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Fighting Diabetes on the Navajo Rez

By Daniel Kraker

Winslow, AZ – About one out of every four Native American adults suffers from diabetes that's nearly three times the average of the rest of the U.S. The problem can seem especially daunting on the Navajo Nation, the country's largest reservation. Diabetes rates there are skyrocketing, even among kids. In one town that borders the reservation, two outspoken sisters are trying to change that. Daniel Kraker reports from KNAU's Indian Country News Bureau.

Ask just about anyone on the Navajo Nation about diabetes, and they'll tell you about a friend or family member who has the disease, or who's died from it. But few people have felt the scourge of diabetes more than Leda Scott.

AX1: We lost a lot of family, we lost uncles, grandpas, aunts. Those are reminders for me and my family about where we have to go to prevent diabetes, and whenever I work I always think about that.

Scott is the diabetes community health nurse at the Indian Health Care Center in Winslow, on the edge of the Navajo reservation. She's a tiny woman, intense and passionate when she talks about diabetes' impact on her people. Shortly after she finished nursing school, her diabetic father suffered a heart attack. From that moment on, she's devoted her career to fighting the disease.

SFX1: start to sneak up ambi from scene with Laura and her dad

So has her younger sister Laura.

SFX2: Laura, That feel good? Yeah 1:30 Did Leda do your toenails Dad? She asks a question in Navajo duck ambi from this scene down below track

Laura Clelland is kneeling in a cramped office, massaging her father's feet. Herman Scott, now 70, is sitting barefoot, his blue jeans rolled up and a black cowboy hat perched on his head.

AX2: Laura: When was it Dad, 95? When you had your heart attack? Herman: Oh yeah. Laura asks him a question in Navajo. Herman: That side. Laura: This side had an ulcer, there was a blood clot, and an ulcer was formed there, and they were talking amputation.

Every year there are about 86 thousand diabetes related amputations in the U.S. Native Americans have one of the highest rates in the world. Herman Scott was lucky; his ulcer healed. But his heart attack moved Laura Clelland to quit her job in Tulsa, Oklahoma, and start a business distributing therapeutic shoes to two thousand diabetics on the reservation.
SFX3: Herman: Is that too big? Laura: I think that's too big Dad. We need to get a smaller size, duck down under actuality
Today she's sizing her dad for a new pair of what look like fancy black leather hiking boots. She pulls out a thick insert in the sole of the shoe.

AX4: What this does, it really protects the feet from developing the calluses which leads to ulcerations and then amputations if people aren't careful.

Since Clelland started she's seen amputation rates among her patients slowly decline. The shoes have done wonders for her dad. Herman Scott still rides his horse, but he misses his cowboy boots.

AX5: I didn't like it in the first place, but I'm getting used to it Big laughs duck under track

When Scott was diagnosed with diabetes in the 1980s, he hadn't heard much about the disease. He blames unhealthy food for its explosion among Navajo people. Laura Clelland says some Navajos still receive commodities, food the government began distributing on Indian reservations in the 1970s in lieu of food stamps.

AX6: One day my grandma is sitting there, she said, why is diabetes so prevalent? My grandma, is a little petite Navajo woman, she's 98. I said grandma, it's the commodity. She said it's no wonder I don't eat that crap! Big Laugh. She said well she should just collect all the commodity food and haul it back. I said where we gonna haul it back to grandma? The White House! Pile it up in front of them and tell them to eat it! It's killing our people, I think we should just haul it back! More laughter duck down under track

Laura Clelland laughs about it, but there's some truth to what her grandmother says. Frank Armao, the clinical director at Winslow Indian Health Care Center, says just a few decades ago under-nutrition was killing Navajo people.

AX7: And suddenly you go from that situation to an interstate highway goes through and there's fast food available and even a lot of the commodity foods that the USDA would market to people out here were filled with lard and fat.

More than half of Navajo adults are now overweight, and nearly half of children. Three decades ago, when Armao moved to Winslow from Philadelphia as a resident, he hardly ever saw diabetes or heart attacks. Now, he says, bad eating habits, combined with inactive lifestyles and chronic poverty, have created a perfect recipe for an epidemic.

AX8: I think sometimes the people get the feeling that there's something wrong with them, it's a genetic thing, or there's some stereotype of being too lazy or too this or that, and it really isn't, it's just a confluence of a lot of unfortunate circumstances.

That's not to say there's nothing Navajo people can do to change those circumstances. But for decades many people say they've felt powerless in the face of the disease. And that makes Laura Clelland's and Leda Scott's work even more unusual, and more important. Scott recently helped start a wellness and exercise center near her hometown on the reservation.

SFX4: start sneaking up tae kwon do ambi

And she's even started a tae kwon do program in Winslow for kids at risk for the disease. Type 2 Diabetes the variety most prevalent among Native Americans historically has targeted mainly older adults; now it's increasingly attacking Navajo kids.

SFX5: bring up sound of class, teacher telling kid knees to target, turn your foot! keep class ambi bedded under this scene

About 30 kids are lined up in starched white uniforms, practicing kicks. Verna Bahe's nine-year old daughter Lucy is one of the students. Bahe herself is a diabetic. So is her mother. But she hopes the tae kwon do classes will help give her daughter a different future.

AX9: Her weight and her attitude has changed a lot, this is teaching my daughter how to stay healthy.

Lucy Bahe is a tiny ray of hope in what can seem like an overwhelming plight. For Leda Scott, it's those stories that keep her going through 12 hour work days, that keep her up until midnight studying for her Masters degree.

AX10: I believe in my culture. I believe that what we were taught traditionally still does apply to everyday life today, in those teachings there's always hope and there's always tomorrow. Even though we're seeing the prevalence increasing, we're also seeing progress, this is progress what we're doing with the kids, it might not show today, it will show in 20 years what we have done, that's progress, and that's hope, saving one life is hope.

For Arizona Public Radio, I'm Daniel Kraker