At the base of the towering sea cliffs on Molokaʻi’s north shore, Kalaupapa sits quietly.
For more than a century, this place carried the weight of exile. Over 8,000 people diagnosed with Hansen’s disease (leprosy) were sent here between 1866 and 1969, removed from their homes, families, and communities.
Today, only four former patients remain. All are in their nineties. As this living chapter of Kalaupapa’s story nears its close, a question looms: what should come next, and who holds the kuleana to decide?
For Mikiʻala Pescaia, that kuleana is personal. She is a descendant of Kalaupapa patients, a cultural practitioner, homesteader, historian, and former Kalaupapa National Park ranger. She now serves as the lay leader of Siloama Church, the oldest Protestant church in Kalaupapa. Her relationship to place is not professional, it’s generational.
“As someone with generational presence and pilina to the island, it’s always been our hope and understanding that the island is one,” she says. “The request from King Kamehameha V to create these imaginary boundaries, to carve up Kalawao from the rest of the island, that’s a legacy of Hansen’s disease. And that isolation is something we still experience as a community today.”
Although the quarantine law was lifted in 1969, the separation is still felt. Pescaia says the trauma of exile doesn’t disappear just because the law changed. “Even though everyone got back their liberty to leave Kalaupapa, the trauma of that legacy still impacts us today,” she explained. “But also, the descendants of patients themselves are looking for reconnection.”
Reckoning with Kalaupapa’s past means understanding it was not a single experience.
“Some patients were deeply attached to their kulāiwi and did not want to be at Kalaupapa,” Pescaia says. “They didn’t want to be remembered for the disease. ʻI’m more than that.’ ʻI am one Kanaka.’ ʻI am one fisherman.’ They wanted to be remembered for being the husband, the wife, the mother they were. But on the other hand, for some patients, they came here as children. Kalaupapa was home. So, we need to think as a society: how do we honor and respect the spectrum of their experience?”
Much of Kalaupapa is currently managed by the National Park Service. Many of the staff are Native Hawaiian and from Molokaʻi, which Pescaia sees as a strength. Still, she warns that critical infrastructure is fragile, and federal support is never guaranteed.
“We only have so much water. We only have so much landfill. We only got one septic tank that gets cleaned once a year,” she says. “We need to think about those things and remember that the Hawaiian homestead lands there could be leased one day.”
Pescaia believes Kalaupapa’s future requires a shift away from conventional federal management. She proposes a model rooted in cultural practice and local leadership, like the Kahoʻolawe Island Reserve Commission.
“Kalaupapa needs a similar model,” she says. “Kalaupapa is a wao akua, a realm of the gods, and should be treated as such. When we go to Kalaupapa, we need to have the right mindset.”
That mindset also means recognizing the depth of Kalaupapa’s reach. “We all have family that was sent to Kalaupapa,” Pescaia says. “We all have aunties and uncles who were sent to Kalaupapa. In that sense, Kalaupapa is not isolated but is part of the moʻokūʻauhau of the lāhui. We really should have memorials on all the islands so that we remember the patients who sacrificed themselves to keep the rest of us safe.”
The work of stewardship, she says, is not just about preservation. It is about care. “In a Western democracy, there are always people who are in and out,” she says.
“But the Hawaiian model, the one Kalaupapa’s residents lived, was different. It wasn’t about exclusion or partisanship. It was about collective pono, making sure everyone from the kauhale to the ʻili to the ahupuaʻa all knew their place.”
Pescaia supports partnerships with the Office of Hawaiian Affairs and the Council for Native Hawaiian Advancement but cautions that any future leadership must center cultural integrity over political efficiency. “We need leadership that doesn’t just preserve the place, but its sense of community that Kalaupapa built while also being innovative.”
Environmental stewardship is part of that kuleana. The waters surrounding Kalaupapa face mounting pressures from overfishing. “Kapu isn’t about restriction. It’s about discipline,” Pescaia explained. “The area around Kalaupapa is the Kapiʻolani Hospital of fishes. If you keep catching the fish around the peninsula, that’s it – no more bēbē, no more fish.”
What comes after for Kalaupapa is not just about land management or historical preservation. It is about how a people respond to silence, to loss, and to opportunity. It is about whether we inherit only the grief – or also the strength.
Kalaupapa’s future, Pescaia believes, depends on whether Hawaiʻi is willing to learn from its example – not just as a historical tragedy, but as a model of resilience.
“Despite the deep trauma, Kalaupapa represents a community that constantly found ways to survive,” Pescaia says.
“They represent the best of us. We need to revere those kaiāulu practices and that pilina with Akua the patients had and bring that into all our communities.”
