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OP ED: Tamaseugogo #5

Once the iconic face of LBJ Hospital, Dr. Saleapaga is unwanted

The old adage “The graveyards are full of indispensible men” has claimed its latest victim in the territory; and he is none other than our beloved “Tamo”, as the popular Dr. Iotamo Saleapaga is known. The unassuming affable doctor was handed his walking papers by his employer of forty years — LBJ Tropical Medical Center — unceremoniously. 

What had transpired within the confidential confines of an LBJ conference room or office immediately filtered its way out to the public; culminating in a closed door Senate Health Care committee hearing held last week, where the senators decided it best to leave the matter to the proper authorities (after getting the “inside scoop” of the CEO’s report). 

The immediate reaction of many to the news of Tamo’s sudden unemployment status was that of sympathy for the doctor who not long ago lost the love of his life, his wife Samalaulu Saleapaga, prematurely. The “Why” question followed to which information varying from general to specific were rumored — all painting a reputation un-bespoken of the invaluable service this man has unselfishly given to the territory since 1972.

Born and raised in Ofu and Faleasao of the Manu’a Islands, Tamo distinguished himself as the first and probably the only American Samoan who received a US medical degree without attending a four-year college, a two-year even. The territory needed doctors in the mid 1960s, and Tamo answered the call; he applied and was accepted to the Fiji School of Medicine (FSM) after graduating from Samoana High School in 1966. 

He returned and served the territory as a physician after graduating from FSM until the territory called once more, this time for US trained doctors. Tamo again raised his hand and relocated to Hawaii so to attend the University Of Hawaii School Of Medicine, where he applied and was accepted, in 1973. While completing his UH medical school program, Tamo worked at LBJ for three months during the summer breaks. He graduated and completed the necessary residency requirements and returned to serve the people he was called to serve in 1982 until Tuesday, last week, October 2, 2012.  

As reported by the media, Tamo found the door to his office locked, on Tuesday, last week, and was told in the presence of his patients by the LBJ CEO that he no longer worked at the hospital. I understand he was informed if he didn’t leave then, he would be escorted by security off the premises — premises where he had worked or administered for forty years. Perhaps for the last time, Tamo bowed out as he was told. 

It appears the indecisiveness of the LBJ board of directors led to the blunt implementation — worthy of a common criminal — by the LBJ CEO of Tamo’s contract non-renewal. Whether the non-renewal is justified or not, we don’t know and perhaps we will never know; unless Tamo takes the matter to the next level to clear his name and reputation if it is shot by the CEO’s report. 

I know however that LBJ is short of doctors, and the humiliation suffered by one of, if not the longest serving doctors in the history of the territory was uncalled for. It didn’t need to happen in this way. A private meeting among parties concerned to convey the non-renewal message would have been appropriate. Tamo paid his dues in this territory by serving his people and deserved professional treatment and common decency.   

As a member of the LBJ board from 1997 to 2005, and perhaps one of Tamo’s fiercest critics, I have come to realize how committed this doctor is to his calling in his own way; and respect his wisdom as a long term public servant. Having being exposed to the British medical school system (FSM) and the American system, he warned us (the board) at the time not to tinkle with the FSM pipeline in place. That is, for ASG to continue to send our medical students to FSM as that is the most successful feeder school to LBJ Hospital in terms of cost, hiring, and retention.

Instead, we yielded to public pressure and the high demand for US trained doctors. This effort didn’t pan out as hoped for because the government of American Samoa does not invest adequately in its scholarship program as it should (ASG’s 2013 budget cut $500 thousand of the proposed scholarship fund); and LBJ just doesn’t have the money to invest in its prospective work force (nor is that LBJ’s responsibility). The few local students the LBJ Hospital Authority struggled to assist financially at the time decided not to work at LBJ Hospital upon completion of their medical schooling and residency in the states. In retrospect, we should have heeded Tamo’s wise advice.

Further, under Tamo’s tenure as Medical Director, the post graduate program, spearheaded by Dr. John Ah Ching, was established with the University of Auckland Medical School in New Zealand for our FSM graduates to pursue graduate diplomas and masters degrees in their specialized fields of study.  Unfortunately, this program discontinued due to lack of funding.

The service and hard work being delivered by Dr. Ledua, Dr. Kumar, Dr. Kama, Dr. Oo (FSM professor before being hired by LBJ) and all the local doctors of FSM affiliation is testament to Tamo’s strong but unheeded position on the value of FSM relative to US medical schools to LBJ Hospital, in terms of where to send our medical students.

Moreover, the above mentioned doctors have all done their post graduate certifications in New Zealand or Australia; with Dr. Ledua who recently sat and successfully passed the US board examinations and certifications.

This is the strong message Tamo has been preaching since 1997, which we awoke up to later (but the FSM pipeline had already been broken) and included in our “Coverage for All in American Samoa” report given to the governor and Fono in 2007. That is to re-initiate the FSM pipeline and start investing in our students adequately and by instituting the US board certifying exams in the FSM program where appropriate; and requiring these students to serve at LBJ Hospital for a certain number of years commensurate with the investment made in them.

LBJ Hospital is understaffed and the current staff is overworked — affecting the quality of service, thus people suffer. The message to the next governor and Fono cannot be any clearer: “Do something about it; heed Tamo’s sage advice as stated above.”

Tamo is one of the “Lupe o le Foaga” (pigeons of the nest) the late Mariota Tuiasosopo had envisioned to return and serve the territory. Tamo never considered lucrative opportunities in the states as he was qualified to pursue but stuck to his calling — to serve his people for as long as he was capable. 

That said, I have no reservation in calling out the LBJ board of directors and management to do right by this long serving public servant.

If the non-renewal is the right call according to the rules and regulations of LBJ Hospital and you stand by it, then man up and inform Tamo face to face in a private meeting with the utmost respect; and allow him the time and space to address the reasons behind your decision. 

Dr. Iotamo Saleapaga from the Manu’atele deserves nothing less.

God bless.



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