In September I visited the Arctic, a rare opportunity to see the top of the world—a hostile yet remarkably and singularly beautiful environment. On board our ship were many scientists, some of whom were conducting research into pollution of the ice. Form their presentations, I learned a tremendous amount about how the planet is warming, and the impact of global warming on glaciers. Glaciers are melting. This is indisputable.

And with these changes at 90° North, the entire planet is affected in various ways. One way is the variability and instability of the weather. You may have noticed. More frequent droughts in some regions, more monsoons, earthquakes and hurricanes in others. And the intensity of these storms is increasing.

Last year at this time, Valencia, Spain was terrorized by a horrific flood, comparable to the effects of a tsunami. Hundreds died. We in the United States were reeling from Hurricane Milton, one of the deadliest storms to hit Florida on record. There were also floods in Nepal and the Sudan, and a hurricane in Mexico and again, Florida.

And just last week, Hurricane Melissa pummeled Jamaica and other parts of the Caribbean, deemed the worst hurricane it has ever experienced. I have many friends in Jamaica who are part of the bleeding disorder. I sometimes send factor to them, and have visited twice over the years, to help resurrect the patient group and to assess needs.

One thing the global bleeding disorder community is not good at is disaster relief. When Nepal experienced a devastating earthquake in 2016, I was the first on the scene—six months after the earthquake. It’s shocking that we cannot do better, when so many patients live in disaster-prone regions, and live in poverty.

We in the US have it better but we still have a long way to go before we can respond well to disasters affecting US bleeding disorder patients. So this leaves it up to each of us to be prepared for disasters. What should you do now to prepare?

1. Know the geography and weather patterns where you live. California has many geographical faults that cause earthquakes; wildfires are particularly bad. The Midwest states of Texas, Nebraska and Kansas are dubbed “tornado alley” for their frequent and sometimes devastating tornadoes. The northeast has “nor-easters” every ten years or so. And Florida is hit with hurricanes that often originate off the coast or in the Caribbean Sea. Here in the east, September and October are hurricane season moths. Normally we are lashed with the tail end of a Caribbean-originated hurricane. Pay attention to weather forecasts daily.
2. Ensure you have factor and ancillaries on hand at all times. When storms hit, you often are not able to travel, and face power outages. Your factor supplier may not be able to bring you factor, and you may not be able to contact them. Keep at least 10 doses in your fridge at all times, and plenty of ancillaries.
3. Keep candles and flashlights ready, with fresh batteries. Keep your cell phone charged, and have a power bank charged and ready if your phone runs low on power.
4. Know your local emergency numbers, in case you need to be evacuated due to your medical condition. Panicked callers have overwhelmed 911 services, so you may not be able to always reach help when you need it.

We still have one month left of hurricane season, which could yield up to 19 named storms and five major hurricanes, according to the National Oceanic and atmospheric administration. That’s above the annual average of 14 named storms, partly as a result of higher ocean temperatures and lower trade winds. Disaster preparation efforts have been affected by staffing cuts and the current administration’s vow to dismantle the Federal Emergency Management agency. The agency has lost at least 25% of its full time staff. Without federal funds, many states may not be able to assist people affected by disasters.

As soon as you know that you are in “weather season,” and then hear that a storm is developing, be prepared for a worst-case scenario. Keep updated with popular apps like RadarOmega and FEMA App. Ask your local bleeding disorder organization what they suggest for being prepared and for help during a natural disaster. Suggest that there is a presentation on it by a local expert for yoru next annual meeting.

Visit this National Bleeding Disorders Foundation’s page to learn of resources available. Read MASAC’s Document $227 policy on having a home factor supply to prepare for emergencies, And also visit the Hemophilia Alliance’s Disaster Relief Fund page to learn how this group assists people affected by disaster. Read a great article here on CNN of what to have in an emergency.

Weather is predicted to become more unstable and intense in the coming years as the glaciers melt. Now is the time to educate yourself and prepare.