The Ministry of Health needs treatment

Something is rotten in the Ministry of Health.

Yesterday the Associate Minister for Health, Tofa Li’o Foleni, became the first person associated with that Ministry to grant an interview to this newspaper after two weeks of complete silence and diversions. It has still been nine days since we have been given an update on the number of people infected but he showed leadership in speaking candidly about the difficulty in getting vaccines to Savai'i. We applaud him and hope others follow his lead. 

Yesterday on these pages we called for a state of emergency to be called for the Government to come in and assume control to spread the containment of the virus.

But this is bigger than measles.

Once the epidemic is over we are also calling for a serious review of the Ministry itself and the way its decisions have had consequences for Samoa’s most seriously ill patients. 

On the face of it, they are failing in their obligation as doctors to do the best by patents; to serve the Samoan people who employ them; and to uphold the ethics of transparency and accountability they should abide by as civil servants. 

Recently this has been on display in the complete absence of communication on measles. 

But two stories in this newspaper on another issue highlight problems of governance goes at the Ministry. 

Monday’s piece about Dr. David Galler who, on his own initiative and while drawing from his own funds to support its establishment, helped Samoa develop its first specialist Intensive Care Unit. (“I.C.U founder mourns “tragedy of its undoing”).

Few people on this planet can match Dr. Galler’s 30 years’ experience in the field of emergency medicine. For the donation of his expertise and his achievements in saving Samoan lives this newspaper made him one of our People of the Year for 2016. 

On Saturday we revealed previously unreported remarks made last month made by the woman who took over Dr. Galler as the head of the I.C.U. before she resigned in April of this year, Dr. Dina Tuitama (“Ex-I.C.U. director says hospital mortality rising”).

By the time of Dr. Tuitama’s resignation, the model of a specialist I.C.U. had been abolished and replaced by a generalist model. 

She revealed some sobering statistics and referenced an internal hospital audit that found in 2012 ventilated patients needing intensive care, were dying at a rate of in excess of 80 per cent (in 2011 an earlier study put the figure at 56 per cent). 

One year after the I.C.U. was established as a six-bed unit with specialist staff its critically-ill patients - mostly children and young people - had a mortality rate of 19.7 per cent.

Since Dr. Tuitama resigned the mortality rate rose to 31 per cent in May and 47 per cent in July. 

In his interview Dr. Galler spoke of the challenges he faced from the health service for years simply to get adequate supplies of medications such as antibiotics despite the I.C.U.'s successes. 

“The outcomes, particularly for critically ill patients were outstanding,” he said. 

“I think ultimately it’s a tragedy for Samoa that this has happened.

“This is a great loss for the country.”

We agree.

We have desperately sought to interview the Ministry this week to get their version of events; they have denied requests and twice arranged meeting with reporters only for them to be cancelled. (Dr. Naseri did find some time to speak to New Zealand media last week). 

How such a frankly, arrogant culture came to take root in the Ministry is anybody's guess. We can only hope that addressing this is at the top of the list for the newly-appointed Minister of Health, Faimalotoa Kika Stowers.

One proposed theory is that while the Ministry has been so focused on the nuts and bolts of merging with the National Health Service, other things have fallen by the wayside.

For his part, the otherwise affable Dr. Galler says people stood in the way; he declined to name them but said “they know who they are.”

We don’t pretend to understand the complexities behind the scenes here, nor are we pointing fingers. 

But that a man of Dr. Galler’s expertise – saw his achievements in lifesaving undone with fatal consequences for very sick people with no public explanation given – is a sure sign that the Ministry of Health is sick and in need of intervention. 


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