How Cherokee Nation Is Beating Back COVID

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S1: In Talika, Oklahoma, the capital of the Cherokee Nation, there’s a bronze statue welcoming students at the local university. It depicts Secoya, the Cherokee diplomat and scholar, best known for translating the spoken Cherokee language into a written one. And these days, that statue is wearing a mask, masks are mandated around here, even though in the rest of the state masks are optional.

S2: It feels like in the heart of the Cherokee Nation, we’re doing as much right as you can and bringing all the resources to bear. But as you go further out, it start to feel like we’re on a bit of an island because we’re impacted by other jurisdictions, principally the state of Oklahoma.

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S3: Chief Chuck Hosken is the guy who put the mask mandate in place around here. He also set up a Cherokee language covid hotline for the elderly, made sure senior citizens could access 400 dollar stipends to help with coronavirus related expenses, and set aside a fund to help with utility costs for his constituents. If you were just looking at the data, you might think you understand the impact the coronaviruses had on indigenous communities like this one as a group, Native Americans have one of the highest death rates from covid-19 in the country, and that mortality rate is getting worse. But here in Oklahoma, the Cherokee community has managed to flip the script here. It’s chiefs like Hosken who are leading while state officials fall behind.

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S1: Governor Kevin Smith is declaring Thursday as a statewide day of prayer and fasting for all Oklahomans affected by the pandemic in his state. I heard about the governor’s day of prayer and fasting last week. We are worse. I’m a person of faith. And and I thought of you. And it just made me wonder what you had thought about that.

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S2: Well, I. I did more than think about it. I, I put out a statement in which I said I was going to join him in praying, but I was going to pray that he and other state leaders had the wisdom and the courage to adopt the statewide mandate because plainly that is what this state needs, among other things. He has been completely absent in terms of real leadership on covid, sending mixed messages on a public health guidance and then just a stubborn refusal to do what is, I think, essential today on the show.

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S3: As covid ravages the American plains, the Cherokee Nation stands alone, an example of how government might work to contain the virus. But as winter sets in, Keith hosken he’s worried his community can’t remain an island forever. I’m Mary Harris. You’re listening to what next? Stick with us.

S1: The Cherokee Nation is large and measuring their success against the coronavirus is admittedly hard. Most of the city of Tulsa is in their territory, but public health officials have singled this tribe out for praise because their aggressive actions seem to be paying off. The Cherokee Nation has seen about half as many covid cases per citizen as, say, the Navajo Nation chief Hosken says part of what’s made them successful is their robust health infrastructure. While many tribes rely primarily on Indian health services, which is operated by the federal government, the Cherokee have established their own separate health care system, including a hospital and a medical school right on the reservation.

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S4: It is night and day. And so the facility that I was born in, Claremore Federal Indian Hospital, Claremore, Oklahoma, the same place my father was born, a federal installation actually was torn down a few years after I was born and they replaced it. And the replacements, an aging facility at this point, the facilities that were around in the rural areas when my father, for example, was to go back to him twenty five years ago, he’s trying to get health care into a rural part of Cherokee Nation. They had an RV that would come around with a with a nurse practitioner and a doctor sometimes. And the ones that were actual facilities were one was in a strip mall in a little town and the other was in a basement of an old building. Those are the kind of that’s the kind of health care that we had over the last decade.

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S5: The Cherokee Nation invested three hundred million dollars into health care, Chief Mankiller to one woman, killing one of the great chiefs in the history of the Cherokee Nation, ushered in some some new health care resources in the 90s. And so from then, with some new federal dollars, but most significantly, new gaming revenues and business revenues led us to create facilities that if you walked into if you walked into our flagship outpatient facility today, which is a four hundred and seventy thousand square foot facility, you would look at it and say that might be a museum. So we’ve come a tremendous way in a very short period of time.

S1: I’m surprised you’re not expressing more frustration because the U.S. government is obligated by treaty to provide medical care to members of federally recognized tribes.

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S5: It’s true. And it may be that you grow weary of the frustration over not just your time in public service, but just generations. I mean, I remember when my father ran for the Council of the Cherokee Nation, our legislature was a teenager, and he went into a clinic and asked them what they were interested in. And they said, well, Mr. Hosken, we would sure like softer chairs in this clinic. Their expectations were very low. Why? Because the governor, the United States had set those expectations very low. And that’s true across Indian country. He was frustrated. I’m frustrated, but we can’t spend our time doing that. If we’re going to make some real strides. And look there. There are aspects of working with the government, the United States, on health care that help us fulfill our mission. A lot of well-meaning people work for the Indian Health Service, but it’s a bureaucracy that’s underfunded, understaffed, and its mission, I think, isn’t always completely consistent with what a particular tribe wants to do. But we’re in a position where we can, again, put our own investment in and we don’t spend a great deal of time wringing our hands over the failures of the United States. I would say the next time the United States fulfills its obligations will be the first time it builds its obligations. And I want them to. I’m a proud American. I think they ought to. But I’m not going to wait around on.

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S1: Back in March, when it was becoming clear that covid was a real crisis, Chief Hosken realized keeping his newly minted health system fully stocked was going to be a challenge. There was now stiff competition for basic gear, masks, gloves, face shields.

S4: At the time, everybody’s kind of going after the same suppliers. There was one particular instance when Oklahoma’s secretary of health and my chief of staff were kind of going after the same batch of PCBs and importantly, they were competing for it. They were they were competing for it. And we worked it out and everyone got to to get some peace.

S1: So what was the deal? Was it like, we’ll split it 50/50 will. How did how do you work it out?

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S5: It was splitting what we were getting, but we also got with the vendor and got some more.

S4: And I think the vendor was sort of torn between, OK, the state of Oklahoma has got a lot of buying power here. We need to be listening to them through talking about it. We decided, hey, we can both use this vendor. This vendor isn’t just completely locked down by the state of Oklahoma. You know, a lot of these things can be worked out really just by talking. And in the midst of a crisis, sometimes you don’t do that. And I think it’s to your detriment if you don’t. We worked it out. So both splitting, splitting what was there and freeing up the vendor to know that it was OK to do business with us.

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S6: But it it it struck me that this was the most powerful and wealthiest country in the world, and yet something as simple as a mask was. Alluding the country, we were running out of mask and I thought this this can’t happen in the United States, but I also got my chief of staff and we said, you know what, this can’t happen to the Cherokee Nation again. Even if the United States finds itself in this position, we’re not going to. And so we are determined to bring some mass production to the Cherokee Nation, which we are in the middle of constructing a couple of facilities right now, even if it’s just for our own our own stockpiles in the future. And so we’re not going to be dependent on that. Again, getting a hold of masks for the Cherokee Nation.

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S1: That was one thing. Getting folks to wear them was another. So when the chief mandated mask wearing, he focused the messaging around the practice. He wanted to speak to the specific concerns of the tribe.

S4: There’s definitely pressures from the rest of society about this idea that it’s it’s every man for himself. We’ve tried to send the message that wearing a mask, for example, is very much about protecting elders or saving the language or putting our communities ahead of ourselves.

S1: Was that important to the members of your community to think about how elderly citizens were doing?

S4: We speak always in terms of taking care of our elders or respecting elders, and we do that good times and bad. And part of revering our elders is knowing that there are just a few among us who speak the language and they’re mostly for an Indian nation that’s the largest in the country, about population three hundred eighty five thousand citizens, only about two thousand of whom are first language furniture speakers, which is a jarring number. And we have to do some things now to save the language. And so we have talked about saving the language in the context of protecting people from covid.

S1: How does that pitch go? Like when you when you talk to folks and you say this isn’t just about the infection, it’s about the community, it’s about the language. Is it that you have signs that express that like how do you explain that to people?

S4: We do. Actually, the sign as you walk into our building has a mask and says mask or mandatories is protect your elders, respect your elders and has language like that. And we really just get direct with it. And so as we speak on our Facebook page, as we do every month, we will remember the first language, fluent speakers that we’ve lost. And you don’t even have to say it’s from covid, even though everybody knows everybody around here, fairly small community to know that most of those speakers were lost to Kopitar lion’s share of them. And so just talking about the loss when so when we lose a Cherokee speaker, it doesn’t matter where you live as a Cherokee, it hits you, I think. And so you don’t even have to say much about covid. So that’s how we, I think, get to our people. And we do pull at their heartstrings as we should. But we also talk about the future. And if we’re going to save this language, we’ve got to protect each other. Now, if we’re going to respect our elders and take care of them, we’ve got to do something to protect them. Now, one of the interesting challenges was trying to get young people to wear masks.

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S1: And you’ve said how if you go off reservation and go to Wal-Mart, you’ll see young Cherokee who don’t have masks or masks down below their nose.

S4: That’s right. And that’s a big challenge. And we’ve got a lot of Cherokees living across the region, a lot of them living in towns where there’s no mask mandate. And so we’re up against that. I feel like the average Cherokee is more likely to wear a mask than the non Cherokee because of our public health messaging and because of our culture.

S1: But it doesn’t mean that I’m satisfied, doesn’t mean that I’m not frustrated when I see it not happening, when it gets into that issue of the fact that you can do a lot as the chief, but you’re still surrounded by Oklahoma. And if Oklahoma is doing something different, it creates enormous pressure on someone like you does.

S4: And just the schools. A good example. I mean, when we maybe have four or five hundred high school kids total, and yet we’re in a region that we have one hundred and one hundred fifty thousand Cherokee living in the region. So that’s a lot of kids in different schools that are that are beyond my control, for lack of a better phrase, in terms of their day to day lives.

S1: And this fall, the chief had to decide what to do about all these school kids, what he settled on.

S3: It didn’t look very much like the rest of the state or the rest of the country. More after the break.

S1: Back in the fall, Chief Hosken showed up at work and found himself in the middle of a protest, Cherokee Nation students protested today because they say they want back in the classroom. High school students had showed up with homemade signs begging to go back to the classroom. The teenagers were worried about remote learning that it would mean they would fall behind academically.

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S7: Robin’s wishes she was spending her senior year at Sequoia High School with her friends. Instead, she’s learning online at home, but she’s hoping to change that.

S8: Everyone’s home life is different, and we feel like some students are struggling right now through online school. And they need that teacher interaction and peer involvement. And we are.

S1: But when the chief heard all this, he was worried about whether he was going to be able to keep them all safe.

S4: One thing about Cherokee Nation, we are a we are a vibrant democracy. People will speak their minds and we shut down our school to prepare for most of the semester to do just virtual learning. We will open the back up just a little bit. But when we shut it down, I think students were looking around the region and they saw all these other schools. Again, in the absence of leadership from the governor of the state of Oklahoma, these individual towns had to make decisions and they were, by and large, opening their schools up, full extracurricular activities. I thought it was too dangerous. And more important than that, people smarter than me thought it was too dangerous, namely my public health folks. And they guided me to the conclusion that we can’t have that kind of instruction. Students were not happy, and I think they longed for the togetherness and the camaraderie of school. They long for the extracurricular activities. I think they wanted some sense of normalcy. They they believed that they were safe. And and frankly, they had some, you know, some of the same political currents that go on in the United States, go on the Cherokee Nation. They had a few adults telling them that they would be safe. And and I didn’t agree with those adults.

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S1: Did it get politicized in the same way it has been everywhere else where it became Democrat or Republican, that sort of stuff?

S5: It did a little bit. You know, we don’t have political parties in the Cherokee Nation, but we sure have people that run against each other for office. And, you know, there were a few of the same folks who didn’t necessarily support me that were out with the protesters. And there was a local state legislative race. One of the one of the people running for office was out there protesting with them. And I think that person may have felt that was some good politics. But ultimately, I think the kids, their hearts and their heads were in the right place. They they had to they love each other. And in their minds, they very much felt safe and they felt like Cherokee Nation was a safe place and that we could keep them safe in the school and that they would behave safely.

S1: In a way, it’s an expression of trust.

S5: Yeah. And some of them made that point. They they were simply saying, Chief, you’ve said these buildings that that determination, as are the safest in the region, which I have said that over and over. Why can’t we walk in there? I had to posit that for a little bit and think about that. And I did get with my public health team and I said, what’s the most we can do right now? And they said right now we wouldn’t do in-person instruction, but we actually a few weeks later got some real a lot of rapid testing. And so what we did was we brought him back one day a week for in-person instruction. So the freshmen, for example, would go on Mondays, but everybody gets tested before they go in the building.

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S1: So every week everyone’s being tested every every week.

S5: Yeah. And what that has done is that’s been a good testing strategy. We’ve actually caught a number of asymptomatic young people taking them, kept them from going into the building and diverted them to our health system and quarantine them. Probably saved some lives of some some elders. The kids, the kids weathered the storm. OK, but but in any case, we were able to when we got the resources and this is what I told people, I said when my public health team tells me, as a matter of facts and science and compassion for people, that’s our mantra. Science, facts and compassion. If we can open the school up to the limited extent, we’ll do it. And that’s what we did.

S1: But Chief hosken, he knows that doing what’s right from a public health standpoint involves trade offs. The reason he can provide covid testing for school kids and financial support for the elderly is simple. He’s got money. Cherokee casinos brought in 679 million dollars in twenty eighteen, but now casinos are exactly the kind of businesses that are most at risk from covid.

S5: We shut down our casinos March the 16th. That’s significant.

S4: I mean, think about a state shutting down substantially all of its tax revenue. I mean, that’s a good way to look at it. Are they still closed?

S5: They are not. They reopened in June and then on a limited basis. So the number of people in the casinos in any given. Heimer are down and we’ve got a mask mandate, which which means we also banned smoking in our casinos, which personally is I think is a wonderful thing, but businesses is suffering. But during the time that we were closed down, we were hemorrhaging 30, 40 million dollars a month, you know, two and a half months because we kept everybody pay. Everybody went home with a paycheck and remain that way and kept their job when they came back. And some are still out because we’ve kept folks over the age of 65 or with comorbidities safe at home with a paycheck.

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S1: I’m glad you brought up the fact that, you know, part of the reason, really the reason you’re able to do so much for your community is because of revenue from the gaming system, from casinos. And, of course, you shut them down. I wonder if part of the reason you’ve been so aggressive with what you’ve done public health wise, is because without fixing that, you worry the casino revenue will go away for much longer.

S4: Yeah, I think I think that’s right. You know, we’ve we’ve got to we’ve got to get our got to get our stride again. We’ve got to get healthy again. We’ve got to protect the people first. Casino revenue has been a blessing to us. So it’s allowed us to get through this so far. But it’s a it’s a finite resource.

S1: Yeah. How long will you be able to keep up some of these investments in the community with the limited revenue coming in from the casino?

S4: I’m concerned about the coming calendar year in terms of revenue, but I believe that we will make it through what I’m looking at. The summer is a time when covid really starts to recede in a meaningful way for people’s day to day lives, summer of twenty, twenty one. And I think when we get there, we’ll still be OK in terms of our revenue.

S1: I wonder if you could talk a little bit about how whether it was difficult at all to get people to trust the health care system in Cherokee Nation after years and years of being part of the Indian Health Service and as you said yourself, kind of getting used to substandard care, whether it was a challenge to get folks acclimated and able to use what you now have to offer.

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S5: I think Cherokees, by and large, have confidence in their health system and they’ve come over the last couple of decades to see the health system as the Cherokee Nation health system, people literally walking in, seeing people that they grew up with or they knew their grandmother or their aunts, that sort of thing. So I think people love, for example, the fact that we have this medical school right next to our health care facility because people feel like their kids might be doctors someday and they might go to med school there. So there’s just this optimism about our system. And not only that, you have non Indians in this region who look at our health system and they’re envious and they say this is a government that provides health care to everyone. This is a government that has all new facilities. Why? What is the United States do this? What is in Oklahoma? Do this? And so I think that helps. And I’m really counting on that optimism and that confidence for the next phase, because the next phase is vaccines. We’re going to directly receive and deploy vaccines and our people have to have confidence in us and the vaccines themselves if we’re really going to get out of this thing, something that stands out.

S1: Listening to the covid response you’ve led in the Cherokee Nation, is that part of what made it? A success so far has been the fact that the community was already used to not having the federal government follow through for you. It was something that wasn’t new yet. And so when this happened, you were more prepared.

S4: You know, that’s true. And I have to say, I I don’t know if I’ve thought about it in those terms precisely, but I think it’s exactly right. I mean, we are used to the government, the states falling short. And so putting our own resources into health care and other aspects of community building and protecting each other is something we’ve been doing a long time, as long as we’ve been what we’ve always done it. But with resources in the last few decades, we’ve really been able to do it. So I think there’s something to that.

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S9: Chief Chuck Hosken, I’m so grateful for your time. Thank you for joining us. Thank you so much. Chuck Hosken Jr. is the chief of the Cherokee Nation. And that’s the show What Next is produced by Mary Wilson, Daniel Hewitt, Alan Schwartz and Davis Land. We are getting a ton of help right now from Frannie Kelley. Thank you, Frannie. We are led everyday by Allison Benedikt and Alicia Montgomery. And I am Mary Harris. You can catch me on Twitter. I’m at Mary’s desk. In the meantime, I will be back here tomorrow with more. What next?