By Rev. Dr Alesana and Lemau Pala’amo
As a CCCS (Congregational Christian Church Samoa) minister and minister’s wife teaching at Malua Theological College in Samoa, and Co-Founders of Soul Talk Samoa Trust, joining the MHPSS Mental Health Psycho Social Services unit at the outbreak of measles in Samoa was an inspiring and humbling experience on many levels. As frontline responders to the Samoa Measles Epidemic in 2019 (MES-19), we were inspired by the resilience of the Samoan people during tragic times. In the face of possible death once infected with measles, many Samoans still placed their faith in God for peace amongst the uncertainty they faced. We were further moved by the immediate and professional response of the global EMTs (Emergency Medical Technicians) and volunteers mobilised from different countries around the world to help a crippled nation impacted by disease. By the time MES-19 was contained and foreign personnel started to return to their sending countries, 41 different rotating teams from 12 countries, and nations from Europe and the United Kingdom, made up the 557 foreign personnel dispersed to help Samoa during this tragedy.
Samoa Measles Epidemic 2019: MES-19
The first reported case of MES-19 was around October 2019 that coincided with the White Sunday event in Samoa. White Sunday is celebrated annually in Samoa and most Samoan churches abroad, as a special day to celebrate children as God’s gifts to families and villages. On such a day the children and the youth are given utmost importance. These young members of parishes lead local worship at their congregations, and share the Gospel of Christ by re-telling Bible stories through song, creative dance, reciting of Bible verses, and drama. Although White Sunday is a joyous day for most, the weeks and months that followed in 2019 was anything but happy times with 83 unsuspecting lives lost to the outbreak who mostly were children.
An incident in Samoa two years prior where two infants died from malpractice when immunised for mumps, measles, and rubella (MMR), sparked hesitation and fear amongst Samoans to immunise their children. An outbreak of measles occurred in South Auckland in New Zealand just before the first reported case in Samoa, yet the outbreak was contained with no fatalities. Several medical practitioners believed that the measles outbreak in nearby New Zealand together with the remarkably low immunisation rate on island at the time, were key contributing factors to the measles outbreak in Samoa. As the epidemic developed from its first known case to around 5,700 infections by the time the outbreak was contained, Samoans were shocked at the ease of spread of measles that took the lives of many children, a disease that rarely leads to fatalities in the modern era.
After the official announcement of the outbreak of measles in Samoa, Soul Talk Samoa Trust was summoned by the Ministry of Health (MOH) Samoa for assistance. The Director General of MOH Leausa Dr. Take Naseri mobilised selected non-government organisations (NGOs) and community leaders to join the Mental Health unit at the National hospital, and form the MHPSS Mental Health and Psycho Social Services unit. The primary task of this unit was to provide spiritual and emotional support to those impacted by measles, through counselling, hospital visitations, and home visits. The Mental Health unit staff provided the clinical support through its doctors, nurses, and social workers, while the selected NGOs and community leaders provided the spiritual and emotional support. Soul Talk Samoa Trust, the agency that we founded and operate, contributed our pastoral counselling and social services to the MHPSS unit as frontline responders to MES-19.
The different teams assigned daily by the leader of the MHPSS unit Seiuli Dr George Tuitama included groups from visiting PACMAT (Pacific Island EMTs from New Zealand) and locals made up of psychiatrists, psychologists, mental health nurses, social workers and counsellors, together with community faith leaders such as church ministers and the wives of ministers. For our part in the assigned teams, we provided spiritual and emotional support to the people we visited, together with counselling and social services of presenting issues during our visits. We undertook roles as liaison, mediating between foreign EMTs and carers and families of patients, especially due to the limitation of Samoan-speaking medical staff available when we turned up for our visits. In addition, the MHPSS unit received many requests for basic needs such as nappies, wipes, towels, and sheets, which our unit provided through the generous donations received locally as well as from abroad.
One important contribution that we made to the MHPSS unit as well as the HEOC Health Emergency Operations Centre daily briefings was to begin these gatherings in prayer and song. Such traditional practices highlight that Samoans are a God-worshiping nation, and drawing strength and guidance from God daily is part and parcel of our way of life. During a crisis such as MES-19, to worship and honour God remained at the forefront of our work as a nation.
The Bible teaches many life-lessons to its readers from the contexts and situations of ancient times. When challenged by unforeseen life situations and crisis presents itself in the world we live today, many of these teachings are sought by faithful believers in the Word and Sacrament for comfort and solace. As witnessed being frontline responders to MES-19, visiting carers of the sick in the hospital wards and bereaved families in the villages, faith in God was the strength Samoans turned to at such a time of tragedy. It was inspiring to observe first-hand that Samoa’s national motto E faavae i le Atua Samoa, Samoa is founded upon God, continues to live up to its emphasis upon God as the foundation of its people.
Observing the solidarity of the visiting global medical teams who assisted with the crisis, shows that there is a common good amongst the world that we live where strangers strive to save and preserve life. It was inspiring to see the care given to the sick during MES-19 as health care comparable to any hospital in places like Australia, New Zealand, and the UK, given the many different foreign teams who worked around the clock during their rotations. These teams offered their time, wisdom, and skills, to help save and preserve the lives of the Samoan people.
The global EMTs who worked the wards often commented to us of the value in the work undertaken by the MHPSS unit. It was humbling to receive such reports, especially from medical professionals from different faith backgrounds to our own who hold to their own belief systems, yet they allowed teams from our unit to share time with patients and carers. Some of these foreign workers expressed how they noticed a difference in the patients, carers, and families we visited, who displayed renewed spiritual and emotional strength following our visits. To be used by God in this way, to align with the MHPSS unit and become part of a team that offered coping strategies for Samoans in need, was truly humbling and rewarding. The reward for our MHPSS teams was to witness and hear of the impact our visits made in the lives of the carers of the sick and bereaved families. Humility was a common trait we observed in the several global EMTs and volunteers that we grew to know, as we worked alongside them and their life-saving work for the thousands of sick Samoans.
We grew accustomed to seeing our global EMTs identified by their respective medical scrubs working the hospitals and out in the field: the AUSMAT team (Australians) had their sky blue scrubs; NZMAT (New Zealanders) also had their sky blue scrubs with khaki trousers; PACMAT (Pacific Island EMTs from New Zealand) had their dark blue scrubs; EMTs from Israel had their green scrubs and many others. Countries that responded to assist Samoa in her time of need in addition to those mentioned above include the following: Fiji, Hawaii, Japan, Kiribati, Norway, Papua New Guinea, Solomon Islands, Tahiti, USA, and nations from Europe and the United Kingdom. Regional representatives from WHO and UNESCO and global bodies such as Save the Children UK and Samoa Doctors Worldwide were also key responders to the MES-19. It was amazing the passion and love these medical professionals and volunteers from around the world had for the thousands of sick Samoans they dedicated their time and knowledge to save and restore to life. The hospital wards were filled with our global helpers and one could easily have been mistaken as walking into a hospital in Australia or New Zealand or the UK, with the several foreign EMTs working the wards. Many EMTs continued to care for Samoans right up until their last shift saving lives in the hospitals.
As frontline responders to MES-19, we both dedicated our time to the MHPSS unit. It became apparent that we were placing our young sons at risk each time we returned home, despite taking strict measures to avoid bringing the measles home with us. So, we arranged to send our sons unaccompanied to Sydney to be cared for by family members and away from the epidemic. When MES-19 plateaued and conditions improved, we had the opportunity to quickly fetch our sons and bring them back home. We boarded the plane from Samoa alongside returning AUSMAT doctors, nurses, and team members who had completed their rotations on island. These returning EMTs had foregone their usual medical scrubs we were so accustomed to, for plainclothes attire. It was on this flight that we witnessed the commitment these EMTs had to saving lives.
One of the young doctors from AUSMAT who we grew to know working the ICU ward at the hospital, was returning to Sydney on the same flight. While most fellow passengers were sleeping or glued to their entertainment screens two hours into the flight, we noticed the young Australian doctor pacing slowly up and down the plane, looking at everyone who were seated in their places. Once he came to our seat, he recognised us and greeted us with ‘Reverend.’ I then responded ‘Doctor,’ and commented that I should stretch my legs as well just as he appeared to be doing. The young doctor leaned over to us and whispered that he was checking whether anyone leaving Samoa showed any signs of being sick. Even off-duty and leaving the country, he was still working endlessly trying to save lives, and prevent taking the disease with us to Sydney. The majority of the 83 fatalities to MES-19 came through the ICU ward where this young doctor was stationed. To most passengers and airline staff, he was just an ordinary visitor returning from a trip to Samoa stretching his legs walking up and down the plane; yet for us who knew him, he was responsible for saving so many young Samoan lives from the epidemic. It is without a doubt, that had it not been for the skills and wisdom from our visiting EMTs, the fatalities and infections from MES-19 would have been so much greater in numbers.
Crisis brings people together from all sectors working towards the common good of helping those affected; MES-19 witnessed the church and the state working in solidarity to help Samoans find peace and resolve from an epidemic that crippled Samoa to its core. Yet God continued to share His Grace through the love and work of our global professionals, working alongside their Samoan counterparts united as one to help overcome the tragedy. One outcome from the work undertaken by our MHPSS unit, was to highlight the importance and relevance of the work undertaken by the Mental Health Unit of the National hospital, together with its Social Services counterpart. Both these units are vital for Samoa all the time, and especially during crisis. The road ahead for the recovery of Samoa from MES-19 although is long and uncertain, yet with the solidarity of community faith leaders aligned with MHPSS, Samoa started a positive and encouraging partnership to pave a possible way forward.
At the last HEOC meeting we attended in mid-February 2020, Director General of MOH warned of a possible added threat to Samoa in the face of COVID-19. At the time of writing, Samoa is preparing for COVID-19 that has infected over 16 million people worldwide, and taken the lives of around 650,000 globally. MES-19 has taught many valuable lessons for Samoans, which saw the Samoan Government close its borders early at the threat of the COVID-19 pandemic.
Our prayer is that God will bless, comfort, and lead Samoa now, and into the future as it still mourns and recovers from the impact of MES-19. Many of our foreign helpers during the measles epidemic in Samoa, no doubt are continuing to work around the clock as EMTs in their own countries, as frontline responders to COVID-19. May God bless, comfort, and heal the broken world impacted in so many ways from the COVID-19 pandemic.
God bless all nations around the world, and God bless Samoa.
This article was published in the August 2020 issue of INSiGHT. For more articles, please visit https://archive.cwmission.org/insight/