On February 28, 1907, the Hawai'i Board of Health took a nine-year old girl named Nailima Lishman into custody. 1 Lishman was suspected of having leprosy, a disease criminalized by law since 1865. According to this Hawai'i law, all people with leprosy were ordered removed from their communities by the Board of Health (BOH). 2 Nailima was brought to Kalihi Hospital and Receiving Station, a large detention compound in the port city of Honolulu. Family members with loved ones detained at Kalihi Station knew this was likely the beginning of lifelong incarceration and separation. If a medical examination confirmed a suspect as leprous, incurable, and contagious, the person would be exiled to a leprosy settlement on the island of Molokai for the rest of their lives, regardless of age or condition. 3 Nailima Lishman would spend four years confined at Kalihi Hospital until she was exiled to Molokai settlement in 1911. 4
Approximately 8,000 men, women, and children were exiled over a period of a century, with hundreds more of their children born into Board of Health custody. 5 Hawai'i's leprosy control was the longest and most severe practice of medical incarceration in modern history. The vast majority of exiled people were Kānaka 'Ōiwi (Native Hawaiians), with smaller numbers of immigrants from Asia and Portugal and their descendants incarcerated. 6 Outbreaks of mumps, smallpox, venereal disease, measles, and influenza since Western contact in 1778 had decimated Kānaka 'Ōiwi, but leprosy brought terrible suffering as an illness that separated family (ma'i ho'oka'awale 'ohana). 7
In the decades prior to formal colonization by the United States, settler occupation and imperial pressure subordinated Hawai'i law, trade, and land tenure to the West. 8 These processes secured the U.S.-backed overthrow of Hawai'i's monarchy in 1893, illegal annexation by the United States in 1898, and incorporation as a U.S. territory in 1900. Yet prior to and during these calamitous political events, a system that I call carceral medicine disrupted Kanaka 'Ōiwi life and relations. Enabled by and articulated through settler occupation, carceral medicine was a juridical-medical system that incarcerated people and produced knowledge about their bodies. 9 By the 1840s, white settlers occupied powerful leadership positions in the Hawaiian government, including the Papa Ola, the kingdom agency known in English as the Board of Health. Enmeshed in a broader settler occupation that upended Native institutions and disenfranchised Kānaka 'Ōiwi, the Papa Ola removed thousands of Kānaka from their natal homes in the name of health beginning in 1866.
Although leprosy had been endemic in parts of Western Europe and reappeared in England in the 1840s, it became racialized and stigmatized as an "imperial danger" and "tropical disease" emerging from the Pacific in the high age of empire. 10 Settlers in Hawai'i, as well as in other nineteenth-century colonial zones of contact, became preoccupied with the containment of leprosy, an illness that can cause disfiguring effects in the face, hands, feet, skin, and eyes. 11 In this swirling colonial imaginary, leprosy was interpreted as a menacing racial-sexual invasion moving from Native to white bodies.
Known today as "Hansen's disease," leprosy is a bacterial disease transmitted through respiratory droplets. It is not highly infectious and requires long-term exposure to untreated people. A cure was not discovered until the 1940s. While the etiology and transmission of leprosy confounded scientists, the colonial public health response was forceful and unrelenting. The state's strategy of leprosy control centered on the removal and incarceration of Indigenous people, despite leprosy having been far less lethal than contemporaneous epidemics of influenza and tuberculosis. 12
Thus, significantly, beyond its treatment as an illness or medical condition, leprosy was experienced and signified in settler colonial Hawai'i as a disability — a disabling social and cultural condition — attached to the bodies, kinship, and behavior of Kānaka 'Ōiwi. Leprous people were excluded from civil society less for their risk to public health, but because their non-normative bodyminds and putative social incompetence were considered intolerable forms of disability. Perceived by settlers as unchaste, unvirtuous, and uncivilized, Kānaka were treated as culpable for spreading the microbe through sexual contact and non-conjugal relations. 13 Those who contracted leprosy became civilly dead and were removed from public life. Kānaka 'Ōiwi experienced the highest rates of infection and medical incarceration, although leprosy afflicted Native Hawaiians, settlers, and immigrants of all economic and social backgrounds. 14
However, during medical detainment at Kalihi and removal to Molokai, Kānaka refused to abandon their loved ones. In this essay, I discuss the efforts of Native Hawaiians to maintain kinship and care across the fences, walls, and laws of Hawai'i's carceral medical institutions in the early twentieth century. Incarcerated people and their families sought visitation and treatments, protested medical decisions, and petitioned for re-examination, reunion, and release. In the everyday experience of empire, these deeds are not often visible or coherent, but they constitute a micropolitics of survival against the aggregate, coercive power of settler colonial institutions and the weight of Western biomedical knowledge. Following people through time and space as they negotiated with these institutions and practices, I argue that in seemingly discrete and heterogeneous acts of contesting medical and legal regulations, Native people and their collateral kin unmade settler colonial processes of ability and disability formation.
In doing so, this essay stakes a broader claim that family histories matter for disability histories, especially disability histories by and about Indigenous people. Why and how should disability histories pay attention to Indigenous kinship? Family histories, as historians and anthropologists have demonstrated, are not merely histories of families or kinship networks. Biological reproduction is attached to processes of social, cultural, and class reproduction, the allocation of labor and property, imperial expansion, and capital accumulation. Such studies can reveal state and institutional formations, as well as broader racial, gender, social, and economic hierarchies instantiated via the "family." 15
Historians of disability also have de-naturalized the unit of the family by usefully examining how state and institutional gatekeeping and ability-making worked through families, such as the encouraged breeding of racial "superiors" and the institutionalization and social exclusion of the "mad," "unfit," "deviant," and "queer." 16 In a parallel scholarly arena tracking the state's genocidal preoccupation with kinship, Indigenous histories analyze how settler colonial institutions forcibly assimilated, eradicated, and terminated Native peoples, often by targeting the family, kinship, and tribe. These were undertaken, particularly in Native North America, through blood quantum regulations that limited tribal rolls, federal termination policies that ended tribal land trusts, colonial health and medicine policies that starved and excluded, and boarding and residential schools that removed, institutionalized, and abused youth. Importantly, scholars in this field document assaults on kinship by the state, but also demonstrate that sovereignty and self-determination rest in tribal and family ties and practices of relationality. 17
My work on kinship practices and Indigenous survival in this essay aims to amplify connections between these scholarly approaches to kinship and ability-making. 18 Disability was often co-constituted with Native kinship in settler colonial contexts, whether with or without the explicit invocation of the term "disability." Put another way, living communally with collateral kin and distributing material and affective resources outside legible heteropatriarchal nuclear units and capitalist labor structures were interpreted as disabilities which justified diverse forms of institutionalized state violence. 19 In Hawai'i, Kanaka 'Ōiwi kinship was stigmatized as a disabling excess of kinship – an overabundance of sexuality, proximity, and intimate care that was considered unclean and disorderly. Within this paradigm, Hawaiians were interpreted as culpable for spreading contagion and unfit for self-governance. 20 Yet, as I highlight here through representative episodes of responses to carceral medicine, Hawaiians drew strength from kinship even as it was censured and waged against them as a disability. They refused to accept state-mandated definitions and expectations of normative families, ability, care, beauty, and love.
A grounding of Indigenous Disability History in kinship history here suggests not only an epistemological framework, but an ethical one. A central guiding principle is that the people I write about, while no longer living, are collateral kin: ancestors, elders, and family who continue to be claimed and loved. 21 While I am a descendant of immigrant settlers to Hawai'i, I hold abiding and accountable relationships with Hawaiian people, land, and mo'olelo (histories), past and present. My research and writing on Hansen's disease is informed by what I call an ethics of restraint—a deliberate attempt to refrain from overexposing and spectacularizing vulnerable people. These protocols about privacy, names, and narratives are informed by ongoing conversations with Kanaka 'Ōiwi scholars and interlocutors, including people who live and work in the present-day Kalaupapa, Molokai settlement. 22
Although a person's appearance as a medicalized subject in Board of Health records may be a starting point, I attempt to place and interpret a person and their kin in wider relational and genealogical contexts using other available sources. Describing where they were from, who they loved, and who claimed them, albeit in partial and provisional ways, before and after medical detention helps to convey lifeworlds and relationships beyond the experience and timeframe of illness and incarceration. Family members seeking to learn more about exiled relations may find more information and sources in the footnotes. In accordance with these principles, except when quoting directly from sources, I avoid the pejorative term "leper," which reduces a person to a stigmatized condition. 23
"In reviewing my tours among the people I can not but be painfully impressed with the recklessness which Hawaiian people exhibit in their intercourse with the victims of leprosy in their midst. They and their children do not hesitate to eat, drink from the same dishes, smoke the same pipe, lounge and sleep on the same mats as are used by the leper that live among them. The wife does not shun her leper husband, nor the lover his mistress who is a leper. This cannot be laid entirely to ignorance. They are keen observers and as a rule their diagnosis of leprosy is remarkably accurate.…[C]all it unselfish devotion, call it what you will it is a blindness that not less severely leads to death."
"Lacking knowledge of the diseases of civilization, or their control or remedies, this [Hawaiian] race has suffered accordingly, and become susceptible to certain infections to an infinitely greater degree than other races dwelling among them."
"…E hookuu, a hoihoi mai i kuu kaikamahine ia Miss Ane N Kekoa." ("Release and return my beloved daughter Miss Ane N. Kekoa.")
As suggested by the first two excerpts from medical reports above, physicians racialized Hawaiians as spreaders of leprosy, arguing their inability to conform to Western norms of civilization made them susceptible to disease. Worse yet, the very devotion Hawaiian bestowed on loved ones with leprosy were cast as irresponsible. Able-bodied Hawaiians performing acts of care for leprous kin could themselves be interpreted as disabled, suffering from blindness or a kind of critical misperception or willful noncompliance. If disability was defined against the bodies, behavior, and kinship practices of Native people, how did they and their kin experience and respond to this colonial ableism? I answer this by connecting and interpreting written documents, letters, and petitions dispersed across the carceral medical archive, as well as reports published in Hawaiian-language newspapers from this early territorial period. 27 The third epigraph above, a letter from a Hawaiian father contesting his daughter's imprisonment, is but one direct response to settler health authorities.
Nailima Lishman, the child introduced at the beginning of this essay, was the only one of her immediate family and her seven siblings to be medically detained. The day after Nailima was admitted to Kalihi Receiving Station–on March 1, 1907–"Mr. and Mrs. Lishman," as her parents' names were recorded, went to visit her. Her mother Nellie Nailima Koli was Kanaka; her father, Thomas Lishman, a white Australian. Every person seeking to visit with someone at Kalihi Station required a formal visitation permit issued by the Board of Health and carried out by the Station keeper. The Lishmans' permits are recorded in the one extant keeper's log that was retained by the Board of Health, documenting visits to inmates between 1904 and 1908. 28
Thomas and Nellie Koli Lishman would have entered a compound surrounded by high wooden fences. After the keeper confirmed them as visitors, the Lishmans went into a bare visiting room. Mesh wire stretched from floor to ceiling, separating the room into two zones. On one side, Thomas and Nellie sat on a small bench. Ten feet away across the wire, nine-year-old Nailima sat in another chair. They were not allowed to touch each other. 29 The record cannot tell us how Nailima and her parents felt–perhaps hope, elation, anguish–when they saw each other in this room. However, week after week, from March 1907 through August 15, 1908, Thomas and Nellie came here to sit with their daughter. They applied for thirty visitation permits that covered themselves and their relations to see Nailima during two-week allotments. 30 After being detained for over four years at Kalihi, Nailima was sent to Molokai on September 27, 1911. She died there on July 1, 1916 at the age of eighteen.
On yellowing sheets of mimeographed paper in the Kalihi Station visitors' log, names and patterns emerge of women visiting their lovers, daughters their mothers, brothers their siblings, neighbors, and friends, as well as a score of other relationships that are unknown today. Captured Hawaiians came from heterogeneous class backgrounds and birthranks, including ali'i (chiefly) and maka'āinana (common people) lineages, but many were from households of modest means, if not cultural capital.
One Hawaiian child detained at this time was Samuel Meheula. His father held positions as a bilingual teacher, Democratic secretary of the territorial house, and police department secretary. 31 Samuel was admitted as a leprosy suspect in 1905 from Auwaiolimu, O'ahu at the age of ten. He had been a student at 'Iolani College, an Episcopal school for boys, where his father once taught. 32 According to the visitors' log, Samuel's parents applied for permits from December 1907 until April 1908. During this time, Meheula's parents visited him every week, usually on Sundays. Some weeks Samuel received two separate visits, with his mother applying to visit on a Friday or Saturday, and both parents coming on Sunday.
A typical typed letter, addressed to the Kalihi Receiving Station keeper and stamped with the signature of the BOH president reads, "Permit Mrs. Meheula to enter the Visitors' House today, January 31st, and on Sunday February 2nd, permit Mr. and Mrs. Meheula to enter the Visitors' House for the purpose of seeing their son, Samuel." During the months of April and May 1908, Samuel's parents were granted visitations every Sunday. The frequency of the permits conveys the Meheula family's determination to bridge separation. Other logs after 1908 were not retained, but families and friends made use of visitation policies until the Kalihi facility closed in 1949. 33
While Nailima Lishman and Samuel Meheula are notable for receiving the most visitors during this period, not all imprisoned people were fortunate to have family nearby. Some Hawaiians brought from neighboring islands did not have family on the island of O'ahu, and removal to Kalihi Hospital marked the beginning of lifelong separation. Yet some Kanaka families exerted strenuous efforts to remain in close proximity with detained patients, such as the 'ohana (family) of Lahela Kanewa.
Lahela Kanewa entered Kalihi Hospital as a suspect on November 10, 1907. She was forty years old at the time and had advanced symptoms of leprosy. Her neck was paralyzed, nodules appeared across much of her face, and her right eye was inflamed. Lahela Kanewa and her family lived in La'aloa in Kona, Hawai'i, the southern-most island. Hawai'i island lies over 150 miles of ocean south of O'ahu. However, her immediate kin accompanied Kanewa on this journey from Kona to the city of Honolulu.
The day after her detention at Kalihi, Lahela Kanewa's husband and seven children received a permit to visit her at Kalihi Station. At least two of her daughters, Ana (or Annie) and Malia Kanewa, remained in Honolulu that month, and they applied for three more visitation permits that November. 34 These family members may have relocated to Honolulu temporarily, perhaps until a final medical and legal decision about Kanewa was declared.
The Wittrock family also relocated from a neighboring island to accompany daughters Augusta and Ella, who were taken into custody at Kalihi in 1912. Frederick Wittrock, a Danish immigrant, and his Hawaiian wife Kukonaalaa (Susan) Kepano left rural Hāna, Maui to stay near the Kalihi pineapple cannery, not far from Kalihi Hospital. Wittrock wrote to the BOH president Dr. John Pratt, for news of their "dear children" who had been taken into medical custody six months ago. His daughters were worried they would be removed to Molokai settlement. Wittrock relayed that the family would "go down and see the children every day from outside the fence" at Kalihi Hospital. Wittrock concluded by asking Pratt, "If your time allows it, please be so kind and let me know something about them." Pratt replied that transportation to Molokai was only a rumor because the Kalaupapa landing was in poor condition. He went on to reassure the worried father, "As long as they show signs of improvement and there is hopes [sic] of doing something for them I do not think that the Board would be likely to send them to the Settlement." 35
Only two months after composing this letter, Frederick Wittrock died suddenly of a stroke in Honolulu. His incarcerated daughters would not have been able to attend the large funeral and burial held in Hāna. Within the next decade, Augusta, Ella, and two of their brothers would be exiled to Molokai. 36
While some Hawaiians went to great lengths to visit family at Kalihi, they also reviewed laws and policies, wrote letters to officials, and petitioned the Board to re-examine their loved ones. Solomon Meheula wrote the BOH to request such a re-examination for his son Samuel on May 6, 1908. Samuel was re-examined that day, according to the reply addressed to the elder Meheula. 37 Although I could not find the outcome of this exam in BOH records, it is likely Samuel was found non-leprous and released from medical detention. 38 As of the 1910 U.S. census, Samuel was living with Solomon and other family members in the Pālolo neighborhood of Honolulu. 39
Another young person held at Kalihi Receiving Station during this period was nineteen-year-old Ane Kekoa from Hilo, Hawai'i. Ane had been ordered to report to BOH examination in September 1905 as a "leper suspect." 40 Some families surrendered to medical agents in their home districts, but Ane's father Edward refused to allow her to be taken to Honolulu for examination. 41 Edward Kekoa was a man of standing; he was pastor of Hilo Hawaiian Church and a lawyer active in Hawai'i's Democratic party. Edward and his wife Mary Pililua had at least seven other children.
According to Edward Kekoa's complaint in 1905, a health agent named D.S. Bowman dragged his daughter from the house, tearing her clothes. Kekoa claimed the leprosy law was unconstitutional and "denied the right of police to arrest his child." He wielded a hatchet and knife against the officers, but Annie was taken into custody and driven to Waiākea detention camp, then sent on to Kalihi Receiving Station in Honolulu. The BOH, however, argued the girl had been apprehended in a "very humane and courteous manner." 42
After Ane was taken from their Hilo home, Edward Kekoa continued to send protests from Hilo demanding that she be released from Kalihi detention. Two of his letters, written in 'ōlelo Hawai'i (Hawaiian language) and in elegant cursive, are retained in the Board of Health's correspondence file. In one written in 1905, Kekoa criticized the BOH for "he mau hana uahoa no ka oukou o ke ano lokaino, na kuu kaikamahine" (the severe actions of your merciless people towards my beloved daughter.") Edward concluded with a final ultimatum: "…[O] keia ka'u uwalo hope loa ia oukou ma ke ano mahiehie a iliwai hoi; a oia keia: E hookuu, a hoihoi mai i kuu kaikamahine ia Miss Ane N Kekoa." ("This is the last time I'm going to ask you nicely: release and return my beloved daughter Miss Ane N. Kekoa.")
Amidst his bitter censure of the Board, Kekoa signaled his deep fondness for his daughter, referring to Ane with the possessive pronoun "kuu" (my) that expresses affection toward intimates. On October 31, 1905, BOH president Lucius Pinkham acknowledged this letter and others sent by Kekoa, but confirmed that Ane had been declared a "leper." He encouraged Edward to accept Ane's fate. 43
Having been verified as leprous at Kalihi Receiving Station, Ane Kekoa was exiled to Kalaupapa, Molokai and spent about three years there. 44 Yet Edward continued to press for Ane's release. In 1908, Ane returned to Kalihi, possibly for additional treatment or because her condition had improved. Her sister Mary Rowland's visits to Ane between February 24 and March 3, 1908 were recorded in the Visitors' permit book. Her father Edward likely coordinated with Mary about Ane, as he sent another demand to President Pinkham on the last day of Mary's visit to the station on March 3, 1908. 45
Edward titled this second letter "Palapala Nonoi," or a petition. Edward cited both his birthrights of his native Hawai'i ("He Hawaii Ponoi ma ka hanau ana") and his rights of American citizenship ("he kupa Amerika"), and argued for Ane's re-examination. He contended Ane had greatly improved at Molokai, observing that only the fingers on her right hand showed slight contraction. Pinkham replied, however, that Ane had not sufficiently improved. Lodging a petition at the Board was neither coincidental nor rhetorical. As a lawyer who had recently experienced the tumultuous overthrow of the kingdom, takeover of the government by white setters, and a broad Hawaiian movement contesting U.S. annexation, Edward Kekoa would have been very familiar with the convention of written petitions and their power. Indeed, Edward had signed his name in beautiful script at the top of a Hilo, Hawai'i petition sheet opposing a 1897 U.S. Senate treaty of annexation. Called Papapala Hoopii Kue Hoohui Aina (Petition Protesting Annexation), this mass petition signed by citizens of all islands successfully defeated a treaty of U.S. annexation in 1897. 46
After the failure of the 1897 annexation treaty, U.S. annexation of Hawai'i was accomplished illegally by the Newlands Resolution, a joint resolution of U.S. Congress in 1898. This resolution required a simple majority, instead of the two-thirds vote in each house for treaty ratification. Yet Edward Kekoa, as Kanaka 'Ōiwi scholar Noenoe Silva has illuminated, continued to denounce the illegal annexation, along with many others who had collectively opposed the U.S. overthrow and takeover of the Hawaiian nation. Kekoa penned essays urging "ke kupaa no ke aloha i ka aina" ("steadfastness for the love of the land"). These were published in the Hawaiian nationalist newspaper Ke Aloha Aina in 1900. 47
Edward Kekoa's palapala nonoi (petitions) to the Board of Health were marked with flourishes reflecting his work as a minister and public intellectual. However, other protests and pleas to the Board took varied forms during this time. Hawaiians of diverse class and occupational statuses sent appeals on behalf of family and friends. For instance, on a simple sheet dated April 29, 1907, eight people signed their names to a short request as "We, the undersigned relatives of George Kakapu." Maram Kahaina, Angeline Kahau Kapu, Keliinui, Kaliko, Mrs. Kalua, John Kaapa, and Fred Hamilton signed in two columns, with women's names on the left and men's on the right. They asked that George "stay at the receiving station up Kalihi for 12 months under Dr. J.T. Wayson to be treated." In this case, Kakapu's relatives' request was validated and may have had some influence on the Board's decision to keep him at Kalihi for treatment. President Pinkham's handwritten notations on the letter confirmed that Dr. Wayson had agreed to keep treating George Kakapu at Kalihi Hospital. 48
These family petitions exemplify acts of care and concern for incarcerated people inside, but those captive also reached toward their loved ones. 49 In 1909, patients and their families petitioned territorial legislators for re-examination by BOH physicians in hopes of being declared non-leprous and freed. Nineteen of these legislative resolutions passed. Eleven people held in leprosy institutions showed enough improvement to be ruled not leprous and were released from custody with clearance certificates. Ranging from ages six to seventy-nine years old, they had been institutionalized from three to twenty years. 50 Hearing of these releases in June 1909, over 170 people sought re-examinations at the Kalaupapa, Molokai settlement later that year. These exams were so numerous that physicians traveled to Molokai between August and October 1909 instead of patients coming to Kalihi Hospital in Honolulu. 51
These legislative events were covered dispassionately by the territory's English-language press. During the same time, however, an exiled patient sent letters to multiple Hawaiian-language newspapers in 1909 penned in the names of S.K.M. Nahauowaileia and S.K. Maialoha. He offered detailed, first-hand accounts of the re-examination efforts to a public sphere of Hawaiian readers. 52 Print culture in Hawaiian, especially in newspapers, continued for decades despite active efforts to suppress 'ōlelo Hawai'i (Hawaiian language) and promote Americanization in the territory. In 1909, for instance, when Nahauowaileia wrote his articles, there were ten Hawaiian-language newspapers in circulation. 53 In these pieces, Nahauowaileia publicized and humanized the individual and collective desires of exiled people to return to their beloved homelands and kin. 54
Nahauowaileia opened his reports with a customary greeting of aloha to the editor of the newspaper. He then presented his fellow residents not as a cohort of inmates, but as people recognizable by their relationships with "kini makamaka" (intimate friends) outside the settlement: "Eia mai ka mea aloha he kane wahine, keiki, moopuna, kaikamahine, kuakahi, kualua, a huli hoi aku no ka aina e ike a e honi hou i na ea hu'i hu'i o ka aina (ke huli hoi aku hoi)…" ("Here are your loved ones: a husband, wife, child, grandchild, daughter, child three generations removed [great grandchild], child four generations removed [great-great grandchild], they turn toward their homes, to see and to smell again the chilly air of the land (if they do return)… 55 He listed the names of 133 people, their gender, land of origin, and the number of years spent in the settlement. In three other articles from this period, he followed the same naming and biographical conventions. 56 Significantly, these kinship terms invited exiled people to be claimed by those on the outside reading their names. Through poetic and metaphoric language that evoked memories of shared sensory experiences, Nahauowaileia represented exiled children and elders alike yearning to return to their homelands. The prospect of return, then, was to both kin and place.
Two of those seeking re-examination in Nahauowaileia's letters were Ane Kekoa and her new husband Joseph Kauhane. Dedicated to her discharge, Ane's father Edward Kekoa would have been following these developments closely. Reunification with her Hilo kin brought another kind of separation, however. Ane had married fellow patient Joseph Iokewe Kauhane in the settlement in June 1909. That fall, after both Ane and Joseph were medically discharged, Ane returned to her birthplace and family in Hilo. 57 Joseph does not appear to have accompanied her. Ane worked as a telephone operator in Hilo, becoming a supervisor. Edward Kekoa died in 1915, and Ane remained in the Hilo district until her death in 1932.
The release of Ane Kekoa and Samuel Meheula back to their homelands and families were exceptions within thousands of other instances, however. The majority of people declared leprous were exiled to Molokai settlement. What could families do once loved ones were exiled? Some petitioned to become kōkua, or unpaid caregivers, for disabled and ailing kin in exile. Kōkua means to help or assist in Hawaiian. "Mea kōkua" or "kōkua" were so-called "clean" (i.e., non-leprous) people permitted by the Board of Health to reside in the settlement in exchange for essential manual and domestic labor, including caregiving for sick friends and kin. These kōkua nursed, buried bodies, built structures, farmed, prepared food, fetched water, and washed clothes, ensuring the function of the settlement.
Five months after Lahela Kanewa entered Kalihi Hospital in an advanced stage of leprosy, the Board removed her to Molokai on April 17, 1908. Again, even within the Board's archive of routinized proceedings are opportunities to apprehend the great determination, deliberation, and sacrifice on the part of Hawaiian families. A week later, on April 24, 1908, Lahela sent a request for her husband Joseph to be allowed into the Molokai settlement as her kōkua. Their petition was considered at a BOH meeting; it was approved and a permit issued for Joseph Kanewa. Joseph joined Lahela at the settlement on May 21, 1908. They lived together until Joseph predeceased Lahela in 1911. 58
The Kanewa family was but one of many who took such actions. At the same meeting, the Board considered the petition of a Mrs. Mary Leialoha Kuokalani, who requested her husband Owen Kuokalani as her kōkua. Their petition was also granted. Owen appears to have lived in the settlement with Mary Leialoha until she died two years later in 1910. 59 During this period from 1908 through 1910, a significant portion of the Board's meetings was spent deliberating petitions, either for kōkua to join family members or to remain in the settlement. Not all petitions were approved, however. The Board denied some without explanation.
Without the work of kōkua, the Board would not have been able to run the Molokai settlement. More importantly, the willingness of kōkua to accompany their loved ones challenged the mandates of carceral medicine that produced stark divisions of clean/dirty, disabled/able-bodied, diseased/healthy, competent/incompetent, and beautiful/unsightly. Although the precise number is unknown, many hundreds of these helpers, usually kin or friends of patients, volunteered to go into exile at the settlement. 60 Kōkua gave up occupations, property, and rights to care for their loved ones. These helpers, although legally and socially designated as "clean" and able-bodied, continued intimate ties with biological, conjugal, and non-biological kin through cohabitation, nursing, sex, feeding, marriage, and adoption. Family members continued to recognize a person beyond external manifestations of illness.
What might these individual and collective actions suggest about Indigenous people and caregiving? It would be wrong to essentialize Kānaka 'Ōiwi as more capable of love and care than settlers. Nor did they dispute contemporaneous Western science that leprosy was contagious. However, many challenged a settler system that removed them from the reach of loved ones: a system they saw as unfair and unjust. Their visits, petitions, letters, and coordinated movements constitute a micropolitics of survival. Responding to suffering, love, and grief, they rejected normative assessments of their bodies and kinship and made deliberate choices to stay connected. If they were to survive illness and the wider colonial practices that threatened to extinguish them, they needed each other.
I wrote this essay fitfully during the vicissitudes of the COVID-19 pandemic, leaning on many near and far. DSQ special issue editors Ella Callow, Juliet Larkin-Gilmore, and Susan Burch provided exceptional stewardship and feedback, while reviewers offered informed and judicious queries. I also wish to thank Makanani Salā and Noah Dolim for lending insights to my translation and interpretation of letters here, as well as conversations about Hawaiian kinship. Finally, I mahalo my own extended relations, especially the Arakawas, Rae Yamanaka, Aunty Shari "Chame" Smith, Aunty Jeanette Yamanaka, and hoaloha Ka'ohulani McGuire, whose love, food, and care kept us closely tied as the pandemic unfolded.
Note on Language: I do not italicize words in 'ōlelo Hawai'i (Hawaiian language), in order to avoid marking an Indigenous language as foreign. As nineteenth-century and early-twentieth-century sources written in 'ōlelo Hawai'i did not employ diacritical marks, I have preserved the original spelling of names and words in these sources, with the exception of prominent places and names that follow contemporary spelling conventions.