Blessing from the Medicine Man, Howard Terpning®, 2011 / The Greenwich Workshop, Inc.
Native American concepts of health and wellness have sustained diverse peoples since ancient times.
Edited by Matthew A. McIntosh / 08.04.2018
Medicine Ways: Traditional Healers and Healing
Many traditional healers say that most of the healing is done by the patient and that every person has a responsibility for his or her proper behavior and health. This is a serious, lifelong responsibility. Healers serve as facilitators and counselors to help patients heal themselves. Healers use stories, humor, music, tobacco, smudging, and ceremonies to bring healing energies into the healing space and focus their effects. The healing process also goes beyond the individual patient. Traditional healers take into account not only the patient’s immediate family and community, but future generations as well.
The Key Role of Ceremony
Grand Medicine Lodge and Chief Ojibway, White Earth Indian Reservation, Minnesota, 1910: The sweatlodge ceremony was first practiced by the Plains Indians and has spread to many other tribes. A sweatlodge is typically a tent-like structure that traps heat under blankets or animal hides, promoting wellness by cleansing and purifying the body and spirit. / Minnesota Historical Society
Ceremony is an essential part of traditional Native healing. Because physical and spiritual health are intimately connected, body and spirit must heal together. Traditional healing ceremonies promote wellness by reflecting Native conceptions of Spirit, Creator, and the Universe. They can include prayer, chants, drumming, songs, stories, and the use of a variety of sacred objects.
Cheyenne Indians at a Sun Dance, by Edward S. Curtis, circa 1910: The Sun Dance is practiced primarily by tribes in the Upper Plains and Rocky Mountain areas. This annual ceremony is typically performed at the summer solstice (the time of longest daylight), with preparations beginning up to a year before the ceremony. Though the dance is practiced differently by different tribes, the Eagle serves as a central symbol in the dance, helping bring body and spirit together in harmony, as does the buffalo, for its essential role in Plains Indian food, clothing, and shelter. / Library of Congress
Healers may conduct ceremonies anywhere a sick person needs healing, but ceremonies are often held in sacred places. Special structures for healing are often referred to as Medicine Lodges. Wherever they take place, traditional healing ceremonies are considered sacred, and are only conducted by Native healers and Native spiritual facilitators. Non-Natives may participate by invitation only.
The Medicine Wheel and the Four Directions
Aerial view of Medicine Wheel National Monument, Wyoming, 2002: This medicine wheel was constructed by Plains Indians several hundred years ago. The star alignments of the wheel are most accurate for about AD 1200. This wheel, a U.S. Park Service National Monument, is one of the largest and most well preserved in North America. / USDA Forest Service
The Medicine Wheel, sometimes known as the Sacred Hoop, has been used by generations of various Native American tribes for health and healing. It embodies the Four Directions, as well as Father Sky, Mother Earth, and Spirit Tree—all of which symbolize dimensions of health and the cycles of life.
The Medicine Wheel can take many different forms. It can be an artwork such as artifact or painting, or it can be a physical construction on the land. Hundreds or even thousands of Medicine Wheels have been built on Native lands in North America over the last several centuries.
Ojibwe Indian stone medicine wheel / Cedar Tree Institute, Marquette, Michigan
Movement in the Medicine Wheel and in Native American ceremonies is circular, and typically in a clockwise, or “sun-wise” direction. This helps to align with the forces of Nature, such as gravity and the rising and setting of the Sun.
Meanings of the Four Directions
Soapstone Navajo Indian eagle sculpture, 2004: Native ceremonial objects and the Medicine Wheel often include the eagle as a spirit or power animal. The eagle represents the vision, insight, leadership, healing, and wisdom needed to overcome health and life issues. In Native legend, the thunderbird is a powerful spirit in the form of a bird, sometimes eagle-like, who produces thunder from his wings and lightning flashes from his eyes. The thunderbird projects power, protection, and even fear. / F. B. Wood Collection
Different tribes interpret the Medicine Wheel differently. Each of the Four Directions (East, South, West, and North) is typically represented by a distinctive color, such as black, red, yellow, and white, which for some stands for the human races. The Directions can also represent:
- Stages of life: birth, youth, adult (or elder), death
- Seasons of the year: spring, summer, winter, fall
- Aspects of life: spiritual, emotional, intellectual, physical
- Elements of nature: fire (or sun), air, water, and earth
- Animals: Eagle, Bear, Wolf, Buffalo and many others
- Ceremonial plants: tobacco, sweet grass, sage, cedar
Mortar (left) and Pestle (right): Today Native Hawaiians use the same implements as their ancestors for pounding and grinding medicinal plants into powders used for medicines and healing teas. / Bernice Pauahi Bishop Museum
Native American, Alaska Native, and Native Hawaiian healers all have a long history of using indigenous, or native, plants for a wide variety of medicinal purposes. Medicinal plants and their applications are as diverse as the tribes who use them.
Aloe (Hawaiian name: Alo’e. Scientific name: Aloe vera), 2011: Used for healing burns, as a tea to detoxify the body, and as a skin moisturizer. / Photo by Kaula Clark, National Library of Medicine
Beyond their medicinal benefits, indigenous plants were a staple of Native people’s diet before Western contact. Today, indigenous plants are central to efforts to improve dietary health for current generations. In Hawai‘i, the “Waianae Diet” and “Pre-Captain Cook Diet” aim to reduce empty calories, fat, and additives and promote a healthier, more balanced diet by restoring the role of indigenous foods. Alaska Natives and various Indian tribes have similar projects emphasizing traditional foods. In this very real sense, food is medicine.
Native Hawaiian Medicinal Plants
Sea salt, red and white (Hawaiian name: Paakai. Scientific name: sodium chloride): Used as a cleanser of places, bodies, and illness. Wahine Paakai is female salt (sea salt with red clay added). Kane Paakai is male salt (white). / Photo by Kaula Clark, National Library of Medicine
Hawaiian medicinal plants grow in many areas, including in the vicinity of heiaus or temples, sites that are considered sacred. In ancient times, Hawaiian traditional healers would practice La‘au Lapa‘au, medicinal healing, at some of the heiaus, using plants from around the heiau and in neighboring forests.
Paul Ortega with large Yucca plant, Mescalero, New Mexico, 2011: Yucca (Mescalero Apache name: Huskane. Scientific name: Yucca elata Englemann) Yucca root is used as a soap and shampoo. A poultice of roots and leaves can be used to treat insect bites. The raw fruit has a laxative effect. The trunk is used to make a tobacco mix and a sore throat chew. The plant is also used ceremonially in fertility rites. / Photo by Paul Ortega, National Library of Medicine
Most Hawaiian medicinal plants are foods that have additional curative properties. Healers view food as medicine, along with fresh, clean air and water. In all cases, healers offer a prayer to ask permission and give thanks for the medicines before harvesting and preparing them, and ask permission to facilitate medicinal healing on behalf of the Creator.
Healing Communities: Extending a Healing Hand, Then and Now
Community is an essential aspect of Native conceptions of health. Wellness of the individual is inseparable from harmony within the family and community and pride in one’s heritage. Whether in a small community in Hawai‘i historically devoted to tending to the sick, or in community-wide activities such as traditional sports and games among many groups today, these values are key to Native health.
Kalaupapa: From Harsh Exile to Healing Community
Cemetary, Kalaupapa, 2009 / Photo by Elliot Siegel, Ph.D.
Historically, Native peoples often had little resistance to diseases introduced from other parts of the world. Hansen’s disease (leprosy) came to Hawai‘i in the 19th century. The disfiguring and then-untreatable disease aroused panic, and in 1866, led the Hawaiian Kingdom to quarantine persons for life on Kalaupapa, an inaccessible peninsula on the island of Moloka‘i.
Kalaupapa Peninsula, Moloka‘i, Hawai‘i, 2009 / Photo by Robert Logan, Ph.D.
The health of the patients and the extraordinarily harsh living on Kalaupapa sparked an international response, including a 19th-century mission led by Catholic priest Father Damien. By 1946 a treatment for the disease using sulfone drugs was discovered, but Hansen’s disease patients remained confined to Kalaupapa until 1969. Today, about 20 patients (whose Hansen’s disease remains under control) live voluntarily at Kalaupapa where they receive free medical care.
Father Damien’s Arrival at Kalaupapa, Molokai, by Herb Kawainui Kane / Herb Kawainui Kane Heritage Trust
The Kalaupapa story illustrates the devastating impact of external contact on Native Hawaiian health. But it is also a story of the compassionate care of Father Damien, and of the physicians who still tend to the remaining patients. It also illustrates how advances in medical knowledge can overcome ignorance. The Kalaupapa saga is commemorated in Hawai‘i by Saint Damien Day celebrated annually on April 15. Father Damien was canonized by Pope Benedict XVI in 2009.
Ball Play of the Choctaws – Ball Up by George Catlin, circa 1846-50 / Smithsonian American Art Museum
Native games are more than just games. They build body and spirit through exercise and are played by all age groups—children, youth, and adults. Many games have roots in ancestral tests of strength and sport that reinforced group cooperation and sharpened survival skills in often hostile environments. For warriors, the games helped maintain their readiness and combat skills between times of war.
Today, games are as important as ever. The gradual shift to a more sedentary lifestyle has highlighted the need to reawaken interest in physical activity, especially among Native youth. Promoting games and sports is an important part of improving the health and well-being of Native populations.
George Catlin painting depicting a Choctaw stickball player named Tullockchisko holding the traditional pair of sticks, 1834 / Smithsonian American Art Museum
Stickball, a Native game that is the forerunner of lacrosse, can be played by a large number of players, sometimes involving entire tribal communities. It is especially popular among Southeastern Indians, including the Mississippi Band of Choctaw Indians. In stickball, both teams must move the ball down the field using only their sticks—no touching or throwing of the ball is allowed. Points are scored by hitting the opposing team’s goal posts with the ball. The Choctaw hold an annual World Stickball Championship as part of the Choctaw Indian Fair.
Iditarod and Alaska Native Games
Eskimo high kick ball, 1914 / Alaska State Library, Historical Collections
For Alaska Natives, the tradition of ancestral games is as strong as ever. Most famous is the Iditarod dog sled race, a highly competitive endurance sport that promotes survival skills in a challenging Arctic environment. Alaska Native John Baker of Kotzebue won the 2011 Iditarod in record-breaking time.
At annual events such as Alaska Native Youth Games and the World Eskimo-Indian Olympics, children and adults test their strength, endurance, and agility in traditional contests such as the high kick, in which competitors kick balls suspended at head level or higher. As of 2011, the world record was 7’ 10” for men, and 6’ 1” for women. Other more conventional sports, such as basketball and cribbage, are also important to Native communities, young and old, especially during the long winters.
Native Heritage: Traditions Preserved and Renewed
Reverence for tradition, for tribal elders, and for a Supreme Being have been fundamental to Native health and culture for generations. Sadly, in the 18th and early 19th centuries, U.S. government policies of removing and relocating Indian tribes, combined with the impact of missionaries and settlers, suppressed Native culture. Many ceremonies and traditional healing practices were banned outright. But traditional values such as loyalty and military service were kept alive. And in the last few decades, Native Peoples who have preserved their traditions are renewing the old ways and teaching them to the next generation.
The Talkers’ Code of Silence
Public Law 110-420 Code Talkers Recognition Act, signed by President George W. Bush on October 15, 2008, recognizing the service of all Native American Code Talkers during the two world wars. / United States Government Printing Office
They were called Code Talkers—or just “Talkers”—by their fellow soldiers. But returning home from combat, the Native American Code Talkers had to take an oath of secrecy about their war service. The Talkers were not allowed to talk.
Navajo Code Talkers Henry Bake and George Kirk, operating a portable radio set in the South Pacific, 1943: This image appears on the official Navajo Code Talkers bronze medal, created to express formal appreciation and recognition of the Navajo Code Talkers by the United States government. / National Archives and Records Administration
The Code Talkers served the United States military during both world wars and were pivotal to achieving victory in the Pacific. The “codes” they used were based on their Native languages—Navajo, Choctaw, Cherokee, and others. They operated on the front lines, relaying by radio and telegraph vital tactical information faster and more securely than any conventional military code. No message sent by a Code Talker was ever successfully decoded by enemy forces.
Flag Raising on Iwo Jima, 23 February, 1945 / National Archives and Records Administration
Their contribution was considered a critical military secret, and the Code Talkers honored their oath of silence for decades. But this order and combat-related stress took a toll. Many Code Talkers sought and found relief through traditional healing ceremonies.
Nonabah and Thomas H. Begay, 2010 / National Library of Medicine
One such ceremony is the Navajo Enemy Way Ceremony, which uses prayer, talking circles, drumming, sweatlodges, and other traditional healing practices to help relieve the veteran of pre- and post-combat stress and sustain connections with family, community, and Native culture.
Thomas H. Begay and Donald A.B. Lindberg, M.D., on the occasion of Mr. Begay’s visit to the National Library of Medicine on September 13, 2010 / National Library of Medicine
Such ceremonies are vital, as Mr. Alfred Gibson, Navajo spiritual leader, has observed: “When soldiers go overseas, we give them warrior ceremonies to armor and protect them against the battle; when the soldier comes back, we have to remove that armor, to help him reconnect with his home.”
Today, the U.S. Veterans Administration and its health professionals support the use of the Navajo Enemy Way Ceremony, as well as other traditional ceremonies, for the health and well-being of Native American veterans returning from war.
Many Paths: Intersections of Traditional and Western Healing
Today, Native people of all groups are often faced with the question of whether to rely on traditional Native healing methods or to seek Western medical treatment. Until relatively recently, the two traditions operated in parallel, with little intersection between them. Today, however, Native Americans can access a continuum of health care. Many traditional healers still practice independently within tribal communities. Other healers may work with Western-trained primary care physicians to coordinate care for Native American patients. Some healthcare institutions offer both traditional and Western medicine, often at the same location.
In most areas, Native American patients get traditional healing from within the local tribal community, rather than through tribal health clinics or hospitals. In the Dakota and Lakota, and Mandan, Hidatsa, and Arikara, (MHA) Tribes of the Upper Plains, tribal members arrange for services by contacting local healers directly. Some Western-trained physicians also refer patients to traditional healers, and will sometimes help coordinate both Western and traditional medicine for a specific patient.
The Waianae Coast Comprehensive Health Center
New building, traditional healing center, 2010 / Waianae Coast Comprehensive Health Center
The Dr. Agnes Kalaniho‘okaha Cope Native Hawaiian Traditional Healing Center, Waianae Coast Comprehensive Health, O‘ahu, Hawai‘i, provides a range of traditional healing practices offered by master practitioners. A Council of Elders oversees the practices, which are located onsite alongside Western primary medical care and comprehensive health and wellness services.
Dr. Agnes Kalaniho‘okaha Cope Native Hawaiian Traditional Healing Center, 2010: The Waianae Coast Comprehensive Health Center, a community health center in the State of Hawai‘i, was successful in obtaining federal funding and private funding to build a new site for its Native Hawaiian healing program. The Dr. Agnes Kalaniho‘okaha Cope Native Hawaiian Traditional Healing Center opened in August 2009. / Waianae Coast Comprehensive Health Center
All practices start with Pule and Oli (prayer and chant). The Native practices at the Traditional Healing Center include:
- Lomilomi, or Hawaiian massage
- La‘au Lapa‘au, healing with herbal medicine
- La‘au Kahea, spiritual healing
- Pale Keiki, art of midwifery
- Ho‘oponopono, family conflict resolution and counseling
- Pule, healing through prayer
- Haha, healing through diagnostic observation
- He Ike Papalua, extrasensory perception or second sight
Alaska Native ceremonial drum with drum stick: This drum, given to the CEO of Southcentral Foundation by Tribal Elders, is painted to represent the Four Directions and to call Native leaders to come together to work for the common good. / Southcentral Foundation, Traditional Healing Clinic
Southcentral Foundation in Anchorage, Alaska, has become a leader in providing traditional healing services that complement services provided by the major Western medicine center, the Alaska Native Medical Center. The Traditional Healing Clinic offers traditional healing practices to patients upon request or referral, in coordination with Western-trained providers. The clinic also offers a range of wellness, lifestyle, and trauma recovery programs for Alaska Natives.
Aerial view, Alaska Native Medical Center and Southcentral Foundation, Anchorage, Alaska, 2010: The Alaska Native Medical Center, jointly managed by the Southcentral Foundation and the Alaska Native Tribal Consortium, provides tertiary care to Alaska Natives. / Southcentral Foundation, Traditional Healing Clinic
In June 2011, the Southcentral Foundation Traditional Healing Clinic received the Indian Health Service Director’s Special Recognition Award for outstanding leadership “in demonstrating how tribal doctors, elders, and traditional healing practices can work side-by-side with Western medicine…for the ultimate benefit of Native patients, families, and communities.”
Southcentral Foundation Traditional Healing Clinic Staff, 2010: Traditional Healing Clinic Staff in medicinal garden. Back row left to right: Julie Wahl, Ken West III, CEO Katherine Gottlieb, Tribal Doctor Apprentice Rose Lawless, Buz Daney. Front row left to right: Tribal Doctor Lisa Dolchok, Tribal Doctor Sarah Smith, Dodie Douglas, Tribal Doctor Mary Sears, Dr. Ted Mala. / Southcentral Foundation, Traditional Healing Clinic
In November 2011, the Southcentral Foundation received the Malcolm Baldridge National Quality Award, in recognition for its outstanding commitment to excellence and results in health care. SCF’s success is centrally based on the Nuka System of Care, which views the Alaska Native people as “customer-owners” and builds strong relationships between customers and the health providers, staff, and facilities. “Medical, behavioral, dental, and traditional health practices and supporting infrastructure work in partnership with the Native Community to support physical, mental, emotional, and spiritual wellness.”
Family Wellness Warrior Poster / Southcentral Foundation, Traditional Healing Clinic
Among Southcentral’s programs is the Family Wellness Warriors Initiative, which addresses domestic violence, abuse, and neglect in the Alaska Native community. Through ceremony and group therapy sessions, the program appeals to male family members to resume their traditional role as family protector, offering healing messages of individual responsibility and redemption.
Alaska Native Traditional Healing, original artwork prepared for American Association of Indian Physicians conference poster, Anchorage, Alaska, 2002 / From Ted Mala, M.D.
The Native practices at the Southcentral Foundation Traditional Healing Clinic include:
- Healing hands and healing touch
- Song and dance
- Talking circles
- Medicinal garden
Caring for the “Invisible Tribe”
Auntie’s Gift, lithograph by Joyce Trayer-Wilson / Seattle Indian Health Board
Today, two of every three Native Americans live in a city rather than on tribal lands. Unfortunately, urban Indians lack practical access to or sometimes lose eligibility for health care from tribal-managed systems or the U.S. Indian Health Service. A 2007 report by the Urban Indian Health Commission concluded that their health status is among the worst of any ethnic minority in the country. While there is not a national policy to address the needs of the “Invisible Tribe,” as the urban Indians are sometimes called, local efforts have fostered some creative, therapeutic responses to help medically underserved Native residents within American cities.
Native Youth, with medicine wheel headband: Anthony, a Native youth, in regalia with a medicine wheel headband, Oakland, CA, 2010 / Native American Health Center, Oakland
Among others, the Seattle Indian Health Board and the Native American Health Center based in Oakland, California, provide Native American patients with a wide range of Western primary medical care and dental services. They also foster community activities, help rejuvenate Native pride, and assist patients in obtaining traditional healing services. These two clinics exemplify the innovative efforts to address the medical and cultural needs of the diverse Native Americans living in large cities.
Seven Directions Building, front view (facing east), with medicine wheel and art totem, 2010 / Native American Health Center, Oakland
The Oakland clinic has a new Seven Directions Building with a Medicine Wheel motif. Its name symbolizes the Four + Three = Seven Directions (east, south, west, and north, plus above, on, and below the earth). The building combines housing and community development with medical and dental services. The National Council of Urban Indian Health represents over 30 Urban Indian Health clinics across the U.S.