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Health Director General disputes report on hospital's failings

The Director General of the Ministry of Health, Leuasa Dr. Take Naseri, has disputed a Samoa Observer article outlining allegations of failures at the national hospital at the height of the measles epidemic. 

The article, carried on the front page of Wednesday’s edition of the newspaper under the headline "Hospital’s fatal shortfalls exposed" was based on an internal review of the Tupua Tamasese Meaole Hospital’s paediatric ward commissioned by hospital management. 

The report that followed, dated November 17 and entitled "The Measles Outbreak Clinical Plan" detailed facing the ward including a lack of resources that led to “gross neglect” attributed to the death of at least one child. 

In a statement issued yesterday, Leausa disputed the report.

“The Ministry has not received such a report and has no record what so ever of any report tabled with the Health Emergency Operation Center based on the timeline stated by the article,” Leuasa said in an e-mail sent to the Samoa Observer on Saturday afternoon.

“To that effect, the Ministry will acknowledge and respond once we have been furnished with a copy of the report to ensure fairness. 

“For the record, the article has a lot of factual errors reflecting the lack of experience by the reporter.”

Leausa does detail what the "factual errors" are.

But he and his two Deputy Directors General were provided with a summary of the findings of the report in an email sent on Monday, February 3 at 4.25pm. Calls were also made to all three. 

Wednesday’s article did not say that the internal review was ever officially tabled outside the hospital. 

The article said that the report was compiled in response to a request for a review of hospital wards’ performance by the National Emergency Operations Centre (N.E.O.C.).

“The document was provided to senior [hospital] officials but never delivered to N.E.O.C.,” the article said. 

“A report prepared by the Deputy Director General of the Health Ministry Tevaga Dr. Ponifasio Ponifasio was submitted instead.”

It is not known why hospital officials chose to provide Tevaga’s review instead; the contents of his review are not known. 

Wednesday’s article noted the report was accepted by the Samoa Observer from a hospital source on the condition that it not be provided to Ministry officials because it contained information which could be used to track the source. 

A summary of the report’s allegations and a request for interview was instead emailed to Leuasa, Tevaga and the Ministry’s Deputy Director of Public Health, Tagaloa Dr Robert Thomsen.

Leuasa’s requested that his response to the article be printed verbatim on the newspaper’s front page. 

It is reprinted in full below this article, alongside a copy of the questions and request for interview sent to the aforesaid officials. 

Leuasa’s response further says: “[The] Minister of Health, Faimalotoa Kika Stowers Ah Kau did not receive any email inquiry nor contacted (sic) via telephone to comment on the alleged report as claimed.”

Wednesday’s story did not say that the Minister was contacted via telephone, only that Leuasa and his deputies did not return multiple calls. 

An email address for the Health Minister’s office was copied in on Monday’s request for comment and summary of the report. The address was taken from a list of contacts used by the Government’s Press Secretariat.  

But on Wednesday evening after the story was published, the Samoa Observer received an automated reply from the web server associated with the Minister’s email stating that the message was not delivered because the mailbox’s “queue [was] too long”. 

The questions were received by Leuasa, Tevaga and Tagaloa and are reprinted below. 

Response from Ministry of Health Chief Executive Officier Leuasa Dr. Take Naseri (received via email at 1.20pm on Saturday, February 8). 

RE; Hospital’s fatal shortfall exposed

In response to your front page article published Wednesday, 5th February 2020 headlined ‘Hospital’s fatal shortfalls exposed’ the Ministry has not received such a report and has no record what so ever of any report tabled with the Health Emergency Operation Center based on the timeline stated by the article.

Checks also have confirmed that the Hon. Minister of Health, Faimalotoa Kika Stowers Ah Kau did not receive any email inquiry nor contacted via telephone to comment on the alleged report as claimed.

To that effect, the Ministry will acknowledge and respond once we have been furnished with a copy of the report to ensure fairness.

For the record, the article has a lot of factual errors reflecting the lack of experience by the reporter.

On that note, MoH stands by willing to respond on the provision of such a report.

The MoH also requests our response to be published on the Front Page verbatim, again for fairness as the article was good enough to be meet your Front Page standards.

Sincerely

Leausa Dr. Take Naseri

CHIEF EXECUTIVE OFFICER


Email from Samoa Observer reporter, Sapeer Mayron (sent Monday February 3 at 4.25pm)

--------- Forwarded message ---------

From: Sapeer Mayron <[email protected]>

Subject: Request for comment

To: Leausa T Dr Take Naseri <[email protected]>, Robert Thompson <[email protected]>, Ponifasio Ponifasio <[email protected]>, <[email protected]>

Talofa lava Leausa, Tagaloa and Tevaga,

An internal hospital report dated the 17th of November outlines a number of serious deficiencies in the Paediatric Ward in the height of the measles epidemic, including the following:

  • At least two children died as a result of gross neglect due to the measles surge, when they were moved to another ward to avoid measles infection but were not monitored closesly (sic). 

  • All NICU patients discharged during this period had their follow up clinical care suspended, leading to more potential harm.

  • There was a significant lack of infusion pumps, feeding pumps, Airvo units and blood case syringes, leading to poor hydration care levels and inaccurate blood readings for the children

  • There was no stock of treatment for severe croup

  • Despite the presence of measles in New Zealand, there were no supplies of measles laboratory tests in Samoa in the case of a case arriving on island, leading to the drawn out process of having samples tested at VIDRL. 

  • The measles protocols that already existed at the beginning of the epidemic were not briefed to all staff at the outset of the outbreak, and so were not followed

  • The lack of nursing staff led to some parents feeding their children themselves via syringe measured feeds without supervision

  • The Spacelab medical monitors had several missing parts that were not available or being ordered and so were not fully useful in monitoring patients.

In addtion (sic):

A source from the hospital claims that your leadership team was warned several times of the growing number of measles cases presenting to the hospital but their diagnoses were not believed, none of you visited the ward to see the cases for yourselves,  and extra resources or attention was not given to the ward or doctors managing the situation, until the AUSMAT scoping mission arrived.

Do you have any comments or rebuttals to the above matters?

Please advise if you would like to meet in person, respond over the phone or via email.

Ma le fa'aaloalo lava,




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