By Erin Rubin
NonProfit Quarterly, May 1, 2020
Native American Health and Education
“You know, we’re very communal, very family oriented, community oriented. Even in this crisis where you’re supposed to be distancing yourself, what does everybody do? . . . They run to grandma’s house—you know, ‘Is Grandma okay?’—even when they’re not supposed to be doing that.” . . . it’s hard to stay away from elders who need support. — Rosalyn LaPier
LeAnn Littlewolf helps run a nonprofit in Duluth, Minnesota that provides housing, food, counseling, and other support services to the Native American community. They do critical work serving the community’s most vulnerable members, but when coronavirus began spreading across the US and cities prepared to shelter in place, they were left high and dry. Littlewolf, who belongs to the Anishinaabe/Gaa-zagaskwaajimekaag Band of Ojibwe, had no idea that shelter residents had special priority for COVID-19 testing until she listened in on a press conference given with the director of another shelter, who’d been contacted by the county to set up a special fast track for its residents.
“I thought, well, we have a shelter,” she said. “I’m curious, did the county contact us to set up a similar protocol so that we could also have a plan in place if someone got sick? I think that sometimes there can be those kinds of discrepancies; we see that consistently. We have to say, hey, could you help us—whereas other people are just like top of mind; [county officials think] we’ve got to go to that shelter and say, can we partner with you and how can we help you?”
Littlewolf is the Economic Development Director at the American Indian Community Housing Organization (AICHO), and this experience isn’t unique to them, or to a situation like coronavirus testing; it’s pretty typical for Native American organizations. They’re diverse, resourceful, and critical to their communities, but also chronically underfunded and usually overlooked. Raymond Foxworth (Navajo), Vice President of Grantmaking, Development, & Communications at First Nations Development Institute, described an “invisible population [who] is further invisible in this health crisis and economic crisis.”
The rate of infection amongst Navajo people is more than eight times the overall rate in New Mexico, one of the states their reservation crosses. If they were a state, they would rank third in COVID-19 deaths.
Littlewolf said, “It’s just heartbreaking to watch other communities that have endured so much. And then to see them lose lives at a very fast pace….I think that a lot of communities are really scared about that.”
Native American communities also worry, like everyone else, about the financial impact of sheltering in place. They experience higher rates of poverty and unemployment even in normal circumstances, and tribal revenue—which dries up without tourism and other sources of income—is a critical resource.
“I mean, they allocate it differently per tribe,” said Foxworth, “but it [supports] sort of the social service programs, the safety net programs that that we know are already underfunded from the federal government. So usually they’re using that money as patchwork to bridge those budgets for education and care for the elderly and things like that.”
Even seeking out care in a crisis can be tricky. Indian Health Services is perpetually underfunded, and every tribe’s health infrastructure can be a little bit different.
Daryl Melvin (Hopi Roadrunner) is an expert in Native health systems; he was a CEO for numerous tribal hospitals and health centers. He explained that while Indian Health Services (IHS) might run the hospitals or the direct care clinics, most tribes run the outreach or behavioral health programs themselves.
Navajo territory is home to 244,000 people living on 25,000 square miles. There are four IHS hospitals and twelve clinics, five of which are part-time.
“It becomes difficult when you have a different entity that’s more national in focus running the hospital, and you have a tribe which has more locally based solutions,” Melvin said. “They will have the best ideas and try to implement them. And there’s a conflict.”
Cynthia Lindquist (Spirit Lake Dakota) is President of Cankdeska Cikana (Little Hoop) Community College. She said that whether a nearby health facility has a tribal liaison to help people navigate the system “kind of depends upon who’s in charge and what they’re doing.”
Lindquist herself faces a great challenge, keeping her students on track with severely limited resources; Little Hoop gets about $8,000 per student, compared to an HBCU like Howard University that gets about $22,000. The challenge is compounded by issues common to rural communities.
“I’m realizing how limited my infrastructure is,” she said, “because we do not have coverage across the rez. I mean, there’s the rural isolation relative to bandwidth, let alone what do my students have.”
Students’ scarcity mentality was so ingrained that it defined what internet access meant for them. When classes first went online, many of Lindquist’s 165 students assured her they had internet; she later learned this meant they had smartphones with a pay-per-minute data plan. “They’re telling me with their little TracFones, ‘Yeah, I’ve got internet, I’m connected.’ I’m like, ‘No, you’re not, you need a computer. You need a laptop.’ And we rounded up whatever we had.”
Little Hoop is extending their campus internet to the parking lot so students can come watch lectures and download materials while keeping distance, but when we spoke to Lindquist in early April, it was still cold enough on the reservation to go ice fishing.
Classes aren’t the only thing she’s worried about. Tribal colleges, like many Native organizations, fill a lot of gaps in basic services. “That’s what the tribal colleges do,” she said. “We’re really, really good at understanding the needs, the dynamics of our students, their families’ lives. It’s really encompassing the whole person.” Lindquist also runs a Head Start program, which has pivoted to delivering food and books to children on the reservation while they’re sheltering in place. The college’s COVID-19 Angel Fund offers gift cards for groceries and gas—anything to keep them in school.
Despite her worries, Lindquist has confidence in her community. “We’ve lived through this before,” she said, “like when smallpox was being brought to our people. Because of our history and all the historical trauma, our people are very, very resilient and we know how to survive.”
LeAnn Littlewolf agrees that past experiences of epidemics have taught her tribe resilience; she said it’s not a distant memory for Native peoples. “I think maybe that’s why people respond so quickly and take it so serious,” she said. “It’s not distant…that’s something that we think about all the time.”
Littlewolf is what’s known as an “urban Indian,” or someone who doesn’t live on the reservation—like about half of Native people in the US. Her nonprofit, AICHO, administers an astonishing variety of programs in Duluth: they run a permanent supportive housing unit and mental health services, a domestic violence shelter plus a hotline and advocacy services, a climate and cultural resilience initiative, a cultural center and gift shop, and a food sovereignty program and farmers’ market.
All of these programs are impacted by coronavirus and social distancing restrictions. When local jails released detainees, no one notified AICHO that people accused of domestic violence had been released; they found when one woman’s abuser broke into her apartment. AICHO had to intervene to get the police to come, due to COVID restrictions. In addition, child protection services—which AICHO also supports—are down staff and “phone calls are just not enough.”
Even the living situations inside the shelters have drastically changed; residents who primarily spent their time in communal areas have to be shut up in their rooms.
“I just think about how close we are and how collective we are,” said Littlewolf. “It’s really hard to change… I just think about culturally specific practices that are just embedded, to be close to family. I think people really done a great job, with understanding how this virus works and trying to stay safe and keep people safe. We really value our elders, [which] I think is a protective factor for our community.”
One of the AICHO programs still running strong is the food sovereignty work, which has huge implications for both health and culture. “We have people who for generations have just been invested in growing, gathering, knowing food. And they’re experts at it….They’re humble and they do it quietly. But they have sustained those traditional practices.”
Rosalyn LaPier (Blackfeet Tribe of Montana and Métis) knows a thing or two about sustaining traditional practices. She is a writer, ethnobotanist, and environmental activist, an Associate Professor of Environmental Studies at the University of Montana, and a Research Associate at the National Museum of Natural History. She also spoke to the reverence for elders in her community.
“You know, we’re very communal, very family oriented, community oriented. Even in this crisis where you’re supposed to be distancing yourself, what does everybody do?” She laughed. “They run to grandma’s house—you know, ‘Is Grandma okay?’—even when they’re not supposed to be doing that.” She said people were being more careful now, but it’s hard to stay away from elders who need support.
The Blackfeet reservation already had emergency response teams connected to the Department of Homeland Security, which had been set up for natural disasters and can pivot to address the COVID crisis. They cannot, however, substitute for the substantial disruption of Native health practices.
“In a typical [hospital] situation, Native people have kind of an open door,” said LaPier. “If people want to practice Native religious practices, they’re allowed to do that. If people don’t want to use Western medicines, they don’t have to…The doctor just goes, ‘OK.’ Well, with COVID 19, it’s kind of the exact opposite, right? People are going to be isolated…If they want something for a ritual or anything, you’re not going to be able to bring in something for praying. The medicine man is not going to be allowed in.”
LaPier wants to make clear that Native medicine does not have a remedy for COVID-19; no one does. As a leading ethnobotanist, she’s aware of the virtues and limitations of different medical practices.
“One of my concerns right now with COVID-19 is that there is a lot of misinformation in indigenous communities about herbal remedies,” she said. “I have seen a lot of stuff, especially on social media: burn sage, drink this herbal tea, do these essential oils…I think we still have not done enough in indigenous communities to really educate people, to tell them that no one is immune to this and there is nothing you can do to boost your immunity.”
Lack of information is a big concern amongst communities who are often treated as invisible. Raymond Foxworth said, “HHS has given very little guidance or support on what tribes should be doing…Native communities are sort of having to figure this out on their own; they’re turning to states for help and assistance. But of course, states are sort of focusing their efforts on heavily populated areas, for legitimate reasons.”
A survey from the National Indian Health Board found that only about half of Native tribes reported receiving information from either state or federal governments.
Lindquist said that elders in her community were going on the local radio, offering health warnings and recommendation in Dakota language.
Invisibility affects Native communities in their relationship to philanthropy as much as it does with government, a topic we’ll explore in a future article. Rosalyn LaPier explained her frustrations: “Foundations have a history of providing funding to non-Native organizations to work with Native communities,” she said. “So we end up having a kind of white savior issue happening….You should just fund Native communities.”
Daryl Melvin is hopeful about philanthropy’s ability to help indigenous peoples. “Even though this is a time of crisis we appreciate, you know, the philanthropic community reaching out and helping tribal communities,” he said. “I think the long-term hope would be also that those relationships built out of this crisis can continue on and recognize Indian people today in America, and the contributions that we have provided and that we are your neighbors; building on that relationship going forward, do we help strengthen other things that come along the line, whether it’s a future crisis or in a better life.”
This article originally posted at NPQ. Visit https://nonprofitquarterly.org/never-distant-addressing-the-pandemic-in-indian-country/