Looking to the Future

HMS Native American and Indigenous students, faculty remember past, look ahead

HMS alumna and former Native American Health Organization at HMS co-leader Erica Kiemele celebrates at HMS's 2017 Match Day.
HMS alumna and former Native American Health Organization at HMS co-leader Erica Kiemele celebrates at HMS's 2017 Match Day.

The Harvard College Charter of 1650 established the Harvard Corporation and outlined how the College, and later the University, were to be governed.  It committed the school to “the education of the English and Indian youth of this country.”

The first brick building constructed in Harvard Yard was the Indian College, built around 1655, which housed five Native students. The Indian College would be short-lived, however, and in 1670 the building became dedicated to printing.

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“That is a story that every Native person at Harvard knows,” said Joseph Patrick Gone, professor of global health and social medicine at Harvard Medical School and professor of anthropology in the Faculty of Arts and Sciences.

“It reflects not only Harvard’s initial, original commitment to educate Indian people; it also accentuates and highlights the failure of Harvard to follow through on that through most of its history,” said Gone, who serves as faculty director of the Harvard University Native American Program (HUNAP).

Started 50 years ago as the American Indian Program, HUNAP brings together Native American, Alaska Native, Native Hawaiian and other Indigenous students from across Harvard to advocate for Indigenous peoples in the U.S. and around the world.

Today, Native American and Indigenous students and faculty are making vital contributions to HMS, their home communities and the world at large.

Nathan Nakatsuka, an MD/PhD student in the Harvard-MIT Health Sciences and Technology Program, first became involved with HUNAP as an undergraduate at Harvard. A Native Hawaiian, Nakatsuka found HUNAP to be “a home away from home.”

“HUNAP is a pan-Indigenous organization that has people from all around the world coming to Harvard,” Nakatsuka said.

Meeting members of other Indigenous groups at Harvard, Nakatsuka found certain shared values that connected them, like a dedication to conservation and sustainable environmental practices, a focus on community above the individual, and honoring one’s elders.

“Viewing your history as central to who you are as a person, and viewing your past ancestors and your community as vitally important to who you are as an individual, is really important,” Nakatsuka said.

Ancient DNA

Nakatsuka has brought his interest in history and shared experiences to his work with ancient DNA in David Reich’s lab at HMS. Nakatsuka has worked on studies of ancient DNA from South Asia and the Americas, including a study of the genomic history of ancient civilizations in the central Andes that has provided insight into the region’s population before European contact.

Nakatsuka hopes his work studying ancient DNA will allow a greater number of Indigenous groups to connect more fully with their own history.

“We worked a lot with archeologists who would translate the research, as well as do it in a culturally appropriate way that is in line with the wishes of the Indigenous groups,” Nakatsuka said. “One of the purposes of this research is to allow people to retell their history and to be proud of their history and to be able to engage with science from their cultural worldview.”

Gabriella Herrera, an MD student at HMS, grew up in California’s Central Valley. Her mother’s family traces its ancestry to a tribe in the Mexican state of Chihuahua.

“When my grandparents came to the U.S., they had to put aside a lot of their traditional values and practices because of a lot of discrimination, to the point of not wanting to teach their children Spanish or (Native) languages,” Herrera said. “My mom and I have been trying to reconnect with the stories and histories and practices of our older generation.”

When Herrera came to Harvard as an undergraduate, she got involved with HUNAP as a way to connect with other Native and Indigenous people.

“I learned a lot coming to Harvard and being part of a more tight-knit Indigenous community,” Herrera said. “Being able to hear how different Native communities have been so resilient, and are continuing their own practices and growing their communities today has been really enlightening.”

At HMS, Herrera took part in Massachusetts General Hospital’s Rural Health Leadership Fellowship. The program places early-career physicians in rotations at the Indian Health Service unit in Todd County, South Dakota, home to the Rosebud Sioux Tribe. HMS and HSDM students and faculty participate in the program, providing care to a population experiencing high unemployment and mortality rates.

The experience had a significant impact on Herrera’s academic trajectory.

“The fellowship rotation was amazing,” Herrera said. “It’s how I got involved with the research I’m doing now.”

Her research focuses on mortality rates and health outcomes for Native American populations in the region served by the Rosebud Service Unit.

 As much as Herrera values her experience with the Rural Health Leadership Fellowship, she knows there are plenty of other opportunities to help Native and Indigenous communities closer to HMS.

“Not everyone has to fly to South Dakota,” she said. “There’s work to be done here in Boston; for example, the burden of COVID-19 in local Native American communities. Native American populations are so often overlooked.”

In our own backyard

Victor Lopez-Carmen, a Hunkpati Dakota and Yoeme second-year MD student from the Crow Creek Sioux and Yaqui Tribes, serves as co-president of the Native American Health Organization at HMS (NAHO). He says it is his commitment to serving his community that motivated him to pursue medicine.

“It was instilled in me from a young age that I would use whatever I could at my disposal to give back and contribute to my tribes,” said Lopez-Carmen. “For me, that became medicine. That's what brought me here.”

Lopez-Carmen said his understanding of medicine is informed by his culture and his upbringing in Native communities, and he sees his career in medicine as being about more than just individual health and wellness.

“Traditionally, the roles of the healers in our community weren’t just professional,” he said. “It was a sacred role, to be a healer in the community in all senses of the word. Their example is one that inspires Indigenous medical students.”

COVID-19 has disproportionately affected Native and Indigenous communities, with test positivity rates among American Indians and Alaska Natives that are 3.5 times the rate among non-Hispanic white people. Durable health disparities in Native American communities—including elevated rates of diabetes and hypertension—mean Native Americans have been hit especially hard by COVID-19.

Seeing how Native and Indigenous peoples are being affected by COVID-19, Lopez-Carmen felt compelled to help. He started the COVID-19 Indigenous Health Partnership, partnering with Indigenous communities around the world to provide medical supplies, personal protective equipment and translation services.

He also founded the Translations 4 Our Nations project, an initiative to work with Indigenous communities to translate information about COVID-19 and public health guidance into their local languages. The goal was to provide medically accurate and culturally relevant information for Indigenous peoples.

“We made a fact sheet specifically on information for Indigenous youth to protect their elders,” Lopez-Carmen said, as an example of making the resources culturally relevant.

“During the pandemic, one of the primary concerns was that this was disproportionately impacting elders. For Indigenous peoples, that's really quite scary, because our traditions, languages and stories are passed orally. They're not written down. Our elders are our cultural, spiritual and linguistic dictionaries,” he said.

“We say, ‘We have to protect our elders so we can protect our traditions,’ and that's one of the lines that we translated.”

At a local level, Lopez-Carmen has also been working with the City of Boston’s COVID-19 Health Inequities Task Force, helping the city address inequities in COVID-19 testing, treatment and data analysis.

Initially the task Force did not include a focus on Native Americans and Indigenous people in Boston, but NAHO petitioned the city to include data on those populations. The task force is currently conducting a survey of Native Americans, Alaska Natives and Native Hawaiians in Boston to determine how these communities have been affected by the COVID-19 pandemic.

Carson Moss, a second-year MD student at HMS, a member of the Ottawa Tribe of Oklahoma and co-president of NAHO, worries that too often Indigenous populations can be forgotten or overlooked.

“You’ll see a data table, and you won’t see Indigenous people included there,” said Moss. “And the answer is, ‘The sample size is too small.’ There’s an opportunity to put in effort and really get those data sets. I would encourage people to think about how Indigenous peoples are incorporated into certain conversations, especially when you’re talking about health disparities.”

Creating community

In addition to advocacy, NAHO also organizes events that bring speakers to HMS to discuss issues of importance to Indigenous communities around the world, from health care to climate change. The group also organizes social events in collaboration with other HMS student groups and with HUNAP.

Moss said the NAHO events provide a chance for non-Indigenous students to learn about Indigenous cultures and concerns.

“This is something we invite our non-Indigenous classmates to,” Moss said. “This is an opportunity to share with them a side of Indigenous medicine they may not see otherwise.”

NAHO’s members also reach out to prospective Native and Indigenous students to answer their questions about HMS, life as a medical student and living in Boston.

“One fairly common concern is that people who aren’t from more urban areas are concerned about maintaining a sense of community here,” said Moss. “I’m from California, which has the most tribes of any state in the U.S. and has the largest population of Indigenous peoples. The East Coast just has a lower percentage of Indigenous peoples. That’s kind of a concern—how to maintain the sense of community while we’re here and learn medicine at the same time.”

Nakatsuka sees an opportunity to recruit more Native and Indigenous students to HMS and he regularly attends conferences, such as those sponsored by the American Indian Science and Engineering Society or the Society for the Advancement of Chicanos/Hispanics and Native Americans in Science, to engage with prospective students.

“Some have difficulty with the fact that they will be away from home for so long,” said Nakatsuka. “I think talking to them about the many opportunities at HMS is effective; letting them know they can be prepared to go back to serve their communities. Also highlighting the accomplishments of people who have gone through Harvard and contributed to their communities, like Yvette Roubideaux,” the former director of the Indian Health Service and an HMS alumna.

Some see more opportunity to develop programs to engage with and nurture high school and college students, creating a pipeline to bring more Native and Indigenous students to HMS and other medical schools.

You could view this whole process of developing a career in medicine as a game, and there is a very sophisticated playbook to it. But no one’s ever given Native students that playbook. So, what we try to do is give them access to that.

Thomas Sequist