Alan Brennert’s Moloka’i, published in 2003, offers a fictional account of the life of Rachel Kalama, a native Hawaiian with Hansen’s disease. A writer for television and film and the author of numerous books, short story collections, and comic books, Brennert has won an Emmy and a People’s Choice Award for L.A. Law and a Nebula Award for “Ma Qui,” a short story. As historical fiction, Moloka’i realistically depicts life for Hawaiians with Hansen’s disease, referred to as leprosy throughout the novel. Brennert employs historical facts detailing the overthrow of the Hawaiian monarchy, the bombing of Pearl Harbor and World War II, and the existence of the containment facilities at Moloka’i to describe life for Hawaiians with Hansen’s disease as he concentrates on Rachel and how she navigates exile, marriage, and motherhood. Brennert later published Daughter of Moloka’i in 2019, which focuses on Rachel’s daughter, Ruth. Brennert, who visited Moloka’i in the 1990s, has spoken of his love for Hawaii and Harriet Doerr’s historical fiction set in Mexico as partial inspiration for Moloka’i (“Reading Guide,” Moloka’i, 392).

Other work by this author includes the novel, Honolulu.

This guide is based on the 2003 edition, published by St. Martin’s Griffin.

Content Warning: Moloka’i depicts suicide, gender-based violence, sexual assault, racist and bigoted language, and outdated descriptions of patients with Hansen’s disease.

Plot Summary

Moloka’i traces the treatment of people with Hansen’s disease from the turn of the 20th century to 1970, focusing on Rachel Kalama, a native Hawaiian whose diagnosis of Hansen’s disease leads to her confinement on Moloka’i. Moloka’i begins with Dorothy Kalama and her children, Ben, Kimo, Sarah, and her youngest daughter, Rachel. As they prepare to get ready for church, Dorothy demonstrates her devout faith in instructions and gentle chastisements of her children, as she and Rachel make poi, a Hawaiian dish made from taro. Her husband and the father of her children, Henry, makes his living as a sailor, and Rachel awaits his imminent return to Honolulu, a day she calls “Steamer Day.” Rachel asks questions at the Sunday school, testing the patience of her teacher. Her father returns, giving the children presents, including a doll for Rachel. Dorothy and Henry host a party, and Dorothy’s brother Will and Henry’s brother Pono attend—Rachel and Pono joke with each other. The king dies soon after Henry’s arrival, and Hawai’i mourns publicly, with the king lying in state in Iolani Palace. As Henry leaves again for work, Rachel notices a ship headed for Moloka’i carrying people with leprosy who have to live there permanently.

After Henry leaves again, tragedy strikes closer to home, as the health inspector detains Pono on suspicion that he has leprosy. At the receiving station, Pono awaits his fate. Rachel makes a pretend soup with inedible materials, like her socks and Sarah’s felt hat, she and Sarah fight, and Dorothy discovers a rash that looks like leprosy. Worried, she makes Rachel wear a bandage, and visits a healer who prescribes medicine and prayer. While the rash disappears, it quickly returns, and Rachel soon discovers a similar mark on her foot. After Henry returns, he and Dorothy hold a healing ceremony for their family, seeking to squash any resentments that might drive Rachel’s blemishes. Sarah and Rachel fight again, as Sarah teases her sister for wearing shoes to cover the blemish on her foot and calls her a slur because she has leprosy. Detained later by the health inspector, Rachel moves to the receiving station where she’s tested, and, some months later, moved to Moloka’i.

On Moloka’i, Rachel meets her uncle Pono again, who has a new lover named Haleola, a native healer. Haleola explains how Moloka’i operates and that she has children, now grown, whom she has not seen. Authorities tell Pono that he cannot keep Rachel at his home in Kalawao, but she must stay at the Bishop Home, run by Franciscan nuns. He and Haleola fight the decision but lose. Rachel, sullen at first, soon makes friends.

Pono becomes sick, and Haleola and a doctor treat him, but he can’t visit Rachel, who grows worried about Pono and Haleola’s absence. She tries to visit and expresses her anger at God, and the normally calm Sister Catherine slaps her. Angry, Rachel escapes Bishop Home, leaving Kalaupapa. Moko, an old man, holds Rachel captive after she gets lost in the rain. Forced to do manual labor, Rachel escapes a few days later and finds her way to Kalawao. There, she finds Pono sick. The sisters allow Rachel to stay with Pono, who dies soon after. Barred from the convent following Pono’s death, Haleola manages to visit with Rachel at the beach, where Rachel swims and surfs. Rachel’s letters to her mother return, and Sister Catherine’s letter to Dorothy returns as well. A package arrives from Henry, containing a doll from Buenos Aires. He surprises Rachel in Kalaupapa and tells her that her mother and siblings moved from Honolulu to escape the stigma of Rachel’s diagnosis.

Sister Victor, a moody nun, asks Catherine to join her for a beach trip with the Bishop Home girls, and Bertha nearly drowns. Victor, in spite of her fear and Bertha’s sores, resuscitates Bertha, but, later that night, experiences extreme mental distress and leaves on the same ship as Henry. The girls become restless at Bishop Home, and they decide to escape and go to a party. While the journey is difficult, they have fun. Rachel becomes afraid to touch a local man without leprosy, and the girls regroup and head back to the convent, seeing Mother Marianne in the morning, who ignores their infraction. Rachel tries new treatments for leprosy, and a new girl named Leilani arrives. She and Rachel become friends, and they go to a party, where a man attacks Leilani and attempts to assault her. Haleola treats her, and Rachel, shocked, sees that Leilani has a penis. Momentarily angry, Rachel eventually grows close to Leilani.

Haleola notices the changes to Kalaupapa and the new opportunities for recreation, including a baseball diamond. Rachel sees progress too as the doctor tests skin samples that result in negative tests for the bacteria that cause leprosy. After six negative tests, Dr. Goodhue tells Rachel that she can apply for temporary release and leave Moloka’i. Catherine learns her mother died by suicide, and she becomes angry and lost. Haleola grows weaker, and, two months before her 18th birthday, Rachel moves in to take care of her. Haleola cooks for Rachel, and they hike up to see the island before Haleola dies.

Isolated in her room, Catherine learns that Haleola has died and goes to help Rachel. They bury her in the traditional way, and Catherine disappears after the burial. She jumps off a cliff, into the water, attempting to die by suicide. Rachel saves her, but Catherine breaks her leg in several spots. A lighthouse comes to the island, and one of the young keepers, Jake, gets close to Rachel before recoiling in fear. She tries a new treatment center on the island, but horrified at her treatment, she leaves, and Rachel decides to accept her life.

Rachel’s father writes her to tell her that he has been diagnosed with gout although he prayed for leprosy so he could be with her. Leilani develops breasts, which the doctor diagnoses as a side effect of her leprosy, and yet Leilani is delighted. Rachel meets a Japanese man named Kenji, whom she saves from attempting to die by suicide. They grow close, and soon, they marry. Henry attends the wedding, but he worries he won’t see his daughter again, and he dies later in Honolulu. Rachel becomes pregnant but has to give the baby up for adoption or give it to her family. Choosing adoption, she says goodbye to Ruth after visiting her behind glass for a year. Catherine takes Ruth to Honolulu so she can be adopted.

War arrives in Hawaii, as the Japanese military attacks Pearl Harbor. A sailor named Crossen arrives in Moloka’i, and he ends up living next door to Kenji and Rachel and dating a woman named Felicia. Crossen drinks heavily, abuses Felicia, and grows increasingly unpredictable. He cannot avoid his feelings about the war and his leprosy. Kenji and Rachel involve the cops repeatedly, until Kenji attempts to intervene personally, and Crossen kills Kenji. Put on trial, Crossen receives a 35-year sentence, but, without a proper prison, he serves his sentence at Bay View Home. Stressed and sad, Rachel experiences worsening symptoms, and then a tsunami strikes Hawai’i. Around this same time, doctors discover that sulfa drugs can arrest the progress of leprosy, and Rachel improves enough to win temporary release, which is all but permanent. Confronting Crossen before she leaves for Honolulu, Rachel tells him he’s trapped, and his body is discovered floating in the water days later.

In Honolulu, after much trouble, Rachel rents an apartment and finds a job, until her visible signs of leprosy on her right hand are noticed. She finds her sister and petitions to have Ruth’s adoption records opened. She and Sarah reunite with much joy, and Rachel discovers that her brother Kimo had leprosy, which Dorothy hid until he died decades earlier. Back in Honolulu, Rachel gets Ruth’s contact information, and they speak on the phone. Shocked at the news that Rachel has leprosy, Ruth struggles to talk with Rachel before eventually inviting her to visit California, where Ruth lives. Rachel meets her grandchildren and Ruth’s husband and adopted mother. Decades later, after they grow closer, Rachel returns to Kalaupapa to die, and Ruth and her daughter, Peggy, arrive to bury her under the “blue vault of heaven” (384).