Medical Adventures in Samoa

Maggie Doolan is a past graduate of The School of Total Education. Maggie joined the School in preschool and graduating in 2011. Maggie went on to study biomedical science and is now in her second year of medicine at the University of Queensland. Maggie recently did her clinical placement as a first year medical student in American Samoa and she has been gracious enough to share her experience.

At the end of our first year of med school, UQ students are required to do a clinical placement at a hospital or medical practice. My med student friend has family in American Samoa so we thought we would make the most of that connection and get some insight into a contrasting heath care system. (That just happened to be on a beautiful tropical island!)

The hospital where I did my placement was funded by the US government which meant that it was completely flooded with patients from surrounding islands who would come to take advantage of a free health service. The Hospital was understaffed and many of the doctors were burnt out. Nonetheless they were extremely welcoming to students like me. I flitted around to different specialties and wards hoping not to burden one doctor for too long at a time. I tagged along during ward rounds, scrubbed into some spectacular surgeries and when things were quiet I would go and sit with the babies in the neonatal care unit.

American culture has had perhaps its most striking influence on the local diet. Traditionally, the Samoan diet consists of fresh seafood, starchy foods like breadfruit, taro and plantains as well as an abundance of tropical fruits and coconuts. Now there are convenience stores brimming with processed foods and McDonalds is buzzing with school kids. As you can imagine, this has profound implications for the health of the Samoans. Obesity related diseased such as diabetes, heart disease and stroke are common.

Compared to the Australian healthcare system, there is a lack of preventative health care in Samoa. There is also a stoicism amongst the islanders resulting in a cultural reluctance to go to the doctor. This meant that when patients did finally present to the hospital things had already deteriorated so severely that treatment was just about damage control. It was really tragic to see these potentially manageable conditions like diabetes spiral out of control so that the patient had to endure recurrent skin infections or limb amputations. It highlighted to me the important role of primary healthcare providers such as GPs.

Its such a gem of an island so we made the most of our time outside of hospital hours to explore. After work we could cool off in the waterfall behind of the hospital or swim at one of the beautiful beaches. My friend’s Grandma who we were staying with was extremely strict so every day we went exploring we told her we were just going to the same beach near our house. I think she got a bit suspicious when we came back from climbing the highest mountain on the island covered in sweat and mud…

I felt so cared for a welcomed in Samoa. Neighbours gifted us with coconuts, pineapples and avocados, drivers passing us by offered us lifts home and new friends took us in their boats to untouched islands that would have been inaccessible as a tourist. The doctors I shadowed were generous in sharing their time and knowledge. I was especially grateful to the patients who at their most sick and vulnerable, still shared their stories with me so that I could learn. I was so touched by the generosity I was shown and I hope to be able to practise the same generosity as a doctor and as a person.