When Lt. Gov. Josh Green walked into a rural hospital in Samoa on Friday, more than two dozen children lay lethargically in beds and cots.

The hospital usually only had four beds. Now, there were 28, including cots set up to accommodate the overflow of patients.

It’s been eight weeks since the first child died of measles in Samoa, the start of a national health care crisis that’s claimed 70 lives. The neighboring U.S. territory of American Samoa announced its own measles outbreak Friday.

On Friday — Thursday in Hawaii — Green was in Samoa as part of a hastily assembled Hawaii medical mission to aid in a mass international measles vaccination effort. All the schools and businesses were required to close and non-essential personnel were warned off the roads as teams went house-to-house providing vaccines.

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But for many it was too late. On Friday in a rural hospital in the western part of the island of Upolu, sick children could barely lift their heads off their pillows. It smelled like cleaning products and rubber gloves.

Limited resources have made it tough to respond to the crisis. Green said the Samoa hospital only had four different antibiotics to choose from instead of the 20 to 30 options that exist in Hawaii. A couple of New Zealand physicians and a few nurses were aiding local Samoan health care providers.

Mothers, fathers, aunties and other relatives sat next to their children. Many of the patients were bandaged where their IVs were attached.

“You could see a lot of fear in the faces of the people because some of those children were not going to make it,” Green said. “Children who are that sick we would normally have in an intensive care unit in Kapiolani with a full team.”

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It was the second and last day of Hawaii’s medical mission to the Pacific nation. About 75 doctors and nurses flew to Samoa on short notice to aid in the international immunization effort.

Over just two days, they partnered with local and international teams and collectively immunized about 27,000 people across Upolu. Another 6,000 were vaccinated on another island. The government of Samoa later announced the country’s estimated vaccination rate rose to 90%.

“It was a feat of human effort I’ve never seen before to get 33,000 immunizations across a country,” Green said.

Measles In American Samoa

But the health crisis is no longer contained to Samoa. On Friday, the government of the neighboring American Samoa declared that the U.S. territory now has an outbreak of measles, a move that will lead to the closure of public schools starting Monday and a ban on gatherings in parks.

The government says the territory has nine cases of the disease. Five of those infected had been traveling outside the territory.

Health Department Epidemiologist Dr. Aifili John Tufa said in a television broadcast that samples from those infected were sent to Hawaii for testing and the results came back Thursday. He added American Samoa will get a measles vaccine shipment from the U.S. Centers for Disease Control and Protection on Monday.

Data presented by American Samoan health officials early this week during a cabinet meeting shows a 99.7% vaccination rate for mumps, measles and rubella in the territory. But Tufa said that more needs to be done to up the rate for the 1-5 year age group which is currently at 84.7%.

“The number one way to stop the spread of measles is to immunize,” he said.

More Medical Missions Planned

The Hawaii teams flew back from Apia to Honolulu on seats donated by Fiji Airways just about 33 hours after landing. Two pediatric intensivists stayed behind to continue to help.

As nurses and doctors left Samoa, many commented that the trip was life-changing. Green said it’s inspired him and other partners who made this trip possible to start a new organization called Hawaii Health Corps.

The idea would be to have a group that’s ready to respond to health crises and provide disaster relief, both locally and throughout the Pacific.

“I’ve had offers of about $15,000 already to seed it,” he said. “My plan for the Hawaii Health Corps is for every mission we do abroad in the Pacific to also do one here at home.”

Green said he’s thought about creating that type of organization for a couple of years but this Samoa trip “kind of jumpstarted us with big jumper cables.”

“There seems to be a large appetite for this and because so many people quickly came to the table and wanted to participate in this, it seems activating this kind of organization will work,” he said.

He expects Hawaiian Airlines and Fiji Airways to remain partners as well as big and small local health care organizations like The Queen’s Medical Center, which sent dozens of health professionals on the Samoa trip.

“Our ohana is a larger ohana than just the islands here,” he said. “When you see what happens when an outbreak occurs it’s too devastating not to prevent it.”

The Associated Press contributed to this report.