Crisis offered rare and heartbreaking learning opportunity

For those who were especially busy during the last few months and unable to watch or read much news, measles made a comeback. The disease that has largely been eradicated in many parts of the world sadly returned with a vengeance to Samoa.

The Government of Samoa declared a national State of Emergency on 15 November 2019 which closed schools indefinitely and banned minors from attending public events. In addition, all citizens were mandated to receive the MMR vaccination.

During one single day in mid-November, 114 patients were diagnosed with measles. At the time of publication, more than 5,700 cases were confirmed and there have been 83 deaths, most under the age of five. Considering Samoa’s population of 199,000, the numbers are staggering.

OUM faculty and clinical students soldiered on at TTM Hospital, OUM’s primary teaching facility, which became the epicenter of treatment for the outbreak. Roughly 85 percent of patients needing hospital admission were cared for at TTM, which also received transfer patients from Samoa’s district hospitals and health centers that are without ICU services.

“While the majority of doctors in Australia, New Zealand, and the US have never seen measles, the OUM students here in Samoa are sadly becoming very capable of diagnosing, managing, and treating cases across many stages of presentation,” said Tom Dalton, third-year student and President of the OUM Student Association, who was completing his surgical rotation at TTM Hospital during much of the emergency period. “It was inspiring to see students finish their ward duties, then help in the pediatric clinic to assist with the screening and care of sick children or take on additional work required in the other wards with the loss of NUS students,” he said. (NUS – National University of Samoa – medical students would normally also do clinical rotations at TTM Hospital. The State of Emergency closed NUS, a public institution.)

The United Nations UNICEF agency brought in more than 100,000 doses of measles vaccine and medical support teams arrived from New Zealand. Australian physicians, nurses, and public health professionals brought in a medical tent and established another PICU (Pediatric Intensive Care Unit) near TTM. To date, more than 95 percent of the Samoan population has been vaccinated. All OUM students have always been required to have the MMR vaccine, among others, before arriving in Samoa for clinical rotations.