Navajo Nation
The Navajo Nation is the largest Native American reservation in the United States. It spans over 24,000 square miles across New Mexico, Arizona and Utah, an area larger than West Virginia. More than 170,000 Navajo live spread out on the high plains and plateaus.
The Navajo, unlike their neighbors the Hopi and Zuni tribes, often live in isolated homes, tending to herds of sheep and goats. The sheep provide the wool for their best-known product, the Navajo blankets and rugs. There are small towns scattered throughout the reservation, but it’s not unusual for tribal members to live hundreds of miles to the nearest urban area.
The Navajo Nation is one of the poorest sections of the United States. The average annual family income is around $27,000. Forty percent don’t have electricity, and thirty percent of the homes lack running water or plumbing. The low incomes and lack of access to medical care means that many suffer from chronic diseases, including diabetes and heart conditions.
The Diné
The Diné (the people) maintain Navajo traditions through elders, who pass on the history and culture to younger tribal members. While more than half of the 350,000 Navajo tribal members live off of the reservation, it is the elders living there that keep Navajo life alive.
Life on the reservation today includes trips into “town” to get supplies, particularly water. And, like many Native American tribes in the United States, alcoholism is a very significant public health concern. All of this comes together in Gallup, New Mexico, a city of 22,000 just outside the southern border of the Navajo Nation. Gallup is on a major intersection, where the main east-west route Interstate 40 and north-south route US 491 (previously US 666) cross.
There are two hospitals located in Gallup, the Rehoboth McKinley Christian Medical Center and the Gallup Indian Medical Center. There are sixty beds in the hospital, and eight intensive care units.
COVID 19
Gallup seems a long way from the corona-virus crisis. But I-40 crosses America, from California to North Carolina, and the virus found its way into the town. As in many other towns in America, the stores, bars, and jails served as hot spots to transmit the virus. One particular transmission site in Gallup was the self-service water fill-up, where change from the machine passed the virus. Today, 4071 have COVID-19 on the reservation, and 142 have died. This week, the Navajo Nation passed New Jersey and New York with the highest per person infection rate.
COVID-19 represents a particular threat to the Navajo. Not only are medical facilities scarce but also the pre-existing conditions that contribute to the seriousness of infection are present, particularly among the elders of the tribe. In short, COVID represents not only a threat to people, it poses a threat to the Navajo culture itself. If it kills the elders, it kills the repository of tribal history and tradition.
Epidemics are not new to the Navajo. The flu epidemic of 1918-19 killed thousands, and more recently in 1993 the hanta-virus carried by deer mice had a 50% mortality rate. But COVID-19 has the potential to cause even greater damage.
The primary health care available in the Navajo Nation is the Indian Health Service, a department of the US Department of Health and Human Services, but their services are spread thin across the wide-ranging reservation. Some help from other parts of the United States has arrived, including a team of twenty-one doctors and nurses from the University of California-San Francisco.
Doctors without Borders
Medicins Sans Frontieres (Doctors without Borders) is the legendary medical team that goes where no one else dares. They bring medical care to seventy-four different areas of the world, including war zones like Syria, Somalia and Yemen. MSF often is the only medical care available in war torn and impoverished areas. They arrive in a crisis, whether it’s the Haitian earthquake, or the war in Afghanistan.
Their medical personnel risk their own lives in order to help others.
The American southwest is not a war zone, and few think of the United States as a land of poverty. But Medicins Sans Frontieres put teams into the Navajo Nation in the past few weeks. They are familiar with these conditions: lack of electricity and water, scattered medical services, poverty and difficulty tracking disease and patients.
They went there for the same reasons they have risked (and lost) their lives all over the world. To provide a last-chance at medical care, where little or none is available. As Americans feud among ourselves about whether to “open up” the American economy again versus controlling the virus, it’s easy to overlook what’s happening in the poorer corners of our nation. So poor, that MSF, dedicated to providing medical care to the poorest and most conflicted, has landed: here in the United States.
