Melinda McQuigg may be stoic and strong – it’s the Indian in her – but sometimes she just has to cry, like last week when her husband got the flu and the prescription alone came to $170. Then there’s not knowing how long he will be laid up for. Every day he doesn’t work at his construction job is another day with no money coming in.

It’s never a good time for sickness, but still. Unrelenting north winds have blasted the landscape all around a canvas-brown and the McQuiggs – Melinda, Charlie and their two nearly grown-up children – must all squeeze into the only two rooms of their dilapidated trailer home in the woods that have any insulation. Recently, a venomous copperhead snake got into the bathroom. Food has to be stored at her mother’s or the mice will eat it. A cousin, a meth addict, recently had a claw hammer fight with another man and lost; it cost him part of his brain.

She might almost forget she is diabetic and that her daughter, Breanne, has been almost totally deaf since birth. Things could be worse, she says.

“So long as we’ve got food in our mouths and a roof over our heads, we should be thankful. Because there are some people who don’t even have that. We just struggle from day to day, you know.”

Her final, and financially crushing, problem is that her 1999 Chevy died two years ago. Without a car she can’t work. She is partly right to feel lucky. Ms McQuigg, 48, belongs to the Choctaw Nation – her native blood is from her grandfather – which occupies an 11-county swathe of south-eastern Oklahoma larger than Vermont. This month, the Nation was selected by President Barack Obama to be one of five first-time “promise zones”, areas blighted with exceptional poverty which for 10 years will be targeted for special federal assistance, including tax breaks to spur investment and programmes to improve education, fight crime and help people train for jobs.