The Trailblazing Black Woman Chemist Who Discovered a Treatment for Leprosy

On the east side of the University of Hawaiʻi at Mānoa’s campus, a 25-foot tree with long, narrow leaves and velvety brown fruit pays tribute to Alice Augusta Ball, the first woman and first African American student to receive a master’s degree from the school.

Known as a chaulmoogra, the tree was planted in 1935 in honor of Ball’s groundbreaking research on Hansen’s disease, or leprosy. As a chemist at the university—then known as the College of Hawaiʻi—in the mid-1910s, she developed one of the first effective treatments for the chronic infection, extracting oil from the chaulmoogra fruit’s seeds for injection into the bloodstream.

Before the introduction of sulfone antibiotics in the 1940s, the so-called Ball Method was one of the primary treatments for leprosy, which affects the nerves and skin and can dramatically alter the appearance of the extremities. For decades, however, the woman behind the discovery was overlooked, with the achievements of her short life (she died in 1916 at age 24) forgotten in favor of presenting a male-centric narrative of scientific ingenuity.

“Since we cannot bring Alice back to life, the least we can do is tell the story of her life as honestly and thoroughly as possible so people will know about her outstanding work today and in the future,” says Paul Wermager, a retired librarian who has dedicated the past 20 years to resurfacing Ball’s life and legacy. “She and her work can help educate and inspire [people to] do the seemingly impossible.”

Beyond opening a window into the pervasive racism and sexism of early 20th-century academia, Ball’s story sheds light on a dark chapter in Hawaiian history. Between 1866 and 1969, authorities forcibly removed more than 8,000 leprosy patients, almost all of them Native Hawaiians, to the remote peninsula of Kalaupapa. While white, or haole, leprosy sufferers were allowed to leave Hawaiʻi and seek treatment on the mainland, Hawaiians exiled to the colony were expected to remain there for life—at least until quarantine laws were lifted in 1969.

“It was a total double standard, which is classic during this time,” says Doug Herman, executive director of the Pacific Worlds Institute, a nonprofit that seeks to preserve and share the culture of Hawaiʻi and Micronesia.

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Ball was born in Seattle on July 24, 1892, to Black newspaper editor, photographer and lawyer James Presley Ball Jr. and white photographer Laura Louise Howard Ball. She grew up in a middle-class, distinguished family. Her paternal grandfather, James Presley Ball, was a renowned Black photographer who’d captured portraits of such individuals as abolitionist Frederick Douglass, opera singer Jenny Lind and writer Charles Dickens.

When she was 10 years old, Ball’s family moved to Honolulu, hoping that the warm weather would help treat her grandfather’s arthritis. Even as a young student, she showed intelligence beyond her years, with one middle school classmate later describing her as “brilliant,” according to Wermager, who served as head of the science and technology department at U.H. Mānoa’s Hamilton Library for decades.

When Ball’s grandfather passed away in 1904, the family moved back to Washington. Small in stature due to her chronic asthma, Ball was far from a wallflower—she participated in her high school drama club and earned a reputation for her quick wit. Her graduation quote, immortalized in a class of 1910 yearbook, sums up her ambitious personality: “I work and work and still it seems I have nothing done.”

Ball went on to study at the University of Washington, earning two bachelor’s degrees in four years: the first in pharmaceutical chemistry in 1912 and the second in the science of pharmacy in 1914. As an undergraduate, she co-authored an article in the Journal of the American Chemical Society—“the most prestigious chemistry journal at the time,” says Wermager.

After graduating, Ball moved back to her childhood home of Hawaiʻi to earn a master’s degree in chemistry. She graduated in 1915 and continued her history-making streak by becoming the university’s first Black, woman chemistry instructor, in addition to its first Black and first female master’s degree holder.

“[Ball is] certainly a trailblazer and role model,” says Philip Williams, current chair of U.H. Mānoa’s chemistry department. “It wasn’t every day you found an African American woman in a chemistry lab. It’s hard enough for students going through graduate school these days—I can’t imagine what it was like for her over a century ago.”

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As a master’s student, Ball researched the chemical makeup of plants, particularly the Hawaiian ‘awa root, also known as kava. In Hawaiʻi, ‘awa root is used like a panacea for conditions ranging from insomnia to headaches to kidney disorders. Ball studied the plant’s acids, solubility and resins to determine how it could be injected as a treatment for medical conditions.

Ball’s research caught the attention of Harry T. Hollmann, a physician and U.S. Public Health Officer who was using chaulmoogra tree oil to treat mild cases of leprosy. Though people in Asia had used the oil as a salve for skin conditions for centuries, British physician Frederic John Moaut only brought its curative properties to the Western world’s attention in 1854. Western doctors struggled to use chaulmoogra effectively: Too often, oral doses caused nausea, while injections resulted in painful skin abscesses.

In 1915, Hollmann recruited Ball to help find a way to make the oil more easily injectable. At the time, Native Hawaiians were facing a pandemic of leprosy, a chronic infectious disease caused by slow-growing bacteria. The disease affects people of all ages, and symptoms can appear any time between 1 and 20-plus years after infection. Described in literature dating back to ancient times, leprosy was first documented in Hawaiʻi in 1835.

“Hawaiians had been through multiple pandemics before leprosy arrived, like whooping cough, mumps and dysentery,” says Herman, who authored a 2001 journal article on leprosy’s links to race and colonization. “This is a population that has been massively devastated already. Imagine everybody you see and know in your daily life. Fifty years from now, there’s only 20 percent of them left. This is what the Native Hawaiians had gone through.”

Much of this devastation can be traced to diseases introduced by Western missionaries and colonizers. As early 1778, Captain James Cook and his crew landed on the island of Ni‘ihau, spreading an unknown venereal disease across the archipelago. Though Hawaiʻi had been unified under one kingdom in 1795, the Indigenous population and the kingdom’s monarchs were under immense pressure to Westernize and cede to colonizers’ demands. “It was a tumultuous time of transformation, and [then] we have this disease coming in,” says Herman.

Likely brought by immigrant plantation workers from Asia and Europe, leprosy spread quickly, infecting 274 people across the islands by 1866. The disease disproportionately affected Native Hawaiians, who lacked the protective immunity enjoyed by Western transplants to the region. In 1865, the kingdom passed an act establishing a leprosarium, or hospital for people with leprosy, on 800 acres of state-owned land on Kalaupapa Peninsula. Patients with advanced cases of the disease were temporarily detained before being exiled to Kalaupapa for life; those with milder cases were treated at hospitals and released.

Leprosy has long been a highly stigmatized disease, with patients often ostracized by society or forced into quarantine to prevent its spread. In the late 19th and early 20th centuries, officials established a handful of leprosy colonies across the U.S., from Carville, Louisiana, to the coast of Massachusetts. Kalaupapa was the largest of these leprosariums, housing some 1,100 people—almost all of whom were Native Hawaiians—at its height around 1890.

Blockaded by 2,000-foot-tall cliffs, the remote settlement was only accessible by boat (or later plane), mule, or foot. Initially, conditions were stark, with patients lacking adequate housing and supplies. Board of Health workers, Christian missionaries and na kokua (people who voluntarily joined their loved ones in isolation) helped the exiles transform the leprosarium into a community, constructing churches, a bar, a store, a theater and a social hall that hosted dances. Some residents held jobs, working as clerks, waitresses, fishermen or hospital orderlies. But the fact remained that patients were forcibly removed to Kalaupapa—sometimes by bounty hunters tasked with tracking down leprosy patients across the islands—and expected to remain there for the rest of their lives.

“They catch you like a crook and you don’t have any rights at all,” wrote Olivia Robello Breitha, who was 18 when she was sent to Kalaupapa in 1937, in her memoir. “They didn’t care about ruining a life. They didn’t even give me a few days to take care of my personal life. So be it. I was just a number.”

In Hawaiian culture, the idea of isolating people who are sick is “completely foreign,” says Herman. “Family is super, super close, even extended family,” he adds. “The idea that you yank someone from the household and send them away when they’re sick is traumatic. A lot of times they were little kids being taken away.” (Missionaries established group homes for these unaccompanied children.)

Family members were allowed to visit their relatives but had to stay in separate housing and communicate through a chicken wire screen. If patients managed to escape from Kalaupapa, they were tracked by bounty hunters and could be arrested. A restrictive set of rules governed life in the settlement, even prohibiting residents from raising children. The government seized thousands of infants born to leprosy patients in Kalaupapa, putting them up for adoption and hiding their origins to avoid the stigma associated with the disease.

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When she wasn’t lecturing at the university or volunteering as an English teacher, Ball was in the lab trying to find a way to make chaulmoogra dissolvable in water. Aided by Arthur L. Dean, then a chemistry professor and later the president of U.H. Mānoa, she achieved this goal in under a year—despite conducting her research off duty and without pay. The key, she discovered in 1915, was freezing the oil’s fatty acids to isolate its ester compounds, which could be modified to form an injectable, water-soluble yet effective treatment.

Ball continued teaching while perfecting her technique. In 1916, she reportedly inhaled chlorine gas while demonstrating how to use a gas mask and fell gravely ill. (Alternatively, she may have contracted tuberculosis, which was listed as the cause of death on her death certificate.) Her mother took her back to Seattle, where she died on New Year’s Eve at the age of 24.

Following Ball’s death, Dean made small tweaks to her discovery before publishing it and claiming it as his own. Dubbed the Dean Method, the treatment proved promising. According to a 1922 report by the Department of Interior, it resulted in “rapid improvement, especially in severe cases of leprosy.” Between 1919 and 1923, no leprosy patients were sent to Kalaupapa: Instead, they were treated at Kalihi Hospital and released.

According to the National Park Service (NPS), authorities initially hoped that the chaulmoogra treatment would prove effective enough to allow them to close down Kalaupapa. By the early 1930s, however, “belief in the curative powers of the oil [had] waned.” A highly effective treatment for leprosy only arrived in the 1940s, with the development of sulfone antibiotics.

The state of Hawaii abolished its forced quarantine laws in 1969. Offered the chance to leave Kalaupapa, many longtime residents elected to stay in the settlement, either out of affection for the place they’d come to consider home or fear of reintegrating back into the broader community. “It would be pretty hard to be turned out to the public, the way I am,” Timothy, an elderly man who was sent to Kalaupapa in 1939, told the New York Times in 1971. Breitha, for her part, traveled around the world but continued to reside in Kalaupapa until her death in 2006. As of 2021, the settlement—now part of a National Historical Park—had a population of ten former patients. An additional 80 to 100 people work on the remote peninsula as NPS staff, priests and nuns, volunteers, and more.

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These days, leprosy is curable but continues to affect tens of thousands each year. In 2020, the World Health Organization recorded 127,558 new leprosy cases globally, more than of half of which were in India.

Ball’s contributions to the treatment of leprosy were overlooked for decades. Hollmann clung to the truth of the discovery, giving credit to Ball in a 1922 journal article. “After a great amount of experimental work,” he wrote, “Miss Ball solved the problem for me by making the ethyl esters of the fatty acids found in chaulmoogra oil.”

More recently, the scientist’s legacy has resurfaced thanks to researchers at U.H. Mānoa and a Baltimore retiree named Stan Ali. In the 1990s, Ali came across Ball’s story in The Samaritans of Molokai, a 1932 book about Christian missionaries living among the leprosy patients, while researching Black people in Hawaiʻi. The book mentions a “young Negro chemist” whom Ali later identified as Ball.

In his quest to find more about Ball, Ali met with Wermager, who’d started researching the scientist’s life in 1988, and his colleagues at U.H. Mānoa. The two shared information on Ball whenever they could. “It was just painstaking going through newspaper after newspaper looking for little tidbits,” says Wermager. “I finally got enough to envision what she was like: not a selfish person and very caring and giving.”

“I work and work and still it seems I have nothing done.”

Speaking with the Honolulu Star-Bulletin in 2000, Ali credited the scientist’s erasure from history to sexism and racism. During and just after her lifetime, she was believed to be part Hawaiian, not Black. (Her birth and death certificates list both Ball and her parents as white, perhaps to “make travel, business and life in general easier,” according to the Star-Bulletin.) In 1910, Black people made up just 0.4 percent of Hawaiʻi’s population.

“When [the newspapers] realized she was not part Hawaiian, but [Black], they felt they had made an embarrassing mistake, forgetting about it and hoping it would go away,” Ali said. “It did for 75 years.”

Gifted by King Prajadhipok of Siam (now Thailand) in recognition of Ball’s trailblazing research, the chaulmoogra tree has stood on U.H. Mānoa’s campus since 1935. But it wasn’t until 2000 that Ball received additional recognition, in the form of a bronze plaque placed in front of the tree and the designation of February 29, Leap Day, as Alice Ball Day. In 2007, the university awarded her its Regents’ Medal of Distinction, and in 2017, Wermager established the Alice August Ball Endowed Scholarship, which honors Ball’s achievements by supporting science students from marginalized groups. Visitors to U.H. Mãnoa’s Hamilton Library can find her portrait and thesis on display there.

Members of the school’s student government are also working to spotlight Ball. This year, student leaders are advocating for the school to rename Dean Hall—an earth sciences building named after Arthur Dean—Alice Ball Hall.

“Visible acknowledgements of minority leaders are encouraging, especially to students who face similar struggles, who just need to know that it is possible to make a difference in the world no matter who you are,” says senior Alyssa Renteria, one of the students who introduced the resolution to rename the building. She first heard Ball’s story from a friend.

“As a student from a marginalized community,” Renteria says, “I want to see and hear more of the stories of people who were just like me and still made a change despite all the obstacles.”

Kathleen M. Wong | READ MORE

Kathleen is a Honolulu-based writer and editor who has been published by the New York Times, Vice, the Cut, Insider and more. When she's not writing, she can be found in the ocean or with her rescue dog. Read her work at kathleen-wong.com.