What was the longest and harshest medical quarantine in modern history, and how did people survive it? In Hawaiʻi beginning in 1866, men, women, and children suspected of having leprosy were removed from their families. Most were sentenced over the next century to lifelong exile at an isolated settlement. Thousands of photographs taken of their skin provided forceful, if conflicting, evidence of disease and disability for colonial health agents. And yet among these exiled people, a competing knowledge system of kinship and collectivity emerged during their incarceration. This book shows how they pieced together their own intimate archives of care and companionship through unanticipated adaptations of photography.