How Navajo health workers stepped up efforts to assist vulnerable citizens during COVID-19

Teesto: For as long as Raymond Clark has lived alone on this quiet stretch of the Navajo Nation under the watch of the “Praying Mountain”, he has depended on everyone yet no one. The 71-year-old has no vehicle or running water but is content hitchhiking and carrying jugs down a dusty washboard road to replenish his supply. He works at home in Teesto painting murals and silversmithing, but friends often stop by. Or at least they did before the pandemic. Now, rides and visits are scarcer in an area with no grocery store or gas station and where homes sit far apart. The sense of community, though, never faded. With residents urged to stay home, tribal workers, health representatives and volunteers have stepped up efforts to ensure the most vulnerable citizens get the help they need. “Our grandmas and grandpas teach us, you have to give back to your people,” said Sophia Francis, secretary for the Teesto Chapter, one of 110 tribal precincts that make up the vast reservation that extends into Arizona, New Mexico and Utah. “We have to help our elders. We have to help the community.” Clark is among hundreds who live within the rural chapter, which functioned as a community lifeline even before the pandemic. On a recent day, he stepped outside his home in the midst of juniper trees and greeted a trio of Teesto Chapter employees who were unloading firewood from a flatbed trailer. It was unseasonably warm, but Clark knew he’d need the wood for frigid days ahead. Beside hauling wood, the chapter has filled water cisterns at people’s homes, arranged for a monthly food bank distribution, provided septic cleaning and a one-time supply of propane during the pandemic. A tribal lawmaker also distributed hay. “The biggest thing I was trying to encourage is for people not to travel,” said Clara Tsosie, the chapter manager. In many ways, the groundwork had already been laid. When Tsosie was hired as a chapter planner in 2015, she worked on a rural addressing system that included GPS coordinates to every home. Community assessments mean Teesto knows who needs a bathroom addition, water or wood. The Winslow Indian Health Care Center worked with Teesto and other chapters in its service area to bring the wood split and ready to be delivered. A network of community health representatives track who needs roads cleared to get dialysis, medication or emergency assistance. Many times, they go door to door to check on people. That practice has been amplified by the pandemic, with representatives disinfecting themselves and their vehicles at each visit, honking the horn when they arrive and talking to residents through windows or screen doors. “They are thankful; they are appreciative,” said Sheila Bedoni, who oversees the health representatives in the Winslow-area unit. “And sometimes we show up when there’s nobody.” In that, communities in the region have learned more about themselves and their expanding needs. Health representatives discovered new residents, families living in sheds and even found someone living on a mountain in a makeshift shelter. “When it really happened, nobody knew what to do with the experience we had,” Bedoni said. “We learned a lot. There’s a lot of positive things we can take from it.” Nearly 30,000 people on the reservation have been infected with COVID-19 over the past year, and more than 1,200 have died. What once had been a national hotspot is seeing a significant downturn in infections weeks after the holiday surges. The tribe is planning a soft reopening on 13 March with 25 percent capacity for some businesses under certain restrictions. Still, mask mandates and daily curfews remain. When COVID-19 hit the Teesto Chapter the day before Thanksgiving, Tsosie was floored and worried about her staff. The workers rallied to check up on an infected colleague, delivered food and prepared traditional herbs. “Sometimes I think we all feel like we wanted to give up,” Tsosie said. “We can’t give up.” Other chapters on the Navajo Nation have closed at times. Teesto never shut down completely. Before the pandemic, people went to the chapter house for internet access, fill water drums in the back of their pickups, check mail, dump trash and seek assistance for burials or other emergencies. Those services are more controlled now. The public isn’t allowed in the main chapter building. When people walk up, they knock or are spotted on surveillance cameras, and the staff goes outside to greet them. The meeting hall has limited spots for students to do homework. Others catch the Wi-fi signal outside, from their cars. Signs remind people to wear masks and social distance. Clark used to spend a lot of time at the senior center next to the chapter house but doesn’t venture into nearby communities much now except to check his mail and get shots for chronic hip pain. Before the pandemic, people regularly stopped by Clark’s two-bedroom house, where he has turned nearly every space into an art studio and sleeps on the couch. A mural on his kitchen floor illustrating Navajo men’s role in society soon will be installed at a local school. In the living room, Clark giggles as he describes how he uses a plastic bin for hand washing and sponge baths. He fashioned a faucet with a foot pump, tubing and a five-gallon bucket but drinks bottled water. Outside is an outhouse and a nameless, feisty puppy that someone dropped off before dawn one day. Clark thinks back to his childhood in that area, taking care of sheep and shining a mirror into the sun to summon neighbors for a ride. “We had to learn how to help ourselves, even at a young age,” he said.