Pine Ridge is roughly the physical size of Connecticut, but has no public transportation. The predominant form of travel is hitchhiking or walking. There is one understaffed hospital, consisting mostly of medical students spending one year paying off school debt. Folks rarely see the same doctor twice. There are a couple of village clinics around the reservation staffed by nurses, but they can see only six patients once a week. If you are 7th in line, come back next week. With the rate of diabetes (amputation is not uncommon), heart disease, infant mortality, and the numerous other health problems, this lack of access is deadly - contributing to the fact that the average man on Pine Ridge lives to 57 (some estimates are as low as 45 for men), the lowest rate in the U.S. and worse than any place in the Western Hemisphere except Haiti. All this despite treaties that "guarantee" that our government provide health and education in exchange for land, etc. Federal commodity programs provide some food assistance, but is high in carbohydrates and sugar - not good for a diabetic population.
One of the youth said that the thing that most impacted him last year was the fact that "no treaty between the US and the various Indian nations has ever been honored." Sobering.
Pine Ridge is so isolated that while other nations have profited from casinos, there is simply too little traffic to benefit. There are no banks so a commercial infrastructure needed for business becomes complicated. We were told that the banking system consists of a car that comes from Rapid City (120 miles) twice a week and parks in the gas station lot. Consequently, other than jobs with schools, government, or the tribe, unemployment is estimated at 80-90%. The median income on Pine Ridge is approximately $3,000. Depression, suicide, alcoholism and a general hopelessness, especially among teens, are ever present. Statistics are so bleak that they can become numbing.
However, on the other hand, resilience and resistance are high. Reclaiming their language and culture, after being stripped away in boarding schools up until the 1960s, has contributed to a reality of hope sometimes not appreciated from the outside. That will be the subject of my next post.