Hospitals are not coping

Hospitals in Samoa are struggling to cope with the high rates of non-communicable diseases (NCD) in the country.

NCDs, such as diabetes, ischemic heart disease, cardiovascular disease, asthma, and chronic obstructive pulmonary disease account for 75 per cent of the total disease burden. Alarmingly, the rates continue to rise and it remains the number one killer in the Pacific nation.

These lifestyle disease is not a Samoan problem but is prevalent in many Pacific nations. Much of this has to do with the type of food that is consumed.

The Samoan Government has now started to look at ways of accommodating the increasing number of patients seeking overseas treatment.

Prime minister Fiame Naomi Mataʻafa said the Ministry of Health has been tasked with providing a plan to allow more people to get treatment under the overseas medical scheme funding, but not necessarily at overseas facilities.

Communities in Samoa are being encouraged to adopt to a healthier way of life. Picture Ministry of Health Samoa
Communities in Samoa are being encouraged to adopt a healthier way of life. Picture: Ministry of Health Samoa

The government approved an additional AU$2.3 million for the overseas medical scheme in March this year, on top of the allocated AU$4.6 million in the 2021-2022 budget that was used up before the end of the financial year.

Ms Mata’afa told the Samoa Observer that an option was an agreement with a cardiologist clinic in Fiji that can assess, screen, diagnose and operate on patients in Fiji and there is hope it can also be done in Samoa.

She said the Tupua Tamasese Meaole hospital has to have the capacity and be well equipped in order to have the service available locally where more people can be treated. She also spoke of possible assistance from the Samoa Medical Association of New Zealand.

One major contribution in the high rates of NCDs in Samoa is the lack of systematic NCD disease management in the country, resulting in poor quality NCD services including low screening rates, weak follow-up and referrals, and the lack of a patient tracking system. These are some of the gaps identified in the current NCD care model.

One of the many community programs designed to beat NCDs in Samoa. Picture Ministry of Health Samoa
One of the many community programs designed to beat NCDs in Samoa. Picture: Ministry of Health Samoa

The World Bank’s Samoa Hypertension Cascade study found gaps at all stages of the care continuum. Early detection, referral, treatment, and care of NCD patients are vital and have a direct impact on the reduction of preventable disability and death.

The World Bank in its data estimated that 82 per cent of all deaths in Samoa were caused by NCDs. They have devastating and disproportionately high impacts on Pacific Island countries.

Seven of the top ten countries with the highest rates of diabetes in the world are in the Pacific and over 25 per cent of the adult population in most Pacific Island countries is clinically obese – much higher than the global average of 13 per cent.

NCDs currently account for around 70-75 per cent of all deaths in the Pacific Islands, with NCD-related premature deaths (before 60 years of age) occurring at rates measurably higher than lower-middle-income global averages.

They also impose a heavy burden of disability on individuals, families, and workers through strokes, diabetes related blindness and amputations, and kidney disease.

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