Navajo Jana Livingston overcomes hardship to pursue a career in health care, aspiring to uplift her people.
The Navajo Nation is among the areas in the U.S. that have been hit the hardest by the coronavirus pandemic. The Navajo reservation, which comprises territory in New Mexico, Arizona and Utah, is the largest Native American reservation in the United States. The socioeconomic disparities of life on the reservation have made dealing with the pandemic more difficult than in more developed regions of the country.
COVID-19 is just one of many widespread health issues affecting the Navajo, who have long suffered from a lack of infrastructure and environmental hazards in the region. For generations, the U.S. government and private companies have exploited Navajo land for resources, leaving pollution and environmental catastrophes in their wake, Jana Livingston says.
Livingston, a 29-year-old Navajo, is determined to help her people overcome the injustices they have suffered for so long and to achieve a better quality of life. By becoming a health care professional who possesses an understanding of the Native American situation, Livingston hopes to help Native Americans establish trust in a health care system she says has failed them.
“From a cultural perspective, there have been a lot of historical traumas that Native Americans have faced and been subjected to,” Livingston says. Among the traumas that have created distrust toward the American health care system was the forced sterilization of thousands of Native American women by the Indian Health Services, a branch of the U.S. Department of Health and Human Services, in the 1960s and ‘70s.
Livingston has worked and volunteered in various roles at hospitals for the past 10 years while pursuing her doctorate in pharmacy. In December, she received her bachelor’s degree at the University of New Mexico College of Pharmacy and is on pace to complete the program in two years, at which point she will begin an internship.
In addition to general pandemic challenges most college students have faced, Livingston met an array of extra obstacles during the fall semester, she says. The pharmacy program typically contains a considerable amount of lab work, but due to the pandemic, a few of her classes were moved online. Unfortunately for Livingston, her laptop crashed early in the semester. She managed to get by using her smartphone and borrowed computers, even taking final exams on a tablet.
The week before Livingston’s final exams, someone stole her car. It was also the day she began an internship at the New Mexico Poison and Drug Information Center, where she provides consultation for COVID-19 testing. Her car was later found in operable condition, but with damages.
In the off-campus residence hall where she lives, Livingston has an apartment to herself, with a private bathroom and shares a communal kitchen. She was overwhelmed by the conveniences that became available to her in Albuquerque, she says, and feels humbled reflecting on where she comes from.
“I feel like I’ve journeyed hard,” Livingston says, recognizing the rugged path she and other Natives have traveled.
Livingston is the oldest of 10 siblings. Her family lived on Superman Canyon Road on the east side of Gallup, New Mexico, near Church Rock. The road is named for the location used to film scenes for the 1978 Superman film.
Church Rock is the site of a 1979 uranium spill, the largest radioactive spill in U.S. history, the effects of which have resulted in myriad health issues for many Navajo in the area. Livingston says her uncle died of cancer caused by exposure to hazardous materials during his employment at the uranium mine and that he was never provided with personal protective equipment.
Livingston experienced a traditional Navajo upbringing. She recounts herding sheep with her grandmother in a field full of sunflowers, and at age 8 learning to butcher animals as part of a ceremonial custom.
Until she was in fifth grade, her family did not have running water or electricity in their home. Before that, she did her homework by oil lamp and rode with her father in his truck to a filling station, where they collected water in a large vessel and then portioned it into separate containers for various uses.
Livingston, a first-generation college student, says that because she grew up with so little, she never believed that she could become a doctor. She began her higher education in 2010, majoring in radiography at Pima Medical Institute in Albuquerque.
She describes enduring extreme financial hardships during her first few years of college, homelessness and food insecurity. She bounced around between friends’ houses, sleeping on couches. Later, she shared a bed with her sister in her sister’s dorm at UNM, which they shared with another student.
“There was a point where I ate one meal a day,” Livingston says, explaining how she would ration Subway sandwiches or eat canned tuna and vitamins from a dollar store.
After earning her associate’s degree in radiography, she moved back to Gallup to begin fulltime employment as an X-ray technician at the Gallup Indian Medical Center. At that time, Livingston’s parents divorced and her father started a job out of state.
“My mom wasn’t taking care of my siblings, so I was like the head of household,” she says.
While managing her new responsibilities, Livingston continued college online and graduated with her bachelor’s degree from PMI. “It was a feat,” she says, but she was determined to continue her education in pursuit of a doctorate.
“From my experience of working within the Gallup Indian Health Services, I saw that a lot of the health care professionals were non-Native and I felt that they treated Natives differently,” she says. She had witnessed co-workers dismiss patients as “just another drunk Native…and I hated that,” she derides.
The plight of the Navajo has been ignored by the dominant culture in the U.S., Livingston says. A lack of understanding on behalf of regional health care professionals about how the Navajo live result in inadequacies and failure in the provision of care, she says, providing the examples of Navajo patients who are directed to refrigerate certain medications, but do not have electricity in their homes; or senior patients who live in isolated areas on the reservations and do not have people to assist them with their health care provider’s instructions.
After witnessing the disconnect between Natives and their health care providers, Livingston says she felt compelled to pursue pharmacology, a field in which she could focus on public health advocacy.
“I had to start at square one,” she says, explaining that UNM did not accept her previous credits. After three years, she completed the prerequisite courses and was accepted to the school’s pharmacy program.
During that time, Livingston escaped an abusive marriage. Domestic violence is another epidemic that Navajo women suffer from. Livingston’s cousin and aunt were both murdered by their partners. Her family adopted the newborn daughter of her newlywed aunt. Her cousin was shot by her boyfriend right before her high school graduation.
“I never thought once that I could be in that situation, but unfortunately I was,” Livingston says. She suffered from severe depression that caused her to struggle in school, setting her back a year. In therapy, Livingston confronted her trauma, remained committed to her goal and went on to make the dean’s list.
As a survivor, Livingston says she wanted to help other women suffering domestic violence. She volunteered with the Coalition to Stop Violence Against Native Women. She also volunteered with a clinic to help shelter Navajo suffering from homelessness.
While Livingston has dedicated her life to serving her fellow Navajo, this year she was denied a tribal scholarship due to pandemic-related scheduling setbacks at the hospital where she was supposed to intern, causing her to fall just short of meeting the requirements, she says.
With accumulating student loans, Livingston presses on, spending many long nights, alone, studying in her residence hall’s communal study room.
“I’ve been so lonely. I’ve been so homesick,” she says, explaining that there is too much risk to go see her family in Gallup, with COVID-19 cases surging in New Mexico.
Early in the pandemic, several members of Livingston’s family contracted the virus, including her 102-year-old grandmother, who survived. Livingston has not seen her since March.
As one of only four Native students in her program, she feels that many of her peers do not appreciate how the pandemic has affected vulnerable populations, while facing adversity is all that Livingston and many Navajo have ever known.
While working at the Gallup Indian Health Services, Livingston encountered some Native patients who traveled 100 miles to receive treatment. Besides a lack of basic infrastructure, the Navajo Nation is also affected by environmental hazards and a lack of resources.
“It’s dusty out there,” Livingston says, explaining that many Navajo in the area are predisposed to asthma due to the poor air quality.
Many Navajo also suffer from diabetes and other health issues related to malnutrition. Livingston says the area where she is from is known as a “food desert,” with only 13 grocery stores serving a 27,000 square-mile area. With a lack of running water and electricity, many Navajo depend on canned foods that are high in preservatives,” Livingston explains.
“If there was one thing I could change about the College of Pharmacy, it would be implementing a legitimate cultural studies class,” Livingston says, noting that UNM is built on the territory of the Tiwa people and in an area where many other Indigenous peoples are present, including Apache and Zuni peoples.
“In order to treat someone, you should be more informed about who they are,” she says.
Livingston also encourages more Native youths to realize their potential and not to be afraid to achieve greatness.
“I want them to know that they are capable. They are smart. They can do these things. They can go to college,” Livingston proclaims. “They can do what they think they can’t.”