Set in Hawai'i more than a century ago, this is the story of Rachel Kalama, a spirited seven-year-old Hawaiian girl, who dreams of visiting far-off lands like her father, a merchant seaman. Then one day a rose-colored mark appears on her skin, and those dreams are stolen from her. Taken from her home and family, Rachel is sent to Kalaupapa, the quarantined leprosy settlement on the island of Moloka'i. Here her life is supposed to end—-but instead she discovers it is only just beginning.

This companion tale to Moloka'i tells the story of Ruth, the daughter that Rachel Kalama—quarantined for most of her life at the isolated leprosy settlement of Kalaupapa—was forced to give up at birth. The book follows young Ruth from her arrival at the Kapi'olani Home for Girls in Honolulu, to her adoption by a Japanese couple who raise her on a strawberry and grape farm in California, her marriage and unjust internment at Manzanar Relocation Camp during World War II—and then, after the war, to the life-altering day when she receives a letter from a woman who says she is Ruth’s birth mother, Rachel.