diagnosed on the reservation

[GoodTaste]

I understand "diagnosed on the reservation" as "diagnosed at their home." Well, dictionaries show that in this context, "reservation" possibly means "arrangement". I am not sure.

What does "on the reservation" mean? Does it mean "in our community"? (Because the authors introduce in the very beginning of the correspondence:"Ours was one of the last areas in the state to see Covid-19" - such it is like a natural reservation that avoids human disturbance. Okay, I simply make a guess here)

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The second reason has been the unexpected utility of frequent follow-up visits made by our team members that make them more available to the community. Many patients with the “happiest” hypoxemia — those with minimal or no dyspnea — are young, relatively healthy people who might not otherwise present for medical care at all. We try to evaluate everyone in the household when we are visiting elders, and we frequently discover people with oxygen saturations of 80% or lower who did not know they were infected. Only by being in the field are we able to identify such patients early, initiate supportive care, and perhaps save a few lives.

More than 1600 cases of Covid-19 have been diagnosed on the reservation served by our hospital, with only one of these patients being intubated in our emergency department. Of some 400 patients who needed hospitalization, nearly half have been transported to facilities that provide higher-level care. Our community’s case fatality rate so far is 1.1%, less than half the rate reported for the rest of Arizona.


Source: New England Journal of Medicine July 2, 2020
https://www.nejm.org/doi/full/10.105...=featured_home

 

[tedmc]

On the booking/appointment by the public with the hospital for medical consultation

 

[GoodTaste]

On the booking/appointment by the public with the hospital for medical consultation

But the authors later said in the correspondence that "Any success is due in large part to strong partnerships with tribal leaders who have acted decisively to curb the spread of infection, supporting social-distancing measures despite obvious challenges." Tribal leaders appear to strongly link with native American reservations, which seem to suggest that "on the reservation" simply means "in the community". I am not sure.

 

[tedmc]

But the authors later said in the correspondence that "Any success is due in large part to strong partnerships with tribal leaders who have acted decisively to curb the spread of infection, supporting social-distancing measures despite obvious challenges." Tribal leaders appear to strongly link with native American reservations, which seem to suggest that "on the reservation" simply means "in the community". I am not sure.

You have a point there, that reservation could refer to an Indian tribal community in the US. But I thought the preposition should be "cases diagnosed in (not on) the reservation". But if it refers to bookings, reservation should also be in plural. I am also not sure.

 

[Skrej]

'Reservation' here refers to a Native American reservation. Your clue is the word 'tribal' leaders.

Also, if you had more carefully read the article, you should have noticed this first line in the first paragraph:
"Our critical access hospital in rural eastern Arizona provides health care and public health services for a community of approximately 18,000 Native Americans."

That alone, coupled with the clue 'tribal leaders' in the very line you ask about, should easily clarify that 'reservation' refers to Native American tribal lands. Finally, at the very end, you'll note that both of the doctors who authored the article work at Indian Health Services, out of White River, Arizona.

The article doesn't specify which reservation, but a Google search of White River shows it to be on the White Mountain Apache Reservation, which links up with the author's comment about serving rural eastern Arizona. There are about 20 other federally recognized native reservations in Arizona, which make up about 27% of Arizona's total area. The biggest by far is the Navajo Nation, which actually spills over into neighboring New Mexico and Utah.

We typically refer to places and things being 'on' a reservation, instead of 'in', Don't ask me why, just accept it. Consider it a set phrase, if you will.