COVID-19 in Navajo Nation through Media and Personal Perspectives: a study of colonial tensions in health, tribal institutions, & borders

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Figure 1: Photo of homemade billboard (knau.org)

COVID-19 in Navajo Nation through Media and Personal Perspectives: a study of colonial tensions in health, tribal institutions, & borders

Brecken Byron

Student Number: 11681055

MSc International Development Studies Graduate School of Social Sciences University of Amsterdam

Thesis Supervisor: Dr. Courtney Lake Vegelin Second Reader: Dr. Frederico Ramos Ramon June 25, 2021

Contact: Breckenjbyron@gmail.com

Word Count: 27,331

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“The pandemic has lay bare, the fact that we have inadequate water, inadequate electricity, inadequate internet, and inadequate education. Investment has not been made, and we’re seeing the ramifications

of that.”

Interview Participant 7

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Abstract

COVID-19 killed Indigenous Americans at almost twice the rate of white people in the United States. This thesis considers the Navajo experience in relation to the United States and tribal institutions during the time of the COVID-19 pandemic. It reveals the exacerbated United States-tribal tensions of what it means to be an Indigenous person in the United States and how institutions and media agencies interacted on a personal and collective level in a time of unprecedented chaos. To research Indigenous identity and public health inequities through the lenes of the COVID-19 pandemic, tribal institutions, and borders within the Navajo Nation, data has been analyzed through a media analysis, individual

interviews, and a social media analysis. Research found the media focused on poverty, dependency on United States institutions, the national elections in Navajo Nation, and how COVID-19 furthered Navajo cultural abandonment; while interviews and social media portrayed a return to the Navajo way of life, the power of territory, and the importance of kinship and their elders. The global health pandemic wreaked havoc on tribal communities within the United States, exposing and accelerating century-old issues rooted in institutions, cultural assimilation, territory mismanagement, and how Indigenous people are treated. This project demonstrates how COVID-19 has shaped Indigenous populations on a personal, collective, and institutional level. The spotlight on Navajo Nation during the COVID-19 pandemic should heed as a reminder for damage previously invoked by settler colonialism and how multiscale institutions and tribal leaders have to work together on all levels to mend and respect all treaties and citizens.

Key words: Navajo Nation, COVID-19, identity, healthcare, tribal self-governance, borders

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Acknowledgements

I would like to thank my family and friends back in my home state of Arizona for connecting me with my amazing participants included in my research. I would also like to thank my family for arranging accommodation during the global pandemic and providing support during this unconventional time for fieldwork. A big thank you to all staff members and teachers at the University of Amsterdam for being adaptable and figuring out how to effectively run a master’s program despite the world being temporarily shut down.

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Table of Contents

1) Introduction 8

a. Problem Statement and Motivation 9

b. Relevance 10

1. Societal Relevance 10

2. Academic Relevance 10

c. Research Question and Sub-questions 11

d. Thesis Outline 11

2) Research Context 12

a. General information 12

1. Navajo Nation 12

2. Tribal Governance 12

3. Indian Health Services 14

b. Geographical, Political, and Cultural/Societal Context 15

1. Geographical Context 15

2. Political Context 16

3. Cultural and Societal Context 17

c. Location of Research 18

3) Theoretical Framework 19

a. Internal Colonialism and Settler Colonialism 19

1. Internal Colonialism 19

2. Settler Colonialism 20

3. Social Identity Theory 21

4. Free, Prior, and Informed Consent 22

b. Globalization of Health 23

c. Border Theory 24

1. Power of Territory 24

d. Theoretical Framework Summary 25

4) Research Methodology 26

a. Research Design 26

b. Units of Analysis and Sampling 26

1. Unit of Analysis 26

2. Sampling 26

c. Data Collection Methods 27

1. Media Analysis Data Collection 27

2. Individual Interviews Data Collection 28

3. Social Media (Facebook) Data Collection 28

d. Data Analysis 28

1. Media Data Analysis 28

2. Meta-level Synthesis of Media Data Analysis 29

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3. Interviews Analysis 30

4. Social Media (Facebook) Analysis 31

e. Conceptual Framework 32

f. Quality Criteria 33

g. Ethical Considerations and Positionality 35

5) Empirical Findings/Results: Identity and Borders 37

a. Identity 37

1. Community and Cultural Identity 37

2. Pride 40

3. Distrust of the West 42

4. Trust of the West 44

b. Borders 45

1. Territory 45

2. Border Towns 47

6) Empirical Findings/Results: COVID-19 and Health and Resource Inequities 50

a. COVID-19 50

1. Community Health and Vaccination 50

2. Changes in Daily Life 52

b. Health and Resource Inequities 54

1. Health Inequities 54

2. Lack of Resources 56

7) Empirical Findings/Results: Tribal Institutions 58

a. Tribal Self-governance and Autonomy 58

b. Trust in Navajo Governance 61

c. Distrust in Navajo Governance 62

d. Duality 63

8) Discussion 67

a. Synthesis of Findings 67

1. The Shaping of Identity and Borders through Settler Colonialism 67

2. COVID-19 and Health and Resource Inequities in the Age of Globalization 68

3. Tribal Institutions and Tribal Autonomy 68

9) Conclusion 70

a. Reflection on Theory 70

b. Reflection on Methodology and Research Limitations 71

c. Recommendations for Policy and/or Practice 71

d. Suggestions for Further Research 72

10) References 73

Appendix 1 – Transparency Document 82

Appendix 2 – Operationalization Table 83

Appendix 3 – Media Feature Example 85

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List of Figures

Figure 1 Photo of a Homemade Sign on Navajo Nation Title Page Figure 2 Map of Navajo Nation 15

Figure 3 Code Tree 31

Figure 4 Conceptual Framework 32

List of Tables

Table 1 Media Analysis Information Table 29

Table 2 Media Analysis Descriptors Table 30

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Acronyms

BIA Bureau of Indian Affairs CHW Community Healthcare Worker

ER Emergency Room

FPIC Free, Prior, and Informed Consent IHS Indian Health Service

IHCIA Indian Healthcare Improvement Act IRA Indian Reorganization Act

ISDEAA Indian Self-Determination and Education Assistance Act IST Indigenous Social Thought

NAS Native American Studies

NNHRRB Navajo Nation Human Research Review Board NNLGA Navajo Nation Local Governance Act

SIT Social Identity Theory

TSGP Tribal Self-Governance Program US United States

VP Vice President

638 Tribally run healthcare facility

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1. Introduction

European colonists killed nearly 90% of the Indigenous population when settlers of the “new world”

brought diseases and cultural complications in the 1500sand 1600s (Kunitz, 2002). Additionally, Indigenous people’s basic rights (land, health, culture, resources, etc.) in North America have been in jeopardy since white settlers arrived towards the end of the 15th century. After the United States (US) government was founded in 1789 (Young, 2011), US institutions began the removal of tribes from their ancestral lands in order to promote state interests (Di Iorio, 2007). Over the following centuries, the US federal government transformed how Indigenous people lived by passing multiple federal policies ranging from Indigenous removal and neglect to assimilation and termination (Strommer & Osborne, 2015). The US federal government ‘legalized’ these agreements and policies by the signing of government-to-government treaties (Biewen, 2017).

Foundational federal law decisions in the early and mid-1800s aimed to continue the recognition of tribal sovereignty while legitimizing the expropriation and tribal removal that had already taken place (Strommer & Osborne, 2015). The end of the 1800s and early 1900s, referred to as the allotment era or assimilation era, saw an increase in federal authority through the creation of the Bureau of Indian Affairs (BIA), which widely replaced tribal self-governance (ibid.). The Dawes Act of 1887 allowed for tribally owned lands to be broken up for personal Indigenous ownership as an attempt to assimilate Indigenous communities into the individualistic US social fabric. Land that was not individually owned by tribal members was then sold to white settlers (ibid.). The federal government changed course again in 1934 by passing the Indian Reorganization Act (IRA), which repudiated allotment policies and implemented formal recognition of tribal corporations, constitutions, and membership enrollment processes (ibid.).

Twenty years later, Congress deviated from the IRA and entered the termination era, formally ending government-to-government relations with over 100 federally recognized tribes and giving states civil jurisdiction. The goal of termination was for Indigenous people to become more individualistic and relocate to larger cities in the US, therefore ending federal supervision over tribal communities (ibid.).

The failure of the termination era was recognized in the 1960s and 70s when the Kennedy

administration stopped terminating tribal recognition and the Johnson administration began investing in tribal infrastructure and social programs (ibid.). The Indian Self-Determination and Education Assistance Act (ISDEAA) of 1975 aimed to strengthen tribal jurisdiction and self-governance, laying the foundation for present-day tribal autonomy and legitimacy (ibid.). The IRA and ISDEAA will be discussed more in- depth in the contextual chapter.

The COVID-19 global health pandemic has exposed institutional shortcomings and has shed light on the limitations of agreements regarding tribal health, territorial friction, and poverty regarding tribes in the US. Based on policies and treaties signed by tribal governments and the US federal government, the US government has a responsibility to fund and operate the Indian Health Service (IHS), which provides free healthcare to all Indigenous people within US borders (Singh, 2020). Moving from the broad history of Indigenous people in the US, this research specifically focuses on Navajo Nation, the largest Indigenous population and largest territorial tribal land within US borders (Romero, 2021, May 21). This research looks at how the coronavirus has shaped personal, institutional, and cultural well-being of the Indigenous people of Navajo Nation.

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9 Before moving on to the following sub-sections, it is important to note the word choice used. Word choice will include verbatim names that may not be considered politically correct in all academic circles.

For example, the Indian Health Service, also referred to as IHS, will be used, as that is the current name of the institution. Other words used when acknowledging Navajo people will include ‘Native’,

‘Indigenous’, and ‘Diné’, which is used frequently among Navajo people. Navajo Nation will also be referred to as a reservation, as the terminology refers to an area of land managed by Native tribes in the US (usdakotawar.org, n.d.). The term ‘nation within a nation’ will also be used to highlight the lived experience of Navajo Nation residing within their own territory and the borders of the US. Navajos living in larger cities outside of the reservation are referred to as ‘Urban Navajos’.

1.a Problem Statement and Motivation

The COVID-19 global health pandemic of 2020 and 2021 was the first postmodern public health crisis (Continetti, 2020, February 27). Communities in the Global North and Global South struggled to contain the coronavirus, exposing foundational shortcomings of vulnerable communities amongst tribes in the US, including Navajo Nation. Navajo people have a traumatic history pertaining to western culture and health (Shakya & Yang, 2020). On top of the history outlined in the section above, health policies put in place by the US government included the sterilization of Indigenous women, furthering the feelings of deep mistrust for western healthcare, the US government, and the IHS (ibid.). The following paragraphs will outline the present-day issues that framed the postmodern global pandemic.

Tribal households in Navajo Nation are often multi-generational, making the spread of the virus to multiple household members swift and dangerous. Due to the multi-generational living, many elders were put at risk for infection (Walker, 2020, September 29). In addition, approximately one third of households in Navajo Nation do not have running water, and many places within the reservation have unreliable electricity, including hospitals and healthcare facilities (Brosemer et al., 2020). Almost 40% of residents living in Navajo Nation are living in poverty (Pardilla et al., 2013). Basic health

recommendations to prevent COVID-19 infection, like frequently washing hands, was not possible due to poor infrastructure. Navajo people also have a severe lack of access to healthcare, affordable energy, proximity to services, and accessible income, which were all exacerbated and accelerated due to the pandemic (Brosemer et al., 2020).

Additionally, traveling to the nearest hospital can be a long and arduous trip on unpaved roads. This makes the feasibility of getting adequate healthcare in a timely manner on the reservation much lower than it would be off the reservation (Walker, 2020, September 29). Once an Indigenous person is checked-in to a US hospital, treatment is not necessarily culturally sensitive, and may not align with traditional healing practices (Brown et al., 2020). Some Navajo elders distrust healthcare providers due to westernized medical training, even when the community healthcare workers (CHWs) are Navajo (Gampa et al., 2017). Cultural differences also contribute to the distrust of the US Healthcare system, as some Navajo elders prefer to seek health guidance from Native Medicine Men (Brown et al., 2020).

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10 Disease and viruses know no borders, traveling freely across cities, states, regions, countries, and tribal communities (Yates-Doerr & Maes, 2019). Where does accountability and responsibility fall in a time of unprecedented chaos? During a time of crisis, which institutions are responsible and which institutions are deemed trustworthy?

1.b Relevance

1.b.1 Social Relevance

The recent pandemic has exposed the chronic underfunding of IHS, as well as a lack of equipment, nurses, and doctors in the health system. Healthcare facilities are located in densely populated areas in Navajo Nation (Haroldson, 1988), making it difficult for rural residents to access treatment (Walker, 2020, September 29). These factors, paired with underlying health issues, led to the disproportionate infecting and killing of Indigenous People in Navajo Nation by the coronavirus (ibid.). At the start of the pandemic, the financial response of the US government was too slow. Out of necessity, tribes had to reallocate funds towards health services, taking away from other important tribal initiatives (ibid.).

Currently, the US federal government manages the majority of IHS hospitals in Navajo Nation. In turn, most Navajo healthcare decisions are made by US institutions, not Indigenous leadership (Henley &

Boshier, 2016).

There is free movement while traveling in and out of Native territories within the US. Complex cultural diversities between the US, Indigenous territory, and border towns makes everyday life difficult (Denetdale, 2016). The additional layer of a global pandemic brought new dynamics to an already very tangled web of problems. Finding cultural acceptance and peace is difficult for Indigenous people while coping with health issues, economic turmoil, and unjust treaties (ibid.). Due to the COVID-19 crisis, hundreds of Navajo people were transported to hospitals in large US cities, up to 280 miles away from friends and family. Lack of adequate health resources, changes in communal daily life, and the high death toll of Navajo elders devasted Navajo Nation (Brosemer, 2020). In addition, the restriction of cultural and traditional ceremonies during the pandemic influenced Navajo society and cultural well- being (Henley & Boshier, 2016).

1.b.2 Academic Relevance

Linkages made between the colonial past, health services, territory, and nationalism have been few and far between when reviewing the relationship between Navajo Nation and the US government. This research uses the theory of settler colonialism to ground the analysis and findings. Settler colonialism provides a thorough framework and understanding of the competing goals of the US and tribal communities, as well as provides basic knowledge as to what ‘land’ means to western ideology versus Indigenous ideology. This theory will be more thoroughly discussed in chapter 3.

Colonizers forced multi-culturalism and second-class citizenship onto Indigenous people while

undermining true tribal sovereignty through legal jurisdictions (Denetale, 2009). Indigenous people have

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11 faced racism, discrimination, and ‘othering’ in the US prior to the pandemic, which had been displayed in the border towns of Navajo Nation like Gallup, New Mexico (Denetdale, 2016). Additionally, many Navajo people choose to live in rural areas, further preventing societal and cultural inclusion (Montoya, 2019). Individual, territorial, and institutional tensions have existed since white settlers arrived in North America. However, due to the recentness of the pandemic, Indigenous identity has not been studied within the scope of a global health crisis. Research should be conducted pertaining to the coronavirus and the influence it had on existing tensions. How has the pandemic shaped or changed societal relations between Navajo Nation and surrounding territories? How has the media shaped societal conversations surrounding this topic?

1.c Research Question and Sub-questions

The main research question is: How has the COVID-19 global health pandemic exposed tensions

regarding health inequities, tribal self-governance, and borders shaping the Indigenous People of Navajo Nation?

Sub-questions:

• How is self-governance expressed and/or experienced in Navajo Nation?

• How have cultural perspectives changed in Navajo communities during the pandemic in relation to the existing tensions of health, tribal governance, and borders?

• How has the COVID-19 pandemic shaped feelings of territory and the ‘nation within a nation’ mindset?

• What experience does the media convey surrounding tensions in Navajo Nation during COVID-19? Does this align with personal experiences?

1.d Thesis Structure

This thesis consists of nine chapters. Chapter 2 will provide context needed to understand the history and location of the research. Chapter 3 goes over the theoretical framework that helped develop this thesis project, and chapter 4 provides the research methods used during fieldwork. Chapters 5, 6, and 7 discuss the empirical findings. Chapter 8 is the discussion. The concluding chapter, chapter 9, will provide reflections and suggest future research ideas.

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2. Research Context

This chapter provides historical and contextual information prevalent to this research. The introduction provided a broad overview of Indigenous history in the US, and this chapter focuses specifically on Navajo Nation. It discusses the geographical, cultural, political, and social context in and around Navajo Nation, as well as the location of the research.

2.a General Information on Navajo Nation, Tribal Governance, and Indian Health Services

Navajo Nation 2.a.1

The latest population count was released by the Navajo Office of Vital Records and Identification in 2021, stating that Navajo enrollment had reached nearly 400,000 members, making Navajo people the largest tribe within the US (Romero, 2021, May 21). This count includes Navajo people living within the Navajo reservation, Navajo people residing in border towns near the reservation, Navajo people living in large metropolitan cities in the US, and a fourth ‘Other’ category for all other living situations (Navajo Population Profile 2010 US Census). Navajo people living in a city outside of the reservation are referred to as ‘Urban Navajos’ (Interview 7, personal communication, March 10, 2021), and roughly half of the Navajo people reside within the borders of Navajo Nation (Navajo Population Profile 2010 US Census).

Navajo Nation is the largest Native territory in the US, which is approximately the same size of the state of West Virginia (Brosemer et al., 2020).

Cultural and traditional beliefs are rooted between the four sacred mountains, which span across present day Arizona, New Mexico, and Colorado (Americanindian.si.edu, n.d.); please see below for more geographical context. In the beginning of the 1860s, the US forced Navajo people off their land using the ‘torched-earth’ tactic of burning villages and killing livestock. From 1863 to 1866, around 10,000 Navajo people were given no choice but to walk between 250 and 450 miles to the Bosque Redondo reservation, located in present-day eastern New Mexico, which served more as an internment camp (ibid.). Through the determination to return to their homeland, Navajo leaders successfully

negotiated with the US government to return back to the four sacred mountains and a treaty was signed in 1868, forging a diplomatic relationship between the Navajo people and the US government (ibid.).

Tribal Governance 2.a.2

This section will provide a historical account of the formal formation of the Navajo government operating within the US system to the present tribal government system. Many additional treaties would be signed between the US government and the Navajo government, outlining how the tribal government would come to function both within the US system and autonomously. It is significant to point out that many treaties have gone unfulfilled by the US government, despite the formalized process.

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13 The court cases of Worchester v. Georgia in 1832 (Delaney, 2017) and Cherokee Nation v. Georgia in 1831 (Di Lorio, 2007) are significant. In both instances, the Supreme Court ruled that tribal nations were not the equivalent to other foreign nations (i.e. European states), as they needed protection provided by the US but were not given representation within the US government, almost existing in a state of ‘limbo’

between autonomous statehood and US assimilation (ibid.). In 1923, a tribal government was officially formed in Navajo Nation to better negotiate with large US oil companies who wanted access to resources on Navajo land (Navajo-nsn.gov, 2011). The extraction of oil was and is largely seen as an exploitative practice that goes against Navajo values and respect for their land. This continues to be a point of contention today (Museum of Northern Arizona, 2021). The creation of the tribal council was the first step of major western thought and US institutions cementing themselves within the Navajo community (Singer et al., 2018). This formation created a centralized authority, which does not align with Navajo tradition of a decentralized system with personal accessibility to leadership, making the first major shift towards western systems (ibid.).

The Navajo tribal government navigated through the assimilation period which ended around 1930. This period was a US political attempt to wipe out tribal cultures, communities, and tribal governments by integrating Navajo communities into US institutions and land (Delaney, 2017). This time period made a significant impact on the Navajo community and government, as poverty sharply rose due to the drastic turn to economics and reorganization of social order. The pastoral living style was not providing an adequate income in their new structure (Singer et al., 2018). The Indian Reorganization Act (IRA) in 1934 proposed three-branch governing systems for Indigenous nation states, very much compatible with western thought and the US governing body, setting up constitutional governments in Indigenous communities. The IRA focused on reducing tribal sovereignty but did leave some room for tribal self- governance (Delaney, 2017). The Navajo tribal council refused the IRA proposition, signifying the cultural emphasis on local, decentralized types of government; not a large centralized government the US was trying to impose (Singer et al., 2018).

As discussed in the introduction, the termination period began in the mid-20th century and lasted until the mid-1960s. During this time the Navajo government introduced the Navajo Nation code, similar to a constitution, as well as a judiciary branch, further mimicking western institutions (ibid.). It also resulted in Native advocates learning to work within the powerful US systems to achieve goals, resulting in the passing of the Indian Self-Determination and Education Assistance Act (ISDEAA) of 1975 (Delaney, 2017).

Title One of the ISDEAA laid the groundwork for the Indian Health Services (IHS) and ability to self- govern (Strommer & Osborne, 2015). The ISDEAA is currently the most important legislation in relation to tribal autonomy.

In 1989, the Navajo government underwent a large reform, taking away authoritative powers from the executive branch after multiple scandals (Donovan, 2021, January 28). After dissolving the Chairman’s role, Navajo Nation chose to formally enter into a three-branch governing body with a legislative, judicial, and executive branch (Singer et al., 2018). Despite the overhaul of the creation of a centralized government, in 1998 the Navajo council passed the Navajo Nation Local Governance Act (NNLGA), giving more authority to local decision making and further aligning the tribal government with Navajo culture and values (ibid.).

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14 The present-day Navajo government includes 110 chapters organized in five territorial agencies, and a 24-delegate council that make up the legislative branch (see Figure 2 below). The council used to comprise of 88 delegates, giving Navajo people a more direct line to their local representative.

Delegates are directly elected by the chapters they represent (Interview 8, personal communication, March 16, 2021). The executive branch is led by the elected President and Vice President, and the judiciary branch is led by the President-appointed Chief Justice (Navajo-nsn.gov, 2011).

Indian Health Services 2.a.3

This section will provide context for the current healthcare system operating within Indigenous communities in the US. The Indian Health Service is a federal system set up by US institutions and is responsible for providing federal health services to all US-recognized tribes. The IHS has come to fruition through multiple US Supreme Court decisions, treaties, executive orders, and laws (ihs.gov, n.d.).

Treaties signed by tribal and US governments outline the US government’s responsibility to both fund the IHS and provide free healthcare to Indigenous people (Singh, 2020). There are 14 hospitals located within the Navajo Nation region, servicing about 250,000 tribal members (ihs.gov, n.d.). Eleven hospitals are operated by US federal management, which are classified as IHS facilities, and three are under tribal management, which are classified as 638 facilities (ibid.). The reason behind calling a tribally run facility a ‘638’ is because of the original act’s (ISDEAA) public law number (Strommer & Osborne, 2015). The ISDEAA legislation made it possible for tribes to take over management from federal facilities, creating the 638 hospitals (Henley & Boshier, 2016).

Additional US legislation that was passed pertaining to the federal IHS system was the Indian Health Care Improvement Act (IHCIA) in 1976 and the Tribal Self-Governance Program (TSGP) in 1988. Both pieces of legislation increased the ability for tribal management as well as attempted to include Indigenous people in the planning of their health facilities (Henley & Boshier, 2016). Concerns around federally led facilities and tribal led facilities are still a large cause of tension today. Approximately 70%

of the Indigenous population both living on the reservation and in urban settings in the US practice some form of traditional healing, not always incorporated in healthcare (Henley & Boshier, 2016). Issues with health facilities favoring urban areas and neglecting rural areas is prevalent in Navajo Nation given the size of territory and lack of facilities (Haroldson, 1988). Rural residents are often left behind while trying to service a large area (ibid.).

Both IHS and 638 facilities are attempting to bridge the gap between western medicine and medicine men by incorporating the Navajo language, traditional healing beliefs, and cultural well-being (Brown et al., 2020). Prior to the globalization of health, medicine men were the community healers, providing herbs, prayers, and songs (ibid.). Navajo healthcare workers (CHWs) travel to rural areas to make home visits (ibid.), connecting modern medicine and traditional healing, but trust is difficult to form when elder’s beliefs do not align (Gampa et al., 2017). Home visits from CHWs strive to better link the community and reach the more rural population (King et al., 2017), interlinking Navajo cultural worldviews with those of modern medicine (Henley & Boshier, 2016). However, tensions remain high due to the chronic underfunding from US congress for IHS (Montoya, 2019). Health organizations are

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15 nervous to change to a 638-management structure due to fear of funds being capped and self-

governance restrictions (Henley & Boshier, 2016). Some Navajo health providers prefer to stay within the IHS system, as it is easier to operate within the large US institution that has already laid the

groundwork for worker’s rights, although they omit tribal rights for self-determination (Kamper, 2006).

2.b Geographical, Political, and Cultural/Societal Context

Figure 2: Map of Navajo Nation (Navajofamilies.org)

2.b.1 Geographical Context

As mentioned above, Navajo Nation is the largest territorial Native reservation within the US (Navajo- nsn.gov, 2011). The territory shares borders with the US states of Arizona, Utah, and New Mexico and covers 27,425 square miles (Jacobsen & Thompson, 2020). The largest part of the Navajo Nation lies within the state of Arizona, and the majority of Navajo reservation population also lives within the state borders of Arizona (Jacobsen & Thompson, 2020). The territorial land is of great importance to Navajo culture, traditions, and spiritual beliefs. Traditional belief is rooted in the power of the four mountains, which the Holy people placed in four different directions to create Navajo land. The power of the territory is intertwined through Navajo identity and pride (Montoya, 2019).

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16 Spatiality on the reservation is important to note because it highlights the vastness and ruralness of the reservation. Residents predominantly live in very rural areas in poor households with difficulties

pertaining to transportation and mobility. Additionally, there is a scarcity of health facilities and grocery stores that offer healthy options on the reservation (Pardilla et al., 2013). The vastness along with the high rates of poverty and unemployment are visually striking (ibid.).

To provide more context surrounding the geography and borders pertaining to Native land, it is useful to look at the event of September 11th (9/11), and how that shifted both domestic and foreign affairs. After the attack on the World Trade Center, border security became extremely heightened in the US as well as around the world (Reece, 2012). This transformed our cultural and political relationships with borders (Longo, 2016). With this heightened border security, additional ‘othering’, racial profiling, as well as a cultural shift of acceptance (ibid.), all in the name of safety occurred under the guise of national security (Reece, 2012). It also increased US nationalism among Indigenous and non-Indigenous citizens, as there was an increase in military enrollment after 9/11 (Denetdale, 2009). This, with the increased border security, came the loss of Indigenous naturalized rights, as Native people could no longer freely cross national borders in North America without undergoing difficulties at the border (Di Iorio, 2007). The rights to freely visit sacred Indigenous land in North America were previously stated in treaties by the US government and tribal governments (ibid.). Since heightened border patrol, Indigenous people are harassed and othered by border agents, making it difficult to visit ancestral lands and often opt to not make the journey. With the rise in Navajo-US nationalism, it also made the ‘border’ of Navajo Nation more malleable and integrated with that of the US (Di Iorio, 2007). This will be discussed further in the cultural and societal sub-section.

2.b.2 Political Context

The political context is multifaceted among different groups within Navajo communities and the US.

Some Navajos take great pride in their language, culture, and traditions, excluding Navajos that did not grow up on their sacred lands due to their family’s moving during the assimilation period (Jacobsen &

Thompson, 2020). Political tensions also run high between Navajo people due to their differing views regarding tribal sovereignty, tribal contracting (the current framework in place) and tribal government assimilation (Delaney, 2017). Political tensions are also conflictive with the US government and different views held by Navajo people about land and political parties. With Indigenous people holding office within the US government, specifically Deb Haaland, who became the first Native person to hold the seat of the Secretary of the Interior, complexities to balance the Native and US agendas furthered. While a great number of Indigenous people are proud and ecstatic for her representation, many are worried she will not be able to stay true to Native traditions and appease the entire US population (Lawrence, 2020, December 29).

This paragraph explores the tension caused in politics and the complexities with Indigenous people holding traditional beliefs while being surrounded by US nationalism and propaganda to encourage alliance and patriotism (Denetdale, 2009). Navajo people have multilayered relationships with political bodies due to the nature of the tribal and federal government (ibid.). Due to Native people being dual citizens, belonging to both their tribal group and US citizenry, their feelings of government vary greatly

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17 between the two, with different beliefs on how they should operate (Singer et al., 2018). Tribal

government has historically been rooted in local, de-centralized governance, with the constituents having direct access to their leader(s). In these contexts, decisions should be made on a small-scale level, and all impacted should be involved. On the contrary, the US government is a large, centralized government where the average constituent has little input in the decision-making process (ibid.).

Most Navajo voters support the US Democratic party (Saxena, 2020, November 13). The Navajo tribal leaders also align with the two-party system that is currently in place in the US. The current Navajo President, Jonathan Nez, is a Democrat, while the Vice President holding office is a Republican. In the past century, most Navajo reservation residents have fallen within the borders of typically ‘red’ or conservative states, being Utah and Arizona. However, Indigenous communities vote the highest

percentage for Democrats in the entire state of Arizona. In turn, helping flip Arizona blue, as almost 90%

of voting Navajo residents supported Biden for the 2020 US Presidential election (ibid.). The election of US President Biden has resulted in his Indigenous nomination for Secretary of the Interior, Deb Halaand.

Both tribal elections and US elections are growing in importance on Navajo Nation, with multiple organizations encouraging voter registration, voter turnout, and advocating for more fair voting laws (Montoya, 2019).

2.b.3 Cultural and Societal Context

Most importantly, the cultural and societal contexts need to be defined to provide a solid basis for Navajo worldview. Culturally, Navajo people hold traditions hundreds, if not thousands, of years old. The Navajo worldview is rooted in a holistic, happy, harmonious, and peaceful way of living. The set of values are known as ‘sa’ah nagháí bik’eh hozhóón’ (Singer et al., 2018). Traditions, practices, language, and spirituality are passed down from generation to generation. Cultural relations between Indigenous people and non-Indigenous US citizens widely differ, as traditional Navajo beliefs do not neatly align with the modern or western world (Gampa et al., 2017). Elders in the Navajo community prepare knowledge to pass down to specific tribal members, as not all knowledge is intended to be shared (Museum of Northern Arizona, 2021). This cultural tradition of withholding certain information is important to note regarding an outside researcher.

The ‘nation within a nation’ mindset brings forth a sense of multiculturalism and multilayered identities.

Indigenous people live in a ‘hybrid’ state, living in limbo between tribal political institutions and identities (Denetdale, 2009). Connections linking the traditional views of Native warriorship and patriotism to the US have been used for Indigenous people to better find a sense of belonging both within their tribe and as a US citizen (ibid.). After 9/11, there was an increase of US army enrollment from Indigenous people (Di Lorio, 2007).

Navajo language, ‘Diné Bizaad’, is an integral part of the cultural and social experience (Singer et al., 2018). Not all Navajo people speak the Navajo language, and not all Navajo people speak English, which creates language barriers (Henley & Boshier, 2016), as well as creates a space to exclude Navajo people within the community as ‘not being Navajo enough’ (Jacobsen & Thompson, 2020). However, billboards on the reservation are in both languages.

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2.c Location of research

This section outlines the location that the research took place, as well as provide a detailed explanation of the restrictions due to COVID-19. The research was conducted in Flagstaff, Arizona. Flagstaff is a city near the reservation and is considered a large border town where many Navajo reservation residents travel to for shopping. There is also a large Navajo population living in Flagstaff (Navajo Population Profile 2010 US Census). Flagstaff is a mountain town with a population of about 75,000 people

(census.gov, n.d.). Although the state of Arizona has been historically conservative, the city of Flagstaff is thought of as a progressive area (Weigel, 2020, September 20).

Although the proximity to the reservation was a mere few miles; visually, Flagstaff resembles a midsized US city with no sign of Indigenous communities or Native culture. While driving onto the reservation there were no border stops or restriction of traffic. Due to the COVID-19 measures put in place by the Navajo Nation government at that time, one was not able to leave the vehicle while observing the reservation. The most apparent visual differences from the US to the Navajo reservation included the homemade billboards asking people to not enter, turn around, pleading to protect elders, and

reminding of social distancing rules. The signage present on the reservation conveyed clear, concise, and more severe messaging than anything observed in Flagstaff. Being on the reservation, you have access to a radio station with constant broadcasting of COVID-19 related information. The radio station provided a clear message about the severity of the virus, where and when you could get supplies, how to get vaccinated, and all COVID-19 hotlines to call for health assistance.

All store fronts on the reservation were closed with the exception of essential shops, which included grocery stores and gas stations. There was very little movement of people and cars within the reservation, a stark contrast from that of Flagstaff. Within Navajo Nation, there is a clear lack of infrastructure, as most communities were mobile homes in rural settings. Large trucks hauling huge tanks of water were making stops at different homes to provide clean water. All observational

information of the Navajo reservation location was collected from the vehicle. This was done to respect both Navajo government COVID-19 regulations and to abide by guidelines pertaining to researching in the reservation put forward be the Navajo Nation Human Research Review Board (NNHRRB). No photos were taken during observational data collection for the same reason as mentioned above.

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3. Theoretical Framework

This chapter discusses the theories and academic concepts on which the research was built. The first section looks at internal colonialism and settler colonialism. This is to show the structural importance of both theories, while also pointing out the differences that helped guide the decision to primarily use settler colonialism. From there, it moves to Social Identity Theory and Free, Prior, and Informed Consent (FPIC). This creates links between the interpersonal and collective experience, as well as frames the research within the global conversation of FPIC. Next, the globalization of health is discussed in relation to Indigenous populations to show how public health has changed and the role it plays in shaping communities. The following section discusses border theory and the relevance of physical and institutional barriers present in this research. The chapter ends with the power of territory, tying together the importance of land from a Navajo perspective and a settler colonial perspective. It closes by showing how the theories come together to frame the research topic.

3.a Internal Colonialism and Settler Colonialism

In the following two sub-sections, internal colonialism and settler colonialism will be discussed, as both theories are important to cover in relation to this research topic. Indigenous people within the borders of the US are still experiencing both internal and settler colonialism, and remain dependent on the colonizers due to treaties, dual citizenship, and ‘soft’ borders (Churchill, 1985). The Navajo Nation population are residing in a nation within a nation. With this comes individual complexities of identity, especially with culture and language. This has been reflected in Navajo tribal laws, as there is still a debate whether the Navajo presidential candidates need to be fluent in the Navajo language (Jacobsen

& Thompson, 2020). Territorial and land complexities are also present, as demonstrated in the current struggle for Navajo Nation to expand land protection for the ancestral and culturally important area, Bears Ears (Interview 1, personal communication, January 23, 2021). Both theories presented below are needed to understand all the individual, relational, institutional, and territorial complexities for this research topic. However, due to the current popularity, knowledge, and specificity in relation to Indigenous communities in the US present in settler colonialism, more focus and emphasis stemmed from this theory in the following chapters. The historical emergence of the theories will first be discussed, followed by the content.

3.a.1 Internal Colonialism

Internal colonialism is a theory that was developed out of dependency theory to better explain the racial effects of isolationism and poverty regarding minority communities in the US (Gutierrez, 2004). The basic notions of dependency theory are relational, as it is believed the ties between poor nations (the periphery) and wealthy nations (the satellites) needs to be delinked, as inequalities are nested in the rich nation’s systems (Frank, 1969). This gives shape to key claims for internal colonialism, as ‘the periphery’ can be connected to the marginalized communities within the US experiencing inequalities, cultural impact, racism, and external governing authority (Gutierrez, 2004). The theory ‘Internal

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20 Colonialism’ was first coined by Robert Blauner in 1969, and related to the white population, also referred to as the colonizer, and the Black population, referred to as the colonized (Blauner, 1969).

Internal colonialism expanded to include Mexican Americans and the Indigenous population in the following decades (Gutierrez, 2004). This relational theory is specific to the marginalized groups within the US, as it grew from the experience shared by non-white communities living in the bounds of US institutions, in turn changing their culture and way of life (ibid.). This theory gained acceptance and popularity through the 1960s, 1970s, and into the 1980s. However, beginning in the 80s it was critiqued and dismissed for not being inclusive enough regarding gender and class (Chavez, 2011).

One pillar of internal colonialism is racism, which is practiced towards marginalized groups. The group holding power ‘others’ targeted people based on what the colonizers view as ‘differences’ (Jazeel, 2009). Additionally, ‘othering’ can be viewed as differences in culture, language, and spiritual beliefs (ibid.). Internal colonialism can be related to post-colonial theorist, Edward Said. In his book,

Orientalism, he highlights the importance of knowledge and (colonial) power. “The essence of

Orientalism is the ineradicable distinction between western superiority and Oriental inferiority,” (Said 1978, as quoted in Schaefer et al., 2017). Said expanded the definition of development to not only include economic development, but also society. He widened the conversation to include culture development and argued that the ‘western way’ was not the only route to civilization (Schaefer et al., 2017).

Looking at internal colonialism with the idea of Orientalism provides a thorough basis and

understanding to tie together the concepts of ‘Anti-Indianism’, which is a concept used to explain the systemic violence and discrimination put in place towards Indigenous people near tribally sovereign lands, and ‘othering’ (Denetdale, 2016). Chavez summarizes the theory nicely by stating, “In short, internal colonialism seeks to explain the subordinate status of a racial or ethnic group in its own homeland within the boundaries of a larger state dominated by a different people,” (2011). This expands the knowledge of institutions and relationships as it pertains to this research by framing the social and cultural experience of marginalized people within the US. Internal colonialism has historically followed a pattern after military conquest – as control starts with political, economic, and cultural overhaul; followed by social and psychological subordination (Chavez, 2011).

3.a.2 Settler Colonialism

Settler colonialism became popularized in the early 2000s with the work of Lorenzo Veracini and Patrick Wolfe (Rowe & Tuck, 2017). Settler colonialism is more prevalent in today’s academic world when compared to internal colonialism. The theory was created to explain the Indigenous experience and history in the US, as people came to a land already inhabited by Indigenous people and declared it their own (ibid.). Invaders see land as property or as a natural resource necessary for development, where Indigenous people see land epistemologically - as curriculum, language, and memory (Wolfe, 2006).

Wolfe further develops this theory by stating that settler colonialism was foundational to modernity, as both colonial land and labor was needed to produce raw materials for industrialization (ibid.).

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21 Settler colonialism has been analyzed by multiple studies, especially Indigenous studies surrounding Indigenous social thought and critique (Rowe & Tuck, 2017). The theory emphasizes the settler’s unwillingness to follow through with formal treaties and laws set in place to recognize tribal sovereign lands. Instead, invaders stop at nothing to achieve access to resources on, in, and around Native soil. In relation to Indigenous communities and the social experience in the US, Wolfe states,

Settler colonialism has now been experienced for decades and is a specific social formation that serves the interests of the US. Part of this social formation is the structure and separation of the colonized people (ibid.). This can be seen in the US through the penal system, racial zoning in large US cities, and allocating specific territory for tribes. Most reservations in the US are not consistent with the original land the tribes had lived on prior to colonialization, and the US has used spatiality and separation to deal with a ‘Native surplus’ (ibid.). This increases the power of US institutions, as control is exerted over marginalized populace by influencing way of life and the allocation of funding for certain areas.

The choices made by the colonizers in the construction of the social order has shaped Native tribes in the US by passing conflicting and contradictive legislation. As discussed in the introduction and contextual chapters, social structures created by the settlers varied from respecting sovereignty,

removal, assimilation, termination, and limited self-governance. The evolving social structure diminished the Native way of life by the consistent restructuring of institutions and not allowing for tribal

autonomy. In turn, this has stripped tribes of their agency and further interwoven personal and collective complexities between Indigenous people and their relations to US institutions.

In sum, multi-leveled coordination of institutions has set to eliminate Indigenous societies as a

foundation for modernity, and the land-centered project of settler colonialism is a social structure that is persistent today (ibid.). Settler colonialism provides a granular understanding and framework of the Indigenous experience in the US that frames the Navajo community in this research project.

3.a.3 Social Identity Theory

Social identity theory (SIT) argues that perception of oneness in a group is presented through social identification, stemming from the categorization of individuals and association of traditional factors typical to a group (Ashforth & Mael, 1989). SIT theorizes that support for the same institutions, participation in group activities congruent with identity, and stereotypical perceptions of oneself and the group strengthens the antecedents of identity (ibid.). This can be applied to tribal institutional organization and relations with internal and external groups.

Indigenous social thought (IST), which is a term used to describe the intellectual knowledge and

traditions within Indigenous theory, is rooted in relationships and traditions between Native people and

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22 nature (Rowe & Tuck, 2016). IST is interlinked with SIT, as the theories are based in sociological and psychological expression (Davis, Loves, & Fares, 2019). SIT claims that a group’s perception of oneness is formed by their predecessors (Ashforth & Mael, 1989). IST claims that identity and Indigenous

intellectual traditions are formed by connection to land-based relationships and collectivity (Rowe &

Tuck, 2017). IST demonstrates what holds importance (land and traditions) within SIT pertaining to Navajo Nation.

Native studies, specifically Native American Studies (NAS), also helps situate SIT within the Native experience and settler colonialism. NAS focuses on tribal sovereignty and land (ibid.). NAS and SIT complement each other because NAS provides the foundation that tribal sovereignty and land are of great importance to Native identity, culture, and group beliefs. Expression of group identity,

connectedness to land, and tribal social thought is present through social gatherings and traditional ceremonies in Navajo Nation (Gampa et al., 2017). One could argue that the importance of communal culture and ancestral knowledge in Navajo Nation strengthens the connection to social identity.

How Navajo people identify with their tribe, land, and US institutions on both a personal and collective level influenced how they experienced the global pandemic. Individual, relational, and structural identity all play a role in the media, individuality, and social aspect of the Navajo experience in a settler colonial society (Rowe & Tuck, 2017). The use of SIT aims to highlight the individual and group feelings towards tribal autonomy, land connectivity, and belonging. This approach is essential to the personal interviews in this paper.

3.a.4 Free, Prior, and Informed Consent

The global principle surrounding ‘Free, Prior, and Informed Consent’ (FPIC) is outlined in the United Nations Declaration of the Rights of Indigenous Peoples as well as in the International Labor

Organization Convention (Hanna & Vanclay, 2013). Based on FPIC, Indigenous people have a right to participate as well as make decisions in development projects, as well as use FPIC to further self- determination (ibid.). This principle provides the global assumption of Indigenous rights and self- determination, although it is not consistently exercised in a settler colonial setting. FPIC is vital to include as it adds the relevance of international law, expectations, and conversations pertaining to Indigenous autonomy, decision-making, and land rights.

The notion of FPIC can be used as a policy tool to promote social equity among Indigenous populations as well as provide a platform for groups to shape the direction and outcomes in resource management (Mahanty & McDermott, 2013). FPIC has been operationalized through governance to strengthen social equity and Indigenous rights (ibid.). As outlined in the previous chapters, the struggle for tribal

autonomy and land rights in Navajo Nation has been an ongoing issue since the inception of the US. By using FPIC in multi-level government-to-government relations, goals like social equity, accountability, and due reward can be incorporated (ibid.). Recognition and respect for Indigenous culture, the right to clean environment, land rights, and economic participation are also made possible using the FPIC process (Owen & Kemp, 2014).

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3.b Globalization of Health

Given the unprecedented events that took hold of our world and our health in 2020, the concept of global health, which is rooted in western medicine, is useful to define within the scope of this research topic. This section aims to address how and why the globalization of health is relevant for building the theoretical framework. Global health is used so commonplace in discourse; it is often not defined or contested. However, it is important to address where ‘global health’ comes from. The concept was created by western science, which is organized with a certain perspective, set of values, and belief system not shared by all cultures (Yates-Doerr & Maes, 2019). The values that were prioritized are consistent with the values of wealthy, western countries. For example, “charity over political justice, moral universalism over cultural specificity, global citizenship over Indigenous sovereignty,” (Butt, 2002 as cited in ibid.). Global dissemination pertaining to public health calls for high-level and concise

transmission of knowledge, coming from a western-scientific source (De Cock et al., 2013). This does not leave space for the multiplicities of minority, Indigenous, or Global South communities. The globalization of health is also a westernization, furthering western thought and institutions, while pushing aside marginalized perspectives. The globalization of health has ‘watered down’ other health preferences and practices across cultures by having western institutions create and manage the health systems that serve Indigenous populations. The following paragraphs discuss these nuances.

The globalization of health, settler colonialism, and power dynamics all play a role in Indigenous health.

“Any western medical institution more than a century old and which claims to stand for peace and justice has to confront a painful truth—that its success was built on the savage legacy of colonialism,”

(Horton, 2019). The relationship and power dynamic between the colonizer and the colonized influences how institutions are structured, as the decision-making process typically leaves out the marginalized group (De Cock et al., 2013). Global health and settler colonialism were both created from western thought, the industrial revolution, and modernity, interweaving the ideas and western standards into Indigenous communities. Indigenous groups with low agency do not have a seat at the table when making decisions about the health of their community (ibid.). This has further contributed to the institutional and structural interrelations between the external power and the marginalized group on a personal and societal level.

Cultural obstacles are also present. Navajo culture prefers small, decentralized involvement with institutions (Singer et al., 2018). This builds trust, creates a feeling of community, and aligns with traditional beliefs. Approximately 70% of Natives within the US use traditional healing practices, integrating spirituality into the process. This can cause friction between cultural beliefs and modern medicine (Marrone, 2007 as cited in Henley & Boshier, 2016). The US health system is representative of a large, central institution. Indigenous health preferences include traditional healing and Medicine Men, which is representative of cultural specificity and sovereignty (Brown et al., 2020). Tensions exist between the standardized, larger institutions of global health, and the smaller, less universal understanding with cultural complexities.

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3.c Border Theory

How is a reservation border experienced through Indigenous communities within the US? To fully set the foundation for this research, it is crucial to include border theory, as borders influence the Indigenous experience from a historical and present-day perspective, prompting how the pandemic played out on Navajo Nation. Border theory is analyzing the division of countries, institutions, and spaces that can be both physical (visible) and metaphorical (invisible) (Chan, 2019). Borders are both governmentally and socially constructed, intertwining citizenship and identity. Boundaries, spatiality, and the power of territory deeply influence social relations (ibid.).

A westernized definition of a border is that they are flexible but focused on the ability to control the capitalist and modern economic system currently in place (Bauder, 2015). The movement of goods and capital have been increasingly globalized, where the movement of people is still heavily regulated (ibid.).

In relation to Indigenous communities and their relationship to land, the socially constructed concept of borders was introduced when settlers arrived and presented the concept of property and property ownership. Furthermore, the regulation of the movement of individuals across land was also new. The creation of reservations, a reserved area of land in the US for Natives to reside, was also a new societal formation that influenced Indigenous communities (Montoya, 2019).

Border theory highlights that a defined geographical territory comes with a very complex set of social constructions. In relation to settler colonialism, the social relation of Indigenous people to their land contributes to the complexity of identity, second-class citizenship, and duality of allegiances (Denetdale, 2009). Borders represent western thought, western societal organization, and institutional control.

Borders also help regulate and record citizenry, which is not a common practice within Indigenous traditions.

Navajo people live within two borders, Navajo Nation and the US. This presents two conflicting social realities, as the US border represents modernity, industrialization, and globalization. The Navajo border represents community, traditions, and cultural specificity. Like global health, borders are also

constructed from a western mindset, greatly impacted by globalization, and further perpetrating tensions of modernity and Indigenous communities.

3.c.1 Power of Territory

The power of territory is defined by place-based citizenship, rights, and identities (Graham, 2020).

Navajo citizenship is tied to both Navajo Nation and US space, tribal and US rights, and duplicative identities. The power of territory highlights the tensions brought to light in this research.

The increase of globalization must be addressed in conjunction with territory, as some argue

globalization decreases the legitimacy of territory and borders, as international ideas and institutions are making our understanding of space more porous (Paasi, 2009). Wealthy nations drive global projects, gaining access to different territories and resources for the right price. However, territory and local government is a vital organizer for how people experience space (ibid.), especially for Indigenous people. Indigenous autonomy and land rights provide communities decision-making power for resource

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25 accessibility. For this research, territory and borders are believed to be imperative symbols of

institutions and ideologies, as the concepts are used and understood through multiple perspectives and lenses. The lens of settler colonialism interprets territory as a resource-rich property used for monetary gain. COVID-19 uses territory as a porous and flexible notion, showing the weaknesses in the social constructivism of borders, as the pandemic affected all communities despite mobility regulations.

Contradictive to the wide reach coronavirus had, tribal institutions view territory as a way to legitimize tribal autonomy and use land epistemologically.

The power of territory connects the tensions of settler colonialism and Indigenous communities in the US. The goal of settler colonialism - the acquisition of land - and the tribal connection of culture, sovereignty, and the ancestral understanding of land are at two opposing understandings. Having land means tribal authority to rule its people by tribal law, as well as expand a sense of belonging, place, promotion of cultural health, and environmental protections (Montoya, 2019). Complexities regarding failure of treaty fulfillment and actions of multi-level US governments perpetuates settler colonialism with complications around tribal autonomy, public lands, and US-Native citizenship (ibid.). Territory comes with a multi-layered connection, understanding, and relationship to land for Native people.

3.d Theoretical Framework Summary

This section will address the broad themes put together from the theories presented above. In the briefest of terms, this framework weaves together power dynamics and societal structure that has been produced through colonialization, and the relationships between land and institutions formed by Indigenous communities.

First, the power dynamic that is presented through settler colonialism is important to note. Power, decision-making, resource control, and institutional construction all play a role in shaping Indigenous communities. Through the social and institutional construction put in place by settlers; western thought, industrialization, and globalization expanded into colonized societies. Globalization contributed to the understanding and reshaping of the world order, including marginalized groups in the Global North (Thrall, 2008). This includes the expansion of global health and the healthcare systems put in place. The fundamental concept of land and how territory is used can be shown through the different lenes. Dual institutions are structured from an Indigenous and western perspective, leaving Indigenous

communities with the complexities of sorting out how to navigate through both. How space is experienced; in rural or urban, poverty or wealth, resource affluent or baren; shapes Indigenous expression of identity, health, autonomy, and citizenship.

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4. Research Methodology

4.a Research Design

My research design was grounded in a remote or virtual ethnographic approach (Crichton & Kinash, 2003), using qualitative methods including virtual individual interviews, a media analysis, and a social media analysis based on Facebook. Virtual ethnographic research primarily uses the internet to conduct interviews as well as using online resources and tools for qualitative research collection (ibid.). A thematic mode of analysis was used for data collection, and the data collection for the media analysis and interviews was done concurrently. The social media (Facebook) analysis took place at the end of the research period. A framing approach (Scheufele, 1999), which will be explained in the following sections, was used specifically for the media analysis. A discourse analysis approach was used for the interview transcriptions and social media analysis when reviewing comments left on a Facebook video publicly posted by Navajo Nation President Jonathan Nez and Vice President Myron Lizer (Sloan & Quan‐Haase, 2017). Additional details will be provided in the following section(s).

The ontological approach for this research was based in constructionism, as reality is subjective, not pre- determined, and there can be multiple perceptions and truths (Bryman, 2012). The epistemological approach will be rooted in interpretivism, respecting differences between humans in social settings versus natural sciences (ibid.), as I believe it is impossible to be fully objective when analyzing the human experience.

4.b Units of Analysis & Sampling

4.b.1 Unit of Analysis

The units of observation are individuals, social media (Facebook) comments, and media outlets. The media agencies that were analyzed include the Navajo Times, Arizona Republic, Associated Press, New York Times, CNN, and Fox News. This research focused on Navajo individuals as well as individuals whose work involved the health of Navajo people.

The units of analysis are the social experience evaluated on multiple platforms (media and social media) and relationships towards institutions.

4.b.2 Sampling

Interviews began with a purposive sampling, as I used my personal connections for my initial interviews.

Additional interviews were conducted using the snowball sampling approach (Bryman, 2012). Ten individual interviews were completed during the fieldwork research. Nine of the interviews were completed via zoom or phone call. One interview was conducted outdoors at a safe distance, which ensured that participants and I were safe during COVID-19.

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27 For the media analysis and social media analysis, I used the internet to collect data. The media sources mentioned above were selected to represent local, regional, and national news agencies. The media agencies were also selected based on accessibility, relevancy, and use of key words. Lastly, they were chosen to represent different political views and affiliations. The Facebook video was chosen due its relevance and public accessibility. The video was posted by the official ‘Navajo Nation President Jonathan Nez and Vice President Myron Lizer’ Facebook page. The video displayed a COVID-19 vaccination event that was occurring at a 638 hospital in Navajo Nation.

4.c Data Collection Methods

As indicated above, data was collected from three sources. The most prevalent form of data collection was completed online in the media analysis, finding eight to ten news articles from six different US news media agencies. In addition, semi-structured interviews were conducted with ten individuals, including Indigenous community members living on and off the reservation, as well as non-Indigenous individuals who were working in Navajo Nation during the global pandemic. Lastly, a social media analysis was completed using discourse analysis to achieve triangulation. All data was stored on my password- protected laptop, using Google Sheets, Microsoft Word, and ATLAS.ti.

4.c.1 Media Analysis Data Collection

The media analysis was conducted with the belief that media is a ‘soft power’ (Chung, 2019). Soft power in media is defined as a transcultural and ideological influence, without the use of coercive power to achieve a goal (ibid.). I used the internet to access online articles from the six media agencies selected.

The data collection methods were conducted with the frame approach in mind. Created by Dietram Scheufele, the articles collected were under the assumption that social constructiveness frames realities that are then portrayed in the media in certain patterns (1999). Media controls how stories are

communication, discussed, framed, and interpreted. It is up to the individual to digest the news by peer discussions, media sources, and personal life experiences (ibid.). I bought subscriptions to the Navajo Times and Arizona Republic to gain full access to articles. All articles were originally written in English;

thus, no translation was needed. As mentioned above, media agencies were selected to represent different levels of geographical and population scales, as well as represent different political views and affiliations.

I selected articles based on publication date and key words searched. Articles included were published between April 2020 and March 2021. The following key words were input into the online ‘search’

function for each news outlet during the article collection phase: ‘Navajo Nation’, ‘COVID-19’,

‘Indigenous’, ‘Healthcare’, ‘Tribal Government’, ‘Native American’, ‘Culture’, and ‘Borders’. I also combined key words during the search; for example, ‘Indigenous + healthcare’, ‘Native American + culture’, and ‘Navajo Nation + COVID-19’. Once the articles were identified, content was saved in individual Microsoft Word documents, separately stored in a folder based on which news outlet published the article. Once saved, documents were transferred to ATLAS.ti to organize and analyze.

Stored documents were saved under their publication date and news agency.

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References

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