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When two cultures collide
Prairie Doc
Richard P. Holm MD
Richard P. Holm MD

As I was researching the history of Native American health care, I took note of the various terms used early on by indigenous people to describe European immigrants. Initially, the references had to do with skin color. Several tribes labeled Europeans as “white skinned,” or “yellow-hided.” Some tribes still use the term “umsewah,” meaning “bleached wood.”  

Other tribes described Europeans as “hairy mouthed,” “hair faces” and “dog faces,” referencing facial hair on European men. Ears were also important in naming. One tribe characterized the immigrants as “ears sticking out” because they did not have long hair covering their ears as did Native Americans. Some say that the ear label referred to that tribe’s word-meaning for donkey or mule.

As time went on, Native Americans began to describe Europeans based not only on how they looked, but on how they behaved. A Lakota word for Europeans is “wasichu,” which means, “taker of the fat, or a greedy individual.” Recognizing the transgression over the last two centuries, I can’t blame the Lakota for choosing the label, “wasichu.”

These Native American words reflect the impact of two cultural worlds colliding and reveal a disharmony resulting from the loss of access to traditional hunting and farming lands, the loss of family and language as children were shipped to boarding schools, the loss of self-respect with isolation on the reservation and much more. The result of all this has been decades of health disparities. For example, American Indians are 50% more likely than white people to have a substance abuse disorder, 60% more likely to commit suicide, twice as likely to smoke cigarettes or to die of childbirth, three times more likely to die from diabetes and five times more likely to die of tuberculosis. 

But change is coming. Revered Oglala Lakota medicine man, Black Elk, prophesied that with the seventh generation following the tragic Wounded Knee massacre of 1890, Native American people would begin to recover from the historical trauma experienced since the collision of these cultures in the mid-19th century. 

From 1890 to 2020, that’s 130 years. Divide that by seven and, right now, you have 19-year-olds who constitute that seventh generation. It’s time for those of us with ears sticking out and those without, people of all skin colors and cultures, to create an environment that allows all people to come out of poverty and help make positive changes in Native American health care.

Richard P. Holm, MD is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® library, visit and follow Prairie Doc® on Facebook.