It was one of the most dreaded of diseases. It disfigured its sufferers almost beyond recognition. It was a scourge of humankind for thousands of years, and was considered incurable. Because of fear of contagion and the belief that leprosy was a punishment from God, victims throughout the centuries were removed from the “civilized” world, forced into isolation, and stigmatized for life.
Leprosy was not known in Europe until after Romans invaded Egypt and carried the disease back to Italy. From there the Roman invasions took the disease into Germany and beyond. By 550 A.D. leprosy reached far away Ireland. Incidence of the disease grew enormously during the Crusades. It affected huge numbers of people in northern Europe, possibly a quarter of the population at one time. That percentage was drastically reduced by the Black Plague, which killed many people already infected and weakened by leprosy.
Throughout the ages, little progress was made in the welfare of those afflicted. Few physicians would treat leprosy patients. Their care was left to priests and other religious workers. Although medical science continued to advance, there was little improvement in the care of leprosy patients. Many were doomed to die in grim isolation.
The Disease Invades Hawai`i
It is not known when or precisely how leprosy arrived in the Hawaiian Islands, but it was detected as early as the 1830s. Leprosy cut across all populations in the islands, but Hawaiians were particularly vulnerable to introduced diseases, having no immunities. By the mid-nineteenth century, the Hawaiian people suffered death and disfigurement at alarming rates. People afflicted with leprosy usually had short life spans, falling victim to other opportunistic diseases.
Fearing further spread of the disease, the Kingdom of Hawai`i took action by authorizing the setting aside of land for confining leprosy patients. The police and district justices were required to arrest any persons suspected of having leprosy. In Honolulu, the Kalihi Hospital and Detention Station opened in November 1865 for initial evaluation and treatment. People with advanced cases of the disease were sent to the remote, isolated north shore of Moloka`i.
This is how Kalawao, and subsequently Kalaupapa, came to be the principal places of confinement for leprosy patients throughout the Hawaiian Islands. The first group of 12 patients arrived at Kalawao on January 6, 1866. Their numbers increased through the years. During the third quarter of the nineteenth century incidence of the disease occurred in more than 1% of the population in Hawai`i. In 1890 Kalawao’s patient population peaked at around 1,100. By 1900, the number of new patients in the islands began a slow decline, a trend that continued until the 1940’s when it was determined that the disease was not spreading in the general population.
How was a treatment found? Read about the hard work that led to the control of Hansen's disease.