A Christmas Message for American Samoa

When I made the decision to leave for Pago Pago after the damaging September 29th earthquake and tsunami that hit American Samoa, one of my brothers gave me some advice. 

As an adventurous, curious world traveler who had explored some of the least "touristy" places on the planet, he thought his experience would be helpful during the months I would serve as a surgeon providing medical relief on the only U.S. territory south of the equator.

"Every day will have some great, amazing parts," he told me. "And every day will have some parts that hurt. If you spend at least 51% of your day focused on the great, amazing parts, you will have the trip of a lifetime. It will change you."

Though the past two months in American Samoa have often been joyous, the last forty-eight hours were painful. 

After assisting another surgeon with a nine-hour operation for recurrent cancer requiring massive blood transfusions, I spent most of the night taking care of my critically ill, unstable patient with the limited resources available on the island. In between efforts to stabilize him, I spoke to his anxious family members. They sat on a bench outside the hospital, waiting for each update and getting little rest. 

At 2am, I was called to the ER to repair the wounds sustained by a teenager trying to protect his mother from a drunk with a machete. During the ninety minutes it took to suture his many deep lacerations, he never complained.

This morning, after another operation, my critically ill patient was returned to the ICU and started showing signs of improvement. And then his heart stopped.

I gave him every drug in our "code" cart. After thirty minutes of chest compressions without any response, my colleagues and I declared his death. He was 46.

I led his widow to see her husband's body for the last time. Even as she sobbed, she thanked me for doing all that I could.

It was in that frame of mind that I came home to check my email.

Photos of Project SAVE volunteers loading a shipping container at a Chico, California storage facility were waiting for me. Heavy coats and hats worn by those in the photos reminded me how cold it is back home in northern California. 

While I look outside at the dense green jungle outside my apartment behind the hospital, I think of how unpleasant it must have been to stand outside on the concrete all day and load heavy boxes into a steel container.

The photos showed me a group I wouldn't ordinarily expect to see together.  There were at least five different ethnic origins represented.  There were college kids in fraternity sweatshirts, middle-aged men, "Mom" types and girls wrapped in scarves who looked barely out of high school.  There were a couple of guys who looked like they could hold their own in a bar fight.

All of these people spent hours of their own time on a cold morning loading 766 boxes of medical equipment and supplies into a forty-foot shipping container bound for American Samoa. 

They needed a forklift for pallet after pallet of boxes, for dental chairs and exam tables that filled a parking lot, for wheelchairs and surgical technology that will change the standard of care for people on a remote American outpost in the Pacific. 

Not one of these volunteers had visited American Samoa. I knew the lady who led the organization that arranged this donation only by e-mail messages exchanged across seven thousand miles. 

It is unlikely that any of the Project SAVE people who loaded that container will ever meet the people who will benefit from their gift. The critically needed equipment will help a stranger's husband or wife. The supplies will be used to repair the wounds of someone else's child on a 77-square-mile island that flies the American flag.

Yet the photos show smiling, willing workers proudly pointing to the container's contents.

The last photos show the final touch the volunteers decided to add to the tightly packed container. 

It is a message from some northern Californians who got up early on a cold day to help out some people they don't know. It is sent on behalf of the medical and nursing professionals, hospitals and clinics across my home state whose donations represent hundreds of thousands of dollars worth of medical supplies given without publicity, governmental involvement, or recognition.

The last item placed in the shipping container that will be unloaded at American Samoa's LBJ Tropical Medical Center was an American flag.

Like my brother told me before I left for Pago Pago, parts of today did hurt. But with those photos, today was much more than 51% good.

Dr. Linda Halderman is a General Surgeon and policy adviser to California State Senator Sam Aanestad. Since the September 29, 2009 earthquake and tsunami that devastated the South Pacific, she has been providing medical relief on American Samoa.

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