On Water and Wild Rice: What Americans Might Learn From The Ojibwe People About Health, Healthcare and Public Health - An Interview with Staci Lola Drouillard | By Kimberly J. Soenen
February 17, 2022
(Good Harbor Hill. Grand Marias, Minnesota. Photo by Kimberly J. Soenen)
“If our communities are to heal from the wounds of the past, historical truths, like sunken barrels of wartime munitions, must be brought to the surface, carefully uncapped, and responsibly disposed of so no further harm can be done.”
-Staci Lola Drouillard
Of the states in the United States of America that have seen at least one rural hospital close over the past decade, Texas leads with 21 rural hospital closures followed by Tennessee, which has seen 16 hospitals close.
A variety of harmful governance models in the United States have put rural hospitals in rural areas in a fragile position. The people—The Patient—in rural areas are at risk, often left with little or no access to Primary, Urgent, Maternal or Emergency care.
Since 2005, 180 hospitals in rural communities have shut down, and the number of closures has steadily increased over the past five years. Nearly every state in the United States had at least one rural hospital at immediate risk of closure before the pandemic. In 22 states, more than 25 percent of rural hospitals are at immediate risk of closure.
As the SARS-CoV-2 global pandemic continues to impact the economy, stability, mental health and Public Safety, I spoke with Staci Lola Drouillard about her views on health, healthcare and Public Health.
Drouillard is a descendant of the Grand Portage Band of Lake Superior Ojibwe. She lives and works in her hometown of Grand Marais, Minnesota, on the North Shore of Lake Superior. Her first book, Walking the Old Road: A People’s History of Chippewa City and the Grand Marais Anishinaabe (2019) won the Hamlin Garland Prize in Popular History and the Northeast Minnesota Book Award for nonfiction and was a finalist for a Minnesota Book Award. Her forthcoming book, Seven Aunts (University of Minnesota Press) is scheduled for release in June of 2022. She also has two storybooks in progress that are scheduled for publication by Harper Collins in 2023 and 2024.
We began our conversation with the importance of a name, and a sense of place.
(Grand Marais Harbor. Photo by Kimberly J. Soenen)
In Ojibwe-language, you were taught as a young woman that in Ojibwemowin, persons tell their name and then tell where they are from. Would you share with readers your name and where you are from?
Staci Drouillard indizhinikaaz. Kitchibitobig indonjibaa. Good Harbor Hill indaa. My name is Staci Drouillard and I’m from Grand Marais (Double Bay), Minnesota. I live on Good Harbor Hill, in the highlands along the North Shore of Lake Superior.
About 60 million people—nearly one in five Americans — live in rural areas and depend on their local hospitals for healthcare. Across the United States, 136 rural hospitals have closed since 2010. What has your health, healthcare and Public Health experience been in your rural county since early 2020?
Cook County, where I’m from, has the highest vaccination rate in Minnesota. This is primarily due to our committed Public Health team, who have been in clear communication with the residents of Cook County since the first Covid-19 illness cases appeared back in 2020.
We’ve had three deaths, which I would say, is quite sad and yet wildly different from what friends in Duluth and the Twin Cities have experienced. Small communities just seem to do better when it comes to outreach and connections between people. That being said, our local hospital and clinic staff are overworked, and it’s very hard to get an appointment, because our local healthcare system is overwhelmed.
We are very remote. Very rural, and if you get hurt, there’s only one small hospital and clinic to care for you. At the height of the pandemic, a number of local people were not able to secure appointments or beds at Duluth hospitals, because they were on divert status due to Covid-19. One of my friends died because she was not able to get specialized services in Duluth. So, that death, to me, is also related to the pandemic and should be counted as part of the collateral loss.
(Good Harbor Hill. Grand Marais, Minnesota. Photo by Kimberly J. Soenen)
The SARS-Cov-2 pandemic has exposed the long-existing failures of the uniquely “American” approach to, and model of, healthcare. Cook County, Minnesota has a population of about 5,600, making it Minnesota's seventh-least populous county. The Grand Portage Ojibwe Reservation is in the Cook County, as well.
A while back, the pharmacy in town and the Obstetrician/Gynecology clinic closed at your hospital. There is also no Vision Care locally. What is the pharmacy access status now for local residents and citizens and are women able to birth children here locally?
The local hospital opened a pharmacy in the lobby of the local independent healthcare clinic called Sawtooth Mountain Clinic to fill the void. They actually did that remarkably fast!
The decision to send pregnant mothers to big city hospitals was, in my opinion, a financial decision based on insurance liability costs. Given that my sister and I were both born into the capable hands of Roger MacDonald M.D. at the local hospital back in the 1960’s and 70’s, it makes me feel sort of bad for mothers and babies now—they can’t really say they were born in Grand Marais anymore, unless they choose to work with a mid-wife and plan for an at-home birth. Which comes with other risks. I don’t have kids, so I can’t really say how these families feel or how difficult that decision might be.
(Toasting the grains of wild rice over the fire. Photo by Staci Lola Drouillard.)
Secretary Deb Haaland made history in 2020 by becoming the first Native American to serve as a cabinet secretary. She is a 35th generation New Mexican and member of the Pueblo of Laguna. Her life story is a legacy of firsts. She entered office during the era of factory farming, large scale mining, processed foods, white sugar harm, domestic militarization and poor Environmental Health. Among White American peoples, Public Health and health are often discussed in a separate conversation from Environmental Health. What does this appointment mean to you and has Secretary Haaland been an effective catalyst for new (or, a return to old) thinking around health and Public Health?
The appointment of Secretary Haaland is indeed groundbreaking, but it really shouldn’t be.
The Indigenous people of the world have by-and-large been advocates for a wholistic approach to health in which the mind, body and spirit of the people work in tandem with our surrounding environment.
The environment gives us what we need to be healthy, not the other way around.
Ojibwe people, for example, came to live at this place on Turtle Island because of manoomin—wild rice. The prophecies pointed the Ojibwe/Anishinaabeg here, because it’s the place where food grows on water. And it turns out that manoomin is one of the only perfect proteins on earth. The health of manoomin is inextricably tied to the health and well-being of the people. There’s no separation.
Bacteria, parasites, and viruses are all infectious agents, but bacteria and parasites are not viruses. However, illness caused by these agents travel with persons and do not discriminate with regard to politics, religion, age, gender, or caste. We also know that human animals are interconnected by glaciers, lakes, rivers and oceans. The SARS-CoV-2 virus has traveled relentlessly, unapologetically, and underscored how we are all interconnected.
Grand Marais is a gateway to the Boundary Waters Canoe Area Wilderness, the 1,090,000-acre (4,400 km) wilderness area within the Superior National Forest here. More than 1,200 miles of streams wind their way through 1.1 million acres of land thick with fir, pine and spruce and lakes left behind by ancient glaciers. What happens in the water here impacts all of the Great Lakes, the entire Mississippi Flyway, downstream farms and livelihoods all the way down to the Gulf Coast.
What does water mean to you in the context of health and Public Health?
Nibi is a being. Like humans, like trees, like animals in the woods. Water is alive and has a spirit.
In Ojibwe culture, women are the water carriers. The water, the womb, the life cycle of all things—it’s beautifully and wonderfully connected. If the water environments that feed us are polluted—whether it’s the realm of lake trout, manoomin, moose, grouse, deer or the plants of the forest, the people will not survive.
It’s really quite simple. If things get out of balance and humans continue to mistreat the water, the animals, and the plants that sustain us, human beings will continue to suffer the consequences.
(Maples in the Drouillard / Anakwad Sugarbush. Photo by Staci Lola Drouillard)
Maple syrup flows here and infuses the culture, health and spirit of this place in countless ways. What does the maple tree signify for you and what is the health relationship between maple woods and the Ojibwe people?
Going to sugarbush every spring is something that my Great-grandma Elizabeth Anakwad Drouillard did throughout her life. Even as she got older, she always tried to make it out into the maple stands and tap syrup in the old way.
Once there was a terrible spring blizzard—the kind that will drop 18 inches of heavy snow in the highlands along Lake Superior. Great-grandma bundled up her kids and started walking up to Maple Hill in the middle of the blizzard. That’s how strong the tradition was for her. And so, when we hear these incomplete stories that try to justify expanded development into the highlands, or allowing the unregulated “harvest” of maple sap using large-scale, commercial methods that prevent access for tribal members, what we’re talking about is erasing the story of my great-grandmother, and all Ojibwe people who legally retain usufructuary rights to hunt, fish and gather in ceded territory—which includes the entirety of the maple stands that range from Lutsen, Minnesota to Thunder Bay, Ontario.
The Pigeon River straddles the United States/Canada border near Southern Ontario, but the river is much more than a geographic border. It’s also a symbol of the divide between two very different worlds and approaches to society, health, and well-being.
For North Shore Ojibwe, the river is the line between the White male-dominated, competition-driven, combative approach to, and model of, healthcare as a free market commodity in the United States, and the “old” ways of Ojibwe medicine.
Mid-pandemic, as we witness the United States model of healthcare buckling under the distress of budget cuts, privatization and historic levels of profiteering and greed by the commercial health insurance industry, corporate health systems and the pharmaceutical lobby, what might Americans learn from Ojibwe people about health, interconnectedness and respect for life?
The Pigeon River is where we fish.
We’ve literally caught hundreds of walleyes in the muddy water below High Falls.
I was in the boat the day my dad caught the biggest walleye of his very long life as a fisherman. She weighed at least 15 lbs. My dad sent her back into the river to make more little walleyes.
There are many family stories about people going up to Canada to visit family, gather medicines, harvest rice, go trapping, hunting—-just living life. So, the concept of an invisible border has always been problematic for the Indigenous people of the Americas, whose traditional territories don't adhere to these rules and property lines and imaginary boundaries. It's antithetical to who Ojibwe people are.
Our relationship with The River is a place of joy. Of family. Of beauty. But it's also the arbitrary border between the United States and Canada, a decision that was made by the people in Washington D.C., in part because the treaty-writers wanted to keep Isle Royale inside the United States border because of the rumor that the Island was so full of copper it would "ring like a bell," if you hit it with a hammer.
Because of its place as an arbitrary border between municipalities, The Pigeon River has become complicated. The bridge to Canada used to be a relatively friendly place, but since September 11, 2001, it has become something else entirely, and a number of tribal members have been stopped, frisked and asked for their identification while fishing for supper on the river.
Back in the 1970's a group of people, mostly tribal members from Grand Portage, Minnesota staged a protest on the Pigeon River Bridge in solidarity with the Canadian First Nations who were taking action against government rules barring the free crossing to and from the United States by tribal members—something that is guaranteed in the Jay's Treaty of 1783. It's written into the treaty that Indigenous people of at least 50% blood quantum have the right to travel freely across the border to work in the United States, visit family, shop for things, whatever, without having to pay a Duty Tax, sign government documentation of any sort or be detained in any way. It's guaranteed in the Treaty! But the Canadian government saw it differently and the tribes had to go to court to prove what they always knew.
The protest on the Pigeon River Bridge back in the 70's resulted in the local law enforcement driving their squad cars through the crowd of people and my friend, whose parents were on the bridge that day, told me that it still causes them a lot of pain and anger. I think about the "protest" happening now in Ottawa supposedly over a narrow and ugly version of personal "freedom" and it's another example of how a very important part of that story —the story of the border—is not being told.
(Good Harbor Hill. Grand Marais, Minnesota. Photo by Kimberly J. Soenen)
There is a local battle being fought through educational and advocacy channels on two fronts in this region: One is related to mining, and another related to land usage and the Treaty of 1854. What are these battles over land and water about and why should people outside of Cook County Minnesota care about what is occurring related to Environmental Health in this region?
I don’t view these things as battles. I view them as incomplete stories.
In the case of mining, we have the mainstream story that tells us that money and short-term gain is more important than big-picture sustainability. It’s that relatively young story that tries to convince us that mining is our cultural heritage here in Minnesota, but that story is missing a lot of information. It’s an incomplete story. And the story we are told about Minnesota is that no one existed here until the Europeans arrived in their boats, waiting to claim the land and resources of the Lake Superior watershed.
When the 1854 Treaty was signed in September of that year, men were literally waiting just off shore at the Grand Marais Harbor, waiting to stake their claim on the land. And that story is missing a big part of the narrative. It’s an incomplete story.
Why should people outside of Cook County care about these things? Because there is only one Lake Superior. It’s one of the most powerful and uniquely pristine bodies of water on the planet and what happens to Lake Superior happens to all of us.
(Grand Marais Harbor with Dogwood. Photo by Staci Lola Drouillard.)
Who was Naniboujou and what lessons have been passed down to the Anishinaabe about making the world a healthier, safer place for humans?
Well, I’m not a storyteller per say, and speaking about Weniboujou should be left to my Ojibwe elders and cultural teachers, not me.
Some people may be surprised to hear you say you are not a story teller because you are known as one of the great documentarians of history on the North Shore. You have produced multiple award-winning radio series and segments for WTIP Radio related to Ojibwe stories, and recently published a book titled “Walking the Old Road” that received high honors and recognition. The book contains nearly 20 pages of historical references, sources and footnotes. You also have three additional writing projects in the pipeline with University of Minnesota Press and Harper Collins. Can you explain in greater detail why you feel you are not a storyteller and what does that mean in the context of the Ojibwe band regarding elders, history and respected roles?
I only tell stories that are within my personal realm to tell.
My teachers have instilled in me the awareness that there are only certain times for adizookaan (storytelling), and that speaking about Weniboujou is something that you need permission to do. There are too many people co-opting Indigenous storylines, stealing characters and trying on Indigenous concepts who really have no place in doing so. It’s a form of cultural appropriation and that’s why I’m so very careful to only tell the stories that I have permission to tell. It’s part of treating words, language and cultural traditions with honor and respect.
(The Old Road to Sugarbush. Photo by Staci Lola Drouillard.)
What were doctors and early healthcare like on the North Shore and how does the White male-dominated Health Philosophy and model in the United States differ from First Nation and other peoples?
When my dad was a kid some of the White doctors wouldn’t make house calls to Ojibwe families who needed care. There was never a guarantee that a doctor would be willing to help you. And so, the family relied on neighbors, friends and family who had knowledge of traditional medicines or basic first aid methods to recover from accidental injuries, child birth or every-day ailments. One of their closest neighbors was a woman named Lucy Caribou, who on many occasions, was called on to bring medicine, assist in child birth or in one case, stop my dad’s knee from bleeding after he accidentally hit it with an axe. I write about this history in Seven Aunts, about how the Ojibwe side of my family survived because of traditional medicine, not because a White doctor arrived to administer care.
As of 2019, there were about 69,000 male Family Medicine and General Practice Physicians compared to 48,000 females in this specialty. What do you feel are the biggest differences between our White male-dominated healthcare model in the United States and the Ojibwe Public Health Philosophy?
I worked as student support staff for the Center of American Indian and Minority Health (CAIMH) at the University of Minnesota in the Twin Cities. It is a department within the University of Minnesota School of Medicine that was created by Dr. Gerald Hill, (Klamath) to specifically recruit, train and place Indigenous medical and nursing students.
The philosophy behind the CAIMH is that the health and well-being of Native communities is better served by doctors and healthcare professionals who have an understanding of the people they are serving.
Each tribal nation in the United States has their own way of viewing what it means to be in good health, but there are also commonalities across tribal nations that can be applied to family and child health, mental health, elder care and an openness to incorporating traditional medicine and more holistic approaches to medical care.
What I’ve always appreciated most about your lyrical writing and broadcast segments over the years is that your work consistently hits in a very cubic way at the intersection of so many social, economic, ethical and Public Health issues.
In “Walking the Old Road” you write: “If our communities are to heal from the wounds of the past, historical truths, like sunken barrels of wartime munitions, must be brought to the surface, carefully uncapped, and responsibly disposed of so no further harm can be done.”
Can you expand more on this in the context of Public Health, healthcare and health?
Historical trauma is a byproduct of institutional racism. Recall that in the 27th accusation against King George III, the framers of the Constitution and writers of the Declaration of “Independence” used the word “savages,” to set themselves apart from Britain. The accusation is of course, in reference to how a number of tribes on the East Coast took up arms against the Revolutionaries because they could see the writing on the wall. If Britain lost the battle, then the newly forged American colonizers would then bring war to the tribes. And that’s exactly what happened. And so, the very bones of our very first legal, government document codify the racist, harmful and traumatizing language of colonization.
The words of the past tend to stick to people like burrs, and these words and associations then become implicit biases about people of color that are passed along from generation to generation. Until we confront that history and accept that “independence” in the U.S. comes with “conditions” for people of color, for women, for LGBTQ Americans…we’ll never reach parity of healthcare, well-being, education or equality.
(Wild Rice on a nearby lake. Photo by Staci Lola Drouillard.)
As of this writing, violence and threats to Public Health and Safety persist across the United States at astonishing levels. Some of the physical violence is pandemic-motivated, some is generated by civil unrest, and other expressions of anger are due to ongoing systemic oppression, structural violence, economic distress and inequity.
How do you respond to, and feel about, the unique brand of American violence in the United States and its impact on the health of individuals? It seems harm is more difficult to impose upon people when the person you disagree with politically could be the one who rescues you from a snow drift while driving in a storm at midnight on The Gunflint Trail.
Does living in a small community reduce trauma and prevent violence?
I do believe that the “Divide and Conquer” approach to maintaining a political upper hand has come to roost all over the United States. If we don’t see each other as fellow humans, as citizens with the same future at stake, it’s easier to do harm to each other. To blame the other side for your troubles. To point fingers at someone who practices a different religion than you do. And political power functions well inside that vacuum.
At the small town, rural level divisions still exist, but you don’t have the option to “other” someone when they might literally be the only person with the gear to pull your car out of the snowbank, or give your elderly father a haircut, when the only barber shop in town has closed due to the pandemic. Realistically, you still might “other” them when it works for you, but maybe, just maybe, you’ll think better of it. That’s where change happens on the micro level.
What this question is really about is how we develop and maintain a sense of community when it’s easier to exist inside an echo chamber.
I am of the mindset that a return to a true sense of community is the only thing that is going to save us. This is something that tribal societies have always understood and have been built on. Having a strong bond with community comes with a kind of safety net that won’t be found elsewhere.
I maintain that there is a lot that mainstream society could learn from tribal societies, should mainstream society be willing to listen.
After posting $4.1 billion in profit in the fourth quarter of 2021, UnitedHealth Group, the major Twin Cities-based commercial health insurance company/employer, ended 2021 with $17.3 billion in total profit. The company’s full-year revenue grew more than $30 billion, or 11.8%, to $287.6 billion year over year. Their full-year earnings in 2021 were $24 billion.
Grand Marais, Minnesota is about 260 miles north of Minneapolis, and yet, the local medical clinic, the hospital and Emergency Room services and capacity here are understaffed and under-resourced.
Not only here, but across the United States, Americans who are working 40 hours a week are on the taxpayer-financed Supplemental Nutrition Assistance Program (“SNAP,” which was previously called “Food Stamps”) because of hunger; others are working three jobs without any health insurance or benefits; and still others are unemployed. For example, the well known Kowalski’s Grocery Store chain here in Minnesota is known for making new hires wait one year before qualifying for the company group health insurance plan and many of their employees are working 2-3 jobs to meet the current cost of living and inflation pressures.
How do we reconcile the wealth disparity and financial divide between rural community strife, and the record-breaking profiteering by corporate health systems, commercial health insurance industry companies, pharmaceutical companies and their collective shareholders who are profiting from illness, injury, disability and death?
This really hits home as it relates to having access to elder care.
My dad is 87 years old and has Alzheimer’s Disease. What we’ve learned is that even though he is a tribal member (Indian Health Service doesn’t cover Long-Term Care) and has general healthcare coverage through Medicare, Long-Term Care is currently unavailable here at home, and every Memory Care facility within 300 miles that accepts government payments has a waiting list and is not accepting new patients because of low-staffing issues or other complications related to the pandemic, or the perilous state mandated Staff-to-Patient ratios.
He is from this place, has never lived anywhere else, and yet our local healthcare system is not equipped to care for him in his time of need. Our family is just one of many who are on thin ice, due to the wealth disparities that uphold our current, profit-driven healthcare system. And we are suffering because of it, especially Mom, who is also elderly, struggling to care for her ailing husband and will soon need Long-Term Care herself.
(Good Harbor Hill. Grand Marais, Minnesota. Photo by Kimberly J. Soenen)
In the months and years ahead as we emerge from this pandemic (and I say “this” because there will be others…) what can we learn from the North Shore Ojibwe people about peaceful conflict resolution, health, wellbeing, environmental health, healthcare and Public Health? And, what have you learned over the last two years about your own health, your own local community, and your own definition of Public Health?
I can’t speak for anyone other than myself, but I can tell you that Ojibwe culture is resilient, strong and intelligent when it comes to traversing the choppy waters of government-to-government relations and how to survive, in spite of constant threats to tribal sovereignty, the environment, and having treaty-guaranteed access to land and resources.
In small places like the North Shore, Community Health is the key to individual wellbeing and success. It was like that before the pandemic and it will still be like that when this is all over.
A few more questions related to health and well-being?
Bring it.
Lake Trout or Herring?
Both please.
Summer or Winter?
Winter.
Scone or Pie?
Pie—100%
Ocean or Lake?
Lake Superior.
Hawk or Wolf?
My imagination says Hawk. My reality says Wolf.
Snow Shoe or Ski?
Snow Shoe.
You are a drummer. Topper Headen of The Clash or Tré Cool of Green Day?
Topper—100%.
Weezer or The Ramones?
Oh my goodness—The Ramones, of course.
Sleater-Kinney or Pussy Riot?
Babes in Toyland.
“Hope and Change” or “The Fierce Urgency of Now?”
The Fierce Urgency of Hope.
Miigwech, Staci LoLa.
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RECOMMENDED READING
Holding Our World Together: Ojibwe Women and the Survival of Community, by Brenda J. Child
Minong: The Good Place, by Tim Cochrane
The Wolf’s Trail: An Ojibwe Story, Told by Wolves, by Thomas Peacock
The Assassination of Hole in the Day, by Anton Treuer
RECOMMENDED LISTENING
This Land | Podcast, Hosted by Rebecca Nagle
In the Spirit of Medicine | Radio Series, Produced by Arne Vainio, M.D.
Native Lights | Podcast, Hosted by Cole Premo and Leah Lemm
STUDENTS
The Center of American Indian and Minority Health was founded on the principle of self-determination. Through native leadership, they have made a tremendous impact in developing Native American physicians, pharmacists, and health professionals.
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