Nursing Book Club


Living with leprosy in the Hawaiian Islands

By Albert Brennert
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Reviewed By Christine Contillo, RN, BSN

If you went to Catholic school, you are likely to remember the story of Father Damien and the leper colony on the Hawaiian Island of Moloka’i. He arrived there in 1873 and died of the disease himself in 1889. Father Damien is still held in high esteem for his work with these untouchables, much like Mother Theresa and her work in India.

Albert Brennert’s book Moloka’i gives us a vivid look at that time period, when Hawaii was still a monarchy and leprosy was considered a scourge that brought shame to a family and caused children afflicted with it to be sent away.

Written as a historical fiction piece, the book focuses on the life story of five-year-old Rachel Kalama, born in Honolulu during the reign of King Kalakaua and before the island nation became a U.S. territory. Rachel’s father is a sailor, like a lot of men during that time, and he brings gifts for his children from around the world, such as matryoshka nesting dolls from Russia, which he gives to his daughter. Unfortunately, as Rachel’s family soon learns, sailors also brought foreign illnesses home, and to populations ill prepared to fight them.

Stricken with leprosy, Rachel‘s illness is eventually discovered by the local health officer, who, like a bounty hunter, visits schools examining students for sores and is paid for each affliction he reports. Her mother tries desperately to shield her, but to no avail. Rachel is torn from her family and follows an uncle to the leper colony, where they learn that the administrators put in charge of their care are stealing money from the colony’s funds, and as a result the inhabitants are suffering from severe neglect, forced to rely on each other for help.

Shunned at school and at work, the Kalamas are forced to move away and lose all contact with Rachel. Her only visits — and infrequent ones at that — come from her Uncle Pono, who is also in the colony, and from her father. She’s a spunky girl, though, and determined to improve her situation.

We follow her to old age, as schooners give way to motorboats and the United States government becomes responsible for the island. Sulfa is finally discovered to arrest the progress of the disease, and some are able to return to the main island.

In the end, Rachel is left with a life-altering decision: stay in the safety and familiarity of the colony, or re-enter a world she hasn’t known since she was five, without a way to find employment, and with scars that mark her battle with the disfiguring disease.

The book has some guided questions for book groups, and references to the source information the author used. It’s sad to realize that at one point the excessive mortality there comes not from the disease but from dysentery, which was entirely preventable.

Moloka’i should be particularly interesting to nurses who wish to gain insight into a patient’s point of view. Knowledge is power, and without a keen understanding of disease transmission we’re left with only fear and isolation, as witnessed by the AIDS epidemic in the 1980s.

Brennert’s experience as a screenwriter comes through with rich details that bring the reader into each event, as if he or she were directly part of the experience. He helps us feel what it is like to be the “other” — ignored and alienated. The book is an easy read and one that may change for the better your ability to empathize with your patients.

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written extensively for various nursing publications, as well as The New York Times.

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