Teuila Fuatai: How did measles crisis in Samoa get so bad?

Heartache and terror of measles marks one of tiny nation's darkest periods. Photo / Supplied

COMMENT:

There is something about the air in Samoa. Ever since I was a kid, my first steps off the plane have been about appreciating the thickness of breathing in the air of motherland.

The sensation lasts less than a minute but is affirmation enough that I am in a place with its own rhythm and way of life - wholly different to its southern neighbour New Zealand.

It is a sentiment which has become increasingly relevant as I have observed the devastation of the measles outbreak from afar, and reaction to it in New Zealand.

Perhaps, it is best framed through the key question: "How did things get so bad"?

As beautiful as Samoa is, life can be and is hard for many. Reliance on overseas money, either as aid, investment or remittance, is crucial to its economy and people. Impacts of that are everywhere, from contributions families make as part of traditional fa'a Sāmoa custom to the buildings and shops that spring up in Apia. Local businesses and initiatives are also mixed in, driving the homegrown economy in their own way.

Rightly or wrongly, it is a current reality of life in the island nation. When it comes up in casual conversation, it is often difficult for this NZ-born Samoan not to smile. For example, the main hospital in Moto'otua is commonly referred to as "built by the Chinese".

Translated in English, it sounds quite crass. However, in Sāmoa, it is a genuine descriptor for the facility and has no further connotations to it. Can you imagine the same comment being uttered over here without disparaging undertones?

I mention this because understanding how Sāmoa works is crucial to understanding the measles outbreak it is battling. A significant part of that is the role and influence of the state or "malo".

Undoubtedly, health authorities and the Samoan Government have significant questions to answer around the deterioration of the country's immunisation programme. The heartache and terror caused by a preventable disease in a population of just 200,000 will be marked as one of its darkest periods.

While anti-vaxxers and the worst types of entrepreneurs have contributed, ultimately the State holds responsibility for what has happened. Importantly, "state responsibility" in the island nation is entirely different to what it is in New Zealand.

Fonoifafo Mcfarland-Seumanu administers the measles vaccine in Samoa as the Samoan Government tackles the epidemic. Photo / Supplied

Much of it links to the respect and standing Prime Minister Tuilaepa Sailele Malielegaoi and his office have among Samoans. No mainstream politician in New Zealand yields a similar level of influence.

It can be incredibly effective in times of crisis when an emergency response like last week's mass vaccination drive and economic shutdown is needed.

However, it also means certain communities - like Sāmoa's rural villages - rely heavily on clear leadership for access to basics like healthcare and education. When that safety net fails, those most vulnerable are worst-affected – as we are seeing now.

Tuilaepa understands that implicitly. As the measles crisis has worsened, he has refrained from blaming individuals and rebuffed criticism from opposition MPs. Questions around an inquiry have also been dismissed. Instead, all messages from him have been around the necessity of vaccinations.

"What we decided to do is to inject all children first to ensure that the needs go hand in hand with the quantity of medicine that we have," Tuilaepa told the Samoa Observer last week.

"And as more vaccines arrive, we extended the coverage to include the older people who have more immunity than the young ones. We didn't leave it [too late]."

While rolling out a successful emergency response does not absolve Tuilaepa and health authorities of ineptness, it does signal how well they understand the needs of their own people.

For those families who have buried loved ones in the lead-up to Christmas,
identifying what went wrong will likely mean little at this point. Further, what will assigning blame really bring to Samoans?

I believe it epitomises the difference between politics, and life, in Sāmoa and New Zealand.

Inquiries, resignations and public condemnations would be the norm over here. While, I have no doubt heads will roll in Apia, real progress will come when a new immunisation scheme is enforced. That type of systemic change will come from the top and likely be driven by the Prime Minister's office when the time is appropriate. Sadly, it is also the type of progress that tends only to emerge after devastating, avoidable harm.

For now, Samoa will continue to do its best to overcome the current crisis.

• Teuila Fuatai is donating her writer's fee for this column to the measles response in Samoa. For more information on how you can help, click here