Regarding Covid-19

Native Americans mostly on their own in COVID fight

IHS Pine Ridge Hospital in South Dakota. (Indian Health Service via Twitter)

Mary Annette Pember

In states without mask mandates or other policies, tribes suffer most

Davidica Littlespottedhorse didn’t really feel terribly sick; at first she thought she had the flu or a sinus infection.

Soon, however, she developed a frighteningly painful headache. Almost immediately, her entire family of 10 living together in a three-bedroom home fell ill; nearly everyone complained of similar distinctive headaches.

Littlespottedhorse’s son-in-law Carl tested positive for COVID-19 a week earlier. Despite their best efforts at sanitizing the house and ensuring Carl quarantined in his room, the virus quickly spread through the household, affecting members who range in age from 7 months to 47 years old.

The family quickly went to the Indian Health Service hospital in the town of Pine Ridge to get tested; the nurse, however, told Littlespottedhorse that since she’d been tested a week ago, she’d have to wait another month to get retested.

“I told her I’m symptomatic and need to be tested again. Finally I contacted the CEO of the hospital, and he intervened,” she said.

The adults in the home all tested positive. Hospital staff told Littlespottedhorse the babies, all under 2 years, didn’t need to be tested; the family should just assume they are positive and treat their symptoms as needed.

“If I hadn’t insisted on getting us tested, we might have thought we just had the flu and gone on as usual; we could be out there infecting people,” she said.

Davidica Little Spotted Horse of Pine Ridge. (Photo by Mary Annette Pember)
Davidica Little Spotted Horse of Pine Ridge. (Photo by Mary Annette Pember)

Littlespottedhorse, of the Oglala Sioux Tribe, wondered if that might be the case with others in the community.

“It seems like we have a bad flu. We’re not completely debilitated, although my daughter who is 7 months pregnant is feeling really bad,” she said.

In response to an email regarding testing protocols at the Pine Ridge hospital and other facilities, Indian Health Service public affairs staff wrote, “Patients who have had a previous negative COVID-19 may be retested if they start to have symptoms of COVID-19.”

According to the FAQ pages for both the Indian Health Service and U.S. Department of Health and Human Services, however, “IHS facilities generally have access to testing for individuals who may have COVID-19; however, there are nationwide shortages of supplies that may temporarily affect the availability of COVID-19 testing at a particular location.”

(Previous story: ‘Level of suffering is unlike anything we’ve ever seen before’)

The Indian Health Service has received over $2.4 billion in new funding to provide resources that will support a wide range of COVID-19 activities, according to an agency news release.

The agency has also expanded to deliver 470 rapid point of care analyzers to 342 federal, tribal and urban sites, according to releases from the Indian Health Service and Health and Human Services. But for an agency that is so chronically underfunded and staffed, a one-time infusion of cash may not be enough to shore up an inadequate infrastructure.

Littlespottedhorse and her family are now quarantined in their home in Oglala, on the vast Pine Ridge reservation, where grocery stores are few; Walmart and other large shopping centers are located hours away, in Rapid City and Nebraska.

Littlespottedhorse’s household is dependent on deliveries of food and cleaning supplies from family members and the Oglala Sioux Tribe’s Covid Task Force. Her situation is not unique to Pine Ridge.

Mercedese Littlespottedhorse, daughter of Davidica Littlespottedhorse, stays hydrated while fighting the COVID-19 virus. (Photo courtesy of Davidica Littlespottedhorse)
Mercedese Littlespottedhorse, daughter of Davidica Littlespottedhorse, stays hydrated while fighting the COVID-19 virus. (Photo courtesy of Davidica Littlespottedhorse)

Housing is scarce on most reservations, and poverty rates are high so more than one family often occupies a single home, making Native people here especially vulnerable. Underlying poverty-related health conditions such as diabetes, obesity, asthma and high blood pressure add to the risk of developing serious complications, noted South Dakota Rep. Peri Pourier during an interview with MSNBC.

Pourier and Sen. Red Dawn Foster, both Lakota, recently sent a letter to South Dakota Gov. Kristi Noem asking her to impose a mask requirement.

“This letter is written with grave urgency to appeal to your rational sensibilities as a person, looking above and beyond political party lines and political obstructions,” they wrote.

“We write to implore you to try and think of those who are vulnerable and need our protection, not to get bogged down in petty politics.”

Maggie Seidel, senior advisor and policy director for Noem wrote in an email response to the legislators’ letter, “I think our answer has been well covered.”

“Mask mandates don’t work — they haven’t worked anywhere in the world. We respectfully request the news media cover the facts,” Seidel wrote to Forum News Service regarding Pourier and Foster’s letter.

To date, Noem has declined to enact any COVID-related restrictions and continues to downplay the seriousness of the disease.

According to the Centers for Disease Control and Prevention, South Dakota is among the worst states in the country for measures of per capita deaths and hospitalizations.

Both South and North Dakota are near capacity at all hospitals. In general, rural hospitals in the U.S. are not equipped to handle critically ill patients, according to the Wall Street Journal. The pandemic has laid bare these shortcomings for the entire population.

Native Americans on remote reservations in the Dakotas are effectively on their own.

As they have for generations, however, Native people are organizing to provide care for themselves and their families.

No time off since June

“It’s unreal how busy we’ve been,” said Patrick Swallow, public health investigator for the Oglala Sioux Tribe.

Swallow works with two other investigators and eight contact tracers who notify tribal members who have tested positive for the virus and determine how many others with whom they may have been in contact.

“We first try to contact positive cases by phone, but many times their phone numbers have been disconnected; we’re finding a lot of people have prepaid phones and can’t afford to pay the bill,” Swallow said.

Investigators must then drive to peoples’ homes, don protective gear and notify them in person.

“I’ve been putting on over 300 miles a day driving around; we haven’t had a day off since June,” he said.

“We get anywhere between 30 and 50 cases per day; it’s been hard on us, but everybody on our team is so dedicated. Thankfully, none of our staff has gotten sick so far.”

Predicting the virus’ spread and progression has been almost impossible, according to Swallow.

“In some homes, one person gets sick and then everyone gets infected. In others, only one person gets sick,” Swallow said. “As soon as we think we have this thing figured out, it just changes.”

Swallow speculates that there are likely far more cases of the virus that have gone untested because some patients have no symptoms.

“You can be running around and not even know you have it and still be contagious,” he said.

Unfortunately, the many funerals now taking place for those who have died from the virus are contributing to its spread, according to Swallow.

“It’s a real touchy subject; how do you tell people they can’t have a funeral or wake if their loved one passes away?”

Littlespottedhorse and her family are recovering. Although she has a number of underlying health conditions such as diabetes and high blood pressure, she is beginning to feel better.

Eschewing over-the-counter medications, Littlespottedhorse relies instead on traditional herbal remedies. She credits her teas and supplements with her family’s recovery.

“Thankfully the fevers have passed for everyone. We’re staying true to only herbal remedies, being gentle with ourselves, eating healthy and staying hydrated. We smudge and pray every day,” she said.

“This healing is definitely a process. Luckily our family and the tribe have been stepping up to help us; I’m humbled and eternally grateful to have such compassionate, generous people in our lives. Pilamiya Tunkasila for courage and patience.”

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Mary Annette Pember, citizen of the Red Cliff Ojibwe tribe, is national correspondent for Indian Country Today. On Twitter: @mapember. Based in Cincinnati, Ohio. Pember loves film, books and jingle dress dancing.

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