Lolofietele Taulealeausumai Dr Eti Enosa FRACS
26 June 1941 - 31 July 2011
It is with sadness that we recall the passing away of Eti Enosa last year. He was the first Samoan to achieve the Fellowship of the Royal Australasian College of Surgeons. Eti changed surgery in Samoa, introducing techniques and ideas which improved patient care. He was instrumental in improving the health service in Samoa and developing surgical training for the Pacific island region.
Eti (Airdhill) Enosa was born in 1941 at Airdhill, near Port Moresby, Papua New Guinea, where his parents Toloa and Mutaaga were missionaries for the Samoan Congregational Church as part of the London Missionary Society. One of six children, Eti attended the mission school and learned the local Pidgin, Samoan and English. Eti was eight when his family returned to Samoa, his father becoming pastor for the village of Lotofaga on the island of Upolu. Eti excelled in national examinations, gaining entry to Malifa for intermediate school and then Samoa College, the best government high school in 1953. He enjoyed rugby and joined the Boys Brigade, developing a team spirit which marked his work later. Fellow students remember him as a quiet, studious boy. On leaving high school he worked for a year at the post office.
Eti was awarded a WHO scholarship to the Fiji School of Medicine in 1961. He picked up Hindi and Fijian, adding their phrases to his vocabulary which he used years later. At medical school he worked hard while enjoying sport, continuing to play rugby and taking up tennis. He was elected President of the Students Council, and head student for the Medical School in 1965. While at Medical School he met, fell in love with and married Susana, a Samoan nurse studying at the Nursing School. They were to work together in theatre and later the health service. He always could rely on her support and advice. They started their family of five while working and living at Motootua.
Having completed his MB ChB in 1966, Eti returned to Samoa and started work at the National Hospital at Motootua. His interest in surgery started while working in the District Hospitals in Safotu, Sataua, and Fusi from 1969 to 1974. He spent as much time in surgery as possible, devoting considerable time to reading, a habit he continued in later years. He developed mentorships with senior surgeons, Dr Walter Vermeulen and Dr Hermann Oberli. In 1977 Eti was awarded a postgraduate fellowship to study in New Zealand and between 1977 and 1979 he worked in Timaru, Lower Hutt and Wellington Public Hospitals. With WHO support, he returned to New Zealand in 1986 working in Auckland Hospital until 1988, gaining additional practical skills.
On his return to Samoa, Eti was appointed Chief Surgeon and built up the surgical unit, becoming the second Samoan surgeon after George Schuster. Under Eti's steady guidance the theatre developed a core of experienced nurses and anaesthetists confident in his good judgement and careful choice of interventions. In 1990 Eti was awarded the FRACS, the first Samoan to achieve this qualification. Roger Chambers, urologist, visiting frequently, became a friend and mentor as Eti developed a urology service, filling a much needed gap. Percy Pease also visited regularly and together they treated many paediatric patients.
Eti was hard-working and, as a sole surgeon, was continuously on-call for many years. His courtesy and calm demeanour in difficult situations was memorable and his steady, thoughtful, scientific approach to surgery helped save many lives. As a student, house surgeon, and later registrar in Samoa, I recall Eti's humorous encouragement to all his staff. I remember calling him for desperately ill patients in the middle of the night, always grateful for his support and advice. His fatherly guidance and mentorship helped us all. Eti was generous with his advice and in his training of skills he served as a role model for myself and other Samoans to enter surgery, and complete the training.
A landmark was the Australasian College meeting hosted at Sinalei resort in 1995. There, where Eti was part of negotiations, the Sinalei Declaration for a Pacific Islands regional training scheme to increase the supply of surgeons in their home countries was completed. The College has continued to support regional-based training, through the development of a Masters of Surgery degree at the Fiji School of Medicine. Eti represented Samoa at the WHO in Geneva on several occasions.
Unfortunately this work took a toll on his health. In 1995 he suffered his first heart attack, and had to cut back his clinical commitments. At the same time, in 1995, he was asked to take the post of Director General of Health for Samoa. He took this up with enthusiasm, and advocated strongly for better conditions for doctors, including improved on-call facilities and conditions. Eti's health slowly worsened, however, and he retired from this post in 2004. He started in private practice the following year with his sons. Following a further heart attack in 2008 Eti underwent coronary artery surgery in Auckland City Hospital spending several weeks in the ICU. He recovered and returned to part time work in private practice with his sons, Toloa and Pai and the assistance of his wife, Susana, and daughter Sinefu. He took up walking, and remained as active as possible. Eti became the Chancellor of the Oceania University School of Medicine in 2009, a cause he had strongly supported in his time as Director General.
Although busy and frequently on call, Eti found time after work to socialize with colleagues and continue tennis, a sport he enjoyed for many years. Golf later became his hobby. He was Secretary, then subsequently President, of the Samoa Medical Association and of the Veterans Soccer Association. He maintained lifelong support for his local church, and was a long-term member of the Lions club.
Eti continued to work until shortly before his death, aged 70 after a short illness. Susana and his family were around him. Eti's encouragement saw two sons, Toloa and Pai, become doctors, and one daughter, Sinefu, became a NZ Registered Nurse. His other daughter, Mutaaga, is a District Court deputy registrar and his third son, Tisu, a telecommunications engineer. His eldest granddaughter is studying medicine in Auckland. Eti was buried at home, a common practice in Samoa. He will be fondly remembered and missed by all who worked with him.
Semisi Aiono FRACS
(With assistance from Eti Enosa's family).