In the early decades of the 20th century, life was very hard for the Eastern Band of Cherokee Indians (EBCI) in western North Carolina. Every major index of quality of life, including housing, education and health care, was deplorable, even by the standards of the time. Lula Owl Gloyne, RN (1891-1985), the first EBCI public health nurse, spent her life and career improving the health of Cherokee people through direct service, political advocacy and community partnerships.
Gloyne’s pioneering work motivated other young Cherokee women, notably Ernestine Walkingstick, RN, to follow in her footsteps. Today, Lula Owl Gloyne’s story is all but unknown outside of North Carolina, but her dedication to her people as well as the broader community continues to inspire a new generation of public health nurses.
History and Trauma
For centuries, Cherokee people lived in the southern Appalachian Mountains before white explorers and homesteaders started moving onto their lands. Treaties between various white governments and Indian nations that identified boundaries between the two groups were violated and ignored by white settlers. Fighting and wars broke out as whites continued to encroach on Cherokee land. The Cherokee tribe was decimated by war and by disease, such as smallpox and measles, contracted from encounters with white people.
Greatly outnumbered by the mid 1830s, the Cherokee were rounded up by U.S. government troops and forced at gunpoint to leave their ancestral homelands and walk to federally designated “Indian Territory” in what is now Oklahoma. This forced relocation is known as the Trail of Tears because thousands of Cherokee people and other Native Americans died from exposure, starvation and disease along the way. However, a few hundred Cherokee either evaded the federal troops that rounded up tribal members or escaped along the Trail of Tears and returned to the mountains of southwestern North Carolina. Their descendents are the primary constituents of today’s Eastern Band of Cherokee Indians.1
In the decades that followed, the appalling conditions imposed by slavery and the destruction resulting from the Civil War created a climate of extreme poverty in the American South. As the turn of the 20th century approached, most families in rural Appalachian North Carolina had no electricity, running water, sewage services or paved roads. If life was hard for the average white mountaineer at this time, it was generally even more difficult for the Cherokee people living on or near the Qualla Boundary (the present-day home of the EBCI) near the town of Cherokee, N.C.2
By around 1900, the tribe numbered less than 10,000 and its members were not welcomed by either the local white or African American communities. In a misguided effort to “help” the Indians, various Christian missionaries and later the federal government established Indian boarding schools. Believing Cherokee children would be best served by assimilating into white culture, the government forced them to leave their families and attend these schools, where they were severely punished for speaking their native language, practicing their religion and wearing tribal clothing.1 Lula Leta Owl was born into this environment in 1891.
Following her Calling
Lula Owl was the first of 10 children born to Daniel Lloyd Owl, a Cherokee blacksmith, and Nettie Harris Owl, a Catawba Indian who was a traditional basket maker and potter. Lloyd did not speak Catawba and Nettie did not speak Cherokee, but both parents shared a basic knowledge of English which became the primary language in the household. Mrs. Mary Wachacha, Lula Owl Gloyne’s granddaughter, surmises that the Owl children’s mastery of the English language explains why all seven siblings who survived to adulthood went on to professional careers. Lula Owl attended a mission school on the Qualla Boundary and then went to Hampton Institute in Hampton, Va., to complete her education.3
Hampton Normal and Agricultural Institute (now known as Hampton University) was chartered in 1868 as one of the first colleges for African Americans in the south after the Civil War. Hampton’s mission was to train students to become teachers and return to their home communities to uplift their race through education. From 1878 until 1923, the institute conducted a unique experiment in biracial education by admitting and educating American Indian students alongside African American students. Well over 1,000 Indian students from over 20 tribes graduated from Hampton during this period.4
After her own graduation in 1914, Lula Owl spent a year in the classroom teaching Catawba children in Rock Hill, South Carolina. During that year, she decided to follow her calling to become a nurse. Mentors from her Hampton days arranged for Owl to enter the Chestnut Hill Hospital School of Nursing in Philadelphia.
All nursing students at Chestnut Hill Hospital were required to attend church services weekly. Owl was raised a Southern Baptist but she had no way of getting to the Baptist church located many miles away. The only church within walking distance of the hospital was St. Paul’s Episcopal Church. Owl started attending this church, whose members not only welcomed but “adopted” her. They collected donations of love offerings (cash contributions) and used clothing for her. When Owl graduated from Chestnut Hill in 1916, she was awarded the gold medal in obstetrical nursing and became the first EBCI registered nurse.5 Her church arranged a job for her as the missionary school nurse at St. Elizabeth’s Episcopal School on the Standing Rock Sioux Reservation in Wakapala, South Dakota.3
During her two years at Standing Rock, she milked cows, learned to ride horseback and worked her way into the Sioux Indians’ hearts and homes. According to her granddaughter, her duties extended far beyond the school infirmary. Owl undertook immunization campaigns, delivered many babies and provided home care to the aging and infirm. Early in her time on the reservation, one of the chiefs experienced a headache so severe he thought he was dying. Owl brought him some kind of medication that brought relief. He became one of her biggest supporters on the reservation.
In 1917, the United States joined its allies in fighting World War I. The Red Cross and the Army Nurse Corps encouraged all RNs to serve their country during the war. Owl had planned on going to Europe to be a field nurse for the U.S. Army but failed the “seaworthy” exam due to extreme seasickness. Instead, she was assigned to Camp Lewis in Washington State as a second lieutenant in the Army Nurse Corps.3 Owl was the only member of the Eastern Band of Cherokee Indians to serve as an officer in WWI.6.
While in South Dakota, she met Jack Gloyne, an Army enlistee passing through the west on his way to Camp Lewis. They rekindled their acquaintance at Camp Lewis, but since she was an officer and he an enlisted man, fraternization was prohibited. Despite the ban, they were secretly wed in 1918. After the war ended they spent a short time in Oklahoma while Lula Gloyne cared for a sick family member. Around 1921 the couple returned to Cherokee to set up housekeeping.3
Advocating for Change
At that time, the town of Cherokee did not have a hospital or a full-time doctor. Lula Owl Gloyne was the first professional health care provider available to help the people on the Qualla Boundary.6
In a 1983 interview with a local newspaper, Gloyne recalled her early years as a nurse in Cherokee. “There was no hospital in Cherokee then, just a clinic at the Quaker grade school and a doctor who worked there part time,” she explained. “When I came home [to the EBCI reservation] they asked me to help out, and at first I worked without pay. I did all the outside work. I got called to homes all around here. I didn’t have a horse or a wagon back then, so I had to make my calls on foot. I got caught in places [too far away from the doctor] where I’d just have to do what had to be done. Men got cut up and I’d have to sew them up. Women would call on me to deliver their babies. Today it would be illegal to do a lot of that, but back then there was no one else.”7
Gloyne’s desire for the Cherokee people to have a hospital on the Qualla Boundary impelled her to go to Washington, D.C., where she talked with two officials who oversaw all public health work for the Indian Health Service. In 1934, her efforts resulted in the enlargement of the clinic dispensary to include a nine-room inpatient ward and sunroom for women and a six- bed ward for men. For the first time, people who lived on the Qualla Boundary had access to hospital care. A doctor began to make regular hospital visits and Gloyne was appointed head nurse. In addition to overseeing the hospital, Gloyne continued to see patients in the community, providing home health, hospice and midwifery services. With her Indian Health Service salary, she bought herself a horse. Later, as paved roads became more common, the government bought her a car to make her travels in the community quicker and easier.7
Gloyne’s advocacy efforts in Washington also resulted in a general health survey of the EBCI people living on the Qualla Boundary, conducted from June 5-17, 1933. The U.S. Public Health Service, the U.S. Department of the Interior’s Office of Indian Affairs, the North Carolina Tuberculosis Sanatorium and the North Carolina State Board of Health collaborated on this project, to determine the tribe’s “public health needs with some accuracy and define federal and state responsibilities” in this area. More than 900 Cherokee people of all ages received a complete physical examination, dental examination and free immunizations for smallpox, diphtheria and typhoid fever as part of the survey.
Among the survey’s findings were that 9% of those surveyed had active tuberculosis and 4.6% had syphilis. Higher-than-state rates of trachoma, a disease of the eyes, were also found. Beyond simply gathering data, the survey project provided treatment for the people suffering from these ailments.8
Forty years later, a report published in the April 1972 issue of the North Carolina Health Bulletin (the official publication of the state’s Department of Health) stated that tuberculosis, syphilis and roundworms had become only minor problems on the Qualla Boundary, while the most pressing public health issues were diabetes, motor vehicle accidents, homicide, suicide and dental carries in children. Lula Owl Gloyne’s work as the primary “field nurse” on the Qualla Boundary for many of the intervening years was probably at least partially responsible for the decreases in infectious diseases in her community.
Continuing Her Legacy
The Gloynes had four children, but unfortunately Jack Gloyne died before the youngest was two years old. After her husband’s death, Lula Gloyne moved west to work as a nurse at the Wyandotte Indian School and Clinic in Miami, Oklahoma. In 1936, while on an ambulance run, the ambulance was in a serious accident and Gloyne nearly lost her life. The doctors initially thought she might never walk again. She returned to Cherokee to recuperate near her family and slowly resumed her nursing career.
Gloyne worked as she was able and as needs arose. Over the years, she served as a private duty nurse, in hospital staff and supervisory positions in nearby Sylva and Bryson City, N.C., and as the company nurse for the outdoor drama “Unto These Hills,” a summer theater production that tells the story of the Trail of Tears. In 1969, at age 77, she retired from her last paid position as the supervisory home visiting nurse for the Community Action program in Cherokee.3
From her retirement until her death in April 1985 at age 93, Gloyne remained an asset to her community. She was honored by District 23 of the North Carolina Nurses Association on May 1, 1978, when she was 87 years old. Part of the speech delivered that night reads: “Even though Lula is officially retired, she has never been out of nursing. She started at an early age, when as the big sister she was responsible for much of the care of the younger children, and of the parents when one was ill or in need. Between her league bowling, weaving classes, extension club activities, church activities, gardening etc., she still helps with blood banks, aids invalids in the home, helps when new babies arrive and often has ailing relatives in her home.”9
Lula Owl Gloyne’s work inspired several young Eastern Band of Cherokee women in North Carolina to follow her path and pursue careers in public health nursing. Ernestine Sharon Walkingstick (1937-1999) was one of these nurses. Born in Cherokee, Walkingstick graduated from Northwestern State School of Nursing in Louisiana in 1961. She then returned to North Carolina and became the director of community health nursing for the EBCI reservation.10 In that capacity she established the first clinic for the Indian population in Robbinsville, N.C., a remote village in the mountains where travel is difficult in the winter months.11 Walkingstick also initiated, coordinated and operated the Eye, Ear, Nose and Throat clinics at the Cherokee Indian Hospital in Cherokee.10
Walkingstick followed Gloyne’s example of tireless community service. In addition to her paid employment, Walkingstick was actively involved in numerous professional and community volunteer activities. She was instrumental in founding the first domestic violence shelter in her region, which is now named in her honor. She raised money for the Cherokee Children’s Home, was an officer in the Cherokee Lions Club, served as board chairman of the Cherokee Center for Family Services and was named “Woman of the Year” for community development by the area North Carolina Cooperative Extension. Walkingstick was also a member of the health advisory committee for the local Head Start program and served on the EBCI Tribal Health Board.
Nurses of all races and ethnicities, in all parts of the country, can be inspired by the life and work of Lula Owl Gloyne. She triumphed over many obstacles to bring health and hope to the Cherokee people in western North Carolina.
References:
Conley, R.J. (2005). The Cherokee Nation: A History. University of New Mexico Press.
Pollitt, P.A. (1991). “Lydia Holman: Community Health Pioneer.” Nursing Outlook, Vol. 39, No. 5, pp. 230-232.
Wachacha, M., personal interview, December 11, 2008.
Lindsey, D. (1994). Indians at Hampton Institute, 1877-1923. University of Illinois Press.
Carney, V.M. (2005). Eastern Band Cherokee Women. University of Tennessee Press.
Finger, J.R. (1992). Cherokee Americans: The Eastern Band of the Cherokee in the Twentieth Century. University of Nebraska Press.
Carden, S. (1983). “Former Boundary Field Nurse Got First Hospital Opened.” The Sylva Herald, November 17, pp. 4-5.
North Carolina Department of Health (1933). “Health Work Among the Cherokee Indians.” North Carolina Health Bulletin, 6-8.
North Carolina Nurses Association, District 23 (1978). “Recognition of Lula (Owl) Gloyne.” Paper presented at May 1 meeting.
North Carolina Nurses Association (2003). North Carolina Nurses: A Century of Caring calendar.
Martin, J. (1999). “Walkingstick, a Dedicated Public Servant, Passes Away.” Cherokee One Feather, July 13, pp.1, 5.
Bienick, S. (1999). “A Letter to Ernestine Walkingstick.” Cherokee Voice, XVIII, Summer/Fall.
Janice Kekahbah, MSN, RN, American Indian Nursing Leader Janice Kekahbah, co-founder of the first professional organization for American Indian nurses, passed away last October 12 at the age of 67. A member of the Kaw and Potawatomie nations, Kekahbah was a tireless mentor, supporter and inspiration to generations of Native nurses. She received her nursing education at St. John Hospital and the University of Oklahoma, then earned her MSN in pediatric mental health nursing from the University of New York. With her lifelong partner, Rosemary Wood, Kekahbah co-founded the American Indian Nurses Association, which eventually evolved into today’s National Alaska Native American Indian Nurses Association (NANAINA). She also held various nursing and administrative positions with the Osage and Kaw nations.
One of the nursing profession’s most internationally respected experts on cultural competency and health disparities, Dr. Ruth Davidhizar, died on September 11, 2008. A psychiatric nurse practitioner, educator and researcher, she was employed since 1987 at Bethel College School of Nursing in Mishawaka, Ind., first as an adjunct professor, then as chair of the nursing division and finally as dean. Dr. Davidhizar developed a groundbreaking theoretical model for delivering culturally appropriate care that is used and taught today by health care professionals around the world. Her textbook Transcultural Nursing: Assessment & Intervention, co-authored with Dr. Joyce Newman Giger, has been widely adopted by schools of nursing and is now in its fourth edition.
Susie Walking Bear Yellowtail, RN (1903-1981) was a nursing pioneer whose life was filled with groundbreaking accomplishments. And even after her death, she continues to make history: On July 1, she became the first American Indian nurse to be inducted into the American Nursing Association’s prestigious Hall of Fame.
Born on the Crow Agency reservation in Montana, Susie Walking Bear Yellowtail was the first American Indian registered nurse in the U.S., as well as an activist who fought tirelessly to achieve better health care for Indian people. After graduating from Boston City Hospital School of Nursing in 1923, she returned to Crow Agency to work in the Bureau of Indian Affairs Hospital. The injustices she witnessed there–such as the forced sterilization of Crow women without their consent–galvanized her into a lifelong fight to end abuses in the Indian health care system.
From 1930 to 1960, the Crow/Sioux nurse traveled to reservations throughout the country to assess the problems American Indians faced. One of Yellowtail’s assessments revealed that seriously ill Navajo children were literally dying on the backs of their mothers, who often had to walk 20 miles or more to reach the nearest hospital. To fight these iniquities, she joined state health advisory boards and quickly became well known among national health care policy-makers.
In the 1970s, Yelowtail was appointed to President Nixon’s Council on Indian Health, Education and Welfare and to the federal Indian Health Advisory Committee. These appointments gave her a national platform for advocating for the health needs of her people. She also founded the first professional association for Native American nurses and was instrumental in winning tribal and government funding to help Indians enter the nursing profession. In 1962, Yellowtail received the President’s Award for Outstanding Nursing Health Care.
I am a recent graduate of the BSN nursing program at New Mexico State University (NMSU) in Las Cruces, N.M. I am also Native American, a member of the Navajo tribe. My family and I live on the Navajo reservation outside of Ganada, Arizona. During the summer of 2001, prior to the start of my senior year, I had the opportunity to spend four weeks in Austin, Texas, working as a research intern with Alexa Stuifbergen, RN, PhD, FAAN, at The University of Texas at Austin School of Nursing’s Center for Health Promotion & Disease Prevention Research in Underserved Populations (CHPR). It is not an exaggeration to say that this experience changed my life.
The CHPR is a program funded by the National Institute of Nursing Research (NINR), one of the National Institutes of Health (NIH). The center’s mission is to improve the health of medically underserved populations–such as racial and ethnic minorities, women, people with disabilities, children/adolescents and the elderly–through research designed to reduce health disparities.
I first learned about the summer research internship opportunity at CHPR from one of my professors at NMSU, Dr. Becky Keele-Smith. She had just returned from a meeting in Washington, D.C., where NINR announced it was providing special grant funding to several research-oriented schools of nursing to enable them to form partnerships with smaller schools that have large numbers of minority students.
The UT Austin School of Nursing was one of the institutions that had applied for one of these grants. It planned to use the money to sponsor a program that would help increase minority undergraduate nursing students’ interest in careers as nurse scientists. An additional goal was to provide research training and development opportunities for junior nursing faculty at minority-serving schools who were interested in researching minority health disparities.
(L-R): Research interns Nina Ortiz, Denise Griffin, Melanie Long, (standing) and Amber Kozak
As part of NIH’s Research Supplements for Underrepresented Minorities program, NINR awarded the CHPR an administrative supplement grant to partner with New Mexico State University and another minority-serving school, the University of New Mexico. As a result, a group of nursing students from our school was able to travel to Austin and participate in the Summer Research Institute. In addition, two of my professors at NMSU, Dr. Keele-Smith and Dr. Alison Druck, were given the opportunity to “team up” with faculty at UT Austin to develop their research ideas.
When Dr. Keele-Smith asked if I would be interested in working during the summer in Austin doing research, I was very excited. And when I learned that the program was being sponsored by NINR and that my professors would also be collaborating with researchers at UT, I was ready to pack my bags.
The two schools are quite different. The University of Texas at Austin has the highest enrollment of any university in the nation–over 49,000 students. New Mexico State, which is classified as a Hispanic-Serving Institution, has approximately 15,000 students on its main campus. Nearly 50% of NMSU’s students are non-Caucasian (41% Hispanic, 3% Native American, 3% African American and 2% Asian American). It seemed like a wonderful idea for professors and students at NMSU to team up with the large research-oriented nursing school at UT Austin. NMSU is a great school, but its students and faculty can learn a lot from working with established researchers, just as those researchers can learn a lot from working with a school that serves a large number of minority students.
Meeting, Greeting and Learning
There were six undergraduate research interns from NMSU working in Austin that summer. All but one of us were minority students. Each of us was assigned to a faculty mentor at UT, an experienced nurse scientist who helped us understand research from an insider’s perspective.
My days were spent working with Dr. Stuifbergen’s research team on their studies of people with multiple sclerosis and post-polio syndrome. I assisted with data entry and coding narrative data from the research surveys. I even did a data analysis of Dr. Stuifbergen’s study and presented it as my own mini research project at the end of the internship.
The other interns worked on similarly interesting studies, examining minority health issues such as obesity after childbirth in Mexican-American women, sleep patterns of cancer caregivers, and self-care behaviors of children with diabetes.
Besides immersing ourselves in the research process, we spent a day in San Antonio at the annual conference of the National Association of Hispanic Nurses, where we had the opportunity to meet many of the staff from NINR and other branches of the National Institutes of Health. We also got to meet other researchers at UT, some doing research in nursing and some from other disciplines, like sociology, communications and social work.
In addition to our research mentors, we had the staff at CHPR to help coordinate our activities and give us support as we became accustomed to a new town and a new workplace. They helped with travel and transportation arrangements and coordinated housing and food service for the interns. We stayed in dorms and were assigned a CHPR doctoral student who served as a “den mother.” The CHPR staff also organized events and programs for us, such as lunchtime colloquia.
A Researcher Is Born
The Center for Health Promotion was an interesting place, because its mission to eliminate the health disparities of underserved groups is the same as my personal goal as a nurse. It was not surprising that a strong bond developed between the CHPR researchers, the staff and myself.
What was surprising was that I became really interested in the other part of CHPR’s mission: promoting, disseminating and supporting research. I had always thought of research as something that only doctors and lab scientists did. But my experience in Austin that summer changed that idea, both for me and for my fellow interns. We discovered that research is a way of understanding life and exploring ways we can help make things better for people who are truly in need.
Since then, spreading the word about the importance of health promotion research in underserved populations has become my calling in life. When I returned to the reservation after my experience at UT and told my story about what research means to me, I introduced the concept that research can help Native Americans combat problems that are unique to us. However, one person cannot perform all this research alone. Therefore, when I am asked to speak in front of people, I stress the importance of research and give them the confidence that Native Americans can obtain the education and training to do research that will help improve the health of our people.
My research internship at CHPR changed the goals I had set for my nursing career. What I learned in Austin has built a foundation for my future. Our faculty mentors and the staff at CHPR inspired me to give research a chance and to think about pursuing graduate education.
Participating in this internship broadened my horizons. It gave me a chance to meet new people, learn to work with computer programs and databases, experience a place different than home and much more. Most important of all, my research experience at UT Austin helped me discover a lifelong passion that I never knew I had.
Did you know that within the United States of America there are several functioning governments? American Indian and Alaska Native (AI/AN) tribes possess a nation-within-a-nation status, meaning that the U.S. Constitution recognizes American Indian and Alaska Native tribes as distinct governments. There are more than 560 federally recognized tribes in the U.S. , and the nation’s estimated 2.6 million members live mainly, but not exclusively, on reservations and in rural communities in 35 states.
Unfortunately, the AI/AN people have experienced a lower health status in comparison with other Americans. Their lower life expectancy (almost six years less than the “all races” population expectancy) and the disproportionate disease burden (see the Mortality Rate Disparities chart for details) have been rooted in economic adversity and poor social conditions. There is an organization working to remedy the disparity.
Providing Health Services
The Indian Health Service (IHS), an agency within the Department of Health and Human Services, provides a comprehensive, health service delivery system to approximately 60% of the AI/AN population living in the United States . Their stated goal is to “ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to all American Indian and Alaska Native people.” To that end, the IHS actively assists tribes in developing their health programs.
AI/AN people now have access to health care services in 49 hospitals and over 500 other facilities. A combination of U.S. federal funds allocated to the IHS through the Snyder Act of 1921, Public Law 93-638 self-determination contracts, and more than 9,000 contracts between tribes and independent health care providers have made this possible.
The IHS ensures that preventive measures involving environmental, educational and outreach activities are combined with therapeutic measures into a single national health system. Within these broad categories are special initiatives in traditional medicine, elder care, women’s health, children and adolescents, injury prevention, domestic violence and child abuse, health care financing, state health care, sanitation facilities and oral health.
Career Opportunities Abound
With so many responsibilities, the IHS employs a large staff to meet the diverse needs of the American Indian and Alaska Native population they serve. The agency employs approximately 15,000 people, including members of virtually every discipline involved in providing health care and social and environmental health services. They currently have a vacancy rate of about 12% for health professionals, so there are many career opportunities available.
Individuals with health-related degrees can join the IHS as civil servants or as commissioned officers in the Public Health Service (PHS). All Indian Health Service jobs, along with some tribal and urban Indian health program positions, are listed on-line at the IHS Web site (www.ihs.gov) under the Job Vacancies Database link. Additional IHS jobs can be located through an on-line search at FedWorld Federal Jobs Search and USAJOBS.
Each vacancy listing on IHS’s Web site contains contact information for the position; get in touch with the person listed in order to apply. For most permanent positions, you must be a “status” candidate. Status candidates are Indian Preference eligibles, current permanent federal employees, reinstatement eligibles or applicants with special appointing authority. All IHS positions are subject to Indian Preference laws.
Education and Continuing Education Opportunities
The Indian Health Care Improvement Act, Public Law 94-437, authorizes the IHS to administer three interrelated scholarship programs to meet the health professional staffing needs of IHS and other health programs serving AI/AN people. The IHS also administers a Loan Repayment Program for the purpose of recruiting and retaining highly qualified health professionals to meet staffing needs.
The PHS Commissioned Officer Student Training Program and Extern Program provides students of the health professions the opportunity to gain experience in a health service environment during free periods of the academic year. The Indian Health Professions Program provides scholarships, loans and summer employment in return for agreements by students to serve in IHS, tribal or urban Indian programs. As a matter of law and policy, the IHS gives preference to qualified Indians in applicant selection and career development training. And the PHS National Health Service Corps offers scholarships to medical students who agree to enter primary care specialties and to sign on for a minimum two-year tour of duty in PHS programs, including IHS direct and tribal programs.
In a speech given at the Montana/Wyoming Tribal Leaders Council Meeting this past April, Charles W. Grimm, DDS, M.H.S.A, and interim director of the IHS asserted his personal goals and the spirit of the goals of the IHS. He states, “I am committed to raising the health status of American Indians and Alaska Natives—and it is not just about access to care, or just about improving the educational opportunities for our people, or establishing a safe community, or building homes. It is about all these things, and many more that are interdependent and necessary. One Aspect of well being builds on another. Each of these things requires all of these things.”
