OHSU's Doernbecher Children's Hospital is expanding pediatric cardiac care and education to American Samoa, targeting rheumatic heart disease (RHD) — a condition that has been virtually eliminated in the mainland U.S. but remains endemic in Pacific Island communities. The initiative sends Doernbecher pediatric cardiologists to provide direct clinical services, train local healthcare workers, and establish screening protocols in a territory where access to subspecialty care is severely limited.

Rheumatic heart disease — caused by untreated streptococcal infections that trigger autoimmune damage to heart valves — disproportionately affects Indigenous and Pacific Islander populations living in overcrowded, under-resourced settings. American Samoa's healthcare infrastructure lacks pediatric cardiology capacity entirely, meaning children with RHD have historically required medical evacuation to Hawaii or the mainland for diagnosis and treatment. OHSU's program addresses this gap through a combination of telemedicine follow-up, on-site echo screening, and workforce training designed to build sustainable local capacity.

For the Oregon healthcare community, this initiative reflects OHSU's growing role as a Pacific regional referral center and its commitment to health equity beyond state borders. It also has practical implications: Oregon providers, particularly those in Portland's large Pacific Islander communities, should be aware of elevated RHD prevalence among recent arrivals from the territories. Primary care and dental providers — since strep throat is the upstream trigger — play a critical role in early detection and antibiotic treatment that prevents rheumatic fever progression. The program also strengthens OHSU's academic mission and competitive positioning for federal global health funding.

Watch for whether OHSU formalizes this as a permanent Pacific Islands health partnership and whether Medicaid coverage gaps for territorial residents get legislative attention.