Traditional Knowledge Holders and Practitioners: First Responders in Native Nations During the COVID-19 Pandemic.

Native Americans in the US experienced disproportionate risks of COVID-19 infection and mortality. Despite these adversities, Native Americans relied on the world view and lessons of their cultural teachings, as strategies to find personal solace and social harmony amid the crisis. Traditional Knowledge Holders and Practitioners (TKHPs) reinforced these survival strategies and were essentially first responders. In 2021, 22 TKHPs from three Arizona Native nations were interviewed about their personal reflections and practice during the pandemic. A cross-Native nation analysis of the narratives revealed three determinants shaped the health of Native peoples in these communities: (1) relationships with all living beings and the natural environment, (2) the intersection of non-Indigenous and Indigenous health care systems, and (3) cultural continuity. TKHPs' contributions to their communities' physical, social, cultural, and spiritual health during the COVID-19 crisis elucidates the need to ensure their inclusion in public health emergency response plans. Their knowledge and practice are foundational assets in Native American communities, offering invaluable lessons to promote mental wellness and resilience. TKHPs' approach to addressing pandemic-related challenges extended beyond the typical Western approaches to medicine, making them vital providers for current and future efforts in improving the health status of Native Americans.