Book Review

Canada and the United States

The reputation of Indian reservations has undergone a remarkable metamorphosis. Initially understood as places of confinement and laboratories for the transformation of "Indians" into "Americans," they have evolved into sites for cultural persistence, renewal, and regeneration. Yet rarely do people perceive reservations as places of physical health or prosperity. Robert A. Trennert's detailed history of government-sponsored health care on Navajo reservations relates the grim story of efforts to deliver that care. It is largely a story of failure. Happily, since 1955, when the Public Health Service took control from the Bureau of Indian Affairs, conditions have improved markedly.

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Throughout the nation, implementation of the reservation policy meant ostensible federal responsibility for Indian health and welfare; an obligation that was long neglected, underfunded, and consequently insufficiently met. For the Navajos, the story began at the Bosque Redondo reservation, where over 8,000 Navajos came under federal jurisdiction after the Kit Carson campaign drove them from their homes in the early 1860s. Malnutrition, disease, lack of sanitation, and mental distress led to a high mortality rate. Navajos turned, first, to their own healers but proved willing to adapt Western medical practices that offered tangible benefits. Individuals voluntarily came in for smallpox vaccinations, for example. By 1868, policy makers declared the Bosque Redondo experiment a failure, however, and Navajos returned to their homelands of northern Arizona and New Mexico.

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