British physiotherapists tackle deadly measles outbreak in Samoa

A group of British doctors and nurses, recruited and trained by the charity UK-Med, focused on helping patients in Samoa recover from complications related to measles. Three specialist physiotherapists trained by Humanity & Inclusion, Gaelle, Susie and Maeve, completed the team.

What is measles?

Measles is a highly contagious virus that can spread to others through coughing and sneezing. Each case can infect up to 12 other people and complications can lead to pneumonia, severe diarrhoea, and encephalitis or inflammation of the brain.

Rehabilitation in emergencies

Humanitarian emergencies often result in short term and longer term rehabilitation needs but, despite this, rehabilitation in emergencies is often neglected. Humanity & Inclusion has been working as part of the UKEMT project since 2013 to train rehabilitation professionals to work in humanitarian crises.

In Samoa, it was important to provide rehabilitation as part of the humanitarian response. Complications induced by measles such as severe respiratory complications and encephalitis can kill or cause disability, and they tend to be much worse in children. Access to early rehabilitation can help to prevent or reduce respiratory complications and enhance recovery.

The emergency response in Samoa

With the Samoan health system facing overwhelming numbers of severely unwell children, Gaelle, Susie and Maeve’s job was to support the Tupua Tamasese Meaole Hospital (TTMH) with early rehabilitation - in particular respiratory physiotherapy for young children, and to work with the local and international teams there to identify any additional rehabilitation needs. They were all supported by Humanity & Inclusion’s humanitarian advisors back in the UK.

“These deployments are also so important for the UK – Gaelle, Susie, Maeve and the team brought back skills in managing outbreak responses that might one day be vitally important in the UK.”

Zoe Clift, HI’s Global Emergency Rehabilitation Specialist

Reports from the ground

Gaelle Smith

British physiotherapist, UKEMT.

^{Gaelle Smith © Anna Daniell UK-Med}

"I feel privileged to have been asked to join the UKEMT team going out to Samoa, under HI.

"As a physiotherapist in an emergency setting such as that seen in TTMH, you use respiratory skills to help settle a child's work of breathing and prevent them from deteriorating or, in children that are so unwell they require non-invasive or invasive ventilation, you can help make it easier for them to take bigger breaths in, or help clear secretions that are often causing significant respiratory distress. It's tough. It's challenging.  But there is nothing  better than  seeing a child's breathing improve, no longer have to fight so hard, no longer in such acute distress and the worry that is replaced by relief on their parents face as  they too notice their child's work of breathing has improved and they are more settled."

"We take the ability to breathe for granted on a daily basis, but the moment we struggle to breathe you realise it is the most horrific feeling possible, even more so for a child."

"In the UK, we forget how much devastation infectious diseases like measles cause and the lasting impairments that then follow. Through HI, the UKEMT team that went out to help was able to provide three physiotherapists to assist - valuable input that helped not only in the acute outbreak but hopefully left locals with some basic therapy skills that will prevent some of these children developing ongoing respiratory complications that can be life altering."

Maeve Tohill

British physiotherapist, UKEMT.

^{Maeve at the Tupua Tamasese Meaole Hospital © Anna Daniell UK-Med}

"This is my first experience of deployment with the UKEMT and I was apprehensive before arriving but all my worries were dispelled on meeting the members of my own team, the international teams and the local staff."

"Arriving in Samoa we were welcomed with open arms. Being the first physiotherapists to deploy in this way has been an honour and a learning experience for us all. We were there to help the significantly increased workload for the two local physiotherapists who were overwhelmed with the need for the service. We treated adults and children with measles, and helped with those patients who were in hospital with varying other conditions, whilst the outbreak was occurring. Being there enabled the local staff to provide care to the district hospital which prevented further measles admissions to TTMH (Tupua Tamasese Meaole Hospital)."

Susie Wolstenholme

British physiotherapist, UKEMT.

^{Susie with a patient in Samoa © Anna Daniell UK-Med}

"Having never worked abroad I was a little anxious about coming, however, the welcome from the Samoans has been incredible. As a physiotherapist the work has been varied; from small babies to adults. We have supported the small Samoan physiotherapy team, who have worked tirelessly since the start of the outbreak."

Rube Une

Head of physiotherapy at the Tupua Tamasese Meaole Hospital, Samoa.

^{Samoan physiotherapist, Rube, with UKEMT members Susie and Maeve © Anna Daniell UK-Med}

"I am very proud of the team from the UK. We really needed physios who could help us with all these chest physio cases."

"They came all the way from the UK and on behalf of me and my team we are so happy having them around and working with us. They have been helping us a lot. Right from the beginning with Gaelle, all the way through to Susie and Maeve – I’m so proud of them."

"Having them here has allowed me to focus on the district hospital and try to slow down admissions from there, while Susie and Maeve were concentrating on the intensive and high dependency units on the paediatric ward. The outcomes have been excellent. I hope that we will continue the relationship between UK physios and Samoa."