2022  MCH Emergency Planning and Preparedness:

American Samoa has continuously experienced various public health emergencies in past years, including natural disasters along with disease outbreaks and pandemics. Title V program is often called to provide leadership and support in delivering critical MCH services during these emergencies, assisting local communities to respond to emergency threats and needs. This also provides opportunities for MCH leaders to contribute to emergency plans that are conducive and appropriate for MCH populations.  Past natural disasters included the 2009 Tsunami, various tropical cyclones such as Hurricane Val and Gita. All produced catastrophic results; displacing many families from their homes; lives lost; businesses, plantations and government buildings damaged. American Samoa also experienced major disease outbreaks. Within the past 8 years, AS has faced a Zika outbreak in 2016, Dengue outbreak in 2017, Measles outbreak in 2019, COVID-19 pandemic in 2020-2022 and most recently the local measles outbreak declared 2023.

MCH’s role during these past emergencies extended from risk communication and community engagement, data surveillance, care coordination, community needs assessment, and supporting health outreach projects. MCH Title V continues to be proactive in the territorial emergency preparedness planning and coordination with partners during disease outbreaks and assist in mitigating preventive and control measures to ensure the needs of its MCH population are identified and addressed. This was exercised throughout the COVID vaccination outreaches during 2021-2022 as MCH staff prioritized pregnant women and all children in American Samoa regardless if they were not clients.

The Department of Health Emergency Preparedness and Response Division (EPRD), formerly known as the Public Health Emergency and Preparedness Program (PHEP), conduct quarterly meetings with its Healthcare partners to review and update the State Emergency Operating Plan (EOP) when there is no emergency. During an emergency, healthcare partners meet monthly to review and report on lessons learned, plan for and conduct drills and tabletop exercises to improve emergency response and mitigation plans. The purpose of the Healthcare EOP is to outline standard operating procedures on how to mitigate public health and medical assistance in response to a disaster, emergency or incident that may lead to a public health, medical, behavioral, or human service emergency.

The MCH Title V has a responsibility to review and provide recommendations to EPRD on their EOP depending on what type of public health incident it may be. Natural disaster EOP does address at-risk and medically vulnerable pregnant women, infants and homebound population. Mostly to ensure they are evacuated to adequate shelters if needed and also to ensure they have basic needs such as medication, water and food.

Title V does not play a role in the Incident Command Structure unless populations affected are women and children such as the Zika Outbreak. The MCH Title V Program Directors acted as the Media Liaisons for DOH during the COVID-19 response due to their with Risk Communication and Community Engagement experience during the previous Zika and Measles Outbreak. This opportunity also places MCH populations as a priority in all communications pushed out as a response to these emergency situations.

The MCH Title V continues to be part of the EPRD’s healthcare partners and their quarterly meetings. This will ensure opportunities for having close-up involvement in the planning and development of the State’s EOP. The Title V leadership was never included in past emergency preparedness planning before a disaster but is actually brought in for consultation once the UHC is activated.

Based on ongoing public health and Title V program needs assessment efforts and lessons learned from previous emergency responses such as Zika, the Measles outbreak, and the COVID19 pandemic, critical gaps in emergency preparedness and/or surveillance data were identified and addressed. Best practices from lessons learned and recommendations made in past disasters are now being utilized to produce favorable outcomes during the COVID-19 pandemic response. The territory presently has a team of 3 Epidemiology personnel in American Samoa who contribute to surveillance monitoring and are instrumental in providing timely data. Actively utilizing the Pacific Syndromic Surveillance data reports enable American Samoa to contain the Measles outbreak with no fatalities, close its borders early, and boost its vaccination coverage across the islands. Revised EOP and lessons learned from these responses continue prevent extreme situations during emergencies across the territory.