In some countries, leprosaria were essentially fortified prisons -- but worse, because in the latter, inmates sometimes are allowed contact with people from the outside world, and even for those with long sentences, there was always the hope that they'd someday be released.
Leprosaria, in contrast, aimed to sever any connection with the outside world. That lack of hope could make the inmates more difficult to deal with, because after that, any other punishment paled in comparison. S.P. Impey, superintendent of the South African colony on Robben Island (later famous as Nelson Mandela's prison) noted in the 1890s: "You cannot starve them and you cannot flog them; all you can do is deprive them of their liberty" [source: Edmond].
The Hawaiian leprosarium on the Kalaupapa Peninsula in Hawaii, in contrast, was a little more pleasant. It didn't need any walls or barbed wire. It was cut off from the rest of the island of Molakai by a sheer cliff about 2,000 feet (609 meters) high, and otherwise was surrounded by the ocean. In addition, the land around the colony was fertile and provided an ample supply of nourishing food -- sweet potatoes, fruit and a local vegetable called taro [source: NPS]. The Hawaiian government built a hospital and houses for the exiles to live in, and allowed clergy from various denominations to go to the colony to help them [source: NPS].
One of those religious workers was a Belgian-born Roman Catholic priest, Rev. Joseph De Veuster, who arrived in the early 1870s to assist the colony's 700 inhabitants. Father Damien, as he became known, did his best to make life there more bearable. He planted trees, organized schools, musical bands and choirs, and continually badgered the Hawaiian government for more resources for the exiles. Because he wasn't particularly careful about hygiene, Father Damien eventually became a leprosy patient himself and died in 1889 at age 49. One hundred and twenty years later, he was canonized as a saint by the Roman Catholic Church [source: NPS].
But even with those efforts, living in captivity and isolation was incredibly hard for people with leprosy -- some of whom had been snatched up by officials as young children. "They told me right out that I would die here, that I would never see my family again," recalled one man, who was exiled at age 13. "I heard them say this thing that I will never forget. They said, 'This is your last place'" [source: NPS].