Combating measles in Samoa

In 2019, a devastating measles epidemic hit Samoa; thousands were infected and hospitalised. In a bid to stop measles in its tracks, New Zealand sent a team of vaccinators, administrators and ICU specialists to support Samoa’s own health response. Project manager Leilani Jackson was one of them.

Leilani Jackson was raised in a Samoan family dedicated to service and healing. With a sister who passed away from rheumatic heart disease and a minister's wife for a great-grandmother, Leilani was surrounded by people attending to the physical and spiritual needs of the community and her whānau when growing up. Generations of her forebears were traditional healers.

“I was always very health conscious because of my family,” says Leilani. “My grandmother and great aunties were traditional healers; my mum was a president of Red Cross, and my uncle was an anaesthetist. When my sister was ill, we were constantly back and forth to the hospital and that made me want to be a doctor, but educational opportunities were limited on Savai’i; there was no physics, no chemistry, just biology – and that wasn’t enough for a scholarship in medicine.”

Instead, Leilani studied nursing and physiotherapy, moving to New Zealand in 2010. It was here that she realised that to really make a difference to people’s health, it was communities rather than individuals that needed attention. “For me, bedside nursing was the end-product of inequity, of a lack of resources and a lack of engagement about health. The person I nursed in front of me would most likely go back to old habits when we sent them home. I wanted to change that, so I took a role in care coordination for Pacific cancer patients and communities. That was the push that pulled me into this work – a desire to help more than just one person.”

Long days for Leilani’s team comprised 5am starts and 9pm finishes. Vans would set off to villages with a driver, a policeman, a data processor and two or more vaccinators. “The policeman would have a loud hailer announcing their arrival. The vans would stay out as long as possible – if we didn’t get people then, we wouldn’t have another chance."

Collaboration was important to Leilani, who said differences in processes and practices between the New Zealand and Samoan teams provided learning opportunities for everyone.  “We weren’t there to judge or have opinions. Where we saw opportunities to teach, we took them. It was important to remember that we were there today and gone tomorrow. If we could make a positive impact and encourage small changes, that was something to be grateful for. A few of our nurses commented that they ‘get it now’ – the way people live – the communal, intergenerational living in Pacific homes. There was a reciprocity of learning.”

Tragically, a relative of Leilani’s aged only 37, died from measles while she was there. “That was a real low point for me. We were working so hard to prevent that very thing from happening. The benefit – if you can call it that – of the measles outbreak in Samoa, is that people are now aware of the vital importance of vaccines."

This awareness helped Leilani in her next role coordinating the training of vaccinators for the Pacific roll-out of the New Zealand-donated Covid-19 Pfizer vaccine.

“Measles gave way to collaboration between nations and government ministries. This was great preparation for Covid-19. Being able to go back and help in my own community, working collegially, were high points for me. We boosted morale and made the most of learning moments for all."

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"It’s natural for nurses to want to help and that’s what we did.”

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