Why has Navajo Nation been hit so hard by the coronavirus?

Navajo Nation has the highest per capita infection rate in US, highlighting centuries of neglect, native leaders say.

Navajo Nation leaders announced last week that it had the highest per capita COVID-19 infection rate in the United States, outpacing hot spots like New York. The grim statistic highlights the historical failings of the US government, Navajo leaders say. 

There were 4,794 cases out of the Navajo Nation's 173,000 residents as of Monday, according to Navajo Nation authorities, and that number could rise as testing increases. At least 157 people have died.

Navajo Nation President Jonathan Nez said in a Monday press release that "14.6 percent of our citizens have been tested so far. The Navajo Nation continues to test at a higher rate per capita than any state in the country."

The Navajo Nation government has issued emergency measures: Masks are required in public, and total lockdown curfews are implemented over the weekends to inhibit movement in an effort to stem the virus' spread.

Compounding the problem are the high rates of heart disease, diabetes and obesity on the reservation. 

About 30 percent of homes on the Navajo Nation are also without running water. This presents challenges to meet Centers for Disease Control guidelines, including the thorough washing of hands. 

"You got the feds, you got everybody saying, 'Wash your hands with soap and water,' but our people are still hauling water. Here's a great opportunity for us to get running water to the Navajo people," Nez said at a digital town hall meeting on May 12.

Raynelle Hoskie attaches a hose to a water pump to fill tanks in her truck outside a tribal office on the Navajo reservation in Tuba City, Arizona [File: Carolyn Kaster/AP Photo] 

For Mark Charles, a member of the Navajo Nation who is running as an independent for US president in 2020, it is important to understand why the Navajo Nation faces these issues. 

"It's a problem 250 years in the making, going back to how this nation was founded. The ethnic cleansing and genocidal policies … that's where the problem lies," Chares told Al Jazeera.

The reason "healthcare is poor, treaties are not being upheld", according to Charles, who is running a campaign on creating a nation "for all people".

Generational discrimination 

The Navajo Nation is a 71,000 square kilometre (27,413 square mile) semi-autonomous territory spanning three US states - Arizona, New Mexico, and Utah. It essentially serves as a reservation for the over 350,000 Navajo people who live there.

The Dine, as the Navajo call themselves, faced a long history of displacement and dispossession as the US expanded west in the 19th century, with conflicts and forced relocations common.

It culminated in the 1864 "Long Walk", when the Navajo were forcibly removed from their traditional homelands in present-day Arizona and Western New Mexico and forced to walk over 500 kilometres (310 miles) to Fort Sumner in eastern New Mexico, where they were kept in internment camps.

The Long Walk and the wars that preceded it decimated the Navajo. Many died along the way from exposure, starvation, exhaustion and violence from the US troops that escorted them.

The Navajo population went from roughly 25,000 to between 5,000 and 8,000, according to estimates.

The Navajo signed a treaty with the US government in 1868 which established a sovereign Navajo Nation that was still dependent on Washington.

As with many Indigenous peoples, the treaty between the US and the Navajo promised funding for healthcare, infrastructure - including that which contributes to water access - and other important areas. 

However, the US government has continually failed to uphold agreements with the Navajo Nation, Charles claimed, citing a lack of funding for healthcare and infrastructure that has contributed to the challenges faced by the Navajo Nation.

"The infrastructure is never fixed. The treaty is never honoured", Charles said. 

Underfunded

The Navajo, like other federally recognised tribes, are provided healthcare by the Indian Health Service (IHS), a US government agency. The IHS operates largely on reservations, but also maintains facilities in nearby communities.

But the IHS has been accused of "unacceptable" care.

"What we've found is simply horrifying and unacceptable. In my view, the information provided to this committee and witness first-hand can be summed up in one word: malpractice," Wyoming Republican Senator John Barrasso, who was then chairman of the Senate Committee on Indian Affairs, said at a hearing on the IHS in 2016. 

A member of the Navajo Nation, receives his monthly water delivery in the town of Thoreau [Spencer Platt/Getty Images/AFP]

But the IHS has been chronically underfunded, presenting challenges to operations.

"The number of doctors, nurses, and dentists is insufficient," according to a report on the IHS prepared for the Interior Department cited by US media. "Because of small appropriations, the salaries for the personnel in health work are materially below those paid by the government in its other activities concerned with public health and medical relief."

The Trump administration has made increased funding for the IHS a priority, and the coronavirus pandemic has spurred this effort, according to IHS officials.

"President Trump has prioritised the health and well-being of American Indians and Alaska Natives throughout his presidency and the COVID-19 crisis," Health and Human Services Secretary Alex Azar said in a statement emailed to Al Jazeera. 

Congress allotted tribal nations eight billion dollars in total for tribes in the $2.2 trillion CARES Act passed in March. The majority of the funds allotted for the IHS has been distributed, while other funds for Indigenous governments meant to lessen the economic impact of the pandemic were delayed by court cases.

The Navajo Nation had received roughly $600m of these funds by May 6, Nez confirmed to local media.

On May 22, Azar announced the Trump administration is "making a targeted allocation from the funds Congress provided to send $500 million to Indian healthcare facilities.

"Combined with other funding, supplies, and flexibility around telehealth, we are working with tribal governments to do everything we can to support heroic Indian healthcare workers and protect Indian Country from COVID-19", Azar said.

Indigenous resilience

For his part, Nez has claimed the US has "forgotten" about the Navajo Nation, although they are US citizens. But the "curve is flattening" on the Navajo Nation, Nez said in the release.

"Testing, contact tracing, and the public health orders that were implemented months ago requiring protective masks in public and weekend lockdowns are working and flattening the curve".

For Charles, the Navajo running for president, this is largely thanks to the efforts of the Navajo themselves.

"I applaud President Nez and the work that the entire Navajo Nation is doing. I recognise that it is because of this 250 year of this unreconciled injustice" that the situation has gotten to this point, Charles said.

"I call on the government to immediately begin to honour treaties that were signed and to begin to build true nation-to-nation relationships with Indigenous nations."