PAGO DOCTOR GOES DOOR TO DOOR IN MANUA ISLANDS

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By B. Chen-Fruean

PAGO PAGO, American Samoa (Samoa News, Oct. 31) – American Samoa Department of Health physician Dr. Ivan Tuliau returned last Tuesday from the small islands of Ofu and Olesega in American Samoa’s Manu'a group after a volunteer mission to offer free medical examinations and medicine.

He said he plans to make the trip to the Manu'a islands a monthly routine.

He was scheduled to depart yesterday to visit the people of Ta'u, also among the Manu’as, for two days.

In the two days that he was in Ofu and Olesega, Tuliau saw over 30 residents, or about 10 percent of the population. He said that upon his arrival, he waited for a half hour but nobody showed up. So instead of sitting around, he made home visits, walking from door to door, offering his services.

"The look on those people's faces was very touching. They were very happy and grateful to see me, and it is indeed a very good feeling," Dr. Tuliau said.

He described most of the people he visited as elderly, whom he checked for high blood pressure, diabetes, asthma, and arthritis, among other things.

"I examined a couple of older ladies who had very severe cases of arthritis," Dr. Tuliau commented.

He offered medical services and went equipped with a box of medications, which were distributed, with the unused medication to be distributed during next month by the Ofu and Olesega Public Health nurse.

Currently, there is one dispensary and one Public Health nurse stationed in Ofu and Olesega, and two nurses staffing the Ta'u dispensary.

Dr. Tuliau said that his trip was a result of numerous discussions and meetings held over several months with Department of Health director Uto'ofili Asofa'afetai Maga.

"We both agreed that there was a need for someone from our office to travel to the Manu'a Islands to offer medical assistance to those residents, especially the elderly, who may not be able to come up with the US$140 round-trip ticket between Manu'a and Tutuila," Dr. Tuliau said. "It seems as if people have been sitting around, not realizing that there hasn't been ample medical treatment available to Manu'a residents for years. I am not from Manu'a, but I have ties there. Those people have to go out of their way to get the assistance that we receive here for free. The lawmakers in the local Legislature have been voicing their concern over this issue for a long time, and it definitely is an old problem. Those people deserve treatment."

The monthly visits by a medical doctor may also limit the number of medical evacuations from Manu'a to Tutuila, said the Public Health medical officer. According to Dr. Tuliau, between March and September of this year, there were five emergency medical evacuations from Ofu alone.One of the patients had acute appendicitis, while another was a 72-year-old who had a leg infection.

"In both cases, the situation could have been fatal, had they not been evacuated to Tutuila, where they received the proper antibiotics," Dr. Tuliau said.

He referred to a 37-year-old minister whose toe was literally hanging off from his foot after a large table had landed on it.

"In cases like that, although not life threatening, we still receive telephone calls from the nurse informing us about them, and from there, it is up to us to make a decision. There are not many flights to Ofu and Olesega. The residents there have to fly back and forth to Ta'u in order to get to Tutuila, as there are no direct flights. The planes are rarely used for direct flights to Ofu and Olesega, but the biggest problem is, the round trip airfare from there to Tutuila costs more than the round trip airfare to Samoa," Dr. Tuliau pointed out.

"The dispensaries need maintaining and the bottom line is, we feel for the residents of the Manu'a Islands. Most of the people are the elderly who have children living here or abroad, trying to make a living. Some of the families I visited had only one child who stayed in the home to look after things. These people are trying to survive, and it's not easy for them out there," Tuliau said.

"Judging from the homes I saw, I can honestly say that these people cannot afford to pay the airfare to travel to Tutuila to seek medical attention. Our main plan now is to place a doctor there permanently, to serve those residents. But first, we need to renovate the dispensary and make the conditions livable before we assign a physician there," Tuliau said.

An estimated appropriation of US$1.5 million was approved by the Capital Improvement Project (CIP), administered by the Department of Commerce (DOC), for the construction of a new dispensary in Ta'u, which is expected to begin next year and be completed within seven months.

The dispensary will include a mini morgue, nurses' and doctors' quarters, and other facilities "for better services."

November 2, 2005

The Samoa News: http://www.samoanews.com/

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