wars, humans have had, infection, disease, and accidents are the number one killers. So the best way to prevent a medical problem or health emergency is through prevention.

Let us look at an extreme example.

If you hang out with drug using and dealing felons, you are more likely to be shot. If you live in a neighborhood with rival gangs that deal drugs, you are more likely to be shot, also.

So, to prevent being shot, hangout with law abiding citizens in a decent neighborhood.

OK, let's come back to reality, for most of us.

Prevention
To prevent being sick from the cold; wash your hands. Avoid people who are sick, and the surfaces they have touched. Keep your fingers out of your nose, eyes and mouth.

To prevent catching the flu, wash your hands. Avoid people who are sick. Keep your fingers out of your mouth, nose, and eyes. Get a flu shot.

Washing your hands is a common factor in preventing most diseases. Use the bathroom; wash your hands. Shake hands; wash your hands. Sneeze; wash your hands.

Another common factor is keeping your fingers out of your nose, mouth, and eyes. If you shake hands, and can't wash your hands, keep your fingers away from your face.

The last common factor, I will mention, is to avoid sick people and their things.

Immunizations
There is another method of preventing diseases; it is to receive vaccinations from the local public health clinic, family doctor, or other health professional. You’re family’s health care provider will be able to assist you in getting the correct immunization shots for your family.

However, those may not be enough.

During certain events, community preventative measures such as mosquito spraying may be stopped because of money problems, equipment damage, or loss of experienced personal. Plus, sewage and water treatment plants could become damaged. If those events happen, once common diseases found in developing countries like yellow fever, cholera, and many others could quickly emerge.

If you and your family are planning for those possible events, once again, you will need to speak with your family’s healthcare provider to receive the proper vaccinations. If your doctor is unwilling to provide these immunizations, you may need to hide your intentions, by telling your healthcare provider that you are headed on a trip to Africa or other developing country where these diseases are common.

Controlling Vectors
Another method of preventing diseases is to control disease by controlling vectors. Vectors are the animals and insects that carry a disease.

An example, which most people have heard about, is the bubonic plague that wiped out 1/3 of Europe's population from about 1350 to 1400 A.D.

To recap the bubonic plague, fleas living on rats carried bubonic plague. The fleas bite the rats; the rats die of plague. The fleas, looking for a new host, jump on humans and bite the person. The person, most likely, dies of bubonic plague.

A more recent example is malaria. Mosquito carrying malaria bites a person; the person comes down with malaria. The person may or may not die. Either way, life will suck for anyone catching malaria.

Now, there are various ways of controlling vectors. One method is to prevent the vector from living.

You can do this by interrupting the vector's life cycle. For mosquito's, you make sure every container holding more than a teaspoon of water is empty of water. This works because the mosquito larva can only survive in water.

Traps
Another way to interrupt a vector's life cycle is to kill it. You set a trap. The trap kills the rat; keeping the rat population under control. This reduces the number of fleas.

You have to be careful using traps. The bigger traps can hurt your fingers, if they are caught in the trap. Traps with dead animals in them also expose you to the diseases carried by the dead animal, so you have to have a safe way of disposing of the dead animal in the trap.

You can do this a number of ways. One method is to design the trap, so the trap is disposable. The inexpensive mouse traps you see in the home and farm stores, usually 2 for $1 are designed to be thrown away when they kill a mouse.

To dispose of this trap, put on a pair of medical gloves; pick up the trap, place it in a piece of newspaper and dispose of it in your outside trash can.

……….
Bucket Trap with Ramp (left) Bucket Trap Interior with Water (right)
 Peanut Butter is placed on top of the rolling plastic can, as the bait

Another method is to design the trap to dispose of the critter for you. One trap is the bucket trap. Basically, you take a 5-gallon bucket, fill it with water, get a board to act as a ramp to the top of the bucket, and bait the trap with peanut butter.

To empty, all you have to do is take the bucket and throw the water and dead critters out by your property line.

Prevent Being Bitten
Another method, of protecting yourself from vectors, is to prevent vectors from biting you.
You can do this in a variety of ways.

One example is using a sleeping net. The net protects you from mosquitoes as you sleep. If global warming is actually happening, the changing climate may increase tropical diseases in the southern maybe even the whole United States. Some of these diseases are carried by night-time mosquitoes.

Another method of protecting yourself, from biting insects, is to wear DEET. DEET is the active ingredient in bug spray.

Preventing medical emergencies is not limited to preventing diseases. It also includes preventing accidents, and there are many ways to prevent accidents.

The Don’ts
Don't store medicines next to candy, and don't tell your kids that medicine is candy. Because when they want "candy," they may eat all of your medicine as candy. Just like you said.

Don't store fuel, gasoline, diesel, or propane, in your home.

Don't smoke in bed. Heck, just quit smoking.

Don't put power cord under rugs.

The don'ts could and do continue forever. There are many of them. You will need to use common sense and do research on your specific situation.

The Dos
Just like the "Don'ts," the "Dos" are endless.

Do wear the proper safety equipment when using any equipment. Goggles or safety glasses are needed to protect your eyes. Ear plugs or ear muffs protect your hearing, Gloves protect your hands, and a hard hat protects your head. Climbing harnesses protect you, if you fall from the roof. But all of this equipment will only protect you, if you are wearing and using the equipment properly.

Sleep is also important. Get enough sleep, so you are rested before doing something potentially dangerous.

First Aid
OK, you have taken steps to prevent accidents. What happens if there is an accident? What do you do?

Call 911.

What happens if emergency services are too far away?

You could provide "First Aid." Don't know first aid?

That's OK. The Red Cross will teach you first aid for a small fee.

Don't have any money. You can download the U.S. Army's first aid manual, and you and some friends can practice on each other. If you don't know how to get the U.S. Army first aid manual, for free, read “Appendix C: Download the U.S. Army First Aid Manual” for instructions.

....
Workplace First-Aid Kit with Supplemental Resuscitation and Burn Kit

If you are going to provide first aid, you are going to need a quality first aid kit. Now, don't go to the store and expect to buy a quality first-aid kit for $19.95.

The inexpensive kits are ok, if you are expecting to only treat minor cuts and scrapes. If you are expecting to treat broken bones, severe bleeding, gunshot wounds, and other severe injuries, you are going to need a better kit.

Building a Better Kit
There are several different methods of getting a better first aid kit.

One way is to buy it. When buying a prepared kit, you are paying someone to assemble the contents of the kit. This reduces the amount of supplies you have. Plus, you don't know the quality of each individual item in a prepared kit.

Another way is to prepare the kit yourself. Do some research and buy the equipment and supplies, you think you will need.

Another way is to make or improvise the items you need. Some things, you will have to buy, like antibiotics and prescription painkillers. Some things you can make, such as backboards from plywood and bandages from bed sheets; additionally, you can improvise wound compresses from maxi-pads.

Obtaining Further Medical Training
So you have a first aid kit, but you feel the need for something more. You can obtain further medical training.

Usually, people check out the local community or technical colleges. These colleges offer classes on becoming an Emergency Medical Technician (EMT), Paramedic, Registered Nurse (RN), and beginning courses for people later transferring to medical school to become Physician Assistants (PA), Medical Doctors (MD), Dentists (DDS), Veterinarians (DVM), and Pharmacists.

Avoid "Doctor Assistants" or “Medical Assistant” schools. They usually teach people to be paper pushers for doctors.

Since prepping has gone more or less mainstream, there are numerous ‘combat’ related medical training classes available. Of course, this chapter's 'Additional Resources' page has links to some of these sources.

Appendix A: Common Mistakes

The first common mistake is failing to be fit and taking care of your health. You and your family need to make sure y’all are exercising, eating right, getting medical and dental check-ups, taking your required medications, eliminating the use of cigarettes and alcohol by your family, stop taking illicit narcotics, watching you cholesterol and blood pressure, and all the other stuff, so you and your family are healthy.

The next common mistake, just not in medical preparations, is failing to take everyone’s specific needs into consideration. Yes, guys that means we need to store feminine hygiene items for the ladies in our lives, spare glasses or contact lens cleaning supplies, cloth diapers for our children or grandchildren, and critical medications.

I’ll say it again. You and your family need to make sure you are storing supplies for the ladies, too.

The next common mistake is a two-for. First, there will be doctors, nurses, and other health-care professionals after a disaster. They will have the training to save your life, but they may not have the supplies to make it possible, so you and your family may want to store more advance medical supplies. These advance supplies, legally obtained, such as sutures, scalpels, and prescription antibiotics, would be used by trained professionals.  Second, you and your family need to get advance medical training or, if you can’t afford the training, training on first-aid using the Red Cross or military manual, so that you survive the trip to the hospital.

Lastly, most people fail to realize that clean water and proper disposal of waste have saved more lives than all the doctors and nurses, combined, in all of history. So, wash your hands and use proper procedures to get rid of your family’s poop and pee.

Appendix B: Other Information

Washing Your Dishes
During an event, with limited medical care, preventing diseases will be important. One way of preventing some diseases is correctly washing the dishes. Correcting washing the dishes, along with proper cooking and food storage procedures, will prevent such diseases as food poisoning.

To properly clean your family’s dishes, you will need a few supplies. You will need three wash pans or dish pans; the three to four gallon-sizes (12 to 16 liters) are fine. Some liquid dish soap, powdered soap will do in a pinch. Some kind of bulk food scraper such as a dish brush or plastic scraper for scraping caked or burnt food off of dishes, pots, and pans. Your family will also need a dish washing pad, sponge, or towel. Next, you will need some kind of disinfectant like chlorine bleach. Lastly, you need a dish towel.

Some folks recommend a dish rack instead of a dish towel because a dish towel can become contaminated. A dish rack will prevent this, since the dishes will air dry. Of course, if you’re in a hurry and need to take the dishes with you, using a dish towel will be quicker than air drying.
Once you have the supplies, you will fill the first dish pan with hot water and add a few drops of dish detergent. In a pinch, you can use clothes washing powder, automatic dishwasher detergent, or even hand soap. Just don’t add too much. Too much soap may give you and your family the runs, in other words loose stools or diarrhea.

In the next dish pan, you add hot water. This pan is used to rinse the dishes.

The third dish pan will also be filled with water, but this water will need to be cold water. The water can be any temperature, but the disinfectant will last longer, in the dish pan, if it isn’t hot. Next, the disinfectant is added to the water. One teaspoon per gallon (four liters) will work, so three to four teaspoons of chlorine bleach for a three to four quart (12 to 16 liters) dish pan.

Using the Three Pan Method
The first step is to scrape all remaining food off the plates and utensils. The scraping should go into a covered trash can to prevent flies and other vermin. Next, the dishes are washed with the hot soapy water from the first pan. Once they are clean, the soapy water is allowed to drip off the dish.
After that, the dishes are dipped into the second dish pan, swished around, and removed. Once again the wet dishes are allowed to quickly drip dry. Lastly, the dishes are placed in the third dish pan for one minute, completely submerged in the disinfection solution.

Next, the pots and pans are washed, but differently than the plates and utensils. First, any remaining food is scrapped out and placed in food storage containers or placed into the trash can. Next, soapy water from the first dish pan is poured into the pots and pans. The water is used to wash the inside of the pot. After the pot or pan is washed, the dirty and soapy water is discarded down the drain or poured out onto the ground with a big long swing of your arm, disbursing the water over a large area.

If you are staying in an area for a long time, you and your family will need to dig a sump hole for the used dish water. The sump hole is dug away from any water sources, about 300 feet (92 meters). The hole should be big and deep enough to handle all of your dirty water for two or three days. Once you leave the area, the sump hole is filled with dirt.

Back to washing your family’s pots and pans.

Greasy pots and pans are checked to make sure all the grease and oil have been removed from the pans after washing. You can do this with a touch test. Have a family member wipe their clean fingers across the inside of the pot. If it’s greasy, the pan gets washed, again. If it isn’t greasy, the pot or pan is rinsed in the second dish pan.

Of course, the rinsed pot or pan is allowed to quickly drip dry then it is soaked in the third pan for one minute, in the disinfection solution.

Warnings
First, if, at any time, the water in any of the three pans too greasy or too dirty, it will need to be replaced with new properly prepared water.

Second, you do not clean cast iron skillets, pots, or pans using soap and water. Only hot water is used and a food scraper or dish brush and a metal or plastic scouring pad. No soap!

To clean cast iron cookware, any remaining food is removed into a food storage container or the trash then it is filled with hot water and scrubbed with a dish washing pad.

If you have a stubborn spot, the pan is filled with water and is heated. Next, it is scrubbed. If the spot is very stubborn, you can use salt and a metal scouring pad to remove the spot. Lastly, the cast iron cookware is dried and given a light coat of oil like canola, peanut, olive, or other food-grade oil.

Next, don’t wash your dishes close to a water source. It may contaminate the water, requiring you and your family to move the campsite, increase the amount of chemicals you will use to treat your water, and just be bad for the environment.

Lastly, if you are in the wilderness, the dish water may attract animals and other vermin, so you may want to wash dishes away from your campsite.

Needless to say, you can skip doing all this “If” you have electrical power, hot water, automatic dishwasher detergent, and a functional automatic dishwashing machine.

Or, …

Your family is using paper plates and plastic utensils.

Washing Your Hands
Another method of preventing diseases, even during ‘good times,’ is to properly wash your hands. You should wash your hands before handling food, using the restroom, changing a diaper, or cleaning up after someone with diarrhea or loose stools.

To correctly wash your hands, turn on the water. Warm water that is a comfortable temperature for you is the best. If you don’t have tap water, use potable water.

Get the soap on your hands. Don't worry if the soap isn't antibacterial. Any soap works, even the cheap stuff.

Rub your hands together. Lathering up your hand (lots of soap bubbles) for about 30 seconds. Count from 1 to 30; sing Happy Birthday, twice; any way you want but rub your hands together for 30 seconds.

As you wash your hands, wash between your fingers and under your finger nails.

Rinse the soap off.

Dry your hands, and turn the water off with your towel.

The hardest part is to remember to turn the water off with the towel. The reason for turning the water off with the towel is because you just turned the water on with your dirty hands.

Washing Your Body
There are various methods of washing yourself during an event; some require a large amount of equipment while others don’t. Plus, a nice hot bath, a quick shower, or at least a quick cat-bath would be good for moral.

Cat Bath
To wash yourself with about 8 ounces of hot water, you will need a cup, bar of soap, and a washcloth.

First, heat the water, not too hot; you don’t want to burn yourself.

Next, strip down. If you can’t strip down, because of weather, modesty, or some other reason, remove as many clothes as you can. Next, wet the washcloth with the hot water and scrub some soap on it, not too much.

Next, starting with your face, start scrubbing. Don’t forget to get behind your ears and your neck. Your mom will thank you. Next, wash your chest, under your armpits, your back then your arms.

If you’re real dirty, rinse out the washcloth, scrub some more soap on it, and wash again.

Lastly, at least for the top part of you, rinse out the washcloth and rinse off the places you have washed with the rinsed out washcloth.

Next up is your lower parts, wash your legs then rinse. Wash your pubic area then rinse. Finally, wash and rinse your butt.

Lastly, wash your feet. Don’t forget between your toes and rinse.

All this time you should be giving yourself a vigorous washing.

Improvised Shower from #10 Can
An improvised shower can be created, various ways, by using a #10 can. The first method, a #10 can is cleaned then holes are poked through the bottom of the can. Next, two holes are created, near the top, on both sides. A piece of string or wire is laced through the side holes to allow the #10 can to hang from a support. Next, warm water is poured into the can. As the water drains out of the bottom holes, you or a family member take a shower.

Improvised ‘Bush Shower’
at the Rollingstone Army Camp, Queensland (ca 1943)
source
John Oxley Library, State Library of Queensland

A more elaborate improvised shower can be created by substituting the can’s bottom holes with a larger single hole. Pipe fitting, from a home improvement store, are installed, so a shower head can be attached. If you decide to create something like this, an ‘On’ and ‘Off’ valve might be added, for an additional upgrade.

Another upgrade would be to use a larger container to hold the warm water, such as a bucket or barrel for a longer lasting shower or allow different people to use the same batch of heated water.

Another Improvised Shower
Another method, others have recommended, is using a clean and unused garden pump sprayer. These sprayers are usually used to spray garden chemicals on plants. Needless to say, you will want to use a clean, unused, and brand-new garden pump sprayer for your family’s shower.

To use this method, the sprayer is filled with water then the pump sprayer is pressurized by operating the pump handle. Next, whoever is taking the shower; sprays themselves, soaps up, then sprays themselves again to rinse. For younger children and older adults, an adult or teenager may have to assist with the pumping and spraying.

Manufactured Showers
Another method of washing your body is to purchase a collapsible shower from your local sporting goods store or an internet provider, such as Cabela’s, REI, Campmor, or other retailer. These manufactured showers hold 2 to 5 gallons of water. Most are black or a dark color, so the water will be heated, for a hot shower if left in the sun.

Solar Heated Shower Facility
Because I don’t know to what extent you and your family are getting prepared, I am going to describe the almost ultimate solar powered shower facility that you and your family could build in a day or two using a 55-gallon drum.

First, you will need to acquire the following materials; a 55-gallon drum, enough lumber for an eight  foot (2 meters) stand to hold the 55-gallon drum, a shower head, and some pipe fittings. Next, you select the site for you shower. Like storing water, you need to select a position that will allow the water to runoff without damaging any supplies or other valuable equipment. Next, you build the stand to hold the 55-gallon drum. Next, attach the shower head to the drum, place the drum on the stand, and fill with water. Needless to say, the water will need to be clean, potable water. Lastly, if you build the stand in a sunny spot and allow the 5-gallon drum to be heated by the sun, you will have warm water for your family’s showers.

Be warned, the water can get very hot, on sunny days, so you may have to mix the heated water with cool or cold water to prevent scalding from the hot water before taking a shower.

Lastly, there are many pictures, of some truly ultimate solar heated showers, on the internet; for you to get an idea on how to build a solar heated shower facility.

What to do with your Poop
During an emergency, you may lose the ability to flush your toilets.

There are several ways to deal with this problem. One way is to have extra non-potable water to place in the toilet tank. Filling the tank will allow you to flush the toilet. You can even cause the toilet to flush by adding extra water to the toilet bowl; however, you may not be able to do either, if the sewer lines are broken.

If you are out in the woods, temporarily, you can use a method used by many military forces. It is called a cathole. A cathole is a 1 foot deep and 1 foot wide hole dug in the ground. You squat over the hole and poop. Once you wipe your butt, the paper goes in the hole. Next, you add a handful of leaves from the ground. Lastly, the hole is covered with the soil you took out of the hole when you first dug the hole

If you have a folding shovel, you can rest your butt on the flat part of the blade of the partially folded shovel to help hold your pooping position.

Another method is a thunder bucket; it seems to be an actual nautical term. A thunder bucket is the name for a 5 gallon bucket with kitty litter in the bottom of the bucket. Needless to say, a thunder bucket would be a good use for one of those 5-gallon plastic buckets that have contained chemicals, paint, or other nonfood items

Another way is to buy a port-a-potty these come in a variety of styles. One style is a seat with a plastic bag. Another style is a 5-gallon bucket with a snap-on toilet seat. Another style is the portable camping toilet.

Camping or Portable Toilet
The portable toilet is good for a few days maybe even a few months. You will need to store water (non-potable is ok), the fluid that the toilet uses to reduce the smell, and toilet paper.

Don't forget potable water to wash your hands! You will also need soap and water. The hand sanitizers are not as effective as regular soap and water.

If you don't have a lot of money, you can poop in a plastic shopping bag and pee in a large mouth bottle. The poop is covered with sawdust, shredded paper, or other absorbent material. The bag is loosely tied shut and placed in your outside trash can. The trash can lid is placed tightly on the can. The pee is diluted with water then poured on your garden.

If the emergency continues for a long time, you may need to build an outhouse. Basically, you build a small building over a deep hole.

If you don't like that idea, try this one.

There is a group that advocates using human poop as fertilizer. There is even a book written about it called The Humanure Handbook. It can be downloaded for free.

This idea could be adopted for use in a long-term emergency, but watch those opinions.

What to do with your Trash
For some events, disposing of trash will be similar to what you do now; collect the trash, bag it up, place it in the trash can (don’t forget to separate the recyclables), and wheel the trash can to the curb for regular, but slightly delayed, pickup.

During other events, you and your family may need to store excess trash for a greatly delayed pick-up. Needless to say, trash will begin to stink during hot weather. Plus, vermin; mice, rats, and insects; will attempt to get to the trash, so they can have a meal, too.

To deal with this problem, you and your family will have to compact your family’s trash, so you may need to crush or flatten sturdy metal cans so they take up less space in the trash can. To flatten a sturdy metal can, remove both ends of the can then step on it, flattening the can. To crush a can, like a soda can, stand the empty can straight up and stomp on the can. (children usually like doing this task)
Your family may also need to flatten cardboard boxes by opening the box on both ends then folding the box into a small bundle. To keep the bundled cardboard boxes from unfolding, you may need to tie the folded boxes with a string.

Another technique, you will need to find a secure location, away from your home, to store the excess full trash bags. The secure location should be rodent proof, such as metal 55-gallon drums with lids.
Don’t forget, villains! Criminals may also try to steal your family’s personal information from the trash even during ‘bad’ times.

In other events, disposing of trash will be more complicated. You and your family may be faced with removing huge amounts of trash and debris, like part of your home or large trees. In this instance, you will have to rely on outside organizations, such as insurance companies, local government agencies, or the National Guard. These organizations will coordinate to provide disposal services like dumpsters, skid-steers, and other equipment. Plus, volunteers may be available to help your family clean up.

For other situations, you and your family may be on your own for trash disposal, in an extreme event.
In this situation, you and your family will need to implement a couple different techniques.

The first technique, your family separates the trash into two categories, usable and non-usable. The useable items are saved, so those items can be reused or recycled. Some of these usable items may be plastic or metal cans to cover mouse holes, as roofing shingles for small building, and plant pots; inedible food could be used to create compost, as animal feed, or for improvised lighting; and unwearable clothes for stuffing pillows, patching holes in other clothes, and making children’s dolls.

The next technique, you and your family can use is to make a burn barrel and a bury pit. Once again, your family’s trash is separated into burnable and non-burnable items. The burnable trash is placed in a burn barrel or fire pit then the trash is burnt. A bury pit receives all the other trash.

Making a Burn Barrel
Before I begin, remember fire is the greatest threat preppers and their families will face, so you and your family need to find a location, for the burn barrel, that will be safe. That means, the burn barrel needs to be away from your home and any outbuildings, away from any trees, bushes, and other vegetation that may catch fire, and in a location that will prevent a strong wind from spreading ambers causing a fire.

..........................
55-Gallon Metal Barrel used for Burning Trash

After you have located a safe location for your family’s burn barrel, you need to find a barrel. An open-head 55-gallon barrel is the classic burn barrel. You can find this type of barrel at a junkyard, used metal yard, surplus store, or your local Farm and Home store.

Next, you need to prepare the barrel. Now, you can use the open-head barrel (without the top) as it is for a burn barrel, but it will be more effective and last longer if you follow the next steps.
To prepare the barrel, you need to drill holes around the bottom and in the bottom of the metal barrel. These holes will allow air to flow through the barrel giving a better burn. These holes will also allow rainwater to run out of the barrel, preventing the barrel from rusting out.

Next, to prevent the bottom of the barrel from rusting out, you will need to lift the bottom of the barrel off the ground. Your family can do this by placing bricks or other non-flammable items under the bottom. Lifting the barrel bottom off the ground will also allow air to easily flow under and around the barrel providing a better burn.

When using a burn barrel, most folks overload trash into the burn barrel. The overloaded barrel bellows smoke and slowly burns the trash. The partially burnt trash falls to the bottom of the burn barrel, plugging the side and bottom holes allowing water to build up thus prematurely rusting out the barrel.

Your family can prevent the bellowing smoke and partial burnt trash by insuring only burnable material is placed in the burn barrel and making sure the paper, cardboard, and other burnable are loosely placed in the barrel.

Lastly, you need to have a non-flammable screen over the top of the barrel to prevent ambers from flying into the air and possibly landing on the ground and starting a fire. Most folks use metal window screen to accomplish this step. Another possible non-flammable screen material is a very small-mesh metal fencing material; you can find at most big-box home improvement store or a local Farm and Home store.

Creating a Bury Pit
Before your family creates a bury pit, you need to insure the location of the pit will be able to be identified in the future; just in case, the contents need to be removed. Next, the pit needs to be located, so the contents do not contaminate the ground water.

After your family has identified a location for the bury pit, you dig a hole in the ground. The hole needs to be big enough to hold all of the non-useable and unburnable trash your family will create during the event. Needless to say, if you make the bury pit too small, you will need to make it larger or create another bury pit, later.

Obtaining Prescription Medicine
Prescription medication is controlled for several reasons. One reason, some medicine can be used by druggies to get "high." Another reason for prescription medicine being controlled is because it can do great harm if used improperly. There are other reasons, but I'm not going to discuss them, here.

Now, one way to get prescription medication is to explain to your doctor why you want the extra medication for your current condition. You have a heart condition, and you think it would be a good idea to have a 90 day supply, just in case.

Another way would be for you to discuss with her that you are a survivalist, (Don't use the word survivalist; too many negative connotations. Try preparing for a long-term emergency, instead.) and you would like to have a few antibiotics on-hand, just in case. You might even offer to have her store the antibiotics for you in her office.

Another method is to use drugs designed for animals. This way is starting to be or has been closed, so you may need to get a veterinarian to sign a prescription for you.
Another method is to buy them from oversea or out of country pharmacies. Be careful, there have been reports of scams. The buyer gets sent fake, ineffective, or even deadly fake drugs.
One news report I saw, talked about a pharmacist receiving antifreeze as cough syrup. Another received a toxic chemical as an anti-malarial drug.

Don't, Do Not, Never take less than the medication that your doctor has prescribed. The antibiotics have been designed to be taken in the amount and the time indicated by your doctor. If you take less or stop before you are supposed to, you can cause the disease you are fighting to get stronger.

This has been happening with tuberculosis (TB) and other diseases.

Hoarders
My wife and I have cable TV. No, we don't have a big screen television; it's a 30 inch from 1993. We bought it new after our old one died in ...

Yep, 1993.

I bring this up because there is a show on A&E called Hoarders. I have never seen the show, but I know what it is about because preppers, if they're not careful, can get the disease, problem, or syndrome.

It begins innocently, the old 410 bolt-action shotgun with the broken stock sitting in the gun safe waiting for a replacement stock, a pair of cheap gloves with a small hole sitting in a box waiting to be durned, or 10 computer bookmarks for internet sites waiting to be read on a stormy day.

Then the problem begins.

Bags of groceries bought on sale, food you and your family dislike, stacked in the basement, piles of clothes with mice living in them, and ammunition for obsolete foreign pistols you will never own or use.

So don't let the problem begin.

Make sure you're giving away or throwing away your useless stuff and organizing the remaining (so you know where it is in an emergency) water, food, and other necessities for survival.

Appendix C: Download the U.S. Army First Aid Manual

Go To: HYPERLINK "http://www.train.army.mil/" http://www.train.army.mil/

Click On - Public Access to the Central Army Registry (CAR)
it’s written in black in the top tan box, top left hand corner of the page

This will take you to a search page

In the search box

Type - FM 4-25.11 First Aid
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FM 21-10 Field Hygiene and Sanitation

ATP 4-25.12 Unit Field Sanitation Team

Appendix D:  Preparing for a Woman’s Needs

If you don’t know this by now, women are different from men. Their upper body strength is less than men, generally. Men are taller and heavier than women, on average. Women are more likely to suffer from osteoarthritis, osteoporosis, and blindness. Lastly, women can get pregnant; they will carry the baby for nine months, barring any difficulties; and they have a menstruation cycle

So, what does this have to do with prepping?

It depends on your threat analysis. Just like your family’s threat analysis for everything else, it will determine what supplies you will need to store for the women in your life. Next, this means you’re going to have to get them involved, at least enough, to offer their opinion on what supplies are needed by them.

Let’s look at some general preps.

Feminine Hygiene Products
First, women of a certain age have a menstruation cycle. When their uterus is shed each month, if a fertilized egg fails to implant on the uterus, this will cause bleeding. Most women will want a method to control this bleeding.

One method is to stock regular store-bought supplies. These are the disposable tampons, panty shields (liners), and menstruation pads; we see in the store every day.

To determine how many you and your family will need; you ask the women in your life to keep track of the feminine hygiene products they use for a month. Multiply that number by the time period, you are getting prepared for, and stock that amount of feminine hygiene products.

Like any paper and cloth supply, these supplies will need to be protected from moisture and vermin. Plus, like all your supplies, your family will need to rotate these feminine hygiene products.

Another method is to purchase reusable menstrual pads and panty liners. These pads; such as Luna Pads, GladRags Pads, or New Mon Pads; are commercially manufactured. Homemade pads can be purchased or made by you and your family.

Another method is for women to use a menstrual cup to collect their menstruation fluid.

Of course, if you and your partner are planning to use any of these methods, the women have to practice these methods.

Next, your family needs to store pain relievers, such as aspirin, acetaminophen, ibuprofen, or naproxen. These pain relievers are started as soon as bleeding or cramping starts. If your family runs out of pain relievers, a hot pad or hot water bottle placed on the woman’s lower back or abdomen will offer some relief. A warm bath will also help, if your family can produce enough hot water.

A few more methods of relieving menstrual cramps is to rest, avoid caffeine and salt, and don’t smoke or drink alcohol (If you haven’t stopped smoking, you need to anyway) Lastly, having a partner massage the woman’s lower back and abdomen may also help.

Lastly, two methods to help reduce pain from menstrual cramps are to regularly exercise and take oral contraceptives. Of course, you and your family will have to see the family’s healthcare provider to obtain prescriptions for the length of the event; your family is preparing for the oral contraceptives.

Multi-Vitamins
Another common medical prep for the women in your life is to provide nutritional supplements like multi-vitamins for everyday use. These multi-vitamins and other nutritional supplements, such as iron and calcium, provide needed vitamins and minerals to insure proper health during and after an event.
If the women in your family are old enough to conceive, you and your family may need to stock prenatal vitamins, also. These vitamins will help insure the woman’s and child’s health during the pregnancy.

Some families may discount this prep. I am unable to overstress the importance of stocking prenatal vitamins because women formerly lost their teeth, suffered from anemia, and other health problems during pregnancy because of the lack of adequate nutrition and medical care during a pregnancy.

This leads to my next point, birth control.

Birth Control
Before and during an event the women in your life may want to investigate some of the longer lasting birth control methods, such as implants and intrauterine devices (IUDs). Implants are inserted under the skin and release a hormone, for a multiyear long affect. IUDs are either copper or hormonal; they provide about three to ten years of birth control.

During and after an event, birth control may be unavailable, so you and your family may want to stock birth control products such as oral contraceptives, condoms, and other birth control aides.
If you can’t or because of religious reasons don’t want to stock contraceptives, the women in your life can use natural methods like the fertility awareness method, calendar rhythm method, and the basal body temperature method to control the possibility of becoming pregnant.

Fertility Awareness
The fertility awareness method involves knowing when a woman ovulates, so the women in your life must watch for the signs (things that can be ‘seen’) and symptoms (things the woman ‘feel’) of ovulation.

One of these signs is cervical mucus becomes more abundant. The cervical mucus takes on a watery to raw-egg-white-like consistency and stretches up to an inch or more between your fingers. Another sign is a woman’s basal (resting) body temperature will decrease then increase a few tenths of degrees and stay elevated. The last sign, I will mention, is a woman’s cervix will change position becoming higher. Plus, the cervix will become softer and open more.

Of course, there are two more signs of ovulation, but these require supplies. The first is an ovulation predictor test stick. Like a pregnancy test stick, a woman urinates on the stick for one to two weeks before possible ovulation.

The other method requires a special microscope (usually a 60X to 100X microscope) to look at a woman’s saliva. To use this method, a saliva sample is taken; early in the morning before eating, drinking, or brushing her teeth; from under the tongue and placed on a microscope slide. The saliva sample is allowed to dry for about five minutes then it is looked at with the microscope. If the saliva forms a ‘fern’ pattern, the woman could be ovulating.

There are two known symptoms of ovulation, to use for the fertility awareness method. They are an increased desire for sex and breast tenderness.

Calendar Rhythm
The calendar rhythm method requires a woman to track her menstruation cycle for almost a year, before using this method. Once this information is placed on a calendar, the women in your life, subtract 18 days from her shortest menstrual cycle to determine her first fertile day, and subtract 11 days from her longest menstrual cycle to determine her last fertile day. Next, she can calculate the number of days; she may become pregnant. Of course, if a woman’s menstruation cycle is irregular, which will probably happen during an event, there will be a greater number of days, she may become pregnant.

Basal Body Temperature
The next method is the basal body temperature method. Just like the fertility awareness method, a woman records her body temperature at the same time, every morning, before getting out of bed. Of course, her temperature must be taken with an accurate and sensitive thermometer, made specifically for taking the woman’s basal body temperature, so a regular fever thermometer will not work.
To use this method, for birth control, the morning body temperature is taken and recorded every month. Once the woman’s body temperature drops and until three days after her temperature increases again, the woman refrains from having sexual intercourse.

Abstinence
They last method of birth control, I will discuss, is abstinence. Using this method, during an event, the women in your life refrain from sexual intercourse to prevent becoming pregnant.

Other methods
There are other healthcare provider prescribed methods of birth control; I didn’t discuss, such as an Intrauterine device (IUD), diaphragm, vaginal ring, patch, or an implant, or the natural birth control method of withdrawal.

Effectiveness of These Methods
Abstinence is 100% effective so are some of doctor proscribed methods. The fertility awareness method is about 98% effective while the calendar rhythm method is 80% effective. Lastly, the basal body temperature method is effective from 85% to 98%, depending on a woman’s commitment to using this method.

Either method the woman chooses must be respected by her partner because the women in your life will have to personally deal with the implications of becoming pregnant during and after an event.

So, …

When the women say “No,” she means “No!”

Preventing Blindness
It seems women are more likely to suffer from vision loss than men because women live longer and hormonal factors. To prevent this vision loss, during tough times, women should receive a yearly eye exam, know their family history, eat healthy, quit smoking, take supplements, and wear sunglasses.

A yearly eye exam allows a woman’s doctor to dilate the eyes to check the retina. This checkup will allow the eye doctor to catch any problems, early.

Yes, I know, during certain events, women will be unable to receive a yearly eye exam that includes dilating the eyes to check the retina (back of the eye), but during ‘normal’ times an exam will be possible. Plus, a woman losing her eyesight is a preventable event.

Just like it sounds, knowing her family medical history will allow the women in your life to notify a doctor of possible problems that may be prevented.

Of course, during an event, eating health may be difficult, but you and your family may be able to ranch or grow foods rich in beta carotene (sweet potato, carrots, spinach, squash), lutein and zeaxanthin (kale, spinach, swiss chard), zinc (pumpkin seeds, squash seeds, beef, lamb), and omega-3 fatty acids (brussels sprouts, canola oil, tuna)

Another similar method is storing and taking supplements which contain antioxidants such as vitamin A, B2, vitamin C and zinc. Plus, you can store foods rich with antioxidants and fortified with beta carotene, lutein, zeaxanthin, omega-3 fatty acids, vitamin A, B2, C and zinc.

I can’t say it enough. If you and your partner are still smoking, you need to quit, today.

Lastly, everyone in the family, especially the women, should wear sunglasses that are rated to block or absorb 99% to 100% of UV-A and UV-B rays and a wide brimmed hat when working outside.

Appendix E: Mental Health

During an event, you and your family will be under severe stress. This severe stress can cause extreme behaviors to include bed wetting in younger children, acting out by your older children, thoughts of suicide by teenagers and adults, and abuse of our families. You and your partner may also see other extreme behavior by your neighbors such as people taking their lives (suicide by cop), robbing banks, committing other crimes, or just acting crazy. Yeah, people like you and me.

Some of us, maybe most of us, would dismiss this behavior as no big deal. I think it is a big concern because you and your family will be under a lot of stress during and after an event.

I have provided some links, at this chapter's "Additional Resources' page, about mental health. I urge you to seek help if you are having difficulty.

If you can't afford a professional, you need to find an ear to bend. Someone you are comfortable talking to about your feelings. This person could be a friend, priest, or family member.

If someone seeks you out to talk about their problems, take time to listen. You don't need to help, just listen. My wife and I call this "venting."

Since we have been venting (no venting about each other, by the way) for a few years, I have learned to recognize when she does this. I would suggest that you explain to your friend or family member what you want to do. Tell them upfront that you are not seeking help, just someone to listen.

For younger children, adults will have to help them cope with their feelings. Adults can do this by allowing the children to draw; using crayons, markers, and paper; about their feelings and thoughts. Another technique for children (and adults) to express their feeling is to use dolls or toys to work through their emotions and feelings.

For teens (and adults) that may feel uncomfortable talking with an adult or others, a journal to write their thoughts, feelings, and other observations may help. Of course, just like a young lady’s diary, a journal is ‘off-limits’ unless the owner gives permission for you to read it.

If you are seeking help for a problem, tell your friend upfront, so they knows that you are seeking assistants to solve this problem. This is important; you have to let people know that you are seeking help to get help.

Yes, network! People may have the answers you are looking for.

Always ask if there are questions you should have asked. As government budgets get smaller, you will need to turn to family, friends, and neighbors for assistance.

Now, some of us are going to try to work this out on our own. For me, I remember the Serenity Prayer. When I am feeling tough, I recite the Commando Prayer.

Appendix F: Serenity Prayer

Serenity Prayer

God, give me grace to accept with serenity
the things that cannot be changed,

Courage to change the things
which should be changed,

and the Wisdom to distinguish
the one from the other.

Living one day at a time,

Enjoying one moment at a time,

Accepting hardship as a pathway to peace,

Taking, as Jesus did,

This sinful world as it is,

Not as I would have it,

Trusting that You will make all things right,

If I surrender to Your will,

So that I may be reasonably happy in this life,

And supremely happy with You forever in the next.

Amen.

By Reinhold Neibuhr, American theologian


Appendix G: Commando Prayer

Commando Prayer

Give me, my God, what you still have;
give me what no one asks for.

I do not ask for wealth, nor success,
nor even health.

People ask you so often, God, for all that,
that you cannot have any left.

Give me, my God, what you still have.

Give me what people refuse to accept from you.

I want insecurity and disquietude;

I want turmoil and brawl.

And if you should give them to me,
my God, once and for all,
let me be sure to have them always,
for I will not always
have the courage to ask for them

By Corporal André Louis Arthur Zirnheld, French Squadron, Special Air Service

Appendix H: Dealing with the Dead

Where there is life; there is death, so dead bodies will need to be properly cared for by you and your family. Depending on the event and whether civil authorities are operating will determine how you handle the situation.

If civil authorities are operating, you will need to contact them for their policies and procedures. These civil authorities are usually the police or sheriff, fire department, and public health office. Hopefully, they will be able to inform you of the necessary procedures, where to take the body for proper disposal, and provide any needed paperwork to report and record the death.

By now, some folks are thinking: 'It's a disaster. Why do I need to contact the government to report a death?'

First, insurance companies are going to want proof. No death certificate; no insurance money. Next, how do the cops know you didn't kill your youngest daughter? They weren't informed at the time of her death, so they didn't investigate to clear you of any wrong doing. Lastly, you don't want a dead person starting to spread disease and stinking up the place, so you will need to take them to a designated location for disposal, such as a funeral home, church, or mass grave. And I'll bet you, they will want some kind of government 'proof' before they allow you to leave a body.

Of course, your family may be preparing for an event when public offices may be closed. If the government authorities are absent, you and your family are going to have to handle it.
First, document, document, document.

If a camera is available take pictures of the body. The first few pictures should be full-body pictures highlighting the dead person’s clothes. Next, take close-ups of the face, front-view portrait and both profiles, left and right side, in focus. Lastly, remove the shirt to allow pictures to be taken of any identifiable scars or tattoos. There is no need to remove the dead person’s pants or a dead woman’s brassier (bra) because most people will be able to be identified with these pictures.

If no camera is available, you or someone artistic will need to make drawings of the dead person’s tattoos and their location on the body. You will also need to do this for scars.

Next, you and your family need to start writing. These writing will include witnesses' accounts of the accident, shooting, or whatever happened to cause the person's or people's death; names and addresses of the dead person or people, and any other information. Remember, more information is better in this situation.

Note:
If it is a crime scene you will need to make sure you get photographs, sworn witness statements, and collect evidence. If you have seen a crime drama, you know what I'm talking about. Don't forget to have a ‘chain of custody’ for these documents as your collect, store, and transfer the evidence.

After taking pictures of the body, collecting witness’ statements, recording any identifying information, you, your family, or other folks are going to get the body ready for burial. The most important thing to know about this process:

Protect yourself!

Whoever is preparing the dead body needs to be wearing protective gloves for the hands, a mask covering the mouth and face, cap covering the head and hair, with a waterproof apron covering a protective gown or suit, and protective rubber boots. If there is a splash hazard, goggles should be worn over the eyes.

Most families will not store these supplies, so these items will need to be improvised using dishwashing gloves to cover their hands, a rain suit to protect their clothes, rubber boots, and a paper trash bag turned into an improvised cap and face mask with safety goggles to protect the eyes.
In an ideal situation, all wound drainage (blood and pus) should be cleaned from the body with a strong bleach solution. Once the wounds are cleaned, all cuts, wounds and body openings should be covered with water-proof bandages or dressing. The body opening (butthole) should be plugged with a swabs soaked in bleach solution. After this is completed, the dead body is cleaned with a soap and water. Lastly, the body is dressed with clean clothes, if possible.

Next, the body is ‘bagged and tagged.’ The dead body is placed in a body bag. Once again, most families will not store body bags, so an improvised bag will have to be constructed out of large plastic bags and duct tape. Another improvised method is using rolls of plastic sheeting, found at the local home improvement store, and duct tape.

The method I will discuss requires four large trash bags, around 50-gallon size, and a roll of duct tape; items most families will have on hand. The first two plastic bags are placed next to the body. These two bags are taped to form a long thin ‘sheet’ of plastic, large enough and long enough to lay the dead body on.

To prevent any unnecessary lifting and moving of the dead body, this sheet is then rolled up long ways. The rolled ‘sheet’ is placed next to the body then the dead body is rolled away from the sheet and carefully held on its side. The rolled sheet is unrolled where the body used to lay. Next, the body is rolled back to its original position, so it lies on top of the plastic sheet.

The next two large plastic trash bags are taped together forming another long, thin plastic sheet. This second sheet is placed on top of the dead body and taped to the second sheet.

But, before you do that (close up the body bag); you need to ‘tag’ the dead body. To tag the body, you place copies of any identification (name, address, and next of kin) in a plastic zipper bag (zip lock baggie) and place it inside the body bag. Next, place any personal effects in the large improvised ‘body bag,’ such as wallet, cellphone, jewelry and any other items in the pockets or on the person.
Next, if you don’t have a body bag, the dead body wrapped in the plastic bags will need to be secured in a cloth wrapper. This cloth wrapper allows the body to be grabbed without tearing the plastic. A bed sheet with strong cordage wrapping the body works very well as an improvisation. Just make sure not to tie the rope too tight or around the face and head, for possible later identification.

After all this is done, the person handling the body removes the protective gear and properly disposes of all of the items. If your family is using an improvised method of protecting themselves, the gloves and rain suit will need to be cleaned with a bleach solution and the paper items placed in the trash.
Of course, you may not to want to go through this process for someone who has tried to kill you and failed, died of an easily contagious and deadly disease, or there are so many dead; it is impractical for your family.

Either way your family processes the body, I suggest you adopt the Jewish tradition of getting the body in the ground in less than 24 hours, after death. You know why.

If you don't, place a 1-inch cube of meat in a jar with a lid that has a couple of holes punched in it and wait. Sniff it, every day. You'll know when to throw it out. Don't do this inside; do it outside.

Needless to say, burying someone isn’t going to be easy.

First, the grave site should be away from any bodies of water, at least 300 feet (91 meters). Plus, the dead body should be buried 6 feet (1.8 meters) above the water table, to prevent contaminating the ground water.

Lastly, the grave should be 6-feet deep (1.8 meters), to prevent animals from digging up the body and the smell issue. If you can’t dig the hole 6-feet deep, don’t worry. It just needs to be away from the house and watched over to keep animals out of the grave.

Now that you and your family have the body cleaned, dressed, placed in a body bag with any personal effects, and have the hole dug (away from any bodies of water), you are going to mark the body, again. Yes, I know, it’s a dead person, but friends and family will want to collect the dead and intern them in a cemetery, after the event.

To mark the body, one last time, you place a sealed plastic jar with the dead person’s name, address, and any other information on a sheet of paper that is placed in the jar and buried next to the body, basically all the information on a driver’s license. If you don’t have a plastic jar, you can use another sealed plastic bag, like the one you placed in the body bag.

Next, you are going to need to mark the location of the grave, twice. The first is with a grave marker. The grave marker has the person's name and date of death. Next, you need to create a map showing the location of the grave or graves with reference points marked on a map.

Lastly, you and your family will need to perform some kind of ceremony, depending on your family’s religious convictions. This ceremony will allow folks to grieve and morn the dead. Remember, funerals are for the living.

Of course, during an event, you and your family may find yourselves collecting and interning more of the dead then you had planned on. In that case, I have provided some references at the “Prepper: Surviving the Tough Times Ahead” blog to help your family.

Appendix I: Games, Binkies, and Makeup

During an event, you and your family may be struggling to survive by looking for employment, trying to stay warm with an improvised heater, filtering water to drink, growing your family’s food to eat, or walking to a refugee center, but what are your children going to do? What about when there is nothing to do?

Entertainment
As hard as it is to believe, you and your family will have time to play and relax during and after most events, so you will need distractions, such as colored pencils and paper, crayons and coloring books, and dolls or action figures for younger children; and appropriate reading books for teens and adults for low-level activities while you’re waiting or confined to one location.

When your family is at home, you might consider storing board games, decks of cards, and other family friendly games. These games can be the old stand-bys like Monopoly, Sorry!, The Game of Life, and Risk, or the new family favorites such as Apples to Apples, CoMotion!, or card or dice games like Uno and Yahtzee.

Of course, your family can save money by purchasing these games used at local garage sales or swap meets. Just be careful and check the games for missing pieces.

For those times when you and your family can be outside being active and playing; you may need basketballs, footballs, soccer balls, or bouncy balls. Add a few cones, you, your children, and the neighbors could have a bonding experience during an event.

Lastly, you and your family may need to purchase a portable DVD player and have age-appropriate movies for the whole family. Yes, having an internet connection and a Netflix account might be something for you and your family to consider having for tough times.

Binkies
If you have children, you know what I’m talking about. The soft but worn towel or blanket your son seems to carry everywhere or your daughter’s stuffed rabbit that has had major surgery; she needs to sleep, every night.

Or, …

The silky smooth but faded poncho liner, the hardened Soldiers, Marines, Airmen, and Sailors carries with them to the far flung regions of the world.

Whatever it is, and whatever it is called; these binkies will help you and your family cope during an event. Just make sure, you take it with you!

Makeup
Most guys would discount this prep for you and your family, but women like to look nice. Plus, during certain events, women will be going to work; they will need makeup to look presentable, just like men going to work.

This includes the hand, face, and body lotions, the women in your life use every day, and the haircare products, like shampoo and conditioner, body wash and scrunches, and other items you and your family use to stay clean and presentable. They will need to be stored, also

What? You thought you wouldn’t have to shave and shower, during and after an event.

Toilet Paper
Lastly, I know I haven’t specifically said it, but you and your family need to store toilet paper, too.


Additional Articles ...                    Chapter Eight: Protection

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