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The first significant European influence came in 1832 when a Protestant mission was established at Kaluaʻaha on the East End of the island by Reverend Harvey Hitchcock.

The first farmer on Molokaʻi to grow, produce and mill sugar and coffee commercially was Rudolph Wilhelm Meyer, an immigrant from Germany who arrived in 1850.

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.

The northern half suffered a catastrophic collapse about 1.5 million years ago and now lies as a debris field scattered northward across the bottom of the Pacific Ocean.

Molokaʻi is part of the state of Hawaiʻi and located in Maui County, except for the Kalaupapa Peninsula, which is separately administered as Kalawao County.

He built the first and only sugar mill on the island in 1878, which is now a museum.

Ranching began on Molokaʻi in the first half of the 19th century when King Kamehameha V set up a country estate on the island, which was managed by Meyer and became what is now the Molokaʻi Ranch.

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.

Former patients living in Kalaupapa today have chosen to remain here, most for the rest of their lives.

In the 21st century, there are no persons on the island with active cases of leprosy, which has been controlled through medication, but some former patients chose to continue to live in the settlement after its official closure.

Molokaʻi is home to a wingless fly among many other endemic insects.

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