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Leprosy!
By Diannek


Molokai is known as the friendly isle, but that seems an inappropriate description. To me it feels like the strange one, when compared to the other islands. There's not much happening on Molokai. No industry, no farming, not much fishing, not even much tourism. It's hard to figure out what those 7,000 people who live there do for a living. Visitors don't feel welcome. For the tourists, there is one resort and one golf course, but even that appears to be struggling. The brochures like to refer to Molokai as old Hawaii, but to me it looks more like down-on-its luck, nothing-happening, where's-my-welfare-check Hawaii.
Molokai
Here's a photo I snapped over the pilot's shoulder as we flew into Molokai's Kalaupapa. The dark land just  below the cloud is where the victims of leprosy were dropped off beginning in 1865. Notice the steep 2,000 foot cliffs at the right.

When people think of Molokai, the word leprosy automatically comes to mind. Molokai and leprosy are chained together. Unfortunately, leprosy plays a huge part in the history of the Hawaiian Islands. It's a heartbreaking tale of woe. Apparently, in the pre-contact days of old Hawaii there had been no devastating illnesses to speak of and as a result, the Hawaiians were not equipped physically to cope with the onslaught of bacteria and viruses that would find their way here with contact from the outside world.

It has been noted that Captain Cook's men were the first disease carriers and most likely they infected the natives with several venereal diseases, which began to take hold almost immediately after contact in the late 1700s. And then a variety of illnesses nearly wiped out the entire population of the islands. They had no immunity to small pox, whooping cough, or even measles.  But it was leprosy that took more lives than any other disease to come ashore. It was never determined exactly how the first Hawaiian victim of leprosy became infected.  Part of the reason for that lack of knowledge was because until the mid 1900s nobody even knew how people catch it in the first place.

Some medical historians speculate that it came to Hawaii with the arrival of Chinese laborers who were engaged as contract workers when the plantation economy and its need for manual laborers came into full swing in the mid 1800s. Workers were needed to clear fields, to work in the sugar cane industry, to dig irrigation ditches and do all the other heavy labor demanded at the time. The Chinese were willing laborers. They may have brought the disease with them.

Leprosy was and still is a dreadful illness, where, if untreated, the victim dies a slow and painful death. A person can live on for years after catching it. The first symptoms are barely noticeable, but they become increasingly more apparent and more devastating as the disease takes hold of the body and begins disfiguring its victim. Arms and legs might become numb, open and running sores appear that won't heal. Disfiguring lesions around the facial area erupt, leaving the victim nearly unrecognizable. Lungs won't function properly. There was no cure in those early years and there wouldn't even be a way to control it until the late 1940s, when it was discovered that sulfanate drugs relieve the symptoms and even allow the body to restore itself to its pre-leprosy status.

And then of course, there was the social stigma that comes with the disease.  Leprosy victims were often mentioned in the bible as unclean outcasts to be shunned by the rest of society. The missionary influence was strong in Hawaii during the time when the first cases of leprosy began to occur.  So if a family member became stricken with the first symptoms of this dreaded disease, the rest of the family would deny that anything was wrong and go to extremes to hide the sick one from the others in the community. Unfortunately, this only made the problem worse because it has been determined later that people catch leprosy by close and frequent contact with the infected one.

It was thought at the time that leprosy was a type of venereal disease that was transmitted by sexual contact.  So of course this added to its social stigma. People continued to believe this theory of infection even when children came down with it, and when old people came down with it, and even when grandmothers came down with it, and priests and nuns came down with it. The evidence didn't fit the theory but the theory remained. So besides being dreadfully ill, the victims were also seen as outcasts from grace, a terrible situation for the newly converted Christians.

As hundreds and then thousands of Hawaiians began to die of this dreadful disease, it became apparent that drastic measures would have to be implemented.  In 1865, King Kamehameha decreed that the Hawaiian lepers had to be separated from the rest of society.  A place had to be found to banish them to where they couldn't escape, but where they could fend for themselves until a cure for their illness might be found.

That's where Molokai comes into the picture. It's a smallish island with no safe harbors so there was no easy way for the boats to land there. And on the island itself there was one very special place that had at one time been a refuge of kings. It was beautiful, it had good soil for gardening and clear drinking water. But the one thing that made it desirable as a place of banishment was that it was a small outcropping of land protruding into an angry sea, nestled below 2,000-foot cliffs that form the backbone of Molokai. It was called Kalaupapa, and it was the perfect place to dump the victims of leprosy.

The king didn't actually decree that they should be dumped there. It was proclaimed that they should be deposited there until a cure was found.  In the meantime, since many of them were assumed to be in relatively good health, it was assumed that they would build themselves shelters and do some gardening and build a community and live together and care for each other.  They were taken by boat to the breakwater and offloaded to swim to shore.  Some of the first ones to be shipped off died even before they reached the shore because of the rough and pounding waves beating the shores of Kalaupapa. 

Conditions were horrible because most of the patients were too sick to take care of themselves, and things only became worse as more and more hapless victims were deposited there. Once the word reached the outside kingdom of Hawaii, nobody wanted their family members to go, so families became even more protective of their sick ones. And of course, this contributed to even more Hawaiians coming down with this scourge.

Eventually, in 1873, a catholic priest by the name of Father Damien convinced his organization to let him live with the victims on Molokai and take care of them. The story of Father Damien's courage and resourcefulness in establishing Kalaupapa into a more benevolent place has been told by several historians.  It's one of those stories that give us hope.

Hello from Kalaupapa
Our tour guide took our photo when we first arrived on this
remote part of Molokai. It was quiet and sort of spooky, like 
the spirits of all those who had died were there with us.

Several years ago I visited Kalaupapa.  It's a national park now, but there are still residents living there who suffer from leprosy.  These days leprosy is referred to as Hansen's disease so as to separate the disease from the social stigma that surrounds it.  All of the residents are in remission and none are contagious.  They have permission to leave the island at any time but they prefer to stay there, as many of them have lived most of their lives there. 

Visitors must get permission before they are allowed into the area. A visitor can reach Kalaupapa three ways. You can hike down the cliffs or ride down on mule back, or you can fly in on a small plane. These days there's a cement wharf on Kalaupapa and a barge shows up every few weeks to offload supplies for the residents. I'm not sure if visitors can hitch a ride there on the barge.

Our guide met our party at the Kalaupapa airport. Our tour would last four hours and our guide would be with us the entire time. We arrived about ten a.m. and the first thing we did was go to the cliff trailhead to meet a couple who were hiking down that day. They would join us for our tour. There were six of us in our party that day.  

The only people we saw was our tour guide, who explained that he had been transferred to the island when he was a small boy in the 1940s, and his wife.  He had been on Kalaupapa ever since. He appeared to be in good health. He had a wonderful sense of humor and was very talkative. He was a fascinating companion. He went to great lengths to explain in a dramatic fashion the oral history of Kalaupapa. He explained that there were nearly a hundred residents still living there but that they always went indoors on visiting days.

Kalaupapa is truly a tropical paradise. The waves crash onto the shore, the palm trees sway, and the trade winds cooled us as we toured their home. We traveled in a small yellow school bus over an unpaved road that winds from the graveyard to the school house and the infirmary and then onto the bandstand by the church where Father Damien conducted Sunday services.

We were asked to bring our own lunches with us and at noontime we stopped at the bandstand for our picnic. It was a pleasant place to rest for a few minutes. It looked like a park that a visitor might find in any small town anywhere in the US. The birds begged for scraps and my husband tried to make friends with a couple of housecats and a ferret that were nosing around waiting for a handout.  

We took this opportunity to ask our guide some personal questions about living there. The one thing that he was most excited about was the satellite TV that had recently been installed. The residents were always eager for news of the outside world and satellite TV would bring it to them. We were quite amused to hear that they too were interested in the outcome of the OJ trial and the latest football scores.

Probably the highlight of the trip was to accompany our guide into Father Damien's church. That's where he told the priest's story with reverence and awe. We could almost feel his presence with us as we listened to our guide's passionate retelling of that early time. Afterwards we met our guide's wife, whose health seemed to be more precarious then his. Apparently she was in a more advance state when her leprosy was finally controlled. Her eyesight was nearly gone and she was missing some of her fingers. This was to be our one visual reminder of the devastating effects of this horrid disease.

Our guide returned us to our plane. We took off into the wind and circled the area to gain altitude for our short trip up over the cliffs and back to the main Molokai airport.  We were once again in awe of how isolated this little piece of Molokai is from the rest of the island.  The mysterious aura of Kalaupapa seems to hover over the entire island of Molokai, making it one of the strangest and most remote of all the Hawaiian Islands.


References:

Kalaupapa and the Legacy of Father Damien: a pictorial history
by Anwei V. Skinsnes Law and Richard A. Wisniewski
Pacific Basin Enterprises, Honolulu, Hawaii (1988)

If you're interested in historical fiction, try this superb novel:

Molokai, by O. A. Bushnell
University of Hawaii Press


Find it here!     

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