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wowieThis link was posted on the friendsonboard blog this morning. I've gone back and forth between public, to private, to friends only, to editing my comment at the bottom of a couple of times today. It put me in a bit of a funk this morning, I guess, being overwhelmed contemplating the sheer numbers of needy folks in this world, not just on the Reservation. Anyway...
Shortened lives marked by diabetes and despair
Sunday, November 05, 2006
BY CAROL ANN CAMPBELL
Star-Ledger Staff
PINE RIDGE, South Dakota -- Lawrence Red Feather inches his wheelchair toward home, a desolate, faded box of a house with a dirt yard on the sun-washed prairie.
He tucks a pant leg beneath his left stump, all that remains of a limb lost to diabetes -- a scourge of these Northern Plains Indians. The disease has plundered the rest of Red Feather's body, too. Surgeons patched his ailing heart a few years back, and now, three times each week, nurses hook him up to kidney dialysis machines.
He's also going blind.
Men die young here. The men on the Pine Ridge Indian Reservation can expect to live only to the age of 58, the lowest life expectancy of any group in the nation.
Red Feather is 59. "I'm on borrowed time I guess," he says.
Everywhere in these sand-colored grasslands and rolling hills is extreme poverty and early death. A federally funded study that examined death records found Indian men in six counties of South Dakota -- including Shannon County and the Pine Ridge reservation -- are the least likely to live into old age.
Red Feather, an Army veteran, says the Lakota people were healthier before they were forced onto reservations. "We hunted deer and buffalo," he says. They also gathered berries and grew corn, tomatoes and squash.
Today people on the reservation eat bacon and eggs with fried potatoes for breakfast. Poverty means budget-stretching meals of macaroni and canned meats, washed down with cheap soda. Lunch could be burritos from Taco John's, since just one grocery store exists on the reservation of 40,000 people.
With this modern American diet has come disease. The diabetes rate on the reservation is 37 percent, according to the Indian Health Service, a part of the U.S. Department of Health and Human Services. Obesity is rampant, and 70 percent of young people are overweight. Even teens get diabetes.
Among Indians, deaths related to alcoholism are six times the rate of all races in the United States. Infant mortality is three times as high and accidental death twice as high.
WORKING THE 'REZ'
Carole Anne Heart hits the gas pedal and heads from her office in Rapid City to the reservation. She zooms through the Badlands National Park, passing ragged buttes and an occasional herd of wild pronghorn antelope.
Heart is full-blood Lakota, part of the Great Sioux Nation, and she straddles two worlds. She grew up "on the rez," she says, learning about the Lakota ways from her grandmother.
"You can't forget the past," says Heart. "But my grandmother always told me, 'Get an education. Look forward.'"
Today she lives in a condo in Rapid City and dresses like a Wall Street executive. She directs the Aberdeen Area Tribal Chairman's Health Board. As her car passes tourist traps on the edge of the reservation, homes appear, many of them dilapidated trailers, some with sheets on the windows and junked cars on the lawn.
"People have no money to tow the cars away. And they can use the old cars for parts," Heart says.
The board advises the Indian Health Service on how to reduce infant mortality and target diabetes and smoking. It pushes to improve nutrition, diagnose children with asthma and increase physical activity, often by connecting the health efforts to Indian traditions.
For instance, one local poster displays a turn-of-the-century photograph of lean and muscular Indian men in tribal dress. "Physical Fitness is the Lakota Way," it reads.
Heart blames many of the health problems on reservation life, which, she says, has destroyed the tiyospaye (ti-osh-pie-a), the family structure that acted as the scaffolding of Indian society.
The tiyospaye, which governed rules of dating and marriage, would never have allowed men to have children with a series of women, which happens frequently now. It would not allow family violence, she says, or drug and alcohol abuse.
Children forced into boarding schools, meanwhile, lost many of the old ways, such as gathering wild turnips, creating wasna, a mixture of dried buffalo meat and chokeberries, or cooking soups of corn and wild onions.
"My grandmother had a garden of tomatoes, cucumbers, squash and corn," says Heart. "Now we get our spinach from Mexico."
The male role as hunter and protector also disappeared, setting many men adrift.
Forced to live on land incapable of sustaining crops, Indians began relying on government surplus food distributed to reservations. Heart says government food and reservation life created something new in Native American culture: "chubby Indian kids."
COMMODITY BODIES
Jeanne Bedell loads her flat-bed cart at the commodity center in Pine Ridge, a nondescript building near the center of town.
"I had the 'commod-bod,'" Bedell says, referring to the weight she gained eating commodity food. She even had early signs of diabetes.
Bedell says the food is better these days, with fresh produce joining the typical surplus products, such as canned meats, white flour and processed cheese.
Commodity foods distributed on reservations used to be only government food distributed to keep farm prices high. Today the Pine Ridge center operates more like a food bank, distributing a variety of food to 5,500 people each month, said Joe Blue Horse, who runs the center. The food is meant to supplement what people buy on their own, but Blue Horse said for many the commodity food is the mainstay.
"The economy is so poor. People have low-paying jobs or no jobs," he said. Often, one person making $7 or $8 per hour will support an entire family. One trailer can be home to two, three or even four families.
Healthy eating is difficult. Some towns, such as Wanblee, are an hour-and-a-half drive from the nearest grocery store, so people eat at fast-food places or buy high-salt, high-fat snacks, or maybe deli sandwiches at convenience stores and gas stations. The fruit is often canned and packed with syrup.
The usual diet revolves around high-fat processed cheese, which often is bartered like currency, and casseroles made from cans of commodity meat and starches. A popular breakfast is fried bread.
"Do you think there's a Whole Foods on the reservation? Not in 100 years," said Leo Nolan, a policy analyst at the Indian Health Service. Finding a fresh, crisp apple seems like finding a gold nugget.
"We have such high rates of diabetes because there's a lack of nutritious, wholesome food for people to eat," Nolan says. "It's easier to get a soda on the reservation than a quart of skim milk."
STEMMING THE TIDE
Ethel Swallow's job is to teach young people to eat well and to exercise so they will reduce their risk of diabetes. As a Community Health Representative for the Oglala Sioux Tribe, she is trying to prevent diabetes from claiming another generation.
It isn't easy.
She urges young people to get out and walk, but the roads are narrow, the cars move fast and there are few sidewalks on the reservation,
The adults aren't much more active. Few have jobs, so work-related exertion is unlikely. Most live sedentary lives, often staying inside.
Swallow urges people to eat healthy foods and to reduce portions. But few know how to cook. And many don't even know they have diabetes until they go blind or an infection rages out of control.
There also is genetic susceptibility. A recent report of the Human Genome Project noted a Caucasian with a blood sugar count of 200 has a 20 percent chance of developing diabetes after 20 years, while a Native American with a same count has an 80 percent chance.
A SUBSTANTIVE CHALLENGE
Lack of nutrition and exercise on the reservation is a recipe for diabetes. But it gets worse. People here smoke like it's 1950s America.
The anti-smoking movement is just reaching the reservation, where half of the adult population smokes cigarettes.
In downtown Pine Ridge, outside the offices of the Oglala Sioux Tribe, older men sit, puffing away.
Several just shrug when told they have the lowest life expectancy in the country. No one seems surprised.
Two recent copies of the Indian paper Dakota/Lakota Journal, for instance, include 13 obituaries, and just two of the deceased are over age 65.
"I don't mind. When it's my time to go, I'll go," says 57-year-old Abraham Tobacco.
Health programs try to keep cigarettes and smoke away from the youngest Indians. At the Northern Plains Healthy Start in Wounded Knee, counselors help pregnant women, some of them teenagers and a few in middle school.
The counselors act like the "aunties" of the tiyospaye, who in the past guided pregnant women. Now the "aunties" must teach the mothers-to-be not to binge drink (most will stop when told of the risks) and stay away from tobacco. Other programs encourage adults to sign smoke-free-home pledges.
WHERE HOPE FADES
There is a fog of despair that lingers over the reservation. Sociologists call it "cultural trauma." By any name, it can been seen in the staggering 80 percent unemployment rate and a suicide rate that is twice the national average.
Mixed with the desperation is a palpable anger over the past. People talk about broken treaties and stolen land, and a lack of opportunities
In a parking lot, Jerry Bear Shield, a tall 26-year-old man with long hair and a striking face, approaches people to sell the beaded necklaces he and his family make.
"There are no jobs here for us," he says despairingly. "This is what I do for a living."
Many here also blame alcohol, introduced by early European explorers, for further destroying the tiyospaye and Indian culture. Nearly every morning, Bill Pourier, chief executive of Pine Ridge Hospital, sees the results of alcohol abuse in the emergency room, usually in car accidents.
"We're starting to see more drug abuse, cocaine and now meth," says Pourier. "I would say 90 percent of our motor vehicle accidents are related to drugs and alcohol."
Also contributing to the high accident rate are unsafe cars, narrow roads with high speed limits, and animals, such as cattle, horses and deer, that wander onto the roads.
Alcohol cannot be sold on the reservation, but is available a mile from the Pine Ridge border in White Clay, Neb., where some Indians drive to "case up" for a weekend of binge drinking.
TRYING TO LET GO
Red Feather's niece, 24-year-old Jennifer Warrior, says she knows about early death.
Her mother continued drinking despite liver problems, she says.
"She died in her 40s."
At the dialysis center where she picks up Red Feather after his treatment, Warrior tells Ethel Swallow that others in her family have diabetes. She knows she is at risk, too.
"You can learn to eat better," Swallow tells her. "Get out. Walk."
Warrior puts her head down, slightly embarrassed at a comment about her weight. Later, though, she says she wants to learn more about how to prevent diabetes.
Looking at her uncle -- with his kidney failure and amputated leg -- Warrior sees a future she can still escape.
My heart goes out to these folks, and so many others in this country that need it. The needs can be so overwhelming to think about, and here I am typing away with my cup of tea, full belly, and many other creature comforts. It's almost embarrassing to think about. We - my family - live comfortably on our income. Maybe too comfortably?
Shortened lives marked by diabetes and despair
Sunday, November 05, 2006
BY CAROL ANN CAMPBELL
Star-Ledger Staff
PINE RIDGE, South Dakota -- Lawrence Red Feather inches his wheelchair toward home, a desolate, faded box of a house with a dirt yard on the sun-washed prairie.
He tucks a pant leg beneath his left stump, all that remains of a limb lost to diabetes -- a scourge of these Northern Plains Indians. The disease has plundered the rest of Red Feather's body, too. Surgeons patched his ailing heart a few years back, and now, three times each week, nurses hook him up to kidney dialysis machines.
He's also going blind.
Men die young here. The men on the Pine Ridge Indian Reservation can expect to live only to the age of 58, the lowest life expectancy of any group in the nation.
Red Feather is 59. "I'm on borrowed time I guess," he says.
Everywhere in these sand-colored grasslands and rolling hills is extreme poverty and early death. A federally funded study that examined death records found Indian men in six counties of South Dakota -- including Shannon County and the Pine Ridge reservation -- are the least likely to live into old age.
Red Feather, an Army veteran, says the Lakota people were healthier before they were forced onto reservations. "We hunted deer and buffalo," he says. They also gathered berries and grew corn, tomatoes and squash.
Today people on the reservation eat bacon and eggs with fried potatoes for breakfast. Poverty means budget-stretching meals of macaroni and canned meats, washed down with cheap soda. Lunch could be burritos from Taco John's, since just one grocery store exists on the reservation of 40,000 people.
With this modern American diet has come disease. The diabetes rate on the reservation is 37 percent, according to the Indian Health Service, a part of the U.S. Department of Health and Human Services. Obesity is rampant, and 70 percent of young people are overweight. Even teens get diabetes.
Among Indians, deaths related to alcoholism are six times the rate of all races in the United States. Infant mortality is three times as high and accidental death twice as high.
WORKING THE 'REZ'
Carole Anne Heart hits the gas pedal and heads from her office in Rapid City to the reservation. She zooms through the Badlands National Park, passing ragged buttes and an occasional herd of wild pronghorn antelope.
Heart is full-blood Lakota, part of the Great Sioux Nation, and she straddles two worlds. She grew up "on the rez," she says, learning about the Lakota ways from her grandmother.
"You can't forget the past," says Heart. "But my grandmother always told me, 'Get an education. Look forward.'"
Today she lives in a condo in Rapid City and dresses like a Wall Street executive. She directs the Aberdeen Area Tribal Chairman's Health Board. As her car passes tourist traps on the edge of the reservation, homes appear, many of them dilapidated trailers, some with sheets on the windows and junked cars on the lawn.
"People have no money to tow the cars away. And they can use the old cars for parts," Heart says.
The board advises the Indian Health Service on how to reduce infant mortality and target diabetes and smoking. It pushes to improve nutrition, diagnose children with asthma and increase physical activity, often by connecting the health efforts to Indian traditions.
For instance, one local poster displays a turn-of-the-century photograph of lean and muscular Indian men in tribal dress. "Physical Fitness is the Lakota Way," it reads.
Heart blames many of the health problems on reservation life, which, she says, has destroyed the tiyospaye (ti-osh-pie-a), the family structure that acted as the scaffolding of Indian society.
The tiyospaye, which governed rules of dating and marriage, would never have allowed men to have children with a series of women, which happens frequently now. It would not allow family violence, she says, or drug and alcohol abuse.
Children forced into boarding schools, meanwhile, lost many of the old ways, such as gathering wild turnips, creating wasna, a mixture of dried buffalo meat and chokeberries, or cooking soups of corn and wild onions.
"My grandmother had a garden of tomatoes, cucumbers, squash and corn," says Heart. "Now we get our spinach from Mexico."
The male role as hunter and protector also disappeared, setting many men adrift.
Forced to live on land incapable of sustaining crops, Indians began relying on government surplus food distributed to reservations. Heart says government food and reservation life created something new in Native American culture: "chubby Indian kids."
COMMODITY BODIES
Jeanne Bedell loads her flat-bed cart at the commodity center in Pine Ridge, a nondescript building near the center of town.
"I had the 'commod-bod,'" Bedell says, referring to the weight she gained eating commodity food. She even had early signs of diabetes.
Bedell says the food is better these days, with fresh produce joining the typical surplus products, such as canned meats, white flour and processed cheese.
Commodity foods distributed on reservations used to be only government food distributed to keep farm prices high. Today the Pine Ridge center operates more like a food bank, distributing a variety of food to 5,500 people each month, said Joe Blue Horse, who runs the center. The food is meant to supplement what people buy on their own, but Blue Horse said for many the commodity food is the mainstay.
"The economy is so poor. People have low-paying jobs or no jobs," he said. Often, one person making $7 or $8 per hour will support an entire family. One trailer can be home to two, three or even four families.
Healthy eating is difficult. Some towns, such as Wanblee, are an hour-and-a-half drive from the nearest grocery store, so people eat at fast-food places or buy high-salt, high-fat snacks, or maybe deli sandwiches at convenience stores and gas stations. The fruit is often canned and packed with syrup.
The usual diet revolves around high-fat processed cheese, which often is bartered like currency, and casseroles made from cans of commodity meat and starches. A popular breakfast is fried bread.
"Do you think there's a Whole Foods on the reservation? Not in 100 years," said Leo Nolan, a policy analyst at the Indian Health Service. Finding a fresh, crisp apple seems like finding a gold nugget.
"We have such high rates of diabetes because there's a lack of nutritious, wholesome food for people to eat," Nolan says. "It's easier to get a soda on the reservation than a quart of skim milk."
STEMMING THE TIDE
Ethel Swallow's job is to teach young people to eat well and to exercise so they will reduce their risk of diabetes. As a Community Health Representative for the Oglala Sioux Tribe, she is trying to prevent diabetes from claiming another generation.
It isn't easy.
She urges young people to get out and walk, but the roads are narrow, the cars move fast and there are few sidewalks on the reservation,
The adults aren't much more active. Few have jobs, so work-related exertion is unlikely. Most live sedentary lives, often staying inside.
Swallow urges people to eat healthy foods and to reduce portions. But few know how to cook. And many don't even know they have diabetes until they go blind or an infection rages out of control.
There also is genetic susceptibility. A recent report of the Human Genome Project noted a Caucasian with a blood sugar count of 200 has a 20 percent chance of developing diabetes after 20 years, while a Native American with a same count has an 80 percent chance.
A SUBSTANTIVE CHALLENGE
Lack of nutrition and exercise on the reservation is a recipe for diabetes. But it gets worse. People here smoke like it's 1950s America.
The anti-smoking movement is just reaching the reservation, where half of the adult population smokes cigarettes.
In downtown Pine Ridge, outside the offices of the Oglala Sioux Tribe, older men sit, puffing away.
Several just shrug when told they have the lowest life expectancy in the country. No one seems surprised.
Two recent copies of the Indian paper Dakota/Lakota Journal, for instance, include 13 obituaries, and just two of the deceased are over age 65.
"I don't mind. When it's my time to go, I'll go," says 57-year-old Abraham Tobacco.
Health programs try to keep cigarettes and smoke away from the youngest Indians. At the Northern Plains Healthy Start in Wounded Knee, counselors help pregnant women, some of them teenagers and a few in middle school.
The counselors act like the "aunties" of the tiyospaye, who in the past guided pregnant women. Now the "aunties" must teach the mothers-to-be not to binge drink (most will stop when told of the risks) and stay away from tobacco. Other programs encourage adults to sign smoke-free-home pledges.
WHERE HOPE FADES
There is a fog of despair that lingers over the reservation. Sociologists call it "cultural trauma." By any name, it can been seen in the staggering 80 percent unemployment rate and a suicide rate that is twice the national average.
Mixed with the desperation is a palpable anger over the past. People talk about broken treaties and stolen land, and a lack of opportunities
In a parking lot, Jerry Bear Shield, a tall 26-year-old man with long hair and a striking face, approaches people to sell the beaded necklaces he and his family make.
"There are no jobs here for us," he says despairingly. "This is what I do for a living."
Many here also blame alcohol, introduced by early European explorers, for further destroying the tiyospaye and Indian culture. Nearly every morning, Bill Pourier, chief executive of Pine Ridge Hospital, sees the results of alcohol abuse in the emergency room, usually in car accidents.
"We're starting to see more drug abuse, cocaine and now meth," says Pourier. "I would say 90 percent of our motor vehicle accidents are related to drugs and alcohol."
Also contributing to the high accident rate are unsafe cars, narrow roads with high speed limits, and animals, such as cattle, horses and deer, that wander onto the roads.
Alcohol cannot be sold on the reservation, but is available a mile from the Pine Ridge border in White Clay, Neb., where some Indians drive to "case up" for a weekend of binge drinking.
TRYING TO LET GO
Red Feather's niece, 24-year-old Jennifer Warrior, says she knows about early death.
Her mother continued drinking despite liver problems, she says.
"She died in her 40s."
At the dialysis center where she picks up Red Feather after his treatment, Warrior tells Ethel Swallow that others in her family have diabetes. She knows she is at risk, too.
"You can learn to eat better," Swallow tells her. "Get out. Walk."
Warrior puts her head down, slightly embarrassed at a comment about her weight. Later, though, she says she wants to learn more about how to prevent diabetes.
Looking at her uncle -- with his kidney failure and amputated leg -- Warrior sees a future she can still escape.
My heart goes out to these folks, and so many others in this country that need it. The needs can be so overwhelming to think about, and here I am typing away with my cup of tea, full belly, and many other creature comforts. It's almost embarrassing to think about. We - my family - live comfortably on our income. Maybe too comfortably?
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no subject
Date: 2006-12-04 08:53 pm (UTC)The same sort of problems occur in parts of the world that were colonialize, like Africa and Latin America. People who used to grow their own food were forced to switch to commodity crops like cocoa, tobacco, or coffee. With all their arable land claimed by cash crops, they had to buy imported food to eat, and malnutrition and disease followed.
One hopeful note is that, unlike people who live in urban poverty, Native people still have land they can use to grow good food, for themselves and for their community. Someone needs to get in there and show people how to create a farm and grocery cooperative.
That's the sort of thing Peace Corps workers with agricultural specialties do overseas. Couldn't there be an AmeriCorps version for Indian Reservations? I'd be happy to send my tax dollars there.
Thanks to you and FOB for the thought-provoking article.
Soapbox
Date: 2006-12-04 10:52 pm (UTC)I would also be happy to see my tax dollars helping out ALL the needy tribes, if that help included means to sustain themselves. Job training would be great if they also relocate jobs within reach of the res. These problems took a long time making and will need time, resources and tax dollars to fix.
But we also need to remember that not all our poor live on a reservation. If just the money spent on Iraq were used for the relief of poverty in this country we could help all the poor here and still have money left to help overseas. We have our priorities all mixed up. Food, clothing and shelter for everyone in need should come before guns and bullets. Eh, I got to clime down of my box now.
no subject
Date: 2006-12-05 12:06 am (UTC)there definitely should be something like that within the US. We need to help 'our own' first and foremost.
Re: Soapbox
Date: 2006-12-05 12:09 am (UTC)And that's the problem with helping any underprivileged group. If you don't teach them that, all the help in the world is in vain.
Climb back up any time.
no subject
Date: 2006-12-05 06:16 pm (UTC)no subject
Date: 2006-12-05 06:17 pm (UTC)no subject
Date: 2006-12-05 09:16 pm (UTC)no subject
Date: 2006-12-07 10:16 pm (UTC)no subject
Date: 2006-12-07 10:52 pm (UTC)no subject
Date: 2006-12-08 04:11 am (UTC)