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There are hard questions to be answered over NZ’s role in Samoa’s measles epidemic

Amidst the heartbreak of the tragedy, we must ask whether the Government was forceful enough in communicating the known risk of measles spreading to Samoa.

In November 1918, passengers from the steamship Talune were allowed ashore at Apia, despite several being seriously ill from influenza. As extraordinary as it may seem, the acting port officer was unaware that a flu epidemic was raging in Auckland, the ship’s port of departure.

The consequences were catastrophic. Within a week, the disease had devastated the main Samoan island of Upolu and spread to neighbouring Savai‘i. Approximately 8500 people, more than a fifth of the population, died in the outbreak. Eighty-two years later, Prime Minister Helen Clark formally apologised to Samoa for New Zealand’s “inept and incompetent” administration of what was then a colony under New Zealand control.

As with influenza in 1918, so with measles 101 years later. Once again, Samoa has been stricken by a deadly virus thought to have been imported from New Zealand, this time unwittingly carried by an airline passenger. And although the number of deaths is relatively small compared with 1918, the heartbreak is no less crushing for the dozens of Samoan families who have lost young children – including three siblings – as a result of the epidemic.

As in 1918, it could have been avoided. Though this time New Zealand has not been so damningly culpable, there are some disturbing parallels. Newsroom reported in October that New Zealand health officials had known for years that gaps in measles vaccine coverage for Pacific Islanders living in New Zealand posed a risk to other Pacific countries. In 1991, a survey showed that only 42% of Pasifika two-year-olds living here were vaccinated.

As measles infections ramped up among the New Zealand Pasifika community earlier this year, so the risk of someone carrying the disease on a visit to family and friends in the islands inevitably increased. It follows that when New Zealand and Samoan officials review the handling of the Samoan measles outbreak, as they surely must, they will need to consider whether enough was done to contain the threat in New Zealand, whether the risk of the disease spreading was communicated forcefully to Pacific governments, and whether those governments acted with due urgency to counter the threat – especially in Samoa, where vaccination rates were among the lowest in the world.

Once the scale of the outbreak became obvious, a massive international effort was mounted in which New Zealand played a key role. But it was not so much a case of too little as too late.

Tragically, there were other contributory factors that could not have been foreseen. Vaccinations were suspended for several months in Samoa after the deaths in July 2018 of two babies who were given incorrectly mixed vaccine. The nurses responsible were jailed for negligence, but the damage was done. Even when immunisation resumed, vaccination rates fell even further as parents backed away. Last year, only 13% of Samoan infants completed the course of two MMR immunisations that experts say delivers 99% immunity.

The deaths played into a cocktail of distrust, fear and ignorance that opponents of vaccination were happy to exploit. Even as babies were dying, anti-vaxxers were peddling the pernicious notion that protection against measles could be assured by vitamin doses. Even worse, one local charlatan made money from naive villagers by convincing them that desperately ill people could be cured by the application of “healing water”. Cars full of children continued to turn up at his property even after the Government had shut the operation down.

Not all dangerously wrong-headed decisions could be put down to ignorance. Just as lamentable was an Auckland medical clinic’s denial of a measles vaccine to a susceptible Apia-bound Samoan infant because it wrongly believed the rules meant he needed to be a New Zealand passport holder.

But this crisis has at least lifted the lid on a global network of anti-vaxxing activists for whom no propaganda is too daft or dangerous – not even a 1969 episode of the anodyne family comedy series The Brady Bunch, circulated earlier this year as a social-media meme, in which the Brady children celebrate having measles because they are kept home from school even though they don’t feel sick. The message was that childhood measles is a harmless rite of passage, when in fact it’s a life-threatening contagion. That’s a lesson Samoa has learnt in the most agonising manner imaginable.

This editorial was first published in the December 14, 2019 issue of the New Zealand Listener.