'There are no words': Samoa buries its children as measles outbreak worsens

Fa’aoso Tuivale sleeps on her children’s grave during the day, when she misses them most.

She and her husband, Tuivale Luamanuvae Puelua, are sitting on the newly-dried concrete that mark the graves of their three-year-old Itila and 13-month-old twins, Tamara and Sale, talking about the week that has passed since they buried them.

“My children’s deaths came like a thief in the night, so sudden and unexpected,” Puelua said.
“Your mind becomes empty and you are speechless because there are no words on this earth to describe how my wife and I feel having to say goodbye to our children.”

The Tuivales are the worst affected family by a disease that has been ravaging the tiny south Pacific of Samoa for over a month.

Samoa, which is 4,300km east of Sydney and graduated to developing country status in 2014, is known to most people outside it as a peaceful, tropical holiday destination. But over the last six weeks, the country has been gripped by a devastating measles outbreak. There have been more than 3,000 confirmed cases in a country of just 200,000 people and 42 people have died, 38 of them children under four.

The Tuivale family live in the village of Lauli’i, 9km from the capital of Apia. Their home, tucked among their plantation of pineapple, banana, taro and papaya trees is at the very back of a long dirt road that follows the Namo river.

“Sale was the quiet one, he was usually well-behaved,” Tuivale recalls of the children he has lost. “Tamara and Itila are known to be the ones that argue and fight all the time.

“My father’s garden is usually used as a playground for the three-year-old; he would mess up the plants and give his grandfather headaches.”

‘No one ever thinks of burying their children’
A perfect storm of events has meant that the global measles outbreak that has ripped through so many countries over the last year has had such a devastating impact as it reached Samoa’s shores.

The world’s most infectious disease has spread throughout much of the developed world this year, and while some countries have suffered devastating losses as a result, developed countries have seen comparatively little loss of human life. New Zealand recently suffered its worst epidemic in 20 years – 2,000 people were infected, none died.

Samoa has a huge diaspora community in New Zealand making it inevitable that measles would eventually reach Samoan shores. When it arrived, it reached a population with devastatingly low vaccination rates and a health service ill-equipped to meet the challenge of such an epidemic.

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Samoa’s total population immunity has been estimated by the WHO to be as low as 30-40%, compared with its Pacific neighbours, such as Tonga and American Samoa, which boast immunisation rates of over 90%, close to or matching recommended rates for achieving immunity.