American Samoa's LBJ hospital is to expand its Dialysis Unit this year to accommodate the increasing number of patients being treated for diabetes.
The LBJ chief executive, Joe Davis-Fleming, says there has been a 77 percent increase in patient numbers over the past four years, from 70 patients in 2009 to 124 this year.
He says that's an annual increase of about 19 percent.
The CEO says all dialysis patients receive treatment three times a week.
To accommodate them, the hospital operates the Dialysis Unit over three shifts, sometimes starting at 3am and going as late as 9pm.
Mr Davis-Fleming says it is cheaper to expand the Dialysis Unit rather send patients off island, which is much more expensive and inconvenient for the patient and their families.
The expansion will take 18 months to complete.