It has been over a week since multiple teams from Samoa’s Ministry of Health (MOH) began the mass administration of drugs in all of Samoa’s islands. 

The exercise targeted members of the public, in a bid to fight off the risks of lymphatic filariasis infection, which local authorities warned continued to be present in the community with blood surveys from 2017 and 2018 showing widespread infection. The MOH says lymphatic filariasis, which is spread by mosquitoes, can lead to the development of permanent swelling of the limbs, breasts and genitals with significant disfiguration. It is also known as elephantiasis and is caused by filarial worms living in infected people’s blood and lymphatic vessels. According to the Health Director General, Aiono Dr. Alec Ekeroma, people can get infected with lymphatic filariasis without them knowing it.

In a joint statement issued last week with Aiono, the World Health Organisation [WHO] Representative to Samoa, Dr. Kim Dickson said this is the second year for the country to implement the mass administration of lymphatic filariasis drugs. The treatment will comprise three anti-parasitic drugs that together can kill the worms and stop their transmission, said the WHO Representative. 

But if this is the second time for Samoa to roll out the treatment, why have there been cases in recent days in some of our schools of children getting double doses of the drugs because the health workers and the schools’ records are in total disarray?

We are referring to an article (Filiarisis campaign gone wrong) that was published in yesterday’s edition of the Weekend Observer which reported on a case at the Seventh Day Adventist Primary School of a female student, who was administered the cocktail of tablets on two occasions last week and without the consent of her parents.

In fact, even the school principal, Taala Tepora Fuimaono admitted that she was at fault for giving the MOH staff access to the students without the consent of parents.

"They came on Wednesday first and asked if they could carry out the administration of the drugs in the school without informing us or me beforehand so I could advise the parents of that," she said. "But I banned them when they came again on Thursday and told us they need to carry it out this week because all administrations close this coming Sunday.

"I agreed because I was thinking of the importance of the drug for the kids without thinking of the other side of things, getting the parents' consent which is paramount."

But what sort of deadlines are the MOH workers working around and do they need to rush to make the deadline when administering these drugs? Who set the deadline and what is the purpose of imposing deadlines for the administering of this cocktail of tablets when you want to exercise caution to avoid fatal errors?

Surely, staff at the MOH would be familiar with the case of two nurses from the MOH in 2019 who prepared the Measles, Mumps and Rubella (M.M.R.) vaccine wrongly and when administered with an expired anaesthetic caused the death of two infants in Savai’i. They were jailed for five years after they were found guilty by the Supreme Court of negligence causing manslaughter following the deaths of two one-year-old infants.

While the principal of the Seventh Day Adventist Primary School was able to get the Ministry’s health workers to leave last week, we remain concerned that there appears to be no sharing of information between the respective schools and the MOH teams. We believe the overdose of the child wouldn’t have happened if both the school’s and the health workers’ records were updated daily.

The absence of consent forms from the students’ parents for them to be administered the cocktail of drugs could also potentially place the school in a precarious legal position – especially when the administering of the drug protocols goes wrong and the educational institution is forced to take on the legal liabilities should parents sue due to oversight.

The MOH yesterday gave an update on the rolling out of the lymphatic filariasis drugs while advising that an investigation is underway to determine how there were cases of students being given multiple treatment regimes. At some point, the Ministry should decide whether it should suspend the further administering of the drugs until it completes its inquiry, to avoid endangering innocent lives until clear protocols are established and put in place.