Health disparities

Standing Rock Two Years Later: Public Health Lessons and the Physician’s Responsibility

By PHUOC LE MD 

A close look at disease and suffering would lead most of us to the same conclusion: our natural environment is inextricably linked to our health. When the Army Corps of Engineers approved the construction of the Dakota Access Pipeline (DAPL) in July 2016, thousands of water protectors from across the world gathered in protest. Through staunch, organized resistance, indigenous activists and their non-indigenous allies refuted the proposed pipeline, which now shuttles over 500,000 barrels of oil per day through the Standing Rock Sioux’s sole water supply and most coveted burial grounds.

In December 2016, I joined the thousands at Standing Rock to briefly bear witness to their commitment to protecting the health and well-being of future generations. Eager to assist, I provided medical care to these heroes, many of whom had given up their jobs, quit school, or come out of retirement in solidarity with the water protectors. Their determination and strength became even more inspirational when a blizzard brought -40° F in its wake, trapping everyone inside the camp for several days.

Photo Courtesy of Phuoc Le, MD

After battling corporate juggernauts, state governments, and fossil fuel lobbyists for months, the Standing Rock Sioux Tribe and their allies neared victory when the Obama administration denied a permit required for the pipeline’s completion. Just a couple of months later, however, President Trump authorized its advancement and on February 23rd, 2017, the U.S. National Guard evicted the final Standing Rock protestors from the Oceti Sakowin camp. Last week marks the two-year anniversary of that eviction.

Photo Courtesy of Phuoc Le, MD

Let us utilize this regretful anniversary to remind ourselves that the construction of DAPL is far from an isolated example of U.S. federal policy privileging corporate interests over Native health. Between 1944 and 1986, mining companies exploded more than four million tons of uranium on Navajo lands, producing adverse health outcomes that remain to this day. A recent study found that over 160,000 abandoned hard rock mines throughout the Western United States have “created a legacy of chronic exposures to metal mixtures in Native American communities.” According to the authors, “as mineral resources were identified on those lands, ethical and legal responsibilities set in the treaties were abrogated by the US government to provide access for mining by successively shrinking the area of lands designated to each tribe.”

As a result, adults, neonates, and children from communities near these abandoned sites live with higher levels of uranium and other toxic metals, increasing their risk of “developing multiple chronic diseases linked to their proximity to the mine,” such as “kidney disease and hypertension.” Surely not by coincidence, between the 1970s and the 1990s, cancer rates doubled on the Navajo Nation. Unfortunately, as this week’s anniversary reminds us, this era of profit-driven exploitation has not yet passed.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429369/

As physicians, we must educate ourselves on how profit-driven policies lead to specific diseases in the Native American patients we have the privilege to treat. To be sure, involuntary exposure to uranium is a root cause of suffering and disease in these communities. We have a responsibility to our patients to avail ourselves of this history that is taught in few- if any- medical school textbooks.

Above all else, this anniversary is a reminder of the power in mass mobilization to catalyze a movement that spurs headlines and support from all over the world. The water protectors at Standing Rock were a fraction away from halting the construction of DAPL, and they have not given up yet; two years later, thousands of water protectors struggle together, mostly unseen from the public’s eyes or the media’s attention. With the health consequences of these policies historically evident, it is time that more physicians join the struggle to protect the health of future generations.

Internist, Pediatrician, and Associate Professor at UCSF, Dr. Le is also the co-founder of two health equity organizations, the HEAL Initiative and Arc Health. This article originally appeared on Arc Health here

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pjnelsonPeterWilliam Palmer MD Recent comment authors
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pjnelson
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pjnelson

As a matter of perspective, the earth’s land masses have slowly merged and then subsequently split apart three times since the the origin of our planet. Historically, the origins of biologic entities is recent. Of our planet’s 4.6 billion year existence, the oldest known organisms that still exist are the cyanobacteria that have been around for 2.5 to 3.5 billion years. We humans are quite recent @ 100,000 – 200,000 years. I still wonder about the effects on the earth’s core with all of the nuclear testing, primarily between 1950 and 1990 involving @ 2,000 blasts. The number of devices… Read more »

pjnelson
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pjnelson

Not to mention the fall out from the nuclear, atmospheric explosions numbering 219 in Nevada alone from 1945 thru 1963. Including oceanic and under ground testing, the USA conducted 1,054 tests, the last in 1992. The net atmospheric fallout is known to affect male to female sex ratios at birth and probably a population health increase in Thyroid Cancer. See best over-all review by Remus Pravalie published in AMBIO (2014). See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165831/ In the Prevalie report, be sure to look at map (e) on Figure 7. It represents the net fallout pattern, state by state, of I-131 from the atmospheric,… Read more »

William Palmer MD
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William Palmer MD

Pretty political. Shouldn’t we be talking about total risks to everyone? …sending oil by train, trucks vs pipeline? …vs not sending oil and resulting prices of heating homes and businesses? And health risks therefrom?

Also, U238 with <1% 235, hmmm? Not very radioactive. We need to go way back and study this from scratch. You may be right; you may be wrong.

Peter
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Peter

“…sending oil by train, trucks vs pipeline? …vs not sending oil and resulting prices of heating homes and businesses? And health risks therefrom?”

Sending oil by any means is death to this planet and the life it supports. This is the oil age and as with all ages it will come to an end by exhaustion of the resource. In the mean time population explosion and global warming from fossil fuels will mean the health risk of extinction.

Are you proud to leave your kids and grand kids with this legacy?

William Palmer MD
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William Palmer MD

The number of carbon atoms on earth has essentially stayed the same since the eath’s last bombardment. Much CO2 had to be in the air so that photosynthesis could come along and split water. We know plants came along. The hydrogens were tacked on the CO2 and made carbohydrates. These were reduced to petroleum and coal in the soil of the earth’s crust. So the natural state of the earth is to have lots of CO2 in the atmosphere. We and fires and volcanoes put it back into the air and stimulate plant life and this returns it to petroleum… Read more »

Peter
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Peter

“So far, we haven’t seen the predicted effect of H2O. People have mainly two squabbles: does H2O greatly increase heat coming in to ground level or does it not?”

So does that mean you’re a global warming denier?

William Palmer MD
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William Palmer MD

Science—me too—is only interested in sharpening our predictions of what is going to happen in nature. It has nothing to do with beliefs. There were some papers in Nature magazine recently trying to show that H2O was forcing, as it should be, but a statistician found big problems with the papers. The climate was not predicted well from 1998-2019. The lower troposphere temps were almost unchanged.

William Palmer MD
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William Palmer MD

Peter, you don’t have to listen to others on this. Dig out an infrared spectroscopy text and study it. You will find that CO2 does absorb light strongly at about 13.6 micra and that when it doubles in concentration, the second half only
absorbs half of what the first half has absorbed. I.e it has a logarithmic effect. So each layer of new carbon dioxide absorbs 1…1/2…1/4…1/8th the amount has the first layer.

Look at water vapor and water droplets and look up latent heats, etc. Then you can figure out all this stuff by yourself.

Peter
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Peter

“Peter, you don’t have to listen to others on this.”
“Then you can figure out all this stuff by yourself.”

Then I don’t have to believe my doctor – I can go out and study WebMed to better make my own diagnosis.

William Palmer MD
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William Palmer MD

I think that’s right, Peter. You can focus in on what you think is your diagnosis, and, if is a rare disease, you may arrive at the diagnosis sooner than your doctor. But go to ncbi.nlm.nih.gov….so you can read the literature. Docs get experience, osmosis, and wisdom just from long careers and this can’t be beat if your illness is common.

Peter
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Peter

“I think that’s right, Peter. You can focus in on what you think is your diagnosis, and, if is a rare disease, you may arrive at the diagnosis sooner than your doctor. But go to ncbi.nlm.nih.gov….so you can read the literature. Docs get experience, osmosis, and wisdom just from long careers and this can’t be beat if your illness is common.” You obviously missed my point entirely. I was relating medical diagnosis to climate science – since you’re a doc I figured you get it. Both rely on the complicated relationship of symptoms that an experienced professional is best to… Read more »