Pago Pago, AMERICAN SAMOA — Senators were not satisfied with the mortality rate information provided by the LBJ Hospital officials during the Senate Health Committee hearing last Thursday claiming it was too difficult to understand, and they have requested a more detailed list in another hearing to be announced later.

Testifying were LBJ CEO Dr. Akapusi Ledua, CFO Sefanaia Kaumaitotoya, Acting CMO Dr. James Sunia and LBJ HR Director Stanley Iakopo.

Dr. Ledua had gathered statistics of the number of deaths from 2020 to the end of June 2024, which he read out.

According to Ledua, the number of deaths from 2020 to December, 2023 ranges from 330 to 406 per year, and up to the end of June 2024, the number of deaths recorded is 193.

The breakdown of the deaths point to 50% of patients dying in the hospital while the other 50% were pronounced dead on arrival, which means they either died at their homes or communities, or on the way to the hospital.

And, looking at the crude death rate or the number of deaths from any cause, it is divided by the number of the population of a community per 1,000 or 10,000 population.

Dr. Ledua said the crude death rate for American Samoa is based on this data is 6 per 1,000 population. He added that for clarity, in 2020, the crude death rate globally was 7.7 per 1,000 population.

In the US, it was 8.3 per 1,000 population and these figures are based on the approximately 50,000 to 55,000 population of American Samoa.

A further breakdown of the number of deaths per year revealed that in 2020, there were 330 deaths, in 2021, there were 336 deaths, a total of 406 deaths were recorded in 2022 with COVID-19 being a major contributing factor, then in 2023 there were 361 deaths recorded, and from January to June 2024, a total of 193 deaths were recorded.

Senator Satele Aliitai Lili'o who raised the issue addressed committee chairman Senator Tuiasina Dr. Salamo Laumoli saying it's been four days since the Senate requested the list which was just presented by the LBJ CEO.

However, he complained that he could not understand most of the data in the report.

The Vaifanua senator said he knows the LBJ management and the Senate Health Committee chairman had been worried about the issue when he first raised it last week because of comments made by some members of the public that gives the hospital an unsavory reputation.

Satele was referring to comments made by some people who were unhappy with the high mortality rate at LBJ and were calling the Territory's only medical center a House of Death.

He stated that he wanted to clarify with the hospital management that the committee chairman claimed that members of the Senate did not agree with this description, saying on the contrary that the honorable members of the Senate support a lot of people who refer to LBJ as a place of refuge.

Satele reiterated that senators had requested the list because they wanted to know the actual number of deaths, the cause of death, how many died at the hospital, in their homes or communities, or died on their way to the hospital.

He suggested that the list be brought again with all missing information intact in another scheduled hearing that will be announced later.

He then asked Acting CMO Dr. James Sunia if a permanent CMO had been hired, to which Dr. Sunia replied that the LBJ Board will be interviewing applicants for the position on Monday August 19th (today).

Senator Satele commented on doctors' ability to perform their duties effectively by relying heavily on modern technology and state-of-the-art equipment, then asked Dr. Sunia if the CT Scan was currently operational.

Dr. Sunia answered that the CT Scan had not been working for the past two weeks but fortunately, the parts that were ordered arrived last Monday and technicians were working on rectifying the problem.

Satele continued his line of questioning by asking what maximum weight the CT Scan can accommodate and the Acting CMO answered 350 pounds.

Satele pointed out that the average weight of Samoans is 300 pounds which means the CT Scan cannot accommodate those who weigh more than 350 pounds up to 400 pounds.

The Vaifanua senator asked the LBJ officials why they did not consider this very obvious fact when they bought the CT Scan.

LBJ CEO Dr. Ledua explained that they are getting a new CT Scan machine that can accommodate more than 500 pounds. He also stated that they have already purchased an MRI unit but it hasn't arrived yet.

The problem of not enough space in the morgue for dead bodies to be placed temporarily to await burial, was raised by Senator Alo Paul Stevenson who said the number has increased dramatically to the point where there is no space available in the morgue, and now the hospital chapel has been used for this purpose.

Alo said some of the deceased have been in the morgue for two or three months awaiting burial and asked the hospital CEO why this problem was happening and if he is doing something to address the problem.

Dr. Ledua revealed that the main reason was because some families have relatives off-island who want to attend the funeral.

The LBJ CEO said that the hospital has a policy to limit the number of days for the dead to placed inside the morgue to 30 days. However, he said it is difficult for them to enforce this policy when families cite various reasons why they want to keep their deceased relatives in the morgue.

He emphasized that the morgue and the chapel is their highest priority right now and they have already initiated the bidding process for the design and build of the morgue and once a contractor is finalized, construction of the morgue will commence.

He elaborated that the plan was to first build a casket holding area to where all the caskets currently kept in the chapel can be moved, and renovation can get underway so that the chapel can be used for the purpose it was built. Work is slated to begin in September.

Senate President Tuaolo Manaia Fruean asked how much the hospital charges a day for the deceased to be kept temporarily in the morgue.

Dr. Ledua said he was not sure but it might be $30 or $50, to which Tuaolo said that he should raise the cost to a higher amount like $500 a day, so that families will take out their deceased relatives for burial faster.