Rhonda Grantham stood in the snow, guarding the tent where a fellow midwife worked. Coming to the Oceti Sakowin camp had been an easy decision for her, despite fears of a raid, demands from the North Dakota Governor's office that everyone leave, a National Guard and police barricade on the road to the north, and frigid, snowy conditions. "Well there's women here and we wanted to be able to serve the women warriors," she said. Grantham spoke to me several days before the Army Corps of Engineers announced it would deny a key easement, allaying some fears at Oceti Sakowin that a raid was imminent, and sending many visitors packing before the next snowfall. But the medical tent where Grantham volunteers likely isn't going anywhere, as protesters, or water protectors, as they prefer to be called, worry that Energy Transfer Partners may continue to construct the pipeline under Lake Oahe anyway. (Already Energy Transfer Partners and Sunoco Logistics Partners have released a statement saying that they plan to complete construction under Lake Oahe, dismissing the Corps' decision to deny the necessary permit as a purely political move.) Grantham is from the Cowlitz Nation in Washington state, and she decided during her undergraduate training that she wanted to offer support and a voice for indigenous midwives like herself. The organization she founded, the Center for Indigenous Midwifery, takes her away for six months each year to disaster-relief zones and the developing world. During those trips abroad, she sets up birth centers and attends to other basic health needs. "So I'm very used to rural, out-of-hospital harsh conditions," she says.
It takes the right amount of grit and idealism to volunteer as a medic here in Oceti Sakowin, and people like Grantham have stepped up to the task. A small encampment by a dirt road in the middle of the land advertises emotional support services, an herbalist, an emergency care clinic, and the woman's health tent where Grantham works with one or two others at any given time. Citing patient-privacy laws, Grantham will not disclose if anyone has actually given birth here. Instead, she stresses that her tent, while equipped to deliver babies, provides all sorts of women's health services, such as prenatal checks and sometimes just emotional support. By her feet are what she describes as the "Tampon Tent" and the "Pad Palace," where hygiene products are freely distributed. "Because people are being ripped out of sweat lodges and there's threats of raids, a lot of women for those basic safety and comfort reasons are preferring to go elsewhere to give birth," Grantham says.
On Saturday night, young doctors sitting around a campfire at a popular soup kitchen in Oceti Sakowin talked in awe about the care they had witnessed at the medical area.
"They stress consent," says Revery Barnes, a family physician in south Los Angeles who is undertaking a fellowship specializing in HIV treatment. "In the hospital, all the consent is about not getting sued," she says, referring to the medical consent forms that doctors ask patients to sign. "Here, it's about relationships. Can I touch you? Is it okay? We're having an equal exchange. That is what real medicine is, rather than I'm going to treat you in a certain way, I'm going to look down at you, I'm going to have you sign a form so you can't sue me for whatever I'm going to do with you. It's a totally different way of thinking about things, and the way they're doing it here…it's such a beautiful thing to experience."
Barnes grew up in San Francisco and viewed medicine as a productive way to channel her activism. When it came time to apply to medical school, a professor tipped her off to a program in Cuba at the Latin American School of Medicine, where tuition is free and students are trained to work in poor areas. Now working long hours at the county hospital in Los Angeles, Barnes would like to see medicine at her workplace more closely what she has seen at Oceti Sakowin.
At the hospital, "I get in trouble for taking too much time with each patient," she says. "It's like, 'No, you've got to work faster. You've got to be more efficient and less detailed.' That's not medicine."
Barnes invited her friend Dhulkifl Franklin to join her in North Dakota for their brief trip here. Franklin, a Kenyan doctor who recently moved to Los Angeles, used to work as a hospital administrator in his home country. The small budget he received from Kenya's national healthcare system often did not even cover the cost of fuel necessary for ambulances to pick up and drop off patients. And finding a ride to a hospital didn't guarantee that all the necessary equipment for the patient would be there. "You have one CT scanner from the government that serves a population of about 5 to 6 million," he says. "There's always a line, and what happens when you load a machine all the time? It crashes." Franklin recalls watching the first patient he treated out of medical school, a man hit by a tow truck, die before his eyes because nobody at the hospital could tell him where the life-support machine was, and there was no money to fuel the ambulance to take the patient elsewhere.
"In my opinion, the medics have always been frontline people," he says. "When I came up here [in North Dakota], I actually didn't have any intention of doing any medical thing. I just wanted to help out, cook, do whatever destiny was wanting to bring. So it's been an enlightening last one or two days. "
Back at the midwife tent, Grantham is scheduled to leave the Oceti Sakowin camp soon so she can assist Sudanese refugees crossing the border of Uganda. Taking her place is a midwife who has also worked with her in Uganda. Practicing in medicine disaster zones or places like this camp is not something for all professionals, she cautions. "It's not a place for a new midwife or any practitioners who are not comfortable with very little in terms of bells and whistles in modern maternity," she says. "So that means your skills and comfort level have to be raised."