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Rebecca Tsosie has been a community health representative in Navajo Nation for more than 20 years. She visits about five patients in their homes every day, logging an average of 200 miles a week on her pickup truck. (Rebecca E. Rollins / Partners In Health)

Tsosie takes 79-year-old Betty McCurtain’s vital signs at her home in Crystal, New Mexico. Tsosie visits McCurtain once a month to check on her and ensure she’s keeping up on her medications. (Rebecca E. Rollins / Partners In Health)

McCurtain, who was born and raised in Navajo Nation, worked as an educational aid for the Bureau of Indian Affairs for nearly 35 years. She learned she had diabetes in 1990, so now she carefully reads food labels and takes a variety of medications. (Rebecca E. Rollins / Partners In Health)

McCurtain’s coffee table is covered with information about nutrition and diabetes, which enables her to manage her own care between Tsosie’s visits. (Rebecca E. Rollins / Partners In Health)

At the end of the visit, Tsosie checks McCurtain’s bulletin board, which contains notes from recent doctor’s visits pinned among family pictures. (Rebecca E. Rollins / Partners In Health)

Across the border, Lenora Shirley, another COPE community health representative, visits 63-year-old Judy Singer near Ganado, Arizona. (Rebecca E. Rollins / Partners In Health)

Singer, who has diabetes, brings out a plastic bag filled with medication. Shirley checks these bottles against her list to make sure Singer has enough medicine for the month. (Rebecca E. Rollins / Partners In Health)

To encourage Singer to keep physically active, Shirley walks her through COPE’s “Keeping Active” curriculum. “Dancing is good,” Shirley says, as is herding sheep, chopping wood, and feeding livestock. (Rebecca E. Rollins / Partners In Health)

Singer struggles with getting enough exercise, so Shirley goes through some basic exercises with her. She also helps Singer set goals for the next meeting—to walk for 30 minutes every day. (Rebecca E. Rollins / Partners In Health)

COPE also sponsors a garden project in Ramah, New Mexico, to bring local Navajo families together to learn about community gardening. Accessing fresh food can be difficult, but the hope is that exposure and access to healthy foods will positively impact diets—especially among children. Marcy Martinez and her 5-year-old daughter Reanaanah Bitsilly live within walking distance of one of these gardens. (Rebecca E. Rollins / Partners In Health)

This garden, started June 2, includes corn, beans, squash, and peppers. (Rebecca E. Rollins / Partners In Health)

Martinez’s daughter waters the plants as her mother watches. Martinez’s family uses mostly canned foods purchased during monthly grocery trips to Gallup, New Mexico, about an hour and a half drive from Ramah. Martinez says the COPE program has been helpful to her and her family. (Rebecca E. Rollins / Partners In Health)

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