An Environmental Scientist and an Educator Highlight Navajo Efforts to Balance Tradition with Scientific Priorities
This article is part of the magazine, "The Future of Science In America: The Election Issue," co-published by LeapsMag, the Aspen Institute Science & Society Program, and GOOD.
The global pandemic has made it impossible to ignore the stark disparities that exist within American communities. In the past months, journalists and public health experts have reminded us how longstanding systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19. Still, the national dialogue noticeably lacks a general awareness of Indigenous people's needs and priorities, especially in the scientific realm.
To learn more about some of the issues facing often-overlooked Indigenous tribal communities, we sought the perspectives of two members of the Navajo Nation: Nonabah Lane, Director of Development of New Mexico Projects at Navajo Power and the founder of Navajo Ethno-Agriculture, a farm that teaches Navajo culture through traditional farming and bilingual education; and Elmer Guy, Ph.D., president of Navajo Technical University, the first university to be established forty years ago on the Navajo Nation that today stands as a premier institution of higher education focusing on a balance between science and technology and traditional culture.
Elmer Guy and Nonabah Lane.
Credits: Navajo Technical University, left, and Diana Levine
Nonabah Lane: The COVID pandemic is really highlighting a lot of ways in which we are lacking, and that's especially true here in our tribal community, because the first thing you need to even address where we are in this science and technology space is the internet. There's a considerable gap between the haves and the have-nots in terms of internet. The Navajo Nation is roughly the size of West Virginia, but we don't have anywhere near the broadband and internet access that other "states" this size would have. Some of the more glaring reasons for this go back to historical policies, lack of funding for infrastructure on tribal lands, and current rights-of-way issues, and a lot of it has to do with the fact that larger corporations aren't as willing to take risks in doing business on a tribal trust land. When you don't have the internet, you don't have access to information, you don't have access to what is going on in the world or science or technology, and you can't keep up with work or school.
Dr. Elmer Guy: That's right. In this pandemic, as we're being forced to go online, I see school buses parked outside for students who don't have internet at home. The buses are equipped with Wi-Fi, so if students can find a way to get to where those buses are parked, they can get on and do their homework. But only then.
Internet has long been an issue, and the Navajo Nation's telecommunications department created a cyber task force that we at Navajo Technical University (NTU) are members of. One of the things we recently did was to petition the FCC for special temporary authority of an EBS [Educational Broadband Services] 2.5-GHz spectrum that was available but not being used. So now we have that and we're using it to set up hot spots for students to connect. We're also working with the four internet-service companies: Cellular One, Navajo Tribal Utility Authority, Sacred Wind, and Frontier. As Nonabah was saying, the Navajo Nation is quite large and has five agencies. NTU is in the eastern agency, but Navajo Tribal Utility Authority doesn't have a footprint here, so we partnered with Sacred Wind as well as Frontier to broaden our bandwidth.
We've also been collaborating with the Navajo Cyber Team on developing a Navajo Nation broadband policy, and we're almost done with that. The Navajo Nation received some CARES [Coronavirus Aid, Relief, and Economic Security] funding, and part of that is being used to address broadband. One of the things we're trying to do is see if tribal colleges can qualify for E-Rates [educational rates], since schools are eligible for E-Rates. And so some of the schools are getting connected.
What's also happening is that the Navajo Nation is trying to expand water lines to families so that they have water to wash their hands during this pandemic. We're recommending that if they're going to dig for the water lines, they might as well lay down conduits, too, so that later we will be able to install fiber as well. We happen to specialize in wireless technology here at NTU, and that is making a significant impact. In the past, it used to be about point-to-point, and when you're trying to serve a community in the valley, you'd have to find a water tank or something high and then get down and into that community from there. But with newer technology, they can bend now into those valleys. We keep reminding the state that they need to address rural communities. We've reached out to congressional members to push them to address broadband issues with Indian communities, and there are a couple of bills out now addressing that.
Of course, there are other things we're looking at in terms of scientific priorities: artificial intelligence, robotics, and climate change. We're in a high-desert environment, and the sand dunes are increasing because of overgrazing and other factors. Water sources are limited, and air pollution doesn't really help, so robotics could be promising. For example, we're looking at the water-filtering systems for wells so that both animals and humans have access to safe water. We're beginning to see the reach of technology in places like grocery stores, where people can check themselves out without the need for cashiers. So we try to look ahead and project what kinds of jobs will and will not be needed on the Navajo Nation, then have our faculty think about ways of adjusting the curriculum to stay in line with where the world is headed.
"One of the biggest challenges for us is how we make sure there's a connection between the students who want to go into science and how they can continue to contribute to Navajo communities—to their parents' and grandparents' way of life."
NL: Since we're talking about the internet and A.I., I think one of the key issues that isn't addressed in tribal communities is data: data security, privacy, and, ultimately, ownership. It's such a gray area. Take this pandemic, for instance, and the numbers and the data that's being collected: who's taking all of this information out of our communities and who's accounting for it? It's an important component being extracted seemingly covertly. Our tribal communities don't necessarily understand how valuable it is to keep that data within our communities.
I know there are various data holders who are not Navajo who have studied Navajo people and our environment, from soil samples to diabetes rates, and it's just not information we fully have access to as a population—our own information. It's critical to get everyone on the same page and to understand the importance of that.
There's a water project I'm working on that came out of the Gold King Mine waste-water spill of 2015, which was a major environmental catastrophe in New Mexico that affected the run-off from the San Juan Mountains. The water contamination really hurt agriculture, especially Navajo farmers on the San Juan River. We still feel it, even if the pandemic has kind of overshadowed it, and before the pandemic, my organization, Navajo Ethno-Agriculture, adopted a lot of the hard-science data that was taken by the University of Arizona. We've been working with New Mexico State University in continuing to collect and share data with the community in order to build back confidence with Navajo consumers about our farm produce. We have an ongoing partnership with New Mexico State University where they come out and do soil testing, and Navajo Preparatory School students are developing a curriculum around this as well. The point is to get easy-to-use, low-cost technology so that farmers can do this testing on their own and not have to wait for and rely on a university or the government agencies to come out and test it. This initiative would not have been possible without the support of the MIT Solve Indigenous Communities Fellowship.
Of course, you're always going to have the people in the community who don't believe in science and don't believe that the water is, in fact, okay, but it's essential that we have that scientific data. It's about empowering farmers to be able to relay that message as well—and finding a bridge between our longstanding traditions and modern science. A lot of the farming among the Navajo is deeply traditional to this region, and, as a culture, we're focused on the traditional aspects of the food. That's really why we felt like it was important to be proactive about this—because if you lose one more generation of farmers who don't produce these heritage foods, it's not just your food, it's your whole culture and way of life—your heritage—that could be gone. So it's important to preserve that tradition, but also alongside Western science—and data is critical.
EG: Nonabah is right about tradition, and I think one of the biggest challenges for us is how we make sure there's a connection between the students who want to go into science and how they can continue to contribute to Navajo communities—to their parents' and grandparents' way of life. A lot of the time, you have to create those opportunities. For example, we're trying to develop an environmental laboratory at one of our sites in Chinle, Arizona, where we want to be able to test the water, soil, air, uranium, etc. We have people who can run that facility mainly to help with the uranium mine clean-up. There are over 500 abandoned uranium mines, and what might usually happen is that funds would become available and outside entities would get those grants and they'd come in and do the work. Then, as soon as the grant is up, they leave and everything disappears, but the problem remains. It's these kinds of situations where we say, Why can't we do that ourselves? And the only way is to train and prepare engineers ourselves, from our community.
A lot of our students intern with the U.S. Army and Air Force Research Labs Faculty Fellowship or with Boeing or NASA, and, when they graduate, those groups grab them for themselves. So I keep asking the Navajo Nation where they are in all of this. A lot of times we are the ones who create the barriers that only end up hurting us. When the Navajo Nation puts out job vacancies, they require candidates to have so many years of experience, and our students don't qualify. There is a tremendous need for our graduates, but everybody except the Navajo Nation ends up hiring them.
NL: As Dr. Guy says, creating opportunity is so important. My family's non-profit organization, Navajo Ethno-Agriculture, actually came about for that particular reason. We had people coming in and doing workshops and telling us how we should plant and do this or that. It was absurd—how can you come from Washington State and tell us how to plant when you don't know what native crops have been planted in our home region for centuries? And so, because of my family's background in the sciences and the traditional upbringing we all share, we built this program ourselves. We incorporate the science into our program, and we encourage students to pursue a career in science, while trying to create those job opportunities for them here. I find that more than 75% of the Navajo students I interact with—whether in high school or college—want to come back home. They just don't have the work or career opportunities to do so.
EG: NTU also has a partnership with the Navajo Nation's economic department, and we run their business incubator program. We encourage people to go into businesses here on Navajo. One of the challenges is that, even though the Navajo Nation may be the size of West Virginia, we don't own the land. So you have to deal with leases or homesite land-use permits, and it's daunting. We streamline that process and help people put together business plans, set up payroll taxes, figure out marketing strategies, and so forth.
One of the challenges is resistance, and that's something you have to deal with. For example, when I was pushing my faculty to develop an engineering degree, no one could understand why. So I told them about the national goal—that the United States has set a goal for itself that by the year 2026 or whenever, it wants to have 100,000 engineers. But what about the Navajo Nation's goals? We don't have a goal, but we should, and you have to push people to get there. Eventually everyone sees the benefits of these kinds of decisions.
NL: I also believe we have to encourage the entrepreneurial mindset: If something doesn't exist here already, then ask yourself what's needed and create it. This is our community, and we can make that change. I'm really biased toward starting your own thing because that's what I do. Before COVID-19 hit, I was developing a water lab that would stand closer to the Southern Ute Reservation so that it could be at the opening to the tributaries that run into the Colorado River and downstream to the tribes. I wanted that specific site because it would allow us to monitor the water that's a priority for tribes—because everyone else already has their own resources. And all of the water scientists involved were Navajo. If people like us don't take the initiative for these kinds of projects, the absolute wrong person is going to do it, without understanding the community.
EG: Whether it's the environment or water or some other scientific need, it's important that we remember to develop the smaller steps necessary for achieving any goal. For example, if we need veterinarians, then we have to ask what the steps are to get us to that point. A veterinary or medical school probably won't happen at NTU, but we could begin by identifying and building the steps needed to get there. We did this by starting a veterinary technician program and then added an animal science degree and then a biology degree, which is designed somewhat as a pre-medical degree, so that students can go into either medicine or veterinary science. We know we can't always make a leap right away, but we can build the pathways that get us there.
NL: For everything we've been discussing, I think it's really important to understand that we're not talking for the whole of the Navajo Nation; the Navajo Nation is large, and its culture is regional. There are different priorities in different communities. Where I live, we have abundant water around us, so that is not a need, but if you go 100 miles south, there's no water infrastructure whatsoever. And there are other issues, from coal and oil and gas extraction, to the uranium issue, which are regional. Some people live close to large health facilities while rural communities only have access to a clinic. NTU is resource-abundant in terms of having that academic outlet for students while people on the other side of the reservation may not have that. I'm always very clear about this. I may be speaking from a tribal nation, I may be speaking from experience, but I'm not speaking for the Navajo Nation as a whole, and I'm not speaking for tribal communities as a whole. Yes, we are a community, and we can expose a greater picture in our area of expertise, but there are definitely different areas that have individual needs.
Still, I do believe in the promise of what the future can hold for us in terms of both science and tradition. The two can complement each other and are not at odds, even though we tend to think of sustainability in scientific terms. And yes, science can help us achieve sustainability through things like solar tech, health innovations, and natural sciences. But I'm talking about sustainability overall and of the Earth: sustainability of water, energy, and agriculture, but also of human capacity and Navajo culture.
[Editor's Note: To read other articles in this special magazine issue, visit the beautifully designed e-reader version.]
In June, a team of surgeons at Duke University Hospital implanted the latest model of an artificial heart in a 39-year-old man with severe heart failure, a condition in which the heart doesn't pump properly. The man's mechanical heart, made by French company Carmat, is a new generation artificial heart and the first of its kind to be transplanted in the United States. It connects to a portable external power supply and is designed to keep the patient alive until a replacement organ becomes available.
Many patients die while waiting for a heart transplant, but artificial hearts can bridge the gap. Though not a permanent solution for heart failure, artificial hearts have saved countless lives since their first implantation in 1982.
What might surprise you is that the origin of the artificial heart dates back decades before, when an inventive television actor teamed up with a famous doctor to design and patent the first such device.
A man of many talents
Paul Winchell was an entertainer in the 1950s and 60s, rising to fame as a ventriloquist and guest-starring as an actor on programs like "The Ed Sullivan Show" and "Perry Mason." When children's animation boomed in the 1960s, Winchell made a name for himself as a voice actor on shows like "The Smurfs," "Winnie the Pooh," and "The Jetsons." He eventually became famous for originating the voices of Tigger from "Winnie the Pooh" and Gargamel from "The Smurfs," among many others.
But Winchell wasn't just an entertainer: He also had a quiet passion for science and medicine. Between television gigs, Winchell busied himself working as a medical hypnotist and acupuncturist, treating the same Hollywood stars he performed alongside. When he wasn't doing that, Winchell threw himself into engineering and design, building not only the ventriloquism dummies he used on his television appearances but a host of products he'd dreamed up himself. Winchell spent hours tinkering with his own inventions, such as a set of battery-powered gloves and something called a "flameless lighter." Over the course of his life, Winchell designed and patented more than 30 of these products – mostly novelties, but also serious medical devices, such as a portable blood plasma defroster.
|Ventriloquist Paul Winchell with Jerry Mahoney, his dummy, in 1951|
A meeting of the minds
In the early 1950s, Winchell appeared on a variety show called the "Arthur Murray Dance Party" and faced off in a dance competition with the legendary Ricardo Montalban (Winchell won). At a cast party for the show later that same night, Winchell met Dr. Henry Heimlich – the same doctor who would later become famous for inventing the Heimlich maneuver, who was married to Murray's daughter. The two hit it off immediately, bonding over their shared interest in medicine. Before long, Heimlich invited Winchell to come observe him in the operating room at the hospital where he worked. Winchell jumped at the opportunity, and not long after he became a frequent guest in Heimlich's surgical theatre, fascinated by the mechanics of the human body.
One day while Winchell was observing at the hospital, he witnessed a patient die on the operating table after undergoing open-heart surgery. He was suddenly struck with an idea: If there was some way doctors could keep blood pumping temporarily throughout the body during surgery, patients who underwent risky operations like open-heart surgery might have a better chance of survival. Winchell rushed to Heimlich with the idea – and Heimlich agreed to advise Winchell and look over any design drafts he came up with. So Winchell went to work.
As it turned out, building ventriloquism dummies wasn't that different from building an artificial heart, Winchell noted later in his autobiography – the shifting valves and chambers of the mechanical heart were similar to the moving eyes and opening mouths of his puppets. After each design, Winchell would go back to Heimlich and the two would confer, making adjustments along the way to.
By 1956, Winchell had perfected his design: The "heart" consisted of a bag that could be placed inside the human body, connected to a battery-powered motor outside of the body. The motor enabled the bag to pump blood throughout the body, similar to a real human heart. Winchell received a patent for the design in 1963.
At the time, Winchell never quite got the credit he deserved. Years later, researchers at the University of Utah, working on their own artificial heart, came across Winchell's patent and got in touch with Winchell to compare notes. Winchell ended up donating his patent to the team, which included Dr. Richard Jarvik. Jarvik expanded on Winchell's design and created the Jarvik-7 – the world's first artificial heart to be successfully implanted in a human being in 1982.
The Jarvik-7 has since been replaced with newer, more efficient models made up of different synthetic materials, allowing patients to live for longer stretches without the heart clogging or breaking down. With each new generation of hearts, heart failure patients have been able to live relatively normal lives for longer periods of time and with fewer complications than before – and it never would have been possible without the unsung genius of a puppeteer and his love of science.
Sarah Watts is a health and science writer based in Chicago. Follow her on Twitter at @swattswrites.
Elaine Kamil had just returned home after a few days of business meetings in 2013 when she started having chest pains. At first Kamil, then 66, wasn't worried—she had had some chest pain before and recently went to a cardiologist to do a stress test, which was normal.
"I can't be having a heart attack because I just got checked," she thought, attributing the discomfort to stress and high demands of her job. A pediatric nephrologist at Cedars-Sinai Hospital in Los Angeles, she takes care of critically ill children who are on dialysis or are kidney transplant patients. Supporting families through difficult times and answering calls at odd hours is part of her daily routine, and often leaves her exhausted.
She figured the pain would go away. But instead, it intensified that night. Kamil's husband drove her to the Cedars-Sinai hospital, where she was admitted to the coronary care unit. It turned out she wasn't having a heart attack after all. Instead, she was diagnosed with a much less common but nonetheless dangerous heart condition called takotsubo syndrome, or broken heart syndrome.
A heart attack happens when blood flow to the heart is obstructed—such as when an artery is blocked—causing heart muscle tissue to die. In takotsubo syndrome, the blood flow isn't blocked, but the heart doesn't pump it properly. The heart changes its shape and starts to resemble a Japanese fishing device called tako-tsubo, a clay pot with a wider body and narrower mouth, used to catch octopus.
"The heart muscle is stunned and doesn't function properly anywhere from three days to three weeks," explains Noel Bairey Merz, the cardiologist at Cedar Sinai who Kamil went to see after she was discharged.
"The heart muscle is stunned and doesn't function properly anywhere from three days to three weeks."
But even though the heart isn't permanently damaged, mortality rates due to takotsubo syndrome are comparable to those of a heart attack, Merz notes—about 4-5% of patients die from the attack, and 20% within the next five years. "It's as bad as a heart attack," Merz says—only it's much less known, even to doctors. The condition affects only about 1% of people, and there are around 15,000 new cases annually. It's diagnosed using a cardiac ventriculogram, an imaging test that allows doctors to see how the heart pumps blood.
Scientists don't fully understand what causes Takotsubo syndrome, but it usually occurs after extreme emotional or physical stress. Doctors think it's triggered by a so-called catecholamine storm, a phenomenon in which the body releases too much catecholamines—hormones involved in the fight-or-flight response. Evolutionarily, when early humans lived in savannas or forests and had to either fight off predators or flee from them, these hormones gave our ancestors the needed strength and stamina to take either action. Released by nerve endings and by the adrenal glands that sit on top of the kidneys, these hormones still flood our bodies in moments of stress, but an overabundance of them could sometimes be damaging.
A recent study by scientists at Harvard Medical School linked increased risk of takotsubo to higher activity in the amygdala, a brain region responsible for emotions that's involved in responses to stress. The scientists believe that chronic stress makes people more susceptible to the syndrome. Notably, one small study suggested that the number of Takotsubo cases increased during the COVID-19 pandemic.
There are no specific drugs to treat takotsubo, so doctors rely on supportive therapies, which include medications typically used for high blood pressure and heart failure. In most cases, the heart returns to its normal shape within a few weeks. "It's a spontaneous recovery—the catecholamine storm is resolved, the injury trigger is removed and the heart heals itself because our bodies have an amazing healing capacity," Merz says. It also helps that tissues remain intact. 'The heart cells don't die, they just aren't functioning properly for some time."
That's the good news. The bad news is that takotsubo is likely to strike again—in 5-20% of patients the condition comes back, sometimes more severe than before.
That's exactly what happened to Kamil. After getting her diagnosis in 2013, she realized that she actually had a previous takotsubo episode. In 2010, she experienced similar symptoms after her son died. "The night after he died, I was having severe chest pain at night, but I was too overwhelmed with grief to do anything about it," she recalls. After a while, the pain subsided and didn't return until three years later.
For weeks after her second attack, she felt exhausted, listless and anxious. "You lose confidence in your body," she says. "You have these little twinges on your chest, or if you start having arrhythmia, and you wonder if this is another episode coming up. It's really unnerving because you don't know how to read these cues." And that's very typical, Merz says. Even when the heart muscle appears to recover, patients don't return to normal right away. They have shortens of breath, they can't exercise, and they stay anxious and worried for a while.
Women over the age of 50 are diagnosed with takotsubo more often than other demographics. However, it happens in men too, although it typically strikes after physical stress, such as a triathlon or an exhausting day of cycling. Young people can also get takotsubo. Older patients are hospitalized more often, but younger people tend to have more severe complications. It could be because an older person may go for a jog while younger one may run a marathon, which would take a stronger toll on the body of a person who's predisposed to the condition.
Notably, the emotional stressors don't always have to be negative—the heart muscle can get out of shape from good emotions, too. "There have been case reports of takotsubo at weddings," Merz says. Moreover, one out of three or four takotsubo patients experience no apparent stress, she adds. "So it could be that it's not so much the catecholamine storm itself, but the body's reaction to it—the physiological reaction deeply embedded into out physiology," she explains.
Merz and her team are working to understand what makes people predisposed to takotsubo. They think a person's genetics play a role, but they haven't yet pinpointed genes that seem to be responsible. Genes code for proteins, which affect how the body metabolizes various compounds, which, in turn, affect the body's response to stress. Pinning down the protein involved in takotsubo susceptibility would allow doctors to develop screening tests and identify those prone to severe repeating attacks. It will also help develop medications that can either prevent it or treat it better than just waiting for the body to heal itself.
Researchers at the Imperial College London recently found that elevated levels of certain types of microRNAs—molecules involved in protein production—increase the chances of developing takotsubo.
In one study, researchers tried treating takotsubo in mice with a drug called suberanilohydroxamic acid, or SAHA, typically used for cancer treatment. The drug improved cardiac health and reversed the broken heart in rodents. It remains to be seen if the drug would have a similar effect on humans. But identifying a drug that shows promise is progress, Merz says. "I'm glad that there's research in this area."