Dogs and chickens abound on these premises
This is American Samoa's only full service medical facility

Advocates for Change at LBJ Tropical Medical Center

A diverse group of medical professionals and citizens with extensive experience and personal ties in American Samoa are gravely concerned about the appalling state of healthcare delivery at the LBJ Tropical Medical Center.

Within this group, dedicated to improving the delivery of healthcare services for the people of American Samoa, we will employ all necessary efforts to accomplish this end, including the use of mass media outlets in various modalities. We will also contact those entities, both local and Federal, who are responsible for funding the provision of healthcare in American Samoa.  Additionally we will not forget to include those Agencies charged with the oversight of this funding.  Finally, we will take on the role of whistleblower to bring this deplorable situation to the attention of our entire nation, as well as the outside world.

Many things can happen, even in a small community such as American Samoa, that can impact healthcare elsewhere.  One immediate example is the current lack of control of the Zika Virus, not to mention the serious challenges faced in diagnosing and treating it.  It is well known that Zika is present in American Samoa.  It is also well known that mosquitos are essentially omnipresent there, and it appears as though very little is being done to control them.

Zika is only the most current public health crisis however.  There are numerous others, such as Dengue Fever, Chikungunya and Leptospirosis.  There is also a huge burden of illness involving non-communicable diseases in the Territory, such as Diabetes and Morbid Obesity.  We will additionally be discussing these, as well as many other public health issues among these pages, since their treatment and complications normally require heavy use of the Medical Center.  Due to the fact that control and prevention of these types of public health issues generally fall under the purview of the local Department of Health (DOH), you will also find many references to the DOH throughout this website.

Current State of Healthcare in American Samoa for U.S. Veterans?

This annual Holiday reminds me of the great debt of gratitude that we all owe to our veterans, and everyone knows that American Samoa has way more that its "fair share" of them...  Has there been any progress made towards getting a permanent, full-service VA Medical Hospital established in the Territory?  In the meantime, has the LBJ TMC done anything to improve its most basic services for the many former servicemen/women that still reside there?  Is at least the ASG Off-Island Medical Referral Program back up and running again, even if it is still not fully-funded?  Finally, what do the Residents of AS think about all of this, and what are the Territorial/Healthcare leaders doing (or even saying) about it...?  Everyone there deserves better, but ESPECIALLY our veterans!

The public's observations and opinions can make a real difference.  THANK YOU to all who have served and are serving our country!  May you have a blessed Veteran's Day, and may your medical needs never be neglected.  Warm Regards, Dr. JIM MARRONE

Congress Looking Into LBJ

Congressional panel discussion LBJ Hospital


Our Congresswoman Aumua Amata is taking a strong stand on matters relating to LBJ Hospital.  She wants to know why we are not spending all the money the Federal Government is making available through the Medicaid program.  She also wants Congress to evaluate feasibility of building a new facility and staffing it with true professionals.  This news report by Talanei tells the story pretty well.

You can also see more on the Congresswoman's website by clicking here.

It is time for the people to be heard and this site is a good place to speak out.  Please comment.


Medical supplies shortage at American Samoa hospital

This article from Radio New Zealand.  Read full story on RNZ

Nurses at American Samoa's LBJ Hospital say the hospital's shortage of medical supplies is affecting the quality of patient care, with nurses forced to use bed sheets as dressings.

Nurses say dressing supplies and other basic supplies such as gloves and gauze pads have run out, and LBJ Hospital is also reported to be out of some IV solutions.

The chair of the hospital board Leilua Mase Akapo says the hospital is in a grave financial situation because of the government's failure to transmit funds to the hospital.

Our correspondent in American Samoa, Monica Miller, says nurses who have spoken out are describing a dire situation.

"According to these nurses, they're using trash bags as underpads for the beds, to cover under the sheets. So that's a very worrying situation. I know that there's been a series of meetings between the governor and the people at the treasury. And the governor has basically told the treasurer that he should find money to pay the hospital."

Ms Miller says off island vendors are requiring the hospital to pay up front for orders before they release any supplies.

Last month the Hospital Authority Board informed the governor that LBJ's account payables had reached US$8 million, with sources at LBJ saying unpaid bills for medical supplies represents about three quarters of this.

The chairman of the hospital board told the governor that the funds the government has failed to pay to the hospital include a monthly subsidy of US$500,000 per month, a two percent wage tax and Medicare and Medicaid payments.

A report that the chairman provided for the governor, shows that the amount the ASG owes LBJ was US$5.7 million as of December 28, 2015.

Doctor shortage fears in American Samoa

This article from Radio New Zealand point out a very serious problem but, unfortunately, the problem is much more severe than just the lack of a few medical staff. 

Read full story on RNZ

Medical sector workers in American Samoa say there is an urgent life and death situation with the hospital relying on a single pediatrician.

Two doctors from the Department of Health have been sent to help out at the Pediatric Department of the LBJ Hospital, after the sudden death of long serving pediatrician, Dr Tagilima Iatala, last week.

A replacement is due on island next week.

The chief medical officer at the LBJ, Iotamo Saleapaga, said the two public health doctors would mean they could manage until then.

But some medical staff said the situation was more serious than what the LBJ management is making it out to be.

They pointed out that the work load for the remaining pediatrician was too much and had been for a long time.

They said it had taken the hospital more than a year to recruit new pediatricians and one additional doctor was not enough.

They said some inpatients had conditions where the pediatricians had to keep an almost 24-hour watch because of seizures and other complications.

The medical staffers said this was an urgent life-and-death situation and the leaders needed to come and see for themselves and not take the management's word for it.

Loss of Many Qualified Staff

Well, hoping to spark some conversation and at the same time get some answers posted...

As we know, in the past several years we have lost many valuable staff, some leaving by choice ( had enough, disgusted) and others via un-renewed contracts. ;The decision to not renew the contracts has been due to " high salary " and with the exception of Dr. ;Maronne, kept very low profile. I would like to know what are these high salaries?
What are the salaries of the current CMO, CMO assistant, CFO, and CEO?

If we have saved all these salaries ( no one was replaced), where is the money? We are still short on supplies, staff, space, etc etc.

How much more can we lose and still function?

The docs at  over worked, tired, and fear we may lose more if they have a place to go...

One patient report today arriving at the clinic at 8 am where she had an appointment and did not get seen until 3 pm.  Are we back full circle to poor service again all because of some administrative. _________________(fill in the blank, cannot find the words)

CMS and our USMLE physicians

i know a few years back we were cited for lack of US licensed physicians, and there was even a movement to no longer hire physicians non USLicensed, and to assist current physicians to get their US license.  Now, we have lost most of our USLicensed physicians and  I wonder,

1.  How many physicians at LBJ currently have a US locense

2.  Will this affect our Medicare standing?

I want to contribute to this effort!

Hello, everyone.  My name is Dr. Jim Marrone, and I am a U.S. Board-certified pediatrician originally from California who lived and worked in American Samoa and at LBJ for over 14 years, from 2001-2015.  From 2008 until late last year (when the Hospital Management and I could not come to an agreement on the renewal of my contract), I was also the Chief of Pediatrics there.  So I feel like I should definitely have a whole lot to add to this site...  I also agree that it is clearly high-time that some of these things be not only thoroughly discussed in public, BUT FINALLY REMEDIED!

Despite the incredible warmth and generosity and spirit of the Polynesian culture and its people on island, there are also undoubtedly heaps of problems in American Samoa ranging from educational, to governance, to financial and of course medical, which is not even to mention a decaying infrastructure much like there is in many other parts of the U.S. as well.

In any case, I firmly believe that one of the highest, if not THE HIGHEST priorities of the "powers that be" in the Territory absolutely must be THE HEALTHCARE OF ITS PEOPLE.  After all, what kind of society or civilization for that matter do we really even have, if basic healthcare provision cannot be guaranteed for our people?  And certainly I would not absolve the U.S. Government of its serious responsibilities there, since it promised this in writing to the residents of AS all the way back in 1901.

Furthermore, I am of the belief that the LBJ Hospital in its current state is tragically but only a window into a very messy house that is the Territorial Governance of American Samoa, obviously under the auspices of good ol' Uncle Sam.  So I want to hereby pledge to do my part in cracking open these rusty older doors and windows, and at least trying to help let some "fresh air" into the place!

Happy blogging and forum-posting to all, and I look very much forward to your thoughts and observances (and potential solutions!) here.

Cheers, JRM

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