Senior Psychiatric Registrar Acknlowledges Samoa’s Mental Health Clinic

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Senior Psychiatric Registrar from Counties Manukau Health has stepped forward to acknowledge the work of the Mental Health Clinic under the leadership of Seiuliali’i Dr George Tuitama.

“I commend Dr Tuitama and his team for the leadership, courage and the heart they have to run a service with limited staff, medications and other resources,” acknowledged Tongan born Senior Psychiatric Registrar. Dr Staverton (Tony) Kautoke.

Dr. Kautoke was deployed in Samoa through the Pasifika Medical Association (PACMAT) Emergency Medical Team that responded to the measles crisis.

Senior Psychiatric Registrar from Counties Manukau Dr Staverton (Tony) Kautoke

“I was thoroughly impressed and emotional when they went out of their way to support the less fortunate families and provided immense support to a young 12-year-old and her younger siblings who were looking after 3 of their family members who unfortunately died secondary to measles complications,” continued Dr Kautoke.

“They were showered, clothed and fed and given space to sleep. The children and their family were always welcomed to the Safespace.”

The following is the full text Dr. Kautoke’s Public Letter of Acknowledgement;

30th December 2019
Talofa Lava and Malo e lelei,
‘O lo’u igoa ‘o Dr Staverton (Tony) Kautoke a senior Psychiatric Registrar (Tamasi’i Tonga) currently working in Counties Manukau Health, New Zealand. I had the privilege and blessing of being deployed as a PACMAT member (under the NZ government) to work alongside Seiuliali’i Dr George Tuitama and his team members at the Safespace (Mental Health unit) at Tupua Tamasese Meaole Hospital.

Dr Tuitama is the sole mental health doctor in charge of the Safespace/Mental Health Unit and has been integral in establishing the psychosocial support services provided to the hospital.

My deployment was from the 26th December and ended on the 3rd January 2019. I was part of the PACMAT Lima Mental Health team.

The first PACMAT mental health team was led by Dr Allister Bush. Most PACMAT mental health teams consisted of Psychiatrists, Clinical Psychologists, Psychiatric Nurses and social workers. We all worked under the leadership of Dr Tuitama and his team who already had an ingenious method of working prior to our arrival.

STRENGTHS                                                              Prior to the PACMAT team arrival, Dr Tuitama had already coordinated a psychosocial response to the measles crisis.

Dr Tuitama brought together a team of volunteer faifeau, faletua, social workers, Red Cross workers, environmental health clinicians and counsellors which had commenced on the first week of December.

Seiuliali’i Dr George Tuitama

Dr Tuitama and the team decided on utilising an approach consistent with Fa’a Samoa values relating to respectful approaches regarding va and consistent with asiasiga as mentioned in Dr Allister Bush’s report.

This approach emphasized the spiritual focus of pastoral care a skill already familiar to Samoan staff, faifeau and counsellors. The team agreed on an approach that avoided forced retelling of possible traumatic experiences which can be more harmful to victims and patients but invited aiga to reflect on their strengths and a wide range of coping styles that they use in the face of stress.
BRIEFING & DEBRIEFING

Dr Tuitama led daily briefings every morning with the psychosocial support team emphasizing the importance of checking in with the hospital ward charge nurses and doctors identifying new patients and staff members that required support. Also enhancing the va as mentioned above.

Close to the end of the day, the psychosocial teams would return to debrief their work, share cases and also used this as a learning opportunity to enhance their work. Clinical oversight was provided by Dr Tuitama and one of the visiting Psychiatrists. My main role was to look after the mental health outpatient clinic, patients admitted to Safespace and to review patients at Goschen Trust to free up Dr Tuitama to focus on the psychosocial support team.

The Psychosocial support team continued to grow from strength to strength.
This was highlighted in one of the HEOC meetings where the Samoa Director General of Health commended Dr Tuitama and his team for the ongoing work being carried out for staff, patients and their families.

Over the week I was present, I observed the strengthening va between the psychosocial support team, medical staff, patients and their families. This further increase the awareness on the importance of looking after one’s mental health and well-being.

Many individuals, entrepreneurs and organizations collaborated to donate gifts, food, clothing, baby wipes, nappies and many other practical things to enable the psychosocial support team to provide referred patients and their families.

I commend Dr Tuitama and his team for the leadership, courage and the heart they have to run a service with limited staff, medications and other resources. I was thoroughly impressed and emotional when they went out of their way to support the less fortunate families and provided immense support to a young 12-year-old and her younger siblings who were looking after 3 of their family members who unfortunately died secondary to measles complications.

They were showered, clothed and fed and given space to sleep. The children and their family were always welcomed to the Safespace.

TOUCH OF SAMOA
I had the opportunity to experience a Samoan massage (fofo). When given the choice between soft or hard, I thought I would go for the hard but quickly reverted to the “soft” after I felt my shoulders were about to dislocate during the “hard” massage. The Psychosocial Support Team organized a free fofo for all hospital staff at the Mental Health Unit.

This was funded by the NZ government and it provided staff a break and sensory modulation to help relieve some stress. There was an increase in uptake on this support.

I was blessed to partake in the daily breakfasts and lunches provided by Frankie’s Supermarket and Mama Agnes. Mama Agnes and many others provided me with the Samoan hospitality by looking after my large Tongan appetite.

RECOMMENDATIONS
MOH Samoa will need to continue to grow the Mental Health workforce to support Dr Tuitama and his team.

This includes increasing mental health staff and further planning to attract younger doctors, nurses, psychologists and social workers to work with Dr Tuitama and team.

Continue to maintain the va between the psychosocial support team and ward staff. For medical staff to utilise this important resource.
Safespace welcomes more donations to help the psychosocial team support the less fortunate
Reconfiguration of the Mental Health unit and possible expansion to house wards with rooms but again this will require more staff
Acknowledgements

I would like to take this opportunity to thank God, PACMAT, Government of NZ and Government of Samoa for the opportunity to be able to serve the people of Samoa. I would like to thank Seiuliali’i Dr George Tuitama for the opportunity to work under his leadership and his team and I pray for God’s grace, blessings and strength upon you all to continue the hard but rewarding work that you do. Special thanks to Mama Agnes for the fantastic hospitality. I would like to thank my family for understanding and giving me an opportunity to help Samoa.

Finally, I would like to thank the people of Samoa for opening your hearts and your homes to myself and the rest of the PACMAT. Thank you wholeheartedly for the Samoan hospitality and all the Alofa.

There is no health without mental health.
Fa’afetai tele lava, Fai tui puipui,
Dr Staverton (Tony) Kautoke

Senior Psychiatric Registrar from Counties Manukau Dr Staverton Tony Kautoke