Health Ministry's measles double talk another setback for trust

Let us begin with a brief reconstruction of events. 

Our information gathering was, like all reporting, incremental but more than enough to show that Government’s statements on the state of measles in Samoa last week were at best powerfully understated and at worst powerfully confusing.

On Monday, a one-year-old boy who had contracted a case of measles was put into a paediatric isolation ward; by Sunday afternoon he was dead. 

Fast forward to Thursday night. A patient was witnessed being told of a shortage of treatment spaces because 18 beds were needed to be used for isolated cases of highly suspected measles. 

On Wednesday, the Ministry of Health disclosed – in a a most inclusive sense of the word – the extent of a looming crisis it had been warned about for at least six weeks on this newspaper’s front page (September 1 “Measles' spread to Samoa now 'inevitable': expert”).

“Our current update is that there is an outbreak in Auckland New Zealand and it is continuing [to increase],” Director General Leausa Dr. Take Naseri said.  

“So far we have one case that they it’s confirmed but we need to have reconfirmation; an adult, a contact of a person from New Zealand.”

More than three dozen “suspected cases” had been sent off to Melbourne for confirmatory testing, he said in a tone devoid of urgency.

In fact he said the Ministry’s to-do list included the following item: “We also have [a] plan to make a strategic plan to respond to an outbreak”.

Most everything said that day was entirely factual. 

But why the Director General didn’t think to mention the gravely ill child thought to have been infected; and that a large section of the national hospital was reserved for quarantining more than a dozen "highly suspected" measles patients in his update on the national state of the disease most curious.

Perhaps these minor details slipped his mind. But the Director General was not done.

In a press conference that took an oddly jovial tone he took exception to questioning by the Samoa Observer's Ms. Soli Wilson and defamed her professional honour by suggesting she fabricated stories. Keep hold of that thought.

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The following day, with doctors, nurses and hospital staff acting as sources out of concern for orders from above to suppress mention of the quarantine ward, she was able to establish positive proof of its existence.

The Assistant C.E.O. of the Ministry of Health, Tagaloa Dr. Robert Thomsen, who takes the professional obligation to inform the public part of his job description more literally than others confirmed: “All specified [16] cases are highly suspected [of being infected]”. 

Ms. Wilson’s story on the front page of the Sunday Samoan (“Sixteen suspected measles cases, Ministry awaits confirmation) blew the lid off a secret.

Days later and after originally claiming it would take weeks to test for measles the Ministry said on Wednesday “A total of seven confirmed cases have been reported to date. In anticipation, we now confirm a Measles Epidemic”. 

One wonders absent Ms. Wilson’s story whether this statement would have ever been made.

We still  aren’t told why the tests are taking so long to arrive when companies in Australia can perform them in a matter of hours; we still don’t know if there have been any new infections or admissions to the isolation ward; and we still don’t have numbers on recent vaccine rates.

It is difficult to see what ends are achieved by an attitude such as what we have seen from the most senior health official in this matter. The harms are obvious. Public mistrust of vaccinations is a growing global trend but one acutely felt in Samoa following the Savai'i fiasco in which two infants died following a wrongly prepared vaccination.

To do so while bellowing at female reporter 30 years his junior all feeds a perception that the medical elite is contemptuous of the public. This is precisely at the time, one year after one of it’s most tragic incidents, when the Ministry and hospital system should be doing everything it can to rebuild trust.

Perhaps a strategy document might have even been compiled some months earlier if a transparent accounting of our heath challenges has been provided.

Right now Samoa is a tinder box. Measles has gripped much of the world (it’s doubled in Europe the first six months of this year alone). 

These epidemics are in countries around the global average of an 85 per cent immunisation rate.  In 2017, before the Savai’i scandal, just 58 per cent of infants received M.M.R. vaccinations.

If Samoa is to see off the rare scenario in which the medical profession has fallen in the eyes of the public it’s going to require outreach from people communities actually do trust.

The best suggestions made recently have come in the form of enrolling village, women and church leaders to boost our vaccination rates and promote programmes. That would be a surefire way to bridge a credibility gap that is currently putting lives at risk.

What do you think, Samoa??

Have a good Saturday, and God bless.



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