Fighting Invisible Enemies

Brian Balogh:
In the early 20th century, Martha Manuel was a little girl growing up in San Manuel Indian Reservation in Southern California. She loved to play around the foothills of the San Bernardino Mountains. But one day something happened that caused Martha to become very ill.

Clifford Trafzer:
While she was playing with her cousin-

Brian Balogh:
This is Clifford Trafzer, professor of history at the University of California, Riverside.

Clifford Trafzer:
A shaman came out of the Aroyal, the wash, and he said to these kids, “You cannot play here. Now you go on, I’ve left something down here and I don’t want you to mess around here.”

Brian Balogh:
Shamans or medicine people were born with or given the gift of spiritual healing. They existed in every Native American group.

Clifford Trafzer:
They have power to find this energy that is out there around all of us, and then pull it in and then use it.

Brian Balogh:
Shamans were considered very powerful, able to affect the physical body with their medicine, for better or for worse.

Clifford Trafzer:
He left the area and the kids went away and played in another area but they got curious and came back to that area.

Brian Balogh:
Pretty soon Martha started getting sick.

Clifford Trafzer:
Her cousin got her home and her grandmother doctored her for a while, but they didn’t know what was wrong with her. She got a high fever. She was sweating. She was moving her head back and forth in delirium.

Brian Balogh:
Martha’s family got her into a hospital where she stayed for several days, but they couldn’t do anything for her. She was put into a horse drawn wagon and taken to Agua Caliente Indian Reservation in Palm Springs to see a high level shaman named Pedro Chino.

Clifford Trafzer:
He laid her down in front of a hot spring that is still there, of course at our Caliente, and he started praying and singing and he was asking for his familiar, his power to come to him so that he could diagnose what was wrong with this girl. As he was singing and praying, then he would smoke a cigarette and blow smoke on her. This is one of the diagnostic ways of shamen to find out where the problem was. Then he used his breath to blow over her body until he found it in her leg.

Clifford Trafzer:
Then he was a sucking doctor, and he probably used a pipe, a clay pipe to put it on the area and then sucked and pulled out a white worm. Then he took it and he threw it into the fire to kill it, and Martha woke up right away.

Brian Balogh:
While researching healthcare on Southern California reservations, Cliff spoke to many Native Americans who told them about the incredible healing powers of the shaman. But in the early 20th century, around the same time Martha got sick, there was a health crisis much bigger than a white worm and shamans were having a hard time fighting back against it.

Clifford Trafzer:
Infectious diseases were spreading among the Indian people of Southern California. Although some of the doctors, Indian doctors could address symptoms, they were not successful in getting rid of the various diseases.

Brian Balogh:
Decades of physical and cultural genocide robbed Native Americans their traditional diets and lifestyle, leaving them susceptible to infectious disease, particularly tuberculosis.

Clifford Trafzer:
By confining Indians to reservations in small areas, and then they could not live as they used to live so their housing was very poor, often living in shacks. In addition, that their food sources had been destroyed by settler communities.

Brian Balogh:
Tuberculosis and other infectious diseases also circulated at Indian boarding schools that would send children home to die and infect their families on reservations. Even though Native Americans were dying of tuberculosis at much higher rates the rest of the population, the government wasn’t doing anything about it. Many officials erroneously believed Native Americans slept outside in the fresh air and had access to healthy food, and that the diseases only infected those in city slums.

Clifford Trafzer:
The various commissioners of Indian affairs kept not believing that this was really happening, even though they received letters from missionaries from teachers from Indian agents saying we really have a problem with TV and it’s growing.

Brian Balogh:
But a turning point came in 1922, when Hubert Work was appointed Secretary of the Interior. He was an army doctor who had served in Europe during World War I.

Clifford Trafzer:
He had worked with nurses, college trained nurses. He had such a positive view of these women that when he became Secretary of Interior, he insisted that something had to be done. He felt that one of the first things that should be done was to put college educated nurses onto reservations to help families in every home.

Brian Balogh:
The field nurses were sent to the reservations around the country, getting to know indigenous communities.

Clifford Trafzer:
They were writing monthly reports talking about who they were seeing and what the problems were and how they were going to address whatever the problem is. It could be eye problems, teeth problems, and it could be tuberculosis, measles, chicken pox, mumps, you name it.

Brian Balogh:
Younger Native Americans who had been to boarding schools knew about infectious diseases, bacteria and viruses. They had already been teaching older community members about these things, and often assisted field nurses with translation.

Clifford Trafzer:
We have a testimony of going into homes and showing them if you could use this room and scrub it down with like Clorox and will totally sanitize this room and then put this young person in here, this older person in here. I know of instances where nurses helped families build small shacks out back of their homes and explain to them you need to isolate this person.

Clifford Trafzer:
They would teach folks how to boil plates and forks and urge them to burn all excess food. Don’t eat after this person eats because you’ll spread the bacteria, it will come in to you.

Brian Balogh:
A key to the nurses success depended on a close relationship between nurses and Native American mothers, grandmothers and aunts. They controlled indigenous households and made decisions regarding the health and care of children and family members.

Clifford Trafzer:
The disease was so horrible, and it was so local that you saw people dying of this horrible disease that consumes your body. That families understood, we don’t want this, we want to follow your instructions, and they did, they worked together.

Brian Balogh:
Field nurses were not pressuring communities to give up their traditional medicine ways. Most Native Americans believed it made sense to accept their help. Tuberculosis was a separate disease and it needed separate solutions.

Clifford Trafzer:
The nurses began tracking who has TB? They name names and then they find out who their contacts are, and they would go to them and they would test them. Just as we’re in a pandemic now, what is being argued by the public health people today is exactly what was argued in the 1920s and ’30s, as well as the 1940s and they did get control of tuberculosis before they had an antibiotic.

Brian Balogh:
In fact, Native American Health improved across the country, thanks to the partnership between the tribal leaders and healthcare workers, but it didn’t last. After President Roosevelt died and Truman became president, Congress turned very conservative. In an attempt to wash their hands of the, “Indian problem”, the government moved to terminate the legal relationship between the United States and Indian tribes. They dissolved the medical branch of the Indian service and made Native American Health responsibility of states and counties. But this move ended up defunding healthcare for many indigenous communities.

Clifford Trafzer:
The problem here in Southern California was that the Public Health Service did not serve the Indian people of the Mission Indian Agency and the Southern California Indian Agency. They just closed the hospital, they fired all the doctors, they fired all the nurses and stopped medical health care for American Indians.

Brian Balogh:
From that point on, Native Americans across the country had to figure out health care for themselves. Many communities created Western healthcare systems on reservations, controlled and funded by the people who live there.

Clifford Trafzer:
They fill up the boards and they decide who they’re going to hire and fire and they decide how they were going to use their money.

Brian Balogh:
But having a completely independent healthcare system means having limited resources. In the era of Coronavirus, this translates into a much higher infection rate. As of this broadcast, the Navajo Nation has the highest infection rate in the country.

Clifford Trafzer:
Many people are frightened because COVID-19 has really taken off on the reservations, and they have not received the federal funding that was allocated two, three weeks ago it was approved, but it hasn’t come to them. All the tribes… We know about the Navajo Nation, but all of the tribes are feeling the effects of COVID-19. It’s catching up onto their reservations now and spreading rapidly.

Brian Balogh:
Some people in reservations have limited access to computers, telephones, or even television or radio. It’s reminiscent of the information gap 100 years ago, when tuberculosis on reservations was at its worst. With information about the virus changing daily, Cliff says that field work is the best way to reduce COVID-19 infections on reservations.

Clifford Trafzer:
We need teams of people, health care workers to go to tribes and tribal homes to explain what is happening and how best to prevent the spread of COVID-19.

Brian Balogh:
Clifford Trafzer is a professor of history at the University of California, Riverside, and the author of Fighting Invisible Enemies: Health and Medical Transitions Amongst Southern California Indians.