General Practitioners to lead own measles review

The Samoa Association of General Practitioners (S.A.G.P.) is not backing calls for a Government-led national commission of inquiry into the measles epidemic and will focus instead on an independent review.

Association President, Le Mamea Dr. Limbo Fiu, said at a members meeting nearly three weeks ago that the group decided not to demand Government action, saying they want to do something “achievable.”

Last year, measles claimed at least 83 lives and infected over 5000 people, mostly children. 

The Government successfully vaccinated nearly the entire eligible population and put a stop to the disease spreading; there has not been any new cases since early January.

Le Mamea told the Samoa Observer he and other practitioners will spend the next several months reviewing their own experiences on the frontline, and their part in a health system that allowed for such a low rate of immunisation. 

He says clinical hospital data should be used to analyse the admissions of patients with measles and their treatment and outcomes.

Another aspect of the review would involve looking at disaster planning, and how to effectively mobilise private practice doctors, based on their experience of the epidemic. 

That will lead to working more closely with the Ministry of Health and Government on what role the association and its members should take in future disasters and how they could even begin to prepare even today for imminent threats like the novel coronavirus. 

“These kinds of threats will not be a one off, everything is changing around the world and we must prepare,” Le Mamea said.

Asked why the Association would not be asking for a national inquiry, Le Mamea said the doctors wanted to take a practical approach.

“Government has made up their mind and I don’t think we can change what they have put out, so we are not going to dwell on that, we are going to do what we think is achievable,” Le Mamea said. 

“We just decided we are going to focus our energies on what we do usually in these kinds of situations, which is do our own review, focusing on aspects of the epidemic […] We have to be quite practical and do things we can actually do and achieve.”

He described the processes as a normal “quality assurance exercise” to audit work, and look at ways to improve the profession. 

As early as December, Prime Minister Tuilaepa Dr. Sailele Malielegaoi was rejecting the claim that his Government had failed its public health obligations, and said he would not order an inquiry into how the epidemic happened or was handled.

In the first weeks of Parliament sittings in January, he deflected from Opposition Member Olo Fiti Va’ai’s calls for an inquiry, and reiterated previous remarks that the parents, not the Government, were to blame for Samoa’s abysmal vaccination rates.

Le Mamea said he does not know what the Samoa Medical Association (S.M.A.) - of which the General Practitioners are a part - thinks about a national inquiry into the epidemic.

At their June Annual General Meeting, the S.A.G.P. and S.M.A. will be exploring as many facets of the epidemic as possible.

They will present a copy of their reporting and a summary of issues and recommendations raised in their meeting to the Director General of the Ministry of Health, in the hope of improving the country’s health services. 

Le Mamea said an important component to the discussion is how Samoa became so vulnerable to infectious disease, and how vaccine rates plummeted so much: “We cannot ignore what the country went through and I think our review will be very useful.”

He said work has already begun on holding talks with the Ministry about having private practice take on immunisation roles, in line with primary health care service models around the world, and in neighbouring New Zealand too, he added.

“I really feel strongly they (Government) should be open to some of these suggestions going forward, and we are already talking about providing immunisation, which is an area we can provide the public,” he said. 

“We do feel we have a huge role in this area and we have had some discussions around that in the past but I think with the measles epidemic we went through it’s a good opportunity now to really look at our own role.

“We see a lot of patients, all the private practitioners. We see hundreds and hundreds of patients a year and we might be looking at other ways we can expand on the services we offer, and perform services the Government is doing.”

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