We cannot verify your location
Browse Book and Journal Content on Project MUSE

Ma‘i Lepera

A History of Leprosy in Nineteenth-Century Hawai‘i

Kerri A. Inglis

Publication Year: 2013

Ma‘i Lepera attempts to recover Hawaiian voices at a significant moment in Hawai‘i’s history. It takes an unprecedented look at the Hansen’s disease outbreak (1865–1900) almost exclusively from the perspective of “patients,” ninety percent of whom were Kanaka Maoli (Native Hawaiian). Using traditional and nontraditional sources, published and unpublished, it tells the story of a disease, a society’s reaction to it, and the consequences of the experience for Hawai‘i and its people.

Over a span of thirty-four years more than five thousand people were sent to a leprosy settlement on the remote peninsula in north Moloka‘i traditionally known as Makanalua. Their story has seldom been told despite the hundreds of letters they wrote to families, friends, and the Board of Health, as well as to Hawaiian-language newspapers, detailing their concerns at the settlement as they struggled to retain their humanity in the face of ma‘i lepera. Many remained politically active and, at times, defiant, resisting authority and challenging policies. As much as they suffered, the Kānaka Maoli of Makanalua established new bonds and cared for one another in ways that have been largely overlooked in popular histories describing leprosy in Hawai‘i.

Although Ma‘i Lepera is primarily a social history of disease and medicine, it offers compelling evidence of how leprosy and its treatment altered Hawaiian perceptions and identities. It changed how Kānaka Maoli viewed themselves: By the end of the nineteenth century, the “diseased” had become a cultural “other” to the healthy Hawaiian. Moreover, it reinforced colonial ideology and furthered the use of both biomedical practices and disease as tools of colonization.

Ma‘i Lepera will be of significant interest to students and scholars of Hawai‘i and medical history and historical and medical anthropology. Given its accessible style, this book will also appeal to general readers who wish to know more about the Kānaka Maoli who contracted leprosy—their connectedness to each another, their families, their islands, and their nation—and how leprosy came to affect those connections and their lives.

18 illus.

Published by: University of Hawai'i Press

Title Page, Copyright Page

pdf iconDownload PDF (2.4 MB)
pp. i-vi


pdf iconDownload PDF (128.9 KB)
pp. vii-viii

read more


pdf iconDownload PDF (97.9 KB)
pp. ix-xii

What began more than ten years ago as an examination and exploration into a social history of medicine, concerning patients’ experiences with leprosy in nineteenth-century Hawai‘i, has become for me a much more extensive journey into Hawaiian history, culture, and worldview....

read more

Note to Readers

pdf iconDownload PDF (134.7 KB)
pp. xiii-xiv

A few words about terminology and language use in this work. Readers will notice that I use many Hawaiian terms and their English counterparts interchangeably throughout the book—this interchange is not meant to confuse but rather to illustrate the space this history...

Mō‘ī of the Hawaiian Kingdom

pdf iconDownload PDF (105.0 KB)
pp. xv-xvi

Significant Events in the History of Leprosy in Hawai‘i

pdf iconDownload PDF (411.5 KB)
pp. xvii-xviii

read more


pdf iconDownload PDF (1.8 MB)
pp. 1-16

This is a book about a people, a place, and a disease. It is not an easy story in which to engage oneself, but it is an important story. Filled with social and cultural challenges of a feared disease, displacement, and death, this microhistory metaphorically mirrors the history of...

read more

Chapter 1 A Land and a Disease Set Apart

pdf iconDownload PDF (2.4 MB)
pp. 17-45

The Hawaiian Islands began to form several million years ago, and they lie some three thousand kilometers from the nearest continent.1 They are the most geographically isolated archipelago in the world, and, as one writer has noted, “more than any other factor, it is the isolation of these...

read more

Chapter 2 The Criminalization of Leprosy in Hawai‘i

pdf iconDownload PDF (1.5 MB)
pp. 46-77

Kauikeaouli (Kamehameha III) had the longest reign of any monarch of the Kingdom of Hawai‘i and oversaw some of the most significant and complex political changes of the nineteenth century. Ka‘ahumanu’s influence on him had been great, but upon her death on June 5, 1832,...

read more

Chapter 3 Accommodation, Adaptation, and Resistance to Leprosy and the Law

pdf iconDownload PDF (2.3 MB)
pp. 78-108

Lota Kapuāiwa’s (Kamehameha V’s) reign encompassed a new constitution, growth in industry and business, increase in immigrant labor, and a synthesis of traditional and Western concepts and institutions. A prime example of this merging of tradition and Western ideas was the establishment...

read more

Chapter 4 Living with Disease and Death at Makanalua

pdf iconDownload PDF (5.4 MB)
pp. 109-140

Lot Kapuāiwa (Kamehameha V) died in December of 1872, and because a successor had not been named, an election was necessary to select a new Mō‘ī. Two front-runners emerged, William C. Lunalilo and David Kalākaua. Lunalilo was a cousin to Kapuāiwa and a descendant of a...

read more

Chapter 5 The Journey into Exile

pdf iconDownload PDF (840.7 KB)
pp. 141-168

David Kalākaua became Mō‘ī on February 12, 1874, after defeating Queen Emma in a special election. The new king had the support of sugar planters and businessmen who wanted the monarch to support their financial endeavors and ties to the United States. The Reciprocity...

read more

Chapter 6 Ma‘i Ho‘oka‘awale—The Disease That Separates

pdf iconDownload PDF (6.4 MB)
pp. 169-195

When Lili‘uokalani ascended the throne after the death of her brother, King David Kalākaua, her priority was simple—to preserve the independence of the Kingdom of Hawai‘i....

read more


pdf iconDownload PDF (1.1 MB)
pp. 196-198

From 1866 to 1969, seven to eight thousand people who suffered from or were suspected of having leprosy (now known as Hansen’s disease) were sent to Makanalua (Kalaupapa peninsula); the majority of those sent arrived prior to 1900. While the conditions at the leprosy settlement...

read more

Appendix A: He Kanawai—E Kaohi Ai I Ka Laha Ana O Ka Mai Lepera

pdf iconDownload PDF (121.3 KB)
pp. 199-202

No ka mea, ua nui ka laha ana o ka mai lepera iwaena o na kanaka, a no laila, ua loaa ke kumu oiaio e anoninoni ai ka manao; a no ka mea ua kanalua kekahi poe no ka mana o ka Papa Ola e lawelawe ma ia mai, oiai nae e waiho nei ka Pauku 302 o ke Kanawai Kivila; a no ka mea...

read more

Appendix B: An Act to Prevent the Spread of Leprosy

pdf iconDownload PDF (96.6 KB)
pp. 203-206

Whereas, the disease of Leprosy has spread to considerable extent among the people, and the spread thereof has excited well grounded alarms; and whereas, further, some doubts have been expressed regarding the powers of the Board of Health in the premises, notwithstanding...


pdf iconDownload PDF (275.7 KB)
pp. 207-242


pdf iconDownload PDF (163.5 KB)
pp. 243-246


pdf iconDownload PDF (229.5 KB)
pp. 247-258


pdf iconDownload PDF (318.7 KB)
pp. 259-bc

E-ISBN-13: 9780824865795
Print-ISBN-13: 9780824834845

Publication Year: 2013

Research Areas


UPCC logo

Subject Headings

  • Leprosy -- Patients -- Hawaii -- Kalaupapa -- Social conditions.
  • Kalaupapa (Hawaii) -- History -- 19th century.
  • You have access to this content
  • Free sample
  • Open Access
  • Restricted Access