Ma'i Lepera attempts to recover Hawaiian voices at a significant moment in Hawai'i's history. It takes an unprecedented look at the Hansen's disease outbreak (1865-1900) almost exclusively from the perspective of "patients," ninety percent of whom were Kanaka Maoli (Native Hawaiian). Using traditional and non-traditional sources, published and unpublished, it tells the story of a disease, a society's reaction to it, and the consequences of the experience for Hawai'i and its people. Over a span of thirty-four years more than five thousand people were sent to a leprosy settlement on the remote peninsula in north Moloka'i traditionally known as Makanalua. Their story has seldom been told despite the hundreds of letters they wrote to families, friends, and the Board of Health, as well as to Hawaiian-language newspapers, detailing their concerns at the settlement as they struggled to retain their humanity in the face of ma'i lepera. Many remained politically active and, at times, defiant, resisting authority and challenging policies. As much as they suffered, the Kanaka Maoli of Makanalua established new bonds and cared for one another in ways that have been largely overlooked in popular histories describing leprosy in Hawai'i. Although Ma'i Lepera is primarily a social history of disease and medicine, it offers compelling evidence of how leprosy and its treatment altered Hawaiian perceptions and identities. It changed how Kanaka Maoli viewed themselves: By the end of the nineteenth century, the "diseased" had become a cultural "other" to the healthy Hawaiian. Moreover, it reinforced colonial ideology and furthered the use of both biomedical practices and disease as tools of colonisation. Ma'i Lepera will be of significant interest to students and scholars of Hawai'i and medical history and historical and medical anthropology. Given its accessible style, this book will also appeal to general readers who wish to know more about the Kanaka Maoli who contracted leprosy-their connectedness to each another, their families, their islands, and their nation-and how leprosy came to affect those connections and their lives.