Dear Editor,

I am writing to share a personal experience at the main hospital in Apia that raised serious concerns regarding patient intake and emergency care procedures. This account reflects my observations and recollections on the day and is shared in the interest of public reflection and possible improvement, not as an accusation against any individual.

I am married to a Samoan citizen. On 13 December 2025, around midday, I accompanied my brother-in-law, who was experiencing significant pain, to the hospital’s emergency department. My sister-in-law was also present. There were three of us in total: the patient, his sister, and myself.

We arrived at approximately 12:45 a.m., seeking urgent medical attention due to the patient’s condition.

At the time of our arrival, the reception desk appeared unattended. No staff member was immediately available to receive patients or provide guidance. We completed and left the required medical forms at the reception area. Through a small window on a nearby door, I observed staff members in an adjacent room.

After knocking to indicate that patients were waiting, one staff member gestured toward a colleague. Shortly thereafter, another staff member came out and asked what we needed. I explained that we had a patient in pain and were seeking medical assistance. We were asked to wait, and the staff member returned to the adjacent room.

During the waiting period, my brother-in-law continued to show visible signs of discomfort. Several other families were also present, each accompanying individuals who appeared unwell or in pain. To the best of my observation, no formal triage, assessment, or medical attention was provided during this time.

We waited for approximately one hour and nineteen minutes.

Around 1:45–1:50 a.m., a further exchange took place between my sister-in-law and hospital staff. The discussion became tense as concern and frustration increased. During this exchange, it was stated to us—according to my recollection—that no doctor was available at that time, and words to the effect of “there is no doctor available” were communicated. The implication conveyed to us was that no immediate medical care could be provided.

Given this information, and with the patient still in pain, we made the decision to leave the hospital.

Later, pain relief was managed with over-the-counter medication. The following morning, my brother-in-law traveled to Savai‘i, where he sought alternative care through traditional treatment and/or local medical services.

I come from a deeply underdeveloped country, where many citizens survive on less than one US dollar per day. I am familiar with extreme hardship, limited infrastructure, and systemic challenges in public services, including healthcare.

Even in such environments, however, once a patient reaches a hospital, basic intake procedures are typically initiated. Patients are assessed while administrative steps are completed. Pain is acknowledged, and efforts—however limited—are made to respond.

The experience described above was therefore deeply concerning to me.

This account is shared respectfully and in good faith. It reflects a concern about systems, processes, and emergency responsiveness, rather than the actions or intentions of any particular individual. I hope that by sharing this experience, it may contribute to constructive discussion and potential improvements in patient care and emergency services.

Healthcare is not only about resources—it is also about procedures, communication, and human dignity. Even small improvements can make a meaningful difference for patients and families in moments of vulnerability.

The intention of this submission is not to single out or accuse any individual, but to raise a broader concern regarding patient intake, emergency responsiveness, and communication in situations involving individuals in pain or distress. I believe the matter may be of public interest and could contribute to constructive discussion and potential improvement within the healthcare system.

I understand and respect your editorial discretion regarding publication, length, or formatting. I am also open to any edits you may consider necessary for clarity or suitability.

Thank you for your time and consideration.

Kind regards,

A concerned resident of Apia