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An examination of the history of leprosy, or Hansen’s disease, in the Territory of Hawaii is a clear window upon how the federal government addressed its fundamental responsibilities to an indigenous people of this nation. Over the years, and in particular prior to 1934, various federal agencies oversaw the array of this nation’s territories, but the Department of the Interior was always accountable for those of Alaska and Hawaii. Each agency acquired annual reports from the assigned administrators of such areas. These federal documents offer a remarkable perspective of these diverse geographic locations, and contain data on aspects of local life that are difficult to find elsewhere. This article speaks specifically to the leprosy reports contained in the Annual Reports for the Territory of Hawaii, between 1900 and 1959.