Faced with historical health disparities, North Dakota tribes battle to keep COVID-19 at bay

Registered nurses from Spirit Lake Health Center and the Spirit Lake Tribal Health - Lisa Wallace, Jessica Tweeton, and LaShawnda Kenner on April 21 at Spirit Lake Tribe surveillance sampling on April 21 partnered .jpg
On April 21, the Spirit Lake Health Center, Spirit Lake Tribal Health, North Dakota Department of Health and North Dakota Army National Guard conducted COVID-19 testing at the Spirit Lake Nation. Pictured, from left, are nurses Lisa Wallace, Jessica Tweeton and LaShawnda (Fassett) Kenner. Cheri Schaffer / Special to The Forum

FORT TOTTEN, N.D. — Every morning Peggy Cavanaugh wakes up and looks at the North Dakota Health Department’s coronavirus page.

As chairwoman for the Spirit Lake Nation, "I keep watching that state map, and that one county on there that is gray, and every day I wake up and say, ‘We’re still gray,’” Cavanaugh said.

As of Friday, May 1, the Spirit Lake Nation, which takes up much of Benson County, still had no positive cases despite having three mobile test drives. But with only 326 tests completed — 15% of the tribe’s 2,069 members — Cavanaugh is worried.

Native Americans, especially the elderly, are uniquely vulnerable to COVID-19, a respiratory illness, if the virus finds a way in.

“That’s one of the highest concerns we have,” Cavanaugh said. “We know our population has a lot of disparities due to their health conditions. It would make us feel a lot safer if we could test more, and we respect the shortage of testing and the shortage of abilities, but I wish we could do more. We could be ahead of it more.”


While watching the virus run rampant through other tribes, such as the Navajo Nation, Cavanaugh and the tribal council are doing everything they know how to do to keep the virus out.

Roads into the reservation are blocked to outsiders. Residents must report if they leave or return from infected areas. Strict curfews are meant to keep people home from 10 p.m. to 6 a.m. Food programs for the elderly and school lunches are being delivered. Some people are still underestimating the dangers of the coronavirus, and aren’t listening to tribal guidelines, Cavanaugh said.

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Registered nurse LaShawnda (Fassett) Kenner and community health representative Jesse McKay, both enrolled members of the Spirit Lake Nation, help conduct COVID-19 testing on the Spirit Lake Reservation. Cheri Schaffer / Special to The Forum

When residents gather in large numbers, warnings, by an understaffed police force, are issued first. Charges, including breaking public nuisance and reckless endangerment laws, could come next, Cavanaugh said.

Each sovereign tribe in North Dakota has declared a state of emergency, which opened the state’s medical supply stash, said Scott Davis, executive director of the state Indian Affairs Commission.

Although Davis wasn’t sure exactly how many test kits have been distributed to the tribes, he said the state along with the North Dakota Army National Guard will be managing additional mobile test drives at all the reservations.

“The other key to this is contact tracing. As we plan, as we’re coming up there to do this testing, we also want people to be trained to do contact tracing on their own,” Davis said.


Health workers can learn how to trace the contacts of coronavirus patients through online courses and with help from the state health department, he said.

As of Friday, the state had conducted a total of 29,525 tests, with a positive rate of about 4% rate — the sixth lowest in the nation, according to Gov. Doug Burgum. Continued testing, he said, is "our gas pedal and our steering wheel as it guides us through these uncharted waters."

In Benson County, North Dakota officials reported the testing rate is 51.1 tests per 1,000 people.

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Scott Davis, executive director of the North Dakota Indian Affairs Commission, speaks during an April 14 news briefing in Bismarck. Special to The Forum

Standing Rock: 2 positive cases

Before April 21, the Standing Rock Reservation did not impose a curfew like the Spirit Lake Nation. Many questions were raised during a tribal council meeting held the same day. Did the curfew apply to non-Native residents? How could police enforce the curfew? Would imposing a curfew create more criminals to feed into the judicial system?

So far, Standing Rock has had about 1.4% of its 15,568 members tested, and have had two cases of COVID-19 out of a reported 230 tests, according to the tribe’s police chief, Sparky Edwards. The tribe has also seen an increase in juvenile runaways and misbehavior, along with problems related to alcohol and drug usage. The issues prompted Edwards to testify before the tribal council while leaders deliberated on setting a curfew.

“I’ve been voicing some of these concerns. Our juvenile crimes are still spiked, heavily involving alcohol, and we’ve even had assaults on officers involving juveniles,” Edwards said.


“There are also large groups of adults drinking at night. There is definitely a specific group of people that are not hearing our advice and moving more toward drugs and alcohol to deal with things in a different way, which puts a strain on us.”

Tribal council member Wayne Looking Back questioned Edwards, asking if the police could enforce a curfew when he sees crime on the streets as a daily occurrence.

“Price of food is going up already, and what we got is meth coming in from across the river,” Looking Back said. “So what I’m asking is what are you going to do? Is there a plan to patrol all the districts and be able to control these?”

Police officers in Standing Rock — like first responders everywhere — have to protect themselves from contracting COVID-19, Edwards said.

“Right now when I take someone to jail, everyone is claiming they have it. They want to cough on us, they want to spit on us. I’ve been spit on twice,” Edwards said.

Four days later the Standing Rock Tribal Council announced that the resolution to impose a curfew had passed. The curfew on the reservation is from 11 p.m. to 6 a.m., and for children under 18 from 8 p.m. until 6 a.m.

“We’re not trying to be mean .... It’s meant to be protective of all,” Chairman Mike Faith said. “We can’t do this ourselves. We need you, the people, to help us in a good way to make sure we don’t get a community spread and affect future generations to come.”

The Standing Rock Reservation covers Corson County, South Dakota, and Sioux County, North Dakota. In Sioux County, North Dakota officials reported the testing rate as 15.8 tests per 1,000 people.


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Native prayers were said before an April 11 COVID-19 testing drive at the Mandan, Hidatsa and Arikara Nation. North Dakota Army National Guard Maj. Amber Schatz / Special to The Forum

MHA Nation: The hardest hit

The hardest hit tribe in North Dakota so far has been the Mandan, Hidatsa and Arikara, a nation tucked into the state’s western oil lands.

As of Friday, the tribe had reported 33 positive cases among a total of 733 tests. Of those sick, 31 people had recovered, and no one had died, according to the MHA Nation Community Impact Dashboard . The nation's 7,304 residents have been living under a dusk-until-dawn curfew since late March.

“I just think they’re not as isolated because of the nature of the industry up there,” Davis said. “The place has grown tremendously in the past 10 years compared to the other tribes.”

MHA Nation Chairman Mark Fox said the tribe began preparing for the coronavirus in January. After the pandemic hit, the tribe set up a COVID-19 task force, and soon after forgave all rental, mortgage, small business and student loan payments for the month of April. The tribe has not made a decision about payments due in May, Fox said.

“The statistics make it look like we have more positive cases than all the tribes in the Great Plains, and we are ahead of them for positive cases, but I don’t put them all on Fort Berthold (Reservation) as being more infected. I put more of that on … a lot of our people travel a lot. But that wasn’t really it. I think it was our testing,” he said.

When people ask him why he doesn’t close off the reservation, he asks a question in return: “How many did you test? If you make an assumption that you close borders nobody will get infected, that’s not really true. The reality of it is, we built a really strong team, the COVID-19 task force, and we started building that in mid-March. We got out ahead of the game.”


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Scott Davis, executive director of the North Dakota Indian Affairs Commission, working in his office. Special to The Forum

The MHA Nation is also supplying isolation cabins and essential goods for their sick. School-aged children have also received free iPads to help with distance learning, paid for by tribal tax revenue and a little federal help, Fox said.

Many registered members of the MHA Nation have not received their federal stimulus checks because they failed to file their taxes, or because they lost their jobs due to the recent oil crisis, Fox said. To help make ends meet, the tribe authorized $500 checks for all registered members on and off the reservation.

But with one eye on the Navajo Nation, where more than 50 people have died from COVID-19, Fox said his tribe needs more testing done.

"The people at Fort Berthold, in general, know that we need to take this seriously. And it wasn’t just the government saying that, we’ve had our history of smallpox and measles that nearly wiped out our people 200 years ago, and we don’t need it again,” he said.

In the Fort Berthold area, North Dakota officials reported the testing rate as about 39 tests per 1,000 people.


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A mobile health unit is seen during a COVID-19 testing drive at the Mandan, Hidatsa and Arikara Nation. North Dakota Army National Guard Maj. Amber Schatz / Special to The Forum

Turtle Mountain Band of Chippewa: 3 cases

Turtle Mountain Times reporter Dave DeCoteau hasn’t done a face-to-face interview since March 13, but the social distancing hasn’t hurt the newspaper’s story lineup.

"Actually, we’ve been doing a lot of stories, and you wouldn’t think that with nothing really going on, we’re still finding stories and filling up our newspaper,” DeCoteau said.

With 30,995 enrolled members and about 8,656 living on the reservation, they’ve had a total of three people — two from the tribe — who tested positive for COVID-19, according to Davis. Testing numbers were not immediately available.

The North Dakota Department of Health reported one of the cases in Rolette County, where the Turtle Mountain Band of Chippewa is located, ended up being a person from Cass County.

“Our tribe has a curfew from 10 p.m. to 6 a.m. The cops are patrolling pretty heavily, and as soon as they see someone out, they're stopping them,” DeCoteau said.

"People are doing a pretty good job at following the curfew rules and at social distancing," he added. "But there hasn’t been a whole lot of testing going on, to be honest."

After the tribe had its first positive case of COVID-19, tribal Chairman Jamie Azure sent out a news release on April 19 saying residents needed to stop underestimating the dangers of the virus.

“Tribal proclamations cannot do it alone, we need everyone to do our part and follow the guidelines. We completely understand that many of these guidelines are in direct conflict with how we were raised along with no physical contact with elders and social distancing of six feet from others,” Azure wrote.

DeCoteau said many in the community have stepped up to share stories and to buy ads in the weekly newspaper, even when clients most likely were struggling financially.

"We’re kind of scratching each other’s backs," he said. "A lot of times these advertisers can’t afford what they’re doing either, they’re not working or if they are working, it’s not much right now."

Despite the dusk-to-dawn curfew and social distancing guidelines, DeCoteau said much of the tribe is staying connected, and most are waiting out the pandemic at home.

In Rolette County, North Dakota officials reported a testing rate of 11.2 tests per 1,000 people.

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