There have been an alarming number of deaths in Samoa from measles (38 and rising). This is an absolute tragedy. For such a small population, how come the death rate has been so high? Low rates of immunisation do not fully explain this high rate of mortality and it never will. There is more at play than the experts are telling us.
Once the crisis has ended, let's think about the root causes as to why Samoa is suffering this devastatingly high death rate and deal with them.
I'll start this conversation with some travel pictures. Alofa and I have the goal of cycling the main islands of every Pacific Islands state. So far we have cycled Samoa, Tonga, Niue, Vanuatu and Fiji. We have also done Bali. All of these islands, bar Niue, have one thing in common and that is poverty and corruption, sometimes abject poverty.
So, what has this got to do with measles?
When you travel the islands by bicycle and make a point of living with the natives you see, time and again, the displacement of native populations by foreign tourist developments and farming operations that take over the best arable land and reef. Young men and women leave the villages and congregate in the towns seeking a better life. Traditional ways of living, including food production and food preparation, are being seismically disrupted.
The displacement and impoverishment of native populations are best seen in the dramatic way that food has changed in just a few generations. Traditional foods such as whole fish, seaweeds, shellfish, crabs, coconut, taro and breadfruit have been displaced by white rice, flour, soft drinks, sugar, margarine, pork belly and, of course, KFC. Diseases of "modern day malnutrition" are now rampant in the islands. Tooth decay, obesity, thyroid disease, diabetes, heart disease and arthritis to name some.
Poverty in the Pacific Islands suits New Zealand and Australia. Without having thousands of desperately poor people on our doorsteps who else is there to do our seasonal labour-intensive and back-breaking horticultural work in places like our vineyards and orchards? New Zealand and Australian workers won't do it. It is hard labour, repetitive, weather-dependent and sometimes isolated. The pay is so little per hour and unreliable that nobody in their right mind will do it. Pacific Islanders will do it because they are desperate for any kind of work. They'll do it for next to nothing. Seasonal labour from the islands enables New Zealand and Australia to cheaply produce food and wine to sell to rich consumers. If there was no poverty in the islands our horticulture industry would be in trouble. Food prices would climb while export profits would decline.
With this displacement and impoverishment of island populations comes things like overcrowding, poor sanitation and malnutrition, sometimes affecting thousands of natives on a single island. Alofa and I have seen plenty of it. This produces the perfect conditions for the transmission of diseases such as typhoid and measles.
According to the World Health Organisation, " The impact of malnutrition on Samoa, and particularly on the children of Samoa, is shocking. "
Read more about what the World Health Organisation has to say about the conditions in Samoa to understand why measles has gone like wildfire through Samoa and why it has killed so many (You don't see these things in the travel brochures do you?):
In New Zealand, as with the islands, diseases like measles and their worst impact are closely related to poverty, hence the current measles outbreak in New Zealand is mostly confined to places and ethnic populations with the lowest socioeconomic status, like Polynesian people living in South Auckland. Refer here: https://surv.esr.cri.nz/PDF_surveillance/MeaslesRpt/2019/WeeklyMeasles25112019.pdf
Rather than deal with the root causes our Pacific neighbours must now add expensive vaccines to their list of imports of flour, sugar and KFC. They have no choice because the horse of disease has already bolted. But once the outbreak has been contained how about we deal with the root causes? I doubt we will see any changes. The changes we need are not good for business: not good for our horticulture industry and not good for selling highly processed junk foods into the islands.
I do not blame our famers for this, I blame the economic system that has us trying to compete with countries that care little for worker welfare or their families. We are trapped in a race to the bottom, especially when it comes to agricultural production. For my entire adult life I have been hearing our leaders telling us workers that we must be more productive. It is never-ending and we are all working harder than ever and for what? For me, this flogging of the message to improve productivity is code for meaning that we have to work longer and harder for even less than ever.
Healthy, well-nourished individuals within healthy populations get a disease, they resist it, they kill it and they become even more robust in readiness for the next invader. This is not the case for Samoa and not for South Auckland.
If we are really serious about promoting good health then we would be doing much more to address poverty in all of its forms - and the exploitation that goes with it. Not just here in New Zealand but also in our Pacific neighbourhood.
For more reading about how to protect your family from measles and other viruses, in addition to vaccination, here is some reading that I have prepared for you:
Currently, there is not a vaccine for poverty.
Oh, and about the myth that measles can give you immunity amnesia?
Vaccines are wonderful but not on their own. Instead of this idea that good health can come from a single technology in isolation of other factors such as malnutrition, overcrowding and poor sanitation is bonkers. It serves only to increase the wealth and power of those who profit from ill health and social inequality.
Here is some more reading on the topic of nutrition in the Pacific Islands: