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In total over the decades, more than 8500 men, women and children living throughout the Hawaiian islands and diagnosed with leprosy were exiled to the colony by the Hawaiian government and legally declared dead. Patients were not allowed to leave the settlement nor have visitors and had to live out their days here.
Although Captain James Cook recorded sighting Molokaʻi in 1778, the first European sailor to visit the island was Captain George Dixon of the British Royal Navy in 1786.
Leprosy (also known as Hansen's disease) was among Eurasian diseases introduced to the Hawaiian islands by traders, sailors, workers and others who lived in societies where these diseases were endemic.
Because of the islanders' lack of immunity to the new diseases, they suffered high rates of infection and death from smallpox, cholera and whooping cough, as well as leprosy.
The eastern half of the island is a high plateau rising up to an elevation of 4,900 ft (1,500 m) on Kamakou peak and includes the 2,774 acres (11.23 km The eastern half is covered with lush wet forests that get more than 300 in (7,600 mm) of rain per year.
The high-elevation forests are populated by native ʻōhiʻa lehua (Metrosideros polymorpha) trees and an extremely diverse endemic flora and fauna in the understory.
The government established Kalawao located on the isolated Kalaupapa peninsula on the northern side of Molokaʻi, followed by Kalaupapa as the sites of a leper colony that operated from 1866 to 1969.