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Hit hard by COVID, Native Americans come together to protect families and elders

The pandemic has been stressful on many fronts for Chris Aragon, a caregiver for his older brother who has cerebral palsy.

"The left side of his body is atrophied and smaller than his right side, and he has trouble getting around. He's kind of like a big teenager," says Aragon, 60, who is part Apache and lives with his brother on the Fort Berthold Reservation of the Mandan, Hidatsa and Arikara Nation, in North Dakota.

He worried during the worst months of the pandemic about keeping his brother safe from COVID. And finances have been a stressor, too, says Aragon. He worked reduced hours in 2020, and had periods with no work in 2021. "I'd wake up at night to go to the restroom, and then I wouldn't be able to go back to sleep."

COVID exacerbated long standing stresses created by historic inequities, says Spero Manson, who's Pembina Chippewa from North Dakota, and directs the University of Colorado's Centers for American Indian and Alaska Native Health.

The pandemic, he says, heightened "that sense of pain, suffering of helplessness and hopelessness," says Manson. And it's manifesting in higher rates of anxiety, depression, post-traumatic stress disorder, he says.

Native communities in the United States have had higher rates of infection, are nearly three times more likely to be hospitalized and more than twice as likely to die from the disease than whites. Half of Native Americans ina poll conducted last year by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health said they were facing serious financial problems. And 74% said someone in their household was struggling with depression, anxiety, stress and problems with sleeping.

"I think the pandemic has definitely triggered this historical trauma that Native people do experience," says Adrianne Maddux, the executive director at Denver Indian Health and Family Services, which runs a primary care clinic.

She's witnessed a higher demand for behavioral health services, including addiction treatment. "Our therapists were inundated," says Maddux.

Responding to collective grief with collective support

But native communities also have unique strengths that have helped them approach the COVID crisis with resilience, says Manson. Tribes have responded to the pandemic with new initiatives to stay connected and support one another.

"American and Alaska Native people, we are very social and collective in our understanding of who we are, how we reaffirm this sense of personhood and self," says Manson. "Some of the strength and resilience is in how collective and social these communities are."

Part of the struggle in the pandemic has been "having a limited ability to get together and gather for things like powwows and ceremonies and other events that really keep us connected," says Victoria O'Keefe, a member of the Cherokee and Seminole Nations, and a psychologist at the Center for American Indian Health at Johns Hopkins University. And she adds, there's "collective grief, especially grief around losing elders and cultural keepers."

But that collective mindset has also brought people together to heal. "We really see so many communities mobilizing and are really determined to protect each other," says O'Keefe. "This is driven by shared values across tribes such as connectedness, and living in relation to each other, living in relation to all living beings and our lands. And we protect our families, our communities, our elders, our cultural keepers."

That was evident in the Navajo Nation, says O'Keefe's colleague, Joshuaa Allison-Burbank, a member of the Navajo Nation and a speech language pathologist at the Center for American Indian Health.

"This concept of Navajo of K'é," he says. "It means family kinship ties."

Allison-Burbank spent the early months of the pandemic working on the frontlines at a COVID care clinic of the Indian Health Services in Shiprock, N.M. He says people were quick to start masking and social distancing.

"That's what was so important for getting a grasp and controlling viral spread across the Navajo Nation was going back to this concept with respect to other humans, respect to elders," says Allison-Burbank. "It's also the concept of taking care of one another, taking care of the land."

It also helped communities find creative solutions to other pandemic-related crises, like food shortages, he adds.

Left: Josiah Concho and his nephew Kaleb Allison-Burbank helped grow produce in Waterflow, N.M., during the summer of last year. They then gave the crops to native families in need. Right: Joshuaa Allison-Burbank and his family hung red chiles to dehydrate. The excess produce helped combat food shortages in their communities.
/ Joshuaa Allison-Burbank
Joshuaa Allison-Burbank
Left: Josiah Concho and his nephew Kaleb Allison-Burbank helped grow produce in Waterflow, N.M., during the summer of last year. They then gave the crops to native families in need. Right: Joshuaa Allison-Burbank and his family hung red chiles to dehydrate. The excess produce helped combat food shortages in their communities.

Many people, including his own family, started farming and cooking traditional crops like corn and squash, which they previously ate only during traditional ceremonies.

"My whole family, we were able to farm traditional Pueblo Foods and Navajo crops," says Allison-Burbank. "And not just have enough for ourselves, but we had an abundance of to share with our extended family, our neighbors and to contribute to various mutual aid organizations."

He says farming also allowed community members to spend more time together safely — which helped buffer some of the stress.

Helping kids and elders navigate COVID fears

Families also had more time to speak their native language and practice certain cultural routines, which he thinks helped people emotionally.

Allison-Burbank, O'Keefe and their colleagues at the Center for American Indian Health also spearheaded an effort to help American Indian and Alaska Native children cope during the pandemic. They wrote, published and distributed a children's story book called Our Smallest Warriors, Our Strongest Medicine: Overcoming COVID-19.

The book, which was illustrated by a native youth artist, tells the story of two kids whose mother is a health care worker treating people with COVID-19. So, the kids turn to their grandmother, who helps them navigate their fears and anxieties.

"Storytelling is an important and long standing tradition for tribal communities," says O'Keefe. "And we found that this was a way that we could weave together our shared cultural values across tribes, as well as public health guidance and mental health coping strategies to help native children and families."

Over 70,000 copies of the book have been distributed across 100 tribes, says O'Keefe. In addition to the book, parent resources and children's activities areavailable for free on the center's website.

On the Berthold Reservation, where Aragon lives, he says tribal leaders were "very proactive" about supporting people with COVID-19 and their families. "All [people] had to do was pick up the phone and call to get extra help, or get groceries brought to their house," he says.

Authorities also helped individuals with COVID-19 isolate, using cabins at a local campground, so that they could minimize the risk of exposing other family members, he says.

And people took the time to help the elderly, he adds. "They definitely treat their elders well here, and they're not just forgotten and put in a nursing home somewhere."

Tribal youth in Minneapolis had similar efforts to take care of elders in their community, assisting them with getting food, medicine and other tasks, says Manson.

"This reflects an enormous sense of importance of elders in our communities as the repositories of cultural knowledge and our spiritual leaders," he says, as well as the importance of intergenerational relationships.

Reaching across tribal boundaries

The Oneida Indian Nation, which is located in upstate New York, recently unveiled an art installation to increase awareness about the disproportionate impact of the pandemic on Native communities as well as resources around COVID-19. Titled Passage of Peace, the installation features large tipis, which are traditional homes and gathering places.

The installation is located just off of the New York State Thruway, about midway between Syracuse and Utica. "We hope the Passage of Peace will bring attention to continued hardship taking place in many parts of Indian country, while delivering a message of peace and remembrance with our neighboring communities here in Upstate New York," says Ray Halbritter, Oneida Indian Nation Representative.

Native communities are also connecting and supporting each other online, with projects like the Social Distance Powwow Facebook group, founded in March 2020 to "foster a space for community and cultural preservation." People from many different tribes share songs, dance videos, conversations, stories, and fundraisers and sell arts and crafts. It now has over 278,000 members.

The sense of community and respect for elders were also behind American Indian and Alaska Native people being more willing to get vaccinated to protect their communities, says Jennifer Wolf, founder of Project Mosaic, a consulting group for indigenous communities.

"We have so many reasons to be mistrustful of a government that has taken land away from us and broken so many promises," says Wolf, "and yet we have the highest (Covid-19) vaccination rates in the country."

According to the U.S. Centers for Disease Control and Prevention, half of all American Indian and Alaska Native people have been fully vaccinated, and 60% have received at least one dose, as compared to only 42% and 47% respectively of all whites.

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Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.