Saint Marianne of Moloka'i

Women's History Month 2020 - Year of the Nurse!

As we gear up for one of our favorite celebrations! Women’s History Month!

Photo: Saint Marianne Cope

We honor Saint Marianne Cope and the Sisters of Saint Francis who brought to Kalaupapa healthcare, comfort, and peace for its patients who were abruptly exiled and torn from their families. Through her work, Saint Marianne helped pave the way for modernized healthcare on the Hawaiian islands and lived out the rest of her life on the island of Molokai, passing in the settlement alongside patients she treated. She is believed to be the inspiration for the hospice care movement, an appropriate summation of her legacy. She was canonized in 2012 as Saint Marianne of Moloka’i.

Saint Marianne’s role in the Kalaupapa settlement, a remote peninsula along the north shore of Molokai where patients suffering from Hansen’s disease (leprosy) were forcibly removed from their communities and exiled.

Moloka’i remains one of the least inhabited of the Hawaiian islands. It’s roughly rectangular in shape, about 40 miles from its east coast to west coast, and only about 10 miles from north to south. Molokai’s north shore is a line of sheer drop, stomach-flipping, impenetrable windward sea cliffs, the tallest on earth at over 3,000ft. If you live anywhere on Hawaii, you owe it to yourself to take a commuter plane to Moloka’i and cross your fingers that the pilot will be flying along the north shore. If you’re friendly to any Moloka’i locals on board (who have made the commute innumerable times), they might offer to trade seats with you for the “good” side of the plane. Based on your trajectory, get on the side where windows open up to views of emerald heads of amphitheater valleys, unbroken waterfalls from summit to sea, cliffs and narrow falls appear as green velvet draped in silver chains. Deep blue and choppy, the coastal waters make the shore near impossible to enter. The Moloka’i mountains and sea cliffs keep out any roads or vehicles, little access for anyone on foot. Only through witnessing the geography in person can you truly understand how isolated the Kalaupapa settlement is.

Right along the middle of the north shore sits the Kalaupapa peninsula. It juts out north like a triangle, backed by those formidable cliffs. Monk seals and porpoises enjoy the private, human-free waters where visitors and residents are not allowed to swim. It is a rule established by the patients who have earned the right to dictate these rules within their tiny community.

To stay in the settlement outside of a guided tour, you must receive sponsorship from patients or staff. Even today, day tours and visitation is extremely restricted to tourists, made even less available by the current closure of the Kalaupapa Pali Trail, the on-foot access to the settlement. Due to local geography, rockslides and heavy rainfall can blow out sections of the trail, blocking mule trains and visitor tours. December 2018, a landslide took out one of the bridges along the trail, closing it until highly skilled National Park staff are able to (very dangerously) clean and stabilize the site for a new bridge. Commuter planes now fly into Kalaupapa, but for much of the settlement’s history, only a small barge is what brought outside resources to the settlement, and it only arrives once a year when the waters are safe enough to dock. It’s one of the most celebrated days of the year, where residents can get necessary and luxury items alike, such as vehicles, appliances, furniture, gasoline, food, and beer.

Aerial image of the Kalaupapa peninsula and Moloka'i's North Shore cliffs

So I hope that paints a picture of Kalaupapa’s relative remoteness. The Hawaiian islands are the most geographically isolated islands in the world, farthest from any continental landmass. The island of Moloka’i has been one of the least inhabited islands in the archipelago. Moloka’i’s North shore is lined with the most formidable sea cliffs on earth. The remoteness needs to be conveyed for one to better understand the traumatizing experiences of exiled patients essentially deposited into the wilderness. It’s remoteness also needs to be emphasized when discussing the selfless bravery of the Sisters of St. Francis who came to care for patients of Hansen’s disease.

These Sisters knowingly put themselves on the front line to carry out their care, risked succumbing to the disease itself as some did.

In 1778, Captain Cook became the first European to reach the Hawaiian Islands. European contact with the Hawaiian Kingdom irreversibly disrupted life as they knew it. I cannot truly speak to the complicated, tumultuous relationships between the Hawaiian community and the all immigrant communities post-contact.

The story since their arrival is of conflicting industries, cultures, and ideologies. Whaling to sugar cane to tourism attracted a diverse labor force from around the Pacific. Hawaiian culture experienced an awkward interface with the arrival of missionaries, yielding the product of Westernized education and a written Hawaiian language, but also shifts in religion, government, and ideologies.

Hawaiian life lived in bio-geographic isolation, even long after the arrival of the Polynesians by canoe. Native Hawaiian people never developed the defenses to foreign diseases due to lack of exposure. Within a century post-Euro-contact, the health of the Hawaiian people took a huge hit. In the mid 1800’s the Native Hawaiian population was in a sharp decline. Queen Emma and Kamehameha the VI implemented a system of universal healthcare and opened the Queen’s Hospital to provide their people free healthcare. Among the various health threats, Hansen’s disease disproportionately impacted Native Hawaiians within the greater population.

It was 1830 that Hansen’s disease (leprosy) was found on Hawaii. Hansen’s disease is caused by the bacteria Mycobacterium leprae . Patients suffering from open sores, loss of sensation, and tissue degeneration. Loss of extremities and blindness sometimes resulted from the nerve and tissue damage. Before the discovery of the leprosy bacteria, it was believed to be hereditary and more contagious than it actually is. Because of these beliefs, 1865 Hawaiian laws dictated the arrest and removal of Hansen’s disease patients from their communities and sent to isolated colonies. In 1866, the Kalaupapa colony on Moloka’i was established.

Born in Heppenheim, Germany January 23, 1838, Saint Marianne Cope would go on to pave the way for healthcare services provided to these isolated leprosy settlements on the islands. Before missionary help arrived to Kalaupapa, patients were left in isolation to fend for themselves. Living conditions were devastating. Patients would resort to stealing rations from the weaker patients. Women were forced into prostitution. The arrival of missionaries and caregivers to the settlement brought much needed aid to the exiled. A community was constructed, along with the Sisters providing care, services, structure, and a sense of community.

Saint Marianne’s impact reached far beyond Kalaupapa and Hawaii. Before taking her work to Hawaii, she helped open two hospitals in New York. She pioneered practices of cleanliness and patient’s rights. They offered services to all patients, regardless of race, religion, ethnicity, and income.

Saint Marianne took the call to Hawaii, a mission many other institutions across America had turned down. She and six other Sisters of Saint Francis arrived on Oahu by boat in 1883 to treat patients suffering from Hansen’s disease. By request of the king and queen, she opened a home to care for the children of leprosy patients, naming it Kapiolani Home to honor the queen.

In 1884, Saint Marianne moved to Maui to manage the Malulani Hospital, the island’s first general hospital. It was in 1888 that Saint Marianne moved her work to Kalaupapa to treat exiled patients on the settlement. She would live in Kalaupapa until passing away August 9th, 1918 at the age of 80.

Since 1866, 8000 patients would be banished to Kalaupapa before treatment would come along. Even though patients are now allowed to leave (as of 1969), many of them have chosen to stay in the settlement as it became the only community they knew. A handful of patients still live today among their care staff. Most of the residents remaining are state and National Park staff who care for the natural, cultural and historical resources.

I'm Anne-Marie Spain, Top Spokes-model for What Makes You Feel Beautiful.

I wanted to share this story to celebrate women who pioneered healthcare in Hawaii and Kalaupapa, places that were, at the time, in dire need of public services due to the rapid changes to the islands growing and increasingly diverse populations. While I do not believe heroism should be defined by an extreme level of self sacrifice, I do resonate with a feeling of that internal call action, to get done a difficult job, and to go where most people would refuse. Nurses and caregivers are at the medical front line when responding to these epidemics. Their impact goes beyond their healthcare services providing comfort, kindness, and leadership to their patients.

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