Navajo Nation suffers from one of the highest COVID-19 infection rates in the U.S.

Lack of social distancing capability and limited access to running water are contributors in the sprawling Four Corners reservation

by Gail Strange | Presbyterian News Service

Trinity Presbyterian Church in Chinle, Arizona, is one of 10 Presbyterian Church (U.S.A.) churches or chapels in the sprawling Navajo reservation. (Photo by Steve Hirsh)

LOUISVILLE — As scientists work at a furious pace to find answers and a vaccine for the COVID-19 virus, the death rate from the pandemic continues to take its toll on this country, having taken the lives of more than 81,000 people as of Tuesday. Statistics tell us that in the U.S. this pandemic is killing black and brown people at a disproportionate rate in communities across the nation.

And, because this novel virus does not have a preference for where or whom it strikes, it appears to be taking a sizable toll on the rural Navajo Nation and its people. The Navajo Nation includes 27,425 square miles of land that extends into New Mexico, Arizona, and Utah, and borders Colorado, which makes Navajo the largest American Indian reservation in the United States.

According to the 2010 U.S. Census there are 332,129 Navajos identified as “Navajo tribal grouping alone or in any combination” (Navajo in combination) in the U.S., with 173,677 people living on the Navajo Nation.

Of the more than $2 trillion coronavirus federal stimulus package approved more than a month ago, $8 billion in relief — less than 4/10ths of 1 percent — went to the 574 federally recognized tribes. Tribal advocates say far more is needed to adequately protect indigenous people from the spread of the virus.

The Navajo Nation suffers from one of the highest COVID-19 infection rates in the nation. In the Navajo Nation and New Mexico taken together, 11% of the population is Native American, but almost one-third of the coronavirus cases are among Native Americans.

Jean Stowell, head of the Doctors Without Borders’ U.S. COVID-19 Response Team, told CBS News that the group has dispatched a team of nine to the hard-hit Navajo Nation because of the crisis unfolding there. The team consists of two physicians, three nurse/midwives, a water sanitation specialist, two logisticians and a health promoter who specializes in community health education.

“There are many situations in which we do not intervene in the United States, but this has a particular risk profile,” Stowell told CBS News. “Situationally, the Native American communities are at a much higher risk for complications from COVID-19 and also from community spread because they don’t have access to the variety of things that make it possible to self-isolate … You can’t expect people to isolate if they have to drive 100 miles to get food and water.”

Like African Americans, many Native Americans suffer from a number of health issues like obesity, diabetes and cancer. These co-morbidity factors coupled with other issues like the lack of accessibility to proper health care, poor diets due to food deserts, adverse socio-economic policies and status, and centuries of systemic racism directly impact the death rate of Native Americans suffering from the coronavirus.

Navajo Nation straddles the Four Corners region in Arizona, Utah, Colorado and New Mexico. (Map courtesy of Bureau of Indian Affairs)

A key element of fighting the virus is hand washing and social distancing. Kathy Mitchell, a ruling elder at the Trinity Presbyterian Church in Chinle, Arizona, on the Navajo reservation and a third generation Presbyterian, says this is not possible for many Native Americans for a number of reasons. “It’s a lifestyle,” said Mitchell. “Because we’re so rural we have a lot of intergenerational family living, maybe even in the same household. Three generations may be in one household. Access to water is another problem. It’s always been a struggle because it’s a very rural area. I’m fortunate. I live in town, but I can go 30 miles from here and people don’t have access to running water. People there [in the reservation] must haul water. So, they have their big barrels or something that they would use to go and get water.”

“There are families out there that can’t go to the kitchen, turn on the faucet and have water. They don’t have that luxury,” she said. “It was like that for my grandma … She would wash and rinse dishes in one pan. That’s reality for a lot of people.”

There are 10 Presbyterian churches and chapels on the Navajo reservation.  The Presbytery of Grand Canyon has raised funds to assist with food and has delivered 200 food boxes to help Presbyterian families and others in need and will be working with tribal government COVID-19 emergency relief program to distribute another 300 boxes of food.

Brad Munroe is presbytery executive for the Presbytery of Grand Canyon.

“This has been an amazing coming together of community with 18 different churches participating in the relief efforts,” said Brad Munroe, presbytery executive. “It was also an amazing bit of logistics by the Valley Presbyterian Church” in Paradise Valley, Arizona.

Munroe said that congregation’s recently-ordained pastor of Mission and Engagement, the Rev. Chris Woodard, handled all of the logistics for the relief effort. The church’s senior pastor, the Rev. David Joynt, worked the larger scene of connecting community help from Shamrock Farms and St. Mary’s Food Bank. “This was your classic Presbyterian connectionalism at its best,” Munroe  said.

Munroe says there are issues of systemic poverty on the reservation that must be addressed. And according to Mitchell, the pandemic is shedding light on any number of issues concerning the Navajo Nation. “What I don’t see, I don’t have to worry about,” she said. “But this crisis has shined a light on this problem.”

In addition to the lack of running water, there are only seven full-sized grocery stores in the more than 27,000 square miles of the Navajo Nation. That makes it necessary for many Native American families to drive to a larger town to purchase food and other staples. “Many of us grew up having to go to border towns to buy our food,” said Mitchell. “The nearest town is about an hour and a half drive.” Unfortunately, with the reservation’s sheltering-in-place restrictions, some are running out of food and household supplies.

In an article in Democracy Now!, Dr. Sriram Shamasunder, an associate professor of medicine at the University of California, San Francisco and the co-founder of the HEAL initiative, says the coronavirus hit the Navajo Nation hard due to a “trajectory of an underfunded health system.” Shamasunder notes the Indian Health Service is funded at one-third the rate per capita as Medicare and that the level of health care inequity is part of the pattern.

When asked about the availability of medical professionals and hospitals on the Navajo Nation and the virus, Mitchell said, “That depends on the type of care you need. We do have a hospital here. But if you need more intensive care, then they would fly you out to another town. So, people would either be flown to Phoenix or Albuquerque and that’s 400 miles away.”

A press release issued late last week from the office of the Navajo Nation President Jonathan Nez reported 103 new cases of COVID-19 and three new deaths. That brought the death toll to 88, with 2,757 individuals testing positive for the virus. Nearly 18,000 COVID-19 tests have be administered, Nez said, with close to 13,000 negative test results on the Navajo reservation.

“We have gone through so much and we will continue to do what we can,” said Mitchell. “I am staying hopeful. My faith is unwavering in knowing that God will see us through this.”