Sun, fun, a mai-tai. Some hula, perhaps a coconut, and grass skirts.
What? Where did that last one come from?
Settle in kids and let’s talk about a lesser known part of Hawaii’s history.
No one knows when, or precisely how, leprosy arrived in the Hawaiian Islands, but State health records suggest local doctors had probably detected the disease by the late 1820s and certainly by a decade later.
By the way, “leper” is considered a derogatory term and the preferred name for the disease itself is “Hansen’s disease.” I use the historical name “leprosy” when talking about the disease in the past and “Hansen’s disease” for references in the current era. E kala mai, no offense intended. But I digress.
The Hawaiian street name for leprosy was mai pake or “Chinese disease” perhaps because Chinese immigrants were among the first diagnosed, perhaps because Chinese immigrants were familiar with the disease in their home country or because trading ships from China were thought to have brought the disease to the islands.
Whatever the derivation of the name, leprosy cut across all populations in the islands, but Hawaiians were particularly vulnerable to introduced diseases, having no immunities.
By the mid-nineteenth century, the Hawaiian people suffered death and disfigurement at alarming rates.
While not a fast killing illness in and of itself, people afflicted with leprosy usually had short life spans, falling victim to other opportunistic diseases.
Leprosy was especially cruel to Hawaiians. They called it mai ho’oka’awale, meaning the “separating sickness” because it split families apart.
To Hawaiians, a person who is separated from his or her ohana – family – is wholly isolated and has no expectation or hope of support. Such a person is totally alone with no link to the land, the sea or to their ancestors; a horrible condition for a people who framed their personal identity within the context of their genealogy.
Fearing untamed spread of the disease, King Kamehameha V, on behalf of the Kingdom of Hawaii, set aside land for confining leprosy patients and the police were instructed to arrest any persons suspected of having the disease under the 1865 “Act to Prevent the Spread of Leprosy”.
A facility was opened in Honolulu to treat the ill but people with advanced cases of the disease were sent to the remote, isolated Kalaupapa Peninsula (originally named Makanalua) on the north shore of Molokai, a natural prison accessible only by sea or by hazardous pathways down 2000’ cliffs, some of the tallest ocean precipices in the world.
The Kalaupapa Leprosy Settlement opened its doors to the sick and needy in 1866. It was first populated with nine men and three women who were allegedly tossed overboard with few provisions and told to swim for shore. Hawaii was the first nation in the world to institute legally enforced exile for people with the disease of leprosy.
From 1865 to 1873 there was no medical service for those exiles, even though they had been exiled on medical grounds. From 1873 until the 1880s some slight medical service was provided by a new arrival who had been employed as a physician’s assistant in Honolulu.
During the third quarter of the nineteenth century, incidence of the disease occurred in more than 1% of the population in Hawaii and the colony’s patient population peaked at around 1,100. Based on data from the Hawaii Board of Health, the mortality rate averaged 15% between 1865 and 1897.
Fear was the primary motivation for this inhumane treatment of sick people. Folks did not understand the disease. It was deemed incurable and was terribly disfiguring. No one knew how it spread or who was most susceptible. The apparent solution was almost inevitable: lock them up and throw away the key.
The new government policies faced resistance in some places. A so-called “Leper War” started in 1893 on Kauai when a deputy sheriff was shot and killed by an infected person while attempting to force an isolated leprosy colony in Kalalau Valley to be deported. Ultimately that “war” devolved to a Pyrrhic victory and nothing of lasting significance came from the dispute.
Amidst the great suffering there were stories of great heroism, none more significant than the dedication and work of a 33-year-old Belgian missionary Father Damien de Veuster who arrived in 1873.
Father Damien lived and worked in the colony and described himself as “the happiest missionary in the world”.
His work at Kalaupapa has been recognized as a model of compassionate care, and there are statues of Father Damien in the US and Hawaiian Capitol buildings. He was canonized as a saint by the Catholic Church in October, 2009.
After twelve years among the residents of Kalaupapa, Father Damien began to notice symptoms in his foot.
One day, while preparing a bath, he unknowingly placed his foot into scalding water. His skin blistered, but he felt nothing, a well known symptom of leprosy.
For what would be the last three years of his life, leprosy ravaged Damien’s body. What started as pain in his foot turned to open sores on his left hand and disfigurement of his face. All the while, he continued his priestly work, pushing the limits his deteriorating body imposed.
After his diagnosis as a leper, he was shunned by both civil and church leaders. Father Damien died of leprosy on April 15, 1889, at the age of 49. His body was buried in Molokai, but in 1936, at the request of the Belgian government, it was exhumed and returned to his homeland.
Another great story of compassion is the beautiful and caring Franciscan nun from Syracuse, Mother Marianne Cope.
In 1883, her religious order received from Hawaii’s King Kalakaua a personal plea for help in caring for leprosy sufferers. More than 50 religious congregations had already declined his request for assistance.
Cope and six other Sisters traveled to Honolulu to answer this call, arriving on November 8, 1883. The Sisters’ initial task was to manage the Kakaako Branch Hospital on Oahu, which served as a receiving station for leprosy patients gathered from all over the islands. The hospital processed the more severe cases and shipped them to Molokai. Later, she established the first general hospital on Maui.
In November, 1888 Cope moved to Kalaupapa, both to care for the dying Father Damien who was already famous internationally and to take over Father Damien’s burden in caring for the leper community. She had met the priest shortly after her arrival in Hawaii, when, while still in good health, Father Damien had gone to Oahu to attend the dedication of the chapel in the hospital she was establishing.
When Father Damien died, the government officially gave Cope charge for the care of the boys of Kalaupapa, as well as her original commission for the female residents of the colony. Acceptance of this assignment meant that she could never return home to Syracuse yet she agreed enthusiastically to dedicate her life to helping the sick.
Cope never contracted leprosy; she died on August 9, 1918, due to natural causes. Her remains were returned to Syracuse in 2005. She was canonized, in other words declared a saint, by the Catholic Church on October 21, 2012.
A statue of Marianne Cope is located in Waterfront Park in the Kakaako neighborhood of Oahu. Flowers frequently appear at the statue, sources unknown.
By 1900, the number of new patients in the islands began a slow decline. While still stigmatized the peninsula became a destination for the adventurous tourists of the day.
Jack London wrote about his visit to the island colony in 1908, saying that, from a distance and thanks to its reputation, it seemed “the pit of hell, the most cursed place on earth.”
But after landing and spending time with the residents – watching horse races and listening to dinnertime sing-a-longs – he found himself to be “having a disgracefully good time along with eight hundred of the lepers who were likewise having a good time.”
The early visitors were looked on as daring and intrepid souls even though it is now generally agreed that up to 95% of the world’s population is genetically immune to this mild but persistent infectious disease and even among susceptible individuals the incubation period for leprosy is up to thirty years.
Antibiotic treatments for the condition began in the 1930s to block transmission of the infection and medical advances and drugs eliminated the contagious effects of leprosy in the 1940s.
Although Hawaii’s official policy was not retracted until 1969, the forced isolation of leprosy patients ended about twenty years earlier. At that time, celebrities such as Shirley Temple and John Wayne went to Kalaupapa to perform and helped to change the public perception of the now curable disease.
Today, there are no active cases of Hansen’s disease in Kalaupapa or on Molokai. The few remaining residents (I think there are about 9 people) are elderly former disease patients and their descendant families. They are far outnumbered by those in the cemetery, where there are an estimated 2,000 unmarked graves in addition to those with headstones.
They are also outnumbered by the approximately 100 staff members, from doctors and nurses to National Forest personal, who also call Kalaupapa home.
At its prime, there were a total of four churches and eight bars. Today, the four churches are still there yet only one bar remains.
There’s a gas station that sells fuel for around five bucks per gallon, and each resident is entitled to seven gallons a week.
Many folks don’t realize you can visit Kalaupapa which is now a US National Park. Visitation is strictly limited, however, and unless you are invited by a resident, tours must be arranged through Damien Tours or the Hawaii Department of Health.
For $199.00 per person you can take a mule ride down a narrow trail along those perilous sea cliffs to the Kalaupapa peninsula.
The trail is the only land access. There is a 1,786 foot drop along the 2.9 mile trail with 26 switchbacks.
Folk are left speechless by the beauty or terrified by the exposure on a near vertical hillside for the 90 minute trip.
There is a maximum of 18 mules on the trail per day so you need to plan in advance, way in advance. Age and weight restrictions apply.
If you prefer, you can arrange to hike down and back up the cliffs for about $69.00 per person.
It will help if you have a high level of cardiac fitness to do the hike. If you don’t, and if you hate heights, there is a scenic flight in from Molokai’s main airport.
All trips include a tour of the village which is like stepping into the 1960’s. Since only one barge arrives a year with supplies, much has stayed the same for a long time.
Max is afraid of heights. He says he will take a pass on an adventure to Kalaupapa, a unique piece of this island state.
Instead, the Malt prefers to forage at the local pet shop for the bits and pieces that a vertically challenged dog can find under the racks of dog food.