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Pandemic Exposes Navajo Nation’s Water Access Crisis and Health Disparities

The Navajo Nation is one of the largest tribal nations in the United States and the hardest hit by the outbreak.

As the COVID-19 death toll continues to rise in the U.S., fear is mounting that the spread of the virus could devastate tribal communities. We look at how the coronavirus is impacting Indian Country with Dean Seneca, a citizen of the Seneca Nation and epidemiologist who spent nearly 20 years as a senior health scientist for the Centers for Disease Control and Prevention, and Navajo activist and artist Emma Robbins, director of the Navajo Water Project, a community-managed utility alternative that brings hot and cold running water to homes without access to water or sewer lines. “One of the hardest things right now is being able to wash your hands in the Navajo Nation,” says Robbins. The Navajo Nation is the largest tribal nation in the United States and the hardest hit by the outbreak, with nearly 30 deaths and more than 830 confirmed cases.


AMY GOODMAN: This is Democracy Now! I’m Amy Goodman. Democracy Now! The Quarantine Report, as we broadcast from the epicenter of the pandemic, New York City.

We turn now to look at how the coronavirus is impacting Indian Country. As the COVID-19 death toll continues to rise in the U.S., fear is mounting the spread of the virus could devastate tribal communities. Already at least 44 people in the Indian health system have died. There are more than 1,100 confirmed cases, according to Indian Country Today.

Navajo Nation, which stretches some 27,000 square miles across portions of Arizona, New Mexico and Utah, has been the hardest hit by the virus so far, with more than 830 reported cases and 28 deaths as of Tuesday. In Arizona, 16% of COVID-19 deaths have been Native Americans, who make up only 6% of the state’s population. Meanwhile, two pueblos in New Mexico, Zia Pueblo and San Felipe, have some of the highest rates of infection in the United States. In Oklahoma, the first COVID-19-related death in the state was a citizen of the Cherokee Nation.

And experts warn these numbers will only grow due to a disproportionate number of preexisting health conditions in tribal communities and resource-starved tribal healthcare systems ill-prepared for the pandemic. The coronavirus federal stimulus package provides $8 billion in relief for the 574 federally recognized tribes, but many say far more is needed to adequately protect indigenous people from the virus’s spread.

For more, we’re joined by a public health leader for American Indian and Alaska Native populations, epidemiologist Dean Seneca. He spent nearly 20 years as a senior health scientist for the Centers for Disease Control and Prevention. He’s now executive director of Seneca Scientific Solutions Plus. He’s a citizen of the Seneca Nation.

Welcome to Democracy Now!, Dean Seneca. Can you give us a lay of the land right now? How hard has the pandemic hit Indian Country here in the U.S.?

DEAN SENECA: Well, thank you. Thank you for having me.

The pandemic, it’s hit pretty hard in certain areas throughout Indian Country. Like you said, the Navajo Nation is definitely hit the hardest. And some areas where we have high populations or cities where people can come together, we have a sparsity of cases, you know, for example, in Portland, Oklahoma and some other areas. But overall, given the situation that Native people are in regarding health disparities and preexisting conditions, except for Navajo Nation, I think we’re not doing that bad, as far as the pandemic hitting Indian Country. You know, with just 12,000 tests only and over 1,100 confirmed, like you pointed out, many at Navajo Nation, the rest of the country is faring pretty well, in my opinion, given what the outbreak has done throughout the rest of the country.

Now, having said that, my fear is that the virus hasn’t really hit rural America yet. And as you know, many of our tribal nations throughout the country are in rural America. So, that will be the big test. I feel that it will be a matter of time before we really see if the spread has hit into the deep pockets of Indian Country.

AMY GOODMAN: I wanted to go to Navajo Nation for a minute, the largest tribal nation in the United States and the hardest hit by the coronavirus outbreak, with nearly 30 deaths and more than 830 confirmed cases as of Tuesday. Government and health officials, as well as community members, are scrambling to protect the roughly 175,000 people living on and around the reservation, as many residents still lack access to clean water and face the scarcity of other resources that are crucial to curb the spread of the daily virus. I wanted to go to Navajo Council Delegate Amber Crotty.

DELEGATE AMBER CROTTY: When you come back home to your remote area, you’re surrounded by family and friends. And so, that’s where the contact also happens, when you’re in a household with multigenerational families, grandmas in the household, with grandpa. Then it’s you, and then it’s your children, and possibly if you have older children. And so it’s multiple generations that are being hit, and that’s what we’re seeing. And the remoteness now, we can — as long as we’re moving, the virus is moving with us. It’s just shedding light on the disparities that have already existed and also the lack of federal funding to meet the demand of the health needs.

AMY GOODMAN: Navajo Nation is currently on lockdown. Meanwhile, Navajo Nation President Jonathan Nez and Vice President Myron Lizer have quarantined themselves after learning they came in contact with someone who tested positive for COVID-19. Neither of them is currently presenting symptoms.

I’d like to bring Navajo activist and artist Emma Robbins into the conversation with Dean Seneca. She’s the director of the Navajo Water Project, a community-managed utility alternative that brings hot and cold running water to homes without access to water or sewer lines.

Emma, welcome to Democracy Now! I wanted to ask you — I mean, if people were to say what’s the number one rule all over the country right now, it’s wash your hands, and wash them well and often. Talk about Navajo Nation, how hard hit is right now, and your access to water.

EMMA ROBBINS: Yeah. Good morning. Thank you, Amy, for having me.

As you mentioned, one of the hardest things right now is being able to wash your hands on the Navajo Nation. If you don’t have hot and cold running water and access to soap, that’s extremely difficult. And as we’ve all heard throughout the past weeks, that’s one of the ways to flatten the curve the most.

In addition to that, not having drinking water on the reservation is very difficult, because when you need access to running water, you need to actually get bottled water and travel to these different grocery stores. And a lot of times when residents arrive, there just isn’t any left.

AMY GOODMAN: And so, talk about how hard hit Navajo Nation is right now.

EMMA ROBBINS: Yeah, as mentioned, you know, we’re one of the hardest-hit areas. Not only does our reservation have an extremely high infection rate, but those surrounding ours, as well, of the Pueblo Nations, do, too. So it’s very concentrated in one area. As you mentioned, there are over 800 cases of COVID on the Navajo Nation currently. And unfortunately, we’ve lost 28 community members.

AMY GOODMAN: Dean Seneca, if you can talk about the Trump administration’s response to the pandemic in Indian Country, and overall? I mean, you, for years, worked for the — you’re an epidemiologist, you’re a citizen of the Seneca Nation, and you worked for the Centers for Disease Control, an agency that now everyone in this country has come to be familiar with.

DEAN SENECA: Well, as you can tell, you know, right from the very beginning, I mean, he didn’t make this pandemic a priority. He did a lot of mixed messaging in the very, very beginning when he started to talk about this. And you see that he’s trying to now — in his recent reports, trying to justify that, “No, we were on top of this right from the beginning.” And that’s far from the case. You know, his mixed messaging is what was really critical. At times, he would say, “Well, hey, this virus is just going to go away. And we’ll wake up one day, and it won’t be here.” You know, people listen to this information, and that is the wrong thing to send. He made a major mistake in eliminating his council on international health and global pandemics. That was huge right from the beginning. He should never have done that.

AMY GOODMAN: And explain. That was in that National Security Council. So, when he’s talking in — what? — December about more money for bombs and building a wall, if that pandemic group were represented, they would have said, “Sir, what about China?” although it’s clear, very early on, the intelligence agencies, his closest Cabinet members, I mean, heads of agencies —

DEAN SENECA: Correct. Correct.

AMY GOODMAN: — were actually warning him about this.

DEAN SENECA: Yes. And he kind of put it aside, thinking that the pandemic would never leave China and reach the United States. And actually, one of the things that I predicted early, when I saw 20,000 cases in China, I said the virus is already here. And I said that, you know, way before many of the experts.

But here’s the big thing. When I did the Ebola outbreak, you know, I can say with certainty that the White House, CDC, FDA and USDA were literally connected at the hip. OK? I think that that’s one of the big things that made us successful, is that our communications were very, very tight, and we were working together and communicating several times a day.

During this response, we know that the White House is really, really struggling on who is in charge and who’s overseeing this. At one time it was CDC that was in charge. Then they recently moved it to the FDA. So they were scrambling for leadership there. And, you know, that speaks to poor leadership right from the top. I hate to say that, being a veteran myself, a military person in the Army, Army Reserves. I don’t ever want to see the United States fail. But I really do feel that the administration really did not get on board in a timely manner when they needed to. That’s evident. The leading expert from NIH has also pinpointed to that a little bit, and then he had to go back on TV recently to justify his hypothetical comments.

So, you know, strong leadership right at the beginning of a pandemic like this is critical, is essential, because we’re fighting a war. This is a war where you can’t see the enemy. You don’t know where the enemy is. The enemy can be around you at any time. And you have to do your best to protect yourself. This is a different kind of war. And in any kind of war, in any kind of situation like this, you need strong leadership. And that’s evident it did not happen.

AMY GOODMAN: Your perspective is an unusual one, Dean Seneca. You’re there in Seneca Nation, upstate New York. You’re a Native epidemiologist, worked for the CDC for years. You took on Zika and H1N1. Explain the differences.

DEAN SENECA: Well, you know, the big difference is, you know, those viruses really — I mean, they did hit the United States, but they never hit the United States hard. And we were able to do very effective contact tracing. And that’s one thing I’ve been preaching throughout this whole pandemic, is that contact tracing is the tool in which we can really stop and mitigate an outbreak.

But, you know, H1N1, we had a few cases here, something that we never saw before as a country. We ramped up our emergency operations components. You know, we did see a couple deaths, and we did see a minor spread. And then, after a while, it was another strain of the flu, very, very different. It did give us an opportunity to kind of exercise our emergency preparedness capabilities.

Zika, a little bit different. It did impact a little bit the southern part of the country, but not a major life-threatening situation with Zika — not in all cases, but, you know, pretty much the southern border, a different kind of a situation where it was a vector-borne virus that was transmitted, and it caused several different chronic conditions. This, the corona —


DEAN SENECA: Oh, yeah, and Ebola. And I must say that Ebola was probably the hardest thing that I ever did in my life, when you go overseas and you have to prepare for something like Ebola, which is, you know, a very violent kind of hemorrhagic fever where the body, when infected, literally bleeds internally. You know, that was the hardest thing I ever did, very dangerous situation. I went over there, and I was part of a team of scientists, I’m proud to say, that actually were a part of putting the curve into the ground. And what we did there is we went from passive epi-surveillance to active epi-surveillance, to prospective, you know, being active and getting out into the community and seeking cases ahead of time, instead of people being sick and getting this information reported to us.

AMY GOODMAN: So, Dean Seneca, when you hear that President Trump is ending funding for the World Health Organization, what is your response?

DEAN SENECA: This is a very ill-responsible move on behalf of a leader that is leading the world in good public health and leading the world in almost every facet — economics, military, education, health. You know, it’s just — really speechless at how ill-responsible that move is. If anything, we should be trying to work with the WHO, which is such a very nonpolitical, very, very passive, has a lot of empathy organization. You know, it’s a caring organization. They try to do their best with the limited resources they have. And they’re all around the world.

AMY GOODMAN: And very quickly, Dean Seneca, for understanding how Indian Country works, when a governor like Governor Cuomo declares, you know, shelter at home, does that apply to the reservations in New York, or do you issue a separate order?

DEAN SENECA: Well, what I’ve been promoting is that — you know, we coordinate with our state and local and county health departments, but tribal nations have the ultimate public health authority. And, you know, they need to exercise that public health authority when necessary. Given this situation, yes, we want our tribal nations to work with other state entities and those kinds of things in order to isolate and practice social distancing. And I know, for example, that Seneca Nation, recently, President Armstrong issued a stay-at-home order, which is a very, very good thing, to kind of reduce the spread of this virus.

AMY GOODMAN: I wanted to go back to Emma for a moment. One of the things we’ve been focusing on on Democracy Now! are the mutual aid efforts that are going on all over. This is Kim Smith, a Navajo woman who’s running a relief operation from a farm in Hogback, New Mexico.

KIM SMITH: We’re stepping up for the community members at a time that is so crucial. And that’s what we’re here for, ultimately, as young people, to be able to sacrifice ourselves, sacrifice our well-being, so that more of our people don’t get sick. And the reality is, is that our ancestors sacrificed so much more for us to continue to be here.

AMY GOODMAN: So, I wanted to go back now to Emma Robbins to talk about what is happening in Navajo Country — you run the Navajo Water Project, as we said before — the mutual aid that’s going on, and also why the Navajo community is so hard hit, a hot spot in — not only in places like New Mexico and Arizona, but in Indian Country overall.

EMMA ROBBINS: Yeah. You know, that’s such a great question, because the Navajo Nation experiences some of the highest rates of water poverty in the United States. Navajos are 67 times more likely to not have indoor plumbing and potable water and sanitation in their homes. And again, getting back to the idea of not being able to wash your hands, you’re not able to flatten the curve then. And we’ve seen a rise of COVID cases when that happens. As I mentioned, when people go out to haul water, whether that’s from stores or watering points, they’re also exposing themselves to others. I think it’s also been really tough because we don’t have a ton of health facilities across the reservation. And those that do have access to it often live very far away and aren’t able to get there in time.

AMY GOODMAN: And can you talk about the role of Navajo women in leading mutual aid?

EMMA ROBBINS: Yeah. I’m glad that you asked that question. I think I’ve seen many Navajo women step up and fight for our communities, which is our traditional role. That’s not to say that we’re in the ’60s and it’s the idea of stay in the kitchen. It’s that we are the caretakers of our communities. And this is nothing new for us. It’s time to step up and work together and just make it happen, where people are able to get the help that they need and to really just come back and serve our communities. I think of this as by Navajos, for Navajos, of projects that are happening on the reservation successfully.

AMY GOODMAN: And now the chairman of the Navajo Nation, Jonathan Nez, and the vice president — he’s the president — currently in quarantine?

EMMA ROBBINS: Yes, that’s correct. They do believe that they could have come in contact with COVID themselves.

AMY GOODMAN: And the hospitals and clinics on the reservation, are they adequate? And what do you think needs to happen at the national level in the United States? We’re talking stimulus package. The kind of aid that Indian Country is getting from that $2 [trillion] — it’s obviously much more — $4 [trillion], $6 trillion stimulus package?

EMMA ROBBINS: Yeah. So, it’s important to understand that on the Navajo Nation we have two types of hospitals. One is IHS, or Indian Health Service, which is across Indian Country. And then we have what are called 638 hospitals, which are hospitals that were originally part of the federal government but have been taken over by the tribal government. And on the reservation, there are 16 health centers. Nine of those are clinics. Seven are hospitals. There are about 400 hospital beds across the nation and 46 ICU beds. You know, talking about these numbers, that is not proportionate at all, and it’s scary to think about these numbers rising. And so, yes, we are a sovereign nation. Yes, we are able to help ourselves. But it’s also important that we do have our treaties honored and have that funding from the federal government, because this is when we need help. Right now we can’t wait.

AMY GOODMAN: Well, Emma Robbins, I want to thank you so much for being with us, head of the Navajo Water Project. And I want to thank Dean Seneca, epidemiologist and citizen of the Seneca Nation, where he was speaking to us from, in upstate New York. For years, he worked at the CDC, took on H1N1, took on Zika, took on Ebola, now dealing with this century’s most significant, hardest-hitting pandemic of all, the coronavirus.

This is Democracy Now! When we come back, why was an African-American doctor, wearing a mask, getting together his equipment to test homeless people in Miami, Florida, handcuffed? Stay with us.

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