They provided the loving care that lacked at Kalawao. Their presence served to eliminate loneliness and pain. Often, Board of Health and religious workers could not keep up with the workload of providing medical care, let alone complete other chores. Na kokua provided able–bodied labor for many tasks, including carrying water, handling freight, gathering wood, and raising livestock.
In addition to friends and relatives of patients, many religious workers arrived at Kalawao and Kalaupapa to provide care. Board of Health administrative and medical staff lived in the settlements as well. Through the years strict regulations were enforced to minimize contact between patients and non-patients. Physical barriers, such as fences, kept people apart. Life was divided this way until the isolation laws were lifted in 1969.