Diabetes from Unnatural Causes
By Hwaa Irfan
Over the years, the American diet has changed dramatically due to the forces of the market.
• Fat content has increased, and the content of protein in food has decreased
• Vitamin and mineral content has dwindled due to the lack of availability of locally grow fresh produce.
• The increase on refined sugars
• The increase in non-nutritive sweeteners
Dr. Donald Warne refers to the high prevalence of diabetes amongst the indigenous peoples of the U.S. as “unnatural causes,” but any disorder is caused by an imbalanced that creates an unnatural balance within the body physically, emotionally, or psychologically. However, in order to underpin the peculiarity of a dis-ease in the case of a community, what is highlighted is that diabetes is not simply a genetic, or dietary disposition in the following video >>>
Type II Diabetes (Diabetes Mellitus)
Diabetes is in response to the body’s ability or inability to produce insulin, which is a hormone that assists in the processing of blood glucose/sugar to be used by the body for energy. Type II is most common amongst those who are over 40 years of age.
Type II Diabetes can lead to:
• Vascular disease (disrupting the circulation of blood in the extremities, which can lead to amputation).
• Loss of feelings in limbs
• Lesions in the retina of the eye, bleeding, blindness
• Kidney disease
• Coronary heart disease, stroke
• Periodontal disease
• Excess ketones in the blood
• High blood pressure
A 2000 study by the Center for Disease Control and Prevention, CDC, reported a 30% increase in diabetes amongst full blood indigenous Americans and Alaskans from 1990 – 1997 with a significant increase amongst indigenous Alaskans (76%). Every year 54,000 lose a foot or a leg due to diabetes. Classified as the most frequent cause of non-traumatic lower limb amputation, I argue that it should re-classified when one explores the initial reason(s) behind the signposts to diabetes with indigenous Americans being amputated ¾ times higher than the general population.
We are referring to a people who traditionally have always been self sustaining, never taking more than they need from the land. Indigenous Americans (including those in Canada) cultivated their own crops, breeding new varieties. With colonization their way of life changed as they were no longer to live of the land of which they were the caretakers. Subject to many wars, and forced onto reservations where they could be contained, these people had suffered great loss, and experienced many diseases, diseases previously unknown. From a complete life, they were faced with the impact of the reservation system:
• Dismantling of their food system
• Break up of their family system
• Break up of their communal system (leadership etc)
• From a physically active life, to a sedentary life
• It was forbidden to speak their language or practice their religion
• Children were taken by force and placed into Christian boarding schools and were not allowed to leave until they were adults, which was organized by the Friends of the Indians.
• In the boarding schools they were only taught to develop skills in manual labor
With everything they have known take away from them including self sufficiency, the indigenous healthy life was replaced by a careless other, consisting of a staple diet of canned meat and fish, bread, beans, sugar, coffee, and tea from the 1920s – 1950s. In fact, since the 50s malnutrition became a part of their lifestyle as the reservations that they lived on was not self sustainable in terms of food, making the indigenous peoples of America dependent on government checks and food aid but subject to food insecurity with a diet that became the same as the rest of the non-indigenous population, i.e. a Western diet ( from traditional high-carbohydrate diets to modern high-fat diets).
Dr. Ann Bullock stated:
“There’s been an unusual amount of trauma that has happened to Indian people and there are very clear physiologic as well as behavioral responses to trauma. Historical trauma is a critical perspective for understanding that.”
Dr. Carrie Johnson commented:
“A lot of our children that we see, for example, have been through not only one trauma but often multiple traumas in their life, in terms of physical abuse, sexual abuse, and neglect. But then when we look at multi-generational trauma, we look at what has happened to their parents, or what has happened to their grandparents, or their great-grandparents, and how that has been passed on from generation to generation.”
With a finger strongly pointed in the direction of Post Traumatic Stress Syndrome, PSTD, indigenous peoples experience this ten times over than the population at large.
“When people have been traumatized, they pass it on,” said Dr. Bullock.
“The vector of disease transmission, if you will, is parenting. It’s not because parents don’t want to try or because they’re not trying because they don’t care. It’s because they can’t.”
Type I diabetes mellitus, Insulin Dependent Diabetes Mellitus, IDDM/Juvenile On-Set Diabetes. As an autoimmune disorder, it is when the pancreas is no longer able to produce insulin. Amongst the indigenous Americans however, IDDM is most common amongst those with a significant non-indigenous identity.
Type II diabetes (mellitus) has become the second cause of death amongst indigenous Americans today, yet it was not always like this. Type II diabetes or Non-Insulin Dependent Diabetes, NIDDM, crept into this community in the 1950’s, by the 1960s it became a common condition, and by the 1970s it became rampant. Type II diabetes was not known then, in fact it was not until 1962 that it was proposed that there are those whose response to ingested food is to over-produce insulin.
To reclaim one’s health when everything you have is dependent on someone else is very difficult, especially when one is not included. Indigenous Americans living on reservations were not included in the national data. It was in 2004, that the U.S. Commission on Civil Rights (established by congress in 957) issued a report highlighting the disparities in the health care system for the indigenous Americans. Despite the $3 million being spent annually on this health care system, it was not a system that benefited the target group at all. The report states:
“Specifically, Native Americans are 770% more likely to die from alcoholism, 650% more likely to die from tuberculosis, 420% more likely to die from diabetes, 280% more likely to die from accidents, and 52% more likely to die from pneumonia or influenza than the rest of the United States, including white and minority populations. As a result of these increased mortality rates, the life expectancy for Native Americans is 71 years of age, nearly five years less than the rest of the U.S. population.”
It also states that:
“Native Americans have the highest prevalence of Type 2 diabetes in the world, and rates are increasing at “almost epidemic proportions.”
Another alarming factor is that increasingly young indigenous Americans are also suffering from Type II diabetes, which is an adult’s disease, and that indigenous Americans are also at a higher risk of having a mental disorder than any other ethnic grouping in the U.S.
“Alcohol abuse is widespread in Native American communities. Native Americans use and abuse alcohol and other drugs at younger ages, and at higher rates, than all other ethnic groups.”
The above underlines the state of a people who are foreigners in their own land experiencing the highest suicide rates in the 15 – 34 age group. For those who wish to believe that the state has no obligation to the indigenous American people is as stated in the report that:
“The disparities in health status and outcomes experienced by Native Americans are an indictment of the federal government’s commitment to fulfilling its moral and legal obligation to provide for the health of Native Americans. This federal obligation is the result of Native Americans ceding over 400 million acres of tribal land to the United States pursuant to promises and agreements that included providing health care services, among other benefits. This federal obligation, from the Native American perspective, was stated very simply by Rebecca Ortega, a member of the Pueblo Santa Clara:
“And us mothers and grandmothers, we don’t understand why if we in the treaties . . . gave all our land, [and] our land in the United States of America is worth so much right now. [W]e feel like how come if we gave all that up, why isn’t our health care, why hasn’t it gone up as well””
It is not a case whereby the indigenous people have become lazy and dependent on the state like so many non-indigenous peoples, but a case whereby a people have been stripped of everything that constructs their identity and self worth to the extent that they have been going through a long term collective trauma – a collective memory that reminds them constantly that they have nothing to live for. Dejected and dispossessed, their body is bound to react to their state of mind. In good faith, a history of broken promises has meant in real terms that:
“The Articles of Confederation contained a general power over Indian affairs, but the Constitution enumerates only one power specific to these affairs: the power “[t]o regulate Commerce . . . with the Indian tribes.”
Underlying the efficacy of the health care system provision that was promised to them is “intentional and unintentional racism”. Michael Bird, a member of the Santo Domingo and San Juan Pueblo tribes and a former president of the American Public Health Association, describes the historical relationship between Native Americans and the federal government as follows:
“…when you dispossess people of their land or labor, their culture, their language, their tradition and their religion you set into force powerful forces that impact in a very negative and adverse way.”
Powerlessness and Health
The most common experience in the general population of the sense of powerlessness is the case of long term domestic violence. What ensues is a lack of self esteem, and depression, and depression is the response to the feeling of powerlessness. De-motivated, there is a general impact upon one’s immune system which opens the gate to many illnesses and infections. Looking at powerlessness in everyday life of those in care, Gea C. van Dijk et al found that these people tended to have disabling chronic disorders such as:
• Decubitus ulcers
• Problems with self-care
From the point of view of psychological displacement that impacts on a group of people, the closest example in the West is that of the Holocaust of WWII. Natan Kellermann who looked into the issue found that:
“Survivors who were children during the war continue to struggle with their basic insecurities and prolonged mourning for parents they hardly or ever knew. The offspring of both these groups, the so-called ‘second generation’, gain more awareness of the repressed pain that they indirectly have absorbed from their parents. Traces of Holocaust associations may even be found in the third generation who, in their quest for past roots, discover the prematurely broken branches of their family trees. Finally, relatives, close friends and caretakers show signs of having been secondarily traumatized by the plight of the survivors, and then there are certain populations that suffer from bystander guilt”.
Kellermann noted the following characteristics of Jews who survived the Holocaust:
(1) Massive repression, numbing of responsiveness, amnesia, alexithymia
(2) Intrusive memories, Holocaust-related associations, “shattered assumptions”
(3) Anhedonia, suicidal ideation, depression, chronic state of mourning
(4) Survivor guilt
(5) Sleep disturbances and nightmares
(6) Problems with anger regulation and in dealing with interpersonal conflicts
(7) Excessive worries, anxieties, catastrophic expectancy, fear of renewed persecution
(8) Suspiciousness, paranoia, isolation from the community, lack of trust, loneliness
(9) Utilization of survival strategies “from there”
(10) Low threshold for stress in difficult situations.
Child survivors portray:
(1) Learned helplessness
(2) Abandonment and isolation
(3) Interrupted mourning of loss
(4) Identity problems
(5) Memory loss and
(6) Primitive defenses
What happened to the indigenous American people has never been referred to as a holocaust, but that is what happened to them. Put all of the above together lasting for 500+ years, then what do we have?
In the process of defining and understanding of the epidemical proportion of Type II diabetes amongst a people who previously never had such a problem, one of the lessons learnt is the importance of self worth and identity. Through self awareness programs, health activists, and financial support from the government, all efforts have been made to improve access to health care for indigenous Americans. These efforts have included workshops, indigenous websites, nutrition counseling, school mentoring initiatives, and community farming programs.
“Things have been changing. There’s a new energy,” says Chippewa Ann Bullock, the medical consultant for the Health and Medical Division of the Eastern Band of Cherokee Indians, in Cherokee, North Carolina.
“We’ve listened to tribe elders from the beginning, and through our Traditional Foods project, we’ve honored the concepts of harvesting, gathering and preparing traditional foods like squash and berries,” said Dawn Satterfield to USA Today, a team leader for the Native Diabetes Wellness Program (CDC).
On the Bad River Indian Reservation have been able to harvest from their efforts: maple syrup, venison, perch, wild rice, wild turkey, partridge bear and rabbit are but some of the goodies, along with the trout, wintergreen, leeks, apples, juneberries and more they are able to enjoy. The harvest also includes traditional practices such as rituals like the powwow.
As part of their tradition, storytelling passes on the lessons they want to preserve. Psychiatrist Dr. Rif Kamil told the following story:
Through The Eyes Of The Eagle
“Brother sun and sister moon have come and gone many times as I fly over the land of my native people. I have seen many changes – some good and some bad.
“As I soar high above, I see Brother sun as he greets each day with his morning light. I see him fade to make more room for sister moon. In the past, the other animals and I could see the children playing and running in their communities.
“The men, with their legs so strong, keep up with the antelope as they run.
The women, so beautiful as they work in the fields, grow things to make their family healthy and strong.
“I remember when running was a way of life for everyone as was living off Mother Earth with what she provided.
“Times were hard but the Native People all worked together and shared in their labors and good fortunes through many feasts and celebrations.
“People came from far and near to join them in giving thanks to the Great Spirit. But now, I am troubled and sad.
“My people no longer have the strength of their ancestors.
“Modern days have caused many changes.
“My people are getting sick by the threes and fours with this thing called “too much sugar in the blood”, They suffer lost vision and strength.
“The feet that once carried them over the lands of their birth now suffer great pain.
“Some of my people no longer have their legs and now use wheels to get around and others need special machines to keep their blood clean.
“I hope to find a way to give my people courage and strength to turn this around.
“As I come to rest on my mountaintop. I close my tired eyes to what I have seen and begin to see a vision of how to bring back strength, courage and long life to my people.
“My native people are getting out and around. Slowly they come out , by ones and twos, to work and enjoy the riches and beauty that Mother Earth gives”.
“They are walking and beginning to run. They slowly get stonger as their sugars come down. As others see them getting stonger, they share their ideas of what they can do to grow healthier. They begin slowly by making one change, then two, to eat less sugar and less fat things.
“As they get stronger and continue to make these changes, they come to know that they are healthier, not only in the body but in mind and spirit too, as they control the thing called “… too much sugar in the blood.”
“Their children and grand children know what they too can grow and become stronger and healthier.
“By learning and through example taught by their parents and grandparents, they have obtained the wisdom of knowing what they need to do to keep their sugars down and have healthier life.
“As a new day approaches with brother sun bringing his light, I no longer feel troubled, for I know they will learn what they can do to make my vision come to pass.
“My people will once again be healthy and strong as they make the necessary changes to turn things around.
“Once again they will be strong in body and spirit!”
Marcus, M. “Native Americans Embrace Tradition to Defeat Diabetes.”
Dijk, G.C. An Analysis of Care of people who are Powerless in Daily Living http://dissertations.ub.rug.nl/FILES/faculties/medicine/2008/g.c.van.dijk/04-c4.pdf
Edwards, A, K. State of the Science: A Cultural View of Native Americans and Diabetes Prevention http://www.britannica.com/bps/additionalcontent/18/37248006/STATE-OF-THE-SCIENCE-A-CULTURAL-VIEW-OF-NATIVE-AMERICANS-AND-DIABETES-PREVENTION
Gohdes, D. Diabetes in North American Indians and Alaska Natives
Kamil, R. Through The Eyes Of The Eagle http://www.turtleisland.org/discussion/viewtopic.php?t=1037
U.S. Commission on Civil Rights “Broken Promises: Evaluating the Native American Health Care System” http://www.usccr.gov/pubs/nahealth/nabroken.pdf
Historic Trauma May Be Causing Today’s Health Crisis
Kellermann, N. The Long-term Psychological Effects and Treatment of Holocaust Trauma http://www.amcha.org/Upload/folgen.pdf
King, G. Type II Diabetes, the Modern Epidemic of American Indians in the United States. http://www.as.ua.edu/ant/bindon/ant570/Papers/King/king.htm
Native Americans and Diabetes – The Facts
Native American Traditions Return to Heal Diabetes