Banished to Paradise
Janet and I spent last week in Hawaii. After attending a conference in Honolulu, we opted to spend our free time not at a beach resort but rather on the small, sparsely developed island of Molokai. There, we hiked the Kalaupapa trail, a vertiginous descent that negotiates 26 switchbacks in three miles, the only land route to Hawaii’s historic leprosy colony.
Before statehood, the kingdom of Hawaii tore leprosy patients from their homes and shipped them to Kalaupapa, a peninsula isolated from the rest of Molokai by 3000-foot cliffs. From lookout points along the trail we caught glimpses of the peninsula, a lovely strip of land surrounded by a turquoise sea that caresses the coast with foamy white waves. The setting resembled an artist’s version of paradise, the kind of place that might attract a Hyatt or Ritz Carlton resort.
Instead, for more than a century Kalaupapa served as the dumping ground for some 10,000 leprosy patients, who called it “The Place of the Living Dead.” Such was the fear of contagion that the administration erected fences to prohibit patients’ contact with workers. One doctor examined his patients by lifting their bandages with the tip of his cane. Family members who visited an infected relative had to sit behind a barrier, as if visiting a prisoner. And if patients produced children, authorities seized them and sent them off the island.
At first the diseased lived in anarchic squalor. Disfigured, outcast, they lived by their own rules in a kind of community of the damned. It took the dedication of a Belgian priest, Father Damien, to bring order. Damien began honoring the dead with proper burials, found a safe water supply, and oversaw many construction projects: roads, a reservoir, 300 houses, several churches, an orphanage, hospital and school. He had little medical treatment to offer, but believed strongly that human beings should never be cast aside, regardless of their affliction. An advocate and activist, he got on the nerves of the government as well as his superiors. Who but the church, he asked, would care for the sick, the unwanted, the unloved?
Damien’s close contact with the sick eventually cost him his life. One morning in church he approached the pulpit and, instead of his normal “My Dear Brethren,” opened with the words, “We lepers…” He had contracted the disease, and died before he turned fifty, in 1889. Years later, Damien’s body was returned to his home country to lie in state before reburial. Among those who greeted the quayside procession, the King of the Belgians stood bareheaded as a mark of respect for “The Martyr of Molokai.”
Since Damien’s time, nearly everything has changed in our understanding of the disease leprosy:
It is one of the least contagious diseases; 95 percent of people have a natural immunity.
As modern versions reflect, the biblical word leprosy likely refers to a different ailment, an infectious disease of the skin.
Drugs now control the disease, and global rates of new infections have plummeted, to around 200,000 per year—although many of the 16 million patients judged “arrested cases” still need treatment and rehabilitation for previous damage.
Leprosy attacks nerve cells that carry pain signals, and almost all the feared aspects (blindness, loss of fingers and toes, etc.) can be prevented if patients safeguard any activities that might cause injury.
Due to my work with Dr. Paul Brand, with whom I coauthored three books, I have visited leprosy hospitals on several continents and heard firsthand many poignant stories from patients. Strangely enough, those who feel no pain have historically borne some of the greatest suffering, due to societal prejudice. As a patient in India told me, “I lost my job. I was kicked out of my village and rejected by my own family. I could not ride a bus, or enter a café. I was truly outcast.”
Christian history includes episodes that rightly cause shame and embarrassment, but the treatment of leprosy makes a proud balancing chapter. Most of the advances in the treatment of leprosy came from missionary doctors and nurses, the only ones willing to work with the dreaded disease. The tradition of compassion traces all the way back to Jesus, who ignored societal rules against touching those believed to have leprosy.
St. Francis of Assisi famously embraced a beggar with leprosy. In the Middle Ages, as leprosy ravaged Europe, an odd rumor spread that Jesus himself must have suffered from the disease, due to the prophetic description in Isaiah 52-53 of a Servant “disfigured beyond that of any man.” Improbably, leprosy gained a reputation as the Holy Disease, and Christians in Europe sought out sufferers as representatives of Jesus, who had promised that, “whatever you did for one of the least of these brothers and sisters of mine, you did for me” [Matthew 25]. The devout, defying society’s stigma as well as their own fears, looked past the unsightly symptoms of leprosy and began treating its victims as they would treat Jesus.
Orders of nuns devoted to Lazarus (the beggar in Jesus’ parable of Luke 16, who became the patron saint of leprosy) established homes for patients—twenty thousand such homes across Europe. These indomitable women could do little but bind wounds and change dressings, but the homes themselves, called lazarettos, helped break the hold of the disease in Europe, by limiting transmission and improving living conditions.
In the nineteenth and twentieth centuries, Christian missionaries, including Father Damien, spread across the globe to establish hospitals and clinics for leprosy patients. The American Leprosy Mission formed, one of very few ministries dedicated to combating a single disease.
e spent seven hours at Kalaupapa before beginning the long trek back up the cliff. Now a National Park, the site duly honors the memory of Father Damien. His church has been lovingly restored, along with a few patients’ homes. Volunteers are helping to repair some of the 7,000 graves scattered among several cemeteries. The lava-rock ruins of scores of former buildings, now unneeded, are the ultimate tribute to those who served leprosy patients before a cure was found.
Only eight elderly patients remain at Kalaupapa, and they do so by choice. I spoke with one 92-year-old resident who has a home on Kauai yet keeps returning to the former colony, “because they’re my community.” Museum displays recount the stories of patients who lived through the era of fear and prejudice. As I read them, I could not imagine a more incongruous setting for the agony they described: coconut palm trees, wild orchids, the rhythmic sound of crashing waves, verdant craters straight out of Jurassic Park. Nevertheless, this paradise lies in the shadow of a wall of separation from the rest of humanity—a literal wall in the form of towering, tree-covered cliffs. A century ago, leprosy patients at Kalaupapa had every possible advantage save one: the love that only comes through human contact.
I had much time to reflect on Father Damien, Dr. Paul Brand, and others like them as I climbed the trail back to what locals call “topside.” I breathed a prayer of thanks for those who faithfully serve God, usually out of the limelight, often putting themselves in harm’s way. Diseases come and go, but the tradition of sacrificial service endures: the first foreigners to contract the Ebola virus were missionary health workers.
Mother Teresa once called the beggars she ministered to, “Jesus in most distressing disguise.” What if every follower of Jesus took seriously his assurance that we serve him by serving “the least of these”? Besides the sick, Jesus’ list in Matthew 25 includes the hungry and thirsty, strangers, the destitute, and prisoners. What would happen if we broke through the walls of isolation around the needy? Would those conditions fade away too, like leprosy?
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