What is the main conflict in Moloka'i by Alan Brennert?

The novel Moloka'i tells a story full of tragedy and hope that spans seventy-nine years of history. Most of the novel takes place in the Kalaupapa Peninsula of the island of Moloka'i, a place infamous for being the location of a settlement where people with leprosy were detained. The story focuses on the life of Rachel Kalama and covers the course of her life.