By Robert Hodierne
Reporter, Crossing Continents
Albert Laughter, a fifth generation Navajo medicine man, sits on the ground inside a towering white tepee.
Fire and smoke are central to the Navajo healing process
A small fire of cedar logs burns in the centre of the floor, its aromatic smoke curling through the opening at the peak of the tepee, 20 feet overhead.
On a buckskin on the ground in front of him, the medicine man has arranged eagle feathers, two soft leather pouches filled with corn pollen and cedar needles, a pipe, some sacred tobacco and a wooden flute.
Draped over his shoulders is a shawl, the left-half dark red, the right dark blue.
He chants in Navajo, a language so obscure that a coded form of it was used in the Pacific islands during World War II.
Mr Laughter is offering a blessing to one of those ageing World War II code-talkers, as they are known, who is currently in hospital, in a coma.
As Mr Laughter and his small audience of younger military veterans lose themselves in ceremonial chants as ageless as the Native American people who populate the US South-West, his cellphone rings.
But the jarring intrusion of 21st Century technology goes unnoticed. Here, such juxtapositions are commonplace.
The tepee sits on the grounds of a hospital for American military veterans.
Many of its buildings date back to the mid-19th Century, when this was an army post during the Indian wars.
Today, the challenge is not to subdue the Native Americans, but instead to get the Native American veterans to come to the hospital for treatment.
No ethnic group joins the US military in such high proportions as the Native Americans.
The complex Navajo language was used as a code during the war
And, while they talk about patriotism as a motivation, most agree that the primary motive for enlisting is to find a steady job, something in short supply on Indian reservations.
As the wars in Afghanistan and Iraq drag on, like veterans of all ethnicities, many Native Americans are returning home with emotional problems.
The US military estimates that as many as 30% of returning veterans suffer from post-traumatic stress disorder or PTSD.
While critics note that the Department of Veterans' Affairs has been slow to meet the challenge of this flood of emotionally injured troops, the problems of small budgets, overworked staff and inadequate understanding of how to treat the condition is compounded among Native Americans.
"I do not think we have served the Native American veterans as well as we could have," said Dr David D. Fero, a psychologist at the Prescott Veterans' Affairs hospital.
"We have community-based outpatient clinics in every part of the state, except north-east Arizona, where the largest Native American population and largest land area of Native Americans is in this country, so we have not been able to provide them with the services they deserve."
Finding a path
In some places, the enemy is geography. The scale is hard to grasp unless you have driven across the expanses of land. The Navajo reservation, for example, is three times the size of Wales.
It is so large that the reservation of a smaller tribe, the Hopi, is surrounded by Navajo land.
Many who live on the reservation are four hours' drive from the nearest Veterans' Affairs hospital.
Richard Anderson lives deep in the heart of the Navajo reservation, well off the main roads.
A Vietnam veteran, Mr Anderson came home from the war emotionally shattered.
He drank, got in fights, and had trouble holding down jobs.
"I was sick, a sick man," Mr Anderson said.
"There was no-one there to point the way. I had to find it myself. I found it through the Blessing Way."
Mr Anderson explained his healing while sitting in a Hogan, a traditional, eight-sided structure common in Navajo country.
These are places for meditation, and the observation of traditional ceremonies, like the Blessing Way.
"Back in time, we had this harmony between the universe and us," he said.
"Things were put here for us to use, not misuse it. Ourselves, we were created whole; our mother cared for us for nine months. Everything in place, nothing missing. Part of creation."
Mr Anderson spent seven years studying to become a medicine man.
Now, he helps other veterans with post-traumatic stress disorder find peace.
"Things occur in your life where you do not recall where you come from so the Blessing Way helps you get reconnected with who you are.
"Helps you forget the past and look to the future. Put things back together."
There are no Veterans' Affairs clinics on the Navajo reservation. Efforts to build and staff clinics there have repeatedly run into difficulties.
"Where do you put it?" Dr Fero asked. "On whose land? Would Hopi come to Navajo land?"
Without smaller clinics closer to the patients the trick has been to get the Native America veterans to come to the large, yet distant, hospitals.
Dr James M Gillies, another psychologist, works at the Veterans' Affairs hospital in Albuquerque, New Mexico, east of the Navajo reservation.
"We have hosted ceremonies here called gourd dances, a special traditional Native American ceremony for warriors. We have had two gourd dances here on our grounds," he said.
They have also built a sweat lodge on the hospital grounds, a sauna-like structure in which Native Americans perform traditional healing ceremonies.
"In this way we hope to let them know that they can trust us, and that we trust them. We trust their way of healing, honour that, respect that."
Dr Gillies acknowledges that they do not yet have definitive data proving that incorporating traditional Native American healing practices has benefits beyond those provided by conventional psychotherapy and medication.
But both he and Dr Fero believe their Native American patients benefit. One Canadian study has found that sweat lodge ceremonies have psychotherapeutic benefits.
But Mr Laughter, the Navajo medicine man, firmly believes his ways help his people.
"We sit on the ground, we are here," he said as he sat in his tepee.
"Over there," he added, gesturing towards the hospital, "We do not talk. It is hard for me to talk in those rooms, inside the four walls."
"I cannot help anybody in a room. I can help somebody with the fire here. That is the main thing, to have that fire going, have the herbs here, have the smokes here and be able to help them, have the patients here to understand, get a real understanding of the problem."
There is one final thing you should know about Mr Laughter - he is taking psychology courses. Online.
Crossing Continents on BBC Radio 4 reported from the American South-West on Native Americans and the US Military on Thursday, December 20 at 1100 GMT.