- hcn.org/issues/43.8/three-tribes-a-dam-and-a-diabetes-epidemic/the-garrison-dam-a-history
- hcn.org/issues/43.8/three-tribes-a-dam-and-a-diabetes-epidemic/article_view?b_start:int=3&-C=
Provide names of other journalists involved.
Stephanie Paige Ogburn, Paul VanDevelder, Jodi Peterson
List date(s) this work was published or aired.
16-May-11
Provide a brief synopsis of the story or stories, including any significant findings.
Well into the 20th century, the agricultural Mandan, Arikara and Hidatsa tribes of North Dakota defied the ill health already making its way into Native America. The three tribes were lucky — their home on the Ft. Berthold Indian Reservation included their ancestral land, and the subsistence farming lifestyle they had established well before white settlement continued into the 1950s. In 1954, the reservation doctor noted with satisfaction that there was no recorded diabetes on Ft. Berthold. But then the US government built the fifth-largest earthen dam in the world, inundating one-sixth of their reservation. Ironically, the waters of Lake Sakakawea flooded the only hospital the reservation has ever had. Families were split, social ties were strained, and farming as they knew it was over. The three tribes were consigned to high, barren land, a significant amount of commodity food, and declining health. In the subsequent 60 years, the three tribes’ diabetes rate has rocketed to 16 percent — twice the rate for nonnative North Dakotans and average for Native Americans. More than 60 percent of Ft. Berthold’s adults are obese. This public health emergency has been fielded by a chronically underfunded Indian Health Service — it was just this October, and only through the strenuous efforts of North Dakota’s US senators, that the inundated hospital was finally replaced with a facility that even comes close to meeting their health needs.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Many documents and health statistics from the Indian Health Service, as well as from North Dakota health agencies and the Fort Berthold Indian Reservation. Doctor’s records from 1954 (specifically, Dr. Herbert Walker’s typed medical records from his years as the Ft. Berthold tribal doctor.) Medical journals from the early 20th century. Quiet Crisis — Federal Funding and Unmet Needs in Indian Country, a 2003 report by the U.S. Commission on Civil Rights. And the tribal data-crunchers were very helpful in plotting the increase of diabetes in their population.
Explain types of human sources used.
I initially went through the Indian Health Service’s press office, which supplied me with studies and statistics. They said that many of their records had been lost, especially those prior to 1950, claiming that this was commonplace for all federal agencies. I had interviewed a few people, they more or less cut me off. I responded to this by redoubling my efforts on the ground in North Dakota, with the tribal officials I had met there during a four-day visit. This story was a lot of work to report. But a couple of sources, like Red Gates — the head of the commodity food program at the Standing Rock Reservation — and Arne Sorensen — the diabetes director on Fort Berthold — were terrific.
Results:
I that the story increased tribal officials’ confidence that they would get funding for their new health facility from the federal government’s Indian Health Service. But I heard this prior to them receiving their actual appropriation from the government: The $1.072 million the budget-slashing US Congress gave them for operations in 2011 fell far short of the $8.3 million they had asked for. They had hoped for four doctors and at least that number of physician’s assistants — they currently have two doctors and one physician’s assistant. And so the beat goes on for health care in Native America — despite occasional efforts to meet its historic mandate to provide health care to Native Americans, the federal government fails a lot more than it succeeds.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No challenges to its accuracy.
Advice to other journalists planning a similar story or project.
The Indian Health Service is pretty tough to negotiate, especially if you haven’t developed sources within the agency — which I had not. It really challenged my ingenuity and patience to find enough to keep going with this story. But it was worth it — I found some terrific sources and uncovered some other great story leads in the process of writing this one.