This mysterious and dreaded disease reached epidemic proportions in the islands in the late 1800s. At the time, there was no effective treatment and no cure. With new cases threatening to eradicate the native population and no knowledge of what caused the disease, officials became desperate. To government officials, isolation seemed the only answer. In 1865, the Legislative Assembly passed, and King Kamehameha V approved, "An Act to Prevent the Spread of Leprosy", which set apart land to isolate people believed capable of spreading the disease.
This place was chosen to isolate people with, what was at that time, an incurable illness. The peninsula was remote and fairly inaccessible. To the south, the area was cut off from the rest of Molokai by a sheer pali, or cliff, reaching nearly 2000 feet. The ocean surrounded the rest of the area to the east, north and west. Boat landings were only practical in good weather only. Hawaiians had inhabited this peninsula for over 900 years, so the land could support people. Vegetables such as sweet potatoes, taro, and fruits could be grown in the valleys and on the flatlands. The ocean and tidal pools provided seafood. Fresh water was available from Waikolu and Waihanau valleys.
Once the decision was made, and the law passed, the government proceeded to purchase lands and move the Hawaiian residents to other homes, severing their long connection to the land. The village Kalawao on the isolated Kalaupapa Peninsula thus became the home for thousands of leprosy victims subsequently moved here from throughout the Hawaiian Islands. On January 6, 1866, the first group of nine men and three women were dropped off at the mouth of Waikolu Valley, the closest accessible point to Kalawao on the southeast side of the peninsula. By October of the same year, 101 men and 41 women had been left to die at Kalawao.