Samoa

Samoa is a tropical island nation in the southern Pacific Ocean, about halfway between Hawaii and New Zealand. Two large islands, Upola and Savai'I, comprise 96 percent of the total landmass, with eight small islets providing the remaining 4 percent. The total area of 2,944 square kilometers is comparable in size to the state of Rhode Island. All the islands are volcanic in origin, although there have been few eruptions over the past three centuries. Total population on the islands is 176,900. The growth rate is minus 0.2 percent annually, with a [Page 1517]migration rate of minus 11.76 per 1,000 people. Only 22 percent live in urban areas. The economy depends on agriculture (particularly coconuts), fishing, tourism, manufacturing, and remittances, as more and more working-age Samoans look for a better life beyond the islands. The population has become more heavily weighted toward the young, with 39 percent under the age of 14. Life expectancy at birth is now 68 years for males and 74 years for females. Mortality rates for children are low, with 24 deaths per 1,000 for infants younger than 1, and 29 deaths per 1,000 for those between the ages of 1 and 5.

There have been significant improvements in the prevention and treatment of infectious diseases. All Samoans have access to sanitation, and 88 percent use clean water sources. Immunization programs have virtually eradicated polio, tetanus, and diphtheria. The government is now trying to end lymphatic filariasis. Typhoid and dengue fever remain endemic in some areas, and there are an average of 33 new tuberculosis cases diagnosed each year.

Like most of the Pacific region, human immunodeficiency virus (HIV)/AIDS is almost nonexistent, with only 12 cases verified since 1990. However, a survey in one region found that 38 percent of women who visited prenatal clinics had at least one sexually transmitted disease. Combined with the modest tuberculosis rate, Samoa has a potential for a major HIV outbreak. Health officials are working to improve surveillance and education programs.

“Lifestyle” diseases are a major problem on Samoa. Obesity affects 57 percent of the population, with 67 percent of women and 48 percent of men falling into the obese range. The diabetes rate is 23 percent, double what it was in 1990. More than 21 percent of the population suffers from high blood pressure. The actual number of cases is unknown because it is generally believed that for every one confirmed diagnosis of diabetes, there are three more that are undiagnosed, and most people on the islands do not seek screening for either diabetes or high blood pressure. These problems are being seen in younger and younger people, and are beginning to strain the resources of the Samoan medical community.

Surveys clearly illustrate the source of these problems. Forty percent of the population smoke tobacco. Twenty-one percent say they have little or no daily physical activity. Thirty-eight percent say they rarely eat fresh fruit. Thirty-eight percent drink excessive amounts of alcohol. The Ministry of Health has launched a variety of programs to try to improve the general health of the population.

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