Having the ability to save a life is a specialised skill and takes many years of training for doctors, nurses, and health workers generally.

This is why the salaries of health specialists such as doctors take up a large chunk of the national budget, regardless of whether it is in Samoa or any other Pacific Island nation for that matter. The demand for their services is currently on an upward trend with the poor health status of many Samoan citizens becoming an added burden on the country’s health infrastructure as well as its personnel. 

It is the main reason why the Government’s health bill continues to increase. In May last year, the 2022/2023 annual budgetary appropriation for the Ministry of Health (MOH) eclipsed SAT$140 million, which was $14 million more than the budgetary allocation from the previous financial year. 

Unfortunately, while the country’s health budget continues to increase annually to reflect the enormity of the health challenges we face as a nation today, the same cannot be said for the remuneration of the country’s health workers despite rising demands for their life-saving services.

An article (More nurses join fire services) in yesterday’s edition of the Samoa Observer was a stark reminder of the challenge that faces the Ministry of Health (M.O.H.) and how it can get to retain health workers such as nurses without losing them to another Government entity.

According to the article, nine registered nurses who previously worked for the M.O.H. were recently recruited by the Samoa Fire and Emergency Services Authority (SFESA) as paramedics. SFESA Commissioner, Tanuvasa Petone Pauga confirmed to Samoa Observer that since the latest advertisements by the authority for new paramedics, their numbers have increased to 10. Previously, the authority only had one qualified paramedic.

"The only paramedic we had was the son of Samoa who graduated from overseas and worked for us but we managed to obtain others through the advertisement we did recently. So we now have 10 paramedics," he said.

"In terms of the job as a paramedic, it needs people who already have the skills and knowledge as also stated in the criteria of the advertisement. All the new paramedics are registered nurses from the hospital although the advertisement was open for anyone other than nurses, with the qualifications."

Congratulations to Commissioner Tanuvasa, on the recruitment of the nine registered nurses. Their addition to the authority’s staff roster will lessen the pressure on the authority’s sole paramedic, and more importantly, result in the saving of more lives under their care during the emergency run to the hospital. It was a strategic move by Commissioner Tanuvasa, no doubt, as an increasing country population translates to more demand for ambulance services which then justified the need to recruit more paramedics. He also confirmed that being a paramedic pays more than what a registered nurse normally gets working for the M.O.H.

Therein lies the challenge. Can the national health system managed by the M.O.H. afford another exodus of health workers like nurses or even doctors to another organisation outside the confines of a public hospital? 

It is worrying that close to 10 nurses chose to leave the Ministry for greener pastures at this time, especially with a measles outbreak right at our doorstep in American Samoa, coupled with the struggles that the M.O.H. staff are currently facing to contain the spread of the influenza-like flu over the last two months.

Wouldn’t the Ministry have moved quickly to negotiate with the nine nurses on better salaries and working conditions to avoid creating gaps in the level of service and interventions that the public health system is able to provide for patients?

Losing one nurse to another organisation is probably manageable, but to see nine of them leave the M.O.H. in one go, should immediately set off the alarm bells at the Ministry, and warrant intervention from the executive management.

But this “brain drain” phenomenon of specialist health workers leaving Samoa’s public health system for greener pastures, either locally or abroad, is not new. It has been an ongoing issue for Samoa’s M.O.H. for a long time, going back some 20-plus years or so according to former staff.

The solution is in the Ministry’s annual money plan or budget and putting in a request to the Government of the day to specifically allocate more funding to increase the salaries of Samoa’s health workers including doctors and nurses. The proposed pay increase is commensurate with experience. This would be the obvious solution to rectifying this issue once and for all.

We acknowledge the recent initiative by the current Health Director General, Aiono Dr. Alec Ekeroma to get Publish Service Commission (P.S.C.) and the National University of Samoa (N.U.S.) approval for health specialists, who are currently teaching at the university’s Medical School, to work part-time at the national hospital. 

But that is a short-term fix for a human resource problem that has existed for a long-time. An efficient and able healthcare workforce is critical to the success of the nation and it is time for a long-term solution.