Stigma, in its original meaning, refers to the bodily marking in ancient Greece that signified exile, and stigma operates in similar ways throughout Moloka’i. Those people with Hansen’s disease, mostly Hawaiians but also other immigrants, experience the effects of stigmatization, from the first appearance of painless blemishes through their journey to Moloka’i and into death. This stigma centers on the body, regardless of character or personality, and the appearance of tumors, rashes, and other effects of Hansen’s disease that marginalize the person who has it.

The shunning of people with Hansen’s disease remains a constant in the novel, long after the facts behind the disease’s communicative properties become clearer, and long after former Governor Judd apologizes for the decades of harsh treatment of those who suffered from the disease, even as he can’t imagine another way. As administrators consider closing Kalaupapa and moving the patients to O’ahu, these plans themselves are shunned—“Science was slowly recognizing that the disease which today was called leprosy was not the same as the Biblical scourge of that, but Biblical stigma was hard to overcome” (266).

Throughout the novel, this stigmatization centers on those who have Hansen’s disease, but the effects of this stigma, based on bodily signs, go beyond the exile to Moloka’i.