Gloria Marks — at the age of 74 and with the help of a wheelchair — once again will begin the 10,000-mile pilgrimage from her home on the remote Kalaupapa peninsula to Rome on Friday to witness the canonization of Hawaii’s second saint for her 19th- and 20th-century work with Hansen’s disease patients.

Like many of the other eight patients making the trip from Molokai’s once isolated leprosy settlement, Marks will rely on a wheelchair and the aid of a helper to navigate Rome’s bumpy cobblestone streets to witness Mother Marianne’s canonization in St. Peter’s Square before Pope Benedict XVI on Oct. 21.

"I cannot walk too long," Marks said. "My knees and my hips will lock on me."

But after witnessing Father Damien’s canonization in 2009, Marks has readied herself again for the long journey to Vatican City and the payoff of witnessing Mother Marianne’s ascension to sainthood, after which she will forever be known as the Patron Saint of Outcasts.

"It’s the travel that I don’t care much for, the plane ride that I don’t care much for," Marks said. "But I wouldn’t miss it. It is a privilege to go. I’m excited and appreciative."

Mother Marianne will join six other new saints to be canonized Oct. 21, including Algonquin-Mohawk Indian Kateri Tekakwitha, who died a virgin in 1680 at the age of 24; and Pedro Calungsod, a Filipino lay church member who was killed on Guam in 1672 while assisting with a baptism.

Calungsod’s story of having his body dragged out to sea, never to be found, was nearly forgotten but has recently gained a following among devoted Filipinos from California, Hawaii and Guam — many of whom will also make the pilgrimage to the Vatican.

The trip will be particularly hard on the Hansen’s disease patients from Molokai, whose average age is 80, according to their physician, Dr. Kalani Brady of the Department of Native Hawaiian Health at the University of Hawaii’s John A. Burns School of Medicine.

"I have tried to discourage the patients from feeling obligated to attend everything," Brady said. "These are patients who have been institutionalized their whole life and were sentenced — some as children, some as teenagers — to life in prison in Kalaupapa. So they’re used to taking orders and they tend to try to do everything that’s on the tour until they drop. It was a challenge three years ago when they were three years younger and it will be a challenge this time, too."

Even with caregivers assisting the patients, riding in a wheelchair over Rome’s cobblestone streets "is no small feat," Brady said. "It’s like getting your teeth knocked out. The kokua (health aides) are going to get their workout."

The trip out of Honolulu will involve more than 200 people, including Honolulu Bishop Larry Silva, who will preside over a series of Masses beginning in Syracuse, N.Y., where Mother Marianne served as the superior of the Sisters of St. Francis of Syracuse.

The former Barbara Koob was born in West Germany in 1838 and immigrated to the United States with her family the following year. She entered her order in 1862.

She came to Honolulu after answering a plea for nuns from King Kalakaua and Queen Kapiolani in 1883 to care for Hawaii’s women and children. She soon began treating Hansen’s disease patients on Oahu and Maui, where she also established Maui’s first general hospital, Malulani Hospital.

In January 1884, Mother Marianne met Father Damien de Veuster on Oahu before he, too, was diagnosed with Hansen’s disease in 1886.

Marianne responded to the Hawaii government’s plea for help ministering to the patients in Kalaupapa in 1888 and arrived before Damien’s death the following year.

Mother Marianne died of kidney and heart disease in 1918 at the age of 80 at Kalaupapa’s Bishop Home and was buried on the grounds.

Interest in Kalaupapa zoomed after Damien’s canonization three years ago and continues to grow with Marianne’s upcoming canonization, said Stephen Prokop, superintendent of the National Park Service’s Kalaupapa National Historical Park.

"Visitors are most interested in the story of how the people of Kalaupapa that were afflicted with leprosy were given fairly harsh treatment and the social injustice that occurred here," Prokop said. "That story serves as an example for the world of what can happen when people are discriminated against from a disease that they had no control over. That story of social injustice is very compelling."

Even though more people want to visit the Hansen’s disease settlement, a cap of 100 visitors per day remains in effect for the privacy of the patients.

Planes arriving at Kalaupapa can bring no more than nine passengers. And the hike down sea cliffs that otherwise block access to Kalaupapa "is strenuous," Prokop said. "Even riding a mule requires upper-body strength to hang on. Even though we’re getting more inquiries and more interest, it’s not an easy place to come visit due to the geography and due to the access."

Visitors have been drawn to Kalaupapa for generations, inspired in part by the writings of Robert Louis Stevenson and Mark Twain, who shared the lessons of pain and humanity they found at Kalaupapa.

Each visit to the remote and beautiful peninsula seems to touch every tourist differently, said Norman Soares, who has been driving a bus throughout Kalaupapa and maintaining equipment for Gloria Marks’ Kalaupapa tour company for the past 12 years.

Many of the tourists tell Soares that they were compelled to visit Kalaupapa by forces they cannot explain.

"They’ll say, ‘I don’t know why I had to come here. I just knew I had to come,’" Soares said.

Despite all of the tourists he has greeted and shared the story of Kalaupapa with, Soares himself continues to be touched through the experiences of others.

This month, a visitor from the mainland stared at the gorgeous ocean and the uninviting sea cliffs and rocky shoreline surrounding St. Philomena Church, founded by Damien, and thought about all of the pain and humiliation that the patients suffered through.

"Did they know how beautiful it is here?" the tourist asked Soares.

"I’m still thinking about that one," Soares said. "Some of the questions go deep because there is a presence here, a spirit here."

In 2009, as Damien was being canonized in Rome, the patients who stayed behind paraded throughout Kalaupapa with the federal and state employees who keep the settlement running, yelling "Happy St. Damien’s Day."

This time, an invitation-only celebration will be held at Kalaupapa on Jan. 12 after the nine patients return from Rome, Prokop said.

Marks will be ready.

"I’ll be recharged by then," she said.

But while in Rome, Marks is ready for a tiring but satisfying experience.

"I don’t know when I’ll have another chance," she said. "I might as well do it now."