The Sores of Leprosy on Hawaiian History

Leprosy has a long and painful history in Hawai‘i. It ravaged many of the local peoples and tore countless families apart, changing the bodies and landscape of the Hawaiian people. The history of leprosy is a part of the history of Hawai‘i and its people, a part of it which did not die with the cure but will only suffer a true death when the last of the inflicted in the islands closes their eyes for the final time, and it shall not be forgotten even after that. It is a history that goes on to affect the stories and lives of Hawai‘i and its people today, as there is no cure for the cruelties of history.

Many believe that the Chinese brought the sickness to the islands. There is a story that Chief George Naea—the father of Queen Emma—contracted the disease from his Chinese chef. This is why it is known as Ma‘i Pake, the “Chinese sickness”, or Ma‘i Ali‘i, the “chief’s sickness” (Kalaupapa: A Collective Memory 17). Leprosy is also known to Hawaiians as “the separating sickness” because it often resulted in the separation of families. Around 8,000 people were sent to Kalaupapa over the course of a century, many ripped from their lives and their family lands to become isolated in a new place in which they had no history and therefore lost their connection to the land (Barry).

The first official report of leprosy was made in 1835, concerning a woman named Kamuli from Koloa, Kaua‘i (Kalaupapa: A Collective Memory 15). There had been several cases of the disease in the past and there continued to be more before anything was done about it. On January 3, 1865, King Kamehameha V signed the Act to Prevent the Spread of Leprosy, therefore possibly saving many from the spread of infection but also condemning many of the infected to lives of suffering and loss. This law decreed that land would have to be separated for the lepers to provide their isolation. The first group forced from their lands to the designated area of Kalaupapa on Moloka‘i consisted of thirteen people, who sailed on the Warwick to their new home on January 3, 1866. About 90% of those who would be evacuated to Kalaupapa were Hawaiians (Kalaupapa: A Collective Memory 3,4).

Though it was the law that all lepers must be removed to the colony of Moloka‘i, not all gave in to those demands. Many people, especially those with loved ones, ran away and hid in the wildernesses of their homeland to escape incarceration. This was the case with Kaluaiko‘olau, a Hawaiian man who contracted leprosy and escaped into the wilderness with his wife, Pi‘ilani, and their son. Together they eluded the authorities until Kaluaiko‘olau and his son both died from the terrible disease. The true story was recorded by Pi‘ilani, which she wrote when she returned to civilization. The True Story of Kaluaikoolau As Told By His Wife, Piilani became a book, and told the story that many other Hawaiian families of the time surely could have related to.

Kiana Davenport’s Shark Dialogues gives a fantastical and detailed retelling of the same escape to nature story that was prevalent among the lepers. In the novel, the main protagonist, Pono and her lover stricken with leprosy, Duke, escape into the beautiful wilderness of Waipi‘o. “Sometimes the bounty men found rags, cooking utensils, bones, where fugitive lepers had died, dissolved into the soil. Objects remained, but people disappeared” (Davenport 111). Fugitives did not only need to escape the authorities, but bounty hunters who scoured the valleys in search of those on the run. The wilderness took a heavy toll on many of those who had gone into hiding, and though some lived the rest of their apparently short lives in relative freedom, many were caught and sent to Moloka‘i.

For many years, Kalaupapa was a terrible place to be. There was minimal housing and a constant lack of food. There was not even a physician present at Kalaupapa until 1879. There was virtually no kindness to be found for the sufferers. Once doctors were present, ten foot poles were used to keep distance between them and the patients, and medications would be put on certain gate posts for the patients to pick up only once the doctors were out of range (Kalaupapa: A Portrait 10).

In Kiana Davenport’s Shark Dialogues, she describes the terrifying procedures which are forced upon some of the patients at the colony. “Instruments forced open the nose blocked with mucus. Opium-dipped sticks softened up the tissue, allowed the stick to penetrate all the way up the nostril. After a while, doctors withdrew the applicator sticks from deep inside the nasal passages, attached to which came mucus, tissue, and blood. Children fainted with pain. Each day they fainted, each and each, every day, year after year” (Davenport 135-136).

Davenport goes on to describe other heinous treatments that the lepers were subjected to. Their living situations were less than comfortable, and many missed their families. Unfortunately, it is difficult to ascertain if the treatments mentioned in Shark Dialogues actually took place. It might be worth mentioning that in the research done for this paper, no references of any treatments or procedures committed on the island could be found. The closest thing found was in The Leprosy Inpatient Program in Hawaii: An Analysis. It stated under “Laboratory Services,” “Tissue scrapings are collected from all leprosy suspects, new cases, and at various times from patients undergoing treatment” (AD HOC Special Study Group 65). This is vague, and could simply refer to the basic scrapings of the wounds that were known to have been taken. Any further possible information on the subject is not to be found at this time.

In 1873 Kalaupapa was changed forever when the Honolulu Catholic mission sent Joseph Damien de Veuster—better known as Father Damien—a Belgian Roman Catholic missionary, to Moloka‘i (Hotez 76). It was Father Damien who changed the face of Kalaupapa for the better. Through his nurturing nature and his belief in God he aided the lepers in any way that he could. One of his great acts of kindness was assisting in making coffins for the deceased (Inglis 129). Before this, lepers had been buried wrapped in a blanket or net which was tied around their ankles, waists, and necks. They would be put in often shallow graves in a sitting position, and it was not uncommon for their graves to be dug up by wild boar (Inglis 129). Unfortunately, Father Damien contracted leprosy after some time living in the leper colony, which he eventually died from (Gaudet, and Carville 10-11). This only enforced the fear of leprosy. He became known as the “martyr of Moloka‘i,” and was beatified in 1995 by Pope John Paul II for his dutiful sacrifice (Hotez 76).

Though Father Damien was of much importance, he was not the only person to help the lepers of Kalaupapa. In 1883, Mother Marianne Cope, a Sister of St. Francis, left New York to come to work in Hawai‘i (Greene 134). It was not until 1888 that Sister Marianne and two of her fellow Sisters were beckoned to Kalaupapa by Father Damien, where they aided the sick and assisted in running the Bishop Home, which housed 103 girls. She died on the island in 1918 at 80 years old, and was buried on the grounds of Bishop Home (“Mother Marianne Cope and the Sisters of St. Francis”).

Countless families were torn apart by ma‘i pake throughout Hawaiian history. This is why Hawaiians sometimes referred to leprosy as “the separating sickness” and Kalaupapa as “the place they never come back from” (Gaudet and Carville 151-152). Some people did accompany their leper inflicted family members to Kalaupapa, and they were referred to as mea kokua, or “people who help” (Kalaupapa: A Collective Memory 3). Even once on Moloka‘i the lepers were sometimes still faced with the loss of those that they loved. Besides the obvious passage of death, birth also sometimes brought suffering for the lepers of Kalaupapa. Before 1903, babies born to lepers were allowed to stay with their mothers at least until the time that they were weaned, at which point they may be shipped off to family or to some other living situation on a neighboring island. From 1903 and on, babies were taken as soon after birth as possible to avoid infection, leaving many heartbroken mothers in their wake (Inglis 122).

What is this disease that tears bodies and families apart? In the late 1800s, a Norwegian scientist named G.H Armauer Hansen discovered mycobacterium leprae, the bacillus that causes leprosy (Hotez 77). This is the reason that leprosy is now more commonly known as Hansen’s disease. It is a disease of the peripheral nerves that also affects the skin. The most common symptoms of leprosy are the loss of feeling in certain body parts, the loss of muscle control, and lesions on the skin (Gaudet and Carville 11-12). It is a common misconception that leprosy causes the loss of limbs and other body parts directly. The harm done to the body usually results from the loss of feeling in the infected person, which often leads to accidently harming of oneself (Gaudet and Carville, 11-12). These somewhat typical symptoms are a result of the tuberculoid form of leprosy (Hotez 77). The worse and less common form of leprosy is the lepromatous form, which may invade the bone or testes of the infected. Replication of the bacillus on the skin can lead to the skin thickening and becoming nodular and shiny (Hotez 77).

Despite the massive percentage of the Hawaiian population that was destroyed by leprosy, about 95% of people have a natural immunity to it (Gaudet and Carville 11). The disease isn’t hereditary, but one’s genetic susceptibility to it may be (Gaudet and Carville 13). Thankfully, leprosy has been controlled to an extent with drug therapy since sometime in the 1940s (Gaudet and Carville 14). In 1946, Promin, a drug to help with leprosy was first introduced to Kalaupapa, and a massive change was noticed in the leper population (Kalaupapa: A Collective Memory 455).

In 1971 research was greatly forwarded by the discovery that the nine-banded armadillo could be infected with leprosy (Gaudet and Carville 15). Unfortunately for a selection of armadillos, they began being used as test animals to search for a cure. It was the armadillo that eventually led to a successful treatment and cure for leprosy. Thanks to this, there are only about 6,000 diagnosed cases of leprosy in the United States and the possibility of about 4,000 undiagnosed cases (Gaudet, and Carville 14-15). The World Health Organization has declared that leprosy is no longer a public health problem in the United States because it no longer exceeds the 1 to 10,000 ratio. The places that currently have the highest rates of leprosy are Central and South Africa, Brazil, India, and Napal (Hotez 76-77).

Isolation of the leper colony on Moloka‘i was abolished in 1969, about 20 years after the development of the medicine that controlled and cured the disease (Barry). In 1980, Kalaupapa was made into a national historical park, which helps to preserve the land and history of the colony (Kalaupapa: A Portrait 7). Some people still live there and have no desire to leave the place that they now call home.

Leprosy changed the history of Hawai‘i drastically. Many Hawaiians were taken from their land, families were ripped apart, and the Hawaiian population plummeted. Though a cure was found, many people were irreparably affected by the terrible disease. Hawaiian history itself was scarred with the disease as it scarred its people. Despite this suffering, Hawai‘i and its people live on.

Works Cited

AD HOC Special Study Group. The Leprosy Inpatient Program in Hawaii: An

Analysis. Honolulu: Hawaii State Department of Health, 1975. Print.

Barry, Dan. “A Story of Exile and Union Few Are Left To Tell.” New York Times

1 Dec. 2008: A17 (L). Web. 8 Feb. 2015.

Davenport, Kiana. Shark Dialogues. New York: The Penguin Group, 1995. Print.

Gaudet, Marcia and James Carville. Carville: Remembering Leprosy in America.

Mississippi: University Press of Mississippi, 2004. Web.

Greene, Linda W. Kalaupapa: Exile in Paradise. Honolulu: US Department of the

Interior National Park Service, 1985. Print.

Hotez, Peter J. Forgotten People, Forgotten Diseases: The Neglected Tropical Diseases

and Their Impact on Global Health and Development. Washington, D.C: ASM