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CHAPTER VII - 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 leprae 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 leprae. 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 leprae.
There's the place for your money, you philanthropists.
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