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Today, Native women are using traditional methods to heal the wounds of disease, poverty and and under-funded health care budgets.

On an early spring afternoon, nestled in a steep ravine in the middle of the Pine Ridge Reservation, the inside of her cramped trailer has an orange glow and smells of pine and sweet grass. Vibrant red and yellow star quilts adorn the walls, now yellowed from nicotine and age. Tiny plastic bags of medicinal plants – sage for colds, bitterroot for toothaches, valerian and mint tea for insomnia – peek out of a large plastic box on the kitchen table.

Today, Rose Mesteth is reflecting on her former nursing career and how all the herbs and plants found in the homeland of the Oglala Lakotas has changed her view of Western medicine.

After two years as a Vietnam combat nurse and 28 years at an Indian Health Services hospital, Mesteth had had enough.

She left nursing and returned to her roots, to the way her grandparents had taught her to heal with plants .

She believes in treating people – not just their bodies.

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Journalism students from UNL’s COJMC taste a native delicacy at the home of Rose Mesteth on the Pine Ridge Reservation in South Dakota and learn a lesson about differences between the “white world” and “indian country.” According to Rose, it doesn’t look like something else, it just is.

Mesteth is stuck between two worlds. On one side is modern medicine. On the other are the traditions of her people. It’s been that way for as long as she can remember.

“Western medicine wants to only heal the body, but you’ve got to look at something else too: mind, heart, soul, spirit,” Mesteth said. “At the point the body shows physical ailments, some other problem hasn’t been dealt with, and it manifests itself in sickness.”

Although Native healing traditions typically are linked to medicine men, women historically had a significant influence on the health and well being of their families. In fact, for many tribes, it was women who treated the sick, restored balance to the spiritually wounded and gathered medicinal plants, the uses and whereabouts of which had been passed down by elders.

Today, after generations of drastic social and cultural changes, many Native Americans face epidemics of diabetes, alcoholism and obesity. But some are countering the devastating health problems by merging the old ways with the new. And often it is young Native women who are spear-heading this effort.

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Rose Mesteth demonstrates a natural toothache remedy to some of the UNL COJMC students in her home on the Pine Ridge Indian Reservation in South Dakota.

A prominent example is Dr. Lori Arviso Alvord, a Stanford-trained physician who was the first Navajo woman to become a board-certified surgeon. But in 1991, when she returned to work in a Navajo community in New Mexico, she discovered that “although I was a good surgeon, I was not always a good healer.”

So she sought help from a Hataalii, a Navajo medicine man. He told her to connect with her Navajo patients, who felt powerless within the impersonal Western model, by incorporating more harmony and positive thinking into her practice.

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Rose Mesteth prepares a relaxing drink for overly energetic UNL journalism students who have invaded her home on the Pine Ridge Reservation in South Dakota.

Today, Dr. Alvord, who now helps train the next generation of doctors at the Dartmouth Medical School, encompasses many aspects of the role healers traditionally played in Native culture. She also reflects how that role is adapting to meet the medical challenges of today and tomorrow. That role includes:

  • A traditional approach focusing on long-established tribal healing practices.
  • The modern medical professionals who blend Western medicine with the traditional.
  • Understanding how mind, body, soul and the environment affect health, what the Navajo call hózhó, meaning “everything in beauty.”
  • Trying to drastically curtail the high rates of disease plaguing Indian Country.
  • Students investing in medical careers to improve the lives of their people.

Someday, Alvord said, many more patients may be introduced to traditional Native healing principles and the concept of hózhó.

“We are more comfortable and we heal better when we are at peace with out treatment,” Alvord said. “If we have a beautiful surrounding and doctors who connect with the patients and patients who participate in their healing, we are better off as a health care community.”

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During the bitter cold winter of 1535, French explorer Jacques Cartier’s North American expedition lost 25 men to scurvy. Isolated and desperate in present-day upstate New York, Cartier encountered a local Iroquois chief who took him to the women healers of his tribe.

The medicine women gathered bark and needles from the hemlock – a “magical tree,” boiled the branches and needles and then told the explorers to drink the concoction. It saved every explorer’s life.

“No amount of drugs from Europe or Africa,” Cartier wrote in his journal, “could have done what the Iroquois drugs did in a week.”

Although traditional Native healing practices vary among tribes, most are deeply embedded in Native culture and religion: The Navajo practice sandpainting; the Lakota use sweat lodges to heal; and the Iroquois’ False Face Society relied on wooden masks to frighten evil spirits from the body. Traditionally, many tribes also used plants, herbs and roots to heal the sick.

Sanapia, a traditional Comanche medicine woman who died in 1968, specialized in treating a type of recurring paralysis she called “ghost sickness.” Like many others, Sanapia became a healer through family tradition and by conquering her own illnesses.

She first diagnosed her patients’ spiritual problems and gave them a purifying bath to reduce the power of harmful spirits. She then summoned an eagle spirit helper to find appropriate herbs. In a trancelike state, she would chant and massage the patient with herbs.

Shortly before her death, she said she was not opposed to scientific medicine but believed her cures offered more complete and permanent relief because they attacked the root cause.

Sanapia knew the uniqueness of her skills and her position in her tribe, but she foresaw the final end of her traditions.

“I just can’t think how it came this way. Maybe I should be with my (dead) grandmother because my way is getting no good today,” Sanapia said as she sat overlooking skyscrapers in Oklahoma City. “Even my own kids growing up like white people, they think I’m a funny old woman.”

Today, women like the Oglala’s Mesteth, who teaches a summer camp on traditional herbal healing, keep some of these traditions alive by spreading the knowledge passed down by elders.

Although traditional herbal healing is popular on Pine Ridge, she said, it will never become mainstream because of too many regulations, misconceptions and fierce opposition from drug companies.

“This healing will eventually die,” says Mesteth, whose mother and grandmother used herbs and plants to treat the sick. “Most of the younger generations are just not interested in this. They are too close-minded and have been indoctrinated with the idea that ‘the white way is the right way.’”

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In the early years of the 20th century, Susan La Flesche Picotte kept a yellow lantern on her front porch every night, a beacon of hope for many sick Omaha Nation families and white neighbors desperate for medical care.

The young Omaha woman was the nation’s first Native female doctor.

As a doctor, Picotte became so active in the community that she was the informal leader of the Omahas. She dreamed of opening her own reservation hospital, a dream realized in 1913, just two years before her death.

“Her story is a litany of frontier vignettes of which classic legends are made, and it needs no embellishment,” Dennis Hastings, historian for the Omaha Tribe, noted in a La Flesche biography. “Dr. Susan could very well emerge as one of the more notable heroines in American history.”

A century later, Dr. Alvord, who grew up in a remote town on the Navajo Reservation, skirted cultural, class and educational boundaries to become part of a medical world where minorities received few opportunities.

In fact, her college advisers at the University of New Mexico told Alvord to not get her hopes up and even discouraged her from attending medical school.

In her book “The Scalpel and the Silver Bear,” she says colleagues told her, “As a minority physician you will constantly be challenged, your decisions will be questioned, your authority doubted. To be successful you will have to have higher standards than anyone else.”

Those words still hold true, she said, as her authority is questioned in the operating room and occasionally at Dartmouth.

Alvord’s Navajo heritage also created unique problems. By custom, her people aren’t allowed to touch the dead, and it’s unacceptable to touch another person without knowing them.

Yet throughout her medical career, she routinely touched cadavers and operated on patients. She justified her actions because they saved lives.

After a successful six-year stint as a surgeon in Gallup, N.M., Alvord returned to her alma mater, Dartmouth Medical School, where she is the associate dean of Student and Multicultural Affairs.

One day, she hopes to open her own hospital back on the Navajo rez – a hospital with aesthetic beauty and a sense of calm, a hospital in hózhó.

***

The word hózhó is almost lost in translation. Harmony, peace, balance and beauty are as close as it gets.

To be in hózhó is to be deeply connected to your environment – an ideology that defines Navajo, and to some extent, the Native philosophy of healing.

A Navajo prayer states: “Beauty is before me, and beauty behind me, above me and below me, hovers the beautiful. I am surrounded by it, I am immersed in it. In my youth, I am aware of it, and in old age I shall walk quietly the beautiful trail. In beauty it is begun. In beauty it is ended.”

Mind, body, soul, spirit – medicine and religion are one and the same, Alvord said. It’s the concept of finding the underlying problem that is causing the illness, rather than simply curing the ailments. It’s about being in balance, having harmony in all facets of life.

“It sounds mystical and spiritual, but it sounds like how science describes us,” Alvord said. “Carbon creatures share and exchange carbons all the time. We are interconnected with the world.”

So she looks for the places in the patients’ lives – relationships, work, community and environment – where things are out of balance. When she finds them, she conveys them to the patients, who then have to make the lifestyle changes. She can only give the recommendation.

She also looks at the environment. In 1993, for example, a mysterious disease swept through her New Mexico reservation.

That year, a wet summer triggered a large fall crop of pinon nuts, which in turn triggered an explosion of deer mice. The mouse droppings contained a Hantavirus that unleashed multiple problems, including flu-like symptoms. She eventually lost a patient to the disease. It was one of her first deaths.

In Dr. Alvord’s words, the natural patterns of the universe were disturbed. Everything had not been in hózhó.

***

Natives, more than any other population in America, face amplified rates of alcoholism, obesity, cancer, tuberculosis and diabetes. And often, it is Native women who are fighting the effects of these killers.

Diabetes is a significant concern for Yvette Roubideaux, director of Indian Health Services, who has worked on diabetes prevention and care research for 12 years. More than 9 percent of Native Americans have Type 2 diabetes – almost three times the nation’s rate.

“When you think that none of our tribes really had any substantial or even recognizable problem with diabetes 100 years ago, and now in some of our communities, one out of every two adults has diabetes, you think about what’s the difference between then and now?” said Roubideaux, a member of the Rosebud Sioux tribe. “The whole way people live their lives is different.”

With modernization comes decreased physical activity; with a Western diet comes larger portions and higher rates of obesity. Add it all up, Roubideaux said, and you get an outbreak of chronic problems like heart disease, cancer, obesity and diabetes.

Cancer rates, previously reported to be lower in Natives, have increased significantly in the past 20 years. It’s now the second-leading cause of death among Natives older than 45, according to the National Library of Medicine.

And cancer is no stranger to Dr. Marilyn Roubidoux of the Ioway tribe, whose relatives have fought many battles with the disease. She finds satisfaction in bringing mobile mammograms to reservations where breast cancer screenings aren’t readily available.

When she pursued radiology in college, she didn’t know how it would relate to helping her people until she helped develop this remote mammogram method.

“I thought, ‘Maybe this is what I’m supposed to do,’” said Roubidoux, who graduated from the University of Utah School of Medicine in 1984.

Meanwhile, Dr. Jennifer Giroux, a Rosebud Sioux physician, started her career as an epidemic intelligence officer with the Indian Health Service. For more than a decade as a medical epidemiologist, she promoted preventive measures to lower the rates of tuberculosis and HIV infection, cervical and breast cancers and diabetes among Native populations.

In 1998, Dr. Giroux investigated the 17 American Indian tuberculosis cases in South Dakota
and found a 41 percent mortality rate.

Historically, the majority of TB cases in South Dakota are found in the Native population, a population that comprises about 7 percent of the state’s population but 70 percent of its TB cases.  It was unusual to see such a high mortality rate, she said, noting that TB rates have declined in the past decade.

“It is still a significant health disparity, and it is decreasing slower for American Indians than ideal,” Giroux said.

But Native people, she said, are more knowledgeable about the free prevention “available to all of us when we exercise, get the rest we need, eat healthy and avoid excess alcohol.”

Dr. Alvord, the Navajo surgeon, said processed foods and stagnant lifestyles are killing her people, who traditionally had diets high in vegetables and grains and had active lifestyles.

“Obesity was rare for our people 150 years ago,” she said. “The new foods they gave us devastated our population. If we return back to our original ways and diet we may be able to decrease health care disparities and the harmful effects of obesity.”

Meanwhile, alcohol-related deaths account for 11.7 percent of all deaths among Native people, which is twice the rate of the general population.

Because of a small budget, reducing alcoholism isn’t a priority for IHS, Roubideaux said.

“I think IHS has a role in improving the health of the community and encouraging healthy habits, but we can’t do it alone,” Roubideaux said. “The resources we have are for immediate care services. Until the budget increases, it limits what we can do.”

***

The stories of three young Native women in different parts of the country are almost identical: They waited for hours to see a doctor and endured crowded hospitals – conditions that have partially inspired each to seek a medical career.

Shontel Mousseau, an Oglala Lakota high school student on the Pine Ridge Reservation, loves children. She wants to leave her impoverished reservation, become a family physician, then return home to treat Lakota children.

“I want kids to feel comfortable with their doctor,” Mousseau said. “I want to make our community feel better.”

Rachel Ray, a Cherokee in her fourth year of medical school at Oklahoma State University, became inspired after shadowing a Native doctor at an IHS clinic in Oklahoma City. Someday, she wants to connect with her patients not only on a medical level but also on a cultural one.

“I think a sad part of Indian health care is the way patients feel about their providers,” Ray said. “Most physicians serving in IHS are not of Native American descent and do not have a full understanding of the culture.”

But groups like the Association of Native American Medical Students are striving to provide support and a resource network to increase the number of Native medical students.

Naomi Young, a medical student at the University of Arizona, grew up learning about traditional medicine from her grandfather but was mostly treated in the Western way. Throughout her training, she’s tried to incorporate Navajo prayer and walking in beauty at school.

A former president of the Native medical student group, Young said ANAMS will help bridge the ratio gap of Native patients to Native physicians.

The statistics are providing some hope. More Native women are finishing college than ever before, and more are entering the medical field.

The number of Native women applicants to medical school has increased since 2003. It peaked in 2007 with 77 Native women applying across the nation. Over the past decade, an average of 24 Native women were accepted each year.

Ray said the increasing numbers of Native women students encourage her and said she hopes it will continue.

“The support of those of us who have already walked this path will serve as role models to the upcoming generations who wish to practice medicine,” Ray said. “These students can see that no matter your upbringing or where you came from, you should always pursue your dreams and never give up.”