Paths of Life

Navajo Health Practices, by Dr. Jennie Joe

The Navajos, or Diné ("The People") as they call themselves, are Athapaskan speakers whose language is similar to that of the Apache. Scientists believe the Navajo and Apache came into the Southwest sometime in the 16th century as small bands of hunting and gathering peoples. Their successful movement from lands far to the north reflects their well known ability to survive and to adapt to local cultures.

Thus, though the Navajo are renowned today for their pastoral lifestyle and prized rugs, both pastoralism and weaving were borrowed from their Spanish and Pueblo neighbors in the Southwest. While Navajo health and health practices in the 1990s also reflect a long history of contact with non-Athapaskan peoples, "well being" has always been of great importance in the Navajo lifeway.

Navajo beliefs and attitudes about health and "unwellness" are an integral part of their religion. The Diné believe that their ancestors and other companions from the animal world emerged from a series of worlds. Creation stories recall the journey and tell of primordial ancestors such as First Man, First Woman, and Changing Woman who played important roles in healing ceremonies.

There are over 35 Navajo ceremonials, some of which are for protection or prevention of misfortune and illness while others are specifically for healing. The key to healing in the ceremonials is the restoration and maintenance of social, physical, psychological and spiritual harmony. The health status of the Navajos prior to European contact is not well known, but their population, like that of other American Indians, was decimated by epidemic diseases that Europeans brought to the New World. Depopulation also resulted from warfare, starvation and raids in which Navajos were taken as slaves. One devastating military campaign against the Navajos in 1863 ended with the "Long Walk" when the Diné were forcibly removed from their lands and imprisoned at Bosque Redondo, New Mexico, for four years.

In 1868, the incarcerated Navajo leaders signed a treaty with the United States government that included medical services for the 8,000 survivors (of an original 10,000 captives) who returned to their homes in a newly created Federal reservation that encompassed only a fraction of their traditional lands.

Health care eventually became available to the Navajo, but resources and manpower were far from adequate, and the wellness of many Navajo deteriorated. Poverty, substandard housing, poor sanitation, and deficient nutrition kept infectious diseases such as trachoma and tuberculosis endemic among the Navajos.

Seeking well being through the ceremonials was effective for the Diné in some cases but not in others, and because health services were poor many patients did not utilize hospitals until it was too late. As a result, many Navajos came to view hospitals as places of death instead of places to regain health.

These negative experiences fueled mistrust between the Navajos and health care workers trained in non-traditional medicine. Thus, the practices of medicine men who conducted the ceremonials were often misunderstood by physicians who regarded the "singers" as a liability rather than a resource.

Navajo health has greatly improved since the mid 1950s because health resources have increased and more Navajos utilize physicians and hospitals, though they often seek the services of traditional practitioners.

Of equal importance was the transfer of responsibility of Indian health care from the Bureau of Indian Affairs to the U.S. Public Health Service. Responding to recent Federal policies, the Navajo Tribe has initiated a number of their own health programs.

The strong concern by the Diné for harmony in all things has not been forgotton, however. Navajo healers, with knowledge of beliefs and attitudes about health, are often active participants in seeking culturally appropriate ways to resolve many of the contemporary health problems that result from behavioral and social changes. In this way, the ancestors help to restore harmony.

Dr. Joe, a Navajo, is Associate Professor of Family and Community Medicine and Director of the Native American Research and Training Center at the University of Arizona (1993).