Posted by Eleanor Green and John Green
As part of the collaboration with the Dreyfus Health Foundation (DHF) of The Rogosin Institute and the Pacific nursing project (Pacific Islands Network of Nurse Education Directors/PIN6 Synergy Initiative), we traveled to Hawaii and American Samoa in early July on behalf of the University of Mississippi Center for Population Studies (CPS). The objective of the trip was to meet with current partners, learn about their communities and tour facilities, as well as explore future collaborative opportunities. We investigated the ways in which the CPS can be of assistance to the work in American Samoa, and we discussed what we can learn from American Samoa and apply to our work in Mississippi. Additionally, we learned about nursing education and community engagement efforts taking place through the American Samoa Community College Nursing Department.
During our layover in Hawaii, we had a very productive dinner with Clifford Chang, Director of the Pacific Islands Primary Care Association (PIPCA). Over an introduction to great sushi by Mr. Chang, we discussed the health clinics associated with PIPCA throughout the Pacific, especially the ones located in American Samoa. Further, we introduced him to the DHF’s Problem Solving for Better Health (PSBH) Model and discussed its potential application in the Pacific.
While in Hawaii, we also met with our friend and colleague Cathy Wasem of the U.S. Public Health Service to discuss our current partnership with the PINNED/PIN6 Synergy Initiative. We also had a great breakfast while overlooking the ocean.
We landed at the Pago Pago Airport in Tutuila, American Samoa late on a Monday night, greeted by Lele Ahmu, Chair of the Nursing Department at American Samoa Community College (ASCC). She brought us beautiful lei’s made from the mosooi tree. Lele told us that traditionally lei’s made from this important Samoan tree were used to attract palolo (sea worms). She said that they are delicious sautéed with butter and onions!
The next morning began with a meeting with Motusa Tuileama Nua, Director of the Department of Health, along with other staff from the Department and Lele. We discussed the purpose of our visit to American Samoa and the possibilities for future collaboration. We then toured Lyndon B. Johnson Hospital, meeting several physicians and spending time with two nurses who are also adjunct faculty at ASCC.
After a wonderful meeting over a lunch of locally caught wahoo at a restaurant named Sadie’s by the Sea, we drove to Amouli Community Health Center (ACHC), one of three health clinics on the island. A community health assistant at the clinic gave us a tour of the facility and we learned about the services offered at the clinic. These services included basic medical care and well visits, dental health, nutrition, breastfeeding, and WIC assistance. After visiting the clinic, Lele took us on a driving tour of the eastern villages to see the communities that were served by the ACHC.
We began the next day at a breakfast meeting with Lele at Don’t Drink the Water Café where a delicious breakfast made with local fresh bananas was served. After eating, we went to the Government Executive Building to meet with Mine Timeto, Senior Administrative Assistant in the Statistics Division of the Department of Commerce – a Data Center for American Samoa similar to our program in Mississippi. We discussed the American Community Survey and other data sets we had in common and the different applications of that information by The Center for Population Studies and her department. Additionally, we met other staff with the Department of Commerce, including Leifiloa Tanoi.
Our next meeting brought us back to the Department of Health. After hearing about the New Pathways to Health Initiative working with youth in the Mississippi Delta, Director Nua asked John to return to present to the youth interning with the Department of Health for the summer. Nineteen people, including youth, attended the presentation, during which John asked the students “What is a public health problem in American Samoa?” Their answers could have come from youth in Mississippi – “Obesity, HIV/AIDS.” The presentation focused on the importance of interdisciplinary perspectives, interprofessional teams, and leadership.
After the presentation, we headed to another health clinic on the island, Tafuna Family Health Center. There we met with the Ofeira Nu’usolia, Director of the Center. She gave us the history of the organizations and discussed the services provided, which closely mirrored those services available at the Amouli Community Health Center.
Thursday was the United Nations World Population Day and we headed to the Rex H. Lee Auditorium in Utulei for a commemoration in the form of a Policy Workshop to contribute to the Territorial Population Policy Plan (TPPP). The theme of the meeting was “Managing Change to Create a Better Future.” As the University of Mississippi team, we were welcomed into the group focusing on Reproductive Health during the breakout sessions. Our group was moderated by the Family Planning Director at LBJ Hospital and a representative from the Department of Health. Each group worked to draft priorities to be included in the TPPP. We zeroed in on three items to be addressed in the (TPPP): health education as a mandatory subject required for graduation in k-12, data sharing among agencies, and the empowerment of women. The meeting ended with a meal featuring traditional local dishes.
That afternoon, we met Lele at ASCC to tour the Nursing Department. After a tour of the facilities and meeting several students the three of us headed out to visit the western villages of the island and tour the remaining health clinic, Leone Community Health Center. The clinic offers the same services as the other two clinics on the island and serves the western portion of the territory. During the drive, John and Lele discussed some ideas concerning projects and student connections between ASCC and UM. As Lele has been using a variant of the Dreyfus Health Foundation’s Problem Solving for Better Health (PSBH) model with her students, she filled us in on the success of their projects and discussed the possibility of a PSBH workshop with health partners in American Samoa. Additionally we discussed bringing a group of University of Mississippi students to the island to partner with her students on a project. This is an ongoing discussion and we will continue that communication and develop some specific next steps.
Our visit ended as it began with one last meeting with Director Nua to discuss the results of our visit to America Samoa and how we might partner in the future. Lele then took us to the market, as is her Friday tradition. On this night villages come to the market with dinner items they have prepared to sell. We had “vaisalo,” which is a soup-like or pudding dish made with coconut milk, coconut meat, and tapioca and cooked together for a long period of time. Another similar dish we had was, “suafai” composed of coconut meat and milk, banana pudding, and ripe banana. To accompany these soups we had “panikeke” which is a Samoan pancake similar to what we know in the Southern U.S. as a beignet. We then headed to the airport for a night flight. As the airport is for the most part open-air, Lele was able to stay and visit/work with us for several hours to debrief over the trip and plan for the future.
We left American Samoa reflecting on it having been one of the busiest and most productive trips we have ever made to a new place. Lele and all of our American Samoan friends welcomed us with open arms and provided us with detailed information and rich experiences. Who could ask for more?