What happens to the community built on Kalaupapa Peninsula when the last patient with leprosy, now known as Hansen’s disease, dies? That’s a question at least five agencies, including the Department of Health, the Department of Hawaiian Home Lands, the Department of Land and Natural Resources, the Department of Transportation and the National Parks Service are trying to solve in 2025.
In January, Senate Bill 1432 and the companion House Bill 1113, were introduced and propose making Kalaupapa a state historical area. The bills also repeal sections of chapter 326, Hawaii Revised Statues — which established facilities for the treatment of patients with Hansen’s disease — upon the one-year anniversary of the death of the last Kalaupapa patient.
State government offices most recently came together for an informational meeting, held at Kaunakakai Elementary School on Molokai, to discuss the future of the site and each agency’s responsibilities on Oct. 5, 2024.
Kalaupapa, a remote peninsula on the north shore of Molokai, was home to more than 8,000 people with Hansen's disease, who were sent there by King Kamehameha V to live in isolation from the rest of the world starting in 1866. The state legislature repealed provisions of the law requiring the segregation of individuals with Hansenʻs disease in 1969.
“It was the patients themselves who decided that their history needed to be kept as a legacy, so that all would continue to know their experience there,” said Dr. Kenneth Fink, the director of DOH, at the meeting. “They were the ones who proceeded to advocate for a national park to be able to preserve their legacy. The Department of Health’s role has been — throughout this — with the intention of caring for the patients. As we look back, we may disagree with some of the things that did or did not occur, but there was a kuleana to care for those patients for well over a century. DOH is working hard to be a good steward in preparing with NPS for a smooth transition once our kuleana there of patient care concludes.”
Today, there are seven registered patients between the ages of 83 and 100 years old, explained Baron Chan, the chief of the DOH’s branch for Hansen’s disease, at the meeting. In the fiscal year of 2024, DOH’s annual budget for Kalaupapa was $4.3 million. There are 33 employees, including healthcare providers and support staff working in administration, maintenance, food services or housekeeping, Chan said. Between 25% and 40% percent of those jobs are vacant at any time, he added.
“Our oldest patient — many of you are familiar with — he’s 100 years old,” Chan said. “He still drives. He still takes walks every day. He rides his exercise bike every day.”
Currently, the DOH handles patient care, homes, and a community store and gas station, as well as visitor permits and quarters, while the NPS handles law enforcement, utilities, waste management, road and trail maintenance, barge schedules, public tours, maintenance of cemeteries, archeological sites and fire suppression, according to the presentation. Even after patient care ends, DOH will still be responsible for environmental remediation, including removing underground gas tanks and the closing of a municipal and solid waste landfill, among other things, Chan said.
Ownership of Kalaupapa belongs to several agencies. The state Department of Hawaiian Home Lands owns 1,247 acres, including the Kalaupapa settlement and the sea cliff trail, and leases land to the U.S. National Park Service for the Kalaupapa National Historical Park. That lease, signed in 1991, extends for 50 years through July 14, 2041. DLNR owns approximately 7,400 acres in the area, as well as the land beneath the nearby airport, according to slides shared at the meeting. NPS owns more than 20 acres surrounding the lighthouse.
“Kalaupapa is a complicated place,” said Nancy Holman, the superintendent of Kalaupapa National Historical Park. “The jurisdiction is really complicated.”
Starting as early as the 1960s, patients were leading tours of Kalaupapa, she said. That was before the park was established.
The NPS’ annual budget for the location is $5 million, according to slides from the presentation. NPS’ staff includes 43 positions but about 30% of those jobs are vacant, according to the presentation.
“It’s a hard place to recruit,” Holman said. “People don’t always want to live remotely.”
During public comment, one leaser asked if the land could go back to its original inhabitants, who had lived in Kalaupapa before a settlement was established, after the last patient died. Speakers also expressed concern that members of the nonprofit Ka ʻOhana O Kalaupapa, a stakeholder in the establishment of a memorial for the community, are not part of the transition meetings between DOH and NPS.
On Jan. 23, SB 1432 and HB 1113, were introduced and passed first readings. Read the full text or submit testimony here.
The approximate cost of managing Kalaupapa
$5 million: annual budget – National Park Service
$4 million: annual budget – Department of Health
$475,000 - $500,000: annual operating costs - Department of Land and Natural Resources
$310,000: annual operating costs and payroll - Department of Transportation
Total: $9.785 million - $9.81 million
SOURCE: Slideshow for the Kalaupapa Information Briefing held Saturday, Oct. 5, 2024.
Katie Helland can be reached at katie@alohastatedaily.com.
