“One Feeble Leper” – Imperialism and Public Health in Territorial Hawaii

The sharp crack of a Mauser rifle rang out through the Kalalau Valley as Private John Anderson of the Provisional Government of Hawaii fell back down the narrow trail leading up from the beachhead. He had taken a fatal bullet, and as he hurtled backwards his body collided with two more of his comrades, knocking them down the mountainside with him. As more dissuading shots ripped through the jungle vegetation, Sergeant Major John Pratt ordered the rest of his detachment back, took stock of their situation, and ordered a withdrawal back to the beach. The body of Anderson could not be recovered, as it lay open in the field of fire, but both men injured in their fall were gathered in and escorted back to the base of operations on the beach of Kauaʻi Island.

The Independence Day bloodshed was a flashpoint in a growing crisis indirectly related to the newly implemented Provisional Government of Hawaii and its push for control over the Hawaiian Islands. In the winter of 1893 western insurgents with ties to the United States had led a coup d’état against the Hawaiian monarchy of Queen Liliʻuokalani and established the Provisional Government. The goal of the coup and provisional government established in its wake was to push for annexation of the islands by the United States.

Executive Committee of the Provisional Government of Hawaii

Executive Committee of the Provisional Government of Hawaii

To insure a speedy annexation, the white leaders of the Provisional Government believed it necessary to portray the islands as westernized. Of particular concern to the executive council of the newly formed government was the prevalence of leprosy in the islands, which carried an explicit stigma as a disease of the uncivilized. Contemporary reports over-estimated that a full 10% of the native Hawaiian population in the late nineteenth century suffered from leprosy. According to British medical reports, there were at least 6,000 recorded lepers in the islands at the turn of the century. The Provisional Government leadership knew this would be a concern to U.S. officials debating the benefits and detriments to annexation, as “many of those who either know or suspect that they have the disease will undoubtedly attempt to escape to the United States.” U.S. newspapers speculating on the possibility of annexation during the coup of 1893 were quick to point out the prevalence of the disease in the islands as they questioned whether Hawaii was developed enough to become an American territory. The government leaders realized that unless they could show firm health policies dealing with leprosy on the islands, the U.S. would not saddle itself with the infectious burden of Hawaii and their hopes of annexation would be stymied.

Lepers Quarantined at Molokai

Lepers Quarantined at Molokai

With this in mind, William Owen Smith, the Attorney General of the Provisional Government, decided in the spring of 1893 to begin enforcing a much ignored law which required all victims of leprosy to be quarantined at the leper colony on Molokai’s isolated Kalaupapa Peninsula. Common medical wisdom of the day held that leprosy could be prevented “only by complete segregation of those suffering from the disease.” The quarantine colony had been established in 1866, with the site being selected for its inaccessibility, cut off by the sea on three sides and high cliffs inland. Smith’s policy was received by U.S. and British medical societies of the day as “the most practically progressive and modern of measures” and certainly established the new Hawaiian regime as a promising partner in the road to U.S. annexation. The policy on the ground, however, proved much harder to enact.

John Anderson had been stopped in his tracks by the bullet of Kaluaikoolau, a native Hawaiian leper who failed to see this western law as progressive public health policy. Instead, Ko’olau, as he was called, and his followers saw the forced exile away from their families as oppressively foreign. In native Hawaii culture, an infected leper typically stayed with their family and was cared for by their loved ones despite their ailment. Ko’olau’s wife Piilani, for instance, stayed with her afflicted husband and son for many years even though she herself remained free of the disease. As transmission rates of leprosy are actually quite low, this traditional approach of caring for lepers was not as unsustainable as western medical knowledge assumed. Many who were exposed to the disease never contracted it. The western approach to leprosy, however, was unforgiving in its insistence on segregation of the infected. When the Provisional Government began enforcing this policy, Ko’olau and approximately forty lepers and their families fled to the remote Kalalau Valley of Kauaʻi to escape internment on Molokai.

Illustration from Jack London’s short story about Ko’olau, a highly stylized piece titled “Koolau the Leper”

Deputy Sheriff Lois H. Stolz and two policemen came to the Kalalau Valley on June 24th 1893 to carry out the quarantine policy among these refugees. They stayed with the mixed settlement of infected and non-infected natives for several days as they tried to negotiate the deportation of the lepers to Molokai. The two leading lepers of the settlement, Ko’olau and Kapahei Kauai, a former judge, were quite clear, informing Stolz that they deemed it “better to fight than leave Kalalau.” Tensions came to a head between the policemen and the native refugees on the morning of June 27th as Stolz attempted to force the policy by handcuffing several lepers. In the struggle that followed, a gun went off, wounding Stolz and scattering the other two policemen. As Stolz reached for his gun to defend himself, Ko’olau, a renowned shot and former cattleman himself, raised his own rifle and ended Stolz’s life.

Following the murder of Stolz, a full military operation was launched by the Provisional Government, with a mixed detachment of soldiers and police arriving by steamer off of Kalalau on July 1st. William Owen Smith, realizing that resistance would only serve to highlight the leprosy issue on the islands, denounced the murder of Stolz as an embarrassment that must be dealt with swiftly and harshly. Deputy Marshall William Larsen, the leader of the expedition against Kalalau, came ashore with a full detachment of troops and a howitzer, declared martial law and arrested fifteen lepers immediately. Ko’olau was not found, and it was soon learned that “eight lepers, including Ko’olau, who had sworn not to be taken alive” had fled further up the valley, well-armed. Larsen established a base of operations on the beach, began dispersing scouts into the jungle, and formed several groups of soldiers to begin probing up the valley.

The Kalalau Valley today.

The Kalalau Valley today.

Ko’olau’s renegade band was found on July 4th as Private John Anderson and three others scouted ahead of their fifteen man detachment. The bullet stopped the unfortunate soldier and drove back his comrades. Following the ambush, Larsen ordered the howitzer to begin shelling the steep mountainside where Ko’olau and his followers were dug in. After pounding the area for the rest of the day, Larsen led a second reconnaissance up the narrow footpath on July 5th, intending to recover Anderson’s body and rush the ledge where Ko’olau was positioned. John McCabe, an American expatriate and Civil War veteran, was shot in the head while leading the assault up the path, and once again the western soldiers withdrew. Another casualty ensued when a retreating private’s rifle discharged and killed him. With now three dead bodies and bruised morale, the provisional troops fell back to the beach, bested by one native leper, and took up the howitzer barrage again throughout the night and into the next day.

While Ko’olau’s small band continued to elude Larsen’s expedition, more lepers continued to surrender on the beach. While detachments probed and assaulted Ko’olau’s defensive position throughout the days of July 4th 5th, and 6th, other parties of soldiers had rounded up 28 infected natives from neighboring valleys. When a third assault was launched against Ko’olau on the 7th, it was found that he had fled higher into the mountainous jungle, and the decision was made not to pursue.

Ko'olau with his wife, son, and mother-in-law. Photo taken before his exile in the Kalalau Valley.

Ko’olau with his wife, son, and mother-in-law. Photo taken before his exile in the Kalalau Valley.

Already, American newspapers were reporting the incident mockingly as “the Leper War” and the Provisional Government leadership desired a speedy end to the publicity. Larsen, in trying to defend his expedition’s failure to deal with “one feeble leper” reported that from his perch on the mountainside, Ko’olau “could have slaughtered a thousand men who attempted to reach him if he had the required number of cartridges.” The rogue leper himself, along with his family and small following, lived out his days in the mountain fastness of the Kalalau Valley, and his buried body was found years later, still clutching his Mauser rifle.

In nineteenth century parlance, the policy of the Provisional Government to quarantine the native lepers of the Hawaiian Islands was medically sound and socially progressive. In a very narrow, western sense, the policy was applauded as practically modern. The motivations for the policy, however, were more sinister, being rooted in the same imperialist philosophy that had inspired the coup of 1893 and the Provisional Government’s aspirations for annexation. U.S. occupation and development of the Hawaiian Islands was at the heart of the policy as American transplants looked to colonize and westernize the islands under the sphere of the United States. Though the native lepers like Ko’olau lacked the political capital to condemn the policy as imperialism under the guise of progressivism, their actions voiced their discontentment with the quarantine and its motivations. Despite their resistance, the policy would continue on to success for the Provisional Government. The majority of lepers would be gathered to the quarantined internment station on Molokai, which endures as an active leper colony to this day. Within a year, the Provisional Government would declare itself a republic, and on August 12th, 1898, the flag of the United States would be hoisted over the newly minted Territory of Hawaii for the first time.

Company of Provisional Government troops burying the three soldiers killed by Ko'olau in the Kalalau Valley.

Company of Provisional Government troops burying the three soldiers killed by Ko’olau in the Kalalau Valley.

Like this article? Let us know what you thought in the comments below! We’re always happy to answer feedback.

Find this article interesting? Read about another U.S. Territory and its relationship with a polio-ridden president here.

The United States has a long history of battling diseases in remote places. Read about the doctors that explored and fought Rocky Mountain Spotted Fever in Montana’s Bitterroot Valley.

Armed resistance more your thing? Check out some of our articles about native resistance in Minnesota, the New Mexican desert, and the Great Lakes


“From Kalalau: Two Lepers Arrested at the Waimea Pass: The Murderer Drives Them Out”
The Hawaiian Gazette, July 04, 1893.

“From Kalalau Valley: The Waialeale Brings News of the Expedition”
The Hawaiian Star, July 05, 1893.

Leprosy and the Annexation of Hawaii By The United StatesThe British Medical Journal 
Vol. 2, No. 1969 (Sep. 24, 1898), p. 913.

Binford, C. H. “The History and Study of Leprosy in HawaiiPublic Health Reports (1896-1970)  Vol. 51, No. 15 (Apr. 10, 1936) , pp. 415-423.

Inglis, Kerri. Maʻi lepera: Disease and Displacement in Nineteenth-century Hawaiʻi. Honolulu: University of Hawaiʻi Press, 2013.

Jerrold, Michael “The Public Health Service Leprosy Investigation Station on Molokai, Hawaii, 1909-13: An Opportunity LostPublic Health Reports  (1896-1970) Vol. 95, No. 3 (May – Jun., 1980), 203-209.

Law, Anwei Skinsnes, and Bernard Kaʻowakaokalani Punikaiʻa. Kalaupapa : A Collective Memory. Honolulu: University of Hawaiʻi Press, 2012.

Wayson, N. E. “Observations on the Treatment of Leprosy in HawaiiPublic Health Reports (1896-1970) Vol. 44, No. 51 (Dec. 20, 1929), 3095-3110.

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