Samoa's measles epidemic and national efforts to immunise have put Red Cross workers under huge pressure as the death toll continues to rise.
Surgical face masks are now becoming a common sight in the shops and streets of Apia as the community responds to the measles alert. Photo: RNZ Pacific / Jenny Meyer
All but four of the 33 deaths are children - under the age of four - including one who died in the past day.
About 200 people with the disease remain in hospital.
A mass vaccination campaign is under way and dozens of New Zealand nurses are in Samoa to assist.
Red Cross health delegate Karen Page is preparing to spend Christmas in Samoa if she's required to stay and help.
She arrived on Sunday and is working in the capital, Apia.
She's one of seven who have travelled to help get everyone immunised as quickly as possible, as well as educating locals that it takes a couple of weeks before the vaccination is fully effective.
Ms Page has seen a young boy - about eight years old - isolated and waiting to be taken to hospital.
"We have a little roped-off area for children that come in with suspected measles and they're all referred to the hospital ... they get really red eyes ... he was just waiting for his mum to pick him up and he was being shipped off for assessment at the hospital," she said.
As the hospital tries to keep the diesease contained, it is only allowing in one family member per child, she said.
She was not sure if he was now one of the victims. She said hospital staff were under immense pressure.
"The hospital here desperately is needing qualified ICU general and paediatric nurses just to cope with the workload," she said.
Ms Page said the effects from the epidemic were widespread.
"The schools are closed, they've banned public gatherings - that includes children under 19 years old - the swimming pools are closed. I heard this morning that they're going to close the night clubs as well," she said.
Andrea Chapman has been doing door-to-door vaccinations. Photo: Supplied / New Zealand Red Cross
Andrea Chapman, who is also working for the Red Cross, has been travelling door to door around the capital vaccinating people against measles.
She said she had probably immunised about 60 people today.
"Once you are there ... you know they all want vaccines - because there has been a lot of obviously anti-vaccine comments up until now - but now they're all very keen to be vaccinated," she said.
She said some households had kids with measles - but they were on the path to recovery - and not in any danger.
"The children that are home - they just make a recovery - an uneventful recovery without complication," she said.
Auckland University Immunisation Advisory Centre director Nikki Turner said it was unclear how long the epidemic would last.
"The answer is that people have either had measles now - or they urgently need to be immunised."
"Once people have either had measles or they're immunised - the virus can then no longer spread," she said.
The New Zealand government is on standby with more support if that's requested by Samoan authorities.
