THE LEPERS OF MOLOKAI
When the _Snark_ sailed along the windward coast of Molokai, on her way
to Honolulu, I looked at the chart, then pointed to a low-lying
peninsula backed by a tremendous cliff varying from two to four
thousand feet in height, and said: “The pit of hell, the most cursed
place on earth.” I should have been shocked, if, at that moment, I
could have caught a vision of myself a month later, ashore in the most
cursed place on earth and having a disgracefully good time along with
eight hundred of the lepers who were likewise having a good time. Their
good time was not disgraceful; but mine was, for in the midst of so
much misery it was not meet for me to have a good time. That is the way
I felt about it, and my only excuse is that I couldn’t help having a
good time.
For instance, in the afternoon of the Fourth of July all the lepers
gathered at the race-track for the sports. I had wandered away from the
Superintendent and the physicians in order to get a snapshot of the
finish of one of the races. It was an interesting race, and
partisanship ran high. Three horses were entered, one ridden by a
Chinese, one by an Hawaiian, and one by a Portuguese boy. All three
riders were lepers; so were the judges and the crowd. The race was
twice around the track. The Chinese and the Hawaiian got away together
and rode neck and neck, the Portuguese boy toiling along two hundred
feet behind. Around they went in the same positions. Halfway around on
the second and final lap the Chinese pulled away and got one length
ahead of the Hawaiian. At the same time the Portuguese boy was
beginning to crawl up. But it looked hopeless. The crowd went wild. All
the lepers were passionate lovers of horseflesh. The Portuguese boy
crawled nearer and nearer. I went wild, too. They were on the home
stretch. The Portuguese boy passed the Hawaiian. There was a thunder of
hoofs, a rush of the three horses bunched together, the jockeys plying
their whips, and every last onlooker bursting his throat, or hers, with
shouts and yells. Nearer, nearer, inch by inch, the Portuguese boy
crept up, and passed, yes, passed, winning by a head from the Chinese.
I came to myself in a group of lepers. They were yelling, tossing their
hats, and dancing around like fiends. So was I. When I came to I was
waving my hat and murmuring ecstatically: “By golly, the boy wins! The
boy wins!”
I tried to check myself. I assured myself that I was witnessing one of
the horrors of Molokai, and that it was shameful for me, under such
circumstances, to be so light-hearted and light-headed. But it was no
use. The next event was a donkey-race, and it was just starting; so was
the fun. The last donkey in was to win the race, and what complicated
the affair was that no rider rode his own donkey. They rode one
another’s donkeys, the result of which was that each man strove to make
the donkey he rode beat his own donkey ridden by some one else,
Naturally, only men possessing very slow or extremely obstreperous
donkeys had entered them for the race. One donkey had been trained to
tuck in its legs and lie down whenever its rider touched its sides with
his heels. Some donkeys strove to turn around and come back; others
developed a penchant for the side of the track, where they stuck their
heads over the railing and stopped; while all of them dawdled. Halfway
around the track one donkey got into an argument with its rider. When
all the rest of the donkeys had crossed the wire, that particular
donkey was still arguing. He won the race, though his rider lost it and
came in on foot. And all the while nearly a thousand lepers were
laughing uproariously at the fun. Anybody in my place would have joined
with them in having a good time.
All the foregoing is by way of preamble to the statement that the
horrors of Molokai, as they have been painted in the past, do not
exist. The Settlement has been written up repeatedly by
sensationalists, and usually by sensationalists who have never laid
eyes on it. Of course, leprosy is leprosy, and it is a terrible thing;
but so much that is lurid has been written about Molokai that neither
the lepers, nor those who devote their lives to them, have received a
fair deal. Here is a case in point. A newspaper writer, who, of course,
had never been near the Settlement, vividly described Superintendent
McVeigh, crouching in a grass hut and being besieged nightly by
starving lepers on their knees, wailing for food. This hair-raising
account was copied by the press all over the United States and was the
cause of many indignant and protesting editorials. Well, I lived and
slept for five days in Mr. McVeigh’s “grass hut” (which was a
comfortable wooden cottage, by the way; and there isn’t a grass house
in the whole Settlement), and I heard the lepers wailing for food—only
the wailing was peculiarly harmonious and rhythmic, and it was
accompanied by the music of stringed instruments, violins, guitars,
_ukuleles_, and banjos. Also, the wailing was of various sorts. The
leper brass band wailed, and two singing societies wailed, and lastly a
quintet of excellent voices wailed. So much for a lie that should never
have been printed. The wailing was the serenade which the glee clubs
always give Mr. McVeigh when he returns from a trip to Honolulu.
Leprosy is not so contagious as is imagined. I went for a week’s visit
to the Settlement, and I took my wife along—all of which would not have
happened had we had any apprehension of contracting the disease. Nor
did we wear long, gauntleted gloves and keep apart from the lepers. On
the contrary, we mingled freely with them, and before we left, knew
scores of them by sight and name. The precautions of simple cleanliness
seem to be all that is necessary. On returning to their own houses,
after having been among and handling lepers, the non-lepers, such as
the physicians and the superintendent, merely wash their faces and
hands with mildly antiseptic soap and change their coats.
That a leper is unclean, however, should be insisted upon; and the
segregation of lepers, from what little is known of the disease, should
be rigidly maintained. On the other hand, the awful horror with which
the leper has been regarded in the past, and the frightful treatment he
has received, have been unnecessary and cruel. In order to dispel some
of the popular misapprehensions of leprosy, I want to tell something of
the relations between the lepers and non-lepers as I observed them at
Molokai. On the morning after our arrival Charmian and I attended a
shoot of the Kalaupapa Rifle Club, and caught our first glimpse of the
democracy of affliction and alleviation that obtains. The club was just
beginning a prize shoot for a cup put up by Mr. McVeigh, who is also a
member of the club, as also are Dr. Goodhue and Dr. Hollmann, the
resident physicians (who, by the way, live in the Settlement with their
wives). All about us, in the shooting booth, were the lepers. Lepers
and non-lepers were using the same guns, and all were rubbing shoulders
in the confined space. The majority of the lepers were Hawaiians.
Sitting beside me on a bench was a Norwegian. Directly in front of me,
in the stand, was an American, a veteran of the Civil War, who had
fought on the Confederate side. He was sixty-five years of age, but
that did not prevent him from running up a good score. Strapping
Hawaiian policemen, lepers, khaki-clad, were also shooting, as were
Portuguese, Chinese, and kokuas—the latter are native helpers in the
Settlement who are non-lepers. And on the afternoon that Charmian and I
climbed the two-thousand-foot _pali_ and looked our last upon the
Settlement, the superintendent, the doctors, and the mixture of
nationalities and of diseased and non-diseased were all engaged in an
exciting baseball game.
Not so was the leper and his greatly misunderstood and feared disease
treated during the middle ages in Europe. At that time the leper was
considered legally and politically dead. He was placed in a funeral
procession and led to the church, where the burial service was read
over him by the officiating clergyman. Then a spadeful of earth was
dropped upon his chest and he was dead-living dead. While this rigorous
treatment was largely unnecessary, nevertheless, one thing was learned
by it. Leprosy was unknown in Europe until it was introduced by the
returning Crusaders, whereupon it spread slowly until it had seized
upon large numbers of the people. Obviously, it was a disease that
could be contracted by contact. It was a contagion, and it was equally
obvious that it could be eradicated by segregation. Terrible and
monstrous as was the treatment of the leper in those days, the great
lesson of segregation was learned. By its means leprosy was stamped
out.
And by the same means leprosy is even now decreasing in the Hawaiian
Islands. But the segregation of the lepers on Molokai is not the
horrible nightmare that has been so often exploited by _yellow_
writers. In the first place, the leper is not torn ruthlessly from his
family. When a suspect is discovered, he is invited by the Board of
Health to come to the Kalihi receiving station at Honolulu. His fare
and all expenses are paid for him. He is first passed upon by
microscopical examination by the bacteriologist of the Board of Health.
If the _bacillus lepræ_ is found, the patient is examined by the Board
of Examining Physicians, five in number. If found by them to be a
leper, he is so declared, which finding is later officially confirmed
by the Board of Health, and the leper is ordered straight to Molokai.
Furthermore, during the thorough trial that is given his case, the
patient has the right to be represented by a physician whom he can
select and employ for himself. Nor, after having been declared a leper,
is the patient immediately rushed off to Molokai. He is given ample
time, weeks, and even months, sometimes, during which he stays at
Kalihi and winds up or arranges all his business affairs. At Molokai,
in turn, he may be visited by his relatives, business agents, etc.,
though they are not permitted to eat and sleep in his house. Visitors’
houses, kept “clean,” are maintained for this purpose.
I saw an illustration of the thorough trial given the suspect, when I
visited Kalihi with Mr. Pinkham, president of the Board of Health. The
suspect was an Hawaiian, seventy years of age, who for thirty-four
years had worked in Honolulu as a pressman in a printing office. The
bacteriologist had decided that he was a leper, the Examining Board had
been unable to make up its mind, and that day all had come out to
Kalihi to make another examination.
When at Molokai, the declared leper has the privilege of
re-examination, and patients are continually coming back to Honolulu
for that purpose. The steamer that took me to Molokai had on board two
returning lepers, both young women, one of whom had come to Honolulu to
settle up some property she owned, and the other had come to Honolulu
to see her sick mother. Both had remained at Kalihi for a month.
The Settlement of Molokai enjoys a far more delightful climate than
even Honolulu, being situated on the windward side of the island in the
path of the fresh north-east trades. The scenery is magnificent; on one
side is the blue sea, on the other the wonderful wall of the _pali_,
receding here and there into beautiful mountain valleys. Everywhere are
grassy pastures over which roam the hundreds of horses which are owned
by the lepers. Some of them have their own carts, rigs, and traps. In
the little harbour of Kalaupapa lie fishing boats and a steam launch,
all of which are privately owned and operated by lepers. Their bounds
upon the sea are, of course, determined: otherwise no restriction is
put upon their sea-faring. Their fish they sell to the Board of Health,
and the money they receive is their own. While I was there, one night’s
catch was four thousand pounds.
And as these men fish, others farm. All trades are followed. One leper,
a pure Hawaiian, is the boss painter. He employs eight men, and takes
contracts for painting buildings from the Board of Health. He is a
member of the Kalaupapa Rifle Club, where I met him, and I must confess
that he was far better dressed than I. Another man, similarly situated,
is the boss carpenter. Then, in addition to the Board of Health store,
there are little privately owned stores, where those with shopkeeper’s
souls may exercise their peculiar instincts. The Assistant
Superintendent, Mr. Waiamau, a finely educated and able man, is a pure
Hawaiian and a leper. Mr. Bartlett, who is the present storekeeper, is
an American who was in business in Honolulu before he was struck down
by the disease. All that these men earn is that much in their own
pockets. If they do not work, they are taken care of anyway by the
territory, given food, shelter, clothes, and medical attendance. The
Board of Health carries on agriculture, stock-raising, and dairying,
for local use, and employment at fair wages is furnished to all that
wish to work. They are not compelled to work, however, for they are the
wards of the territory. For the young, and the very old, and the
helpless there are homes and hospitals.
Major Lee, an American and long a marine engineer for the Inter Island
Steamship Company, I met actively at work in the new steam laundry,
where he was busy installing the machinery. I met him often,
afterwards, and one day he said to me:
“Give us a good breeze about how we live here. For heaven’s sake write
us up straight. Put your foot down on this chamber-of-horrors rot and
all the rest of it. We don’t like being misrepresented. We’ve got some
feelings. Just tell the world how we really are in here.”
Man after man that I met in the Settlement, and woman after woman, in
one way or another expressed the same sentiment. It was patent that
they resented bitterly the sensational and untruthful way in which they
have been exploited in the past.
In spite of the fact that they are afflicted by disease, the lepers
form a happy colony, divided into two villages and numerous country and
seaside homes, of nearly a thousand souls. They have six churches, a
Young Men’s Christian Association building, several assembly halls, a
band stand, a race-track, baseball grounds, shooting ranges, an
athletic club, numerous glee clubs, and two brass bands.
“They are so contented down there,” Mr. Pinkham told me, “that you
can’t drive them away with a shot-gun.”
This I later verified for myself. In January of this year, eleven of
the lepers, on whom the disease, after having committed certain
ravages, showed no further signs of activity, were brought back to
Honolulu for re-examination. They were loath to come; and, on being
asked whether or not they wanted to go free if found clean of leprosy,
one and all answered, “Back to Molokai.”
In the old days, before the discovery of the leprosy bacillus, a small
number of men and women, suffering from various and wholly different
diseases, were adjudged lepers and sent to Molokai. Years afterward
they suffered great consternation when the bacteriologists declared
that they were not afflicted with leprosy and never had been. They
fought against being sent away from Molokai, and in one way or another,
as helpers and nurses, they got jobs from the Board of Health and
remained. The present jailer is one of these men. Declared to be a
non-leper, he accepted, on salary, the charge of the jail, in order to
escape being sent away.
At the present moment, in Honolulu, there is a bootblack. He is an
American negro. Mr. McVeigh told me about him. Long ago, before the
bacteriological tests, he was sent to Molokai as a leper. As a ward of
the state he developed a superlative degree of independence and
fomented much petty mischief. And then, one day, after having been for
years a perennial source of minor annoyances, the bacteriological test
was applied, and he was declared a non-leper.
“Ah, ha!” chortled Mr. McVeigh. “Now I’ve got you! Out you go on the
next steamer and good riddance!”
But the negro didn’t want to go. Immediately he married an old woman,
in the last stages of leprosy, and began petitioning the Board of
Health for permission to remain and nurse his sick wife. There was no
one, he said pathetically, who could take care of his poor wife as well
as he could. But they saw through his game, and he was deported on the
steamer and given the freedom of the world. But he preferred Molokai.
Landing on the leeward side of Molokai, he sneaked down the _pali_ one
night and took up his abode in the Settlement. He was apprehended,
tried and convicted of trespass, sentenced to pay a small fine, and
again deported on the steamer with the warning that if he trespassed
again, he would be fined one hundred dollars and be sent to prison in
Honolulu. And now, when Mr. McVeigh comes up to Honolulu, the bootblack
shines his shoes for him and says:
“Say, Boss, I lost a good home down there. Yes, sir, I lost a good
home.” Then his voice sinks to a confidential whisper as he says, “Say,
Boss, can’t I go back? Can’t you fix it for me so as I can go back?”
He had lived nine years on Molokai, and he had had a better time there
than he has ever had, before and after, on the outside.
As regards the fear of leprosy itself, nowhere in the Settlement among
lepers, or non-lepers, did I see any sign of it. The chief horror of
leprosy obtains in the minds of those who have never seen a leper and
who do not know anything about the disease. At the hotel at Waikiki a
lady expressed shuddering amazement at my having the hardihood to pay a
visit to the Settlement. On talking with her I learned that she had
been born in Honolulu, had lived there all her life, and had never laid
eyes on a leper. That was more than I could say of myself in the United
States, where the segregation of lepers is loosely enforced and where I
have repeatedly seen lepers on the streets of large cities.
Leprosy is terrible, there is no getting away from that; but from what
little I know of the disease and its degree of contagiousness, I would
by far prefer to spend the rest of my days in Molokai than in any
tuberculosis sanatorium. In every city and county hospital for poor
people in the United States, or in similar institutions in other
countries, sights as terrible as those in Molokai can be witnessed, and
the sum total of these sights is vastly more terrible. For that matter,
if it were given me to choose between being compelled to live in
Molokai for the rest of my life, or in the East End of London, the East
Side of New York, or the Stockyards of Chicago, I would select Molokai
without debate. I would prefer one year of life in Molokai to five
years of life in the above-mentioned cesspools of human degradation and
misery.
In Molokai the people are happy. I shall never forget the celebration
of the Fourth of July I witnessed there. At six o’clock in the morning
the “horribles” were out, dressed fantastically, astride horses, mules,
and donkeys (their own property), and cutting capers all over the
Settlement. Two brass bands were out as well. Then there were the
_pa-u_ riders, thirty or forty of them, Hawaiian women all, superb
horsewomen dressed gorgeously in the old, native riding costume, and
dashing about in twos and threes and groups. In the afternoon Charmian
and I stood in the judge’s stand and awarded the prizes for
horsemanship and costume to the _pa-u_ riders. All about were the
hundreds of lepers, with wreaths of flowers on heads and necks and
shoulders, looking on and making merry. And always, over the brows of
hills and across the grassy level stretches, appearing and
disappearing, were the groups of men and women, gaily dressed, on
galloping horses, horses and riders flower-bedecked and
flower-garlanded, singing, and laughing, and riding like the wind. And
as I stood in the judge’s stand and looked at all this, there came to
my recollection the lazar house of Havana, where I had once beheld some
two hundred lepers, prisoners inside four restricted walls until they
died. No, there are a few thousand places I wot of in this world over
which I would select Molokai as a place of permanent residence. In the
evening we went to one of the leper assembly halls, where, before a
crowded audience, the singing societies contested for prizes, and where
the night wound up with a dance. I have seen the Hawaiians living in
the slums of Honolulu, and, having seen them, I can readily understand
why the lepers, brought up from the Settlement for re-examination,
shouted one and all, “Back to Molokai!”
One thing is certain. The leper in the Settlement is far better off
than the leper who lies in hiding outside. Such a leper is a lonely
outcast, living in constant fear of discovery and slowly and surely
rotting away. The action of leprosy is not steady. It lays hold of its
victim, commits a ravage, and then lies dormant for an indeterminate
period. It may not commit another ravage for five years, or ten years,
or forty years, and the patient may enjoy uninterrupted good health.
Rarely, however, do these first ravages cease of themselves. The
skilled surgeon is required, and the skilled surgeon cannot be called
in for the leper who is in hiding. For instance, the first ravage may
take the form of a perforating ulcer in the sole of the foot. When the
bone is reached, necrosis sets in. If the leper is in hiding, he cannot
be operated upon, the necrosis will continue to eat its way up the bone
of the leg, and in a brief and horrible time that leper will die of
gangrene or some other terrible complication. On the other hand, if
that same leper is in Molokai, the surgeon will operate upon the foot,
remove the ulcer, cleanse the bone, and put a complete stop to that
particular ravage of the disease. A month after the operation the leper
will be out riding horseback, running foot races, swimming in the
breakers, or climbing the giddy sides of the valleys for mountain
apples. And as has been stated before, the disease, lying dormant, may
not again attack him for five, ten, or forty years.
The old horrors of leprosy go back to the conditions that obtained
before the days of antiseptic surgery, and before the time when
physicians like Dr. Goodhue and Dr. Hollmann went to live at the
Settlement. Dr. Goodhue is the pioneer surgeon there, and too much
praise cannot be given him for the noble work he has done. I spent one
morning in the operating room with him and of the three operations he
performed, two were on men, newcomers, who had arrived on the same
steamer with me. In each case, the disease had attacked in one spot
only. One had a perforating ulcer in the ankle, well advanced, and the
other man was suffering from a similar affliction, well advanced, under
his arm. Both cases were well advanced because the man had been on the
outside and had not been treated. In each case. Dr. Goodhue put an
immediate and complete stop to the ravage, and in four weeks those two
men will be as well and able-bodied as they ever were in their lives.
The only difference between them and you or me is that the disease is
lying dormant in their bodies and may at any future time commit another
ravage.
Leprosy is as old as history. References to it are found in the
earliest written records. And yet to-day practically nothing more is
known about it than was known then. This much was known then, namely,
that it was contagious and that those afflicted by it should be
segregated. The difference between then and now is that to-day the
leper is more rigidly segregated and more humanely treated. But leprosy
itself still remains the same awful and profound mystery. A reading of
the reports of the physicians and specialists of all countries reveals
the baffling nature of the disease. These leprosy specialists are
unanimous on no one phase of the disease. They do not know. In the past
they rashly and dogmatically generalized. They generalize no longer.
The one possible generalization that can be drawn from all the
investigation that has been made is that leprosy is _feebly
contagious_. But in what manner it is feebly contagious is not known.
They have isolated the bacillus of leprosy. They can determine by
bacteriological examination whether or not a person is a leper; but
they are as far away as ever from knowing how that bacillus finds its
entrance into the body of a non-leper. They do not know the length of
time of incubation. They have tried to inoculate all sorts of animals
with leprosy, and have failed.
They are baffled in the discovery of a serum wherewith to fight the
disease. And in all their work, as yet, they have found no clue, no
cure. Sometimes there have been blazes of hope, theories of causation
and much heralded cures, but every time the darkness of failure
quenched the flame. A doctor insists that the cause of leprosy is a
long-continued fish diet, and he proves his theory voluminously till a
physician from the highlands of India demands why the natives of that
district should therefore be afflicted by leprosy when they have never
eaten fish, nor all the generations of their fathers before them. A man
treats a leper with a certain kind of oil or drug, announces a cure,
and five, ten, or forty years afterwards the disease breaks out again.
It is this trick of leprosy lying dormant in the body for indeterminate
periods that is responsible for many alleged cures. But this much is
certain: _as yet there has been no authentic case of a cure_.
Leprosy is _feebly contagious_, but how is it contagious? An Austrian
physician has inoculated himself and his assistants with leprosy and
failed to catch it. But this is not conclusive, for there is the famous
case of the Hawaiian murderer who had his sentence of death commuted to
life imprisonment on his agreeing to be inoculated with the _bacillus
lepræ_. Some time after inoculation, leprosy made its appearance, and
the man died a leper on Molokai. Nor was this conclusive, for it was
discovered that at the time he was inoculated several members of his
family were already suffering from the disease on Molokai. He may have
contracted the disease from them, and it may have been well along in
its mysterious period of incubation at the time he was officially
inoculated. Then there is the case of that hero of the Church, Father
Damien, who went to Molokai a clean man and died a leper. There have
been many theories as to how he contracted leprosy, but nobody knows.
He never knew himself. But every chance that he ran has certainly been
run by a woman at present living in the Settlement; who has lived there
many years; who has had five leper husbands, and had children by them;
and who is to-day, as she always has been, free of the disease.
As yet no light has been shed upon the mystery of leprosy. When more is
learned about the disease, a cure for it may be expected. Once an
efficacious serum is discovered, and leprosy, because it is so feebly
contagious, will pass away swiftly from the earth. The battle waged
with it will be short and sharp. In the meantime, how to discover that
serum, or some other unguessed weapon? In the present it is a serious
matter. It is estimated that there are half a million lepers, not
segregated, in India alone. Carnegie libraries, Rockefeller
universities, and many similar benefactions are all very well; but one
cannot help thinking how far a few thousands of dollars would go, say
in the leper Settlement of Molokai. The residents there are accidents
of fate, scapegoats to some mysterious natural law of which man knows
nothing, isolated for the welfare of their fellows who else might catch
the dread disease, even as they have caught it, nobody knows how. Not
for their sakes merely, but for the sake of future generations, a few
thousands of dollars would go far in a legitimate and scientific search
after a cure for leprosy, for a serum, or for some undreamed discovery
that will enable the medical world to exterminate the _bacillus lepræ_.
There’s the place for your money, you philanthropists.