Top doctor joins call for measles crisis review

A doctor who helped found Samoa’s now shut down intensive care unit, Dr. David Galler, believes a national review into the 2019 measles epidemic which killed 83 people would the most sensible way to learn from a disaster.

Dr. Galler, who in 2015 worked with a team of doctors to establish the first specialist I.C.U at the National Hospital, said he would like to see a national review of the measles epidemic conducted in the spirit of learning, and not of blame.

To date, Prime Minister Dr. Sa'ilele Malielegaoi has said he will not commission a national inquiry. The Ministry of Health's report on the mass vaccination campaign submitted to Cabinet has not been made public. 

But Dr. Galler believes a review of what had happened is important.

“It’s a good opportunity to look at the performances of the clinical services under the circumstances,” Dr. Galler, who has been an intensivist doctor at Middlemore Hospital in Auckland for over 30 years, said.

“I don’t think there can be something like this epidemic, with over 80 children dying, without having a really thorough review, looking at how the services responded and how we can build on from that… for the purposes of learning, not for the purposes of blaming.”

Between the end of August and early January, 5,707 people were infected with measles, and 83 people, majority of them children under four years old, died.

At the height of the epidemic, with the nation’s hospitals operating at 300 per cent, doctors and nurses faced the loss of three or four babies a day to the disease and the pneumonia it inflicted on its victims.

Reviewing the entire epidemic, how it happened, how Samoa responded and how to react next time, would offer a look into the “outstanding” work of local healthcare workers dealing with the calamity, Dr. Galler said.

“Obviously it was a terrible disaster for Samoa,” he said.

“But within all that, the hospital and particularly intensive care service was outstanding. They were dealing with absolute horror.  Three or four children dying a day, I don’t think I have ever seen that in my life. 

“It’s an experience no one wants to have, and that went on for days and days. Those Samoan doctors and nurses stuck with it.”

He said a review would help restore confidence in the health service, which even before the epidemic had taken a severe hit when two infants died due to an accidentally fatally mixed vaccine (the vaccine powder had been mixed with muscle relaxant, instead of saline solution, an investigation found). 

Dr. Galler believes any review or inquiry should not be driven by a desire to find any one person, or people, responsible for the epidemic or how it was handled.

“I don’t think you can look for blame in these kinds of circumstances. I think it would become clear if there were decisions that were made that in retrospect would have been made differently, the key is to understand why they made those decisions. 

“When 83 [people] die as a result of a preventable disease, under normal circumstances, anywhere in the world, there would be a serious look at what actually happened that led to this disaster and what might we do in the future, how might we behave in the future to make sure something like this never happens again.”

In New Zealand, where the measles epidemic that began in January 2019 is nearly over, a Ministry of Health report from August obtained by the New Zealand Herald acknowledged that Government inaction let the measles outbreak happen.

“Outbreaks have been fuelled by the immunity gap in the New Zealand population,” the ministry report states.

“No funding has been available nationally to support supplementary immunisation activities to increase immunity against measles.”

The report, and the epidemic in New Zealand and the Pacific, appears to have triggered a long awaited for vaccine catch up campaign, with a $23 million commitment and more promised to come. 

Dr. Galler said for the Samoan Government to go on without any review would be “kind of extraordinary,” and “bizarre.

“I would be surprised if there was nothing.  It’s not to tell people off, it’s to learn.”

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