Leprosy in Paradise

In Pago Pago, storied capital of the paradise islands of American Samoa, there was pandemonium last week over allegations that leprosy was spreading alarmingly among the territory's 20,000 people and was being shamefully neglected.

The charge came from a physician with an unusual background. Los Angeles-born Donald L. Donohugh was 17 when Pearl Harbor interrupted his premedical studies at U.C.L.A. He enlisted, then got an appointment to the Naval Academy. Graduating in 1946, Donohugh served six years (through the Korean war) before he could get to medical school (California, '56). After interning in San Diego and a residency in Monterey, he signed up for a two-year stint as a civilian medical officer in Samoa, took his wife and children to Pago Pago. There, last month, convinced that his alarm signals about leprosy were getting no results. Dr. Donohugh decided to throw his Navy training to the winds. Instead of proceeding only through channels, he labeled his charges "for wider dissemination" and slipped a copy to a newsman. What happened after that would have been grist for Somerset Maugham to grind out a sequel to Rain.

Drugs Delayed. Asserted Dr. Donohugh: the spread of leprosy in American Samoa has assumed "ominous proportions in recent years.'' One reason, he suggested, is that the admittedly low infectiousness of leprosy in well-doctored communities is breeding a false sense of security about places like Samoa, where dress, climate. and social and personal habits speed its spread. The disease did not reach the U.S. islands until 1918: in 1930 there were only three cases; by 1950 there were 42, and now he claims to have traced 212. Dr. Donohugh painted an alarming picture of what might happen in American Samoa by analogy with the flyspeck island of Nauru, where one leprosy victim landed in 1912, and by 1927 the disease had infected 750 people (one-third of the population). And in a recent survey in the Manua group of outer islands, 153 out of 1,521 people showed suspicious signs, and they were so marked in 52 cases that Dr. Donohugh thought he could diagnose leprosy on the spot.

Dr. Donohugh's main complaint: inaction, resulting from lack of interest and shortage of funds. The first of the modern, effective antileprosy drugs did not reach Samoa until 1951, eight years late. Today, this drug (DDS, for diaminodiphenyl-sulfone) is still the only one available there because it is the cheapest, though Dr. Donohugh believes later drugs would be more effective. And the tumbledown barracks building under a banyan tree. used as a leprosarium, is in such disrepair that Dr. Donohugh suggested the only thing to do was to burn it down.

"Pack at Once." The circuits crackled as soon as the Department of the Interior heard of Dr. Donohugh's "wider dissemination" of his blast, and the humid air of Pago Pago became electric. Governor Peter T. (for Tali) Coleman* called in Dr. Lawrence H. Winter, 44. the island's director of medical services, and Donohugh's boss. On the strength of Dr. Winter's complaints about Dr. Donohugh and his ultimatum ("Either he goes or I go"), Coleman summarily dismissed Donohugh, though his contract had three months to run, ordered him to pack and get out of the islands with his family this week. Dr. Donohugh protested that this gave him no time to get an attorney from the U.S. to fight his appeal against dismiss al, had to use ham radio friends to get quick word through to his father in Los Angeles for relay to California's Congressman Cecil King.

Dr. Winter questioned Dr. Donohugh's estimates of the growth in numbers of leprosy cases, but admitted there is a problem that cannot be resolved on the island's leprosy budget of $4,000 a year ( less than the budgeted cost per leprosy patient in the U.S.). Last week Interior officials arranged with the U.S. Public Health Service to send a team of ex pert leprologists to Samoa.

The department also decided that it would be poor public relations to boot Dr. Donohugh out, no matter how wrong it considered him. On its advice, Gover nor Coleman stayed his deportation or der until the PHS crew could get there and Dr. Donohugh could present his evidence to them. Meanwhile, Dr. Donohugh was threatening suits for libel and slander. And in Pago Pago the rain beat down on elephant-iron roofs, and its nerve-racking effect was the same as when Physician Maugham dropped in almost 50 years ago.

* The territory's first native-born Governor, son of an ex-Navyman who married a full-blooded Polynesian.

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