Ma’i Lepera: Disease and Displacement in Nineteenth-Century Hawai’i by Kerri A. Inglis (review)

The basic story of leprosy on Hawaii is well known. As leprosy rose to prominence in the nineteenth century, the kingdom established a settlement on Molokai where Father (now saint) Damien (born Jozef De Veuster) cared for the suffering victims. Inglis renders this story obsolete. She provides a fascinating and nuanced mo’olelo—a “history, story, tale, myth, tradition, literature, legend, or record”—that puts Kanaka Maoli (Native Hawaiians) at the center of the drama (1). Practicing “ethnographic history,” Inglis sets out “to search for voices yet unheard, to translate the silences, and to find meaning in those past experiences” (5, 6). She mines sources that previous historians neglected and makes powerful use of Hawaiian language letters, petitions, complaints, and newspaper editorials to reveal a world of suffering and resistance. The result is an important book for anyone interested in the history of disease and colonialism.

Each chapter leads with a brief summary of Hawaiian political history that situates the discussions that follow. When haole (outsiders) arrived, they introduced a flood of epidemics that decimated the native population. Although other diseases killed more people, “it was leprosy that was visually the most disturbing and lingered the longest” (33). When the presence of leprosy was confirmed in 1848, King Kamehameha III moved quickly to establish the Board of Health. Early efforts culminated in the 1865 “Act to Prevent the Spread of Leprosy,” which established a settlement/prison on Molokai’s Malanalua Peninsula. By the time that the isolation policy was rescinded in 1969, approximately 8,000 people had been sent there.

For many Hawaiians, who named leprosy ma’i ho’oka’awale ‘ohana (“the disease that separates family”), banishment to Malanalua was as bad as the disease itself. Despite the hopes of the Board of Health, the settlement never became self-sufficient. The inhabitants suffered from inadequate food, clothing, shelter, and medical care. They, however, pushed back. They refused to be ignored and sent petitions to anyone who would listen, asking for shoes, clothes, mail service, and coffins for their dead. They argued that if the Board of Health could not meet its obligations to provide promised care, then it had no right to enforce detention and quarantine. Inglis sees parallels between the experiences of people with leprosy and the broader population of Hawai’i. Leprosy displaced its victims from their land and families just as colonization displaced and marginalized native Hawaiians throughout the archipelago.

Ma’i Lepera covers many aspects of leprosy on Hawaii. It situates the disease history of Hawaii in broad narratives of biological exchange. It describes how Hawaiian and Western therapeutic systems interacted and how public-health policies went awry, stigmatizing and criminalizing thousands of people. It adds more exemplars to the troubling history of human experimentation, documenting how doctors inoculated infectious material into dozens of so-called volunteers to understand the transmission of leprosy. The book also explores Malanalua’s representation in American literature, as exemplified by the rosy account of a character in one of Jack London’s stories, who maintained that patients/ inmates had “‘nothing to do but have a great time’” and enjoy the “magnificent” scenery (106).¹ Throughout, Inglis shows herself to be sensitive to the problems of race and discrimination in colonial medicine, as well as to the resilience and agency of an oppressed population.

The book has some frustrations. Inglis’ reliance on Hawaiian vocabulary, even if justifiable, is often a hassle. The fact that the chapters do not adhere closely to a linear chronology often obscures the narrative, and Inglis has a tendency to repeat key points time and time again. Moreover, she seems uncertain about the fundamental causes of Hawaiian de-population, especially the roles of natural selection or colonization (compare pages 21 and 180). But these concerns are mostly minor. Ma’i Lepera makes an interesting and important contribution to the history of...