精东影业

A few weeks ago, I found myself tearing up at my kitchen table as I listened to a health care official from the Eastern Band of Cherokee Indians explain to me the intricate and bold steps my tribe has taken to combat COVID-19 on the Qualla Boundary鈥攕pecifically Cherokee, North Carolina. We had enacted policy and consolidated resources completely separate from state or federal aid and mandate. This was the third conversation on the topic I had had with a tribal official鈥攖he third time I teared up out of pride.

As of July 12, even after the summer holiday surges, the EBCI has administered 5,620 COVID-19 tests, with 86 positive test results. Sixty-one of those have fully recovered. These are exemplary rates compared to our neighbors in surrounding counties such as Henderson and Macon, and in mid-May when I began speaking with tribal officials, our numbers were even more remarkable. But just as I was celebrating our assertion of sovereignty amid a global pandemic, the story took a complex turn. I was about to tear up over a different statistic.

The EBCI has reacted to COVID-19 with an abundance of caution that exceeded much of Indian Country鈥檚 and certainly our home state鈥檚 response. In partnership with the nonprofit Dogwood Health Trust, a nonprofit health organization based in Asheville, we began providing access to free communitywide testing (even for asymptomatic people) long before North Carolina recommended it. We set up roadblocks and allowed only residents or EBCI enrolled members to access the boundary. We closed nonessential businesses, including Harrah鈥檚 Cherokee Casino and our government offices. We employed a sophisticated and comprehensive contact tracing system that has been credited with identifying asymptomatic carriers before they unknowingly transmitted the virus.

However, one week before the removal of roadblocks, my Facebook feed was inundated with local memorial postings. At this point, no enrolled members of the EBCI had succumbed to the virus, yet seven residents of the Qualla Boundary鈥攐ut of a population of about 2,100鈥攈ad died within a couple of days of each other.

While we focused on slowing the COVID curve, we experienced an explosion of drug overdose deaths. Additionally, the total number of overdoses, including those not resulting in death, was incalculable.

Sovereignty is not only a protection from the outside; it is a responsibility to derive power from the inside.

During statewide lockdowns, nonessential tribal employees continued to be paid, though now at home. A per capita loan fund provided ready cash for those not willing or able to wait until the June 1 disbursement of gaming revenue. Food assistance programs continued to run and emergency services ramped up their care for elders and the needy. A tractor trailer even brought a full load of free frozen chicken to the boundary, providing 10 pounds each to anyone who showed up.

These were all tremendous examples of a community caring for the collective and stabilizing an economy, but it also meant that we became one of the few communities in far western North Carolina who still had the means to be paying customers鈥攅specially in the illegal drug trade.

Ready access to cash stiffened across the remainder of the western North Carolina, but the boundary continued to provide a fluid market for dealers.  

The blockades provided a challenge for traffickers, how to move product across barriers when passage required drivers to either be enrolled EBCI members or prove boundary residency. They needed to move larger quantities fewer times. What resulted was an inflow of fentanyl-laced heroin. Dealers could stretch their product and meet the demands of all customers in a timely manner. 

鈥淭he narcotics industry follows a customer service model. It鈥檚 a sophisticated business,鈥� Principal Chief Richard Sneed said. They were going to meet demand. They weighed their risk-reward ratio. 

But members of the community who struggled with substance abuse disorders who were accustomed to a typical dose were caught off guard by this production adjustment, the addition of fentanyl鈥攁 synthetic opioid that is 50 to 100 times stronger than morphine. Seven died. Others turned to Narcan for a lifeline.

Vickie Bradley, Secretary of Health and Human Services for the EBCI, argues that we have a dearth of consistent overdose/drug usage data that can show clusters of overdoses and deaths in almost real time.

鈥淏ut it relies on EMS and health care facilities to code a death as an overdose, and some providers are reluctant to do so because of stigma for the family,鈥� she explained. 鈥淭hey may code it as a heart attack or other similar event instead.鈥� 

The EBCI鈥檚 Overdose Map, where the collected data is housed for analysis, also does not account for instances when Narcan, an overdose reversing medication, was used to revive a patient.

While we have more COVID-19 contact tracers than North Carolina鈥檚 goal, we 鈥渄on鈥檛 have a consistent philosophy鈥� for tracking overdoses, Bradley said. She notes that the takeaway from our COVID response is the effectiveness of a multiuser platform to capture data, and her programs are in the early stages of expanding just such a platform.

Chief EBCI Alcohol Law Enforcement Agent Josh Taylor, who was tasked with expanded responsibilities during the shutdown, believes the COVID-19 precautionary measures highlighted one important truth in the fight against the drug epidemic on the boundary.

鈥淚t was one of the few incidences when we got to take outsiders out of the equation. It was a sad reality that our own people were working so hard to bring [drugs] into our community. Maybe they were now having to traffic the drugs more themselves, or maybe they just always have been,鈥� he said. 

The most difficult adjustment for Taylor was realizing 鈥渢hat dope was killing more of our people than this pandemic.鈥� With COVID-19 proliferation in the drug community, contact tracing simply won鈥檛 be as effective. People abusing or misusing drugs rarely obey stay-at-home orders, even if they test positive. 

Overdoses seemed to diminish with the removal of blockades and officers were no longer needed for border control. Warrant issuing and arrests became the newest trend. Trafficking intelligence was gathered not only from police surveillance efforts but also from community services that were making more home visits as a result of COVID-19. Unfortunately, this led to the next challenges for the EBCI鈥�14 law enforcement officers were exposed to COVID-19 while on a drug-related call and needed to quarantine for two weeks, sidelining them from their duties.

To date, state and federal aid has done little to assist impoverished native communities coping with historical grief and trauma in their fight against substance abuse. But if we are to learn anything from COVID-19, it is that waiting for outside help is a death sentence.

When I speak to them as I sit at my kitchen table, the EBCI officials tasked with safeguarding our communities, whether it be from the coronavirus or illegal drugs, are more than just names and titles to me. Secretary Bradley and Chief Sneed are Vickie and Richie, whose children were students at the school where I teach. Officer Taylor is my cousin, Josh, with whom I grew up. 

This is one reason that their stories are emotional for me. They don鈥檛 sensor their words because they know the importance of being honest with ourselves now, of learning from this seemingly temporary epidemic how we might begin to combat a much more longstanding one. Because sovereignty is not only a protection from the outside; it is a responsibility to derive power from the inside.

This story originally appeared in . It has been edited for 精东影业 Magazine.