Navajo Birth Cohort Study

Yá'át'ééh. Join cohosts DeeDee James and Stacey Litson in a discussion with Navajo Birth Cohort Study's (NBCS) field staff, Maria Welch, to better understand the relationship between uranium exposures and birth outcomes and early developmental delays. The Navajo Birth Cohort Study’s responsibility to the Navajo People is to conduct research while remembering that childbirth is one of the most sacred events for Navajo families. We appreciate your continued support!

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This podcast was sponsored by the Arizona Department of Health Services through federal funding from the Health Resources & Services Administration, with support from the Navajo Native American Research Centers for Health (NARCH) Partnership between Diné College and Northern Arizona University through federal funding from the National Institute of Health’s National Institute of General Medical Sciences, award number S06GM142121. The views expressed are the sole responsibility of the program staff and do not necessarily reflect the views of the Arizona Department of Health Services or the United States Government.

Transcript

Speaker 1 [00:00:05] Navajo (DeeDee) . Welcome to the Maternal and Child Health Podcast, where we discuss maternal and child health topics and provide strategies for improving the health of Navajo families. 

Speaker 2 [00:00:17] Navajo (DeeDee). 

Speaker 1 [00:00:24] We jump into the interview with our guest. I would like to share a snippet of a long legacy of uranium mining in the Navajo Nation that dates back to the 1940s. The Navajo Nation sits on the Colorado Plateau, which was discovered to be one of the largest uranium reserves in the world. The US government, by law, was the sole purchaser of uranium in the U.S. until 1971 to power the development of atomic weapons. Then private companies operated the mines. Navajo men worked in the mines because they were close to home and was the only job available at the time. To avoid a paper trail, mining companies paid Navajo families with sacks of flour, sugar, potatoes, and coffee. Mining companies also did not warn them about the detrimental health effects of being exposed to uranium and radon gas, despite documented studies stating the harmful health consequences. Nor did they provide personal protective equipment. From 1944 to 1986, nearly 30 million tons of uranium ore was extracted from Navajo lands with little environmental, health or safety oversight. By the late 1970s, Navajo miners were dying of lung cancer and other respiratory illnesses at higher rates than other Americans. Today, the Navajo Nation is littered with over 520 abandoned uranium mines and over a thousand contaminated waste sites. We also know uranium exposure increases the risk of developing cancer, respiratory diseases, kidney diseases and reproductive problems. Uranium mining is a toxic legacy we continue to face and will continue to fight for justice for those that lost their lives working in the mines and also to Nassar, our Mother Earth. So please stay tuned to learn more about uranium mining and its effect on maternal and chilhealth with our wonderful guest. I am your co-host, Didi James Twitch international. Kiani. Abbas. Justine. Kante, Jeannie. Ada. Shorty Otto. Is Ada Schneller I could add the next sunshine Ted to Jola. Easy denisha Nicole can sunny day care host you. Hi. Hello, everybody. I'm originally from Promise Rock, Arizona, which is a small area south of Mining Valley, Utah, but I currently live here in Flagstaff and work at Northern Arizona University as a research coordinator and currently working with the Navajo Maternal and Child Health Project. 

Speaker 2 [00:03:09] Yet I'm your co-host. I see a ton of change initially to my position. Actually, I should say County.  I am from Sally, Arizona, but I currently live and work at Northern Arizona University in Flagstaff, Arizona. I am so happy to be a part of this podcast to better help our native families and listeners. 

Speaker 1 [00:03:25] So thank you for joining us today to learn more about maternal and child health on the Navajo Nation. Today I, alongside my co-host Stacy, will be discussing the topic of environmental Health. The Navajo Birth Cohort Study, which is a program working to better understand the relationship between uranium exposures and birth outcomes and early developmental delays with our special guest, Maria Welch. Maria, can you please introduce yourself to our audience? 

Speaker 3 [00:03:53] Yes, yes, Asha, Maria Welch and Asha, as she learned the definition of a gene because of the shape of the planet. Now, if I could ask on a slide, tonight is is a day. Not sure. Other, Navajo birth cohort study, but it. So I live in Tuba City, and I'm a research field staff, and I work with the Navajo Birth Cohort study. So thank you again for having us. 

Speaker 1 [00:04:16] Awesome, thank you again for joining us today and being part of our series on Navajo maternal and child health and diving into the topic of uranium and its health effects among the Navajo population. So our first question for you is, to your knowledge, can you describe what the Navajo Birth Cohort Study is and how it was conducted? 

Speaker 3 [00:04:38] Okay. Well, a little bit of background, kind of from our collective knowledge, our collective stories of uranium mining, you know, we've observed things, our people have observed things, health outcomes. And so, you know, grassroots activists really pursued some kind of study, some kind of investigative work, working with the Navajo tribe. The Navajo tribe was able to, you know, make enough noise and get enough support to push for some hearings, for some congressional hearings. So they think they were the Waxman congressional hearings that really kind of, you know, spotlighted this issue and allowed for some of that federal funding to be open for institutions to start investigating these specific problems once again at the direction of the Navajo Nation. So leadership did want these studies. People in public health want these studies. And so now, you know, it's been long overdue. When we started recruiting in 2014. Some of the community reactions we got were, you know, saying things like, this is really long overdue. We know that there's cancer. We know that there's all of these health problems that are plaguing as and it could possibly be tied to uranium, but we just don't have that scientific data points. So that's kind of the background. And other smaller studies have informed the Navajo birth cohort study. So, for example, there was a DNS study. I'll probably send the links for all of that just online. And what they did was they looked at communities that were impacted by uranium in western or not, western, eastern, Navajo and the population that they looked at. They asked for surveys and they did some bio monitoring. So looking at blood and urine and asking them, you know, their questions about their possible exposures and going through that process, they were able to kind of formulate some of these questions, you know, what's the proximity to mine features, what's the family history of mining contamination? And, you know, just that whole legacy, it really informed the Navajo birth cohort study, because what they had found is that it was an older population, too, that they sampled. And so they already had more significant health problems. And what they found is that things like, hypertension, diabetes could actually be connected back to their proximity to a mine waste feature or a mine site. So already that right there tells us, you know, when you control for other variables and that uranium is still popping up, that's worth investigating. So that question kind of informed the birth cohort. And then also animal studies, because there weren't any studies that I know of that look specifically at uranium or other metal contamination on pregnancy outcome and early childhood development. During that time, I had also heard that some people didn't believe that the uranium was able to cross the placenta barrier, thinking that it would kind of catch the heavier metal. But because of the work that we're doing now, that was one of the questions. Is it crossing like if it's already circulating in mom's body when mom's pregnant, is it going down to the child? So with the birth cohort, that was one of the questions that we're kind of able to form around past studies and animal studies as well. So then you have a whole birth cohort study from the main researchers. The PhDs are from the University of New Mexico in Albuquerque. And so these are going to be the people that, have very, very specific research interests, like the toxicologist, the pharmacologist, geographers and psychologists. And so all of these people come from different backgrounds and different areas of their research expertise, which is really great because then they bring a wealth of knowledge to the team. We also they also partner with Southwest Research and Information Center, which is a nonprofit based in Albuquerque. And they have a long history of looking at nuclearism and its impact on indigenous communities. So they had previous experience working with other tribes as well, such as Laguna and other impacted pueblos of New Mexico. So this idea of nuclearism and how it impacts indigenous communities, you know, it really is tied back to, you know, how Navajo is spread out across the States, but also the lands that we share with surrounding tribes. They also have the same problem. So we have Schrag, we have UNM. And then of course, in the center is our mom and our babies are communities and across Navajo Nation. So on the tribal end of things under Navajo Nation, we have the Department of Health. And underneath the Department of Health we have the community health representatives, which are called the C.H.R’s. And so I am always going to talk about the exemplary work that the C.H.R’s do. They're really like the backbone of Navajo Nation. A lot of them are the matriarchs of their family, very intelligent women, all different kinds of backgrounds. And they bring all of that knowledge and heart and commitment to their work. So I'm always going to talk about that. And so underneath the C.H.R program, there are specific research specialists that their job is specifically and for the Navajo birth cohort study. But the really great thing about it is that they're flexible enough to always be involved with the community. So if there's any kind of outreach, any kind of fear, or any kind of, events, sometimes it could be like food donation box pickup. The C.H.R’s will also participate in all of these things. So they have a, you know, they're. Eyes are right there, and they see all of these things, all of these different things that kind of play their problems, the social ills, the health impacts, the socioeconomic factors. They really see that. So they're a big, big part of this project. They're the people on the ground able to travel all over. And so they bring a wealth of experience. And I always like to highlight them. The other people that we coordinate with obviously are going to be the hospital. So Navajo Area IHS, the hospitals that we worked with when we first started out is going to be Gallup, Gallup Indian Medical Center, Shiprock Health Care Facility, say sorry in Fort Defiance, Kayenta Health care facility, and then Tuba City Regional Health Care Corporation. So there are some that are Navajo Area IHS, and then the two that are PL 168 facilities. So when we talk about a big facility or organization like the hospital, it's going to be one of those structures. Again, that's going to be top down. So we have our doctors, our midwives, policymakers, nurses, CNAs that all have to work together, pediatricians as well to start supporting the program. And I'm kind of talking about the background. So now, of course, that they do and the hospitals are on board, but kind of just that planning and how the different working parts all have to come together and different fields of expertise. In addition to the health care workers in the hospital, there's also the lab part. So we're talking about the bio monitoring that's going to be blood, urine, meconium and cord blood. So all of those things of course some of the people, they're duly trained. So some of the students are also phlebotomist, which is so amazing because then they can take their skill set and we can actually go to the homes. And if there's a lab that needs to be collected, they're able to do that. And then part of the lab that works with them are going to be phlebotomist and lab techs. So there's all of these working parts that come together to support this project. The leadership support is very, very crucial to understanding this, to coordinating it, and to eventually supporting it when we're trying to balance that, I guess this realm of research and health care, right? So when we're in the hospital setting or the clinical setting, we have to balance that between what's healthcare and what's research. So the moms and babies, those are going to be the center focus. Like I had mentioned before, Navajo D.O.A. shrink, which is my employer. Under that, we have the research field staff and some past employers include, you know, elders, elders that are veterans, elders that are school board members, elders that used to be past law enforcement and artists. So there has always been representation with our elders in our research program. In addition to these different partners that I've mentioned, we also have, of course, our the cultural component, right. The DINE  knowledge keepers, one of the main ones is going to be Doctor David Begay, who is also a professor at University of New Mexico. And he's one of the leads that really anything that we're doing, it always has to kind of run through this cultural. IS this appropriate? Is this harmful? You know, is this too extractive? Are we using the right terminology? Are we using the right Navajo translations? Right. So a lot of it is known and then a lot of it is unknown. So we've had to kind of learn and adjust along the way putting all of these parts together. So it's a really, really huge team. You know people have come and people have went. Some people have stayed for a long time. I'm kind of one of the ones that has kind of stayed for a while. And I think that's just because I've had the opportunity to stay, locally in a community. And, you know, I'm so grateful for the things that I do have makes this allowable. Otherwise it would be hard, you know, to keep people who are educated if they don't have housing, if they don't have. Yeah, they just don't even have housing in the community, then it's going to be hard for them to work. Otherwise they have to commute, like from here to Flagstaff where there's more housing opportunity. So that's kind of the team. Like I said, there's a whole wide range of people. Oh, and we also partner with childhood experts at University of California, San Francisco. And so they have psychologists, interns and also psychiatric interns. And so they'll also join the team and help with the neurodevelopmental assessments, the clinical assessments that the psychologists come out and do. So that's kind of the bigger picture of the different working part. And the different people are Navajo research field staff. Like I said, I can't highlight them enough. And our ability to, you know, work together. I'm all the way out here in Western agency on the very, you know, on the border. Right. And we, you know, we have people in Shenley, we have people. Shiprock. We have people at UNM and out in Gallup. So, you know, across all of these, we have to be able to communicate. We have to be able to motivate each other. And of course, you know, it's not always perfect, but I think the one thing, especially from the last time that we had talked, I reflected and it's like, okay, you know, we talk about right, our Navajo kinship and how important that is. That really ties us together as well. So just like in Shenley area, they have a phenomenal team. I have, you know, several sisters and they would have never been my sisters if I had never met them, if we had never exchanged our clan’s ship. And so we do how we start to build those bonds. And, you know, this common passion of work, trying to find answers, trying to find solutions. And at the end of the day, you know, centering moms and parents and babies and families. So I hope that was a good overview of, kind of background. 

Speaker 1 [00:16:22] No, that's very interesting. And having all that background and insight that you have with, like, working with all these different agencies and all these working parts is very eye opening to see that all these people are working together with different expertise and trying to give us answers. With uranium mining and all its health effects and how it has really affected the Navajo people. And I like how you mentioned the Waxman hearing that took place in the 60s, where the Navajo women came together once they noticed all the Navajo men that once worked in the uranium mines have all passed away by cancer. And I guess this just kind of shows our resiliency and how long we have been fighting this environmental racism since the 60s, which is kind of crazy to think about. You also mentioned how there wasn't a word for uranium back then. You know, now since they started mining uranium, they have called it sheds hot or yellow dirt, which, you know, the Navajo language is a very descriptive language. And so, yellow dirt depicts uranium, which is yellow. So yellow dirt. And also one thing you mentioned is that a smaller research group showed data about the proximity to abandoned uranium mine could be connected to diabetes and hypertension, which is, you know, that's crazy to think about if it was. And we'd love to share the link to our audience if they are interested in looking at that research. But even more great to hear is how, you know, you mentioned all these moving parts and all these experts come together to give us answers, which is really awesome. And I love how you praised the C.H.Rs and they deserve it, you know, because they are hard working and are the eyes and ears of our community. And they also serve as a liaison for our elders who only speak in here, Dana, which is awesome. So, you know, all of these working parts, all of these organizations, all of these people involved is so awesome. And I really, you know, thank them. And thank you, too, for, you know, being part of this and trying to get justice for Nassar or Mother Earth and also for the Navajo miners that passed away working in these mines. 

Speaker 2 [00:18:50] So it sounds like it was just a whole collaborative effort from since 2014, which is a long time, you know, and to keep that momentum going was is still a lot. And we like to thank you for your efforts and also the grassroots efforts and try to get that spotlighted and kind of get some ground movement. This is here's some noise, you know, and just kind of get, I guess, some help from the federal government and just working with native or the rural health centers and just kind of work with the native community, I think is really appreciative. And just explaining the whole process of everything is just like it's a big effort from everybody. So I guess my next question is, what are your current findings from the study, and are there any future implications for the study? 

Speaker 3 [00:19:37] So along with some background with the Navajo Birth Cohort study, we were a solo cohort effort until we, got new findings. So the first part of the funding was from CDC. And then when that funding cycle ended and NIH offered funding and that was to join a national cohort. So our small cohort were join, you know, 200 cohorts coast to coast, all looking at the same thing. And that's called echo. So our current study name is actually MBCS/Echo Echo Plus and echo stands for Environmental Exposures Influence on Child Health and development. So this new funding allows us to follow up with the original birth cohort babies up through age eight. So if you can think about that wealth of data from prenatal all the way to age eight is totally great. And the ultimate goal would be to follow as many of these participants, you know, to adulthood, so we can see the lifespan. Part of echo is looking at all of these different areas of influence, such as biological, behavioral, psychosocial, medical, societal, and physical and chemical. So across all of the cohorts, there's going to be certain surveys, certain labs that everybody is going to do. So that there's a snapshot, right, of American children, American child health. And so that's the kind of background with the echo. So in addition to the bio monitoring we also get data from a home evaluation. So we go into the home with their permission. All of this is through, you know, a consent form. And at the home we do a radiation screening. We do it indoors and outdoors. And we also take two dust samples. So in those dust samples we'll take one. So if they have a woodstove we'll actually take dust samples from the woodstove. And that's important because we want to see what's being burned and kind of what's left over. And that question becomes important, especially if mom is the main one that's home. And if mom is pregnant and she's the main one, you know, reaching down, opening the stove, poking at it, and you know, what is she inhaling and what is the family burning? So we're able to kind of look at that area. If they're burning coal, we want to observe how old the stove is. If it's a really, really old stove, it might have some cracks and leaks. And of course, that could be problematic if they're burning other plastics and trash. You want to know about that. And the other dust sample is going to be from an area where it's like settled dust, settled dust from either a common living area. So where a lot of people congregate in the home, or from an area where mom spends a lot of her time. So if it's in her own bedroom where she's, you know, sleeping, that will be another area where we get dust. And so in that dust, in about 80% of the homes, the data that I was looking at, it's like 560 homes, 80% of them had detectable levels of uranium. So right, there is kind of an outcome. And then if you look at some of the other outcomes, they kind of break down the different metals. So not only uranium but just other metals. I'm sorry I don't know if that's allowed in the background. So in 83% of the homes, there is detectable uranium in the dust. And in 61.7 of the homes, there's metals found in the dust and some other information, 6.3%. They found levels of indoor radon. And then in 2%, there was some gamma radiation that was detectable as well. So those are some findings specifically from the environment which we would consider, you know, the home assessment and the most frequently occurring metals that were in the dust sample is going to be lead, arsenic, iron, manganese, antimony, and aluminum. And so, these metals that kind of informs the question, you know, if this is in our homes, is there an exposure pathway to our bodies living in Tuba City, I can tell you that we already knew that answer because of our severe sandstorms, severe dust storms. You know, there will be a line in the windows of sand by the door so it can get everywhere about fine layer of dust. So the in those dust samples, there is found metals and uranium. Moving on to some bio monitoring. So looking at the blood, urine they're able to look at some of the nutrients like iodine. And what they found is that in the Navajo birth cohort study population there is an insufficiency of iodine. And iodine is key for, you know, making organs organ agenesis and key for neurodevelopment. So right there is kind of a big indicator. And then 40% fall below the World Health Organization's sufficiency level. And when we look at our when we ask our moms questions, surveys about food, the dietary sources of iodine is low in Navajo population. And our sources of iodine, one of the main ones is fish, fish and seafood. So if you think about our culture and obviously a lot of us are in the desert, we don't have access to those kinds of iodine rich foods and also dairy and whole wheat. And there's also a traditional component to not eating fish or seafood. Another insufficiency is going to be zinc. So 61% of mothers were below the World Health Organization for zinc insufficiency, and zinc is important for repairing DNA damage by arsenic and uranium. So arsenic and uranium causes DNA damage. Prenatal vitamins seem unrelated. So we can ask moms, you know, are you taking your vitamins? And not everybody is taking the same supplement as well. So that's kind of harder to track. But it also gives us a crucial point to look at zinc levels. And if we know that they're insufficient, maybe we can talk to moms and start to figure out how can we put that back into the diet, especially if we know that it helps inside the body some more neurodevelopment. So going on to the site, the psychology team and what they do is they come out, they travel out every three months where they kind of do their rounds. And people, the participants, the kids that are, age eligible, they'll be scheduled and it takes about 3 or 4 hours, just like, you know, if you were to go to a psychologist somewhere else. It's a long process. It's a lot of testing. But with the neurodevelopmental results, what they're able to find is that there's a very high rate of language delay documented by the standardized assessment. Overall, there's much higher nonverbal cognitive abilities than verbal abilities, with boys being more impacted than girls on verbal domains. There's also high rates of autism spectrum disorder and autism like behaviors. Observationally, most of the kids are in good health with few medical problems, not a lot of accidents or injuries. So those are kind of some developmental outcomes. There's also a lot more to talk about. I believe there's between I want to say 60 to 80. Well, it might be closer to 80 publications that have come out from this study. And so there is a lot of data out there that can really start to break down what these things look like. If you want to, you know, look at graphs and really get into it, then that information is there. But that's kind of the general outcome in terms of what we're finding at the home and in the bio monitoring. So like I said, the bio monitoring at the very beginning of the study, when mom is enrolled, she has her enrollment labs, which would be her blood and urine at the time that she's enrolled. So that would be when she's pregnant, because that's one of the criteria to be in the study is that you have to be pregnant to start that prenatal. And then in the consent form, we ask about each of the labs and they consent to different ones, and we give them the option if they want to have their lab samples returned back after they're done with the testing. And that can take some time. It's usually 3 to 5 years after the study is complete. Yeah. So those are a little bit of the outcomes. We have some home data which shows that there's uranium in the homes and other metals in the dust, some neurodevelopmental outcomes. And one of the other outcomes too is at the newborns. Right. So at the time of birth, the moms that consent to look at the cord blood, what they're finding or what they have found is that in the Navajo birth cohort study, there are babies that are being born with a detectable level of uranium in the cord blood at birth. Right. Day zero, there's that detectable level of uranium and up to age five. So from birth to age five, some of the participants, the child participants, they'll have that incremental exposure. So that's another outcome. We can't really determine where the source is coming from in terms of, well, we know that this uranium exposure is causing this one specific outcome. It just hasn't been that simple. I think kind of talking about all the working parts and how we know we're talking about the effects of, you know, nuclear ism in 2023. We don't really have those open minds anymore, but we do have the after effects, right? All of the waste and how that affected our environment from the land, the water, the people in our way of being. So those are some kind of outcomes. Like I said, there's a lot more publications if you really want to get into more of it. I can make that available or send you guys some links. 

Speaker 1 [00:29:49] Yeah. Wow. Those numbers. And just hearing all these outcomes from this study, it's so eye opening and kind of mind blowing to think about the families that live near these abandoned uranium mines and the waste sites and things like that, and how they might be affected and they don't even know. And it's kind of scary to think about, but it's something that shouldn't be feared, you know, like we're just trying to get back to her, trying to restore that balance and harmony and getting back to our the way of life, because uranium has definitely disrupted that. And it's also awesome to hear, you know, like these grassroots organizations and all these studies that have been conducted are super important because it's helping us navigate our way back to how you shop. And I know you also mentioned that you know how some of these areas may be fenced off, but, you know, with the wind blowing, it can travel anywhere. So like a fence is not going to stop that contaminated waste from blowing from one area of Navajo Nation to another area, you know, and like, how do you even try to clean that up? That's my question, because it's definitely going to be harder to clean up when that waste is transferred from one place to another, and it's really not going to be cleaned 100%. But it would be great to see and to hear that these sites, majority of the sites will be, you know, cleaned or moved from the Navajo land. And yeah, you also mentioned that these sites aren't just uranium. You know, there are other metals that are infused with the uranium, and there are studies out there that have already been associated these metals to low birth weight and increase fetal mortality, you know, such as arsenic. It's really interesting to hear and to have these statistics that you shared with us and how it's really affecting our people in our way of life. And I really hope that through this podcast that our audience will be aware of uranium exposure and that they continue to share with others around them. 

Speaker 3 [00:31:55] Yes, yes, yes. I don't know if I mentioned in our home assessment we do leave a radon envelope. We used to live radon canisters, but now we  have an envelope. We leave it in the home between 2 to 4 days in order to kind of capture what's going on. And for an example of some mitigation, if it's high, if it's a higher reading, then we do a referral process with the family's consent and the homeowner's consent, because a lot of our families aren't, you know, unfortunately, are not the homeowners. There's multi-generational families out here and, you know, smaller housing. So people are living in many different situations. So it's not always very clear cut on how to get help and how we're going to get effective help, how we're going to get help in a timely manner. But what we do know is one of the mitigation strategies for higher radon is to aerate the house, to have airflow coming in and out, but it's going to be more problematic during the winter months when things are more shut in and people are more inside. Those radon levels are going to be a little bit higher, but once that's really high, of course there's different companies that have these different equipments and home things that, you know, put in vents and do all of these things. But here on Navajo, that's what we would suggest is to just aerate and open up the doors and try to have constant airflow to help reduce those levels of radon. And so you bring up a very interesting point. I know we talked about that before, but there is an educational component when we're out in the community and also when we're recruiting, when we're talking about moms getting into the study and when we start talking about uranium, a lot of the some of the young moms, they don't know, they're not aware of what it is. And so you have to have an educational component, not where you're trying to, like, drive fear through these moms, of course, because we have to really try to stay in that Hoosier state of mind when we're talking with pregnant women. And, you know, when we're taught, when we're talking about trauma, we have to also rooted in our strengths and also balance it with our resiliency and our strength. So that's kind of a good way to talk about it and to be informed. When I first started with this study in 2014, in the area of Cameron, there were no signs at these different hotspots. So for example, would be an area near the Cameron Training coast, and there weren't even signs, there weren't fences. And of course, that, you know, there's different reasons for that. People, they walk away, people see a fence and they can dig it up and take it home. Right. But still, we still need efforts, visual efforts, so that people know where they're walking into. And so U.S. EPA region nine actually sent people out and they put up a whole bunch of signs. I can't remember exactly what year, but it was after the Navajo birth cohort started, and I think I went out to look at the signs a year ago, and the ones that they had put up were very tattered. So they need newer signs. And, you know, the signs are there, but you can see evidence of human activity because there's no fence. So you see the four wheel tracks, you see trash, you see beer cans, all kind of evidence, animals walking around all of this. So you don't know how serious they're taking it. Right. But having, educational effort involved is important so that our parents are informed about it. Usually when you start talking to them about the legacy of uranium mining, it starts to jog their memory. And what I always tell them is, you know, go home, talk to your, talk to your family, talk to your elders, and you know, you'll be surprised what they remember and what they're willing to share. And then they're like, oh yeah, you know, so-and-so used to come home and they used to have this yellow dirt all over them, and then grandma would pick up the clothes or the boots and wash it. Right. So all these different exposures or the people who worked at the mines when it was done or when they were done with equipment, they would take it home, right, and build it, you know, being resourceful, being resourceful, without the knowledge of how radiated this equipment was and materials. So definitely a lot to consider when we're talking with a pregnant mom and getting her to understand the whole process. And then also another component is just the active research itself. I think nowadays there's a lot more people who are very knowledgeable and accepting, and they can look at the research and see if there's any harm or if it's too extractive. We have a lot of good experts now, so that's awesome out there working for us or on behalf of us. So that's been really good to see those collaborations. And another thing that I wanted to highlight that kind of helps with this education component. The cultural component of the community effort is from U.N.M. They have a resident artist and her name is Mallory Caterpie, and she's from the Zuni Pueblo. And what she does for the team is she generates visuals that kind of incorporate what we need to do. So this one that I can show you is kind of the time flow. So you can see her beautiful artwork. And so this would be something we would give to them and then this as well different dates. And then I think we talked about the corn in our last conversation and how it's a fundamental teaching of a lot of our ceremonies and pivotal milestones of life, like birth. Right. And then she also did this one, and I've had a greater appreciation. I've had some exposure to Pueblo women, and they were talking about the macro, the macro and the micro of nuclear ism. And I think this kind of illustrates that well. When I looked at it again, I was like, well, because at the micro level, you know what we're talking about the science and the very tiny, tiny, tiny particles we have to look at the micro. And then when we step back, you know, that's what we're talking about, all of the working parts. And then the bigger implications, right. So if there's contaminated water source, that's going to be a bigger issue. So here is a beautiful picture that she did. 

Speaker 2 [00:38:09] I like to point out like are those yellow flower things supposed to be uranium. Yeah. Oh well that is very. 

Speaker 3 [00:38:15] So so talented. I have one more. So you see the baby. And the milk. Yes. So yeah I can send you these slides. And then one of the pictures is on the slides. They use that that picture of the baby. They actually use it on a maternal and child nutrition magazine cover or research article cover. So yeah I'm sure we could get those to you. But once again, that kind of shows where we can do this work all day. We can gather all of this data all day, we can analyze it, but if we can't communicate it to our people in various ways, then the message is aligned and it goes so far. I definitely am encouraged, and I look forward to all of the new talent that's going to come out in art and in how they communicate these problems, but also in other methods to really get down, to talk to our children, our youth, and the different ways that they can connect. You know, a great example has been social media, the information that can be conveyed there to the younger generation. I think it's very important. And any kind of effort books, coloring books is greatly needed. Artwork, you know, storytelling, even just sitting around and talking about your own birth story. Right. If you ask your mom, hey, mom, how was I born? Tell me my birth story. Some people are like, what? But then it's a very critical moment of your life. And once you kind of connect to that story, you can connect to your culture, you connect to your clan, you connect to the land. And you see you see that mother, right? You see that connection, Mother Earth. And when something is harmed, how do we fix that? And if there's violence against Mother Earth, violence against us, how do we deal with that and how do we prevent it? Right. Empowering our youth, giving them all of this knowledge and really supporting them on how they want to communicate it back to us. I think we can learn a lot from them because being an older mom, I can struggle to connect with some younger moms. But that I think that's pretty common. And with other programs as well. But like I said, you know, thinking outside of the box and going to where they are is very critical in order to build relationships across the generations and understand that our youth are just as important as our elders. Right. And then there's the rest of us in between. So every voice in those generations is vital. It's crucial because we're not trying to say one point of life is more important than the other. But we do recognize that the beginning of life is also kind of the same at the end of life. Right? But in order to, you know, be sovereign people and to practice our ways beautifully on the land, we have to make sure that there isn't more violence occurring and there isn't more harm occurring, and that we're taking care of the land and that we engage in that reciprocity as individuals and as a community. And I think we talked about that before as well. And, you know, going back to a lot of our old teachings, you know, being involved in a research project like this, you know, when you take a step back, it really highlights a lot of critical areas, right? Early childhood development, maternal care and all of the things that impact how we can thrive. And if we're not thriving, how can we help people and get to the people? And with this birth cohort. It has really opened my eyes to really see the big picture and to really start honoring, you know, honoring myself as a woman, but honoring other women and matriarchs and understanding. Yeah, we need to give ourselves more of that good energy, because that's kind of what's going on in everyone's homes, right? The mom, the dad and the children, grandparents and maybe some other elders. But everybody's trying to figure it out, trying their best. And, you know, when these diagnoses come in and they go to their assessment or they're already having problems, it really impacts them, you know, right, when they're going to school, if they're nonverbal, they're going to have a harder time and it's going to be a lot harder to get them resources. But if they're, you know, if they're in the study and we're able to screen them at two months, we're able to screen in about six months, we're able to screen them at nine months. We're able to keep our eyes on them in a way that we can help support the families if they want, like a referral to growing in beauty. 

Speaker 1 [00:43:00] Yeah, and I like how you mentioned, you know, that this right now, the fight is ours, but it's going to be the future generations fight. Yes. Soon. And  then being aware of this uranium exposure and the waste sites and all these other things across Navajo Nation, it's going to be their fight soon. And I hope that we continue this awareness and education to the younger generation. And, you know, I know we kind of already talked about this, but it started all back in the 1960s when all these Navajo widows gathered together, when they figured their husbands were passing because they worked in these mines. And I guess it's just kind of like tying it back to where the culture of how the Navajo women gathered together as a matriarchal component, and how they started climbing this ladder to get a congressional hearing and to get compensation. Not saying that money can replace lives because it definitely doesn't, but hopefully in the future that our children get justice. And, you know, you also mentioned that how some people are unaware of uranium exposure, and they don't know about uranium mines. For me personally, that's how I was and that's how I grew up. I had no idea what uranium mine was. I didn't know what radon gas was. I didn't know that detrimental health effects that it could cause. And so I learned more about this when I was a freshman in college. And, you know, I just want to share a little story about how I learned about it and how it's become a passion of mine. So I learned about it. When I was a freshman in college, I wrote a paper about it, and I wanted to learn more about it. And so as my graduate research project for my master's program, I was able to look more deeply about radon gas. Right. And, you know, you also mentioned asking your parents, your elders about what their experience with uranium. And that's exactly what I did. I asked my mom about it, and she told me, you know, my, you know, my grandfather worked in the mines and he built the house that I grew up with, with materials that he brought back from the uranium mine. So those materials. We're definitely contaminated, and it's kind of mind blowing to think about that, you know, because my mom grew up in that house, I grew up in that house. So we had no electricity, no running water, and I had no idea until she told me. And so I wanted to measure the radon gas levels in that house. But, you know, it's been a long time now since that house been built. And not to say that, you know, the contamination levels have decreased, but the radon gas levels weren't significant in that house. So, you know, I'm grateful for it. But there are probably other families that are living with higher radon gas levels. And so, you know, the Monument Valley area where I came from, my hometown, it was one of the hotspots. You know, there's different hotspots across the Navajo Nation. And I was curious to see what the radon gas levels were in different areas in the Monte Valley, you know, area, because there's like the BCA, I know you mentioned. And then there's the cheetah. They have a uranium waste site, and then there's other abandoned uranium mines all over that area. So I recruited and I asked families if they were interested in getting their homes measured for radon gas. And there was a lot of people that were interested, and a lot of people that I knew that lived near the abandoned uranium mines. So I would ask them and, you know, they were aware and they were concerned about they've had past health issues. And they were asking me, you know, is it linked to uranium or radon gas? And I couldn't really say because I was barely starting and I don't really have a background in chemistry side of it. So I really couldn't answer their questions. But they definitely do have questions. And I think that through this podcast, they're able to find information that they're searching for and resources they may be looking for and definitely, you know, point them in the right direction in some shape or form, you know, because they deserve it and they deserve to be in a safe environment and safe home. So that was my project to get my master's degree. So that was just something that I really wanted to tell my story and how I got introduced to uranium and radon gas and environmental health. 

Speaker 3 [00:47:54] Yes. Yes. Yes. And. Yeah. Yeah. Thank you. And I think that's amazing to go into higher education and to really, you know, put that problem that's in your heart and to investigate it and to bring that message back. If we don't say anything, if we don't investigate, we won't be able to go a little bit further. This conversation really reminded me about, you know, my own family. You know, I think we talked about my mom, my mom and her family. They grew up in near Monument Valley, but they call us that site, specifically VCA. So my whole childhood I just heard VCA, VCA, we're going to VCA or we're over here at VCA. You know, my grandma used to, they lived very close to the mine. So my chair used to work in the mine. My grandma was pretty sick, and but she it was never really talked about in terms of uranium to me anyway. I've had a couple of uncles on my mom's side who had cancer just unexpectedly. And, you know, there was always this talk about. Yeah, well, maybe it was because they grew up by the uranium or VCA. And once I started reading and you realize, wow, it stands for Vanadium Corporation of America. So that was pretty significant. And the amount, you know, the tons and tons that they have taken out, it really highlights another kind of topic that I wanted to make sure that I mentioned with. I think you were asking me if there were any like important books that I had read that kind of help. This line, it's called Fresh Banana Leaves and this is by Doctor Jessica Hernandez. So she's talking about healing indigenous landscapes through indigenous science. Totally awesome to read a book. And she actually says, you know, indigenous people, we experienced ecological grief. I think when I read that, oh, my tears just came down because it's like, you know, you never hear that. You know, it's always, you know, oh, you know, we don't need to talk about feelings. We don't need to talk about emotions. But that's exactly what connects our heart space right to the environment and how we interact in our ceremonies and all of the things and tools that belong to us. It comes from the land. And if the land is hurt, then we're hurt. So I really thank her for calling it ecological grief because that's exactly what it is to us. So I wanted to make sure I said that about that book. 

Speaker 1 [00:50:31] Yeah. Yes. And definitely. That brings up a really important point, because, you know, that in our culture is we're very spiritual. We are very interconnected with Mother Earth. We know not to take more than what we need and to always give back by saying a prayer, offering Teddy Dean or corn pollen. You know, that's the way of our people, and that's the way that we've been taught for generations and generations. And so with all these abandoned uranium mines across Navajo Nation, we know that Mother Earth is suffering, and we need to continue to fight to get this radioactive waste off of Navajo land and try to restore that balance and harmony. You know, as I said before, but going on to our next question and I feel like we've already kind of touched on this, but how does the project engage and educate the community on the effects of uranium and radon exposure? 

Speaker 3 [00:51:28] Yes yes, yes. There's also another really good book. It's called reproduction on the reservation. I would greatly recommend this book talking about pregnancy, childbirth and colonialism in the 20th century. So I really think, you know, all of the experts that have been it's been since 2014, 15 until now, at the very start of it. There wasn't as much emphasis on colonization. And so I am so glad and thankful for all of the experts and grassroots that have come together to say, hey, you know, we can talk about this without it being offensive. We can talk about this in terms of what do we do now? How do we recover, and how do we get back to our way of life and our teachings, and how do we make sure that we're connecting all of these ideas and that we're doing it in a good, in a safe way? 

Speaker 1 [00:52:20] Did the project engage and educate the community on the effects of uranium and radon exposure? 

Speaker 3 [00:52:27] I guess the way I'm going to interpret that is like feedback, right? Community feedback and individual feedback. The research process, like I mentioned before, has to go through Navajo Nation Human Research Review Board. You know, it's like an N.N.H.R.V. So everything has to go through there in terms of what gets disseminated back out. Before Covid, we used to be more on the ground in terms of being active and present in communities, health. There's anything, any kind of event that was going on. We would try to have a table and a booth there and as the science comes out, then they put it into charts and that can be disseminated out individually or, you know, pushed out to the collective. One of the past methods has been use of Navajo times, and they've inserted their own document into there. So that's actually something tangible. And then brochures and presentations to hospitals. So all the different partners, they'll get the feedback. Health boards. If people like pediatric clinic, if they have their monthly meeting and they want feedback, that can be arranged. If other clinicians and midwives want feedback that can be arranged and then individually or participants get a feedback letter, they get a feedback letter about their home assessment. And then they also with all of their data on there. And then they get a feedback whether from the bio monitoring results at the different time points. All of that is it's an intense process to get these documents out and, you know, get them back to the participants. One of the problems is, you know, some of our participants, they move around and so we can send it out to them, but we don't know if they're necessarily going to get it. And we don't know specifically if they have any specific questions. The only thing we can do is kind of catch them if they're coming into the clinic or if we go out to do a home visit. And we'll ask them, do you have any questions about your feedback letter? Did you happen to look at it? Was it easy to understand? And so what the first kind of round, you know, it was very intimidating if you're unfamiliar with kind of those, you know, charts and numbers and levels and all of that, it can be pretty intimidating. But so far, I think it's been effective in terms of getting individual feedback to the participants. That's always accomplished in terms of getting their their letters and their assessments done. And then also for the neuro as well, and then for the community efforts prior to Covid, it would be more presentations, chapter house presentations. Or if anybody is requesting a presentation, then somebody can, facilitate that. 

Speaker 1 [00:55:08] Yeah, I know it's really interesting to hear and like how you said as individual that you guys try to make sure you get those results back to them because, you know, the numbers and everything like that are very intimidating. And I know for sure that's how I felt when looking and gathering all this data, having to look at the data, look at the numbers, look at the graphs. It doesn't make sense until someone tries to explain it to you. And I think that it's very important that they understand what these numbers are saying and these results are saying about their situation. So that's really awesome to hear that. You guys made sure that they understood the statistics that you guys are giving to them. Yeah, because that kind of relates to what my project was. And when families were asking me, you know, what does that mean for me? What does that mean for my family? And it was a lot, and I feel like I wasn't giving them adequate information and resources because I had just barely started really diving into it. But that's awesome that you guys have these referrals and resources that you can give to them if they want to reach out to different, like, say, the Navajo government and the Navajo EPA in that way, which is really awesome. 

Speaker 2 [00:56:27] Thank you for sharing your efforts and how you guys conduct feedback or some education to the community. My next question is, are you aware of any plan to clean up these abandoned uranium sites? And also, how can our individuals reduce their exposure to uranium or radon gas? 

Speaker 3 [00:56:47] So I was trying to see if there was any kind of plans I didn't give. I didn't look at it enough. But I do know that I think EPA is going to have like $1.6 million dedicated for Navajo Nation cleanup, and then that goes kind of like a priority list. So they already have determined what sites are the highest and the most dangerous. And so that's kind of where that money will go. But just from my own observation, it's very, very slow. And there's all these different acronyms and different people with kind of at sometimes it seems like they all have different agendas. And so that kind of makes it hard to see if there's going to be real change. I think with uranium and cleanup, what we know and what we need is that money that can actually clean it up, right? Or even to make sure that there's fencing or that there's a cover. And if there is a cover put on, if it's going to be, you know, is it going to be the same type of cover that would work in Chile versus something that would work in Cameroon and Cameron in there’s a lot more, like we said, the high winds and even a little bit of water can really deteriorate a lot of these structures. So even if they do, you know, say, hey, while we try to mitigate it to a certain point so that the background isn't exceeding a super high level, and they agree to get it to a certain level, and then it kind of just sits there. It's never going to be zero. And I don't think that they're ever going to, you know, fully clean it up, pull it off, you know, take it to a nuclear waste site disposal site, which also costs millions of dollars. So when I think of uranium, I think of clean up. My mind is like, well, I don't think it's billions of dollars. It's probably trillions of dollars. And like I said before, there were signs that EPA has put out and workshops. So they'll do a series of workshops to try to and, like we had talked about to educate the community, but that's determined on if those people are coming in, if they're motivated to learn or they're curious to learn about it. But getting that message to everybody is kind of is a little bit harder. 

Speaker 2 [00:59:10] So that kind of ties into like how families and individuals can reduce their exposure to uranium. Do you think radon gas?

Speaker 3 [00:59:17] I think the most empowering thing is going to be education. So knowing where you're at and so like you're into Tuba city, right? If we're talking about uranium and we're talking about mine features are mine is automatically going to go to rare metals, right. Because there's a site right there. But the way that it's structured, people in Tuba know what it is. If you drive down to highway 89 and you start driving towards gap, there's mine features out there. They're not fenced, they're not notated. When we first started, we had went out there and the readings were very high in the hundreds, and it looked like they had kind of, you know, dragged dirt down and then made a pile and walking by or driving by, you wouldn't think that it had anything to do with uranium. You would think that they were just hauling dirt or moving rocks. And so in that experience, it's pretty high. But it's probably not the highest one because evidently they're not putting plans into identifying it. That is a contaminated site. And so people who live nearby, those kind of features, what I've noticed is that their family, if they retain that knowledge, they'll be able to tell the story of the exposure and the mining. But if that knowledge is lost or that it's not passed down, then they won't know as well. And so the next thing would be that they would have to seek out that information, or this information is readily available and easily accessible to anybody in the community. 

Speaker 2 [01:00:49] Okay. Thank you. 

Speaker 4 [01:00:50] And like you said about the US EPA, how they have had a five year plan to clean up, but that five year plan was established in 2008, you know, and that's been a long, a long time now. And since then, there's only been, I believe, one mine that has been clean so far. And they keep pushing it off. And I don't know why. You know, we have all these studies that have been conducted saying that there is a link for increased detrimental health diseases and so that. Right there should give them the urgency to clean up these sites and make sure that we are not being affected by it anymore. But that's not the case. And, you know, it's been 80 plus years since the uranium has been mined  on the Navajo Nation. So, you know, it's kind of frustrating. And I think that if it's a collaborative effort of the Navajo people to come together and to demand for justice and to demand to get the uranium mines cleaned up and the radioactive waste cleaned up, and I think that would really make a huge difference in trying to escalate the cleanup around the Navajo Nation. 

Speaker 3 [01:02:09] I think your point really ties back to history when, you know, after the long walk, you know, we want it to come home and we, you know, our ancestors value the land. But the United States government said, put them over there. The land is whatever. You know, they didn't talk about it at that time as mineral rich or, you know, being beautiful land. They talked about it like it's a wasteland. Right. And so that phrase is used in uranium as well. And so now we kind of see, well, it wasn't good land. So after the long walk we could go back there. But then once uranium was found, now it's uranium mineral rich. And then now that the mining is done, we're back to a wasteland. I mean, in that concept, not necessarily like that's the truth, but just in that concept of how it ties back to the historical relationship with the United States government and the fact that a lot of these companies, right, that were involved in all of this mining, if they don't exist, then where is that accountability, right. Where's that reconciliation? And that's when it goes back to the government. And so we're still kind of engaged in some of these older relationships. But you know hopefully it's changing. I believe it is. 

Speaker 4 [01:03:27] So moving on to our last question. I know you mentioned that you guys do referrals, and I kind of talked about it a little bit, but are there any other resources or educational information online that you can share to our audience? And if they wanted to, you know, read more about it. And do you have any suggestions? 

Speaker 3 [01:03:46] Yeah. So online if you go to U.N.M and where you type in I can send you the link too. But it's going to be Health Sciences Center and on their web page, UNM Health Sciences Center. All of that information will come up. And then Navajo birth cohort kind of has its own page. And when you start navigating that, different things will pop up. So online those things are readily available. As field staff, we have a wide variety of pamphlets. So we have like a trifold pamphlet, and we have other smaller cards and presentations, slideshows that have a lot of like what I kind of talked about, like the artwork and the chart outcomes. Other important information can be presented. 

Speaker 1 [01:04:34] Okay. That's awesome. Well, thank you for sending me those resources so people can start doing their own little research and thinking more about what the health effects that are linked with uranium and radon gas and all these different exposures. I guess, for me, just a little clarification question about the study. Is this study still active and are you still recruiting mothers? 

Speaker 3 [01:05:00] No, we are. We're actively recruiting and enrolling right now. 

Speaker 4 [01:05:03] Okay. Awesome. And how, if any, was like interested in being part of the research and wanted to reach out. How can they do that? 

Speaker 3 [01:05:12] So right now we're able to recruit at Tuba City Regional Health Care Corporation. We do have a staff. Her name is Katie also and she works for UNM, but she is located at the hospital in the women's clinic on the third floor. And we also have a car research specialist. Her name is Kathy Nez, and she's located in Tuba area. And so am I. So that's kind of us for Tuba area. Then we have Kayenta area, we have staff for Kayenta, and then we have staff for Gallup and Chamblee. So those are going to be our three big recruiting sites right now. And what we do is we're recruiting pregnant moms, pregnant parents, pregnant mothers between the ages of 14 and 45 with a confirmed pregnancy. And the clinical setting has been our top recruiting site, which makes sense, right? And these people all should have lived on Navajo Nation for at least five years at any time, and also be willing to deliver at one of the participating hospitals. So that's Chamblee, Gallup, and Tuba City. There are exceptions that can be made. So if they meet the criteria, then there can be some other exceptions that they've made in the past. So that's kind of our basic recruitment. And what we do we call, email, home visits, all those different methods to get to moms. Like I said, our top recruiting site is going to be at the clinical settings, but also, you know, just disseminating information and our information, our contact information. So I carry around my own business cards and, you know, write on the back of it. So everywhere I go, that's kind of what I give out. If I have brochures, I give out brochures. But I think most effectively when I'm talking to people one on one or with a family is when I do a lot of talking and a lot of educating. So if they're engaged that I'm engaged, I always sit there for hours. Well, not for hours, but we can sit there for a while and just talk about all of these different issues or, you know, and if they're depending on how knowledgeable they are about the research process, that's also it's kind of it's own educational component, explaining to them about the research process and always being aware of that process and to make sure that there's no harm being introduced. So yeah, that's our top recruitment, any of the hospital sites. And then we do have a Facebook page for Navajo Birth Cohort study. And right now that's kind of our main social media. I wish we had other social media, but for various reasons I think our main one is Facebook. 

Speaker 1 [01:07:47] Yeah, okay. Awesome. That's good to know. And I think that yeah, you know, our audience will really appreciate it. 

Speaker 3 [01:07:53] Yeah. Actively recruiting. Oh my gosh. It's a phenomenal study even just my own personal journey. You know who I was when I started. This is not who I am now. You know I'm very thankful for this. Totally, totally grateful that I'm surrounded by people that understand that, you know that what we prioritize our family, our land, our way of life. You know, it's honored. And being able to do this kind of work in a safe environment is very, very important. People who understand where I'm coming from and honor that and not try to make me conform or change in order to make a difference somewhere else, whereas I want to make a difference here. 

Speaker 2 [01:08:37] Oh, so as we are starting to end the session and interview, is there anything else that you would like to mention about the program? 

Speaker 3 [01:08:48] Let me think. Just that it's a huge collaborative effort when we talk about the legacy of uranium mining, all the people that are impacted. And then when we talk about a research program, understanding that all of the different components and all the different people that are needed, we need people in order to get these things, then we need to be healthy minded. We need to make sure that we're walking in a good way, right? Because we're centering moms and babies and kind of really highlighting, you know what? What am I doing? And with my other training, something that was really brought to my attention was, when you're going to your home visits, what's your your frame of mind? What is your mentality? And, you know, I was told, hey, you know, you should listen to some good music. You should listen to your traditional music so you get in a good mindset. I was like, hey, that's really good. And that does make a big difference. Luckily, I'm totally blessed with amazing coworkers that also know their Navajo fluently and they can sing along songs. And so that kind of knowledge and having access to it is totally amazing. But you need to be willing to step out of your comfort zone if you weren't raised with your culture, you need to step out of your comfort zone and find people who can hopefully support your journey kind of back to your Hogan and back to your fireplace and back to you. All of our tools were given as disaster, right? All the tools we were given to remember how all of that is connected from our sash belt, our stirring sticks, all of that. And when we hold them, when we pray for them, when we collect them, it's from the earth. And if uranium is in there, then is it in our tools? Right. So we forget to think about these. But at the same time, our tools are also protecting us, right? And they're also our protection and the significance and the stories and everything, the ceremonies that is tied to this, that's really, really important. And it can get really, really deep when we're talking about moms and all of the ceremonies that should occur right in pregnancy and after pregnancy, and how these things are tied back to our way of life and how it's tied back to the keynote. And when your mom's pregnant with you, they should already be planning and talks about these things that it's going to carry on to your keynote, and in your keynote that you learn everything again so that you're ready to become a parent. Right. And so all of these things are connected. And when the uranium is involved, you know, you look at it, you kind of, what are we going to do about it? But we don't let it be rooted in trauma or just be rooted in something that is bad and negative all the time. We can say, no, we have our strength and we have our way of life that comes back to keep us in balance and in perspective. And we don't have to say things are a total wasteland. We just can say, hey, things are off balance, right? Things are off balance in that micro level and in that macro level as well. 

Speaker 4 [01:11:59] Yes. Nicely said, I love that. That is really empowering to hear. Our dinner culture. Being a matrilineal society, it's just so important, so vital to bring back these teachings. And it's always comforting to hear that the language, because it's not spoken as much as it should be. And I think that it's really important that we need to learn the Navajo language and to pass it on to our children and grandchildren. So, yeah, you know, thank you for that, for the words that you said. They have a lot of power behind it, for me at least. And for bringing it up because our culture keeps us grounded. It keeps us focused on what we need to do to stay in hygiene. And that's like a huge philosophical teaching that we have, you know, and being in balance and being in harmony and fighting for justice and keeping Nassar safe just because of that interconnection that we have with our environment. Also, you know, thank you for doing this work that you do for our generation to keep them safe and to have them live in a safer environment, you know. So thank you again for all the valuable information that you provided us today at the best of your knowledge. And I know some parts of these you may not be an expert in, but you know the things that you have shared. I want to thank you again deeply from, you know, the bottom of my heart, because this information is just so important, and the work that you're doing is so vital for our people to start being aware of these uranium exposures and abandoned uranium mines and everything. You know. And thank you for coming and joining us on our podcast and participating, answering our questions and whatnot. You know, so thank you for that. 

Speaker 2 [01:14:13] Yeah, same I like to express my appreciation as well. I learned a lot today about research and culture and just yeah, I learned a lot about bio monitoring and just around uranium and the process of everything and how big it takes to bring this whole research and effort together. So thank you so much for your time and keep continuing what you're doing and hopefully have some hope for the future of something being done and just research of more knowledge for our community. 

Speaker 3 [01:14:43] Yeah. So thank you guys. Yeah, especially for the work that you guys are doing and the platforms that you guys have, it's really, really good. That's what fills me is knowing that there's people out there. We all have, you know, the same responsibility and the same accountability. Right. Because at the end of the day, who are we accountable to? And so being able to put ourselves in these conversations with other people, that's kind of how you, you know, you continue to build relationships and how you continue to build on that strength because this is a, you know, a really big impact when we talk about moms, babies and our way of life and family, and when those things break down, it's very harmful. It's very hurtful. Right? It's the part that is really hard to talk about. And then when we to want to talk about these verbal scores and if it's tied back to socioeconomic status, that's a really big deal for us. Right. And it really impacts our families. And if they can't meet certain levels of, you know, just ability, it's harder for them to thrive. So I have a lot of hope for our future. And I have a lot of hope for our children. And I just hope and believe that they'll grow up with more of their language than we had, more of their cultural awareness, and definitely more pride and less shame than we grew up with around all of these topics that we talked about. So I'm saying that so it can be out there. Yeah. 

Speaker 1 [01:16:12] Thanks for listening to The MCH podcast. For more information about the Navajo MCH Project, please visit us on Facebook at the Navajo Maternal and Child Health Project at Jeannette College.