Yes, a small number of people who were once diagnosed with Hansen’s disease (historically called leprosy) still live on Molokai’s Kalaupapa peninsula. As of May 2024, eight patients remain on the Kalaupapa Registry. They split their time between Kalaupapa and Oahu, traveling freely between the two. All were successfully treated and cured long ago. They stay not because they have to, but because Kalaupapa is home.
How Kalaupapa Became a Leprosy Settlement
In the 1860s, the Kingdom of Hawaii began forcibly relocating people diagnosed with leprosy to the remote Kalaupapa peninsula on Molokai’s north shore. The area is naturally isolated, surrounded by ocean on three sides and cut off from the rest of the island by some of the tallest sea cliffs in the world. The government provided supplies but initially sent no doctors or nurses.
In 1874, a 24-year-old Belgian Catholic priest named Father Damien volunteered to live and work among the patients at the Kalawao settlement. He dressed wounds, helped build roughly 300 structures including homes, hospitals, and orphanages, and eventually contracted the disease himself. He died on the peninsula in 1889. Pope Benedict XVI canonized him as Saint Damien of Molokai in 2009.
Over the following decades, roughly 8,000 people were sent to Kalaupapa. Many were taken from their families as children and never returned. The forced isolation policy continued well into the 20th century, long after effective treatments became available. Hawaii did not end its mandatory quarantine law until 1969.
Why the Remaining Residents Chose to Stay
By the time isolation was no longer required, many patients had spent the majority of their lives at Kalaupapa. They had built homes, formed friendships, married, and created a tight-knit community. The outside world still carried deep stigma around leprosy, and some residents had no family left to return to. When given the choice, most stayed.
The State of Hawaii guaranteed lifelong care and housing to anyone on the Kalaupapa Registry who wanted to remain. The eight surviving patients are now elderly, most in their 80s and 90s. They are not contagious and have not been for decades. Their continued presence at Kalaupapa is entirely voluntary.
Hansen’s Disease Is Curable and Barely Contagious
Modern antibiotics cure Hansen’s disease completely. Treatment lasts one to two years depending on the form of the disease, and it renders a person non-contagious within days by killing nearly all of the bacteria. The dead bacteria clear from the body slowly and may still show up in skin samples for years, but they pose no risk to others. About 95% of the human population has a natural immunity to the bacterium and could not develop the disease even with direct exposure.
The stigma surrounding leprosy has always far outweighed the actual medical risk. Even before antibiotics, the disease spread poorly compared to most infectious illnesses. That gap between fear and reality is a central part of Kalaupapa’s painful history.
Visiting Kalaupapa Today
Kalaupapa is both an active community and a National Historical Park, and access is tightly controlled. Hawaii state law requires all visitors to obtain a permit before entering the peninsula. You must book a guided tour; you cannot visit independently. Children under 16 are not allowed. Guests of current residents can obtain a permit through their host, who must apply through the Board of Health Office.
Special use permits are required for filming, photography for commercial purposes, public assemblies, and religious events. The restrictions exist to protect the privacy and dignity of the remaining residents, a promise the state and the National Park Service take seriously.
What Happens When the Last Resident Dies
The National Park Service has been planning for the day when no living patients remain at Kalaupapa. A General Management Plan has been in development for years, shaped heavily by input from the residents themselves and the broader Native Hawaiian community. The NPS has acknowledged the weight of that transition directly, noting that it has heard the “wishes, desires, and hopes for Kalaupapa as it reaches its inevitable place in the future when there is no longer a living patient population.”
The peninsula holds thousands of graves, historic buildings, and deeply personal artifacts from over a century of forced isolation. How to preserve that history, honor the people who lived and died there, and manage public access to one of Hawaii’s most sacred and painful places remains an ongoing conversation. For now, Kalaupapa belongs to the people who call it home.