A forgotten health crisis in Navajo lands

On my first reporting trip to the Navajo Nation, I decided to drop by a school that was troubled in almost every way. Gallup Central Alternative High School, a rundown building surrounded by vacant lots, had some of the lowest test scores and highest dropout rates in the state.

The principal, an educator in Indian Country for more than 30 years, told me his students faced obstacles at every turn.

What problems were the worst? I asked. I imagined he would mention poverty, childhood trauma or substance abuse.

“Roads,” he said. He waited for me to take that in. “And it would help if more students had running water at home,” he added.

His comments were eye-opening — and so were the roads, homes and living conditions I saw in the days to come. I’d written about life on tribal lands in Montana, South Dakota and Canada. But I’d never encountered anything like the Navajo Nation.

The reservation, the largest in the country, is a 27,000-square-mile swath of high plains and desert in New Mexico, southern Utah and Arizona — an area as large as the state of West of Virginia. It is home to roughly 250,000 residents.

More than a third of the Diné (“the people,” in Navajo) live without electricity, paved roads, cell phone service, landlines, safe housing or other essentials of modern life.

About 75 percent of the roads are dirt and washboard, most of them studded with rocks and wheel-swallowing potholes. The dirt turns to gumbo in rain and snow; the roads become impassable.

School buses can’t navigate their routes to pick up children, as the principal explained to me. Many parents don’t have cars; they can’t deliver kids to school on time, or at all. Winter is a nightmare of school delays and cancellations. A majority of children are already struggling academically, and missing class leaves them farther and farther behind.

Up to 40 percent of households in some areas don’t have clean running water at home, a problem so acute that the Navajo often compare the region to sub-Saharan Africa. These families don’t have tap water to wash their hands, cook a healthy meal or bathe.

People haul water home in plastic containers, driving as much as 20 miles each way to fetch it from unimproved wells or livestock tanks, where water is potentially contaminated with fecal waste, E coli, viruses, parasites, arsenic or uranium.

Some Diné live on 10 gallons of water a day, the equivalent of two or three flushes of a toilet. (Most Americans, by comparison, use about 100 gallons a day.) The lack of clean water has many of the same health consequences as in parts of Africa, including high rates of hospitalizations for severe diarrhea, which can be life-threatening for children under 5.

The Navajo Nation, in addition, has more substandard housing than any tribal lands in America, federal reports say. Families with small children and elderly grandparents live in ramshackle mobile homes that lack heat, windows or proper roofs. To stay warm in winter, people burn coal or wood inside the house, releasing toxic smoke that’s linked to high rates of lung disease.

The problems are hardly new: A Senate hearing detailed the very same issues in 2007. As Sen. Byron Dorgan (D-North Dakota) then testified, “One in five reservation homes lacks complete plumbing, and 90,000 Indian families are homeless or under-housed. It is not uncommon in Indian communities for 25 to 30 people to share a single home.”

Eleven years later, the problems remain.

Up to a third of people on the Navajo Nation today lack heating, plumbing, or fully equipped kitchens. Indoor toilets are a luxury. Few communities have proper sewer systems, and it’s not uncommon for septic tanks to collapse under the weight of cars.

Many people lack homes altogether. In Gallup, the homeless sometimes sleep in fields and ditches; more than a dozen people freeze to death each winter. In 2015, 17 people died in open fields or alleys, all of them Native American. In 2014, three men were found dead of hypothermia in a single day. 

The problem would be worse if it weren’t for the fact that families in Indian Country open their doors to people who have nowhere to stay. Nearly 100 percent of respondents to a federal survey said they had friends or extended family sleeping on couches or floors in their already overcrowded homes. Some school districts employ a full-time person just to keep track of the homeless students who ping-pong between friends and relatives.

When there’s no electricity, children can’t turn on a lamp to do homework after dark. Parents can’t serve fresh, healthy foods, because they don’t have electricity for a refrigerator. They wish for better roads so they could get police or an ambulance to their door in an emergency. They wish for phone service.

Landlines rarely exist and cell phone signals are spotty. The common Diné words for cell phone are "bil n'joobal'," and "hooghan bik bil dahjilwo" – loosely translated as “thing you use while spinning around” and “thing you use while running uphill” in search of a signal, locals say.

My 2018 National Fellowship project will investigate the lack of infrastructure, which creates profound challenges for families already struggling with extraordinary disadvantage.

Access to clean water, among other things, is considered a universal human right, essential for health and human dignity.

The lack of water in other parts of the globe attracts international attention, charitable work and millions of dollars in donations. A Google search for “water NGO Africa” delivers 47 million results. Search for “water NGO Navajo” and you get 300,000 results, one of them a document aptly entitled “The Forgotten People.”

I plan to drive thousands of miles and visit as many families as possible to portray what it means to be this forgotten, for this long.