"A lot of people get donated trailers," she said, "but the trailers are already falling apart when they get them." Blue Bird gets by on $1,480 a month in Social Security disability benefits and boxes of food the Agriculture Department hands out in poor rural communities. Her wards -- children of relatives or neighbors whom she takes care of for weeks, months or years at a time -- keep her creative with money, she said. "I can stretch one can of soup to four," she said.
Still, she is always worried.
She was due to drive to Rapid City, 118 miles away, the next day to have a tumor removed from her back, and she was feeling her mortality. Even after she had gastric bypass surgery and lost nearly 200 pounds in three years, her body, burdened with diabetes and hypertension as well as heart problems, was always betraying her. If she were to die the next day, she wondered, what would become of all these children?
"We all try to help one another here -- that's our way," she said. "But life is so hard."
People in Pine Ridge pour their energies into trying to make things better. The reservation needs help with everything: infrastructure, housing, health care, education, economic development. Yet federal money that is supposed to go to the Indians, under treaties or laws, keeps getting cut.
The most glaring example, the Indian Health Service, was created by treaties drawn more than a century ago that promised quality health care (along with quality education and decent housing) for every Native American in exchange for the federal government's taking vast swaths of Indian land.
But the health service, run by the Department of Health and Human Services, is funded at less than $2,000 per Indian each year, half of what federal prisoners receive. This year, Congress rejected legislation to increase its budget. The administration redirected Indian Health Service funding to homeland security and the Iraq war.
In Pine Ridge, people are not joking when they say someone practically has to be dying to receive emergency room care; Indian Health Service hospitals operate under a "life or limb" policy. For lesser ailments, people write off a day of their lives in a clinic waiting room. Often, they just give up and go home.
Deferred health problems take their toll. Life expectancy on the reservation is 47 to 56 years, the nation's lowest. Infant mortality is twice the rate of the rest of the country. Diabetes afflicts about half the population, and people here talk about their blood sugar levels the way other Americans mention their cholesterol counts.
Alcoholism is rampant -- some figures place it at 80 percent of the population -- yet on a reservation about the size of Connecticut, there is no alcohol treatment center. The roadside crosses are too often the result of alcohol-fueled car accidents, which are nearly three times as common here as in the general population.
The Pine Ridge Economic Empowerment Zone, which was the best hope for an economic shot in the arm after Clinton's visit, came with a promised grant of $2 million a year for 10 years as seed money for businesses. But this year, when the zone began to see long-term plans get off the ground, the Bush administration cut its grant to $1.5 million. It allocated no money for the zone in its proposed budget for next year.
Some people blame politics for the funding slights. Senate Minority Leader Thomas A. Daschle (D-S.D.) and Tim Johnson (D), his junior colleague, have proposed bills to increase funding for Indian programs, only to see them defeated in the Republican-controlled Congress. In 2002, Johnson beat Republican John Thune by 524 votes based on late returns from Pine Ridge. Now Daschle, facing Thune in a nail-biter race, is counting on the Democratic voting bloc on South Dakota's nine reservations to win.
Indian programs have been cut or underfunded over many administrations, Democratic and Republican. Last year, the bipartisan U.S. Commission on Civil Rights published a report criticizing the federal government for underspending on Native American programs over generations. Between 1975 and 2000, the study found, funding for Indian programs declined when adjusted for inflation.
The Oglala Sioux Tribal Council, a source of complaints ever since federal law established the tribal council system to help make tribes self-determining, is never stable, since the whole 16-member governing body faces election every two years. It is also on the verge of bankruptcy.