Molokai'i, the island, was where the Hawaiian government, under the influence of the New England Missionaries, set up an encampment for people who had leprosy, now called Hansen's Disease. In its early days, the peninsula really was a brutal prison, surrounded on three sides by rough seas and on the fourth by some of the tallest sea cliffs in the world. The early patients had to pretty much fend for themselves, building their own shelters and foraging their own food.
Molokai'i, the book, chronicles the life of Rachel, who is ripped from her parents at age six and sent to the Molokai'i encampment after her sister kind of accidentally outs her as having leprosy. Hawaiians seemed to be particularly vulnerable to the disease, and Hawaiian children even more so. Parents would hide the condition as well as they could, some even running away from home and living in the jungle with their children, to avoid capture and exile to Molokai'i.
The book combines history and fiction quite well. Rachel and her companions in exile are fiction, but Father Damien, the first priest to volunteer to care for the patients, and other doctors and caretakers are real. It is based on the combined histories and accounts of actual patients who lived on the island.
I had a hard time getting started at first - the idea of having a child snatched from her family because of a disease and then sent to live among strangers far away was too much for me. I considered not finishing the book, but I'm glad I did. I became completely caught up in the life of Rachel and the others she met in exile. Parts of the book are horrific, others are tragic, and still others are absolutely beautiful.
I rarely read fiction, but this is one of the best novels I've read in ages. I didn't want it to end, and when it did, I was in tears, but in a good way.