Important Lessons From the People We Ignore
My crash course in how Covid-19 is affecting Native American reservations and what we can learn from the 1980’s HIV crisis
Pine Ridge reservation has somewhere between 25,000 and 35,000 people over 100x100 miles in South Dakota. It’s home to the Ogala Sioux. Life expectancy is 48 for men, 50 for women.
With the Covid-19 crisis, a state of emergency was declared, but to get money they need to match it with money they don’t have. They did get clean water from the government which they were all too grateful for. There is one hospital run by the Indian Health Service. They have 6 ventilators. Their Covid-19 Council estimates that absent a vaccine, they will have over 2,000 hospitalizations. Otherwise people will need to be airlifted to a hospital 100 miles away.
They reminded me that what is coming to America — hunger, unemployment, poverty, and despair is their way of life. 80% unemployment. 98% below the poverty line. $4,000 median annual income.
Health status on Pine Ridge is also not good:
- 4x the level of diabetic amputation
- 4x the teen suicide rate
- 5x infant mortality rate
Alcoholism, meth, opioids, despair, hopelessness, and a sad resolve. Anyone I know who has been to Pine Ridge leaves sad, angry and confused.
I was reminded by Chase Iron Eyes that they have experience with plagues. So after their first positive Covid-19 test in late March, what did they do? they kicked the infected person (a visitor) out and set up check points. They don’t believe South Dakota Governor Noem will protect them. Few in South Dakota do.
They’ve gotten no test kits even though they have asked for them. As far as they know, they haven’t seen more cases. If they do, it could happen fast. As for food, their reserve supply are 400 buffalo.
They know that large death tolls would go unnoticed and without response. So they go without deliveries or commerce and do not leave the reservation. Once cases come, they do not expect help. So they hunker down.
Six weeks into Covid-19 and we hunger for answers. We know little about who gets it, the symptoms, how the disease progresses, what happens from the virus or how it works. So I called a friend who was an intern at San Francisco General in when the first AIDS patients started dying.
I was most struck by one thing he said about the AIDS crisis and what they saw then. “We knew within a short time what this was. Like within a year or two.”
We’ve only been at this for weeks.
The symptoms then were mysterious:
- PSP (a form of pneumonia)
- Kaposi’s sarcoma
- Wasting away
As it seems with Covid-19, the virus wasn’t the cause of death. The immune system was just destroyed. In the case of Covid-19, the immune system can be over-stimulated. I’m sure other people can give a much better scientific description. I was interested in what we thought we knew and how it turned out.
There were similarities and differences. The population was much narrower — gay men were stigmatized as were IV drug users. Rarely seen infections and cancers were seen as “the gay plague.”
At the time, the President wouldn’t utter the words HIV or AIDS for five whole years. Seven years before he gave a major speech. The political reaction today is different. It is happening to “us”, but this spreads more widely and slowness and denial played a different kind of role.
The death rate from AIDS was 98% before treatments were available. We don’t know the death rate from Covid-19, but it may be 1%.
AZT (an antiretroviral medication used to prevent and treat HIV/AIDS) has massive side effects. It took 8 years for there to be an anti-viral that worked. Zidovudine. But the dosages were too high. The virus mutated. This was the early 90s. After enough experimentation the cocktail was formulated. Almost 40 years later, there is no vaccine.
But today is different. In six weeks the virus was sequenced and a human trial underway. Ten years of work. Vaccine trials are underway as well. Science has advanced. We won’t wait that long. But 18 months to 2 years is really not much time for a thing like this.
I will tell you that since this pandemic, I’ve tried to open my eyes to people and things I don’t spend enough time seeing. The people we ignore.
I think of people we abandoned so long ago — free people who are now shut away. Hundreds of thousands of us dying and no one really caring to mention it. Plagues we’ve passed and plagues we’ve ignored.
In these times of stress we decide what we value. One thing Chase Iron Eyes said to me about the present moment; “We are willing to sacrifice our elders for our stock market.” But we also agreed something beautiful happens out of jarring moments, out of slowing things down, even out of shame. Our of appreciating for the smaller things grows. Maybe we wake up a little.
Pulled from my daily COVID-19 updates on Twitter
