Crises can take many forms, but in all cases, pharmacists need to be aware of their resources and ensure the continuity of pharmacy services as much as possible. Practical advice for pharmacists and pharmacy staff on how to ensure the availability of medicines and what to do in the event of a power cut or shooting has now been compiled in the first handbook, “Action in the event of a national emergency”. Practical training for pharmacists and pharmacy managers is also planned for this year.

Since Russia’s unprovoked full-scale invasion of Ukraine, there has been increasing discussion about the availability of shelters and the need for 72-hour emergency bags. Equally important in a crisis situation is the ability to purchase necessary medicines. The most common situation in a pharmacy could be a power outage, so one of the options for purchasing necessary medicines is cash, which, after the 2023 storm, the residents of Augstkalne parish almost always have in their pockets.

The Augstkalne pharmacy is also prepared for such situations. There is a generator in the auxiliary room and a sheet with the electrician’s recommendations on what to do in which order. Bigger problems would arise if the power went out across the entire municipality or even Latvia and the internet was unavailable, which would also mean no access to e-health services. Iveta Kurloviča, owner of the Austkalne pharmacy and pharmacist, explains: “It is important for people to think ahead about their medication so that they don’t run out and only rush to the pharmacy when they have their last pill left. There is also the issue that we can provide supplies from our own stocks, but these are not large in many pharmacies. We are not a wholesaler. Therefore, this needs to be considered at the national level. Logistics must also be ensured in crisis situations.”

“It is important for people to think ahead about their medicines so that they don’t use up their last pill.” – Iveta Kurloviča

Dace Ķikute, president of the Latvian Pharmacists’ Association, recalls another resource that can be used in a crisis situation: “There is also a very interesting topic regarding medicines prepared in pharmacies. Pharmacists of my generation have been carefully trained in the preparation of disinfectant solutions, for example, and we still have a lot of knowledge in our heads. The issue of raw materials in pharmacy stocks is important so that in times of crisis, when industrially manufactured medicines are not available, pharmacists have both the skills and the raw materials.”

The stress resilience of pharmacists is no less important, points out Dace Ķikute: “I think it’s about people’s own readiness. Am I a patriot? Do I recognize my responsibility towards my fellow human beings? Do I recognize the value of my profession and my responsibility towards my fellow human beings?”

Now, the first handbook for pharmacies and pharmacists on how to prepare for crisis situations and ensure the continuity of pharmacy operations has been published. It is a pocket-sized brochure that summarises general recommendations from specialists in the fields of healthcare, safety and security. Sandra Zilberte, Chair of the Board of the Health Care System Resilience Think Tank: “This book may not contain universal answers on how to act in every situation, but it is definitely the first step towards such answers, which would be suitable specifically for pharmacists and their work, regardless of whether they are urban or regional pharmacists.” As the president of the Pharmacists’ Association pointed out in her presentation of the handbook, it is a starting point for building a better understanding of how to provide assistance in crisis situations.

However, RSU researcher and defense expert Vitālijs Rakstiņš acknowledges that there are still many questions: “They require the involvement of all parties in stress tests, because little depends on the pharmacy itself. That is why it is important to involve them all and ensure that each of them provides at least part of the service, so that in the end, people will be able to access medical care.” Currently, 300 copies of the handbook have been published in paper format, but the print run is expected to increase, as there are around 3,000 pharmacists and their assistants in Latvia. Practical training is also planned for pharmacists and pharmacy managers this year.