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Nurses Association President reveals profession's humiliation

It is the first case of its own in Samoa and possibly in the Pacific: two babies died after receiving routine Measles Mumps and Rubella (M.M.R.) vaccines last July. And nurses across the country say they, too, are continuing to deal with its consequences.

Nurses Luse Emo and Leutogi Teo were sentenced to five years jail for negligence in their roles in preparing and mixing a "deadly mixture" of M.M.R. vaccine powder and expired anaesthetic at a district hospital in Savaii. 

Speaking about the incident, the President of the Nurses Association, Solialofi Papalii, shared her view on the impact of the case has had on local nurses who continue to be vilified for the actions of their jailed colleagues. 

“We feel humiliated because it is the first case of its kind and it was over negligence in mixing the doses without checking,” she said.   

“A lot of people have said some unpleasant things on social media towards nurses and I do apologise for what [has] happened."

(It was revealed yesterday that the death of a baby at the Tupua Tamasese Meaole National Hospital, triggered further fears about vaccination practices following a social media post. But the Ministry of Health (M.O.H.) quickly dispelled those Facebook). 

The President appealed to the public to moderate its response to the incident:

“People must also take into consideration that nurses are humans and they are someone’s daughter and someone’s son and I say this with utmost respect.

“Nurses are also the very first point of contact when you arrive in a hospital and they do carry out their duties in the best of their ability to respond to the needs of the public.”   

About the five-year jail term for the nurses, the President said she knows that the nurses have accepted the decision wholeheartedly as it is undeniable that young lives have been lost. 

“I say this because in Samoa people will not stop complaining and will not let it go unless they see someone being punished,” she said. 

“It does not matter how many apologies we make and sympathies expressed towards the affected parents it cannot pardon what has been done. 

“They have accepted the decision and one of them had resigned before the matter proceeded further in Court because she does not want to remember what happened despite her many years of service.”

Papalii said the case has been a big lesson and a crucial reminder to nurses to always do checks and not treat their job as a regular routine.

She also used the opportunity to apologise to the affected families and the community on the negligence on the role of one of their own that has caused sudden death to the babies. 

"No matter how long it rains it cannot wash away the pain and grief the families have to live with and go through," she said. 

The Court heard that standard procedures for preparing vaccines were not followed on the morning of the incident including a requirement for nurses to thoroughly check the labels on the components used. 

Emo mixed the M.M.R. vaccine powder with an expired anaesthetic without checking the bottle to ensure it was the proper substance for dilution.  

But the Nurses President is puzzled as to how the anaesthetic ended up in the district hospital. 

Health protocol is that anaesthetics are not permitted to be prescribed or administered in the district hospitals.

It can only be administered by a doctor at the main Tuasivi hospital in Savaii and the Tupua Tamasese Meaole hospital at Motootua where surgery and emergency cases are referred to. 

“I still do not understand how the anaesthetic ended up in the community hospital,” said Papalii. 

“The chemical cannot be released outside of the main hospitals but for some reason it ended up in the children’s vaccine stock at the district hospital.”

According to the President, the Tuasivi hospital distributes the vaccine stock to district hospitals in Savaii. 

However she maintained that even if the distributing system had contributed in the anaesthetic ending up at the district hospital it is the responsibility of the nurse to double check.  

In an effort to gain back the confidence of parents that has had fear since babies death, multiple training sessions from overseas experts have been conducted for the nurses. 

A team from New Zealand had just left last week after offering more training for nurses. 

Papalii said it has become apparent that parents have been reluctant to have their children vaccinated fearing the worst case scenario. 

Last week the Acting Chief Justice, Vui Clarence Nelson in sentencing the nurses described the dose as a “deadly mixture”. 

It killed two one year olds: Lannah Samuelu of Sasina and Lameko Siu of Safotu Savaii. 

“Children are of the vulnerable groups in any society; it is therefore incumbent that society takes particular care when it comes to [their] treatment, health and well-being," said Justice Vui. 

“In this case the defendants completely and utterly failed."

She added that it has been an ongoing process to raise awareness and explaining to parents the importance of getting their children vaccinated given their consent to do so. 

Samoa was reportedly falling behind global vaccination targets, according to an Asian Development Bank report released last month.

About 71.8 per cent of children were vaccinated in Samoa in 2017 according to the report citing data from the World Bank.

That is the country's lowest vaccination rate since 2010, when it jumped up to 73.4 per cent from a low of 64 per cent in 2009.

A National Health Services (N.H.S.) Annual Report for 2015 – 2016 showed an increase of 86 per cent of children being fully immunised as opposed to 73 percent from 2014 - 2015. 

The Ministry of Health resumed M.M.R. vaccination programme in April this year after it was suspended for nine months while an investigation and a Commission of Inquiry was launched into the deaths of the babies. 

During the Inquiry in September from the 6,000 babies that were targeted to be vaccinated for M.M.R, more than 480 were still not immunised at the time.  

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