HARBOR SPRINGS, Mich. (AP) - For centuries, the shawls American Indian women wrapped around their bodies were adorned with traditional patterns and colours representing nature and lineage.
Today, with a touch of pink, the redesigned shawls are becoming increasingly identifiable among tribal women as symbols of awareness about breast cancer.
"They represent love, nourishment, sustenance, comfort, security - all of the teachings that go with women are in that shawl," said Lorraine Shananaquet, a health administrator for the Gun Lake Tribe. "We cherish certain parts of our regalia, and now these important pieces of clothing will mean so much more."
When the Pink Shawl project started three years ago in the Grand Rapids area, American Indian women were encouraged to customize the shawls they wear while dancing at powwows. They eventually produced a DVD about breast cancer, which tribes from across the country now use to start projects in their own communities.
Shananaquet, one of the organizers of the project, created a dark blue shawl with a green band and pink hands following the band.
"The hands are mine," she said. "The hand design is very old and utilized by all of Native America, only this time they represent the monthly self exam that is crucial to early breast cancer detection."
Cynthia Greensky wore her own design - a maroon shawl adorned with pink ribbons - when she danced in August at an annual powwow held in Harbor Springs by the Little Traverse Bay Band of Odawa Indians. "It's important that we communicate this message, even when it doesn't directly affect us," she said.
Since 2003, the Avon Foundation has given the Inter-Tribal Council of Michigan, a coalition of the state's 12 federally recognized tribes, more than $160,000 US to promote breast cancer education.
The National Cancer Institute found that between 1998 and 2002, almost 55 cases of breast cancer were reported for every 100,000 American Indian women, and of those, almost 14 of every 100,000 died from the disease.
The breast cancer rate in the American Indian community isn't higher than the national average, but the death rate is, said Noel Pingatore, health education co-ordinator for the Inter-Tribal Council.
"There are a lot of reasons that women don't get checked: fear, access to culturally appropriate providers," Pingatore said.
Another reason: mistrust.
Generations of American Indians learned mistrust stemming from discrimination at the hands of government and religious leaders, and passed it along to their children.
"Sometimes the Indian community is resistant to mainstream health practices. Doctors are seen as authority figures and we haven't always had good experiences with authority figures," said Rick Schott II, president of the North American Indian Association of Detroit.
For 62-year-old Sydney Martin, of Hopkins, Mich., a retired American Indian liaison for the Allegan County Intermediate School District, trusting a doctor has always been difficult.
"It's not in my makeup to go to the doctor, let alone get checkups," she said. "I didn't go to the doctor until I had children."
An article about the Pink Shawl project in her local newspaper turned things around, and Martin started caring more about her body.
"I just got the results of my second mammogram and I'm fine," she said.
According to Colorado-based Native American Cancer Research, language and other cultural factors can be barriers.
More than 200 native languages are spoken in the United States and many don't even include a word for cancer. In some languages, the same word is used to describe epilepsy, leprosy and cancer, and there is no way to distinguish among such disorders.
But the campaign appears to be having a positive effect.
"By having people that look like them and talk like them present them with the information, it makes it more personal," Pingatore said. "Instead of an outsider agency, the women came up with a solution to their problem."
And the message is spreading.
In Oregon, Cicelly Gabriel, a project co-ordinator with the Northwest Portland Area Indian Health Board's cancer control project, heard about the Pink Shawl project at a national tribal health conference last fall and used a $7,000 grant from the state to promote it.
Shawls made by women in Tacoma, Wash., incorporate messages about all cancers.
Through the Southcentral Foundation in Anchorage, Alaska, tribes are adapting the project by making pink kuspuks, a regional knee-length dress worn by many Alaskan tribes.
In Michigan, the Saginaw Chippewa Indian Tribe used the money from the Avon Foundation for its annual Feather Link Tea, which the tribe began a decade ago to promote women's health issues. The tribe also created and modelled pink shawls at a fashion show last year before presenting them to cancer survivors.
And the Sault Ste. Marie Tribe of Chippewa Indians made 50 shawls - about half of them by girls under 12.
"We're not just passing on culture," Shananaquet said, "we're teaching them to be unafraid of changes in their body or disease."
She plans to take the message worldwide this month when she presents the project at the World Indigenous Peoples Conference on Education in New Zealand.
