State of Emergency Orders puts Onus back on Ministry of Health

According to sources within the public health service, the death toll from the measles epidemic went from 14 to 16 as Samoa’s National Disaster Advisory Committee sessions were held today.

Following the State of Emergency declaration last night, an order has been handed down for the entire population to receive MMR vaccination injections immediately as a mandatory legal requirment.

Exactly how this would be implemented in the coming days remains unclear, as the second order handed down places the onus back on the Ministry of Health to “publish its program and schedule for the new vaccination program by Monday 18th November”.

The National Disaster Advisory Committee requires the Health Ministry to ensure that their program sets out a vaccination schedule by location, consider transportation for public movement and “consider any other health precautions the public may require”.

Pre-empting a lack of resources to fully implement an immediate nation-wide vaccination, the orders directs the Ministry to confirm the “age brackets that will be prioritised”.

An order has been handed down for the immediate closure of all schools and tertiary institutions, postponing all exams until further notice.

Children up to 17 years of age are banned from any public gatherings and children below 18 years of age are banned from hospitals unless they are seeking medical treatment.

To help contain the spread of the virus, only one family member is allowed to care for those hospitalised and police have been ordered to assist the National Hospitals with monitoring visitors. Police are also ordered to keep the peace and offer support to staff and family.

There was no mention of a mandatory shut down of business activities or offices to assist with the whole of population vaccination. Rather the public service are ordered “to attend to their jobs and responsibilities, until any further notice”.

It was unclear from the Orders handed down if support would be given to the Ministry of Health to address overcrowding at the TTM National Hospital paediatric ward where children from the same family are sharing beds.

Resources at the TTM Motootua Hospital as well as District hospitals have been stretched evident by Update No.6 that refers to 716 suspected cases with 40% or close to 290 needing to be hospitalised, mostly children and nearly all at the TTM Motootua.

A medical practitioner of 30 years experience says the epidemic is the worst he has seen in all of his lifetime as a doctor and “extreme measures are needed to draw the attention of the authorities to the gravity of the situation”.

“My real concern came from talking to my medical colleagues and hospital staff who are dealing with the situation. Going without proper sleep now for days if not weeks does not do any good to anybody. They are crying out for help.”

He explains that the help immediately needed for babies unable to fight the virus is to do with “the end of the chain before imminent death because there is late presenting”.

“We must loudly advise parents to bring sick children in quickly”.

“Then we need the expertise and specialized equipment and materials needed to care for the critically sick young children”.

“Most of these very young patients need life support and the means to effectively deliver oxygen to the brain while giving the infected lungs time to recover for survival”.

Samoa’s State of Emergency Orders handed down tonight in Verbatim:

GOVT. PRESS SECRETARIAT; In view of Samoa being in a State of Emergency, the following ORDERS, are in effect immediately pursuant to Article 106 of the Constitution:

(a) that MMR vaccinations for members of the public who have not yet received a vaccination injection, is now a mandatory legal requirement for all of Samoa.

(b) that the Ministry of Health (through the resolution of the Disaster Advisory and National Advisory Committee) is to publish its program and schedule for the new vaccination program by Monday 18th November. This must include the confirmation of:

• Location;
• Dates for vaccinations for each Location;
• Modes of Transport (where available);
• Age brackets that will be prioritized;
• Any other health precautions required for the members of the public.

(c) that all schools in Samoa including the National University of Samoa (NUS) are closed forthwith, until further notice; and all Government administered examinations that were pending are hereby postponed until further notice.

(d) that all public gatherings cannot henceforth include the presence of children up to the age of 17.

(e) that at all National Hospitals, only one (1) family member caregiver can attend to the care of any person who is hospitalized anywhere in Samoa.

(f) that unless they are requiring medical attention, no child under the age of 18 can attend to any medical facility.

(g) That the Ministry of Police are ordered to keep the peace, support staff and families of the hospitals, and attend to assisting the National Hospitals to assist with monitoring the visitors.

(h) All public servants are to attend to their jobs and responsibilities, until any further notice.

The Orders of State of Emergency are in effect immediately as of today following the endorsement by the Member of the Council of Deputies Afioga Le Mamea Lemalu Su’a Tuiletufuga Leatuavao Ropati Mualia , acting in the absence of the Head of State and after consultation with Cabinet.

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