At the Edge of the World: A Nurse's First Night at Kalaupapa

At nineteen, Eleanor Silva—born to Madeiran immigrants and newly trained as a practical nurse—found herself caring for Hansen’s Disease patients at the Kalaupapa settlement. Here is part of her story.

“Even though I’d grown up on Molokaʻi, the settlement was a ghost to us. It was five square miles of isolation, a tongue of land licked by the Pacific and guarded by the highest sea cliffs in the world. Kapu—forbidden. That’s what we were told. Ever since the King established it in the 1800s, it was a place where names disappeared. Just mentioning Kalaupapa was enough to make people make the sign of the cross.”

"I remember this one time . . . I was left alone in a hospital full of the dying. That night, the panic finally found me. I had six or eight trachs to change in a row. It’s a terrifying thing, Tom—the patients can’t draw a breath while the tube is out. They look at you with this wide-eyed, silent desperation.”

“I reached a woman who was struggling. She coughed, a deep, racking spasm, and a piece of her own diseased tissue flew out of the tube. It landed right on my face. In my eye.”

She closed her eyes, reliving the moment. “I was gloved and masked, but I was grossly contaminated. I didn’t scream. I finished her procedure, my heart hammering against my ribs, then rushed to the washroom. I scrubbed and rinsed my eye until it was raw. Back then, we didn’t know that the disease was difficult to transmit to non-Hawaiians. I was convinced I had just received my own life sentence. That fear sat on my shoulder for years.”