Under the Hawaiian Kingdom's Act to Prevent the Spread of Leprosy of 1865, people diagnosed with Hansen's disease were arrested, examined and transported to the isolated Kalaupapa peninsula on Molokai, where they were landed — in the early years sometimes put over the side to swim ashore — and were not permitted to leave. The policy continued under the Republic, the Territory and the State of Hawaii, and was abolished only in 1969, more than two decades after sulfone drugs had made the disease treatable. Roughly 8,000 people were exiled over a century, about nine in ten of them Native Hawaiians, and families were broken up: children born at the settlement were taken from their parents. The settlement is best known outside Hawaii through Father Damien and Mother Marianne Cope, who worked there. A small number of former patients chose to remain after 1969 and the peninsula became a National Historical Park in 1980. It is one of the clearest and best-documented instances of compulsory confinement on medical grounds in the atlas.
The Hawaiian Kingdom and its successor governments forcibly exiled people diagnosed with Hansen's disease to an isolated peninsula on Molokai under a compulsory segregation law
The 1866 Kingdom census counted 62,959 residents, of whom 58,765 were Native Hawaiian, a population already reduced by roughly 80 per cent since contact. Of the roughly 8,000 people exiled to Kalaupapa between 1866 and 1969, about 90 per cent were Native Hawaiian.
Most of the roughly 8,000 people sent to Kalaupapa died there, over a century, of Hansen's disease and of the conditions of the settlement, which in its first decades lacked adequate shelter, food and medical care. This is mortality within a long-term institution rather than a discrete death toll, and the burial records are incomplete.
Hawaiian Board of Health records and National Park Service historical documentation record the compulsory arrest and transport of patients and the removal of children born at the settlement.
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