[5][6] Its goal is to preserve the cultural and physical settings of the two leper colonies on the island of Molokaʻi, which operated from 1866 to 1969 and had a total of 8500 residents over the decades.

The peninsula has house sites, cultivated taro fields and irrigation systems, stone walls, and temples (heiau), all constructed by ancient residents.

[7] In 1865 the Kingdom legislature passed a law to try to prevent transmission of leprosy, now known as Hansen's disease after the scientist who discovered the bacterium.

[8] The government arranged for Native Hawaiian inhabitants to be removed from the Kalaupapa to prepare for its development as an isolation settlement for persons with severe leprosy.

The governments of the Kingdom, and subsequently, the Territory and State of Hawaiʻi tried to control leprosy (also known as Hansen's disease), a much feared illness, by relocating patients with severe symptoms to the isolated peninsula.

[7] The settlements were administered by the Board of Health, with local financial control held by Rudolph Meyer, a German immigrant who worked for the Molokaʻi Ranch and lived on the island.

Local supervision for decades was by superintendents of Hawaiian and part-Hawaiian ancestry, some appointed from among the patients or family members with persons with leprosy.

[9] Belgian missionary priests from the Congregation of the Sacred Hearts of Jesus and Mary were among those who cared for persons with leprosy on Molokaʻi.

[10] Mother Marianne and sisters of her community developed hospitals, homes and schools on the islands of Oʻahu and Maui from 1883 to 1888, at which time they traveled to Kalaupapa where she lived and worked there until her death in 1918.