Prepare, Prevent and Respond to COVID-19
This project supported through the CARES Act under the Family Violence & Prevention Services Act informing the community to prepare, prevent and respond to COVID-19
Written by: Kathy Fitisone, Asst Office Mgr, Alliance
American Samoa has been extremely fortunate that we have not experienced the raging effects of COVID that are being experienced throughout the world. We are thankful for all those on the frontline who have put systems in place to ensure the safety of our island population. While the processes and procedures in place are not one-hundred percent fool-proof, they have allowed us to repatriate our loved ones. They have allowed for minimal travel so that those wanting to come home and those needing to leave may have the option.
One of the processes currently in place upon arrival to American Samoa is quarantining for a pre-determined length. This is probably the most enduring part of the process. The traveler is in a state of limbo – home, but not yet home. It can be a source of frustration for those on either side of the fence. How can we help?
There are several ways to support the process. First and foremost, we must all abide by the established rules and procedures. Trying to circumnavigate the quarantine process could be detrimental to the well-being of the entire population. Stay away from the Quarantine Sites until Drop Off Days. Secondly, if you know someone in quarantine, let them know you are there to support them – call, message, video chat. See if there are things you can do for them that will help make the transition easier once they are released (maybe pay their phone bill or air out their house). It is not easy being isolated and alone, so a little love and kindness will definitely go a long way.
Keep abreast of what is happening in the community. The Department of Health is doing a great job disseminating important COVID-19 related information through various media outlets. Trust the process and know that those in charge have the best interest of the entire island at hand and at heart. Finally, remember to practice good hygiene – washing hands and using hand sanitizer, wearing masks where and when required, and practicing social distancing.
Written by Tina Tofaeono, PROVISION
Our island has been blessed to not have Covid or the Delta variant on our beautiful shores. The Department of Health continues to increase awareness regarding vaccination, and at least 59.9% of our total population has received at least one dose and 53.1% are fully vaccinated  With our borders closed we feel safe, but those countries who have opened borders are concerned with new variants. Currently, the Delta variant is the most prominent strain of Covid-19 and has been reported in 96 countries.
The symptoms of the Delta variant appear to be the same as Covid-19. However, doctors are seeing people getting sick quicker. Typically, vaccinated people who contract the Delta Variant are either asymptomatic or have very mild. Their symptoms are like those of a common cold, such as cough, fever, or headache with the addition of loss of smell. Unfortunately, the Lambda variant, which is out of South American is also emerging.
With the Delta variant sweeping across our nation some experts are recommending wearing masks, even if you are fully vaccinated. Health experts are urging people that want to get back to a “normal” lifestyle to get vaccinated. If people remain unvaccinated, new strains of the virus will continue to develop and cause problems. They’re also advising vaccinated people to avoid large gatherings and to mask up indoors where the vaccination status of others is unknown. This is to protect yourself as well as anyone that is not vaccinated because there’s still so much unknown about this variant. Vaccination is the best protection against the variant and the FDA approved the first vaccine earlier this week. The Pfizer vaccine is a two-dose vaccine, with a waiting period between the first and second shot. American Samoa has been offering vaccines, but we still have a long way to go.
Remember to protect yourself and your loved ones by having clean hands, wearing a mask (that covers your nose and your mouth at the same time), and that your hands are clean when putting on and taking off your mask. If you’re using a cloth mask, make sure to wash it regularly and dispose of any disposable face masks and continue to practice social distancing.
“If it is sunny out, people put sunscreen on as a precaution. If you are at a crowded gathering, potentially with unvaccinated people, put your mask on and keep your distance.” Says Dr. Yildirim.
Although we do not have COVID in our territory, we must act as if we do. It is up to us to do our part. We are a close-knit community, dedicated to our families and love for our villages and our churches. It’s common for us to greet one another with a kiss or a hug, but we need to be careful during this time. A simple head nod with a smile or even an elbow bump will have to do, during these changing times. This virus has taken many loved ones and like everything in life, this is an ongoing risk.
 First regular HA flight postponed—rescheduled Sept. 13—maybe. (Samoa News, 2021). Retrieved: https://www.samoanews.com/local-news/first-regular-ha-flight-postponed-rescheduled-sept-13-maybe
Written by: Luana Yoshikawa-Scanlan, MBA, PRIME Consultants
Is it more important to be Equal or Equitable?Dominykas Niaura, a writer on the staff of ‘BoredPanda.com’ posted a story shared by a teacher logged in as ‘aloneindarkness7’ (2019). This teacher starts her school year off with a simple lesson in equity for her 8-year-old students:
I have students pretend they got hurt and need a band-aid.
I ask the first one where they are hurt. If he says his finger, I put the band-aid on his finger. Then I ask the second one where they hurt. No matter what the child says I put the band-aid on their finger exactly like the first child. I keep doing that through the whole class. No matter where they say their injury is, I do the same thing I did with the first child.
After they’ve all received band-aids, in the same spot, I ask if that actually helped any of them other than the first child. They’ll try to get me to understand that they were hurt somewhere else. I act like I’m just now understanding what they needed.
Then I explain, “there might be moments this year where some of you get different things (in the classroom) because you need them differently, just like you needed a band-aid in a different spot.”
While equal and equitable may sound alike, achieving equity can lead to significantly better results for people who need resources, and opportunities, in a different way from others.
Equality means everyone is treated the same way as if they have no individual differences or needs, and in so doing they should share the same experiences and the same results from their efforts.
Equity means treating people according to what they need to achieve the same experiences as others and the same results from their efforts. All people do not need the same things.
Social barriers like racism and wealth, personal barriers like disabilities, age, and gender can make it difficult for people to access resources and opportunities. For example, free healthcare may make a hospital visit equally available for everyone, but those without transportation to the hospital may not receive that healthcare in a fair way. They may need additional assistance such as a bus pass or taxi fare in order to access the hospital. The issue is the inherent lack of something, which in many cases is the lack of access to the opportunity to even try, that others may not have to deal with in their quest for healthcare.
Are policies fair to all people? Are resources accessible by all people?
Equity in policy and government is needed to ensure that people from diverse backgrounds and with diverse limitations, can attain their goals by providing opportunity and access to everyone fairly according to their circumstance. The U.S. Centers for Disease Control defines health equity as a process and equality as an outcome of that process (cdc.gov/minorityhealth). In this article we focus on health equity as a process, and access to COVID-19 vaccination as the outcome.
Kaiser Permanente is one of the largest nonprofit healthcare provider systems in the U.S. with over 12 million members. Kaiser defines health equity as the ‘fair and just treatment, access, opportunity, and advancement for all people in pursuit of their health and well-being.’ (Kaiser Permanente COVID-19 Vaccine Equity Toolkit, 2021) Kaiser provides examples of ‘enablers of vaccine equity’ including flexible hours at vaccine sites, multilingual site staff and information materials, transportation to the sites. These enablers meet the diverse needs of people wanting access to a life-saving vaccine.
The people of American Samoa, regardless of status have been given equitable access to COVID-19 vaccination. Not only were shipments of vaccines received immediately from the CDC, but the local healthcare system set up ‘vaccine enablers’ like multiple vaccine sites throughout the islands, with transportation to and from sites, and multilingual healthcare providers available to answer questions. This is one of the few times that we, as a community, have experienced health equity.
Unfortunately, this is not the case in other countries. The unequal distribution of COVID-19 vaccines throughout the world prompted the (WHO) World Health Organization’s Director-General to declare, “Vaccine equity is the challenge of our time.” (https://news.un.org).
Less than ‘one-percent of the population in low- and middle-income countries’ is vaccinated as of August 3, 2021 according to the Global Dashboard for COVID-19 Vaccine Equity https://data.undp.org/vaccine-equity/.
Wealthier countries like the U.S. have committed to shipping vaccines to poorer countries. However, the lack of infrastructure and manpower to administer vaccines in many of these underdeveloped countries require an average 57% increase in health budgets to vaccinate 70% of their population (WHO). The shipping of vaccines to these countries (providing equal numbers of vaccine shots) does not achieve access or equitable vaccination in these countries. It is simply the ‘band-aid’ for the problem.
In 2019, Samoa experienced an unprecedented outbreak of measles, resulting in 5707 cases and at least 83 deaths. Simply sending measles vaccines to Samoa was not enough to stop the disease. Lt. Governor of Hawai’i, Dr. Josh Green, assembled a cohort of 65 doctors and nurses to join 150 immunization teams from New Zealand and Australia to immunize 50,000 people in Samoa. The WHO-backed mission was described as ‘organized chaos’  by reporters as volunteer healthcare providers managed to keep vaccines cold without proper containers, assess sick children without being able to speak the Samoan language, and distribute vaccines with limited resources.
Based on the medical team’s experiences, if the vaccines had been simply shipped to Samoa it would have taken longer to reach the vaccination goal and possibly resulted in more deaths. While Samoa would have had vaccines in hand (equality with other countries), it lacked the infrastructure and manpower to vaccinate 50,000 people in one week (the enablers for vaccine equity). Equality meant the vaccines were in Samoa. Equity meant that vaccines were in the arms of the people. The ultimate goal is to ‘liberate’ our world from disease. But until such time, we should strive for equity beyond equality.
The Alliance is Awarded Funding through the American Response Plan (ARP) to Aid Domestic Violence VictimsRead Now
During the Covid-19 Pandemic the Alliance has received an increase in requests for assistance from victims of domestic violence. The requests are simple, “I need to get away from my abuser, can you help?” During the Pandemic, the Alliance has provided aid to victims through support letters to access travel to the mainland. We offered cellphone and cellphone plans for advocates to be accessible. Victims have been able to contact us through our social media platforms to request assistance to leave their abusers, and we continue to provide information about the intersections of COVID-19 and domestic violence every month in our newsletters, social media, and our website to increase education for our community. Our ability to do this has been due to the funding provided in March of 2020 through the Coronavirus Aid Relief and Economic Security (CARES) Act Supplemental funding
On May 24, 2021 Human and Health Social Services announced $200 Million in American Rescue Plan (ARP) funding awarded to support domestic violence survivors and their children. As the dual coalition, the Alliance was awarded over $200,000 to be used in the next five years to offer critical support for victims of violence. There is flexibility in the provisions of the funding to provide supportive services which include counseling mobile advocacy, peer support, relocation expenses, etc.
Please follow us as we develop meaningful ways to assist victims of domestic violence through ARP funds. Over the next few months, we will share with the community new services available to help victims of violence navigate away from their abusers, to find healthier lives. The Alliance will continue to boost knowledge regarding COVID-19 and impact on increasing violence for our families. We will continue to support local advocates through cellphone services, electronic usage, making it easier to access their clients and information to improve the lives of those harmed by domestic violence. We will be introducing assistance for travel to help victims leave their victims in cases where that is their only hope to survive. When victims state, “I can’t afford to leave.” We are excited to inform the community about what we will be doing over the next five years to increase safety, and wellness for our community. Please continue to follow us as we share.
Written by: Luana Yoshikawa-Scanlan, PRIME Consultants
The U.S. Bureau of Justice Statistics (2017, May) reports that 40% of domestic violence incidents are not reported to police. This trend is found throughout the world, especially in countries where domestic violence is not a routinely enforced crime or where associated stigma is a significant barrier to reporting. To gauge the impact of COVID-19 on domestic violence in 11 countries, researchers used a novel measure of DV incidents – a Google search intensity index of DV-related topics. “DV search intensity after lockdown increased by 31%” peaking on average seven weeks after a lockdown began (Berniell & Facchini, 2020). Due in large part to forced isolation tactics used to minimize the spread of COVID-19, domestic violence increased by 8.1% in the U.S. in 2020.
Without access to normal support services and routines, including the ability to be away from the perpetrator during an entire work day, victims of domestic violence experienced more trauma and more people became victims during 2020. Researchers found an increase in the use of digital platforms by people seeking information, help, connection to address domestic violence. An 8-country analysis of social media data in Asia identified a 70% increase in online searches related to violence from October 2019 through September 2020. Additionally, online harassment, bullying and victim-blaming increased.
The data illustrates the increasing importance of digital media in helping victims address violence, and the need for digital literacy skills to ensure safe access to the assistance they seek.
Digital literacy is the ability to find, collect, organize and comprehend information accessed through online platforms.
It is also the ability to then synthesize this information into a meaningful understanding, to develop a conclusion and make decisions based on this understanding.
Digital literacy includes ‘cyber safety’ skills to protect the user from unwanted, unhealthy, unsafe digital content. For example, knowing how to determine the authenticity of a website, and how to fact-check information. Also, the ability to protect passwords, browser histories, and eliminate invasive tracking mechanisms.
The National Network to End Domestic Violence provides safety resources on their website: https://www.techsafety.org/resources-survivor/facebook
The website offers a comprehensive array of information regarding digital safety. To minimize risk, victims of domestic violence should strengthen privacy settings on email, social media accounts, and any online application that may store passwords to personal financial and health data. This Security Planning Tool can get the user started on hacker prevention tactics, and prevent abusers from accessing private information. After responding to three simple questions the Tool will provide a listing of free resources to address each of the concerns the user responds to.
The following free resource, https://datadetoxkit.org/en/home, provides ‘6 Tips to Steer Clear of Misinformation Online’, a ‘Data Detox for Youth’ and other ways to improve online privacy. As more people jump onto the internet for support and connection to others, safely accessing and monitoring those resources becomes more significant. Don’t be the one to shout, “I’ve been hacked!”
Repatriation Flight #5 originally scheduled May 2021 was changed to arrive at American Samoa on June 1, 2021. The changes made as two (2) fully vaccinated repatriates tested positive for Covid-19 which required additional quarantine days in Honolulu, Hawaii, and American Samoa.
CDC reports authorized vaccines provided in the United States efficiently protect people against symptomatic and severe COVID-19. There is limited information on vaccine protection, but CDC does provide guiding principles for fully vaccinated people. The principles for fully vaccinated people are as follows (CDC Website):
During times of uncertainty can cause increased stress, particularly as we move forward to opening borders, and cities. CDC continues to recommend delaying travel until you are fully vaccinated. If you do choose to travel, it is safer to meet just members of your household, and with only fully vaccinated people. It is less safe to be in contact with people who are not from your household.
If you do choose to travel you will spend increased times in security lines, airport terminals, that can place you in close contact with other people. The virus and other germs do not spread easily on flights due to air circulation and filtration, but social distancing can be challenging on crowded flights. The increased time on planes can increase your likelihood of contracting COVID-19.
As our borders continue to open it is important to learn what will keep you safe from contracting COVID-19. Stay informed!
 COVID-19 Interim Public Health Recommendations for Fully Vaccinated Peopled retrieved: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html#anchor_1617376555813
Successful Domestic Violence Prevention is Grounded in Relationships with the Community during COVID-19 PandemicRead Now
Written by: Luana Yoshikawa-Scanlan, MBA
Violence prevention work in the American Samoan community is particularly challenging and requires significant investment in changing norms, attitudes and behaviors of men and women. It demands an intersectional approach to intervention – an acknowledgment of the oppression and discrimination that social, cultural, political, and economic differences create in the context of an indigenous culture.
The experience and meaning of violence among Samoans are shaped by fa’aSamoa - a unique and complex system of values dominated by the concepts of extended family (aiga potopoto), chiefly structure (fa’amatai), and ceremonial reciprocity (fefa'asoaiga/fesuiaiga). These foundational experiences of spirituality pervade every aspect of Samoan life from birth to death. To prevent domestic violence in the American Samoan community, those doing the work must understand and respect the fa’aSamoa by demonstrating cultural competency when establishing equality (working through power dynamics), confidentiality (seeking consent and trust), and meaningful engagement (mutual benefit, reciprocity).
Successful domestic violence prevention is grounded in relationships with the community. ‘It is often felt by Pacific people that the development of the relationship is integral and takes precedence over the importance of the issues or business at hand’, (Otunuku, M. 2011). In the context of fa’aSamoa, the basis of a ‘relationship’ is trust and the process of building this trust is critical to successfully preventing domestic violence.
Gaining the confidence and respect of the community involves using appropriate cultural protocols in meaningful engagement. This begins with establishing social connections with individuals, acknowledging their cultural place in the community, discovering familial ties and other meaningful associations. Fāgogo, talanoa and tala mai fafo – sharing present and generational experiences through – can facilitate this process. Meeting people in their natural settings – at home, church, in the village fale afolau, etc. – can also foster respect and mutuality. In this relationship, those working to prevent domestic violence become part of the communities in which it is happening. They must identify their role, a place, in the vā or spatial relationships that comprise Samoan life. It is from this space that they can work to prevent domestic violence in the community.
During a pandemic this personalized, face-to-face engagement may not be possible which is why now is the time, post-pandemic, to assess relationships. In hindsight, strong relationships with efficient communication protocols would have averted disputes between the government, churches, and businesses over COVID-19 restrictions. The COVID-19 Task Force could have been more inclusive, with equal representation from all sectors of the community. The needs of domestic violence victims and survivors could have been considered when developing pandemic related protocols.
COVID-19 was not the first Pandemic and is not the last. Now is the time to seek out those who support efforts to prevent domestic violence to establish relationships built on trust and grounded in the values of fa’aSamoa. Galulue fa’atasi, working together, will ensure effective preparation for preventing domestic violence today and through the next Pandemic.
The Alliance is developing a framework for how culture, fa’aSamoa, can protect family members through respectful relationships, intervention to ensure safety for all, building resilience, and creating safe spaces for discussions about domestic violence in the context of a Pandemic environment. A toolkit of resources will support advocates, parents, leaders, educators to prevent and address violence.
Centers for Disease Control and Prevention lists safer activities you can choose after full vaccination.Read Now
Centers for Disease Control and Prevention (CDCT) shared what to do when you have been fully vaccinated, and how you can safeguard yourself and others. Individuals fully vaccinated can gather indoors with other fully vaccinated people without wearing a mask or practicing social distancing. The same rule applies for family and friends who do not reside in the same household, unless anyone they live with has an increased risk for severe illness from COVID-19. You can host outdoor activities without wearing a mask, but there may be certain crowd activities that require restrictions.
For travel outside the United States you do not need to be tested before or after travel, nor will you need to self-quarantine after travel. CDC does request those who fly research the policies for international destinations BEFORE traveling outside the United States.
At the date of this article, American Samoa continues to require testing before travel, as well as self-quarantine in Honolulu and Pago Pago for those returning. You are still required to show a negative test result or documentation of recovery from COVID-19 in American Samoa, which follows the rules for CDC for international travel. CDC continues to recommend testing 3-5 days after international travel, but there is no need to self-quarantine after arriving into the United States.
It’s important to note we are still learning about the pandemic, as well as efficacy of vaccination. For those reasons you still should protect yourself and others by wearing a mask that fits snugly. Be precautious when attending indoor public gatherings, and when visiting unvaccinated people. Visiting indoor with an unvaccinated person who is at risk increases risk of severe illness or death from COVID-19. If you want to learn more, please visit CDC, Covid-19 website.
COVID-19 is Affecting Males and Females Differently
written by: Luana Yoshikawa-Scanlan, PRIME Consultants
Global Health 50/50 non-profit produces the COVID-19 Sex-Disaggregated Data Tracker, providing current evidence of the impact gender and sex have on national COVID-related policies and pandemic responses. Data from 194 countries are monitored, representing 99% of all confirmed COVID-19 cases and deaths reported worldwide.
According to the organization’s data, gender and sex are significant indicators of who is most likely to become infected with COVID-19, the likelihood of severe infection, and poor outcomes. While females comprise the most confirmed cases, males are more often hospitalized, admitted to ICU and do not survive the infection.
This is a critical issue for people experiencing intimate partner violence (IPV) during a pandemic, especially families who rely on the ‘man of the house’ for financial stability. Not only is IPV escalating as a result of COVID-19 related stay-at-home and community lockdown protocols, but families are also unable to make financial ends meet, fueling tension and greater potential for violence. 99% of IPV survivors experience economic abuse transforming violence into a structural economic issue:
Without a pandemic environment, women are already experiencing more abuse – one in four women worldwide according to the National Domestic Violence Hotline. While COVID-19 may be affecting more males biologically, the emotional impact of the pandemic disproportionately affects women in most countries (data.unwomen.org). Women lose their childcare and in-home assistance, are more likely to be laid off or directed to work from home, and become caretakers of infected spouses in addition to their children.
FreeFrom, a U.S. organization focused on strengthening IPV survivors’ financial security, suggests that as a ‘structural economic issue’ the following institutions can support survivors in the following ways:
The following online tool can help a victim assess her current financial wellbeing and offers links to resources that can help build her financial security: www.consumerfinance.gov/consumer-tools/financial-well-being/
Written by: Luana Scanlan, PRIME Consultants, Owner
The phrase, ‘I work from home’ used to conjure pictures of a coupon clipping mom at her kitchen table, scissors in hand surrounded by newspapers and color-coded envelope files. Or Papa up at the crack of dawn weeding the taro patch. In reality, prior to COVID-19, only 7% of Americans enjoyed the luxury of working from home (Pew Research Center). However, since the pandemic, nationwide surveys conducted by Stanford researcher, Nicholas Bloom, reveal that 42% of the U.S. labor force is now working from home full-time. Thanks to worldwide efforts to stem the spread of COVID-19 and its mutations, physical lockdowns or stay-at-home orders are the norm.
In preparation for the inevitable first case of COVID-19 in American Samoa, the Alliance began modified remote-work protocols in mid-2020. The Alliance’s work is inherently people focused: stakeholder meetings, community workshops, team planning conferences are all part of the Alliance team’s normal workday. Engaging people is the most effective method for reaching the Alliance’s target audiences.
The new remote-work protocol allows team members to work from home at least four days per week with a weekly in-person check-in, practicing physical distancing, at the Alliance office. In-person meetings are replaced with Zoom calls and increased email usage. The office itself is physically modified to house ‘pods’ of individuals who work together most often. For example, the office manager and executive director work from partitioned workspaces separated from the rest of the office by a door. The media manager and her assistant are partitioned in another section. And finally, a safety glass partition and locked door were installed at the front entrance. While these modifications enhance physical safety and encourage physical distancing practices, they also create a sense of ‘social’ distancing that may not encourage the type of interaction team members are used to or sustain a team mindset. It can negatively affect morale and combined with other issues going on within the home, may create a negative work culture.
A quick scan of the internet resulted in the following Four Tips for creating a Positive Work Culture while working from home. Notably, the Alliance’s team implemented all these ideas in the office prior to COVID-19 – the key is to successfully implement them virtually.
Tip #1: Encourage virtual social hours – lunchroom, ‘meet the pets’, game day, etc.
Alliance team members regularly ate lunch together in the office common area. Most days someone cooked lunch in the office kitchen, and sometimes they even shared breakfast. On these occasions they shared stories, gave each other feedback, and yes, talked about work.
Tip #2: Create a weekly ‘work-to-do’ communication mechanism – project updates, a ‘feel good’ forum where everyone can post positive things, resources, request help on projects, etc.
Tip #3: Celebrate and acknowledge team members virtually.
Tip #4: Recreate office traditions in virtual formats. Prior to COVID the Alliance held quarterly ‘Me Day’ sessions. The activities were focused on improving wellness among team members and the work team as a unit. It was a time for personal expression, decompression, and focusing on ‘Me’. Virtual painting sessions, cooking meals (i.e., guess what I’m cooking!), reciting favorite poetry.
Ultimately, these Tips encourage taking the positive aspects of the workplace into the virtual workspace. It is important to note that the Alliance equipped each team member with the technology needed to work effectively at home, including internet access and workspace equipment. Now that’s using your COVID-19 funding appropriately!
Written by staff or Alliance Partners