Castaways



 
Kalaupapa in 1890.

When I was in grammar school, I remember hearing leper jokes: "How do you know that a hockey game at a leper colony has begun? There's a face-off in the center." "How do you know when a lepter is out of a game of poker? He throws down his hand." I had this vision of lepers as staggering creatures, whose skin and features hung off them like raggedy clothes, people who looked like a scarecrow that had been left out during too harsh a winter. I went to Catholic school so I had some vague idea that there were lepers in the Bible (don't know where...as my fellow-Catholic-raised friends know, Catholics aren't usually too well-versed in the Bible. If this is a surprise to you, well, I'll explain it someday). I knew there was a priest named Father Damien who did something with the lepers; I found this out when a boy named Damien transferred into our class and our teacher commented briefly on his name and Father Damien. I knew that you weren't supposed to touch lepers because then you could get it yourself, but I also knew that leprosy was no longer common and the odds of your running into a leper were pretty small. That's why we could joke about it. But I didn't know the real story.

Walking through the library one day, I saw a book called, The Colony. I immediately thought, "What colony?" My guess was Roanoake. I picked up the book and saw I was wrong. John Tayman's book was the story of Molokai, the leper colony off Hawaii. Well, obviously the time had come to learn all about this.

Tayman gets probably the biggest question out of the way early (unless you're a bacteriologist or infectious disease expert): you don't really contract leprosy by having casual contact with a leper. It's a chronic disease caused by a bacteria that behaves a lot like tuberculosis. You get it from "iarbonre particles expelled by someone with leprosy in an active state." But wait--if a person with tuberculosis sneezes on you, you still don't have to worry, because very few people have the disease in an active state. Most people who have it are not contagious. In fact, only people with a genetic predisposition to the disease can catch it, and those people make up less than five percent of the population. Finally, if you are one of those people and you do have a particle-expelling encounter with a leper and contract the disease, don't worry. By the 1970s, researchers had discovered drugs that, while they do not exactly cure leprosy, arrest its progress and prevent the complications that causes deformities and death.

 
An undated photo of Kalaupapa. The high cliffs and rocky shore were supposed to make it difficult for anyone to escape.

There's never been a good time to be a leper (including now--I don't care if the disease can be controlled by medication today, I still would be unhappy to find out I had it). But if you were going to pick a worst time, it probably would have been circa 1866 in Hawaii. The islands had been stung by a wave of diseases that arrived from the constant parade of ships coming into the islands' ports, including a devastating attack of small pox. The Hawaiian government and business owners, fearing that the economy would be hurt if the islands acquired a reputation as a disease trap, decided to deal with the burgeoning leper population in the way that most scientists of the time thought an epidemic should be handled--by isolating the diseased from the healthy.

A location on the island of Molokai was chosen to become home to the lepers. At first it wasn't hard to find them--flyers simply promised treatment to the diseased. And at first, that's what they got, treatment in a hospital in Kalihi, near Honolulu, while the area on Molokai was being prepared. When it was ready, the patients went expecting to find the same level of comfort and care they had had at Kalihi. They also did not know they were being sent to Molokai permanently.

The journey to Molokai, in a boat leased by the government mainly for its cheapness, was awful. The shores were too rocky for a ship to come close to land, so the patients had to climb down to a small whaleboat, and ride that in the rest of the way, with a rainstorm making everything worse. On shore, cold, wet, tired, and hungry, the travelers were met by a French man hired to oversee the colony. Each patient received a blanket, and men were given a shovel or an axe. It had taken longer than expected to clear the way to send the patients to Molokai, and in that time, the huts thrown together for them to live in had suffered from the weather. The patients, expecting a hospital and doctors, were instead left to settle in the cold, damp, shaky unfurnished huts, and get by with the food parceled out by Lepart, which was not much; the people who had devised the colony had expected the patients to get to work planting their own food, with a goal of becoming self-sufficient. However, the first group of exiles included the weakest and sickest patients from Kalihi. Work was a struggle for them and many did not understand the point--why should they be planting crops when they only were going to be there for two or three months. Finally, Lepart coldly informed them that they were going to be there for the rest of their lives, so they better get to work.

The patients became frantic. They sent letters to their relatives, who desperately tried to get an explanation from the government, to no avail. Lepart wrote the boad managing the colony, warning that their would be revolts if he couldn't get more food and supplies (he requested handcuffs in preparation for the coming disaster). Every time the colonists seemed to be making a little progress with farming, a new group of exiles arrived who needed more food. There was some balance, though--the harsh conditions resulted in a much higher death rate than normal for leprosy patients. As it turns out, a cool, damp climate, like the one found in Kalaupapa, where the lepers were left on Molokai, is the worst possible weather for people with leprosy.

Lawlessness took over as many patients, bitter and with nothing to live for, decided they might as well do whatever they wanted. There was plenty of drinking and fighting. Prostitutes were in demand, and any single woman--or even young girl--arriving with a group of exiles--became a target for the waiting men.

It took a while for conditions on Molokai to improve. Complaints from the patients to their families helped raise awareness; it also helped when some higher profile patients arrived, bringing money and the comforts of home. A visit from a reporter revealed the patients' desperate situation, embarrassing the authorities into doing something about the place. Various people were assigned to help administer the operations of the colony with different degrees of success; some were corrupt, some were dictators, some decent (of course, this is not uncommon in any town, city or village--watch the 1955 movie "The Phenix City Story"). It eventually became more like a functioning town than a dumping ground.

The arrival of Father Damien helped--the Belgian priest was supposed to be part of a rotation of priests who each stayed only three months, but Damien felt he had found his mission and never left (he died of leprosy). He did a great deal of good around the colony, building houses (luckily, he was a good carpenter), roads, and an orphanage, but his story also attracted publicity and charitable donations that improved life for the lepers. He died of the disease himself. Robert Louis Stevenson visited the colony, and befriended many of residents, especially the girls at a school run by nuns. He loved the people, but was heartbroken and horrified by their exile. Jack London came a few decades later, and wrote a cheerful account of his experience in an essay, but then slammed the existence of the colony in a thinly veiled description of the place in a short story.  

 
Father Damien with a group of girls in Kalaupapa.

A clearer procedure for determining who should be sent to the colony became more careful and formal, so there were fewer cases of people being sent to Molokai who didn't have the disease. But growth in scientific knowledge didn't make always make things better. As late as the 1930s, the process for inspecting people for the marks of leprosy included standing the naked patient on a revolving table and slowly rotating it while doctors looked. For some reason, this struck me as one of the worst examples of the treatment of the lepers, mostly because you knew that at that time the doctors doing the work must have felt so sure that they were modern, civilized, and scientific.

It's easy to be horrified at the treatment of the lepers. There's no excuse for the poor conditions that awaited the first group of lepers, or for the corruption or disregard for people who were supposed to be taking care of them. But I have to be a little more understanding of the actual decision to segregate them, taken in context of the times and knowledge of science. No one understood the disease, and infections and epidemics were just beginning to become clearer to doctors. In 1865, Joseph Lister was just beginning to formulate his ideas about cleanliness in the operating room. Most people believed that diseases were transferred via microbes that travelled through the air. Separating the lepers from the general population must have seemed like the most sensible way to deal with the disease. It didn't help, but if I was a doctor back then, I don't know if I would have been able to offer a better suggestion.
 
Tayman's style is pretty simple. He lets the story and the quotes--of which, thankfully, there are many--speak for themselves, which means the horror and despair speak so effectively for themselves. Sometimes it can get a little bit too "Years had passed, and Sam's once black hair was now dusted with gray." "Father Damien's skin was deeply bronzed after the many years he had been working on the island." Not actual sentences, but you know what I mean. The ending feels a little tedious, as we work through the bureaucracy of closing down the colony. But overall, "The Colony" is often riveting reading, especially the first person accounts. I completely blame this book for my getting on the wrong train one night. I recommend this book, but don't keep reading it while you're getting on a train.