Pacific emergency care leaders gather in Samoa to discuss how to strengthen systems that save lives

When a patient arrives at the emergency department, the first minutes and hours are critical. A clear triage system, trained staff, the right equipment, and timely referral can mean the difference between recovery and preventable harm.

This urgency was at the centre of discussions in Apia, Samoa, where the Pacific Islands Society for Emergency Care (PISEC) inaugural scientific conference was held from 13 to 14 August 2026. Hosted by the Government of Samoa through the Ministry of Health, with support from the World Health Organization (WHO), the Pacific Community, the Regional Emergency and Critical Care Systems Strengthening Initiative, the National Critical Care and Trauma Response Centre, and other partners, the conference brought together emergency care professionals from across the Pacific under the theme, “Strengthening the Pacific ECO System: Working Together for Our People.”

^{The inaugural scientific conference of the Pacific Islands Society for Emergency Care (PISEC) held in Apia, Samoa. Photo: WHO / Faizza Tanggol}

Participants exchanged experiences, discussed common challenges, and explored ways to improve emergency care across pre-hospital services, hospital-based care, and continued care after the emergency has passed. Earlier in the same week, the Ministry of Health Samoa organized a two-day point-of-care ultrasound (POCUS) pre-conference workshop that brought together doctors, nurses, midwives from primary health care facilities, as well as sonographers, for hands-on training to support faster clinical decisions and improve patient care in Samoa.

^{Point-of-care ultrasound training held as part of PISEC’s pre-conference workshop activities in Samoa. Photo: Ministry of Health Samoa}

A Pacific movement for emergency care

For Pauli Dr Pai Enosa, Head of the Emergency Department at Tupua Tamasese Meaole (TTM) Hospital and the President of PISEC, the conference was an important milestone for their new regional society.

“We identified that there is a need for a standard of care across the Pacific, especially for our people,” Dr Enosa said, recalling how Pacific emergency care leaders first came together through regional workshops in 2018. He explained that the society was created to advocate for better emergency services across the region and to share lessons learnt to better serve our people, with membership open to doctors, nurses, and allied health professionals.

^{Pauli Dr Pai Enosa, head of the Emergency Department at TTM Hospital and concurrent President of PISEC. Photo: Ministry of Health Samoa}

PISEC now brings together members from around 15 countries, spanning Polynesia, Melanesia, Micronesia, and Timor-Leste. Across these island nations, many emergency care teams face similar pressures.

“The common challenge with all the member countries was, number one, not enough staff to actually run the department,” Dr Enosa explained. “And the second challenge is limited resources within the departments, with some of the countries even saying that they don't have a specific area for emergencies.”

In a call to action at the conference, Dr Sebastian Paulo, a junior registrar at TTM Hospital, challenged Pacific emergency care practitioners to focus on practical improvements that reach patients and communities.

^{Dr Sebastian Paulo (left), junior registrar at TTM Hospital, during a training on point-of-care ultrasound in Apia, Samoa. Photo: WHO / Faizza Tanggol}

“From this moment, every discussion here must answer one question: ‘Will this change outcomes for our people or just language in our reports?’” Dr Paulo asserted. He urged Pacific countries to shape emergency care systems grounded in their own realities, noting that “every nation must be supported to build its own pathway, aligned to its workforce, geography, culture, and reality.”

Dr Paulo also reminded the conference participants to keep patients and communities at the centre of every discussion. “That is who we serve. Not institutions. Not conferences. People,” he emphasized.

Samoa launches a five-year emergency care roadmap

During the scientific conference, the Ministry of Health, led by the Chief Executive Officer June Scanlan-Lui, took the opportunity to launch the Accident and Emergency Department Strategic Plan for Tupua Tamasese Meaole Hospital for 2026/27 to 2030/31. The plan provides a five-year roadmap to strengthen emergency services in Samoa and support the development of the Emergency Department as a regional centre for emergency care by 2030.

^{The Ministry of Health, led by Chief Executive Officer June Scanlan-Lui (5th from right) and ED Head Dr Pai Enosa (4th from left), launches the Accident and Emergency Department Strategic Plan 2026/27–2030/31 for TTM Hospital during the PISEC Conference in Apia, Samoa. Photo: WHO / Faizza Tanggol}

The plan is structured around six strategic goals: clinical services and patient care; workforce capacity and education; infrastructure and equipment; systems and processes; data and information; and leadership, governance, and partnerships. It is aligned with Samoa’s health priorities, the WHO Emergency Care System Framework, the Healthy Islands Framework, and the PISEC Regional Emergency Care Framework.

Dr Enosa said the strategic plan is a costed roadmap for the department over the next five years, with the intention of improving health systems to enable staff to deliver quality emergency care for patients, families, and the wider community.

“The main idea of having this strategic plan is to actually make sure we are held accountable so that we create systems to enable us to deliver quality and efficient services,” Dr Enosa explained.

Partnership for safer, timely care

The launch of the strategic plan and the organization of the PISEC scientific conference also highlighted the role of strong partnerships across the Pacific in strengthening emergency care. Both efforts brought together support from WHO and other partners, combining technical assistance and regional collaboration to help advance safer, timelier, and better-coordinated emergency care for Pacific communities.

For Dr Enosa, the long-term goal is to continue growing PISEC, strengthen partnerships, and support Pacific countries to improve emergency care in ways that are relevant to their own settings, “The important thing is that we try to achieve our vision, which is to improve emergency care within our Pacific Islands, to make sure that emergency care across the Pacific is standardized in terms of systems, knowledge, and skills.”

“We’ve had immense support from the World Health Organization, especially with the emergency department,” Dr Enosa added. “We are very appreciative of the support that we get from the World Health Organization.”

“Emergency care is one of the clearest points where health systems meet people at their most urgent moment,” said Dr Wendy Snowdon, WHO Representative to Samoa, American Samoa, Cook Islands, Niue, and Tokelau. “Across Samoa and the wider Pacific, emergency care teams work under significant pressure to deliver the best possible outcomes they can for their patients. PISEC is a great initiative led by practitioners in the Pacific, towards strengthening emergency care services through collaboration and information sharing.”

“WHO congratulates the Ministry of Health Samoa for the launch of their Emergency Department Strategic Plan and is committed to supporting the implementation of this important initiative,” Dr Snowdon added.