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Tag: Health History

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Black and white photo of a military medic kneeling in front of cabinet of medical supplies.
Photo and caption via National Archives Catalog: A military medic kneels in front of a shelves full of variety of medicine bottles

Health care personnel have assisted military units for centuries, both in unofficial capacities and as recognized members of the armed forces. Whether they were actively treating injured soldiers on the frontline or performing complex surgeries in military hospitals, physicians, surgeons, nurses and other health professionals worked alongside soldiers and commanders to ensure that the injured were properly treated. 

Prior to the 19th and 20th centuries, healthcare treatment within the military was largely decentralized and relied on inaccurate information on wound treatment and patient care management. But as more advanced weapons and military tactics were introduced, countries and military leaders invested in their healthcare infrastructure which led to lower mortality rates and the decrease of widespread infection within military camps. Many of the inventions introduced during conflicts such as the Napoleonic Wars, the American Civil War and the World Wars have been carefully refined and serve as the foundation for today’s current military medicine practices. 

Health and medicine have been the focus of research for centuries. Many ancient historical figures and civilizations documented their theories about human anatomy, physiology, the nature of diseases and health remedies. Preserved historical texts from ancient civilizations provide us with a glimpse of some of the health treatments and theories proposed by scholars. In Homer’s The Iliad, surgeons were portrayed as “skilled and professional physicians who expertly treated wartime trauma.” (Manring et al., 2009, pg. 2173) Ancient Egyptians and Babylonian-Assyrians left behind texts and treatises that showed cultures with sophisticated and thoughtful ideas about medicine and the human body. (Van Way, 2016)

During the time of the Roman Empire, “The Roman army had organized field sanitation, well-designed camps, and separate companies of what we would now call field engineers. They had a much better grasp of sanitation and supply than anyone else before, or for a long while.” (Van Way, 2016, pg. 260) While ancient civilizations lacked the technology and scientific theories that form the foundation of modern medicine, these cultures worked to protect their injured soldiers during battle. Some civilizations, such as the Romans, understood the importance of maintaining clean environments to prevent epidemics from debilitating their armed forces. As Dr. Charles Van Way III wrote, “Because of their [The Romans] improved sanitation, their armies suffered somewhat less from the epidemics which swept military camps, but only by comparison with their opponents.” (Van Way, 2016, pg. 261)

Color image of temple ruins.
Photo Credit: Edneil Jocusol via Pexels.com:

Unfortunately, when the Roman Empire fell, their ideas on sanitation and healthcare management were lost. For years, there were few scientific advances and many physicians relied on the ancient and incorrect humoral theory or four humors theory which was first suggested by the Ancient Greeks. According to this theory, the human body consisted of four ‘humors’: black bile, yellow bile, blood and phlegm. If a person was ill, humoral theorists believed the sickness was caused by an imbalance of humors within the body, instead of pathogens or forces outside the body. While there are some critics of this theory, it was the prevailing medical belief until the 18th and 19th centuries. 

With the development of the scientific method around the 17th century, empirical observations became the basis for theories; the humoral theory eventually fell out of favor and more evidence-based practices/theories took its place. This impacted military medicine as healthcare responders developed new techniques that contributed to declining mortality rates and a more sanitary wound treatment management system. 

Some discoveries and resources that were developed during this time include Jean Louis Petit’s tourniquet, Pierre-Joseph Desault’s description of the debridement of wounds and the publication of three textbooks on military medicine. (Van Way, 2016, pg. 262) But it was during the Napoleonic Wars (1792-1815) where military medicine began to improve and leaders recognized the importance of a well maintained military healthcare system. Baron Dominique-Jean Larrey is seen as the originator of modern military medicine. Some of his contributions to the field include an early framework for the triage system, the “ambulance volante” or flying ambulance and the use of field hospitals that were located away from the battlefield. (Van Way, 2016; Manring et al., 2009)

Despite the recommendations created by Baron Dominique-Jean Larrey, armies still failed to create an organized healthcare system within their military. This caused controversy during some campaigns. For example, during the American Civil War (1861-1865) both the Union and Confederate armies “had physicians, but there was only a rudimentary hospital and evacuation system…Public health was terrible. Many soldiers died of disease, often even before reaching the battlefield.” (Van Way, 2016, pg. 336) This eventually led to the establishment of a military medical corps that treated the injured soldiers. And during the Crimean War (1853-1856), public outrage over the treatment of wounded British soldiers led the War Office to enlist the services of Florence Nightingale. Nightingale and her staff of volunteers focused on sanitation, ventilation and waste disposal. Because of her efforts, she “broke the monopoly of health care as the sole providence of the physician, which led to the development of the healthcare team in modern medical practice.” (Manring et al., 2009, pg. 2169)

Black and white photograph of four medical corps members transporting an injured soldier from battle.
Members of the Medical Corps removing the wounded from Vaux, France. Photo via National Archives

Military medicine faced its greatest challenge during the world wars and the field continued to shape itself into the modern version that is present today. When the U.S. joined World War I (1914-1918), hospitals, doctors, nurses and ambulances accompanied the soldiers and commanders. Ambulances were used to transport the wounded from the battlefield, and from there the soldiers would be taken to a healthcare team or moved to a facility where they could recover. (Van Way, 2016) Between the wars, medical advancements were incorporated in the field of military medicine such as “Blood and plasma transfusions, widespread use of intravenous fluids, antibiotics (but limited to penicillin and sulfonamides), endotracheal intubation, thoracic and vascular surgery, and the care of burn wounds.” (Van Way, 2016, pg. 338) 

Military medicine was further tested during conflicts such as the Korean War (1950-1953), the Vietnam War (1955-1975), the Gulf War (1990-1991) and the wars in Afghanistan (2001-2021) and Iraq (2003-2011). According to Manring et al’s 2009 historical review, “Trauma care for US soldiers in Iraq and Afghanistan currently is provided through five levels of care: Level I, front line first aid; Level II, FST (Forward Surgical Team); Level III, CSH, which is similar to civilian trauma centers; Level IV, surgical hospitals outside the combat zone…and Level V, major US military hospitals…” (Manring et al., 2009, pg. 2171)

Aerial photograph of set of military hospital tents in an open field.
Photo and caption via National Archives Catalog. Caption: An aerial view of a field hospital erected during Exercise WOUNDED EAGLE '83.

The path to our current military medicine field and system was windy. The field was influenced by scientific advances and historical figures such as Baron Dominique-Jean Larrey, Florence Nightingale, Dr. Walter Reed, Leonard Wood and thousands of physicians, surgeons, nurses, ambulance drivers and other professionals. If you are interested in hearing firsthand accounts from military healthcare professionals, visit the Library of Congress’ collection ‘Healing with Honor: Medical Personnel.’ The collection features personal narratives from people who served in conflicts such as World War I, the Korean War or the war in Afghanistan. ‘Healing with Honor: Medical Personnel’ is an excellent way to learn more about the field of military medicine and its commitment to the treatment of soldiers harmed during conflicts.

References:

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Photo by EVG Kowalievska

The United States has a history of assisting vulnerable populations with community needs, often with varying degrees of success. The Indian Health Service (IHS), part of the Department of Health and Human Services, is one such government organization that provides healthcare for millions of Indigenous people and since its inception, the service has positively impacted federally recognized Native nations despite budgetary constraints. The Service employs physicians, nurses, dentists and other healthcare professionals to meet the healthcare needs of Indigenous populations and the organization sponsors professional opportunities for Indigenous students at both the undergraduate and graduate levels who express an interest in entering the healthcare field.

The Indian Health Service was created in 1955 and was born out of a long history of the United States government providing assistance to Indigenous nations. “The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article 1, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders.”(Warne & Frizzell, 2014, p. S263) The federal government would send military physicians to Indigenous communities in an effort to address the spread of diseases such as smallpox. Unfortunately the government spent far less money on the healthcare of Indigenous people in comparison to members of the military. In 1880, the Commissioner of Indian Affairs, Thomas J. Morgan requested more funding to cover expenses and he “calculated the disparity in resources, finding that the Army spent $21.91 per soldier and the Navy $48.10 per sailor, while the government only appropriated $1.25 per Indian patient.” (Trahant, 2018, p. 118)

In 1911 President William Howard Taft urged Congress to raise the salary of healthcare workers employed in the Indian Service. But the history of underfunding Indigenous healthcare continued. When the Bureau of Indian Affairs opened a health division in 1921, the system suffered from poor funding, unsanitary facilities and inadequate supplies which placed a strain on the quality of care provided. In 1955, Congress transferred the health programs away from the Bureau of Indian Affair to the newly formed Indian Health Service. They also raised the service’s budget from $10 million to $17.7 million a year. Finally in 1976, “Congress proposed a sweeping new authorization for Indian health programs. The Indian Health Care Improvement Act…called on Congress to appropriate at least $1.6 billion in new funding for Indian health, spending resources on improving staffing, facilities, access to care for urban Indian populations, and, for the first time, opened up Medicare and Medicaid revenue.” (Trahant, 2018, p. 119)

The Indian Health Service’s headquarters is located in Rockville, Maryland and has twelve service areas located across the country. The current head of the service is Roselyn Tso, an enrolled member of the Navajo Nation. Tso began working for the Service in the 1980s and has worked in many different capacities, including serving as the director of the Indian Health Service Navajo Area in 2019. The Indian Health Service provides access to hospitals, health centers, dental clinics and behavioral health facilities to Indigenous communities in the twelve service areas. The organization also offers healthcare education so people can improve their quality of health outside of regularly scheduled appointments. The Indian Health Service is one of the few federal organizations that prioritizes Indigenous applicants during the job search process and they also host funding opportunities for students interested in a career in healthcare. Scholarships are available for undergraduate, graduate and preparatory school students. The Indian Health Service also offers an extern program where participants earn valuable, hands-on skills while working in IHS facilities. 

While the organization continues to suffer from poor funding in comparison to other federal organizations, the Indian Health Service has improved the overall health of their patients. For example, the infant mortality rate for Indigenous communities has drastically decreased since 1955 and “The Centers for Disease Control and Prevention reported that, in the United States from 2004 to 2008, 84 percent of American Indians and Alaska Natives have a ‘usual place for health care.’” (Trahant, 2018, p. 120) Besides the lack of adequate funding, another criticism of the Indian Health Service is the organizations’ lack of focus on Indigenous people who live in urban areas.  Over the years, the IHS has sought  to provide resources to patients in urban areas,  and to meet the needs of over 2 million Indigenous patients.

The Indian Health Service was born out of the numerous treaties, legally binding agreements and promises made between the US federal government and the governments of Indigenous nations such as the 1832 treaty between the War Department and the Winnebago Tribe in Wisconsin in which the federal government promised two physicians in exchange for land (Trahant, 2018). The healthcare and administrative workers in the IHS search for creative solutions to meet the pressing healthcare needs of their patients. And by offering scholarships and externships, the organization aims to tackle the healthcare industry’s lack of Indigenous workers. The Indian Health Service’s mission is “To raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level” and by fulfilling this mission, the IHS provides an example for other healthcare organizations committed to addressing health disparities in other vulnerable and underserved communities.

References:

Indian Health Service. (n.d.). Indian Health Service: The Federal Health Program for American Indians and Alaska Natives. https://www.ihs.gov/

Marcinko, T. (2016, November 13). More Native American Doctors Needed to Reduce Health Disparities in Their Communities. AAMCNEWS. https://www.aamc.org/news-insights/more-native-american-doctors-needed-reduce-health-disparities-their-communities. 

Warne, D. & Frizzell, L.B. (2014). American Indian Health Policy: Historical trends and contemporary issues. American Journal of Public Health, 104(3), S263-S267. https://doi.org/10.2105/AJPH.2013.301682

Trahant, M.N. (2018). The story of Indian health is complicated by history, shortages, & bouts of excellence. Daedalus, 147(2), 116-123. https://doi.org/10.1162/DAED_a_00495

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Portrait of Dr. Antonia Novello.
Photo By United States Department of Health and Human Services

Dr. Antonia Novello is a healthcare professional who for many decades focused on improving the health of women, children and those most vulnerable in modern society. 

She was born in Puerto Rico on August 23, 1944 and is the oldest of three children. During her childhood, Dr. Novello suffered from congenital megacolon which impacted her large intestine. Treatment options were available, but due to her family’s financial situation, Dr. Novella was unable to receive surgery to cure the condition until she was eighteen years old. This experience had a lasting impact on her and was one factor that inspired her to pursue a career in health sciences. Dr. Novello earned a multitude of degrees and certificates including a Bachelor of Science and a Doctor of Medicine from the University of Puerto Rico in 1965 and 1970 respectively and a master degree in Public Health from John Hopkins University in 1982.  

After marrying Joseph R. Novello and moving to Michigan, Dr. Antonia Novello completed an internship and residency in pediatrics and a fellowship in pediatrics nephrology. She took an interest in nephrology after a beloved family member died due to complications with their kidneys. Dr. Novello practiced medicine in a private office for two years, but eventually transitioned to work for the National Institutes of Health (NIH) in 1978. Novello focused on health issues related to women, children and marginalized communities during her time at NIH. She was instrumental in the legislation that led to the creation of the national organ transplant registry and she also played a significant role in requiring all cigarette containers be labeled with a health warning. In 1989, President George H.W. Bush selected her as the new United States Surgeon General making her both the first woman and the first Hispanic American to fill the role. 

Novello served as the U.S. Surgeon General from 1990 until 1994 when the Clinton Administration began. During her tenure, Novello continued to advocate for women and children. “In March 1992, she and James S. Todd, executive vice-president of the American Medical Association (AMA), held a news conference at which they denounced the R.J. Reynolds Tobacco Company’s advertisements featuring the cartoon character Joe Camel, because research showed that it appealed to young children.” (Meier et al., 1997, p. 272) Novello was also vocal about the alcohol industry’s marketing practices, particularly the industry’s use of advertisements which showed people skiing, surfing or mountain climbing with alcoholic beverages close by as it suggested people could perform these activities while consuming alcohol. Novello also raised awareness on domestic violence and its impact on women. (Meier et al. 1997)

After 1994, when a new Surgeon General was appointed, Novello continued to work within the healthcare industry until her retirement in the 2010s. Novello currently spends her time between Puerto Rico and Florida and is still an active advocate for the health needs of others. Most recently during the COVID-19 vaccine rollout, Novello spoke with parents and other community members of the importance of vaccination and even participated in local vaccination clinics and programs. And in August of 2021, she and other living former surgeon generals participated in a White House event where they discussed “getting information and access to vaccines to communities of color, who have been the hardest hit during the pandemic.” (Sesin, 2021)

Novello has received recognition for her work as a healthcare provider and public health advocate. Some of the awards she has received over the course of her career include “the Public Health Service Commendation Medal (1983); Congressional Hispanic Caucus Medal (1991); Order of Military Medical Merit Award (1992); and the James Smithson Bicentennial Medal (2002).” (Brandman, 2021) Dr. Antonia Novello’s lengthy career is inspirational for people committed to serving their communities and her legacy of speaking up for women and children will have profound effects for years to come. 

References:

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In the early 1980s there were official reports of once healthy, young, gay men falling severely ill and dying from an unknown illness. The first five reported cases included men ranging in age from 29 to 36, all displaying various symptoms and eventually developing pneumonia. In the summer of 1981, the CDC established a task force to study this new debilitating condition and since then researchers have worked diligently to understand and find treatment options. The condition and the virus that causes this illness were eventually named Acquired Immunodeficiency Syndrome (AIDS) and the Human Immunodeficiency Virus (HIV) respectively. Since its initial discovery, the spread of HIV has been classified as an pandemic and has impacted millions of people around the world. UNAIDS estimates that 79.3 million people have been infected with HIV since the beginning of the pandemic and as of 2020, approximately 37.7 million people currently live with HIV.  While there is no vaccine available to prevent HIV, over the decades researchers have discovered treatment options to help individuals manage their symptoms. Through ongoing research and clinical trials, HIV/AIDS researchers have several promising leads that could potentially help with the creation of a safe and effective vaccine that will contribute to the end of this decades long pandemic.

Researchers at the National Institute of Allergy and Infectious Diseases (NIAID) are actively studying HIV and how it interacts with people’s immune systems by conducting research and clinical trials. Using a two step, complementary approach towards vaccine development, researchers not only learn new information about the virus, but they also hope to use their findings to develop a vaccine that can be distributed to the general public. Under the empirical approach, researchers rely on observation and experimentation to move different vaccine candidates into the human trial stages. With the theoretical approach, researchers seek to better understand the virus, how it impacts the human immune system and how a vaccine can bolster the immune response when a person is exposed to HIV. These two approaches allow researchers to quickly move vaccine candidates through the different stages of clinical trials.

Infographic depicting information on the history of HIV vaccine research.
Credit: National Institute of Allergy and Infectious Diseases

One of the most significant HIV vaccine clinical trials in recent years was the RV144 Trial in Thailand. This study enrolled over 16,000 volunteers and took place over the course of several years, with researchers reporting their findings in 2009. This trial showed that the vaccine candidates offered some protection against HIV in humans, which was the first time researchers discovered a vaccine could potentially protect people from the virus. The RV144 findings are still being analyzed for how the vaccine combination used in the trial helps our immune responses and other studies hope to build off the modest success of the RV144 trial. In the late 2010s, two other important clinical trials began and their data may offer a glimmer of hope for vaccine development. Launched in 2017 by the National Institutes of Health and other research partners, the HVTN 705/HPX2008 or Imbokodo study enrolled HIV-negative women in sub-Saharan Africa and used a vaccine regime “based on ‘mosaic’ immunogens–vaccine components designed to induce immune responses against a wide variety of global HIV strains.” (“NIH and Partners Launch HIV Vaccine Efficacy Study”) A complementary study called HPX3002/HVTN 706 or Mosiaco used a similar vaccine regime and took place across several countries including the United States, Brazil, and Poland. The Mosiaco study volunteers were made up of HIV-negative men and transgender people from the ages of 18 to 60. The results from the Imbokodo and Mosiaco studies were released in 2020 and 2021 respectively, though it may take years before researchers have a full understanding of the impact of these two clinical trials. In more recent news, NIAID scientists published an article in Nature Medicine that highlighted promising results of an HIV vaccine candidate based on the mRNA program used to develop vaccines for COVID-19. The researchers found that the vaccine showed promise in mice and non-human primates. According to Dr. Paolo Lusso, who led the team of researchers, "We are now refining our vaccine protocol to improve the quality and quantity of the VLPs (virus-like particles) produced. This may further increase vaccine efficacy and thus lower the number of prime and boost inoculations needed to produce a robust immune response. If confirmed safe and effective, we plan to conduct a Phase 1 trial of this vaccine platform in healthy adult volunteers..." ("Experimental mRNA HIV vaccine safe, shows promise in animals") It is difficult to predict when a vaccine will be available to the general public. But the results from clinical trials like the RV144 trial offer hope that one day researchers will create a safe vaccine and bring an end to this decades long pandemic.

 Our understanding of HIV and AIDS continues to evolve. Treatment options are improving allowing individuals with HIV to live comfortably. And every day researchers work to develop a vaccine that will provide significant protection for individuals who may be exposed to the virus. This post is a short overview of the history and current state of HIV vaccine research. If you’re interested in learning more about the history of HIV vaccine development, please visit the NIAID’s website dedicated to HIV/AIDS research and be sure to read through their ‘History of HIV Vaccine Research’ timeline which includes brief information about other previous clinical trials not discussed in this article.  Or click the links embedded in this article to learn more about the specific clinical trials and their results.

References:

“Experimental MRNA HIV Vaccine Safe, Shows Promise in Animals.” National Institutes of Health (NIH), 9 Dec. 2021, www.nih.gov/news-events/news-releases/experimental-mrna-hiv-vaccine-safe-shows-promise-animals.

“Global HIV and AIDS Statistics-Fact Sheet.” UNAIDS, www.unaids.org/en/resources/fact-sheet. Accessed 20 Dec. 2021.

“History of HIV Vaccine Research.” NIH: National Institute of Allergy and Infectious Diseases, 22 Oct. 2018, www.niaid.nih.gov/diseases-conditions/hiv-vaccine-research-history.

“HIV Vaccine Development.” NIH: National Institute of Allergy and Infectious Diseases, 15 May 2019, www.niaid.nih.gov/diseases-conditions/hiv-vaccine-development.

“NIH and Partners Launch HIV Vaccine Efficacy Study.” NIH: National Institute of Allergy and Infectious Diseases, 30 Nov. 2017, www.niaid.nih.gov/news-events/nih-and-partners-launch-hiv-vaccine-efficacy-study.

“NIH and Partners to Launch HIV Vaccine Efficacy Trial in the Americas and Europe.” NIH: National Institute of Allergy and Infectious Diseases, 15 July 2019, www.niaid.nih.gov/news-events/nih-and-partners-launch-hiv-vaccine-efficacy-trial-americas-and-europe.

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Susie Walking Bear Yellowtail (Women's History Matters)

In an effort to remain accountable to communities who have been negatively impacted by past and present medical injustices, the staff at Himmelfarb Library is committed to the work of maintaining an anti-discriminatory practice. We will uplift and highlight diverse stories throughout the year, and not shy away from difficult conversations necessary for health sciences education. To help fulfill this mission, today's blog post examines the life and activism of Susie Walking Bear Yellowtail.

Susie Walking Bear Yellowtail was a Native American nurse who consistently advocated for better access to quality, culturally sensitive healthcare and during her decades long medical career, she documented and recounted stories of medical abuse that Native Americans frequently experienced when visiting hospitals or non-Native doctors. Yellowtail was one of the first Native American registered nurses and the first registered nurse from the Crow people. Her work as an activist paved the way for other medical professionals who sought to end harmful practices that frequently impacted lower-class families and people of color.

Yellowtail was born on January 27, 1903 on the Crow Indian Reservation in Montana. She was orphaned at a young age, but lived with an aunt who took care of Yellowtail and her sister. Like many young Native children, Susie Yellowtail attended an Indian boarding school until she met the Baptist missionary, Frances Shaw. Yellowtail traveled with Shaw to a Baptist convention in Denver, before moving to Oklahoma to complete her education at the Bacone Indian School. When Frances Shaw married and became Mrs. Clifford Fields, Yellowtail once again moved to the East where she lived with the Fields family. During this time, Susie Yellowtail enrolled in Northfield Seminary. Mrs. Fields paid for the tuition fees, but to afford her room and board, Yellowtail worked as a nanny and maid for the Fields family. Eventually she left the seminary and instead enrolled in a nursing program at Franklin County Memorial Hospital and completed her training at the Boston City Hospital School of Nursing. She received her degree in 1927 and worked in several different positions before returning to the reservation where she was born.

Working as a nurse for the Indian Health Service’s run hospital, Yellowtail witnessed firsthand the mistreatment many Crow people experienced during their appointments. She “documented instances of Indian children dying from lack of access to medical care, Indian women being sterilized without consent, and tribal elders unable to communicate their health concerns to doctors.” (Women's History Matters) Yellowtail sought to provide better treatment for her community and was vocal with her criticisms of the non-Native doctors, nurses and medical professionals who worked in the hospital. She blended her Crow culture and traditions with her medical education to care for Native patients who were nervous around the hospital staff or unable to access the hospital and its services. In 1929, Susie Walking Bear married Thomas Yellowtail and the two became major leaders on the reservation.

Thomas and Susie Yellowtail (Women's History Matters)

Susie Walking Bear Yellowtail served as a member of several reservation advisory committees and this eventually led to President John F. Kennedy appointing her to the Surgeon General’s Advisory Committee on Indian Health. She was reappointed to this position by both the Johnson and Nixon administrations. In this role, Yellowtail traveled to other Native American reservations and documented Native Americans’ experiences with visiting their hospitals. Almost immediately, she noticed a similarity in stories and used this information to create recommendations that would improve not only the relationship between Native Americans and health professionals, but also address years of harm that went unchecked. Susie Yellowtail continued her work for decades and died on December 25, 1981.

Yellowtail received recognition for her work both during her lifetime and after her passing. She was awarded the President’s Award for Outstanding Nursing by President Kennedy in 1962 and she was inducted into the Montana Hall of Fame in 1987. In 2002, she was also inducted into the American Nurses Association Hall of Fame.

While Susie Walking Bear Yellowtails’ career and advocacy efforts positively impacted the Crow people and other Native American tribes in her lifetime, her work served as an example on how health rights activists could monitor and document patient mistreatment by the medical field. Yellowtail used her Crow identity and nursing education to provide culturally sensitive care to the Native Americans who requested her services. As one of the first registered nurses of Native American descent, Susie Yellowtail embedded herself in the medical field and brought about long-lasting changes that can still be felt to this day.

Sources

“Susie Walking Bear Yellowtail: ‘Our Bright Morning Star.’” Women’s History Matters, 6 May 2014, montanawomenshistory.org/susie-walking-bear-yellowtail-our-bright-morning-star.

Theobald, Brianna. “Nurse, Mother, Midwife-Susie Walking Bear Yellowtail and the Struggle for Crow Women’s Reproductive Autonomy.” Montana The Magazine of Western History, vol. 66, no. 3, 2016. National Indigenous Women’s Resource Center, www.niwrc.org/resources/journal-article/nurse-mother-midwife-susie-walking-bear-yellowtail-and-struggle-crow.

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