When French trappers first spotted Crow warriors two centuries ago, they called them the "beautiful men." They were tall, lean and had skin that glowed with health.
If the trappers traveled through Montana today, they probably would have different words to describe the indigenous people, said Manuella Mesteth, director of the Crow Tribe's Health Department.
"It was a culture of total well-being," Mesteth said of her ancestors' health. "It was not a culture of poverty and disease."
Mesteth gave the opening remarks at a health summit Sunday at the Sheraton Hotel in Billings. The third annual Montana-Wyoming Tribal Leaders Council's health conference runs through Wednesday.
"We have reached bottom," Mesteth told the audience of about 200. "It's time to gather up and get well again. We have to. There's no other alternative."
From diabetes to drug abuse, health problems continue to rage in Indian Country, especially for tribes on the northern High Plains. Life expectancy for Indians in Montana and Wyoming is nearly a decade lower than the rest of the country, according the Billings Area Indian Health Service Office.
The reasons for the disparity vary widely. On the Crow Reservation, for example, there are rising cases HIV being spread by intravenous use of methamphetamine, Mesteth said.
Although national experts will attend the conference - including Indian Health Service Director Dr. Michael Trujillo - the most valuable information usually comes from local sources, said June Tatsey, Blackfeet Tribal Health Administrator.
Tribes in the region are culturally and genetically linked, she said. A health program invented in Lame Deer is more likely to work in Browning than one devised 3,000 miles away. But given the scope of the problems, tribal officials would consider any possible solution, even if it was from Fiji.
One of the biggest issues, Tatsey said, is tackling health problems by using the best from traditional medicine as well as modern science.
"We're at a point where we're trying to integrate the two," Tatsey said. "We have to look at all kinds of healing."
One health success story helped kickstart the conference. Thirty-two runners from the Wind River Reservation in Wyoming arrived in Billings early Sunday afternoon. The Eagle Staff runners traveled by foot more than 200 miles.
"When we run, we pray," said the group's president, Martin Blackburn, a Northern Arapaho. "We also always carry a message. Before the horse came, we were always running to carry messages."
The message, Blackburn said, is a desire to return to the traditional, healthy lifestyle. Many tribes across the state have begun resurrecting running societies.
But the tribes won't be able to escape the existing problems without the federal government upholding its trust responsibilities. After Sept. 11, expected increases in spending on Indian health programs was diverted to homeland security, said Tony Prairiebear, health director for the Northern Cheyenne.
"The health care needs of our people are growing by leaps and bounds," he said. "We're trying to keep up. We're not being very successful at this, but we have to try."
Many non-Indians can't comprehend the pain being caused by the health problems, Prairiebear said.
People on most reservations share genetic links going back centuries, he said. When the Northern Cheyenne see a statistic showing diabetes rates in their tribe - in the last five years, the number has increased from 165 to 530 - each number represents mothers, sons, cousins.
"Our relatives are very important to us," Prairiebear said. "We don't want to see them suffer."