Before the novel coronavirus spread throughout the country, indigenous communities already faced healthcare obstacles. With limited access to water and an underfunded, understaffed health care system, the Navajo community faced their own crisis before COVID-19 affected their community, according to NBC News. Michelle Tom, an indigenous doctor on the front lines, shared that due to a lack of plumbing, tribe members travel miles across Navajo Nation to a community center where they fill a water tank for their family. "You're saying 20 seconds of washing your hands with water," Tom said. "We have to haul our water. … We do not have plumbing. And that's how I grew up.”
The Navajo Nation is the largest tribal reservation in the country and spreads across Arizona, New Mexico, and Utah. According to the Navajo Nation Department of Water Resources, approximately 30% of homes on the Navajo reservation, which is home to more than 170,000 residents, do not have access to clean and safe drinking water. These individuals resort to local utilities for water, which can sometimes be closed for multiple days in the week. As the community faces curfews put in place in an effort to stop the spread of the virus, individuals face further hardships in accessing clean water.
Tom treats coronavirus patients at the Winslow Indian Health Care Center in Arizona, as well as on the Navajo reservation; she is one of the few doctors in her community on the front lines. Prior to the spread of the virus in the community, Tom told NBC News, supplies were already scarce; Tom has access to only two ventilators. "We cater to 17,000 Navajo, and people come from Apache, Hopi, as far as three hours away," Tom said. "Our resources are limited. Rural medicine is hard enough. We've always been short-staffed in general."
To stay healthy and prevent spread, Tom has purchased her own protective equipment including a suit, goggles, and face shield, NBC News reported. Due to the pandemic, Tom has had to cut off having physical contact with her family. She is currently living with a co-worker to prevent a possible spread in her community.
Last month, the tribe confirmed its first case of COVID-19. Since then at least 1,197 Navajo residents have tested positive for the virus and 44 have died as a result of the pandemic, officials said. According to NBC News, data based on reported cases and the 2010 census found that people of the Navajo Nation are testing for the virus at a rate that is nine times greater than people in the entire state of Arizona.
While the U.S. government had the obligation to provide health care to all indigenous people, medical supplies and care remain inadequate. "Because of the land that the tribes ceded to the United States, the United States has a trust responsibility to Indian tribes, and health care is one of those," New Mexico Rep. Deb Haaland said according to NBC News. She fought to include indigenous tribes in the Coronavirus Aid, Relief, and Economic Security (CARES) Act because the White House had not allocated any relief for tribes. While advocacy groups estimated that tribes would need at least $20 billion, the legislation provides $8 billion for Native American and Alaska Native tribes.
Not only are medical facilities in the area understaffed with limited supplies, but local hospitals are also running at capacity. According to Jarred McAteer, an internal medicine doctor at Tuba City Regional Health Care Corporation in Arizona, many from the Navajo Nation are being hit hard by the coronavirus due to underlying health conditions and lack of infrastructure in the community. "It's really hard to follow [the Centers for Disease Control and Prevention's] recommendations of washing your hands if access to water is a challenge and that water is supposed to be used for drinking, for cooking, for livestock," McAteer told NBC News. He noted that families often reuse water in a water basin.
In addition to the lack of infrastructure and health care available in the community, tribe members face other issues including drug and alcohol use, which has increased nationwide amid the pandemic. According to the U.S. Department of Health and Human Services, Native Americans require treatment for alcohol and drug use at a rate almost twice the national average. According to NBC News, prior to the novel coronavirus, alcohol sales were banned on Navajo Nation, but this past week New Mexico Gov. Michelle Lujan Grisham has suspended alcohol sales at gas stations, convenience stores, and grocery stores near the reservation as well. Tribe members have shared that loved ones battling with alcoholism have resorted back to it during the pandemic and are not effectively practicing social distancing, Navajo Nation Vice President Myron Lizer said in a statement. This has raised concerns about the health of elder tribe members who are seen as a resource of culture.
Allie Young, a tribe member who returned home during the pandemic, started a Facebook group called Protect the Sacred to address this concern. The group shares information on staying safe and away from tribal elders and has the participation of many celebrities, including Paul Rudd and Mark Ruffalo. "They carry a lot of the knowledge and ceremonies that we, the young people, are still learning," Young told NBC News. "Our cultures are in jeopardy right now if we lose our elders."
As the novel coronavirus continues to spread across the country, communities are coming together to address the needs of their residents, but the government also has responsibility in aiding these individuals. Indigenous people face a number of unique challenges, including marginalization, in addition to a lack of funding and support from the federal government. The government by law must provide health care to natives in addition to developing federal budgets and programs for tribal communities. No one should be left behind in a health crisis, especially those whose stolen land our government resides on.