Reports from American Samoa say layoff letters have been delivered to some LBJ Medical Center employees amid a deep funding crisis.
Our correspondent says about 200 staff have been told that they will be put on indefinite unpaid leave from February the 19th.
Hospital sources say among the workers are about 20 physicians.
The letters, which have been signed by the LBJ chief executive officer, Michael Gerstenberger, say the move is due to a lack of funds.
He says he hopes that the hospital can convince the government to provide necessary financial assistance.
The funding problems have prompted the hospital to increase fees, with the government now vowing to take control of the hospital.