Medical Segregation (est. 1865)
The threat of a leprosy epidemic forced the Board of Health to urge King Kamehameha V to isolate those who were afflicted. In 1865, he passed "An Act to Prevent the Spread of Leprosy," which segregated the afflicted to the Kalaupapa peninsula. This decision upset the Hawaiians, whose culture revolved around the maintenance of one's relationship with his family, and revealed the political pressure on Kamehameha V by Americans.
Excerpts from "An Act to Prevent the Spread of Leprosy" (January 3, 1865).
"From a medical standpoint, because there was no established medications for Hansen’s disease available...King Kamehameha V had little options. The Native Hawaiian Population already was vulnerable to many other diseases, and it did not take much to have any disease reach epidemic proportions...I believe the forced segregation was the best means to control the disease available to the decision makes at that time." |
Photo courtesy of Hawaii Magazine (2009).
Medical researcher David Scollard on Kamehameha V's decision to segregate those with leprosy. Courtesy of Stephanie J. Castillo via YouTube (2007).
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Photo courtesy of John Tayman's The Colony (2006).
"It will be the duty of the...Legislature to devise and carry out some efficient, and at the same time, humane measure by which the isolation of those afflicted with the disease can be accomplished." |
Photo courtesy of Ralph Simpson Kukendall's Hawaiian Kingdom 1854-1874.
"[Dr. Ferdinand Hutchison], the minister of the interior brusquely told the King: 'I have to carry out the law which your Majesty approved.' The King bowed his head, realized the unpleasant truth which he had to tell those of his people present...When the emissary reached home from Honolulu and told the other Kama'ainas (natives) the sad news of their banishment, loud lamentations were heard." |
Photo courtesy of Hansen's Disease Medical Examination Photograph Collection from the Hawai'i State Archives.
"The greatest obstacle to be overcome in carrying out the law of segregation...consists in the fact that the Hawaiians themselves do not appreciate, and refuse to be convinced, that leprosy is a communicable disease, that the leper is unclean and should be shunned, as the bearer of a deadly contagion." |
Geographic Isolation
Kalaupapa was chosen for its geographic isolation, which made it impossible for patients to escape once they were isolated.
"You will know that on account of the prevalence of this disease of leprosy in the nation, a division of land has been set apart for the isolation of those [afflicted]. This measure is for the good of the nation, and being law, it must be executed. But it is a sad thing to be thus separated from friends and loved ones; how else however are the laws to be executed?"
-King Lunalilo, in a letter to Kalaupapa residents, Pacific Commercial Advertiser (May 10, 1873)
Photos courtesy of R. D. K. Herman (2001).
"[Kalaupapa] is difficult to access from the sea; has no roads passing through it into other districts; is supplied with water by two running streams; has a large area of kalo [taro] lang; enjoys the advantage of the constant trade wind; has ample grazing lands; and possesses the soil capable of raising vegetables of all different kinds adapted to these islands in the greatest abundance. These lands are situated on a peninsula, washed by the sea on three sides, and bounded by high precipices on the south, the only access being by a path cut in the pali [cliff] of 1,800 foot elevation."
-Dr. Ferdinand W. Hutchison, President of the Board of Health (1865)
NPR correspondent Terry Gloss' interview with The Colony author John Tayman about Kalaupapa's geographic isolation (Feb. 2, 2006).
Medical segregation reflected the Western paradigm of eradicating leprosy for its past use in Europe and North America but was unfamiliar and unacceptable to the Hawaiians.
Video about the isolation in Kalaupapa. Courtesy of Frances Carter via YouTube. (2011)
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"Overwhelmingly, the Native Hawaiian response to any disease, including leprosy was to kokua, or to help the person with the illness. The western approach to leprosy was to quarantine those with the disease. Unfortunately, leprosy quarantine and the way it was so often carried out, was experienced by most as isolation, banishment, and even abandonment." "From the beginning, the people who had leprosy and their families asked the Board of Health and petitioned the Legislature to have hospitals for leprosy established on each island. The people were willing to come in for treatment – what they weren’t willing to do was have family members taken away to a place where they would never see them again." |
"The decision to employ isolation was made easier because the disease was largely extinct in Europe (although it was endemic in Norway) and relatively rare in the United States. As such, only small populations of Westerners were subject to...leper settlements. By contrast, most leper colonies existed in colonial contexts...Poor, dark-skinned, racial Others of the India, Africa, Asia, and the Pacific islands made up the majority of the world's cases [so] white Western authorities had little impetus to shift from this paradigm."
-Nicholas Turse, "Experimental Dreams, Ethical Nightmares: Leprosy, Isolation, and Human Experimentation in Nineteenth-Century Hawaii" (2007)
Resistance to Segregation
Rather than leave their families, many Hawaiians hid from government officials to avoid medical inspections that would sentence them to life at Kalaupapa.
Photo courtesy of the Hawaii State Archives (1900).
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"Hawaiians had no fear or disgust of leprosy or those who had it. What they feared was the compulsory banishment to Kalaupapa, the public health officials that sought to arrest them, and the disdainful treatment by a fearful American community that shared power with and greatly influenced their Hawaiian monarchy." "It was a dark chapter in Hawaiian history. Bounty hunters roamed the islands in search of suspected leprosy cases; families were torn apart by what they called 'the separating sickness.'" |
Photo courtesy of Chronicling America (1893).
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"[There were] rebellions on one or two islands--active in some cases. violent resistance'--by Hawaiians diagnosed with Leprosy who refused to be parted from their families...[An example is] the case of Kaua'i's Ko'olau, who shoots and kills an arresting sheriff in a gun battle and flees into the mountains with his wife and child." NPR correspondent Renee Montagne's interview with The Colony author John Tayman about Ko'olau's defiance (Jan. 23, 2006).
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Photo courtesy of the Hawaiian Mission Children's Society Library.
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Sentenced for Life: Patients Examined and Isolated
In 1866, 141 mostly Hawaiian patients arrived at Kalaupapa, beginning a continuous wave of segregated patients there during the late-nineteenth and early-twentieth centuries.
"Board of Health reports in the first several years of the settlement's existence indicate that the government expected the segregation policy to work quickly.[However,] by the 1870s, leprosy was unmistakeably epidemic among the Hawaiian people...in the 1890s...2 percent of the entire surviving Hawaiian population [was afflicted]."
-Hawai'i Department of Land and Natural Resources, "Kalaupapa Report on Senate Resolution No. 354" (1975)
Photo courtesy of Emmett Cahill's Yesterday at Kalaupapa (1991).
"I have examined over one thousand people. Four hundred and ten cases have been sent to Moloka'i, 240 men and 170 women, all natives and half-whites, with the exception of six foreigners, one American, one Frenchman, one Englishman, and three Chinamen...We may positively declare that by this time there are not over fifty cases at large in the Hawaiian Kingdom. They will be gradually discovered."
-Physician of the Board of Health G. Trousseau (July 8, 1873)
Personal photo courtesy of document from the Hawai'i State Archives.
"Young or old, once their leprosy was diagnosed, it was Hawaii policy from 1865...that they could be subject to involuntary lifetime isolation at Kalaupapa. They were prisoners as much as any person ever sentenced by a court." |
Table courtesy of Pennie Moblo's "Defamation by Disease: Leprosy, Myth and ideology in Nineteenth Century Hawai'i" (May 1996).
"From the time Hawai'i initiated a policy of segregation the rate was stable, averaging about 135 new cases of leprosy per year...while only sixteen whites were sent to the Moloka'i settlement between 1866 and 1885, some 2,997 native Hawaiians were banished there." |
Photo courtesy of Emmett Cahill's Yesterday at Kalaupapa (1991).
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Personal photo courtesy of document from the Hawai'i State Archives.
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Photo courtesy of and Anwei Skinsnes Law's Kalaupapa: A Collective Memory (2012).
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NPR correspondent Terry Gloss' interview with The Colony author John Tayman about segregation to Kalaupapa (Feb. 2, 2006).
"They were strangers to each other, collected by common calamity, disfigured, mortally sick, banished without sin from home and friends. Few would understand the principle on which they were thus forfeited in all that makes life dear; many must have conceived their ostracism to be grounded in malevolent caprice; all came with sorrow at heart, many with despair and rage. In the chronicle of man there is perhaps no more melancholy landing than this."
-Robert Louis Stevenson, Travels in Hawai'i (1889)
Photos courtesy of Hansen's Disease Medical Examination Photograph Collection from the Hawai'i State Archives.