Address by Tuiloma Neroni Slade

Gala Dinner, Auckland, 22 May 2010

Lau Afioga Anae Arthur Anae, Chairman of the Trust
Hon Minister of Pacific Islands Affairs, Hon Georgina Te Heuheu
Hon Members of Parliament
Your Worship, the Manukau City Mayor, Mr Len Brown
The Consul General of Samoa
Leaders of Commerce and Dignitaries of the Communities
Distinguished Fellow-Trustees
Families and Friends,

 

On behalf of the Trust, I want to start with words of warmest appreciation. Thank you for rallying to our cause, so fulsomely, so generously. Your presence alone is overwhelming in its declaration of support. Not only do you signal shared concern, your being here provides to us in the Trust reassurance in our declared aim to assist the poorest in Samoa who suffer from serious heart disease. So, to you all, our first words are of gratitude.

The Trust

We have all been honoured and moved by the message from our Patron, His Highness Tui Atua Tupua Tamasese Efi, Head of State of Samoa. No one could have presented The New Zealand Good Samaritan Heart Mission to Samoa Trust with greater authority and nobility of thought. We are deeply grateful to His Highness.

The Samoa Heart Trust is humanitarian and single-minded in ambition: an outreach of neighbourliness and of professional care. The single aim is to save human lives. There cannot be a higher purpose. Trust is a terminology of honour; for the Trustees, it is our pledge of commitment to assisting and doing what we can.

The mission of the Trust is to reduce and relieve the incidence of heart disease in Samoa and to improve heart-health by supporting the continuation of heart surgery missions, to support primary and secondary prevention of heart disease and to support heart-health education for the Samoan community both in Samoa and New Zealand .

Two missions were mounted in 2007 and 2008. Lives were saved. More lives need to be saved. Through the Trust we must persevere and do what we can to help.

Our purpose is not to be content with principle and high sounding words. Rather, we want to persevere with action together with the support of partners, friends and families, the community, all of you. We want to see the earliest resumption of heart surgery missions to Samoa and, in particular, to provide every support possible for effective preventive measures against heart disease.

Heart disease in Samoa

Heart disease is one of the leading causes of death in Samoa . Rheumatic fever and rheumatic heart disease affect all ages. Rather seriously, rheumatic heart disease registers significantly in the premature mortality for children and younger adults in Samoa . Poverty and poor living conditions are a factor. Increasingly, the most common risk factors are lifestyle-related. The World Health Organisation figures show that Samoans are increasingly suffering from hyper-tension, diabetes and obesity.

But common bacterial infections of the throat and other sensitive areas trigger complications which can also cause damage to heart valves. 

It is important to note, however, that hi gh as the prevalence is, rheumatic heart disease is also highly preventable. It is entirely preventable.

Under Samoan Government auspices, only some ten to fifteen patients with heart disease may be referred to New Zealand annually for further medical treatment or heart surgery. Beyond that there is little other option for the far greater majority.

In a recent article in the Samoa Medical Journal, a Senior Clinical Lecturer in Apia has suggested that cardiovascular diseases are on the rise and have already taken their place as the number one killer. More alarmingly, it is reported that increasing numbers of young adults are already exposed to risk factors of cardiovascular diseases. It is clear that Samoa will need not only a health system that can detect and treat acute heart attacks and stroke but also be able to cater for the long-term rehabilitation for those who survive. With only 74 medical doctors in clinical practice, with 49 at the national health services, the country is seriously short of essential skills at almost all professional levels, including nursing and preventive care.

With the Government funding over 60% of the total health budget, and with the overseas treatment scheme ever increasing year after year, with cardiovascular-disease cases taking almost 80% of the share, there are serious questions about the sustainability of it all.

The poorest

These, then, are the facts on the ground. They are the circumstances that gather us here in shared concern. It is the condition of the poor, of the weak and the young people especially, that motivates the Trust and is the object of our declared mission.

These were the factors which particularly moved cardiac surgeon Dr Parma Nand, a driving force in the establishment of the Trust, who had long held a vision to provide open heart surgery to the poor and needy in the Pacific islands. Dr Nand has headed open heart surgery missions to Fiji since 2006 and he led the two missions to Samoa in 2007 and in 2008.

By naming Dr Nand I will inevitably commit the offence of omission, for there are other medical specialists, like Tim Willcox , who have stood with Dr Nand, shoulder to shoulder and, in the name of the Trust, we hope they will continue to do so. To them and to all who have served on these open heart surgery missions to Samoa and who will make future missions possible, it is entirely fitting that this dinner event serves also as our warm salute to their commitment and talent and to their selflessness and sacrifice.

 

Heart disease elsewhere in the Pacific

I would have to say that my own concern is that the conditions in Samoa mirror what is happening elsewhere in our Pacific region.

 

Non-communicable diseasessuch asrheumatic heart disease are reaching overwhelming proportions in the region with some estimates attributing 3 out of every 4 deaths in the Pacific to lifestyle diseases. The economic cost of such diseases for most Pacific island countries is huge, and will be certain to impact adversely on the quality of life for the workforce. Quite apart from premature death and disability for significant numbers of people, the additional burden could very well overwhelm health resources and services already stretched thin.

Regional concerns

We know that widespread heart disease results from neglectful lifestyles, poor nutrition, often over-crowded living conditions and the unavailability of effective and sophisticated medications. As with the situation in Samoa , the prevalence of heart disease is compounded by the lack of cardiologists and heart surgeons in almost all Pacific island countries. It is pertinent also to note that significant numbers of medical professionals educated and trained in New Zealand and elsewhere choose either to remain or at some point to migrate to other countries. For whatever reason, all too few return to their countries of origin.

So, as The New Zealand Good Samaritan Heart Mission to Samoa Trust seeks to do, there is need to raise awareness of the conditions and dangers of heart diseases in countries like Samoa where, in the absence of an effective medical response, the consequences of premature death and disability would be inevitable.

Surgical intervention, if needed, is of course vital. But, perhaps more so, are preventive care and heart-health education. Ultimately, these are the sustaining elements of any health care system in the community. The Trust itself would need to contribute as effectively as possible to such preventive and educational programmes.

In all this, the Trust must necessarily appeal to the finest instincts and traditions of the surgical and medical profession to intervene and contribute with their volunteered time and expertise. High as the Trust purpose is, determined as the Trustees might be, the declared ambition to assist the poorest in Samoa is a task that the Trust alone cannot achieve. And so we turn to you: partners in Government, business, and the community; our families and friends.

The wider context

As you consider our appeal, consider also the wider context.

Modernisation and globalisation have brought wonders for the Pacific countries. But these are global forces which have also exposed the inherent and sheer vulnerabilities of island communities: to HIV/AIDS, the H1N1 pandemic and other global health problems; to the ongoing financial and economic instabilities of the global economic crisis; to serious biodiversity and global environmental degradation, including to our part of the Pacific ocean; and, above all, to the onset of climate change impacts.

Serious enough in single file, when they come in battalion these global problems, on top of other national priorities, confront Pacific island countries with the most formidable and overwhelming challenges. They are problems so large and innumerable they have been referred to, rightly I think, as “problems without passports”. They are problems created by all humanity and cannot be solved by any one country.

I believe it important to keep proper perspective of this larger global context, because it sheds light on the inability of regional Governments to deal effectively with all priority issues; and highlights why Pacific communities so desperately need assistance in specific areas like heart-health care.

For the Pacific Forum which I have the honour to serve, Pacific Leaders have set a vision for the Pacific region to be a region of peace, harmony, security and economic prosperity so that all of its people can lead free and worthwhile lives. Peace, security, prosperity, yes. But the critical test is to ensure to the people free and worthwhile lives.

In our world today, I believe there is need for more profound awareness of the sanctity and dignity of every human life; and this would require that we look beyond the framework of States and beneath the surface of communities. We must focus, as never before, on people. We need to improve the condition of individual men, women and children, for when they are able to lead free and worthwhile lives they are the ones to give to each country lasting richness and character. Poverty of a nation begins when a single child is denied fundamental rights and expectations and is forced to bear the marks of poverty. And so it is with life: failure to save one life is an indictment against the community that we all must accept.

Pacific neighbourhood

In his message, His Highness spoke of the parable of the Good Samaritan and how this is being employed in naming the Trust. This of course is deliberate for it reflects fundamentally our believe in the neighbourhood concept and the need for the Trust to respond as a good neigbour. The high connectivity and interactions of our times is such that we are all neighbours in a modern global village; though, of course, in our part of the world there is close and natural feeling and affinity with communities in this country and others in the Pacific. Indeed, with the fund-raising activities of the Trust for the Samoa medical missions, one of the most notable and pleasing responses has been from other Pacific island communities, including from the Auckland community of mothers of the Cook Islands . Sincerely, we want to thank them for their wonderful support.

My friends, as I close, allow me to acknowledge and thank my fellow-Trustees and the small core group of exceptional people who have so kindly and willingly committed to additional and exhaustive work to arrange this event. To our esteemed Chairman, Anae Arthur Anae and Tim Willcox in particular, the two I have dealt with most from my distance, I extend special admiration and appreciation.

Thank you all for your kind attention.

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