Apia SAMOA — In Samoa families are increasingly choosing to send patients to India or Fiji rather than New Zealand to avoid high medical expenses.

I presented and compared the costs of New Zealand and India and for example, a cardiac lesion, it would cost only US$7000 in India, but I think it's around US$15,000 in New Zealand," Dr Farah Fatupaito, the head of Paediatrics at Tupua Tamasese Meaole Hospital in Apia said.

"So the cost to have treatment or surgery in India is very cheap. It's okay for the children because the government will pay for the caretaker or the parents [who go]."

To tackle these challenges, Samoa has launched the Manu app, a digital health record system designed to improve patient follow-ups.

The previous reliance on paper records often led to lost incomplete information, disrupting consistent care.

"With the app, it's easy for doctors to access patient information," Fatupaito said. "If this child didn't get their penicillin shot, they can actually see that."

This system is expected to support programs like rheumatic fever prevention, which include school screenings and monthly penicillin injections.

The recent case of whooping cough in Samoa involving a seven-month-old infant highlights the critical importance of immunization.

However, vaccine hesitancy remains an issue, stemming from past events.

Despite this, Fatupaito remains optimistic.

She highlights the syndromic surveillance system established after the COVID-19 pandemic, which enables health authorities to contain outbreaks quickly.

"We are very aware and diligent about these kinds of things so that we can control them," she says, drawing lessons from past epidemics like measles.

Building public trust within Samoa is also a key priority.