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Monday, October 26, 2020

Addressing Critical Needs in Native Communities During COVID-19 and Beyond

Upon notification of the COVID-19 pandemic and its potential impact on the entire globe, Tribal nations implemented some of the most stringent preventative measures to protect their communities. 

Pandemics and disease are far too familiar to Native American communities. The intentional introduction of smallpox into Native communities was one of our earliest introductions to the dangers that new viruses can present.  

The COVID-19 virus has disparately impacted Native Americans. American Indians make up  12% of COVID-19 cases in South Dakota as compared to 9% for the American Indian and Alaska Native (AI/AN) population according to the 2010 U.S. Census. 18% of the state's deaths are AI/AN.  Data from March 1-June 27 show American Indian/Alaska Native people hospitalized from COVID more than all other racial groups. 

The sovereign authority of tribal-nations grants them the right to regulate action on their lands and the option to implement policies to protect tribal-citizens. The Oglala Sioux Tribe and the Cheyenne River Sioux Tribe both chose to exert these rights by creating border checkpoints to help deter movement and the slow the spread of COVID-19 within their tribally maintained, constitutionally recognized borders.

Furthermore, we are community-oriented people. We know that what impacts our relatives who surround us impacts us. Protecting our relatives will affect the seven generations that come after us. While you see citizens of the United States concerned about mask mandates infringing on rights, it is evident that one of the least oppositional groups to preventative measures are tribal communities. I believe this because we know too well how detrimental the impact of diseases like COVID-19 can be and because we care about those around us. 

Historical precedent has made our relatives and communities at greater risk for adverse outcomes from COVID-19. The impacts of historical trauma, an artifact of traumas experienced in our communities through the federal government's efforts to "kill the Indian, save the man," and the chronic underfunding of healthcare and public health efforts in tribal communities have contributed to the rampant health disparities in tribal communities. Many of these are comorbidities associated with higher rates of mortality among COVID-19 patients. 

The housing crisis in Indian Country is on full display as it is not uncommon to have ten or more people living in a home on many reservations. However, multigenerational living situations make quarantine or isolation hard. Preventing the spread of COVID in a household once one family member is ill is merely impossible. 

The rural nature of many reservations has built a supply chain that is subpar on a good day—add a pandemic to the equation, and you can imagine the disastrous effect. In urban areas, poverty and homelessness make caring for and isolating COVID-positive individuals challenging. When essential services such as drug and alcohol treatment programs, food delivery services, and other social service programs closed their doors during the pandemic, our community had little to nowhere to turn. 

Our forward-thinking leadership identified gaps and, in the same breath, were identifying solutions. We received a grant to stand up one of the first-ever tribal Emergency Operations Center (EOC) that serves 17 tribal nations and one service unit over a 4-state area. Since, we have been serving the tribes, providing emergency response training, filling gaps in the supply chain and accessing essential PPEs, and providing food and cleaning supplies to families impacted by COVID. Grants from the Center for Disaster Philanthropy, the CDC, and other organizations are supporting pandemic related EOC efforts as well as assisting us in preparation for COVID-19 recovery and work towards more organized and responsive disaster recovery in Tribes across the Great Plains Area.

Had Tribal Nations, Indian Country generally, Tribal Organizations, and allies who stepped up during the pandemic not taken the actions they did, I anticipate these disparities would be much broader. Providing Tribal Nations support for capacity building in emergency management and public health is of utmost importance in our ability to respond to the needs of and protect our communities and relatives. Empowering self-governance and sovereign rights of tribal nations will continue to provide an opportunity to protect our people and restore for the next 7 generations to come. 

Written by Tamee Livermont, MPH, citizen of the Oglala Lakota Nation, is the Tribal Liaison for the Great Plains Tribal Leaders Health Board (GPTLHB). GPTLHB is dedicated to serving the health and wellness needs of the tribal members it represents. Assisting with the needs of 18 tribes and tribal communities in the four-state region of South Dakota, North Dakota, Nebraska and Iowa, GPTLHB addresses the health necessities of its members by assisting in accessing health-related programs and resources. For more information visit https://www.gptchb.org.

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