As an example of historical fiction, Moloka’i brings together accurate and detailed discussions of Hawai’i’s past and fictionalized depictions of families impacted by that history. As with all historical fiction, there is truth to both the events recorded and the characters imagined.

While Rachel is not located in an archive nor is her existence verified in newspapers or obituaries, she embodies qualities and actions found in Hawai’i’s historical record. Hansen’s disease and the genre of historical fiction, along with their intersections, prove central to understanding Rachel Kalama’s fictional, yet realistic and historical, role in Moloka’i. Alan Brennert depends on archival materials—some of which he includes in the “Reading Guide” at the end of the book—and the documentation of confinement and quarantine at Moloka’i to bring Rachel Kalama to life. Dramatizing the known facts of Moloka’i, Hansen’s disease, and Hawai’i, the novel depicts how Rachel changes and reacts to challenges—first of confinement and, later, increasing freedom.

The first part of the novel details the verifiable end of the Hawaiian monarchy, as the king dies on a trip to America and a committee of rich Americans usurp the throne after his sister and successor proposes a new constitution.