American Samoa And Measles: An Emergency Closer To Home

Three weeks ago, I wrote an article calling for the United States to send aid in the form of vaccines and experts to Samoa because they recently had an outbreak of measles and declared a national emergency. The article also spoke about the necessity of sending both vaccines and experts, and the threat that a measles outbreak in Samoa poses to neighboring states. At the time of their national emergency, the Samoan government had recorded only six deaths. A week later, the United States finally decided to send help in the form of experts and technical equipment. Instead of offering, the United States waited until Samoa officially requested assistance. At that point, 2,437 people were infected, and 32 people had already died, as reported by Washington Post. While reports paraded the efforts as successful, The Straits Times reports that the death toll still doubled to more than 60, which is an unacceptable failure. The margin for error when dealing with people’s lives is zero. Of note is the fact that vaccines were not among the items listed in what the experts brought. The Samoa Observer found that reports of vaccine shortages at a Savai’i hospital went unaddressed by the Samoan government earlier in November, making the necessity of additional vaccines evident.

Now American Samoa, an unincorporated territory of the United States so close to Samoa it is part of the same archipelago, has declared an “outbreak.” Statements from Health Department Epidemiologist Dr. Aifili John Tufa indicate five of the nine confirmed infections had been travelling abroad, and the four others are likely contracted it from being in contact with the original five. This information, coupled with American Samoa’s announcement led to the United States committing to sending a measles vaccine package, according to Dr. Tufa.  The United States delayed aid to Samoa, letting over 25 people die, whereas the United States immediately sent aid to American Samoa. This discrepancy in the United States’ response is evidence of the latent nationalism at play in almost every United States’ foreign policy decision. There’s an inherent bias for defending people closer to home, or those who the United States has national ties to like “American Samoa.” This bias of continually looking for threats to domestic national security issues comes at the cost of ignoring a threat when only others see it as threatening.  This is not a criticism of sending that aid, rather the lack of assistance for the original Samoan outbreak. The central problem is that the media, politicians, and the public never put this bias into perspective. Instead, they break it up, speaking about it as individual cases where it manifests, attributing the failures to distinct, discrete phenomenon each time, ignoring the issue with the modern basis of United States’ foreign policy.

While the damage the United States’ inaction caused cannot be undone, some shifts in policy can still occur that will reduce the future number of deaths caused by measles. The United States should continue aiding American Samoa, and send more contributions to Samoa and countries close by at risk of a measles outbreak. As Straub Medical Center family physician Dale Glenn said, “…immunization has the most dramatic impact. Everybody came together with their aloha to unite and support Samoa and attack this disease head-on in a way that will make a permanent difference…” More hollow promises like experts without vaccines will only result in measles spreading further, immunization is essential. Being conscious of implicit biases towards threats to “our” nation over others comes at the expense of real disaster or threat preparedness. Acting to check those biases is difficult, but critical to creating more informed foreign policy that will save the lives of thousands.

Christopher Eckert