AMY GOODMAN: This is
Democracy Now!, democracynow.org,
The Quarantine Report.
I’m Amy Goodman in New York, the epicenter of the pandemic. Juan
González is in New Jersey. It’s number two for coronavirus infections.
And now we’re going to number three, per capita, Navajo Nation, as we
continue to look at how the Navajo Nation has been so hard hit by the
coronavirus pandemic, highest number of coronavirus infections per
capita in the United States following New York and New Jersey. The rural
community has reported having nearly 2,300 known cases of
COVID-19,
73 deaths as of Sunday. The Navajo Nation is the largest Indigenous
reservation in the United States with a population of some 350,000, a
territory that spreads over 27,000 square miles.
As we turn now to two doctors who know this land well, on the ground
treating patients. Joining us from Gallup, New Mexico, Dr. Sriram
Shamasunder is a leading medical volunteer — he’s leading a medical
volunteer group of 21 nurses and doctors from University of California,
San Francisco, where he’s an associate professor of medicine, to the
Native American reservation near Gallup. He’s the co-founder of the
HEAL Initiative,
which has worked across nine countries, including Navajo Nation, since
2015, promoting health equity. And joining us from Winslow, Arizona, Dr.
Michelle Tom, member of the Navajo Nation, family physician, treating
COVID-19
patients at the Winslow Indian Health Care Center and Little Colorado
Medical Center in northern Arizona near the Navajo reservation. She was a
basketball star in college at Arizona State University.
We welcome you both, Doctors, to
Democracy Now! Dr. Tom, let’s
begin with you. You work in the clinic where you were born. As you
listen to Valentina’s story, a 28-year-old Navajo woman who suddenly
died after being diagnosed with
COVID-19, your response? Can you put it in the context of what’s happening right now in the Navajo Nation?
DR. MICHELLE TOM: It
just kind of is a reflection of what we’re going through as a people,
and it correlates with what this virus can do to our young and someone
who was very motivated, loved our culture, spread our culture, our rich
and strong, and our language. And that’s what we’re trying to fight for.
You know, there’s not many who really promote really great things, who
is a young person, and she was one of them. And she was going to lead
our next generation. And so, it was a hard loss of our community.
JUAN GONZÁLEZ: And, Dr. Tom, why do you think there has been such a devastation in terms of
COVID-19 throughout the Native population, especially in Navajo Country?
DR. MICHELLE TOM: I
think the spread — we’re a very matriarchal society, and we have a
connection to the land and to our community. And so, we really
concentrate on the community. And when someone is sick, we tend to be
there for one another. And we live in multigenerational homes. So, the
contact of that and the spread is obviously more than we wanted, but
that was just part of our culture, is to help one another and to visit
one another and encourage one another. And being with a very strong
family and all these strong ties, that was probably — you know, it’s
multifactorial, but that was one of the reasons.
JUAN GONZÁLEZ: And what about
the external conditions confronted day to day? For instance, as much as
40% of people in the Navajo reservation do not have running water, how
that affects their ability to combat this disease?
DR. MICHELLE TOM: Oh,
absolutely. And that’s from a long state of histories with treaties and
our relationship with the government. We’ve had — set aside for certain
things like that, and our infrastructure for water has never been at
the capacity where we can provide water for everyone on the reservation.
So, you’re telling people to wash your hands for 20 seconds, and yet
people are trying just to get water just to drink and just to cook with.
And we know that water is part of a healthy body. You know, so, when
you’re trying to have people wash things all the time, we are struggling
with just clean water in general.
AMY GOODMAN: I
want to bring Dr. Sriram Shamasunder into the conversation. You’re
leading this group of volunteer doctors and nurses from San Francisco to
Navajo Nation. You’re in Gallup, that is put under lockdown right now
by the governor because of this massive outbreak. You’ve described
treating four generations of one family. Talk about your work that
you’ve been doing there for years.
DR. SRIRAM SHAMASUNDER: Yes. So, I helped co-found the
HEAL Initiative,
which is a global health immersive fellowship that trains and
transforms frontline health professionals to make serving the
underserved a lifelong choice. And so, over the last five years, we’ve
had 150 frontline health professionals come through our program. And
half of them are U.S. doctors or nurses, and the other half are either
Navajo or from countries such as Haiti or Mexico or Malawi or India. And
so it’s this really diverse community of frontline workers that are
trying to get better at serving underserved populations.
And we worked in Navajo Nation for the last five years, since 2015, and
had partnerships. And I think it’s important to know that before
COVID-19,
Indian Health Service, Navajo population, what we’re seeing right now
is this trajectory of an underfunded health system, where
IHS is funded one-third the rate per capita as the VA or Medicare. And the level of inequity that you’re seeing and the
COVID cases
that you’re seeing in Gallup, as well as Chinle, it’s part of this
pattern. You know, in Michigan and Chicago, we know that in Michigan,
14% of the population are Black folks, and yet 40% of the deaths are
Black people. And in Navajo Nation and in New Mexico, 11% of the
population is Native American, but you see almost a third of the cases,
of
COVID cases, being Native American.
And I think in — I’ve been practicing both in Gallup, New Mexico, with
our team of volunteers, as well as Chinle, Arizona. In Gallup, I think
what’s amazing is that I am running a sprint, but my colleagues, like
Dr. Tom, have really been running this marathon for a long period of
time. And so, in Gallup, they’ve done an amazing job. I think you’ve
have seen this incredible local leadership, where they’ve been able to
put 125 unsheltered people, community members, into motel rooms and have
a collaboration to take care of them, as well as stop community spread.
And in Chinle, Arizona, this last weekend, I was taking care of
patients. And like you mentioned, Amy, there’s been four generations — a
great-grandmother, a grandmother, a mother and daughter — that were all
hospitalized. And I think that this is what the Navajo — my Navajo
colleagues have been dealing with for the last six weeks. And the surge
is upon us, where, taking care of a grandmother this last weekend, we’re
always deciding whether these facilities can manage.
And it’s such a humbling disease, because a lot of the facilities that
we’re in, once you intubate the patient, you have to transfer them to
Phoenix or Albuquerque. And so, all the providers are trying to learn
what is the trajectory, because every time you intubate a patient, it’s
just one more level beyond what we deal with in San Francisco, because
the Navajo people, where the land is so sacred, they are going to wake
up isolated in another city, such as Phoenix or Albuquerque. And I think
that that is humbling. So, the providers, the Navajo providers, are
trying to see how much can they take care of their patients in their
facilities, and when is it not safe anymore and they’re going to have to
transfer patients out.
JUAN GONZÁLEZ: Dr. Shamasunder, I wanted to ask you about the extraordinary mobilization of the tribal authorities to combat
COVID-19,
and also how the government of New Mexico, the state government, has
responded. Obviously, there was a lot of reports about the state
invoking the Riot Control Act and sealing off Gallup. Could you talk
about both, the state response and the tribal government response,
especially in view of what we’ve been seeing of the relative inaction at
the federal level on this disease?
DR. SRIRAM SHAMASUNDER: Yeah.
I think that the incredible resourcefulness and resilience of the
Navajo people is totally apparent when we come here. We actually met
with President Nez, the Navajo president, when we arrived. And he’s
really been on the forefront of having people shelter in place. And
really, you know, like Dr. Tom was saying, when you’re trying to shelter
in place and you live with eight or 10 people and this expansive
definition of family where the community is so connected, you’re going
to have community spread. And so, the outbreak, I think, in Navajo
Nation is not a lack of leadership. I think President Nez has been
incredible at having these weekend lockdowns, which is extremely
difficult for the Navajo people, and is really leading with wearing
masks in public, and so doing all the right things, I think, from the
national sovereign level. And he’s been very vocal to say that the
federal response has been extremely slow.
And that’s what I’ve seen in Chinle, Arizona. We have
HEAL fellows that are behavioral health coaches, that are not — are usually not taking care of
COVID patients at this time, so they’ve taken over the cafeteria and are making
PPE and sewing
PPE, and so the whole cafeteria has folks sewing
PPE.
So, I think you see, from the top of the Navajo leadership to the
citizens and health professionals, really leading an incredible
response. And the federal government has just been incredibly slow.
And then, obviously, Gallup is a border town, which is not under
jurisdiction of the Navajo government, but it is an area where a lot of
Navajo people come to get groceries, come into town, and there’s a lot
of activity. And it’s the second-highest caseload of new cases in the
country in the last two weeks. And, you know, I’m here. I’m going to go
on shift later today. And the Gallup providers have just said — earlier,
last week, they said, you know, “I don’t think we need you.” And this
week, they’re saying, “We’re getting exhausted. The surge is just coming
and coming, and there’s more and more patients. And we need you to help
out and do some shifts.” And I think the New Mexican government has
been strong and really almost following the lead that the Navajo
president has put in place.
AMY GOODMAN: And
finally, Dr. Michelle Tom, we have 30 seconds. What you feel the rest
of the country should understand, especially with compromised
healthcare, in general, in the area, due to poverty, due to uranium
mining and how that compromises the health of so many people?
DR. MICHELLE TOM: Yes,
it’s just access, just funding. And it’s kind of made our work harder.
But like Dr. Sri said, we’re coming together as community. I’m proud of
our nation. I’m proud of the facilities I work for. And yeah, just
getting the public health notice out there, of just wash your hands,
social distancing, maybe hand sanitizer, and really just listening to
our leaders right now, and healthcare professionals. So, you know —
AMY GOODMAN: We want to thank you so much, Dr. Michelle Tom —
DR. MICHELLE TOM: Thank you.
AMY GOODMAN: —
speaking to us from Winslow, Arizona, Navajo Nation family physician,
one of the few Navajo doctors on the reservation. And Dr. Sriram
Shamasunder, associate professor of medicine at University of
California, San Francisco, has led a group of doctors and nurses to
Navajo Nation, has been doing that since 2015, and in Gallup, New
Mexico, right now, which is under lockdown.
When we come back, the pandemic in prisons. We go to one prison in Ohio
where 80% of the prisoners have tested positive, half the staff. We’ll
go to Marion. And we’ll talk about prison abolition. Stay with us.
[break]
AMY GOODMAN: That’s the audio premiere of Steve Earle’s new
song, “Union, God, and Country,” from his latest album,
Ghosts of West Virginia,
that will be released May 22nd and centers on the Upper Big Branch coal
mine explosion that killed 29 men in that state in 2010, making it one
of the worst mining disasters in American history. Steve Earle says,
quote, “West Virginia was the most unionized place in America until very
recently. Upper Big Branch was the first non-union mine on that
mountain — and it blew up and killed 29 men. This is a song about better
days,” he said.