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The Invisible War – Healing the Spirit on Native Reservations [Short Documentary]


Health Equity

Gail Small, a Northern Cheyenne leader, attorney, and Health Equity Advisor to Direct Relief.

This video shares the beauty and resilience of the Northern Cheyenne people as they navigate their health and wellness challenges in the face of systemic inequities.

Today, health care is provided by the federal Indian Health Service (IHS) to individuals who are enrolled members of federally recognized Indian Tribes and Alaska Natives. Congressional funding covers an estimated 60% of their health care needs. As a result, serious health disparities exist.

Federal health care policy for American Indian Tribes and Alaska Natives reflects 16th-century doctrines of discovery and conquest. In the formative years of the United States, the War Department attempted to control non-Indian settlers from infecting the Tribes with smallpox, measles, malaria, and other infectious diseases. In 1832, the first U.S. Congress appropriated funds to purchase and administer the smallpox vaccine to Indian Tribes.

Shifting from war to peace efforts, treaties were negotiated between Indian Tribes and the United States. A common treaty clause, which is within the Fort Laramie Treaty of 1868, states, “America will provide a physician, buildings, and appropriations.”

In 2021, the United States Court of Appeals for the Eighth Circuit affirmed this treaty language in Rosebud Sioux Tribe v. United States to mean that the United States has a duty to provide “competent physician-led health care” for Indian Tribes. As a result, Indian Tribes are calling for increased federal health care appropriations to enforce their treaties with the United States.

“A nation is not conquered until the hearts of its women are on the ground.  Then it is finished, no matter how brave its warriors or how strong their weapons.”

Cheyenne Proverb

The historic pattern of treaty violations culminated in the Battle of the Little Bighorn in 1876 wherein the U.S. Army’s 7th Cavalry Regiment, led by Lt. Col. George Armstrong Custer, was defeated in military battle by an alliance of tribal nations, including the Cheyenne, Sioux, and Arapaho. Thereafter, the Cheyenne people were marched as prisoners of war to concentration camps in Oklahoma Indian Territory. Dying from new diseases, they escaped and fought their way home over 700 miles to their beloved Cheyenne homeland.

Today, the Northern Cheyenne live on 500,000 acres of their ancestral homeland in Montana. In many respects, the war has never ended as the Cheyenne people continue to fight for their homeland, which is now surrounded by the largest coal strip mines in the country.

Gail Small, whose Northern Cheyenne name is Head Chief Woman, serves as a Health Equity Advisor to Direct Relief. Gail invited Direct Relief to visit her Cheyenne homeland and the Billings Urban Indian Health & Wellness Center in Montana.

Direct Relief has supported Native Action, the Boys and Girls Club of the Northern Cheyenne Nation, Billings Urban Indian Health and Wellness Center, and other Native American causes with more than $500,000 in grants through its Fund for Health Equity and Covid-19 Fund, as part of an ongoing commitment to support equal access to health care throughout the United States.

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