DOH has been dysfunctional for long time, says doctor

Fono hears from Manu'a physician on state of health clinics

Department of Health is rotating physicians from Tutuila for clinics in the Manu’a island group after the resignation last month of Dr. Malouamaua Tuiolosega, who told lawmakers that the department has been “dysfunctional for a long time”.

House Health/LBJ Committee committee Rep. Pulele’iite T. Liamatua called a hearing Tuesday morning based on a request from House Vice Speaker Fa’afetai Iaulualo, who revealed last week that the only physician based at the Ta’u Clinic, who has also overseen the clinic on Ofu island since 2009, has resigned from DOH.

Although he has resigned from DOH, Tuiolosega said his service is still made available to residents of Manu’a in need of medical care. He works from his own office on Tutuila. He explained that many times there were requests to the main DOH for supplies and other needs that went without a response.

For example, he said a request for half a million dollars was made to DOH as matching funds for a federal grant, with no response. He also requested financial support to fix the air conditioner, as well as well as make some repairs to the morgue, but there was also no reply from the DOH main office.

He also shared with the committee other problems faced by the clinics on Ta’u, which was officially opened more than four years ago, as well as Ofu. Among them, lack of additional physicians and nurses, no set budget to operate the two clinics and no vehicle for use in Manu’a.

While there is no vehicle on Ofu, there is one for Ta’u, but Dr. Tuiolosega testified that it is in need of major repairs, because many times the vehicle died on the road. He also said the vehicle does not make it up the hill from Tau to other villages. The doctor said there is just one representative for Emergency Medical Service, but no ambulance.

He said most of the time, he borrows someone else’s vehicle on Ta’u or uses his bike, which is also his mode of transportation upon arrival on Ofu. And when there is no other choice, he walks to visit homes of patients needing assistance. 

Tuiolosega informed lawmakers that medication ordered from California is now at the Ofu clinic and there are major U.S. companies that provide medication who have offered their assistance to work with him to improve health services and needs for the Manu’a islands.

Responding to questions from the committee, Tuiolosega described DOH as “dysfunctional” for a long time and among the functions that he suggested to be carried out is for DOH to conduct a full inventory. Additionally, there is a need for people who can do the job and who understand the job. He believes that a lot of money is allocated to DOH.

He said Manu’a Island residents are the “most underserved” in the territory and the reason he first decided to return home and be based in Manu’a.


More than an hour into Tuiolosega’s hearing, the DOH deputy director Elizabeth Ponausuia arrived at the House chamber although she was scheduled to testify before the same committee early Tuesday afternoon.  From the House gallery Ponausuia, who is also acting DOH director, heard some criticism by Tuiolosega.

Since she was already at the House gallery, Ponausuia was called before the committee after Tuiolosega’s hearing was completed and the U.S. certified physician had left the House chamber.

At the outset of the hearing, Ponausuia dismissed claims by Tuiolosega that there is a problem with the care provided by DOH for residents of Manu’a. She said the clinics in Manu’a are good and the service is also good.

She also claimed that Tuiolosega didn’t take care of the clinics in Tau and Ofu as well as the offices there, or the living quarters used by DOH staff in Manu’a and this includes living quarters used by Tuiolosega.

Responding to committee questions, Ponausuia said her last visit to Manu’a was last month and she had a chance to meet with Tuiolosega to discuss various issues including DOH service for the island group.

During this visit, she said Tuiolosega gave her a list of what’s needed in Manu’a and upon her return to Tutuila, she responded right away with a shipment sent by ocean transportation. She told the committee that not one time did Tuiolosega ever mention any problems in Manu’a, except during Tuiolosega’s testimony before the committee.

Additionally, she said she was not aware that Tuiolosega was preparing to resign and was surprised when she received the letter of resignation.

Iaulualo questioned the witness on the status of the morgue, which Ponausuia said is operational. Iaulualo said the Fono approved $30,000 to improve the morgue under the current fiscal year budget and wanted to know what happened to that money.

Ponausuia replied that DOH has no idea where it went, as they have already asked the ASG Budget and Planning Office, whose director Malemo Tausaga replied there is no money in the budget.

Iaulualo, who was not happy with the response, requested Ponausuia to immediately contact Malemo again to give the $30,000 to DOH for the morgue. Iaulualo said Malemo cannot say there is no money, when it was budgeted in FY 2012, which officially ends in less than two weeks.

Iaulualo said he is deeply saddened with the way DOH is treating the Manu’a island group when it comes to health care services. He also said there is no car in Ta’u and he has personally witnessed Tuiolosega  actually walking to homes of residents to provide services.  Iaulualo asked if the witness is using a government vehicle and the reply was yes. Iaulualo said this vehicle should be used in Manu’a.

Without a physician based on Manu’a, the DOH deputy director says physicians from Tutuila are now being rotate to the island group. For example, it was yesterday that another DOH physician was rotated to Manu’a.

Responding to other questions from the committee, Ponausuia said most of the time Tuiolosega does not contact the main office on things needed in Manu’a but instead makes his own decisions on issues that should first be discussed with the DOH main office.

For example, she said Tuiolosega would order medical supplies and medication from LBJ without consulting her office. She also claimed she made efforts to contact Tuiolosega via phone or email regarding certain issues in Manu’a but received no response at all.

At the end of the hearing, lawmakers urged DOH to do more to help the Manu’a islands and not ignore their needs. They pointed out that there is no hospital in Manu’a and therefore their needs must be addressed as soon as possible.


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