Standard Procedures Should Be Established
August 31, 2015
First and foremost, I want to offer my sincerest and most heartfelt condolences to the families of Lydia Fataua and Klement Pua'auli. As a mother and grandmother, I cannot imagine the pain and grief that parents must suffer when standing by helplessly while a child slips away to be with the Lord. A parent outliving their child is heartbreaking beyond comprehension. I know I speak for our entire community when I express the depth of my own sadness and know that we all hold these children in our hearts and prayers during this difficult time.
Although my office was contacted only in the late stages of these children's unique and separate illnesses, I am not certain my efforts to identify an aircraft for evacuation would have been sufficient in view of all the other legal and practical issues that had not been resolved in advance.
There was a question of visas for resident alien parents, identification of physicians with the necessary medical specialties at medical facilities that would accept the cases, insurance coverage, stateside residency requirements, guardianship, financial liability and much more.
Time simply ran out.
These children will not have passed in vain if it leads to the establishment of standard procedures that must be followed in future emergencies of this kind. These considerations should include developing a catalogue of medical facilities and specialists who can be contacted and who will expedite approval of accepting our patients when the need arises.
We should not limit ourselves to Hawai'i and the Mainland, either. It is possible some patients can get the needed care in Australia, New Zealand or even the Philippines. Permanent residents with Samoan citizenship may find an easier path to treatment in New Zealand. A government review must include other issues such as those I have addressed above, including travel paperwork, financial responsibility, legal liability, residency requirements and availability of transportation, facilities and medical personnel.
As helpful as I hoped my staff and I could be, at the end of the day, emergency medical evacuation and care is a government-to-government or government-to-institution matter, meaning the ASG executive branch authorities to counterpart federal, state, or county authorities, or private medical institutions.
For my part, I made it a point in Hawai'i last week to raise this question directly with the Commanding General of the Army's Pacific Regional Medical Command and the Commander of the U.S. Pacific Command. Both assured me their staffs would work with the American Samoa Government to review procedures and policies for seeking approvals when it may involve the engagement of military equipment or facilities.
I know the Fono has taken a deep interest in this issue and will be examining ASG procedures and policies to see if new local legislation and funding are needed to make sure we can avoid these kinds of situations in the future. After the Fono and ASG reviews, if I am advised that there is also a need for new federal legislation to implement off-island emergency medical care, I will do my best to see that it is enacted.
Finally, I want to thank Dr. James Marrone, the LBJ Chief of Pediatrics, who worked so heroically to save the lives of these children and made such determined efforts to secure a medical evacuation; the other doctors and nurses who were so tirelessly involved in the children's care; my own staff who worked closely with the military to secure an airlift and the military officials who worked to find ways to accommodate our requests; the officials at a number of stateside hospitals who were trying to find ways to accept these young patients; and the Samoan families living in the states who were willing to shoulder legal and financial responsibilities for the children once they arrived.
Let us strive together to bring some light from this darkness.
Aumua Amata
Member of Congress
Although my office was contacted only in the late stages of these children's unique and separate illnesses, I am not certain my efforts to identify an aircraft for evacuation would have been sufficient in view of all the other legal and practical issues that had not been resolved in advance.
There was a question of visas for resident alien parents, identification of physicians with the necessary medical specialties at medical facilities that would accept the cases, insurance coverage, stateside residency requirements, guardianship, financial liability and much more.
Time simply ran out.
These children will not have passed in vain if it leads to the establishment of standard procedures that must be followed in future emergencies of this kind. These considerations should include developing a catalogue of medical facilities and specialists who can be contacted and who will expedite approval of accepting our patients when the need arises.
We should not limit ourselves to Hawai'i and the Mainland, either. It is possible some patients can get the needed care in Australia, New Zealand or even the Philippines. Permanent residents with Samoan citizenship may find an easier path to treatment in New Zealand. A government review must include other issues such as those I have addressed above, including travel paperwork, financial responsibility, legal liability, residency requirements and availability of transportation, facilities and medical personnel.
As helpful as I hoped my staff and I could be, at the end of the day, emergency medical evacuation and care is a government-to-government or government-to-institution matter, meaning the ASG executive branch authorities to counterpart federal, state, or county authorities, or private medical institutions.
For my part, I made it a point in Hawai'i last week to raise this question directly with the Commanding General of the Army's Pacific Regional Medical Command and the Commander of the U.S. Pacific Command. Both assured me their staffs would work with the American Samoa Government to review procedures and policies for seeking approvals when it may involve the engagement of military equipment or facilities.
I know the Fono has taken a deep interest in this issue and will be examining ASG procedures and policies to see if new local legislation and funding are needed to make sure we can avoid these kinds of situations in the future. After the Fono and ASG reviews, if I am advised that there is also a need for new federal legislation to implement off-island emergency medical care, I will do my best to see that it is enacted.
Finally, I want to thank Dr. James Marrone, the LBJ Chief of Pediatrics, who worked so heroically to save the lives of these children and made such determined efforts to secure a medical evacuation; the other doctors and nurses who were so tirelessly involved in the children's care; my own staff who worked closely with the military to secure an airlift and the military officials who worked to find ways to accommodate our requests; the officials at a number of stateside hospitals who were trying to find ways to accept these young patients; and the Samoan families living in the states who were willing to shoulder legal and financial responsibilities for the children once they arrived.
Let us strive together to bring some light from this darkness.
Aumua Amata
Member of Congress
Issues:Healthcare