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Vol. LXIV, No. 11
May 25, 2012

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Legacy of Fr. Damien
Physician Brady Outlines Story of Hawaiian Leper Colony

On the front page...

Dr. S. Kalani Brady

Dr. S. Kalani Brady

In 1866, the first convicts arrived at Kalaupapa, a remote peninsula in Hawaii. Convicted of leprosy, now known as Hansen’s disease, these were the forebears of patients that Dr. S. Kalani Brady treats today at the Kalaupapa Clinic.

On Apr. 13, Brady gave a talk about the history of this leprosarium, titled, “Kalaupapa and Father Damien: ‘Here I am, send me’” at the National Library of Medicine. Fr. Damien, canonized as a saint in 2009, arrived to help the exiles in 1873. Brady recounted Fr. Damien’s legacy and treatment of the remaining patients at this settlement.

NLM director Dr. Donald Lindberg visited Kalaupapa and included interviews with Brady, patients and other caregivers in preparing NLM’s exhibition Native Voices: Native Peoples’ Concepts of Health and Illness. “Kalaupapa was picked [for the settlement] because it isolates the individuals who were sent there,” Lindberg said, noting that the highest ocean-side cliffs in the world surround the community on Molokai Island. Yet, for the patients who remain, Lindberg said, “Kalaupapa is home.”


Brady wore a traditional Hawaiian sarong during his presentation at NLM.

Brady wore a traditional Hawaiian sarong during his presentation at NLM.

A sarong wrapped over his suit, Brady opened the presentation with a Hawaiian chant before explaining the disease’s history.

“Hansen’s disease is the scientific name of the stigma of a disease that has been around for thousands of years, [and is] recorded in the Old Testament,” he said. “In the 1840s, the disease became epidemic in Hawaii,” as Hawaiians infected through travel to China returned home. “There became a fear that Hawaii would become this bastion of leprosy.”

Native Hawaiians are more susceptible to Hansen’s disease than the world population, of which only 3 to 5 percent are at risk for the disease. Additionally, disease onset for Hawaiians in the mid-19th century typically occurred as early as 5 to 6 years old, much earlier than the median age of onset, between 20 and 30 years, found today.

“When there was a birth, the entire [Hawaiian] family would hold the baby,” Brady said, which spread this air-borne disease. After a 3- to 5-year incubation period, the disease would manifest in the child. In response, the Hawaiian king approved an “Act to Prevent the Spread of Leprosy” in 1865.

“If you were suspected of having Hansen’s disease, you were arrested and then you went to trial,” before a board of physicians, Brady said. “If convicted, you were sentenced to life imprisonment in Kalaupapa.”

The first arrivals suffered greatly, as they found a community without housing, established agriculture or law enforcement. Some of the strongest exiles enslaved women and children. Drunkenness flourished. “And that was the hopelessness and despair of Kalaupapa of the early 1870s.”

In 1873, Fr. Damien arrived, helping to provide health care, protection to children and spiritual support. “Most of Kalaupapa saw this person as an outsider,” said Brady. They wondered, “‘How can he preach to us about being meek? He doesn’t have this disease that will kill him 5 years from now.’” But, in 1883, Fr. Damien manifested Hansen’s disease. Kalaupapa residents’ trust and respect for the priest grew and lawlessness on the peninsula decreased.

NLM director Dr. Donald Lindberg (r) answered audience questions alongside Brady.

NLM director Dr. Donald Lindberg (r) answered audience questions alongside Brady.

Photos: Bill Branson

From the mid-19th century to the mid-20th century, about 8,000 patients were exiled to Kalaupapa. Brady is the primary care physician for the remaining 19 patients, elderly Hawaiians who reside in Kalaupapa but travel freely.

“The people today in Kalaupapa see [Fr. Damien] as a spiritual father,” Brady said. In 2009, he accompanied many of the patients to Rome for the canonization of Fr. Damien. Apr. 15, the date of Fr. Damien’s death, is a statewide holiday in Hawaii.

The Kalaupapa community is now part of Kalaupapa National Historic Park, established in 1980. When the remaining Hansen’s patients die, Brady said, it is unclear what will happen to the land. Led by park staff, discussions are under way in Hawaiian communities about how best to honor the legacy of this once-shunned community.

The Native Voices exhibit, which highlights this story, is on display through fall 2013 at the National Library of Medicine.

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