When the people of Hawai'i saw the first cases of Hansen's disease, they thought it had arrived with early Chinese traders, possibly as early as 1820 or 1830. They called it mai pake, or Chinese disease.
It struck down Native Hawaiians more than others, and children were the most susceptible.
By 1865, there was such a public panic over what was then called leprosy that the kingdom's Board of Health banished the afflicted to the Kalawao settlement on Moloka'i's remote Kalaupapa Peninsula.
The first group arrived there in 1866 — nine men and three women. They found a barren landscape battered by northeast trade winds and shadowed by towering sea cliffs. There were no shelters, no tools, no doctors. It was a wild place without law.
The kingdom tore apart families to segregate the ill from the healthy.
Some tried to hide, but few succeeded like a Kaua'i resident named Koolau, who took his family and a few ailing Native Hawaiians into remote Kalalau Valley. He eluded numerous posses and killed two sheriff's deputies sent to apprehend him. The disease killed Koolau, but he died a free man.
More than 1,000 people had been sent to Kalawao by the 1870s. The average life span of someone exiled to the peninsula was four years.
Some people did go to their aid. Congregational ministers, a few Catholic priests, some Mormon elders, and family and friends of patients voluntarily traveled to Kalawao.
The Board of Health sought to improve conditions by building structures and sending food and supplies, but could not keep pace with the growing number of patients sent to the settlement.
Father Damien, a Catholic priest from Belgium, arrived in May 1873. There were a few structures there — two chapels and a few empty buildings — and Damien used his skills as a carpenter to create new structures out of supplies he demanded from health officials in Honolulu.
Damien built a thriving community that expanded to nearby Kalaupapa, a village named for the peninsula. But he could not escape the disease that afflicted his flock. He died in 1889.
At the time of his death, Damien was being helped by others, including Mother Marianne Cope, a Franciscan nun from upstate New York who spent 30 years on the peninsula and was buried there.
Mother Marianne had come to Hawai'i at the request of the kingdom, arriving in 1883 to run the Kaka'ako Branch Hospital on O'ahu, which served as a receiving station for Hansen's disease patients. In 1888, she and two other nuns moved to Kalaupapa to help establish the Bishop Home for more than a hundred homeless girls exiled there.
In 1915, a young student at the University of Hawai'i contributed groundbreaking research toward treatment of the disease. Alice Ball, a chemist, identified the chemicals in oil from a chaulmoogra tree but died before learning more. Another UH researcher used Ball's work — uncredited, however — to develop a treatment that was successfully used before sulfone drugs rendered the disease non-contagious in the 1940s.
Despite sulfone, people were exiled in Kalaupapa until 1969. More than 8,000 people were sent there. Today, fewer than 30 patients live in the settlement, staying because they choose to and ranging in age from 64 to the 90s.
