key: cord-0731480-08ge9t65
authors: Wood, Frederick B.; Altemus, Anne R.; Siegel, Elliot R.
title: Native Voices Exhibition: Stories of health, wellness, and illness from American Indians, Alaska Natives, and Native Hawaiians
date: 2022-04-26
journal: Information services & use
DOI: 10.3233/isu-210130
sha: 838b6cdf5f6c4c2be23c9d35e0162691fce47ae7
doc_id: 731480
cord_uid: 08ge9t65

The U.S. National Library of Medicine (NLM) exhibition known as Native Voices reflected Donald A.B. Lindberg M.D.’s keen and long-held desire to help improve public understanding of Native American health challenges and honor the culture, tradition, and healing ways of Native Peoples. A centerpiece of the exhibition was a large set of video interviews that Dr. Lindberg conducted with Native health and community leaders. Dr. Lindberg and his team engaged Native advisors in the exhibition development; sought Native input through Listening Circles, Tribal Consultations; and site visits, and made the video interviews accessible via interactive kiosks and iPads. For its time, this was state-of-the-art exhibition technology. The exhibition also included Native artifacts and art works to complement the videos, including a scale model of the iconic Hokule’a Native Hawaiian voyaging canoe, and a full-size Lummi Indian healing totem pole. The totem journeyed across the U.S. prior to its installation next to the NLM herbal garden in Bethesda, MD. A traveling version of the exhibition visited more than 130 venues in 40 States across the U.S. The interview clips and other content are accessible on the exhibition website, and the full-length interviews are retained in the NLM permanent video collection.

Native Voices was a multi-media interactive exhibition on Native People's Concepts of Health and Illness that officially opened at the U.S. National Library of Medicine (NLM) on October 5, 2011. It featured innovative video interviews with more than 80 Native American health and community leaders, resulting in over 250 video clips, the largest such collection of Native American videos known to exist. The video content was presented on interactive displays iPads, and on the exhibition website [1] .

The exhibition was called "Native Voices" to emphasize the importance of sharing Native People's views of health, wellness, and illness in their own words and voices, not filtered through non-Native First, Native people seem to us to share a common view that each person has a responsibility for his or her proper behavior and health. This includes such matters as diet, exercise, traditional or Western treatment, hospice care.

Second, you'll gain a sense of how these Native people place the tribe, the group, the village at the center of their beliefs about health and happiness. The rebirth of voyaging and the canoes of Hawaii seek to rebuild the peoples' pride in their group and its seagoing history. You'll see Choctaw boys and girls taking charge of their own health through traditional sport.

Third, there's a common high regard for Nature, the climate, the plants, and animals, and the land itself. It's a complex topic that blends physical reality with spiritual reality.

Fourth, when you listen to the interviews, you will surely hear a reverence for traditions for tribal elders and for a supreme being.

Fifth, the Native groups all share a history that is lamentably full of rough, unfair treatment as our modern American and Western European industrial civilization enveloped Native lands, abolishing ancient sources of pride. Our timeline shows the history of groups. Interviews of individuals suggest that loss of pride and purpose can be serious obstacles to healthy living and to recovery from illness.

Our exhibition is also about young Native people today and how they incorporate all these experiences in their own ways to make their lives happy and healthy.

Throughout all these discussions is the art of Native people. The art objects represent the ideas of the people often magnificently.

Come back to NLM anytime, read about any of the things you see today. For now, have a fun and enjoyable visit.

Hawaiian); Katherine Gottlieb, MBA, DPS (Alaska Native/Sugpiaq/Filipino); and Aunty Agnes Cope (Native Hawaiian). These and other collaborators provided invaluable advice and connections to establish the level of trust needed for NLM to effectively partner with Native communities, and for Dr. Lindberg to conduct the interviews. For additional Native collaborators, see the Native Voices website credits page [7] .

Dr. Lindberg conducted more than 100 video interviews as part of the Native Voices project. He was supported in that role by NLM's Audiovisual Program Development Branch (APDB), headed by Anne Altemus (then acting chief, APDB, Lister Hill Center for Biomedical Communications -LHNCBC), project manager and production supervisor, and John Harrington, video producer and director, from Madison Films Inc., working for the APDB. See Section 6 for further discussion of the Native Voices videography and production.

Native Voices was a remarkable trans-NLM project, with contributions from nearly all of NLM divisions. The core NLM team members included the following, who participated in the regular planning meetings. The lead coordination was provided by Drs. Elliot Siegel and Fred Wood of the Office of Health Information Programs Development (OHIPD). An exhibition planning team met monthly, chaired by Dr. Lindberg, and included, in addition to OHIPD and APDB: Gale Dutcher, Specialized Information Services Division; Kathy Cravedi, Office of Communications and Public Liaison; Robert A. Logan, Ph.D., Office of the Director; Jeffrey Reznick, Ph.D., History of Medicine Division, and others from across the library as needed. Ivor D'Souza and his staff from the Office of Computer and Communication Systems (OCCS) assisted with the Rotunda information technology implementation. Two Native Americans provided important staff assistance -John Scott, M.A., Consultant (Alaska Native/Tlingit), and Dylan Rain Tree, MPA, JD (Mono/Choinumni/Pomo Indian from California). Rain Tree initially was a WINS Intern (Washington Internship for Native Students) and later became a member of the OHIPD staff. Margaret Hutto served as lead field coordinator for the NLM phase of the traveling exhibit. Patricia Carson, special assistant to Dr. Lindberg, provided overall schedule planning and coordination for Dr. Lindberg's heavy involvement with Native Voices. Mary Lindberg accompanied Dr. Lindberg on several Native Voices visits and provided valuable observations and insights along the way.

In sum, Native Voices was an amazing collaborative effort, with many contributors, and for which Dr. Lindberg provided overall direction, visionary ideas, and hands-on involvement in key aspects. He was a champion of the innovative use of state-of-the art information and audiovisual technology wherever possible.

NLM held three Listening Circles in 2003-2004. Each involved an in-person dialogue between Native leaders and Dr. Lindberg with NLM staff taking notes and chiming in where appropriate. The focus was open ended on any health-related topics and issues of concern to Native participants, and ideas on how NLM resources could help. The exhibition had not been conceived at the time of the Listening Circles, so the discussion was not within an exhibition frame of reference, although much of the discussion ended up being relevant. Video interviews were not yet envisioned, and thus were not conducted at the Listening Circles. The locations for the Listening Circles were selected in part to reach out to each of the three major Native groups -American Indians, Alaska Natives, and Native Hawaiians, and where NLM already had established Native contacts through prior outreach projects. See Appendix A for further information on the Listening Circles.

NLM held six Tribal Consultations in 2006-2011. Dr. Lindberg and NLM staff met with Native leaders in group session and/or individually, with video interviews conducted sometimes as an adjunct to a meeting but always as an important activity. The Tribal Consultation agendas were focused on possible exhibition topics and exhibit material. And the video interviews included questions and topics directly relevant to the exhibition. Each consultation included site visits to venues of significance to the local Native peoples.

Dr. Lindberg participated in all the Listening Circles and Tribal Consultations, and through these many discussions, site visits, and the video interviews, his concept of the exhibition was further developed and refined. See Appendix B for further details on Tribal Consultations.

From the very early phases of planning the exhibition, Dr. Lindberg was steadfast in his commitment to the highest quality production video and audio. He not only recognized the importance of creating an archival video database that would be both preserved and available for the future, he also wanted to honor the brave and generous people who were willing to be interviewed, and tell their stories. Producing the best possible version of the interviews honored the interviewees.

Following the Listening Circles and in the early phase of Tribal Consultations, Dr. Lindberg realized that the use of videography to record his interviews with Native healers and leaders could become the center point and defining contribution for the exhibition. Dr. Lindberg engaged, guided, and learned from the interviewing process, and he kept pushing for the highest quality video product. In addition, he stayed centrally involved in both pre-production planning, the post-production and editing process, and efforts to organize the videos for public access.

After a period of trial and error, Dr. Lindberg concluded that NLM's own Audiovisual Program Development Branch (APDB) needed to head the production effort (knowing that this group excelled in the application of emerging video acquisition, production, and storage formats) in order to assure the highest quality video product. Dr. Lindberg appointed Anne Altemus, then acting chief, APDB, as the lead project manager and production supervisor, and John Harrington, as senior producer, who was and is President of Madison Films Inc. Dr. Lindberg was closely involved, and in addition to conducting all the interviews, he collaborated on technical quality assurance and the ultimate presentation of the video final products in the NLM Rotunda displays including touch screen kiosks and iPads, and the use of iPads as part of the traveling versions.

Following the 2006 Alaska Native consultation, Dr. Lindberg determined that Native interviews, with the Native storyteller as the focal point, would be the primary device used to tell the exhibition's many stories. From October 2006 onward, all videotaping featured Dr. Lindberg as the interviewer, using Anne Altemus as production supervisor and John Harrington as producer. Initially, the film crew was locally provided. From June 2008 onward, an NLM arranged video crew was deployed for quality assurance purposes.

The added benefit of a dedicated NLM video production crew was the cultural sensitivity necessary for the crew to gain the respect and trust of the Native communities that were recorded. Frequently, advanced production communication was required to schedule and scout locations, set-up, and other logistical requirements, which were as varied as the landscapes that were visited. All of the venues were unique, but production quality had to remain consistent.

Along the way, the video production team became ambassadors for the NLM and the exhibition with the full support of Dr. Lindberg. One of the Hawaii visits was the longest, with travel throughout the islands that required cars and planes, and a lot of muscle to pack, carry, set-up and break down lights, cameras, endless cables, and power strips. Advance visits to locations meant the video crew was the first flight of NLM staff who met with communities and individuals. Cultural respect was critical to success at every shoot. Along the way, the production crew gained Dr. Lindberg's trust and respect, and the feeling was mutual. Over the years, through planning and production, post-production and traveling, Dr. Lindberg challenged the technical process, and fully supported the exploration and implementation of advanced video formats and techniques. Planning and logistical challenges were constant.

Many of the interviews were raw and emotional, sometimes challenging. There were quite a few interviews that had a significant impact on Dr. Lindberg, and the crew. The stories that emerged were tragic, compelling, inspiring, and hopeful. In the end, the resilience of Native People emerged over time. And hospitality was always generous. Dr. Lindberg was always present in the moment, immersed in the experience, whether it was a pow wow, a ceremonial performance, a shared meal, or quiet moment. Sitting on a bench on the porch of the Queen Emma Palace in Honolulu, waiting for an interviewee to arrive and after an earlier, very difficult interview, he reflected on how he might have handled the interview better. By example, he inspired all on the videography team.

Native Voices provided Dr. Lindberg an opportunity to combine his interest in top quality photography and videography with his desire to learn much more about Native health and healing concepts from the Native Americans themselves.

One example occurred on a 2013 trip to open the traveling exhibit at the Cankdeska Cikana Community College, a public tribal land-grant community college in Fort Totten, North Dakota, on the Spirit Lake Reservation. NLM staff and crew were invited to an early morning off road tour of a 'buffalo' ranch. Dr. Lindberg sat in the front of the rancher's pickup truck, riding "shotgun" (next to a shotgun) for the tour. He talked to our host with ease, about ranch life, the sacredness of the 'totanka' in the culture, and the beauty of the land. In his hand for the whole ride was one of his cameras, capturing as many moments as he could. Every journey made for the exhibition found him with a camera in his hand.

Dr. Lindberg's passion for photography explained his understanding and encouragement when NLM's crew was shooting in 4K resolution for the first time in Alaska in August of 2013, with a prototype 4K video camera on loan from Sony. On the last day, when production ended fairly early, the crew proposed driving toward Mount Denali to shoot scenic b-roll. Dr. Lindberg's response: "Chase the clouds and get some good stuff!"

That particular trip, like so many, was a test of strength and logistics. Dr. Lindberg enjoyed hearing about the journey, including hiking up the trail to see a glacier with a heavy camera and lens. On the extraordinary trip for a privileged stay in Kalaupapa on the island of Molokai, the small plane carrying Dr. Lindberg, the production crew, and NLM contingent, could not accommodate the weight and size of all of the production equipment. A separate charter was required to fly the equipment to the settlement. On so many occasions like this one, Dr. Lindberg knew the value of doing whatever it took to "get it right". His support for the overall production quality was extraordinary.

Most of the video interviews were conducted at field locations (with a few at the NLM video studio in Bethesda, MD). The field video work was challenging and required background research to identify potential site visits and interviewees, and collaboration with Native organizations to obtain support for participation. NLM's key Native advisors were very helpful in facilitating and arranging interviews.

Preparing for interviews helped bring focus to the overall exhibition development. Dr. Lindberg and the NLM staff prepared lists of focus questions to share with prospective interviewees. The list went through several iterations. Dr. Lindberg used his discretion to customize the topics and questions depending on the interviewee, with the result that most interviews flowed well and covered the key subjects. Interviews typically lasted about 20 to 40 minutes in raw video footage. All videos were recorded with High-Definition digital video cameras.

And yet, in spite of the research and preparation, the best content featured stories that emerged from the conversation on camera, after the key questions were asked and a topic of mutual interest was shared. For example, Dr. Lindberg's interest in the Mohawk Iron workers sparked a wonderful conversation with Thomas Cook, a Wolf Clan Mohawk Indian who spent five years as a high-elevation iron worker in New York working on the World Trade Center. There were many moments like this one, which demonstrated Dr. Lindberg's genuine interest in people, their stories, and common experience.

In addition to the video interviews, the video team shot B-roll footage where possible, in order to have Native cultural, historical, geographical, health, and community imagery available. The b-roll enabled the preparation of several introductory and special event videos that include interview segments in context.

Several of the B-roll and other videos are accessible on the Native Voices website, including:

• Introductory video by Dr. Lindberg; • Exhibition overview video;

• Exhibition opening ceremony video;

• Exhibition thematic introductory videos (total of 5 videos);

• Totem pole journey videos (total of 21 videos); and • Traveling exhibition opening ceremony videos (total of 4 videos).

Another significant challenge arose in post-production -transforming the raw video interview footage into 200+ video clips typically 25 to 45 seconds long, to optimize viewer attentiveness. The editing process was preceded by a project to identify and organize key terms, themes, and topics/subtopics with which to categorize and organize the video clips.

The combination of identifying, editing, and organizing the video clips was time intensive, but was important to Dr. Lindberg and the video production team as the clips were a core element of the exhibition. The final top level organizing themes were determined by the most common concepts that emerged from the interview transcripts.

Again, to accomplish this, Dr. Lindberg turned to specialists in the Lister Hill National Center for Biomedical Communications (LHNCBC). Thomas Rindflesch, Ph.D., Cognitive Science Branch, had a specialty in thematic indexing. Based on interview transcripts of all of the exhibition interviews, Dr. Rindflesch identified thematic clusters of words and concepts that emerged from the interviews. These were themes that flowed through all of the Native tribes and communities represented in the exhibition, and they formed the thematic flow of the content in both the physical and digital elements of the exhibit. The latter approach was essential to Dr. Lindberg. He wanted the themes of the exhibition to be authentic, based on the experiences and perspective of Native people.

The five common themes that emerged from the interviews were: Community; Healing; Individual; Nature; and Tradition. In sum, 88 interviews were divided into a total of 288 video clips organized around these five themes. The video clips also were cross-indexed by interviewee name, and geographic region (e.g., Southwest, Southeast, Alaska, Hawaii). In turn, the video clips could be searched by theme, name, and geographic area.

The video clips are presented on the Native Voices website in the "Interviews" section [8] . The clips also were displayed on the touch screen kiosks in the Rotunda exhibition and were accessible via iPads on coffee tables in the Rotunda, and on stands to accompany the traveling versions of the exhibition.

The distribution of video clips among the themes, and topics within each theme, is shown in Appendix C. Appendix D is an extension of Appendix C. Appendix D contains a representative selection of video clip transcripts, which illustrate the breadth and richness of the video clip content.

Dr. Lindberg was very proud of the multiple display options for the video clips -what he perceived as the crown jewels among the several wonders of Native Voices.

Dr. Lindberg was on the lookout for distinctive Native art works and objects that would be keynotes of the physical exhibition. He initiated visits and requested searches of Native and other museums for items to display in the Rotunda. These included: a vintage heavy redwood Hawaiian surfboard; Holua sand sled; stone mortar and pestle; Duke Kahanamoku's 1920 Olympics swimming gold medal (all from the Bernice Pauahi Bishop Museum); a Navajo Code Talker style World War II radio from the National Electronics Museum; and cultural objects such as "Spiritual Beauty". Others included: Duwayne M. Chee Jr., Navajo, 2003, ceramic, from the Eiteljorg Museum of American Indian and Western Art. The Eiteljorg Museum additionally loaned historic artifacts including a Zuni medicine bowl (circa 1962), Lakota pipe (c 1890) and pipe bag (c 1900), Cheyenne and Kiowa rattles (c 1940), and a Lakota drum (c 1960).

Hundreds of additional photos, maps, and sketches were included in the interactive timeline of Native history, which was developed by the exhibition team at Dr. Lindberg's request. The goal was to provide an historical context for the exhibition. The timeline was included in both the Rotunda and website versions of Native Voices. The timeline covered major historical eras, from the era of First Nations, prior to 1492, to the most recent era of Renewing Native Ways. The timeline entries were organized around the topics of Epidemics, Federal-Tribal Relations, Land and Water, Healing Ways, and Native Rights as applicable to each era.

See Appendix E for additional examples of art and artifacts included in Native Voices. Also at Dr. Lindberg's request, NLM included a book shelf and a Native news display, to complement the Rotunda exhibition. For a small sampling of the books on the bookshelf see [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [23] [24] [25] [26] . Dr. Lindberg also was a dedicated reader of books on Native American history, healing, culture, and art. 

Dr. Lindberg wanted something big and symbolic for the exhibition, that would convey a powerful Native message. His search was successful, in identifying the voyaging canoe Hokule'a as symbolic of Native Hawaiian ocean-going innovation and cultural perseverance, strength, health, and the renewal of traditional Hawaiian culture.

The original Hokule'a was built according to designs by Herbert Kawainui Kane (Native Hawaiian), based on his thorough study of the history and seafaring of the South Pacific Islanders. Kane envisioned a double hulled canoe that could make the voyage from Polynesia to Hawaii using traditional sailing methods, navigation, and seafaring skills. The Hokule'a successfully sailed from Hawaii to Polynesia and back in 1976, thus proving that such a voyage was possible.

Dr. Lindberg and a small group of NLM staff were honored to be invited on board for a training cruise on the Hokule'a in February 2009.

Fortuitously, as it turned out, just prior to the cruise, Dr. Lindberg was able to interview Nainoa Thompson (Native Hawaiian), a master navigator and President of the Polynesian Voyaging Society (PVS).

The PVS is the leading organization that sponsors the Hokule'a voyages. Mr. Thompson explained the powerful imagery of the Hokule'a in the renaissance of Hawaiian tradition, culture, and hope for the future. For further information on the PVS, and for background reading on the Hokule'a and doublehulled canoes, see [22] [23] [24] .

After Mr. Thompson made a powerful and inspirational illustrated presentation to a standing room audience in NLM's Lister Hill Auditorium. Mr. Thompson conveyed the cultural and ecological significance of the Hokule'a journey for Hawaii and the world. A follow up luncheon gave Dr. Lindberg an opportunity to personally honor Thompson, his amazing team of navigators and crew members, and the aspirations for a healthy and peaceful planet symbolized by the Hokule'a voyage. A videotape of Thompson's NLM presentation remains available [28] .

In late 2010, Dr. Lindberg asked if another iconic element could be added to the exhibition? A full-size totem pole was one of the options he favored, as the totem pole is highly respected by Alaska Natives, American Indians, and Native Hawaiians. The totem pole is a powerful symbol of Alaska Native and American Indian spirituality, healing, and strength, and this heritage is shared with Native Hawaiians. A plan emerged to commission a new totem pole since the initial idea to loan an original totem pole was not feasible. Kathy Cravedi volunteered to research the options and eventually proposed that NLM commission the carving of a smallish full-size totem pole. Cravedi identified a tribe (the Lummi Nation of Bellingham, WA) whose carvers had experience in harvesting a suitable downed red cedar tree, carving the totem, and transporting a totem by truck across the country. (The same group carved the 9/11 memorial totems installed on the U.S. East Coast.)

The Native Voices healing totem was commissioned in Spring 2011 and carved by Jewell "Praying Wolf" James and his House of Tears carvers at the Lummi Nation in Bellingham, WA. The totem pole was trucked across the U.S., with stops at tribal or cultural locations for blessings along the way. Appendix F provides a list of totem stopovers. Dr. Lindberg attended the totem journey blessing ceremonies at the Lummi Nation tribal sacred lands at Semiahmoo, WA. and in Seattle WA. in August 2011.

The healing totem pole carved for NLM was installed adjacent to the NLM healing garden in late September 2011 just prior to the exhibition opening. It remains on long-term display on NLM's grounds, and with the healing garden, continues to offer a meditative and respite space to NIH employees and the public.

On his last trip to Alaska as NLM director, Dr. Lindberg visited the Totem Pole National Historic Park, U.S. National Park Service, in Sitka, AK [29] . The extensive totem pole collection and the towering majesty and strength of the totems on behalf of Native culture, healing, and longevity deeply impressed him. For further discussion of the multicultural significance of totem poles, see [26] .

Dr. Lindberg sought to create a traveling version of Native Voices, as was done with several earlier NLM exhibitions. Hence, the exhibition team converted the content and displays of the Rotunda presentation into a six-banner, six-iPad traveling exhibit. The banners covered the major themes of the Rotunda exhibition through carefully selected text, photos, and images combined with the iPads for accessing the video interviews. For videos and photos of the traveling exhibit, see [30] .

Dr. Lindberg requested that the traveling exhibit should be pilot tested at selected regional medical libraries and Native venues. Appendix G describes four of the regional traveling exhibit opening ceremonies and related field visits where Dr. Lindberg participated.

The NLM traveling exhibit pilot test phase identified various implementation issues that needed fine tuning, as well as opportunities for extended outreach to local Native American and library user communities. For example, the University of New Mexico Health Sciences Library and Informatics Center (in Albuquerque) focused on Native Voices traveling and online versions, which reached several tribal college and tribal serving university libraries in New Mexico [31] .

The full Native Voices traveling exhibit tour included over 135 venues in 40 states, some managed directly by NLM, and the majority managed by the American Library Association (ALA) under contract to NLM.

In November 2015, the ALA conducted a nationwide call for proposals to host Native Voices. After review, the ALA selected 104 venues including college, university, public, and tribal libraries from 40 different states. Ninety-four venues were completed, with the remaining 10 venues cancelled due to COVID-19 or other building restrictions. The combined estimated exhibit attendance across all completed venues was several hundred thousand persons and estimated combined attendance at related events was about 28,000 persons.

Each venue held an opening event and at least one special event. Host venues were encouraged to involve local tribal groups in event planning, and many venues did. Twelve tribal libraries participated, with a combined exhibit attendance of about 6,000 persons, and special event attendance of about 8,000.

The Native Voices project was a transformative and capstone activity for Dr. Lindberg and several of the core project staff. For Dr. Lindberg, this project helped fulfill his desires to reach out to Native Americans and provide a way to respect and honor Native views of health, wellness, and illness. He believed this would help empower Native health and improve non-Native understanding of how Native health concepts work, and how they could contribute to and complement Western healing models. It was the hope of NLM's Native Advisors that Native Voices also would help inform Native youth about Native medicine and how Western and traditional medicine can work together to advance Native health and wellness.

The response of the Native advisors and leaders was overwhelmingly positive. Some interviewees who had been uncertain about the project were very pleased with the results. The Native advisors promoted Native Voices in their own communities, and arranged or encouraged individuals or groups from Native and other relevant organizations to visit the Rotunda exhibition in Bethesda MD or online. The exhibition and the outreach work leading up to it even caught the attention of Congress. U.S. Senator Daniel Inouye, Hawaii, had urged NLM in Congressional report language to document Native Hawaiian healing traditions. Now it was done.

For additional observations and reflections of key Native advisors, please see the companion chapter in this book [32] .

Native Voices had an intensified and positive impact on Native locations where site visits and interviews were conducted. This includes the local areas where Listening Circles and Tribal Consultations were held, and from which participants were drawn. The impact included aforementioned site visits and video work associated with the Hokule'a and Healing Totem Pole.

Only a fraction of all Indian tribes and Native villages were included in the project, due to financial and time constraints. To further diversify, the Native Voices team added interviews to reflect Native youth and other geographic areas, and art and artifacts from diverse Native culture groups. A website search function was added to search for all tribes mentioned across all website elements, such as interviews, special events, art works, and the interactive timeline which, as noted earlier, includes 460 Native-related historical factoids and/or images covering antiquity to the present day. The website search function identifies 168 different tribal or Native groups mentioned in Native Voices, which suggests extensive coverage.

However, the broader impact of Native Voices on the general public was harder to assess. The traditional indicators suggest a greater than average impact relative to other NLM exhibitions, based on the number of groups visiting in the first year or two after opening, user feedback during the traveling exhibit pilot testing, visitor estimates associated with the ALA managed phase of the traveling exhibit, and website usage estimates.

The greatest opportunity for future impact may be the use of the Native Voices videos and other materials as an educational resource. The size and robustness of the video database suggests the need for significant user time and effort to extract their educational value. A learning environment may be most compatible, such as is offered at the middle school/high school and college and university levels, including tribal and tribal serving colleges, in history, health, sociology, cultural, art, language, and related studies.

The spirit of Native Voices is admirably presented in the exhibition opening video [33] . This finally honed video weaves together many of the themes and topics in this chapter: the key role of Native Advisors; the iconic Hokule'a and Healing Totem Pole; the importance of Native ceremony and healing; the linkages to Native art and artifacts; and the use of touch screens, iPads, and the website for presenting the Native videos.

While the Rotunda and traveling version of Native Voices have concluded, the website continues to provide access and advance Dr. Lindberg's capstone outreach activity. The full-length Native Voices video archive in the NLM permanent collection also may serve research needs. These possibilities provide an enduring reminder to the authors of Dr. Lindberg's commitment, compassion, and caring for the health and wellness of Native Americans.

Finally, it should be emphasized that Dr. Lindberg appreciated the need to make the multiple visits, enumerated in this chapter, to the Native communities whose people, leaders, and cultures are at the core of the Native Voices exhibition. The hosts saw his personal involvement as evidence of respect and a genuine interest in listening and learning, and it became the basis for establishing a relationship based on mutual trust. The latter provides a model for health leaders who seek to gain the trust of minority communities whose suspicions of motives and memories of past injustices cry out for real and repeated engagement. 

The verbatim transcripts of a small cross section of selected video clips are shown below, organized by each of the five overarching themes of the video clip collection.

Ted Mala, M.D., M.P.H., Alaska Native/Inupiat Eskimo.

No Role Model: I think a lot of us that went to boarding school had a lot of family problems. We had no way to relate. We had no role models. It was-had a lot of trail of tears, also. But the history of the world is that of people doing what they think is right? I mean look at Stalin, look at Hitler, look at everybody that thought that they were on a mission from God and doing the right thing and people did that, the missionaries and the military and the educators and so on, came to Alaska, did the same thing. They all thought they were doing a great thing. You can't live in that sod house; you need a HUD house, and the first HUD houses that came up to the Arctic were trailers, and the trailers were lowest-bid trailers, and not only were they lowest bid, they were made in California, and it was cold as hell when the wind blew through in the Arctic. It would be great in Palm Springs. So again people were doing what they thought was right and all of a sudden we found ourselves going from subsistence economy to cash economy.

Cynthia Lindquist, Ph.D., President, Cankdeska Cikana Community College, Spirit Lake Dakota.

Tribal Colleges: We try to set up posters, and we try to do the dual images with our regalia, you know, really personifying us as Native or indigenous people, but then also with the stethoscope, or the white jacket and that, and we can do this. We can accomplish this, and that's one of the wonderful things about tribal colleges is that we try to utilize and tout the role models who are out there in education, but especially when we talk about math or sciences, we try to relate it back to culture.

Displacement: The displacement of Native people to cities has had a profound effect on their psyche, how they see the world, how they view the world, their ability to trust people, their ability to interact in a way that allows us to be able to instill in them a sense of belonging, a sense of well-being that can translate then into better health. And the work that we do, while we provide medical and dental services and all the clinical care that I think most people associate with a health care system, the role that we've really played in this community is one of acceptance, bringing people together. Being an institution that allows for people to self-identify as being a Native person and for us not to be judgmental in the process of that.

M. Kauila Clark, Traditional Healer, Native Hawaiian.

Healing Power: The key component in all healing process -and I really don't -it's a misnomer for me to claim to be a healer, because the healing is really done by the Creator, and at best I'm a facilitator of energy from the Creator in the universe and trying to put together a healing power so that people can be healed. So a lot of what we do is we're trained to go through meditation, and prayer, and so a lot of what we do is in the mode of prayer, calling upon the universal energies to facilitate what needs to be done in the healing process.

Native diagnosis: My dad used to say the woodpecker taught some of our Native healers. The woodpecker would peck the tree when it's dying, and before it dies, the woodpecker finds that problem which normally is the insect inside the tree, so they would pull that out. So the Native healer would do the same thing. They would feel your body and find the problem, and then they would extract that problem.

Shaman: Originally, Native healers as I see it, were in two major groups. There were the shamans and the magical healers, you might say, that have counterparts all over the world, really, and then you have sort of empirical healers who are the ones who massage, who do bleeding, who do minor surgical procedures that take care of simple illnesses like colds and burns and whatnot, which are not caused by angry spirits or something like that.

Charles Nainoa Thompson, Master Navigator, Native Hawaiian, President, Polynesian Voyaging Society.

Pride: When I was born, when I was raised, to be Hawaiian meant to be second rate. These kids when they're born, they don't feel that or sense that. Their foundation they grow from is different. But, you know, the economic, the social, the health-those issues, those statistical issues which are lagging issues, haven't necessarily really changed. But the genesis of the child being born in Hawai'i -the difference between being depressed or proud has shifted. Katherine Gottlieb, MBA, DPS, Alaska Native/Aleut/Sugpiaq.

Men's Roles: We're trying to get more and more men involved because our Native men are still leaders in our communities. In order to get into a community, we have to work with our men. And, also, I think the strength behind what our men have in the core of them, if it's brought out, they can be the protectors, and that's why it's called the Warrior's Initiative, because of in days of old they would stand, and they would protect their families. They would die for their women and their children. And what we're saying is do that again. Come back and do it today, and this time do it around domestic violence, child sexual abuse, and child neglect. End that for us as strong men and warriors just like they did in the days when they had to stand up and fight for us. We want them to do it today.

Kamaki A. Kanahele, Traditional Healer, Native Hawaiian.

Already Medicine: Everything about us is already medicine: the earth, the sun, the sea, the mountains, the plants, everything that has been given, is healing.

Chief Arvol Looking Horse, Spiritual Leader of the Great Sioux Nation, American Indian/Mni Coujou Lakota.

Mother Earth: In our life everything has to come from alive, the, the medicine. Even the Sundance tree has to be a live tree that gave its life for the people to live, and that Mother Earth is a living spirit, so I made a statement saying that Mother Earth is a source of life not a resource.

Thomas H. Begay, Navajo Code Talker.

Enemy Way Ceremony: Of course, I had a ceremony because I come from traditional. We have ceremony before you go to war. I have ceremony when I was a young man. Way back, five or six years old, I had the Animal Way Ceremony because my relatives were having it, so they have to use me as, you know, part of the ceremony. Then I went to war, and then came back and had another ceremony.

Respect: I'm accountable to my Aunties, I'm accountable to my elders in my community, and if they see me doing something that is hurtful to myself or others, then I can be called on that. When you're part of the Native community you play a part, there is a role for you, and you know people there to tell you that you have to answer to them. I think it's expected when we are very dispersed and we are not engaging each other, you're able to do things without someone telling you, and you may not know that you're making a bad choice, but when you've got people holding you to a higher standard, and they tell you something,

the Native Voices website

We thank the management and staff of the following NLM units for their support of and assistance to the Native Voices project: • Office of the Director

Office of Health Information Programs Development • OD Office of Communications and Public Liaison • OD Office of Administration • Library Operations Division • National Network of Libraries of Medicine and Regional Medical Libraries • Specialized Information Services Division • Lister Hill National Center

Program Development Branch • LHNCBC Cognitive Science Branch • Office of Computer and Communication Systems Division. Some of the NLM staff not otherwise mentioned are listed on the Native Voices credits page

Appendix A: Listening Circles with Native Leaders held by NLM

Executive Director, National Indian Women's Health Resource Center

Center for Hawaiian Studies

Native Voices Exhibition you have respect for them, and you want to make sure that you heed their words and that you follow in their footsteps and

Lindberg also supported commissioning of new Native art works where appropriate, such as a set of ceremonial regalia (pipe, fan, drum, drum stick and rattle) from the MHA Nation; Native healing plants from Native Hawaiian cultural practitioner

a Koa wood spiritual sculpture also from Kauila Clark; and an original Medicine Wheel painting "Spirit of Eagles" by Cree Indian artist Chholing Taha

that included rotating paintings on loan from the Philbrook Museum of Art, such as

Billy Mills (Oglala Lakota) winning the 10,000 meter race, Olympic Games

Neihardt Trust); "Michael Hackwith, USMC Ret., Lakota Spiritual Leader and Sweatlodge

Bryant Pegram/NLM); and "Return of the Hokule'a" from her round trip voyage to Tahiti

The NLM healing totem blessing stopovers -West Coast to East Coast

near the Space Needle, journey kick-off ceremony • Arlee Powwow Grounds, Flathead Indian Reservation, MT • Little Big Horn Monument, near the Crow Nation, MT • Wounded Knee Memorial

Exhibition -Native Voices: Native Peoples' Concepts of Health and Illness

Tribal connections health information outreach: Results, evaluation, challenges

Program management and policy issues in information outreach: Lessons from tribal connections

The National Library of Medicine's Native American outreach portfolio: A descriptive overview

Assessment of the National Library of Medicine's health disparities plan: A focus on Native American outreach

NLM's library network: A force for outreach

Native Voices Exhibition

Exhibition Acknowledgements and Credits Page -Native Voices: Native Peoples' Concepts of Health and Illness

Exhibition -Native Voices: Native Peoples' Concepts of Health and Illness-Interviews

The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing

Living Our Culture Sharing Our Heritage: The First Peoples of Alaska

Kahuna: Traditions of Hawaiian Medicinal Priests and Healing Practitioners. First Peoples Productions

Spirit Lake Nation): A History of the Sisituwan, Wahpeton, Pabaksa, and Other Dakota That Settled at Spirit Lake, North Dakota

Medicine of the Cherokee: The Way of Right Relationship

The Cherokee Herbal: Native Plant Medicine from the Four Directions

Horse Capture and E. Her Many Horses, A Song for the Horse Nation: Horses in Native American Culture

W. Mankiller, intro, Reflections on American Indian History: Honoring the Past, Building a Future

Encyclopedia of Native American Healing

Nature's Way: Native Wisdom for Living in Balance With the Earth

Native Healing: Four Sacred Paths to Health

Dancing with the Wheel: The Medicine Wheel Workbook

Atlas of the North American Indian. Facts on File

Hokule'a, Nainoa Thompson, and the Hawaiian Renaissance

Vaka Moana: Voyages of the Ancestors-The Discovery and Settlement of the Pacific

Ancient Hawai'i

The Totem Pole: An Intercultural History

Nainoa Thompson special lecture on the Hōkūle'a and Native Hawaiian health

Sitka Totem Pole National Historic Park

Available at nlm.nih.gov/nativevoices/traveling/index.html; the host toolkit including traveling exhibit overview, press materials, and photos, is available at nlm

Native Voices: Native concepts of health and illness in New Mexico: Opening a local conversation by hosting a national traveling exhibit

Reflections on Dr. Donald A.B. Lindberg and Native Voices. in: Transforming Biomedical Informatics and Health Information Access: Don Lindberg and the

Exhibition -Native Voices: Native Peoples' concepts of Health and Illness, the Opening Day Video

The co-authors gratefully acknowledge Donald A.B. Lindberg M.D. for his leadership and vision in the development and implementation of all phases of the Native Voices exhibition, and Mary Lindberg for her steadfast support and wisdom throughout the project. We thank the U.S. National Library of Medicine and U.S. National Institutes of Health for their financial support of the Native Voices project.We appreciate the feedback of our colleagues who provided comments on this manuscript: Cynthia Lindquist, Hardy Spoehr, Kalani Brady, Gale Dutcher, Janice Kelly, Kathy Cravedi, Robert Logan, John Harrington, John Scott, Dylan Rain Tree, and Mary Lindberg.Native Voices also depended on the active engagement and contributions of diverse Native community members who were willing to be interviewed, and who provided ideas, artifacts, and art work for inclusion in the exhibition. Beyond those mentioned in the text, other contributors can be found in the credits links