ࡱ> uwt%` J%bjbjNN .^,,< ,***80+<l+,\S,,,,,---RRRRRRR$HThVhR2--22R,,S 6662v,,R62R66NeQ,, nL*3OR S<\SOW3 W4eQWeQL-H.6/0---RR5^---\S2222,, $ ,,,,, Teaching Notes When Our Water Returns: The Gila River Indian Community and Diabetes By Jovana J. Brown Learning Objectives Learn about the Gila River Indian Community (GRIC). Understand the history of the Gila River Indian Community and their historic water settlement. Recognize the basics of diabetes. Explore various causes of diabetes. Understand the dynamics of diabetes in the Gila River Indian Community. Learn about the role of traditional foods in combating diabetes. Audience: Suitable for college students, undergraduate through graduate studies. This case is especially useful for study in public health, American Indian studies, sociology, anthropology, political science, history, and public administration. Implementation: The case can be taught over multiple class sessions by teaching it as an interrupted case, e.g., Part I and than Part II. Small group discussions are particularly fruitful in addressing the key questions in the case. Start with Level 1 questions and progress through Level 3 questions. Encouraging students to do additional research is also recommended. A list of research questions follows. Discussion Questions: (organized by level of complexity with tier one questions emphasizing facts) Part I The Gila River Indian Community Level I How did the Spanish explorers impact the Akimel OOthom and Pee Posh? What was the role of the Akimel OOthom and Pee Posh in facilitating the movement west of EuroAmerican miners and settlers? What significant changes occurred on the Gila River Indian Community (GRIC) after 1870 as non-Indian farmers and ranchers moved into central Arizona? What happened to the Gila River that once flowed through the GRIC? What is the San Carlos project? Did it benefit the GRIC? Level II What was the importance of the Gila River to the Akimel Oothom and Pee Posh people? What were the traditional foods of the Akimel and Pee Posh? What was the impact of the Desert Land Act on the Akimel and Pee Posh? The San Carlos project was passed by Congress to benefit the Gila River Indian Community? Why was it promoted in this way? What is an Indian blanket in a water project? Who ended up with the project water? How did Gila River Indian Community agriculture change after the San Carlos project? What changes occurred in the Gila River Indian Community after passage of the Indian Reorganization Act of 1934? Level III What was subjugation on the Gila River Indian Community? How did it impact the agricultural practices of the Community? What was the role of the Bureau of Indian Affairs on the Gila River Indian Community from the Indian Reorganization Act of 1934 through the termination period of the 1940s? The period of self-determination began in the 1970s. What changes began on the Gila River Indian Community during this period? How did they contribute to the current prosperity of the Community? What are the key features of the Gila River Indian Community water settlement? What does this water settlement mean to the future of the Gila River Indian Community? Part II Health - The Gila River Indian Community and Diabetes Level I What is diabetes? Why is diabetes of such concern in the United States? What do the current diabetes statistics mean for the future of the disease? What is the relationship between obesity and diabetes? Is diabetes a curable disease? Level II What is the history of diabetes on the Gila River Indian Community? What has this high rate of diabetes meant for the Community? What are the complications associated with diabetes that can impact Community members? What is the significance of the individuals choices and quantity of foods consumed to the development of diabetes? What is the role of increasing the level of physical activity play in combating diabetes? Is fry bread a traditional American Indian food? How do you define traditional food? Is it necessary to make a distinction? Level III How has the history of the Gila River Indian Community contributed to the prevalence of diabetes in the Community? Do you think the acceptance of the thrifty gene theory leads to biological determinism? Does this lead to a confusion of genes with race? What are the dangers of this approach? How has the diet of Community members changed from the beginning of the 20th century and continued to change since then? Has this change in diet been the cause of diabetes in the Community? How might the incorporation of traditional foods in the Communitys diet help reduce the rate of diabetes in the GRIC? In the pre 1870s, the Akimel Ootham and the Pee Posh grew crops for trade and sale before water deprivation changed them into wage workers and their land changed from irrigated plots to small 10-acre allotments lacking water. With the water settlement, what must the people do to become individual farmers again? What might it mean to the GRIC if it returns to growing traditional crops? Research Questions Do research on historical changes and health on an Indian Nation that you live near or are familiar with. What has been the impact of these changes on the current generation? Diabetes is a world-wide disease. Describe similar instances in the third world where the history of a people has made them vulnerable to a high rate of diabetes in their population? Find examples of other Indian nations that are using traditional foods and community gardens to fight diabetes. What are the foods? Describe critical elements of some of the success stories you locate. What is the role of trauma and stress in people developing diabetes? Find several research articles on this topic. What do they conclude? Find another example of a recent water settlement of Indian reserved water rights? How did this settlement come about? Does it include a water delivery system? Additional Resources Bad Sugar Episode #3 of the PBS series Unnatural Causesis inequality making us sick? 29 minute video about diabetes on the GRIC and the implications of the water settlement. Information downloaded 7/18/09 from:  HYPERLINK "http://www.unnaturalcauses.org/episode_descriptions.php?page=4" http://www.unnaturalcauses.org/episode_descriptions.php?page=4 DeJong, D. (Forthcoming) Stealing the Gila: The Pima agricultural economy and water deprivation, 1848-1921 Tucson: University of Arizona Press. Websites: American Diabetes Association:  HYPERLINK "http://www.diabetes.org" www.diabetes.org Centers for Disease Control and Prevention (CDC)  HYPERLINK "http://www.cdc.gov/" http://www.cdc.gov/ Indian Health Service. Division of Diabetes Treatment and Prevention.  HYPERLINK "http://www.ihs.gov/medicalprograms/diabetes/" http://www.ihs.gov/medicalprograms/diabetes/ Juvenile Diabetes Research Foundation International:  HYPERLINK "http://www.jdrf.org" www.jdrf.org National Diabetes Education Program:  HYPERLINK "http://www.ndep.nih.gov" www.ndep.nih.gov National Diabetes Information Clearinghouse:  HYPERLINK "http://www.diabetes.niddk.nih.gov" www.diabetes.niddk.nih.gov National Library of Medicine. American Indian Health:  HYPERLINK "http://americanindianhealth.nlm.nih.gov/" http://americanindianhealth.nlm.nih.gov/ U.S. Dept of Health & Human Services. Office of Minority Health. Diabetes and American Indians/ Alaska Natives.  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