A Pattern of Failed Pregnancies, Infant Deaths Baffles Shoalwater Indian Tribe, Which Fears Extinction Because Its . . . : Babies Are Dying

Jim Anderson unlatches the hand-hewn graveyard gate with practiced familiarity, as if it were his own front door.

Following a path, he comes to two small mounds heaped with muddy homemade quilts, toys, rocks, a rattle, a broken sand dollar and a shell filled with buttons.

“This is Fern Willi,” Anderson says, gesturing toward one of the mounds. “And this is John Mitchell.”

Jim and Kathy Anderson’s son, John Mitchell Anderson, died at age 6 months last July; their daughter, Fern Willi Anderson, was dead at birth in November. “This tribe depends on its kids,” says Anderson, 32, straightening one of the quilts. “Without them, it’s . . . extinction.”

Extinction is what the tiny Shoalwater Bay Indian tribe faces if a mysterious pattern of failed pregnancies and infant deaths continues. Of 26 confirmed pregnancies on the reservation in five years, only nine babies lived. Twelve of the pregnancies ended in miscarriages. Three babies died as infants. Two were stillborn.

It’s impossible to compare the Shoalwaters’ plight to infant mortality figures in the larger population because the tribe numbers only 150. In such a small sampling, a death or two can skew the statistics, says Jonathan Sugarman, an epidemiologist investigating the case for the Indian Health Service.

As some basis for comparison, though, Sugarman says the infant mortality rate in the general population is about one in 100, a figure that does not include miscarriages. But according to tribal administrator Ken Hansen, the tribe’s rash of miscarriages and infant deaths “far exceeds anything we’re aware of in the U.S.”

The tribe is working with the Indian Health Service and the Washington state Health Department to try to discover the source of the problem. Theories include contamination from chemicals sprayed on nearby forests, cranberry bogs and oyster beds, or toxic leakage from a local dump. Alcohol, drugs, smoking, lack of prenatal care and poverty also may be factors. According to the 1990 census, the tribe is the poorest in the state, with an annual per-capita income of $2,852.

For now, while investigators gather and analyze data, the Shoalwater tribe has essentially called a moratorium on reproduction. There are no pregnant women on the reservation, and none who intend to conceive, says the tribe’s health planner, Diana Moser.

“Until people can be given some assurances, they’re scared to death to even consider having kids,” Hansen says. “If an answer isn’t found soon, people are afraid the tribe will vanish.”

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The Shoalwaters live on a moody, empty stretch of Washington coast. Their village looks out on an ever-shifting panorama of sand dunes, driftwood, tides and waves.

A few hundred years ago, thousands of American Indians inhabited this part of Washington. The Shoalwaters were expert canoe makers who navigated the seas and inland waters in canoes carved from Western red cedar. The Indians feasted on the abundant shellfish, and each Shoalwater relied on a personal guardian spirit, called Tomanawas.

But in the early 1800s, European visitors introduced smallpox, venereal disease and other illnesses to the tribes, and by the 1850s there were only small pockets of Indians left. Once free-roaming over the vast coastal lands, the Shoalwaters were crammed into a 1,035-acre reservation in 1866. The majority of their land is tidelands and wetlands, with only a few usable acres.

Today, highway travelers could easily overlook the shrunken settlement, which mainly consists of a fireworks stand, a fry-bread shop and a newer cedar building that houses tribal headquarters. The tribal government is the only employer on the reservation.

Across from headquarters is the cemetery and a cul-de-sac with neat, boxy houses where Jim Anderson and other Shoalwaters live.

Anderson’s cousin and neighbor, Sabina Harris, says it was a couple of years ago that the tribe first noticed a new threat to their existence: the declining number of infants.

“It seems like this last four years things started going haywire,” says Harris, who lost a 3-day-old infant in 1989. “We began to realize how many women had been pregnant and how few babies there were running around. There was something crazy going on.

“With Rikki (her daughter), everything was fine at first. She came early, and she slept with me in the hospital. I went to see her the next day, and she was hooked up to an IV. That second night they took her to a neonatal center in Tacoma, and she died the following day.”

Doctors told Harris, 30, the baby died of pneumonia.

When they first raised the issue of infant mortality two years ago, tribal officials say, they received little response from the Indian Health Service. A regional Indian Health Service official, Tom Austin, denies stalling, saying that the tribe raised only the issue of health-care access.

But the deaths of the Anderson children, both last year, finally galvanized the tribe and the various agencies into action.

Six-month-old John Anderson had been sickly off and on since birth. On July 5, the baby was again ill; Kathy and Jim Anderson drove him to an emergency room 30 miles away, in Aberdeen. (The couple also has a 5-year-old son, David, born before the troubles began.)

“He (John) had his fingers wrapped around my finger. He looked right up at me,” Kathy told a local newspaper. “That’s when he died. We were only a few minutes from the hospital.” The death was attributed to dehydration and pneumonia.

Kathy Anderson was again pregnant in November when, five weeks from her due date, she woke in the night with severe abdominal pains. An ambulance rushed her to the hospital, where she underwent a Cesarean section. The baby, Fern Willi, was born dead. As a result of complications from this pregnancy, Kathy is unable to have more children.

“People were wanting to invest in this child,” says Hansen, the tribal administrator, speaking of Fern. “We were thinking: ‘Maybe this one is going to make it.’ I can remember the phone call coming in that the baby had died. You could hear a ripple of sobs throughout the office.

“What you have now are a people not willing to invest emotionally in their children,” he adds. “In Indian communities, we get used to nothing being permanent. It’s difficult to trust. That’s how Indian people feel about jobs, government programs, housing.”

And now, Hansen says, that’s how they feel about their kids and their future.

After Fern Willi Anderson died on the day before Thanksgiving, the tribe gathered at the little cemetery for a funeral accompanied by the boom of an elk-hide drum.

“There are a lot of babies here,” one speaker told the group. “You can just about feel them. It is troubling to see Indian babies dying. There must be something wrong with the environment, with nature herself.”

In an initial effort to identify what is wrong, health planner Moser is interviewing all women, ages 18 to 55, who lived on the reservation for at least a year between 1982 and 1992.

“It’s a holistic overview of their lives,” she says. “We’re looking at what they eat, if they use drugs and alcohol, all about their pregnancies.”

Although Moser has no conclusive data yet, she says the women she has talked to tend to have inconsistent access to prenatal care. The nearest Indian Health Service clinic is 80 miles away, and transportation is scarce.

Moser says everyone asks her how soon the mystery will be solved, but she warns that there is only a 50% chance the survey will reveal the cause of the troubles. After the study is completed, specialists from the Indian Health Service and the state health department will begin to analyze the data. A meeting with the Environmental Protection Agency also is planned, according to Hansen.

But epidemiologist Sugarman says it’s unlikely that these efforts will yield a decisive explanation.

“There are very few single factors that can account for all these different outcomes,” he says, referring to the combination of miscarriages, infant deaths and stillborn births that have plagued the Shoalwaters. “If I had to guess, I would say that it’s a lot of different circumstances contributing.”

Health workers have not even been able to look to other tribes for answers because the Shoalwater situation does not fit a national pattern. Although American Indians overall have a higher infant mortality rate than the general population, Sugarman says he knows of no other cluster outbreaks of “adverse birth outcomes” in Indian tribes.

In fact, as a whole, American Indian populations are increasing.

“The idea of the vanishing Indian is a total misconception,” says JoAllyn Archambault, director of the Native American program at the National Museum of Natural History. “Indian populations are robust and growing.”

Yet the Shoalwaters live under conditions that may make them uniquely vulnerable, says James Floyd, director of the Indian Health Service regional office serving Oregon, Washington and Idaho. The tribe is particularly isolated, extremely poor and especially small--one of the smallest in the West.

Although it is not a factor scientists can measure, the Shoalwaters also are clearly affected by a kind of cultural and spiritual malaise.

The only living Shoalwater elder says she has tried to interest her people in the tribal traditions, but there are no takers. Hazel McKenney, 76, says she is the last Shoalwater to remember bits of the tribe’s language; no one is attempting to carry it on. She only dimly remembers her mother teaching her about Tomanawas, the guardian spirit of Shoalwaters.

Hansen says he hopes the current crisis may inspire the few Shoalwaters who are left to reclaim their past.

“This situation calls for the extraordinary,” he says. “Maybe Shoalwater ancestors can answer the call.”

If the tribe disappears, despite all efforts, it’s impossible to measure what would be lost.

Health planner Moser likens the extinction of a tribe to the extinction of a species: “It would be a real loss,” she says. “Each species has a special quality, and this group of people (the Shoalwaters) brings a special quality to the world.”

Hansen, on the other hand, says, “I don’t think the larger society gives a damn if the Shoalwaters fall off the face of the Earth.” But to other Indian tribes, he says, “it would be like losing a twin.”