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High-tech tools will fight diabetes on Navajo Nation

WINDOW ROCK, Ariz. - In the first few months of 2008, hovering at altitudes between 65,000 and 97,000 feet above the Navajo Nation will be some of the most sophisticated forms of near-space communication systems currently in use.

These six-pound high-altitude balloon-borne transceivers will make it possible for Navajo Nation Special Diabetes Project health professionals to monitor the location, glucose levels and health of Dine; diabetes patients living in the most remote areas of the Navajo Nation.

This state of the art technology has been utilized for the past three years by energy industries in the United States to monitor wells and tanks in extremely isolated areas, but has never before been used for health-related monitoring.

The scenario will be set to motion when the first transceiver-carrying latex balloon is launched in March.

Due to the air patterns at 65,000 feet, balloons will be released from a location near Kingman in the winter months so that the balloons will move east. In the summer months, when the air current moves west, the balloons will be launched in Gallup, N.M.

Helium will fuel the ascent of the load, which will consist of the communication and control electronics, control mechanisms and power source. This single package will provide digital wireless communication between health providers and patients for a duration of 12 - 24 hours.

On the ground, patients will be equipped with a handheld PDA, through which each can key in their own glucose readings. This information will then be sent to the transceiver and relayed to the health professional.

The balloon and transceiver will travel an airborne path of approximately 420 miles in diameter to provide communication to individuals in the pilot areas of the Western Navajo Agency chapters of Birdsprings, Bodaway, Cameron, Coal Mine Mesa, Coppermine, Inscription House, Kaibeto, LeChee, Leupp, Navajo Mountain, Oljato, Shonto, Tonali Lake, Tonalea/Red Lake and Tuba City.

Approximately 21,933 people live within these 7,205 square miles of land, meaning that the average population density is only 3.15 people per square mile. Many of these individuals live without electricity or a telephone. This service area also contains some of the deepest canyons and highest mesas in the region, making cell phone communication impossible at this time.

''We chose 16 of the most remote and rural areas due to their lack of transportation and lack of communication. We thought we'd start with the area of most need and then expand,'' NNSDP program manager Robert Nakai explained. ''If the patient's glucose level is between 200 and 300, an individual can be sent out to the patient. If it reads between 500 and 700, an emergency transport can be sent out.''

The total time each balloon spends in the air will depend upon the air and climate conditions at 65,000 feet and above. As the active balloon loses its momentum, it will fall to the ground and another will be immediately released, increasing the potential for continuous communication.

''What it means to the Navajo people is that - one, we can identify where the patients are; two, we can monitor their own measurement of their glucose levels; three, with this data, staff making home visits will know how to instruct individuals about making sure their environment is safe, they are wearing the proper type of shoes and about healthy eating habits; and the final would be to incorporate a family environment into the project and identify younger members of the family who could help the patient monitor their own health,'' Nakai said.

Angie Williams, former NNSDP supervisor of the Tuba City Service Unit, was instrumental in writing the grant to bring this technology to the Dine' people.

''The goal of this project is to assist and teach diabetic clients of their condition and to take leadership and control of their condition by understanding the importance of changing their lifestyle by selecting a healthier diet and exercising,'' Williams said.

The initial dispersal of PDAs will take place between January and March to approximately 200 NNSDP clients living in the selected area.

Following the successful use of the PDAs, program administrators hope to increase the number of patients in the program to encompass the 28,000-square-mile Navajo Nation and beyond.

''The exciting thing is that we're the first Indian nation in the U.S. to do this. Hopefully we'll be able to expand into the areas of Alamo, Ramah and Tohatchi, and then connect with the Hopi Nation and the Paiutes to make sure we're all working together,'' Nakai said. ''Right now, the PDA messages are in English, but we hope to incorporate Navajo into the messages. We'd also like to add the capability for personal messages like reminding individuals to exercise and more.''

This program will be funded through a $425,000 from the Distance Learning and Telemedicine Grant Program administered by the U.S. Department of Agriculture Rural Development and supported by a $75,000 match from the Navajo Nation General Fund.

Space Data, which has provided near-space communications to the energy industry as well as the U.S. Air Force, will operate the balloon/transceiver dispersal and facilitate the travel, communications and collection. Spent balloon/transceiver packages found on the ground will be returned to Space Data and the individual submitting the package reimbursed.

Space Data CEO Gerald Knoblach said the use of this technology by the NNSDP is especially rewarding, as it brings a new, personal element to the communication formerly used only to monitor oil and gas units.

''It's great to see this technology used to help individuals. There's a one-on-one connection with the clients and it's really amazing to be able to expand our network and something we've been doing for three and a half years,'' Knoblach said.

According to Knoblach, Space Data hopes to develop several elements of the technology, including upgrading each PDA to operate with rechargeable solar-powered batteries. Space Data also hopes to work with the Navajo Nation and former Navajo Nation President Peterson Zah to offer the services to other tribal nations.

Within the next two years, Knoblach envisions the PDAs being replaced by cell phones to allow verbal communication.

For more information about the technology, visit www.space data.net.