UNIVERSITY OF HAWAI'/lIBRARY "ALANDSETAPART": DISEASE,DISPLACEMENT, & DEATH ATMAKANALUA, MOLOKA'I A DISSERTATIONSUBMITTEDTOTHEGRADUATEDIVISIONOFTHE UNIVERSITYOFHAWAI'I INPARTIALFULFILLMENTOFTHE REQUIREMENTS FORTHEDEGREEOF DOCTOROFPHILOSOPHY IN HISTORY MAY2004 By Kerri A. Inglis DissertationCommittee: PaulineKing, Chairperson Jerry Bentley Nina Etkin DavidHanlon Richard Rapson iii © Copyright 2004 by Kerri A. Inglis iv Firstandforemost, this dissertationis dedicated to my dearfriend, Clarence JosephNai'a, "Uncle",whosespirit,love, andencouragementhaveblessed mylifewith the greatestofjoys-knowinghim-and to all ofhis brothersandsisterswhose spirits have andcontinueto dwellupon the'AinaofMakanalua. Itis also dedicated to BernardK. Punikai'a,whoseexample, love, andencouragementhave continuedto inspiremeinmystudyofthis episodeinHawai'i's past. Uahila 'iaikeahaakealoha. v ABSTRACT The 19th centurybroughtmanyforeigners andforeign diseases to the Hawaiian islands, includingthatancientscourge,leprosy. Fearinganepidemic, the Board of Health ofthe Kingdom ofHawai'i chosetosend all sufferers ofthe disease to a peninsula onthe island ofMoloka'i. A greatdeal has beenwrittenconcerningleprosy inHawai'i, althoughmostworkshavefocused onthe life and contributionofFather DamienDeVeuster. Thisstudyendeavorsto lookmorecloselyat the Hawaiian experiencewithleprosyfrom acultural and environmentalperspective. Thegeographicalisolationofthe HawaiianIslands allowed for anenvironment thatwould foster the rapid spread ofintroducedinfectious diseases, as Hawaiians lackedimmunityagainst them. Mostofthe introduced diseases to Hawai'i claimed theirvictims quickly, however,leprosylingered as itdisfigured thehumanform and as suchwas "setapart" from otherinfectious diseases as the public perceived itand inits treatment. Isolationwas the treatmentofchoice. Hawaiianswith the disease were subjectto the 1865"Actto Preventthe SpreadofLeprosy," were deemed"civilly dead," and wereexiledto the leprosysettlementat Makanalua, Moloka'i. Somewould resist the lawand the prescribed "treatment," many Hawaiianswould k6kua(help)those whowere afflicted,butmostsufferersofthe diseasefound themselvesbanished ona beautifulbutdifficult peninsula, strugglingtosurvivethe realities oflivingwith the vi diseaseinlessthanideal conditions. Resistance against the 1865Actvaried. Somehidfamily memberswith the diseasefrom authorities, while others resorted to violencetoavoid banishment. Those whoeventuallyfound themselves atthe leprosysettlementwerefaced withalife (death) sentenceinexile, confrontingmortalityona dailybasis. ThehistoryofleprosyinHawai'iexposes anepisode offar-reaching significance. Disease, ofcourse, oftenleadsto death and a primaryconsequenceof leprosyinHawai'iwas the individualloss oflife. Butthis particular disease, "setapart" from other diseasesinits time, alsohad significantconsequences for the Hawaiian community, culturallyand environmentally. vii TABLEOF CONTENTS Abstract v ListofTables , x ListofFigures xi ListofAbbreviations xii Preface ................................................... . xiii CHAPTER1,"NANANOA KA LA'AUKU HO'OKAHI": LOOKFORTHE PLANT THATSTANDSALONE 1 ,A'ohe pauka 'ikeikahalauho'okahi 5 Ka Waihona0 Ka Na'auao 13 A Land and A Disease "SetApart" 18 TheHawaiianIslands 21 TheIsland ofMoloka'i 31 Makanalua peninsula 35 Forei~n Diseasesand Leprosy 38 Kalawao and KalaupapaSettlements , 42 A HistoryofMakanalua 45 Disease, Displacement. and Death 52 EnvironmentalHistory +HawaiianModels andMetaphors. ............... 54 CHAPTER2, "HEMA'I MAKAMAKA'OLE": THEDISEASETHATDEPRIVESONE OFRELATIVES AND FRIENDS 63 Forei~n DiseasesinHawai'i " . 64 Leprosy 68 A GeneralHistory 68 TheSocialConstructionofLeprosy. .............. . 77 MedicalHistoryofLeprosyand ItsTreatment 81 IntroductionofLeprosyto Hawai'i 85 KanakaMaoJi Reaction(s) to Leprosy 87 K6kuaand Leprosy ................................ . 91 Keikjand Leprosy 93 Haole Reaction(s) to LeprosyinHawai'i 96 viii CHAPTER3, "A PRISONFORTIFIEDBYNATURE": THECRIMINALIZATION OF LEPROSYINHAWAI'I 105 AnActto PreventtheSpread ofLeprosy 105 Makanalua, The Choiceofthe Board ofHealth 110 Patients tobePunished. ....................... . 112 TheRemoval ofKama'clina Fromthe Peninsula 118 LeprosyPatients atMakanalua ............... . 121 TheCriminalizationofthe Victims ofDisease . 124 Keanu and Dr. EdwardArning 129 Isolation, ALife/DeathSentence inthe "NaturalPrison" 142 CHAPTER4, "DONOTTHEHAOLES ALWAYS BRINGDEATH TOTHEKANAKA INTHE END?": HAWAIIANRESISTANCETOTHELEPROSYLAWS AND SETTLEMENT 152 ResistingArrest 153 Ko'olau and Pi'ilani 153 Kapea Kaahea and Dr. Tared Smith 163 Momona and Lohiau 166 Kalama 169 OtherForms ofResistance 171 Kama'clina ofMakanalua 172 ResistanceThroughLegislation , 174 StoriesofResistanceinLate 19th & Early20th C. Literature 175 AlfredLindsley's"Aikualani: The Storyofa Leper" 175 TackLondon's Tales ofthePacific 180 CHAPTER5, "KALUAKUPAPAUKANU OLA": LIVINGWITH DISEASEAND DEATHATMAKANALUA. 187 TheRealities ofMakanalua 188 Climate 194 LackofProperShelter 197 PoorlyDistributedFoodRations 199 InsufficientWaterSupply. ............ . 202 Livingwith the Diseaseand Dealingwith Death 205 MedicalTreatment. ................................. . 206 The Hospital 208 Ho'opauKeaho 211 Na PualiEkolu0 Kalawao(threeknots tieofKalawao) 213 TheAli'iandtheKanakaMaoliofKalawao 214 ix CHAPTER6, "HA'INAMAlKA PUANA, NO NEIMA'I 0 KA LEPELA": WHAT WILLLEPROSYDOTOMY PEOPLE? WHATWILL BECOMEOFOURLAND? 222 Individuals 229 TheHawaiianFamily 232 Ma1Ho'oka'awale 235 HawaiianCulture & Society ...... .237 An EnvironmentofIsolation 258 "Theland isbecomeempty": depopulationby disease 261 The Scars ofDisease . 263 GLOSSARY 267 APPENDICES 270 A. HeKanawai;EKaohiAiIKa LahaAna 0 KaMaiLepera 270 B. AnActtoPreventtheSpreadofLeprosy. ..... . 272 C. KaHoikeakaMea KiekiekeKamaliiwahineLiliuokalam,noka HuakaiakeAliikaMoiwahineKapiolanii Molokai Iualai 1884 274 D. ReportofHerMajestyQueenKapiolani's visittoMolokai byH R. H PrincessLiliuokalam,July, 1884 289 E. HeMau OleloAoEPiliAnaIke OlaKino naKanakaHawaii 0 "NoKa Lepera" 300 F. SanitaryInstructionsforHawaiians, "Leprosy" 305 BIBLIOGRAPHy 311 x LISTOFTABLES Table Page 1. LeprosyInRelationto HawaiianDepopulation, 1866-1910 69 2. PatientAdmissions & DeathsinLeprosySettlement, 1866-1897 233 xi LISTOFFIGURES Figure Page 1. Map ofHawaiianIslands 24 2. MapofMoloka'i 33 3. Makanalua peninsula 37 4. WaikoluValley 43 5. Kalawao graveyard 45 6. Map ofMakanalua peninsula 190 1. Letterfrom Kalawao 207
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