When Howard Billiman came home from work each day to his family in Sawmill, Ariz., his young children ran to greet him, leaping into his arms and grabbing onto his legs, happy to have their father home. His daughter Maggie remembers that his denim jeans and thick work jacket were covered in yellow dust. It coated the children’s hands, arms, and clothes.
“It was everywhere,” she said. “We didn’t have running water, so we would have it on us and go to the well to fill buckets of water. We washed everything with it, ourselves, the pots and pans.”
The yellow dust would follow the Billimans — and thousands more Navajo people — for decades to come.
Howard, a Navajo Code Talker and World War II veteran, was one of thousands of Navajo people, including women and children, who worked in uranium mines on the Navajo Nation. For more than four decades, Navajo miners extracted nearly 30 million tons of uranium ore. Howard died of stage 4 stomach cancer in 2001, and his children would experience a range of serious illnesses that the family believes are connected to uranium exposure.
Maggie’s sister Geneva said it was their father’s doctor, who diagnosed the cancer after years of stomach pains, who first told the family their many health ailments could be connected to the uranium mines.
“He told us this was a very rare cancer,” Geneva said. “You don’t see this unless someone has been exposed to something. It could be in all of your bloodstreams.”
As rising electricity demand, including from AI data centers, fuels renewed interest in nuclear power and uranium, victims, Navajo families like the Bilimans, are still living with the health and environmental consequences of the nation’s first uranium boom.
The Boom
Uranium mining expanded across the Navajo Nation beginning in the 1940s, then surged in the 1950s as the United States sought radioactive metal for its growing nuclear weapons program. The mines drew thousands of Navajo workers with the promise of steady wages at a time when jobs on the reservation were scarce.
Private companies ran the operations, and for nearly 30 years, the federal government was the sole purchaser of uranium from the Navajo mines.
Although it was known at the time that exposure to uranium could cause cancer, little was done to protect the Navajo miners from the deluge of sickness that would befall them and their families as a direct result of working in the mines.
Demand for uranium nearly halted in the 1970s when the U.S. reached its stockpile and the Atomic Energy Commission ceased purchasing it. In 1978, a group of Navajo miners sued the federal government, demanding it conduct studies on the effects of uranium exposure. The case was dismissed, and the last mine on Navajo Nation shut down in 1986.
Today, more than four decades after the mining boom began to recede, 523 abandoned uranium mines remain on the Navajo Nation. In 2016, the Environmental Protection Agency began cleanup, but many say the damage is done.
The Bombs
While private companies were sending workers beneath the earth of the sacred Navajo lands to extract the element fueling a global arms race, 550 miles away in the northwest corner of Nevada, government scientists were testing the nuclear weapons.
From 1951 to 1992, 928 nuclear weapons tests were conducted at the 1,350 square mile swath of land just 65-miles north of Las Vegas, called the Nevada Site. 100 of those tests were done above ground, releasing radiation into the open air, which was then carried hundreds of miles downwind.
People exposed to radiation are called “downwinders” — named for the path of the fallout from the tests, which encompasses areas of Utah, Idaho, New Mexico, and Arizona, including Apache County, where the Billimans grew up.
The Price of Exposure
The Radiation Exposure Compensation Act, known as RECA, provides up to $100,000 to people who developed certain cancers and other diseases after living downwind of nuclear weapons tests. But for Maggie, 65 — who grew up in the downwind path in Sawmill — and other downwinders, compensation addresses only part of what they say they need.
“It [the RECA money] mainly pays for people’s funerals and medical bills,” Maggie said. “We need cancer treatment. We need ways people can get tested. I have to keep moving on it, and that keeps me going.”
The Navajo Nation spans more than 27,000 square miles across Arizona, New Mexico and Utah. One can drive for hours through sprawling desert punctuated by mesas, tower bluffs and a handful of hogans. Accessing specialty medical care is extremely difficult, and for some, almost impossible. Today, Maggie and other survivors are urging federal and tribal officials to bring more cancer care to the reservation.
In 2019, a specialty cancer center opened in Tuba City; it remains the only one on the Navajo Nation. For many patients, getting specialized care means traveling off the reservation.
RECA was passed in 1990, with claims first accepted in 1992. By the time the program expired in 2024, the Department of Justice received 56,733 claims and awarded a total of $2.7 billion.
The 2025 reauthorization reopened the claims from Jan 1, 2026, to December 31, 2027. The bill added previously excluded populations from the bill, brought the application process online, and increased payouts for downwinders. While compensation for downwinders now tops out at $100,000 instead of $50,000, the National Cancer Institute reports that the average cost of cancer care, from initial care, continuing care, to the last year of life, is around $160,000.
A new version of the bill was introduced on August 17, 2026, that would increase the compensation amount to $150,000, extend the fund for 15 years, and expand the list of eligible diseases.
Even if the amount of RECA compensation were to increase, without comprehensive healthcare, no amount would be enough.
“Whatever the amount is, it doesn’t measure up to a human life,” Maggie said. “You cannot put a price tag on somebody’s life. I would rather have my family than have the money.”
Senator Josh Hawley (R-Miss.) introduced the reauthorization of RECA in January 2025, seven months after it expired.
“This is a basic matter of fairness. If the government poisons you, the government should make it right,” Hawley told Native News Online.
What Exposure Leaves Behind
RECA covers 19 forms of cancer for downwinders, but the health effects associated with radium and uranium exposure extend beyond the diseases covered by the program.
Uranium can enter the body through contaminated air, food or water. Once inside the body, uranium can affect the kidneys and other organs, while ionizing radiation can damage cells and DNA and increase the risk of cancer.
Lilly Adams is a campaign manager for the Global Security Program for the nonprofit Union of Concerned Scientists. Her work focuses in part on communities affected by nuclear weapons production and testing.
“You cannot put a price tag on somebody’s life. I would rather have my family than have the money.” — Maggie Billiman
“It’s not like there’s a threshold below which there’s no harm,” Adams told Native News Online. “It’s that even a small amount of radiation exposure comes with a small increase in your risk of cancer or other health issues. So, in that sense, no, there is not a safe level of radiation exposure.”
Adams works with communities affected by uranium mining from government or commercial activities.
She said the effects often fall on rural Indigenous communities and communities of color, where residents may have fewer resources to challenge the government or industry. In many cases, she said, residents were assured the activities posed little risk.
“There’s this concept of sacrifice zones,” Adams said. She said the federal government placed nuclear weapons infrastructure in rural areas where residents often had fewer resources to challenge it.
“Another just common thread is that all of these communities were told the whole time that it was fine; there wasn’t a risk,” Adams said.
The government kept poor records over decades of uranium mining and did not do real-time studies to examine its effects, she said. The result is a burden of proof placed on those most affected, and those advocating for them.
“We’re trying to go back now and understand exposure over time to existing contamination today, sometimes decades after the fact,” Adams said. “We can still learn a lot from those kinds of studies, but to put it on the communities and say you have to come up with the proof when it’s the government’s fault in the first place that we don’t have that proof is incredibly frustrating.”
Decades after uranium mining ended, contamination remains widespread in the Navajo Nation.
In 2016, 13% of springs, wells, and water storage tanks in the Navajo Nation tested positive for unsafe levels of uranium. A University of New Mexico study found uranium in household dust in 85% of the roughly 600 Navajo Nation homes tested. The researchers also found that Navajo people living near uranium mines had higher concentrations of uranium in their bones than 95% of Americans. A 2019 federally funded study of 781 Navajo women showed that a quarter of them, and some of their babies, had concentrated levels of uranium in their urine.
The Burden of Proof
As the Trump administration moves to expand domestic uranium production and ease restrictions on mining, Navajo advocates say the renewed push unfolding before the federal government has finished cleaning up hundreds of abandoned uranium mines from the last boom.
For people living on Navajo Nation with limited access to technology and hours away from doctors, accessing medical records is a momentous task. By the time a person is diagnosed with cancer, gathers their records to demonstrate they were in a designated area during a designated time as stipulated by RECA, applies for the compensation and is approved, it is often too late. And for people like Maggie, who were born during a time when record keeping was scant on the reservation, it’s a task that feels like more punishment during a time when they are fighting for their lives.
And often, the RECA check comes too late.
“I’ve heard so much is that for a lot of people, it feels like you can’t get RECA until you’re about to die because it takes so long to get a diagnosis, and so people are not getting that diagnosis until stage four, and then they get the RECA compensation,” Adams said. “There was even a myth that I had heard was going around in some communities in the Navajo Nation: ‘Don’t apply to RECA because once you get RECA, you pass away.’”
Sent in Circles
Maggie began experiencing stomach pains more than five years ago. Some days, she can barely walk, and sitting for a few minutes at a time, let alone hours in a car, is unbearable. She has seen more than half a dozen specialists, once waiting a year for an appointment. Doctors have identified growths on her ovaries and liver, but she still has no diagnosis and no plan of treatment.
Recently, she was told paperwork for a referral was missing. On another occasion, she traveled 3.5 hours for a test, only to be sent home without receiving it.
“They send me around in circles,” Billiman said.
All of her siblings have serious health problems. Her sister Geneva often struggled to breathe as a child. She was hospitalized several times, but was never diagnosed with asthma. During one hospital stay, doctors discovered a heart defect. She also lives with stomach pain, which doctors attribute to a large cyst. Three of her children have health problems ranging from intestinal issues to severe asthma.
Maggie and Geneva’s brother Daniel has been in and out of the hospital with stomach pains and shortness of breath. One of their sisters was born with an eye disease that left her blind, and another is living with a spinal defect.
The Billiman siblings describe a childhood filled with ailments: shortness of breath, easy bruising, muscle soreness, and stomach pain. All three describe the pain of finding care through a piecemeal system of IHS facilities and private hospitals, and what it is like when they fall through the cracks.
“You don’t want them to confuse your medical record with either one of those hospitals, so you try to stick to one,” Geneva said. “But it’s almost not possible.”
For people like Maggie who must travel for hours for medical appointments, Medicaid can cover the costs of a transportation service. But, services are overrun with requests and are booking weeks out.
Maggie and Geneva’s niece Lorie Sekayumptewa (Diné, Sac&Fox, Hopi) said the needs of victims of uranium extend beyond financial, even beyond a cutting-edge cancer center. Family members, who are often sick themselves, take care of those victims with cancer.
Sekayumptewa is 54 and was recently diagnosed with rheumatoid arthritis after waiting a year for a provider. So far this year, five of her family members have died from sickness.
“Our people here, they just suffer and they live out their life, dying from cancer with no care, no meds, no hospice, no counseling,” Sekayumptewa said. “It’s wrong.”
Still Fighting
Even with the RECA window reopened, applying is exceptionally challenging. Those who are eligible were born during a time when record keeping was scant. Some have no birth certificates and don’t know their exact birthdate. Some only speak Navajo.
Almost as soon as RECA was renewed, reports of scammers descending upon the reservation began to surface.
“You’re talking about people that sign things with their thumbprint at some point, or only have photographs or don’t even have birth certificates,” Sekayumptewa said.
In May 2024, Maggie and a group of Downwinders who call themselves the Sawmill Warriors traveled by bus to Washington to ask Congress to reauthorize RECA before it expired that June.
Maggie recalled a fellow Downwinder, friend and RECA recipient who had planned to join the trip, but had to back out when the cancer she fought for so long had returned. While the RECA money helped with the initial treatment and surgery, the government would not be issuing another check.
“She’s still living,” Maggie said. “They aren’t going to give her another $50,000.”
