CDHB Update 13

EARTHQUAKE UPDATE THIRTEEN – CANTERBURY DISTRICT HEALTH BOARD
A MESSAGE FROM HEALTH MINISTER TONY RYALL TO CANTERBURY DISTRICT HEALTH BOARD CEO DAVID MEATES:
‘This week you and your team have shown the rest of New Zealand and the world how our health services have pulled together to support each other and the community. Many of you will be dealing with losses among family and friends or colleagues, but you have put patients' needs - and the needs of Canterbury people ahead of your own. I thank each and every one of you and wish you and your families well as Christchurch begins the long road to recovery.’

Tony Ryall
Minister of Health

FREE GP CARE HAS BEEN EXTENDED UNTIL SUNDAY WEEK
Canterbury residents with urgent medical needs can visit a GP free of charge until end of day next Sunday (March 6).
PRESCRIPTIONS FEES WAIVED UNTIL SUNDAY WEEK
Patients will not have to pay the $3 co-payment or any other part-charges or premiums on their prescriptions until Sunday March 6).
BOIL ALL WATER UNLESS IT’S BOTTLED
All water should be boiled – unless it’s been bought in a sealed bottle -- that includes water from water tankers at refill stations. Hand-sanitisers have been ordered and are expected to be available from water stations.
Public Health leaflets and hand-sanitisers are being distributed at water tanker depots and welfare centres.
“We’re doing everything we can to minimise the risk of gastroenteritis (vomiting and diarrhoea). Washing hands and boiling water are two of the most important things people must remember to do.”
CHRISTCHURCH HOSPITAL
Total occupancy at Christchurch Hospital as of 26 February is 278. 159 patients have been transferred to other hospitals around New Zealand. There are presently 7 patients in the Intensive Care Unit (ICU) - it is not known at this stage how many in ICU have earthquake related conditions.
As of Saturday morning, there have been 702 attendances at Christchurch Hospital Emergency Department since Tuesday’s earthquake. There were 133 attendances yesterday which is fewer than normal on a Friday.
Maternity Services at Christchurch Hospital are busy but steady with 64 babies born since Tuesday’s earthquake (as of Saturday 26 February). There are currently 60 women in the maternity wards.
There are sufficient numbers of midwives in the immediate and will be contacting a pool of available midwives including self employed midwives to relieve staff over the next few weeks.
MEDIA ARE NOT TO ACCESS CHRISTCHURCH HOSPITAL OR STAFF WITHOUT PERMISSION
• All media queries must be directed to the CDHB Strategic Communications Team. Please phone (03) 337 7390, or 027 502 7523/ 027 531 4796.
*NEW COMMUNITY HEALTH CENTRE AT COWLES STADIUM
The Australian Army field community medical centre began delivering primary care at Cowles Stadium to eastern suburbs residents this morning. The 75-bed facility is staffed by Australian clinicians including six emergency department doctors, 13 nurses, general surgery staff, orthopaedic staff, general trauma, anaesthetists and support staff. It will operate as a Primary Health Centre to support General Practices in the eastern suburbs who are having difficulty delivering health services. The Centre will provide free primary care until Sunday night along with other GP Clinics in Christchurch. The Centre will have capacity to manage expected outbreaks of gastroenteritis in the eastern suburbs. Members of the public who suspect they are suffering from gastroenteritis are urged to go to the Field hospital for treatment. A mobile community dental clinic will also be operational from Monday.
The Community Medical Centre is located at Cowles Stadium in Pages Road and will be open 7 days 8am – 8 pm.
IF YOU NEED MEDICAL CARE PHONE YOUR OWN GP FIRST
Phone your own General Practice (GP) Team first – if they’re not open a nurse will answer the call and direct you to the nearest GP practice that’s open.
If your own GP’s phone isn’t working please contact the Pegasus 24-hour medical centre in Bealey Avenue – 365 7777. They have a team of nurses able to provide health advice and can provide self-care advice on how to care for minor injuries and illnesses at home. They will also direct callers to the nearest medical centre.
The Pegasus 24-hour medical centre in Bealey Avenue is open after-hours and clinics at Moorhouse Medical Centre and the Riccarton Clinic are open from 8am to 8pm daily.
The Rural GP Practice in Kaiapoi is also providing 24-hour services to patients in Christchurch who are not able to access their own GP Teams.
Approximately 84 practices are operating now in Christchurch some with restricted hours.
Please keep Christchurch Hospital for emergencies only. If you need an ambulance, please phone 111.
LIST OF GP PRACTICES OPEN OVER THE WEEKEND OF 26 AND 27 FEBRUARY
Note: This list is subject to change. You should always phone your own GP first and if they’re not available you will be directed to the nearest GP surgery that is open.
Barrington Medical Centre Open
Christchurch South Health Centre Open
Darfield Medical Centre Limited Open
Doctors on Riccarton Sat only
Helios Integrative Medical Centre Open
Lincoln Medical Limited Sat only
Linwood Avenue Medical Centre Open
Lyttelton Health Centre Open
Methven Medical Centre Open
Moorhouse Medical Centre Open
New Brighton Health Care Open
Papanui Medical Centre Sat only
Promed Edgeware Doctors Sat only
QEII Medical Centre Sat only
Riccarton Clinic Open
Sumner Health Centre Sat only

GPs WANTING MORE INFORMATION ABOUT WAIVED FEES
Should phone 353 9966 (Pegasus)
REST HOME RESIDENTS BEING RELOCATED
All 187 rest home residents so far identified for evacuation will have been transferred out of Christchurch to other regions by the end of today (Saturday 26 February).
Only residents from facilities where there has been structural damage are being relocated at this stage.
Rest home staff are doing an amazing job despite trying circumstances – many are keeping their residents safe and well despite no water, power and, or telephone.
Some rest home residents have gone home with family members or friends and it is very important that they or their families make contact and stay in contact with their family general practice to ensure the medical needs of their elderly relative are being met.
Family members and friends are requested not to take attempt to relocate residents to other rest homes themselves. Rest home residents, when required, are being relocated through the CDHB.
Many rest homes need logistical help especially with practical things like, water and laundry.

Respite care capacity is significantly limited and access if via GP referral only.

Staff who have been freed up with the transfer of residents elsewhere are likely to be redeployed and allocated to operating homes in Christchurch.

HEALTH CARE AT WELFARE CENTRES
St John Ambulance, Public Health Nurses and army medics are working together at Welfare Centres.
A team of public health nurses will be working at the Welfare Centres focusing on infection control, hand hygiene and isolating any cases of suspected gastroenteritis or measles. Teams will be on site every day while the centres are open.
The Cowles Centre was closed yesterday to alleviate concerns with sanitation and hygiene with 60 people moving to Rangiora and the rest likely to go the new Rolleston Community Centre today. Rolleston has the capacity to take 1000 people. It has improved facilities and has all services up and running including sanitation and power.
A Welfare Centre has also been set up at New Brighton under the guidance of the New Zealand Police.
Army medics and St John Ambulance staff will also be present at each welfare centre.
Centres are currently located at:
Rangiora Baptist Church
Burnside High School
Rolleston Community Centre
LOOKING FOR AN INJURED FAMILY MEMBER WHO MAY BE IN HOSPITAL?
Relatives looking for injured family members at Christchurch Hospital should go to the Great Escape Café in the main foyer where a relative centre has been set up and there are social workers and police available. To report missing people, contact Red Cross 0800 733 276.
The relative care centre will be open Saturday and Sunday - 8am- 4.30pm at the Great Escape café. It will continue to be staffed by Social Workers.
Police will be located at the Papanui Liaison office at Papanui Police Station.
CDHB HAS SET UP A FACEBOOK PAGE FOR STAFF
Staff can keep up to date via Canterbury District Health Board’s Facebook page.
CHRISTCHURCH HOSPITAL IS OPERATIONAL
Hospital services are continuing to provide care for hundreds of inpatients. Staff are doing a remarkable job considering everyone has been affected by the quake. All hospital buildings are constantly being checked for damage by structural engineers. Patient volumes have been steady.
Staffing levels are good and have been boosted by colleagues from around the country. Stable patients continue to be transferred to other hospitals to free beds for the seriously ill.
Maternity services continue to be busy, as is the neonatal intensive care unit. Babies continue to be transferred to other units around the country. There are currently 76 in-patients at the Women’s Hospital.
Orthopaedics and Cardiology services also remain busy. The emergency department is steady at the moment and managing the workload very well.
There are currently 293 in-patients of which 10 remain in the Intensive Care Unit (ICU).
OUTPATIENT SERVICES AT CHRISTCHURCH HOSPITAL
• All orthopaedic fracture follow-up clinics at Christchurch Hospital are continuing as normally scheduled.
• Patients with elective outpatient clinic appointments for non-acute problems will be contacted by CDHB.
• General Practitioners (GPs) will continue to refer patients for specialist assessment on the basis of clinical need, recognising CDHB’s limited resources.
• Paediatric clinics are closed for the rest of the week.
• Community Oncology – Oncology Clinics will be starting on Monday. Try and have your clinic appointment letter with you to enable you to get through the cordon.
• The Diabetes Centre is closed until further notice. The CDHB diabetes team are offering a semi-acute service and will be working out of Parkside Outpatients. Please send any urgent referrals you may have to Fax number 3640419, attn Diabetes
• Emergency Adult Dental Services. The oral health emergency centre has been relocated to Hillmorton This is a Monday to Friday service only. For appointments Ph 3354260.
ALL ELECTIVE SURGERY POSTPONED UNTIL 7 MARCH
All elective surgery (public and private) in Christchurch is postponed until Monday 7 March 2011 at earliest. Alternative arrangements are being made for non-deferrable surgery.

DIABETES
The Diabetes Centre is closed until further notice. The CDHB diabetes team are offering a semi-acute service for people who cannot access their GP and have unstable diabetes or other serious diabetes-related issues which require further advice or assessment. Patients who are unable to access their GP can phone 364 0640 to be put in touch with a diabetes triage nurse who is available 8am to 5pm only. If outside these hours contact the Bealey Ave 24-hour medical centre.
HEALTHLINE
Healthline provides health advice 24-hours a day, seven days a week. Phone: 0800 611 116. Calls are answered by a registered nurse. Healthline uses language line and can access translators in many languages. Healthline can also transfer callers to mental health professionals for advice and support.
COPING STRATEGIES - STRESS AND ANXIETY
The Ministry of Health has created a series of fact sheets with advice and coping strategies for people experiencing stress or anxiety in the wake of this week's tragedy. These can be found on the Ministry's website - www.moh.govt.nz - under the banner headline "Christchurch Earthquake"
Mental Health Nurses are available to provide support in the community. Please phone your GP Team for information.
POSSIBLE PSYCHOLOGICAL REACTIONS TO AN EARTHQUAKE - ANXIETY DISORDERS UNIT, CDHB.
We have now experienced two major earthquakes and are continuing to experience ongoing aftershocks with significant consequences for many people. Following such immensely upsetting events, people understandably feel distressed. This can last days or weeks. Allowing enough time to heal physically and mentally is important to recovery, as is support from friends and family. Some people find it helpful to talk about what has happened to them, others prefer not to discuss it. Either strategy is fine, provided you feel able to choose what you do.
The earthquakes and the ongoing aftershocks have had their effects on everyone. It is common to experience the following responses:
• Fatigue and exhaustion particularly as time goes on.
• Feeling frightened, on edge, nervous, and tense.
• Sleep disturbance such as difficulty getting to sleep or waking often, waking early and not returning to sleep, and nightmares.
• Being easily startled and looking out for danger.
• Feeling various emotions such as fear, sadness, grief, guilt or self-blame, shame, irritability, anger or feeling numb or detached from self or others. You may also notice marked swings in your emotions.
• Anxiety symptoms like a racing heart, rapid breathing, trembling, sweating, loss of appetite and stomach upsets.
• Impaired concentration, decision making and memory which may obviously make us less productive.
• Worrying about what might have been or having to deal with real ongoing concerns.
• Feeling a sense of lack of control.
• Thoughts and memories about the event continuing to pop into your mind, even days or weeks afterwards.
• Feeling like the distressing events are happening again (i.e., flashbacks).
• Feeling disconnected from reality, like you’re in a dream.
• Increased conflict in our relationships, over-protectiveness or social withdrawal.
Reactions can be triggered by further aftershocks, images (things we read or see), and particularly sounds, smells, or movements (such as shaking or swaying) that remind you of the experience.
Usually, these reactions will gradually lessen over the following days to weeks as we make sense of what has happened.
Many people have lost loved ones, homes, businesses, and other valued aspects of their lives. Grief is a normal reaction to this and can take many forms, such as distress, anger, sadness, disbelief, guilt, and helplessness. Peoples’ reactions may differ; there is no “right” way to grieve and no “right” timeframe.
It is really important to allow yourself time to work through the experience of the earthquakes. There are many different ways of coping. These may include
• Talking to family, friends, neighbours and colleagues if this feels okay for you. This may help you feel less alone and more understood, as well as, leading to offers of help. If you do not feel like talking this is okay too.
• Trying to keep a regular sleep patterns (appreciating aftershocks may be disrupting sleep at times).
• Re-establishing usual routines if and when possible (e.g., housework, meals, interacting with others, exercise).
• Eating regularly and being mindful of nutrition.
• Keep physically active which helps reduce tension and anxiety
• Pacing yourself by keeping busy and taking time to relax.
• Try to increase positive and engaging activities by doing things you enjoy or find satisfying you will improve your mood and less time to dwell. Everyone needs some sense of satisfaction no matter how small.
• Be careful not to overwhelm yourself or your family with excessive media coverage of the events because this may increase your distress at times. This may also apply to checking earthquake activity sites on the internet.
• Setting realistic goals, if you try to behave as you did before the recent earthquake you might begin to feel overwhelmed. Allowing a bit of space to come to terms with the earthquakes is important.
• Try not to become exhausted by trying to get everything done at once. This is a big challenge and will take time.
• Remember having more than four to six cups of caffeinated drinks per day may increase your anxiety levels, and interfere with your sleep.
• Try not to increase your use of alcohol or recreational drugs. These may initially relax you, but as they withdraw from your system, they likely will increase your anxiety and affect your sleep patterns.
There is no set way of doing this. Whatever feels right for you will work best.
A common concern people will often have is the reaction of children to such events. It is important to remember that children generally are resilient.
However, younger children may still be more clingy, be experiencing bad dreams (not always just about the earthquake), loss of appetite, and may complain of physical symptoms such as headaches and stomach aches.
Suggestions for supporting children include the following:
• Be supportive and reassuring, your children may need to be held.
• Your child’s fears are genuine to them, this may include worries they may be separated from their parents and needing them close. Talk this through with them. Your child may want to re-enact or draw pictures about the earthquake, this is okay.
• Listen to your child’s fears and explanations about what happened.

CANTERBURY DHB STAFF ARE TO TURN UP TO WORK FOR THEIR NORMAL ROSTERED HOURS
Staff are not required to come in outside of their rostered hours. Please check with your manager what these hours are.
CHECK ON YOUR NEIGHBOURS AND KEEP IN TOUCH WITH FAMILY AND FRIENDS
At times like this it’s important to look out for elderly neighbours and others who live alone.
TAKE YOUR MEDICATIONS WITH YOU
If you’re moving out of your home or leaving Christchurch remember to take your regular medications and prescriptions with you.
CHRISTCHURCH WOMEN’S HOSPITAL IS OPEN & RECEIVING PATIENTS
Burwood birthing unit is closed today.
Lyndhurst Centre is closed until Monday and women with appointments will be contacted by a staff member.
Rangiora and Lincoln birthing units are open.
METHADONE PATIENTS
If you are a methadone patient and your usual pharmacy is closed, phone the Community Alcohol and Drug Service (CADS) on 335 4350 and they will direct you to the nearest pharmacy.
MEALS ON WHEELS WILL RESUME NEXT WEEK.
Meals on wheels are not available until early next week. It is planned to resume on Tuesday – if you have elderly neighbours or people who live alone, please check on them and help out if you can with meals and support.
OTHER KEY PUBLIC HEALTH MESSAGES
People need to take the following advice to avoid getting sick with stomach bugs and other illnesses.
Surface waters
People should avoid contact with sewage. Assume river, sea water and any other surface water is contaminated with sewage. People should stay away and not swim, fish or gather shellfish in the sea, Canterbury rivers or any standing water until notified.
People who have sewage contamination within their homes should be advised to move to alternative accommodation.
Make sure you wear shoes, due to broken glass, debris and sewage leaks.
Toilets
Conserve water if you have it.
People should be advised to flush toilets sparingly.
“If its yellow let it mellow; if it’s brown, flush it down.”
People who do not have a flushing toilet are advised to make a temporary toilet with a bin lined with two plastic bags. The bin should be covered between uses. The contents can be buried when the bin is no longer needed.
If you have no outdoor area, you can now dispose of wrapped human waste in City Council red bins.
Details of how to make a temporary toilet can be found at http://www.moh.govt.nz/moh.nsf/indexmh/protecting-your-health-in-an-emergency
Hand washing
Frequent hand washing needs to be emphasised. Where people do not have access to water, alcohol gel is a good alternative. Hands do not need to be dried if alcohol gel is used.
Remind people to wash hands, particularly after:
• Using the toilet
• Before and after preparing food
• Handling rubbish or waste
• Cleaning toilets, bathrooms
• Handling soiled clothing or bed linen
• Handling cleaning equipment such as cloths, buckets and mops
Hand washing stops diseases spreading. Cold water is fine as long as soap is used and hands are thoroughly dried.
Dishwashers
Conserve water if you have it. If dishwashers are used a full hot wash with detergent (not economy wash) must be used. Dishes must be allowed to dry fully prior to use.
Contact with neighbours/friends
People should be encouraged to look after each other. Advise people to keep in touch with families, friends and neighbours and support each other.
Food safety
Members of the public and food business operators should phone the New Zealand Food Safety Authority (NZFSA) on 0800 693 721 (0800 NZFSA1) if they have any enquiries.
PHARMACIES THAT ARE OPEN TOMORROW – Sunday 27 February
Airport Pharmacy
Avonhead Pharmacy
Barrington Pharmacy
Bastins Pharmacy
Bush Inn Pharmacy
Dodds Pharmacy
Rangiora Pharmacy
HealthWorks Pharmacy
Hornby Unichem
Life Pharmacy Northlands
Life Pharmacy
Miles Pharmacy
Parklands
Radius Church Corner
Radius Moorhouse Avenue
Shields Pharmacy
Unichem Ashburton
Union Street Pharmacy
Urgent Pharmacy (Bealey Avenue)
Waltham Pharmacy
GUIDANCE FOR DENTAL PATIENTS
The New Zealand Dental Association advises all patients in need of emergency or routine dental care to contact their own dentist first. If their own dentist is un-contactable or unable to assist, a list of practices is available here:
http://www.canterburydentists.org.nz/
ENDS

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