Shortly after beginning her job as a pediatrician on the Pine Ridge Indian Health Service hospital in her home state of South Dakota, Dr. Nancy Iverson visited the National Historic Landmark at Wounded Knee. It was there, on December 29, 1890 that troops of the U.S. 7th Cavalry regiment opened fire on more than 350 Lakota Indians, killing as many as 200 men, women, and children.
Near the mass grave where the Wounded Knee victims were buried, Iverson noticed there were more gravestones, many from recent years; each one told the story of one person after another being buried young.
“Life expectancy on the Pine Ridge Reservation is about 20 years below the national average,” explained Iverson. “In the Western hemisphere, only Haitians have a shorter lifespan.”
As one of the poorest regions in the United States (the average annual per capital income is $4,000), residents of Pine Ridge have massive challenges related to food availability, nutritional education, and access to resources for a healthy lifestyle. That, coupled with a healthcare paradigm that treats disease rather than fosters wellness, contributes to the rampant rate of obesity, diabetes, and cardiovascular disease found in the Pine Ridge population. Northern Plains Indians, including the Lakota, were once regarded as the healthiest in the world: in the 1950s, they recorded zero incidence of diabetes. By the year 2000, the rate skyrocketed to 50 percent of the adult population; today Native youth aged 10-19 years are nine times more likely than non-Hispanic whites to be diagnosed with type 2 diabetes.
Iverson set out to help the Lakota reclaim their health. PATHSTAR (Preservation of Authentic Traditions and Healing) was born as a way to create a catalyst for health and wellness through education and resourcefulness. Iverson designed the program around the premise that when given the opportunity to overcome one challenge, momentum would be created to face other challenges.
The challenge? A week-long crash course in swimming, culminating in the legendary swim from Alcatraz Island to the San Francisco shore.
“Our group has nine days together in San Francisco, and, in addition to swimming, we focus on nutrition, meal planning and prep, physical activity, yoga, Pilates, mindfulness, life coaching, gardening, mentoring, and community building,” explained Iverson. “We collectively explore issues of food insecurity in their local communities and ways the group can influence changes on their return home. We investigate community resources, from school programs, Boys and Girls clubs, and athletic clubs to community gardens, co-ops, and farmer’s markets, again with an eye to what could be implemented back home.”
The Alcatraz swim, which gained notoriety for prisoner escapes from the penitentiary on Alcatraz Island (and later, as an iconic triathlon, Escape from Alcatraz), has particular meaning for participants in the program, explained Iverson: “It’s important in our program because of the Alcatraz Occupation. As PATHSTAR’s focus is with Native Americans, Alcatraz has tremendous historical, political, and spiritual significance for our group.”
The Alcatraz Occupation began in November 1969 with 89 American Indians. Under the Treaty of Fort Laramie between the U.S. and the Lakota tribe, all retired, abandoned, or out-of-use federal land was to be returned to the Indians who once occupied it. When Alcatraz penitentiary closed in 1963 and the island declared surplus federal property in 1964, activists felt that the island qualified for a reclamation by the Lakota. The occupation lasted for than 19 months, and at once point grew to more than 400 people before it was forcibly ended.
The timing of PATHSTAR’s swim week is aligned with both the anniversary of the Alcatraz Occupation as well as Indigenous People’s Day (the second Monday of October). Traditions are integrated into all elements of the PATHSTAR program, from the traditional indigenous meals of salmon or buffalo served for dinner the night before the swim to the songs and prayers recited before entering the water. Doing so underscores the Lakota virtues of bravery, fortitude, generosity and wisdom–virtues they take from the swim to changing their health, their lives, and their communities when they return home.
“The swim is an extraordinary achievement, especially considering that many participants are non-swimmers and we have only eight training swims,” explained Iverson. In addition to building up skills and confidence in the water over the course of the training week, each participant is accompanied by at least one “swim angel” (an experienced swimmer in the San Francisco Bay) and a designated kayaker, rower, or board pilot. Swim starts are staggered with the hopes of all swimmers arriving at the beach together.
Now in its 18th year, PATHSTAR has grown beyond its initial focus on the Pine Ridge Reservation. Today, more than 20 different tribal lineages and 10 different states are represented, with a total of 119 participants in the 2019 event.
“Every year, I am deeply moved and inspired by each participant—first of all, just by showing up here,” said Iverson. “Whether they’re coming from the Auburn/Grass Valley area through the Chapa De Indian Clinic or from Pine Ridge in South Dakota or Ketchican in Alaska, each participant faces huge challenges in getting here and immersing themselves–not just in the bay, which is an amazing feat to progress in one week from a non-swimmer to an Alcatraz swimmer—but also in a rigorous program in nutrition, health, and lifestyle.”