Clifford E. Trafzer - Strong Hearts and Healing Hands: Southern California Indians and Field Nurses, 1920–1950

During the early twentieth century, public-health nurses recognized the key elements to controlling and defeating pandemics: quarantine, testing, and tracking cases and contacts. Today the world is in the grip of the worst pandemic since the deadly flu pandemic of 1918 and 1919. Like that flu epidemic, the United States finds itself woefully unprepared for a deadly new killer virus, COVID-19. Since the public first learned of the Coronavirus, the lack of a systematic national response in the United States is reminiscent of past epidemics. History illustrates that scientists, public-health officials, and medical providers know best about contagions and control of pathogens. As every health-care official understood, vital statistics served a critical role when assessing the general health of a population and changes in mortality and morbidity over time. This public-health axiom remains significant today in the face of the COVID-19 pandemic. The concept of fighting contagious bacteria and viruses is also the key today to stopping the spread of COVID-19 and saving lives. In the pages that follow, it will be clear that nurses were at the forefront of fighting tuberculosis among Southern California Native people, gaining through their efforts the most accurate information about the spread of the disease and the best treatment options.

Then as now its critical that people at the highest level of national policy making confer with those who have experience and knowledge about a specific disease and shape policy based upon that knowledge. Nonmedical professionals and researchers have a different focus than politicians and economists. While it is true that the economy is critically important to the health of thisnationphysical, medical, and financialin the instance of a pandemic the health of a huge swath of the public is also at stake. Balancing all concerns requires respect for those professionals, many of whom have boots on the ground in terms of dealing with communicable diseases. Failing to heed that professional advice can undermine the national response and lead to far more death and suffering.

In 1928, the first nurse entered the Mission Indian Agency, followed by several other nurses who dealt daily with infectious diseasesespecially tuberculosis, the foremost killer of Native Americans during the early twentieth century. Without antibiotics to fight Mycobacterium tuberculosis, field nurses taught Native Americans about social distancing, quarantining, sterilization of eating utensils, and sanitation of items and spaces used by people with tuberculosis. Nurses had knowledge of disease and disease transition, and they used their knowledge to fight tuberculosis and other infectious disease, just as contemporary health-care providers have urged all Americans today to use common sense, social distancing, and isolation to fight COVID-19. Without an antibiotic to fight tuberculosis, during the first half of the twentieth century, field nurses strongly urged Native American patients to follow basic public-health measures. As a result, between 1922 and 1927, American Indian deaths caused by every infectious disease declined.

In and near my childhood hometown of Yuma, Arizona, the Quechan had made the best of their situation as they navigated changing Indian policies, racism, poverty, and sicknesses brought by settlers. They experienced cases and deaths resulting from dangerous bacteria and viruses, but over time, they used Western medicine, which became part of their tribes history and culture. Like other Indians of Southern California, the Quechan and other Native Americans living along the Colorado River learned public-health protocols from nurses, which lowered the number of deaths caused by a myriad of diseases. Like the Quechan, the Kumeyaay, Cahuilla, Cupeo, Chemehuevi, Serrano, and Luiseo learned from public-health nurses, known as field nurses. The nurses contributed greatly to improving Indian health and lowering the number of deaths. However, the nurses could do little about improving Indian health without the willing cooperation and participation of Native Americans of Southern California. Between 1928 and 1950, Native American men, women, and children displayed strong hearts as they worked with white field nurses with healing hands to lower the number of cases and deaths caused by bacterial and viral diseases. This is an account of their interactions together in a protracted and successful campaign to bring better health to American Indians of the Mission Indian Agency.

During my three years as a curator for the Arizona Historical Society, nine years as a professor at San Diego State University, and thirty years at the University of California, Riverside, I have had many conservations with California Indian people who have been my teachers. During conversations, they taught me a great deal about their history, culture, and belief systems. I use the knowledge they share in this work, citing in endnotes as conversations rather than formal interviews. Occasionally, I provide tribal knowledge herein, information tribal people felt comfortable about sharing. In the present study, I have used some of the information that people with knowledge and intellectual authority shared with me to enhance this formal study. In addition, I provide geographic information based on my own experiences, having lived in the Southwest and Southern California most of my life and having traveled with different tribal people to cultural landscapes where they provided special knowledge known to tribal people. For example, in 2009 I began a series of funded projects with the Army Corps of Engineers regarding sacred lands among the Yavapai-Prescott, Mohave of the Colorado River Indian Tribes, Quechan of Fort Yuma, and Chemehuevi enrolled on the Colorado River, Cabazon, Chemehuevi, and Twenty-Nine Palms Reservations. Members of these tribes, Cultural Committees, and elders groups provided me information that gave me depth of knowledge and Native voices to enhance this study.