Selco: The Shocking Reality of SHTF Medicine and How to Prep for When the Medical System is GONE

(Psst: The FTC wants me to remind you that this website contains affiliate links. That means if you make a purchase from a link you click on, I might receive a small commission. This does not increase the price you'll pay for that item nor does it decrease the awesomeness of the item. ~ Daisy)

Author of The Dark Secrets of SHTF Survival and the online course SHTF Survival Boot Camp

Editor’s Note: Something difficult to plan for – or even wrap your brain around – is a world in which medical care is not available. Even though it’s outrageously expensive here in the United States, we can still access care. We may be in debt forever, but it exists.

So, what do you do in a world in which it no longer exists? A world in which there aren’t emergency rooms or doctor’s walk-in clinics? A world in which there aren’t any well-stocked pharmacies?

Today, Selco shares the brutal reality of SHTF medicine. ~Daisy

Since there were no hospitals, how did you treat people who were ill?

Organized (system) of professional medical help ceased to exist.

Hospitals, health centers, EMS, and everything similar was gone. The most advanced medical help that you could find in the hardest period was more or less primitive medical care that some military units had, such as medics and low-level trauma care. But this was not available to common folks.

People with medical knowledge became very important because of this fact, but even the most skilled people were often completely useless because all of the other help that the system offers you is simply non-existent.

One of my old colleagues told me a story that could point out some things.

His friend called him to help him with his father, who had fallen from the roof. The man climbed on the roof to repair broken tiles, and he was there in the middle of the night (which was the safest way). He fell down, and his sons found him unconscious. They brought him in the house and called my ex-colleague, a nurse, for help.

When he arrived, he checked the old man, then called his sons in another room. He explained to them that their father was going to die very soon because most probably he had internal bleeding.

The sons were mad at him and they started to threaten him, asking him that he help the old man in any possible way.

My colleague told them that only way possible was to ask for help from the local paramilitary unit who had some medical stash, but even that was very questionable because the man the needed specialized medical care, and at that moment that kind of care was not available in the whole city.

The sons took a trip that night to the headquarters of that unit, and guys there told them to visit the “hospital” which was situated in the basement of a destroyed apartment building.

They later told my colleague that the “hospital” actually was 3 basement rooms with oil lamps and a stench so bad that they both immediately vomited.

The “doctor” who listened to their story about the old man’s injuries asked the two of them ” Do you have weapons?” They answered  “Yeah, sure”.

They were surprised and started to yell at him, then “doctor” pulled a gun and said, “Get the f…. out of here or I’ll shoot both of you. Your old man is already dead”

They went home. Their old man was not yet dead but he died in the morning.

Some things can be taken care with basic knowledge and a little bit of inventiveness, for example, taking care of a broken rib or similar, but other conditions and traumas were simply too much to take care for most of the folks.

The point of this story is not to scare you. Maybe in your case, the whole situation is going to be much better. Maybe there is going to be some organization, some kind of bigger system when SHTF. I do not know.

Usually, a person who was ill was placed in a separate room and people did as best as they could to help him.

If we managed to get real medication we did that, if not we tried natural remedies.

Honey was one ingredient that was in most of the home remedies, or at least people stated that; pine needles were sometimes there, chamomile mixture, garlic…

Where did you get medicine? Could you buy drugs like antibiotics on the black market?

Just like all other resources, they were there ( in very low amounts, of course) to take, steal, or barter.

Antibiotics were very valuable on the black market, and usually, you could dictate the price with if you owned any.

Antibiotics were used even with expired dates, and people did not care because sometimes it was the only medicine that you could find.

Natural remedies also jumped in, and yes people who had any knowledge about herbal remedies became important. Also, there were a lot of scams. For example, you heard that some man had a good herb mixture for asthma, and if that was your only choice, of course, you would try it.

A lot of people used that and scammed people with “homemade herb mixtures”.

Sometimes you could find a man who offered you 15 pills, not packaged, not in a box, just 15 pills, which he stated were antibiotics, and you really need them, so what could you do?

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Did people with chronic illnesses like diabetes die?

It was a full-scale collapse. People were dying from a lot of things (even if we do not mention violent death). There were no doctors, no hospitals, no X rays no lab results.

One day you are good, the next day you feel sick and you are vomiting, your skin is yellow, you have a fever…

And then a few days later, you are dead.

Maybe you died from food poisoning, maybe renal failure, maybe your blood sugar went down or up. Who knew?

A lot of ordinary folks did not know why someone died.

A lot of people with chronic illnesses died. The majority of them did not have a stash of medication needed for their condition, and when you add to that fact that overall life quality went down very sharply and very deeply, people who were chronically ill and needed medical attention had serious problems.

In some cases and for some illnesses, certain people managed to pull through with acquiring medication from the black market or using some substitutes like herbs. But for example, if you were an older man who lived with his older wife, and you had insulin-dependent diabetes, and you do not have friends or family to help, and you had no stash, your chances were really low. 

Was there an increase in mental illness?

Yes, but if we are talking about real mental illnesses, people who had serious mental problems that were under control by medication simply lost it without their meds and went completely “mad”.

You could see people hallucinating out in the street more often than in peacetime, or breaking down in their rooms. I knew cases when families locked in their loved one who had mental illness in a room, controlling him in that way because there was no other way.

A lot of those cases were connected to the people who were heavy drug users (addicts). When the SHTF some of them simply went “wild” or, even worse, some groups used those people for very dirty jobs in exchange for a drug supply. Bigger organized groups had more power and more connections, which meant they could find drugs even in those circumstances. This meant drug addicts were ready to do whatever they had to for them, and very violent things were usually what was needed for a gang to keep power. It is not too different from “peacetime” criminal organizations, but when the SHTF stakes are higher. Violence is much worse and much more frequent.

If we are talking about people who simply went crazy because the world as they knew it collapsed around them, then no, not really. Not too many people lost their minds because of the eruption of violence and collapse.

Of course, there was an increase in suicides and cases of people simply giving up because they thought it was not worth it to continue to live in that way, but not in numbers that people would imagine.

I think the instinct to fight for survival is stronger then we think.

People mostly pushed through, day by day. There was an increase in alcohol consumption or marijuana, sedatives were a good thing to have or some herbal substitutes… but people pushed on. 

What diseases became common when the SHTF? How did you treat them? 

When the SHTF, all aspects of life changed, and that included aspects of life that you did not even think about, simply because the system had always taken care of those aspects of life.

For example how much physical work you are doing today-if you are an average citizen who works as a clerk somewhere, or truck driver, or housewife or whatever, you are used to some physical activity and certain food quality and quantity.

You are used to having an operating bathroom, and to being pretty warm in your home, etc.

When the SHTF, all that changed.

Food became different. The quality and quantity of it went down. Physical activities went up very sharply. Add to that fact that one day, it was stressful not to find your favorite yogurt in a few stores. Then suddenly, the next day when the SHTF, the levels of stress were about seeing people shot for fun or asking yourself whether your kid was going to survive eating plants only.

All of that contributed to people getting sick simply because people were almost always exhausted.

If we are mentioning the most common illnesses, then those were gastrointestinal illnesses connected with bad food, bad water, and low hygiene (both personally and in the home).

Second to that, a lot of problems were connected with secondary complications of a minor injury.

For example, you might get some nasty cut while you were working in some abandoned storage, trying to scavenge some useful material.

That cut looked nasty, but basically, it could be taken care with iodine, peroxide, sterile dressings and antibiotic treatment. But you did not have any of those so you bandaged it with a dirty bandana. Then, a day later you got a nasty infection which was a huge problem.

A small cut could kill you.

Homemade remedies were used a lot, again with varying levels of success. Home mixtures were used for cuts and infections, and of course, people searched for antibiotics.

If someone broke his arm, for example, you could try to find someone who had a clue about setting the bones, but you can still today find people with funny looking fingers, or a rather twisted arm, or a not-so functioning leg, simply because they splinted it alone at home during that time without any real medical help.

How can we prepare for medical issues?

We can be prepared to some extent, but it is more important to understand that very often ( in case of serious collapse) you can not do too much.

Much more important is to understand “from what end” you need to start your medical preparedness.

Most of the discussions about medical preparedness in the prepping community today have few common characteristics. They are talking mainly about:

  • Taking care of patients in a short period of time in until advanced help arrives
  • Specialized training is given by very specialized instructors (for example combat medics will train you how to take care of a wounded person until evacuation helicopter arrives)
  • Students who are driven to learn things that look “cool and flashy”, for example, you’ll be given the task of stopping bleeding on mankind  (or animal meat) while instructors pointing a flashlight in your eyes or using firecrackers to simulate gunshots.

Those are only examples, or one analogy could be that medical preparedness experts teaching you how to suture wounds even if that wound can be taken care of with simple Steri strip (adhesive tape that gonna connect wound edges).

Nobody mentions the complications that can occur from the wound, prolonged care of an infected wound. This is the material and knowledge that you are gonna need.

One of the reasons is that it looks cool to suture a wound or to train how to use tourniquet until help arrives in the form of an ambulance or a helicopter. The other reason is that most of the training assume that help is 10 minutes or one hour away.

It may not be like that when real SHTF happens and it is completely different. Then, most probably nobody is going to arrive, and you’ll have to take care of everything.

You need to start with basics and go gradually to more complicated things.

Do not misunderstand me. I know how to suture, and I am a combat medic and nurse, too, so I am not talking against that knowledge.

But before learning how to suture as a part of your medical preparedness you need to learn what to do with your waste when SHTF, how to build a latrine, how much water you need, and ways to have it in order to keep a minimum of hygiene.

Before you buy 20 suturing kits you need to learn wound care in prolonged terms, including antibiotic treatment for that wound.

You need to know ways to keep yourself clean and protected in order to minimize the risk of getting injured or getting ill.

Another example would be that a lot of people are fixated with buying antibiotics without real knowledge of how antibiotics work and the differences between groups of antibiotics.

Get gloves, face masks, work gloves, hand sanitizers, and alcohol pads. Then go with antibiotics and tourniquets.

It is about preparation and common sense. So if you have, for example, a person with high blood pressure problems in your family, you need to learn all you can about that condition including proper diet, natural remedies, what to do in a possible crisis, and you need to have a serious stash of medications for that condition.

Think outside of the box.

Just like with all other fields of prepping, here too, you need to think a bit outside of the box.

A lot of medical skills can be learned. Some of them are online, free to research and learn.

For example, sometimes it is simply not enough to give oral antibiotics, sometimes you’ll have to give it through an IV or intramuscular, or sometimes the best choice is to rehydrate person through IV solutions.

Yes, it is probably illegal to do that if you are not a medical professional, but when the SHTF, that is gonna be not so important. On the other side, your skills are gonna be very important.

Learn skills no matter what the system says about who can practice those skills. You are preparing for a time when the system is gone so it makes sense.

About Selco:

Selco survived the Balkan war of the 90s in a city under siege, without electricity, running water, or food distribution. He is currently accepting students for his next physical course here.

In his online works, he gives an inside view of the reality of survival under the harshest conditions. He reviews what works and what doesn’t, tells you the hard lessons he learned, and shares how he prepares today.

He never stopped learning about survival and preparedness since the war. Regardless of what happens, chances are you will never experience extreme situations as Selco did. But you have the chance to learn from him and how he faced death for months.

Real survival is not romantic or idealistic. It is brutal, hard and unfair. Let Selco take you into that world.

Picture of Selco


Selco survived the Balkan war of the 90s in a city under siege, without electricity, running water, or food distribution. In his online works, he gives an inside view of the reality of survival under the harshest conditions. He reviews what works and what doesn’t, tells you the hard lessons he learned, and shares how he prepares today. He never stopped learning about survival and preparedness since the war. Regardless what happens, chances are you will never experience extreme situations as Selco did. But you have the chance to learn from him and how he faced death for months. Read more of Selco's articles here. Buy his PDF books here. Take advantage of a deep and profound insight into his knowledge by signing up for his unrivaled online course. Real survival is not romantic or idealistic. It is brutal, hard and unfair. Let Selco take you into that world.

Leave a Reply

    • Really? I thought there was tons of great information. And what you call fear-mongering, I call reality. A disaster like what Selco endured isn’t rainbows and unicorns. It’s brutal, and by knowing that, we can be better prepared for it.

      • Amen sister! Totally agree!
        Thank you so much for having Selco’s stories. He has helped us tremendously. His advice is so important because he has lived it.
        There’s no fear mongaring here just the truth. I want the truth, I want to know what I can do to prepare….and so do so many others.

        Thank you Daisy and Selco!

    • You seem to have missed his prioritizing preparation knowledge and materials. That is particularly helpful for people like me with very limited resources. And you also didn’t notice that he gave clear examples of what would in normal circumstances would be minor, treatable injuries and illnesses which under SHTF circumstances are life-threatening and very, very difficult to treat. Yeah, that should induce fear. But what he explained is educational for those who pay attention. And not useful to those incapable of learning from the examples provided by others.

    • Did you expect Selco to give specific medical Information? He did pretty well considering he was telling it like it was. He says a lot of things that make us think rather than whitewash the reality. God willing we won’t ever have his experiences.

  • If you want a pain killer that is on par with opioid s without any side effects, get the legal herb called

    • Kratom may be hard to get in some states as some states have deemed it illegal. The top four herbal pain medications are: 1) Kratom; 2) Wild Lettuce Leaf; 3) Kava Kava; and, 4) Blue Lotus Flower. I can attest to the benefits of the last three and while Blue Lotus Flower is usually the most expensive, it does work. You will not get “high” from these. After taking one of these, it will dawn on you after a bit that “Hey, I don’t hurt!”

    • “Opium Lettuce” or wild lettuce is also an alternative and legal option both for pain and a sedative. No side effects but will take care of the brunt of the pain and even mellow you out. It’s a common weed that grows almost everywhere. Google it and/or look it up on YouTube to see how to prepare and use it.

  • There are at least two ways to regain body balance and dis-ease. One is a Korean modality called Danjeon Breathing used and promoted in Korean society for a long time. The other is divine miraculous healing. I have obtained study materials for both. The first from and the second from Sid Roth’s online store.

  • Thank you Selco!

    Having good basic sanitation practices (proper disposal of waste, washing hands, etc.) helps keep us healthy.

    Getting and staying healthy is very important, especially when the normal medical “system” is not working. This reinforces to me the need to know more about herbal remedies. Knowing which plants can be used for healing and how to prepare them is important knowledge.

  • Thank you for this article, Selco.

    I always enjoy your good information. I didn’t see any fear mongering here either and I really like the point you make about learning truly basic skills before jumping into antibiotics and suturing. Take care of it right the first time and you’ll save your supplies and even a life. (I”ve lived without the medical system, off and on, don’t take walk in clinics for granted, and I know how important that can be.)

  • Please note that wild lettuce (lactuca verosa) can be beneficial but is not without side effects such as difficulty breathing, accelerated heart rate, skin irritation and more. Please have on hand a good herb book. I have been practicing herbal medicine for over 40 yrs, I’ve seen a lot of natural healing methods come & go. There can be adverse effects to most anything & it’s good to be aware.

  • Very good and realistic article with useful information.People need to know that in a diaster the military will not have much either or very basic.You need to be prepared that people will die and do you risk people and resources seeking such help.
    In downtown Toronto hospitals are already overwhelmed and crowded.Many procedures done right in hall with blood and other fluids everywhere .Can you imagine in times of crisis .Staph infection rife in hospitsld and shelters Two women died after childbirth in Toronto from staph.
    We need to learn the old skills of our grandparents and not to live in false hope

  • I think this is one of the better interviews from Selco. He confirms that sanitation is probably the most important prep we can tackle. Also he confirms that people in post SHTF need to reduce and mitigate risks towards extremely low end. The man who fell off the roof should have added more safety steps and involved his sons in the repair. Simple things we do now will turn into a minor military operation in those conditions. I am taking a 17 week EMT basic course now. I am very impressed with the level of instruction. This course, I believe, will leave me wanting more knowledge but as Selco describes, there is a great deal of knowledge needed for austere conditions. Besides the equipment to perform more advanced life saving and long term care, I will heed Selco’s advice and stock even more of the basics–antibiotic ointments, sterile items and meds. Prevention is the best prep and some minor ailments can be repaired with rudimentary items but significant trauma like internal bleeding, crushed bones or major vessel cuts will be impossible to fix unless a real Level 1 or 2 facility is available. The solution for preppers is to reduce risk and mitigate dangers for EVERYTHING.

  • My biggest takeaway from the article and comments is: take an EMT course.

    Thanks Selco – much appreciated

    • It must not have gone through. This is the only comment I’ve seen from you, Cricket, and I went through and checked spam also. Would you mind reposting?

  • Check out your local community college or continuing education center. Many of them will offer basic first aid to EMT courses at reasonable costs.

  • Does anyone know of any reputable reference material (published authors) of reliable herbal medicine? I would like a reference book and information on where/how to acquire the seeds to maintain my own medicinal garden. I think Selco’s article was on point and a reality that we should all prepare for.

  • Maybe the ‘tons of great information’ Daisy describes would be easier to appreciate if it weren’t buried in such an great mound of advertising greed?

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