Book Review: The Colony: The Harrowing True Story of the Exiles of Molokai

This is another one of those books that makes me glad I live nowadays, and not in the good old days.

In 1866, Hawaii criminalized leprosy. Officials arrested lepers and shipped them into exile at Molokai, without even a way to protest a misdiagnosis. Exiles were treated as dead - their spouses were considered widowed, their wills were executed and their property distributed. John Tayman tells their story in "The Colony: The Harrowing True Story of the Exiles of Molokai."

The law of exile was based on the fear that leprosy was highly contagious, and there was nothing that could be done for infected people. Neither fear was true. There are two forms of leprosy - a form that settles in the nerves and is not contagious at all; and a form that manifests on the skin as lesions and tumors and is contagious only when in its active state.

The disease is passed by airborne particles, very similar to how tuberculosis is passed - the contagious person has to cough on you an awful lot. Even if exposed, 95% of people will never develop leprosy because their immune system destroys it. There is a genetic tweak that makes about 5% of the population vulnerable to leprosy. The tweak shows up in most races, but is more common in native Hawaiians than in, say, Asians or Caucasians. So Hawaii was particularly hard hit by leprosy. Hence the fear that led to the law of exile.

The original settlement was a travesty. Hawaii was sending sick people off to die in an inaccessible village that the government purchased. The health officials tricked the first exiles - they lured them in with promises of treatment, then stuck them on a boat and shipped 12 of them away in the first load. By the time they reached Molokai, the crops had rotted in the ground and the houses had suffered from disrepair.

Hawaii did not have the money to take care of the leper colony. They planned on the colony being self-sufficient, raising all their own food. Subsistence farming is difficult for the dying, and malnutrition and starvation hastened the process. Hawaii sent the sickest people away first. Not surprisingly, many of them died of starvation and exposure, not leprosy. There was no doctor at Molokai because the health officials believed treatment was useless.

Over the decades (not months, not years, but decades), public pressure slowly improved conditions at Molokai. Building materials were shipped in to build houses so sick people did not have to live in the fissures of the lava rocks. A doctor visited by boat or plane once in a while. An orphanage was built for children sent into exile. The exiles received an allowance to buy clothing and a general store opened.

The Catholics sent a priest who spent the rest of his life at Molokai, eventually dying of leprosy himself. He is in the process of being canonized. A group of eight nuns also spent their lives on Molokai.

Hawaii had unending problems with finding a reliable superintendent for the colony. Lawlessness reigned more often than not, with all the crimes you'd expect in a place where food, shelter, clothing and women were in short supply.

Those first 40 years, Molokai was so awful that lepers were known to murder the doctor who diagnosed them, and the bounty hunters who came to drag them away.

In the early 1900s, the leprosy bacillus was identified, which made diagnosis more accurate. Dozens of exiles who had spent decades in Molokai appealed their diagnoses and were freed. They had lost most of their lives in exile due to skin conditions like eczema. In the late 1940s, an effective treatment for leprosy was finally found. The treatment cured the disease, but could not repair the damage already done.

In 1969, Hawaii repealed the law of exile. Having leprosy was no longer a crime. The exiles were allowed to leave the island. Some did, but the social stigma and terrible deformity caused by leprosy kept many at Molokai, which by now had a decent little village.

In 1980, Molokai was designated as a historic preserve to keep it safe from developers who wanted to turn it into a resort. As of 2004, the average age of the residents of Molokai was 76. It is peopled solely with lepers who lived their whole lives at Molokai, and the people who work in the hospital.

The first half of the book was a history of leprosy and Molokai. In the second half, Tayman followed the personal stories of four lepers from their diagnosis to the time of the book’s publication. The book is very long, but well-written.