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Spiralling overseas treatment costs needs preventative cure – Minister Stowers

The overseas medical treatment scheme exceeded its budget by more than two times, a spiralling cost base that has the Government concerned. 

A total of $13 million was spent on the scheme for the 2017-18 Financial Year, compared to its initial budget allocation of $6 million. 

The Minister of Health, Faimalotoa Kika Stowers, says the increasing use of unbudgeted funds for the service is a growing concern and “demands” a greater focus on preventative healthcare. 

The Minister was responding to questions from the Samoa Observer, regarding unforeseen financial expenditures. The Ministry's $7 million for the scheme was the highest of any part of Government for the last financial year. 

“We have revived the Komiti Tumama (women’s committee) made up of women and there is a certain day of the week that a medical team visits the villages. And the team is made up of nurses and one doctor," the Minister said. 

"And there will be screening for diabetes and high blood pressure. The plans that were in place, are not just plans anymore, we now have Komiti Tumama in the villages and our medical teams are sent out."

The Minister is optimistic that reviving the Komiti Tumama will certainly have positive results in the years to come. 

"Prevention saves lives and saves monies for the Government; monies that can be utilised elsewhere to better our medical services," the Minister said. 

According to the Minister, three contracts were signed with general practitioners last week to assist with this project.

“It’s come at a cost, but we have to do it. We cannot afford to spend millions to send our people overseas for medical treatment; and one way to eliminate this problem is to educate our people; screen them so they can be aware and get the treatment they need before it escalates to the level where a referral overseas is required." 

According to Government financial statements, $11 million was allocated for the scheme in 2014-15; $2.5 million in 2015-16; $5 million 2016-17; $6 million in 2017-18 and $8 million in 2018-19. 

The role of the Komiti Tumama was highlighted in a report in an international medical journal, which called for their increasing involvement to address the country’s growing non-communicable disease crisis. 

The report, published in January 2019 in the Health Systems & Reform Journal, indicated that Samoa’s population of 200,000 is challenged by a limited health workforce and the uneven distribution of medical personnel — with a concentration of doctors at the Tupua Tamasese Meaole (T.T.M.) National Hospital in Upolu and the Malietoa Tanumafili II (M.T.2.) Referral hospital in Savai’i. 

In 2013, there were four doctors and 16 nurses for every 10,000 of the population in Samoa, the report says. 

“This hospital-centric model of care does not address the growing problem of chronic non-communicable diseases (N.C.D.s),” stated the report. 

“N.C.D. risk factors, such as tobacco use, harmful use of alcohol, unhealthy diets high in sugar, fat and salt, and a sedentary way of living, contribute to an increasing N.C.D. burden in Samoa. 

“These lifestyle habits lead to high blood pressure, diabetes and eventually heart disease, stroke and kidney failure. When one person is suffering from an N.C.D., the entire family suffers too. When one family is suffering, the entire village is affected.”

The report said the Samoan Government is undertaking reforms to strengthen community-based care and rebuild primary health care.

Measures underway include bringing back women’s village committees to identify and refer people facing high risks. 

“In Samoa, women’s groups (Komiti Tumama) have historically played a vital role in the delivery of public health and improving access to health services," the report said. 

“Created under the New Zealand administration (1921–1962), Komiti remain in operation until the present day, though their role and influence as agents of public health have diminished."

The report is titled “Achieving UHC in Samoa through Revitalising PHC and Reinvigorating the Role of Village Women Groups". Its co-authors include Rasul Baghirov (the World Health Organisation Samoa country office head), John Ah-Ching (Associate Minister, Samoa Ministry of Health) and Caroline Bollars (Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands).

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