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Story Publication logo November 11, 2021

We’re Still Here: Shall Furnish Medicine Part 3

Author:
Trail of tears
English

Connecting the dots between the history of disease in the genocide of Native Americans all the way...

SECTIONS
Illustration by Zach Kennah.
Illustration by Zach Kennah.

When COVID-19 arrives on reservation borders, tribes aren’t sure if their newly minted health care programs can hold up against the onslaught. The fear is that this is history happening all over again. But the two tribes on the Wind River Reservation in Wyoming decide early to roll up their sleeves–literally–in a fight for the very survival of their tribal identity.


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The Parade

Think back to March of 2020. Before the school closures and the mask mandates and the grocery store shortages. Before the two weeks to flatten the curve that stretched into six weeks and beyond. Do you remember the last normal day of your life? 

For me, that day is March 8. Before I hunker down in my studio apartment in Lander, Wyoming, before my days spent reporting on the pandemic bleed together, I go to a parade. 

The Wind River reservation loves its youth basketball teams. And in 2020, the Wyoming Indian High School Chiefs and Lady Chiefs won the state championship for the second year in a row. So on March 8, the community is showing them some serious love. There are probably 100 people here in the hardware store parking lot. And many more lined up to watch the parade along Federal Boulevard. The fire department has loaned the teams a couple of its engines. Greg Lebeau is celebrating his grandson, Tuff. 

“You must be proud!” I shout to Greg over all the honking and cheers.

“Oh, very proud of him,” Greg shouts back with a chuckle. 

“So, did you get to see the game last night?” 

“You bet! Darn right. Exciting. Up and down, roller coaster ride game, boy.” 

I can tell he’s still pretty jazzed. He tells me these back-to-back wins mean a lot. 

“Yeah, it’s so important,” Greg says. “The young men and women in the old days, we counted coups. They went out and stole horses and all that. This takes its place, to me, in our old traditions.”

Greg has to go off to get a photo with his grandson. So he hands me over to his daughter, Crystal C’Bearing, who’s Tuff’s mom. 

“Yeah I’m very proud of him,” Crystal tells me. “Ever since he was little, he’s always had a ball in his hands. He’s always wanted to be a Chief.” 

By now, all the kids have climbed on top of the fire engines. To kick things off, a community drum group called North Bear plays them an honor song, composed especially for the occasion. 

“Congratulations, you both made history 

Back-to-back champions

Let’s go Chiefs, you’re number one.” 

North Bear stands in a circle, singing as loudly as they can to be heard across the parking lot. Families are huddled together, some sharing blankets to ward off the bitter morning cold. We aren’t thinking much about the strange illness that’s ripping through other countries or about how that illness has started to crop up in parts of the U.S. There are families here who have no idea this is the last time they’ll be together for a year, kids who don’t realize it will be months before they go back to school or play another basketball game. 

Stay At Home

I leave the Chiefs parade thinking I’ll see all of these people again in just a few days. There’s a big feed and a blanketing ceremony planned for the kids this coming week. But that celebration never happens. On the day it was scheduled, the World Health Organization declares a global pandemic. Newscasters announce it on NPR, Fox News, the BBC…

The World Health Organization has declared the coronavirus outbreak a pandemic…” 

“It is a pandemic at this point, let’s talk about what that means…”

“We describe a pandemic as meaning a disease that’s spreading in multiple countries around the world at the same time…” 

On the same day, the first COVID-19 case was identified closer to home and announced on a local TV station. 

“In Wyoming, an adult woman tested positive. The health department is investigating her exposure risk and who may have had contact with her.”

The school districts on the Wind River Reservation are the first in the state of Wyoming to close their doors, then come a flurry of joint tribal health orders. Business councilors from both the Eastern Shoshone and the Northern Arapaho make public statements. First, a state of emergency. 

“The current situation is something that no one is prepared to handle. That is a situation that changes by the hour.” 

Then, all tribal offices and non-essential businesses are ordered to close. 

“Please be cautious during these extremely vulnerable times. Be aware that you could be carrying this disease without any symptoms.”

By the last week of March, the joint council goes one step further. 

“A resolution was passed through the inter-tribal council mandating a stay at home order for all residents of the Wind River Reservation …”

“Please stay home. Do not continue to be out in public places, possibly exposing yourself and our loved ones to this deadly disease …”

“And violators may be subject to civil or criminal contempt.”

That strict stay-at-home order is the first one to be enacted in Wyoming. And for months, it was the only such order in the entire state. 

By now, it feels like months have passed since that parade through downtown Riverton, since this community that thrives on connection and togetherness has become so fragmented. Really, all this has happened in a little under two weeks. And at this point, I have no idea how to do my job. Wind River taught me how to be a reporter. And it taught me that to stay connected with this community and maintain its trust, I need to physically show up: to celebrations, funerals, cross country meets, ceremony. And suddenly, I can’t do any of that. Instead, I’m hitting people up on Facebook messenger, trying to piece together their experiences from afar.

In late March, I get on the phone with Crystal C’Bearing, who I chatted with at the parade, to see how her family is holding up. 

She tells me that her dad, Greg, who was so proud to watch his grandson play in the championship, is isolating with another of his daughters, and that she can’t remember the last time she’s gone this long without seeing him. 

“My dad, he’s almost 80 and, even before we all shut down, we kind of had an idea about keeping our distance from him. You know, he has diabetes, he has issues, and he’s the key to our family that holds us together, and it’s important to protect him and keep him safe,” Crystal says. She’s afraid for him. And for all of Wind River’s elders, who we know by now are especially vulnerable to the worst symptoms of this disease. 

“It’s scary to think, if they were gone, what would we have as a tribe? Would we be able to survive? Would we be able to call ourselves Arapaho even?” 

The Brain Poke

Last episode, we talked about Wind River Cares, the healthcare provider that the Arapaho Tribe built from the ground up when it took over management of its healthcare needs from the IHS. Wind River Cares’ CEO, Richard Branna, remembers the very early days of the COVID crisis.

“It was about maybe February or right around March. For some reason I woke up in the morning, I was scared to death,” says Richard. “Because I looked at our existing President then, Donald Trump, and I know he was totally incompetent. I knew he was totally incapable of having the empathy or any understanding or the ability to manage a healthcare response to a pandemic.”

Richard didn’t see any lifelines closer to home, either. 

“You know, we can’t rely on our state, and then the county is the same,” he says. “And so, throughout my life, it’s always been, we, as our Arapaho people, we have to do it ourselves. We have to rely on ourselves. There isn’t going to be somebody coming in with a big white hat and a big white stallion and rear up and say, ‘Oh, I’m going to save you’ or whatever. We have to do it ourselves.”

Soon after that bad night’s sleep, the Northern Arapaho Tribe launched Wyoming’s first drive-through testing program. 

“Good morning. Wind River Cares, this is Lindsay. How can I help you?” 

“Hi, good morning, I’m out in the parking lot to get tested, and I need to register as a patient,” I say.

“Date of birth?” 

It’s early May now, and COVID-19 testing is not easy to come by in Wyoming. In Fremont County, even people who have had direct exposure are being denied tests unless they’re symptomatic and at high risk for serious illness. But at the Wind River Cares clinic in Arapahoe, they’re testing just about everyone who needs it. 

“Okay, so here I come,” a nurse tells me. “I’ll just have you remove your mask. So here I come … Take a long deep breath. You can breathe. Perfect.” 

This first brain poke does not feel good. It makes my head hurt and my eyes water. 

“We’ll give you a call in three to five days with positive or negative results.” 

I park my car and walk over to the camper that’s been transformed into a testing center. It’s my first time reporting in the field since that parade. I’m wearing a mask, latex gloves, and I’ve rigged my microphone to the end of a broomstick handle, so I don’t need to get too close to anyone. I think it looks like a fishing pole, but the staff have some other interpretations. 

“I was like, ‘Is that a metal detector? What is this?’” one of the staff say when I walk up. 

“I thought it was a climbing clip stick,” another says. “I was like, ‘What are we doing? Where are we climbing? Where are we going guys?’” 

I’m getting kind of a slap-happy vibe from the testing team, a collection of doctors and nurses who had to switch gears overnight and build this program from scratch. Christina Gonzales, the nurse who tested me, tells me things have been hectic. 

“The first couple weeks were touch-and-go,” she says. “That was really hairy. We were working out of a tent. Papers were flying off into the field. This is kind of a castle compared to where we were seven weeks ago.”

Now, it’s a pretty well-oiled machine. Christina walks me through the protocol. 

“So, this is our system that we have here. We have lab corps tests, we have state tests, and we have completed boxes. So with our Labcorps, as you see, Sherry’s grabbing one of those, she’s getting a specific swab that we use. Do you need more? Okay. I’ll be right back.” 

Christina tracks down the swabs. Then we watch from the camper while Sherry tests an SUV full of people. Two elders in the front seats, a teenager, and a couple of younger kids in the back. By now, a few dozen people have tested positive for COVID-19 on Wind River. Compared to other parts of the state, that’s a lot. But it’s hard to know whether this actually reflects a higher infection rate here. That’s because right now, Wind River is the only community in Wyoming that’s conducting mass testing of the whole community. Young and old. With and without symptoms. 

“We had our biggest days last week between the Arapahoe clinic and the Ethete clinic of over 400 tests between the two clinics,” Christina says. “And it was an incredible sight to see as far as lines being lined up all the way down to 17 Mile Road.” 

To make this strategy work, Wind River Cares has deputized most of its staff to help. Receptionists and CNAs are checking in patients, custodians are directing traffic. The other major component of Wind River Cares’ strategy is robust contact tracing. Leading the charge on that is … a dentist. 

“The dental field right now, we’re working on very emergency, limited-type kind of patients. So we’ve really scaled back the dental clinic, but that kind of allowed me to transition back into my public health kind of hat,” says Halley Cazort, who has a Masters in Epidemiology in addition to a Doctorate in Dentistry. Wind River Cares has put her expertise to work. 

“I would say within the last two weeks, the number of cases really blew up,” Halley tells me. “And the reason for that is because we really started hounding down on that contact tracing. The clinic really hit home that we needed to interview cases and really find out who they’ve been in contact with and get in contact with those contacts so that they could either come in and get tested for their peace of mind, or at the very least make sure that they’re being quarantined as well.”

By now, we’re two months into this thing. 

The message we’re getting from state and county health officials in Wyoming is that resources for combatting COVID-19 are scarce, that there just aren’t enough tests to go around or enough public health workers to trace every possible contact. 

But it’s happening here on Wind River. 

Paul Ebbert, the Northern Arapaho Tribe’s chief medical officer, is too busy to talk with me when I visit the clinic, but I catch him on Zoom a few days later. 

“We made the decision early on that we were going to be very aggressive about this,” Paul says. “We are in a situation where we are a very vulnerable population. We have many houses with multiple generations in them where you have young people living with older people that are at high risk. And if this starts really spreading, we are probably the highest risk population in the state.”

The Northern Arapaho Business Council has directed Wind River Cares to do whatever it takes to protect vulnerable people from the virus. Dr. Ebbert tells them, ‘Okay, we’re going to need to take the exact opposite approach as the state of Wyoming.’

“If you do not test, you’re not going to find cases. I mean if you look at the countries that have been successful if you listen to every expert, they say three things basically. One, the way to get on top of this is extensive testing; two, good contact tracing; and three, social distancing.”

Strict public health measures, robust testing, and contact tracing are the gold standard. But what’s allowing this small tribal clinic to do all that while the rest of the state says it isn’t possible? 

“Frankly, part of it is money,” Paul says. “We decided we’re going to spend our money. We are not for profit. We have to make money to be able to provide services, but we are not for profit.” 

To be clear, it’s not that Wind River Cares has tons of extra money to throw around. As we heard last episode, the Indian Health Service provides it with about 35 percent of the funding it needs to care for Northern Arapaho citizens. The difference is made up with tribal funds, which are already stretched thin. 

But the business council has greenlit a big investment in private lab testing — an investment they know they might lose money on. It’s even converted the tribe’s hotel, typically a revenue driver, for quarantine housing. 

“Particularly to try to protect elders,” Paul says. “So if you show up positive in a house where you’re going to put a lot of people at risk, you can go to the hotel. They provide meals. You have to stay in your room except to walk downstairs to get your meals.”

This is especially important since many homes on the reservation aren’t just multigenerational, they’re severely overcrowded. It’s not uncommon for 10 or 15 family members to share a two-bedroom home. This housing shortage is the result of decades of federal neglect and failure to make good on treaty promises. Just like the health disparities on Wind River, the business councils can’t remedy those crises overnight, but they can repurpose what resources they have towards mitigating COVID spread. 

Three Generations

While I’m watching this play out on Wind River, I’m also keeping tabs on other tribal communities, talking with friends who happen to be journalists also covering Indian Country about what’s happening on their reservations. And I realize what’s happening here isn’t isolated. Tribal governments everywhere are taking this thing seriously. The Cheyenne River and Oglala Lakota have set up highway checkpoints to monitor travel through their reservations. Others have gone a step further. Some of New Mexico’s Pueblo’s are locked down entirely. No one in, no one out. The Navajo Nation, the Poarch Creek band of Indians, and many others retooled manufacturing businesses to produce PPE for local hospitals and tribal citizens in need. Tribes are sending their employees home with pay, rather than laying them off. They’re coordinating food and supply deliveries to help their citizens stay home as much as possible. They’re prioritizing the health and wellbeing of their communities above economic interests.

But many of these tribes are doing so without the cooperation of neighboring communities. 

Wyoming is one of a handful of states that never implements a stay-at-home order. On May 17, 2020, the day when most of the state’s initial restrictions are lifted, I speak with Richard Gard, the Mayor of Riverton, the largest town bordering Wind River. 

“Well, I was just out at lunch, and I was hoping that all the restaurants would be open,” he tells me. “But I found that the Trailhead was open and so was the Pit Stop. So I had lunch at the Pit Stop, and I’ll probably have dinner at the Trailhead.” 

The city has just announced that its annual hot air balloon rally will go on, an event that draws ballooners from out-of-state and hundreds of spectators to Riverton City Park. 

“And there’s a lot of things that go in conjunction with that,” Gard says. “I think that there’s lots of activity out there, and people that want to get out there and participate.”

While reservation residents are under a strict stay-at-home order, folks in Riverton and Lander, where I live, are being encouraged to get out and get the economy moving again, despite the fact that Fremont County has the highest number of COVID-19 cases in the state.

When I ask Mayor Gard about this, he rightly points out that the county might not actually be experiencing higher case numbers than other parts of Wyoming. 

“We’re not the hotspot, we’re just the spot that they’re spending all the money to do testing,” he says. “No where else in the state are they testing unless you’re a medical provider. We have the reservation, and we have all of the federal dollars being poured in on that project, and they get special treatment over the rest of the state.”

But Mayor Gard got that wrong, reflecting a lot of misconceptions in the state about the reservation pandemic response. It was tribal, not federal dollars, funding the mass-testing program at Wind River Cares. Just look at the other medical provider on Wind River, the Eastern Shoshone Tribe’s IHS clinic, which is fully funded and operated by the Feds. It’s testing at the same slow pace as the rest of Wyoming. No special treatment there. 

But many border town residents see the Arapaho testing program, not as a proactive investment, but as an unfair benefit for tribal members. Either way, Mayor Gard appears to see it as a waste of money. 

“We want to make sure that everybody understands that their health is their responsibility, but other than that, we’ve got to get Riverton back to work.” 

Wind River and its border towns might like to think of themselves as separate, but they’re deeply intertwined. In normal times, members of both communities move back and forth constantly. Folks like me cross the border to work. Border town kids go to school on the rez and vice-versa. People cross the border to shop and run errands, to visit and take care of family.

I watch that movement slow down when COVID arrives, but it doesn’t come to a complete halt. That means the Eastern Shoshone and Northern Arapaho Tribe’s strict public health measures only go so far. 

It’s impossible to know how the coronavirus first reached Fremont County, whether patient zero lived on the reservation or in a border town. But the reservation’s first COVID-19 deaths start with a trip off the reservation.

Lee Spoonhunter, chairman of the Northern Arapaho Business Council, addresses the tribe on a live stream. 

“It is with great sadness and a heavy heart that the Northern Arapaho Tribe confirms the deaths of four of our own who tested positive for coronavirus. The NABC offers heartfelt condolences to the families of the lost loved ones.”

All four passed away on April 20. Three are members of the same immediate family: Elders Larry and Gloria Wheeler and their 55-year-old daughter Dawn Wheeler. They die in the hospital within hours of each other. 

About a month after their passing, I pack up that broomstick I jerry-rigged into a boom pole, put on a mask, and visit with some of the Wheelers’ relatives outside their home in Fort Washakie. 

It’s a chilly morning. I can see from the yard that there’s still plenty of snow up in the Wind River Mountains. The Wheelers sit on patio furniture with blankets in their laps as they describe the nightmare they’ve lived through. 

“For the past two months, it’s kind of been like a big blur since my aunt Gloria got sick because she was the first one to get sick out of us all. A week before they got sick, my mom was with Larry and Gloria, so everybody in my household got it,” says Julia Antelope, who is Larry and Gloria’s niece and Dawn’s cousin. She’s one of fourteen members of the Wheelers’ extended family who fell ill and one of several who needed to be hospitalized. 

“When I first got there, they had to take me through the ICU,” says Julia. “And I looked to my left, all I could do was peek, but they wheeled me past all four of them and they were all intubated. Nobody could come in and see them.”

Those four family members were Larry, Gloria, Dawn, and Dawn’s 27-year-old daughter, Ashley. Three generations of one Arapaho family. 

Larry’s younger sister, Regina Antelope, tells me she prayed hard for her relatives. But she knew that each passing day spent on ventilators made it less likely that they would pull through. 

“And it kept going on and on, and finally, I started realizing that we were losing Larry and Gloria. I didn’t think we were losing Dawn. I thought Dawn was going to come out of it. It was hard. I got on my knees a lot of times. I’d talk to one of my nieces or something, and I’d say, ‘This is a nightmare. This is just the ugliest thing a family can go through.’ And it was really hell because we couldn’t even go to each other’s house.”

Larry, Gloria, and Dawn’s relatives want the world to know a few things about them: that they were devout Christians, that the home they all shared was a safe haven and a soft place for struggling relatives to land, that Larry loved spending time outdoors.

“My dad’s always hunted, fished, and he always took us everywhere with him. So we went all over the place with him, the mountains.” 

Gloria was the whole family’s spiritual advisor. “I remember having a hard time in my life so I talked to my grandma, sat down and had coffee and pie and my grandma was just telling me to be strong and to not give up. And she was always doing that, but this last time it meant a lot to me and I’ll hang on to that.”

Dawn loved children and babies, and was very close with her own daughter Ashley. “After she had Ashley, all of her time was with her daughter, and they were like best friends.” 

During most of my visit, Ashley is inside resting. She comes outside to speak to me before I leave. More than a month after being released from the hospital, she’s walking with a cane and having trouble breathing. She tells me what it was like to be on a ventilator even though it’s hard to talk about. 

“It was really scary because I guess some people don’t remember, but I remember a lot and it was basically just a really long nightmare and I couldn’t wake up and a lot of it still sticks with me and I’m still trying to deal with it. It’s really traumatic, and a lot of it other people can’t understand.”

On top of this, Ashley is grieving the most important people in her life. Her mom, Dawn. “She was quiet, but she had a lot of love in her. She was really caring, she was really gentle. She was my favorite person and I really miss her."

… And her grandparents. “They were basically like my other parents. They cared about everyone, and they adored everyone. We’re missing a huge part of our family. They were like our glue, they kept everyone together. I think everybody just feels lost.”

“The Creator let them go together and they even waited for Dawn,” Regina tells me. “And they took Dawn before the day was over. They took her with them. So God was in control all that time, and to me, the way I can look at it to get some comfort is Larry and Gloria and Dawn sacrificed for everybody to look and start changing their ways and see how serious this virus is. And you know, they didn’t go in vain.”

The Wheelers were exposed to COVID in early March before the stay-at-home order. They were visiting a relative at a border-town nursing home that would host one of the first outbreaks in the state. The coronavirus spread like wildfire through the home that Larry, Gloria, Dawn, and Ashley shared with a handful of other relatives. That home that everyone thought of as a safe haven. 

Dawn’s sister, Laurencine, told me that Dawn had been looking for a separate place for her and her daughter, that she’d been on the waiting list for tribal housing for years but that never came through. Each of the Wheelers had pre-existing medical conditions that made them especially vulnerable to the worst symptoms of COVID-19. Their tragic deaths were the first of many signs that this pandemic was going to hit Wind River hard. And that even the tribe’s gold standard public health response couldn’t reverse the impacts of colonization. 

"You Feel That Loss”

There’s a question I’ve been asked a few times while I’ve been reporting on the pandemic in Indian Country: by listeners, by editors and other journalists. If tribal governments did such a great job-fighting COVID-19, why have so many Indigenous people died from the disease?  

And far too many Indigenous people have died. 

People like Elder John Brown, who was Oglala Lakota. When John passed, his teenage grandson Corwin lost a friend and a mentor. 

“A lot of people knew him from the powwow trail, so he told me a lot of stories about powwows, and that’s how I got into powwows and stuff,” says Corwin. “He was a good man. A strong person. He was a really good grandpa to his grandkids.” 

And people like Karletts Denison, an accomplished rodeo athlete and a fluent speaker of the Diné language. Karletts’ eldest daughter, Devyn, says the family didn’t expect to lose him so soon when he was just 63. 

“This past year I bought a book, a Navajo language book, and I showed it to him, and I was like, ‘I want to do this because I want to have a conversation with you at some point in Navajo. Just fluent Navajo.’ And he was so excited,” Devyn says, tears in her voice. “And I’m really, really going miss that about my dad. That’s probably the biggest thing I’m going to miss is probably hearing his language.”

From the early days of the pandemic, stories like his have reverberated throughout Indian Country. Stories of grandparents dying alone in hospitals. Aunties and uncles lost long before their time and before they had a chance to pass on language, ceremony, family stories, and traditional knowledge. By the summer of 2021, one in every 240 Native Americans have died of COVID-19 compared to one in every 1,300 white people. 

“You feel that loss,” says Wind River Cares’ Richard Brannen. “Some older people that had a lot of knowledge, a lot of information about our tribe. A lot of individuals who go around and pray for other people and try to help others. And they were more selfless, and so we lost a lot of people.”

Way back in February of 2020, Richard Brannan at Wind River Cares predicted that Indian Country would be hit hard and that help was not on the way. 

“We were basically the front runner, I guess because we knew we didn’t have the luxury of waiting for the COVID to take over. I mean, we got to be proactive.”

The virus is now spreading more quickly through tribal communities because reservation housing shortages have fueled a crisis of overcrowding. The virus is killing more Native people because decades of poor healthcare access makes us sicker and more vulnerable than the general population. In neglecting its treaty responsibilities, the federal government is turning Indian Country into a coronavirus kill box. 

By December 2020, dozens of people have died of COVID-19 on the Wind River Reservation. People are afraid, but they’re also tired of the isolation. Most tribal offices and businesses are still closed, and children are still home from school. 

Around this time, a business council member tells me he’s starting to feel like a broken record, that you can only beg people to stay home for so long before the message starts to ring hollow. Soon after this conversation, the tribes roll out a new tool for keeping their people safe. On a Facebook Live video, a small group of elders and healthcare workers get the very first vaccinations on Wind River. Ceremonial Elder George Moss was first in line. 

“This is for all my people, my Arapaho people! Alright! Hohou!” The room breaks into applause as the needle pricks his arm. After George gets his shot, he addresses his tribe. 

“I’ve seen a lot of my Arapaho people go home. I went to their funerals. And this COVID-19 disrupted everything that we as Arapaho people believe in. Today, it’s a special time. I come forth to show my Arapaho people to come, to each and every one of them. I don’t want to see no more of my people go home. I seen enough.”

All over the country, Native communities are breathing a sigh of relief as their most precious and vulnerable elders get the shot. And from here, there’s really no looking back.

Public Health Before Profit

On a Saturday morning in February, cars are lined up for more than a mile down the road from Gallup Indian Medical Center, an Indian Health Service hospital on the eastern edge of the Navajo Nation. I’m here to check in on this community that was once home to the worst COVID hotspot in the country, now that there’s finally light at the end of the tunnel. A nurse quizzes the next patient through the car window.

“This is your second dose, right? 

“Yes.”

“What’d you get the first time?”

“Pfizer.” 

I park and go inside the gymnasium where nurses, pharmacists, and physical therapists are administering vaccines to hundreds of eager patients. Dr. Jonathan Iralu, the IHS’s top epidemiologist, says many of them arrived here before dawn. 

“I think the record is 4 a.m.” 

At this point, the national vaccine rollout isn’t going so hot. But once again, tribal healthcare systems are ahead of the curve. Dr. Iralu says the IHS’s superpowers are centralization and flexibility. 

“We do primary care, we do hospital care, and we do public health,” he says. “All three segments are wedded together. It’s fairly easy to shift from primary care mode to public health mode and arrange something like this with the same staff.”

Just like the testing operation at Wind River Cares, the vaccination effort here has put the entire hospital’s staff to work. To better respond to COVID, GIMC has scaled back their non-essential care — things like eye exams, dental cleanings and non-emergency physical therapy — and put those providers to work running these vaccine clinics. 

Once again, the Indian Health Service is putting public health before profit. 

In the long line through the gymnasium, I meet 62-year-old Melvin Foster.

“Yeah, I’m getting my second Pfizer shot,” Melvin tells me. And he’s psyched about it. Melvin says getting vaccinated is a no-brainer for him. Less than a year into the pandemic, ten of his relatives have died of COVID-19. 

It was hard for us,” Melvin says. “We had their services grave-side. I mean, this virus is something else that nobody shouldn’t play with or laugh about. This is a serious issue.

Finally, the nurse comes around and it’s Melvin’s turn.

“Easy poke, now,” Melvin says.

“I will, I’ll be gentle as a lamb,” the nurse tells him. “One, two and three…” 

As he waits out the 15-minute observation period, Melvin feels a sense of relief. 

“I’ve got grandchildren, so I gotta stay here as long as I can with them.”

This was the other thing that allowed the vaccine rollout to go so smoothly on tribal lands. For the most part, Native people were ready and willing to get the shot as soon as it was available to them. The Urban Indian Health Institute was among the first groups to explore this trend. It surveyed 1,300 Native people in late 2020, just before the vaccine became available and found that 75 percent planned to get vaccinated right away. Their primary motivation? Protecting their families and communities. 

“Which is, at its core, a public health decision. Seeing themselves as individuals with a responsibility to the larger community,” says the institute’s director, Abigail Echo-Hawk. During the pandemic, she’s been watching stereotypes about Native communities and our healthcare systems get turned on their head. 

“We have these operating public health systems where we know who our community is. We know the barriers they have to accessing services such as transportation. We know how to reach our people. We just need more resources to be able to protect our entire communities.” 

IHS isn’t perfect. Anyone who’s had to wait until the next fiscal year to get their knee surgery paid for understands that. But Abigail says the last 18 months have proved it’s a system that’s not fundamentally broken, just starved of appropriate resources. In 2021, the IHS’s budget was $6.2 billion, a fraction of the $48 billion that tribal leaders say it would actually take to meet their communities’ healthcare needs. 

“What if they had all the resources they needed?” Abigail asks. “We could possibly be at herd immunity in our tribal communities, and we’re already close to getting there without it.” 

During this conversation, Abigail points out another snag in the system. In early 2021, Native people who live on their tribal lands are getting vaccinated months before they would be eligible for shots through their surrounding states. But Natives living off-reservation? Not so much. 

“For Urban Indians living in cities that don’t have Urban Indian Health Programs that have accessible vaccines, they’re going to the same hospitals, same clinics, same grocery store pharmacies that other people are going to, to try to get the vaccine. And they’re not getting it even though they are the most at risk,” says Abigail. 

"Crappy" Options

This isn’t news to me. Like most Native people in this country, I live away from my tribal community in Albuquerque now where I’ve moved for a new job covering tribes across the Mountain West. And while I watch my friends and cousins back home post their vaccine selfies from our small IHS clinic, I’m striking out. 

In early spring, I meet a guy named Jonathan Concha, who’s had the same experience. 

“For the most part, everybody in my family’s been vaccinated already, so I’m the last one,” Jonathan says with a wry chuckle. 

Jonathan is 55, a citizen of Taos Pueblo. When the vaccine became available back home, he was willing to make the two-and-a-half-hour drive north from Albuquerque to get it, but his Pueblo was still on strict lockdown. 

“I had called, and they said since I live outside the county that I wasn’t eligible to get it. So, that’s kind of one avenue that was a roadblock.” 

And when he tried for an appointment at the city’s two urban Indian health centers ...

“I wasn’t able to register,” he says. “And they said it was only eligible to patients.”

As in, Native folks who were already registered as patients at these healthcare centers before the vaccine rollout. Jonathan tells me he has private health insurance through his job as an auto technician, so he would never have needed to use the IHS clinics in the city. 

“If you don’t visit IHS, then you’re basically out of the loop,” says Jonathan. 

I’m in the same boat, stuck between the cracks of the Indian Health Service’s urban and rural healthcare systems and weighing two pretty crappy options. Do I travel all the way home possibly exposing myself and my family to a deadly virus, so that I can get a shot? Or do I wait it out and remain vulnerable while Native people continue to die of COVID-19 and quadruple the rate of the general population? So, my motivation for finding out what’s going on at Urban Indian Health centers isn’t entirely journalistic. I’m not surprised to find out it comes down to a lack of funding. Most Native people in this country live in cities. But Urban Indian Health Centers are funded through a single line-item that makes up less than one percent of the IHS’s budget. 

Adrienne Maddux, who directs the Urban Indian Health Center in Denver, tells me that lack of resources gives these clinics a certain reputation.

“Historically, our Native population in the Denver area has always thought of our clinic as the clinic that takes care of people that can’t afford to go anywhere else,” she says.

The clinic’s share of federal funding is based partially on how many Indigenous patients actually use the clinic, and many who have private insurance choose to go elsewhere. It’s a vicious cycle that leaves too many urban Indians dispossessed of their treaty rights to healthcare. In early 2021, that cycle has been laid bare at Denver Indian Health. Adrienne says urban Natives who have never used the clinic before are now swarming it looking for shots. 

“We have a lot, actually. Probably the majority of those we’re vaccinating probably will not come back.”

As for why the clinic can’t mass-vaccinate the way rural IHS clinics have been? 

“We could do an outside clinic, but we need the staff, we need the people, and we need the storage of these vaccines,” Adrienne explains. “So, a lot of it has to do with what we’re able to do within our infrastructure and the staff we have.”

Adrienne doesn’t have a dental or a physical therapy department she can deputize to run a big vaccine drive. Neither does the Urban Indian Clinic in Albuquerque. They have to enlist help from the state Indian Affairs Department and various other Native-serving organizations to run the first mass-vaccination event for Natives in the city. 

That’s where Jonathan and I finally get our shots in April. 

“Okay, let’s have your sleeve up then,” a nurse tells Jonathan. “Okay, here comes the poke. Ready, poke … You did great!”

By the standards set elsewhere in Indian Country, I was a vaccine straggler, but I still got my shot a month before the state of New Mexico opened up appointments to people my age. 

A Collective Culture

It’s tempting to stop here, with the success of Indian Country’s vaccine rollout. 

By mid-summer of 2021 and beyond, we have the highest vaccination rate of any racial or ethnic group in the country. That’s something to be proud of. 

But tribal communities didn’t just pack it in when we hit that milestone. Let’s wrap this up where we started: on the Wind River Reservation. 

The Northern Arapaho Tribe has a new chairman, a young guy named Jordan Dresser, and he’s proud that 75 percent of eligible Arapahos are fully vaccinated, compared to the 42 percent of Wyomingites. That second number scares him though. 

“Wyoming is one of the lowest in the nation so our tribal members take a risk every time they travel throughout the state, which we’re Wyoming citizens as well. We should be able to go anywhere and feel safe,” says Dresser. “But unfortunately that’s not the case. And masks are basically optional. Vaccines are very low. We take a risk. So we felt that this was a way for us to exercise our sovereign muscle and also protect our people at all costs.”

In the middle of a nationwide labor shortage, the Northern Arapaho Business Council passes a resolution requiring tribal employees and anyone who works with children on the reservation to get the shot. 

“To show that we’re, number one, in the middle of a pandemic. It didn’t go away. It’s here and it’s mutating. And it’s just to show that we’re serious about it and we’re serious about protecting our people.”

Schools and businesses on the reservation have lost employees over this mandate, and it’s made it even more difficult to attract new workers. But once again, this tribal government is putting its economic interests on the backburner. 

“I think it comes down to the fact that Native communities are collective cultures,” Dresser says. “Meaning that we always traditionally thought about each other. As opposed to individualistic culture which is basically Americans, which is me, me, me.”

The pandemic has been hell for Arapaho people. But more than 18 months in, Dresser says his people are still willing to make sacrifices for the community. 

“I think people are comfortable making that sacrifice for each other because it’s not about you. It’s the idea that we take care of each other. When somebody’s down, we try to help as much as possible. That’s the power of a collective culture.” 

Back to that question about why tribal governments’ best efforts weren’t enough to prevent so many Indigenous people’s deaths. 

When the pandemic arrived in Indian Country, tribes weren’t just battling the virus itself. They were battling history. 500 years of colonization. Centuries of land theft and coercive treaty-making. Decades of failure by the federal government to actually make good on the promises laid out in those treaties: things like good healthcare, housing, and basic infrastructure that would allow people to live safe and healthy lives. The United States Constitution — the bedrock of American democracy — declares these treaties the supreme law of the land. So let’s ask instead, why is this country so comfortable breaking them? 

This episode is dedicated to Larry, Gloria and Dawn Wheeler, John Brown, Karletts Dennison, and every Native person who lost their life to COVID-19. And to their families who have had to learn to live without them. 

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