"At the edge of the remote prairie town called Eagle Butte, just past a fireworks stand, there is construction. Where winter wheat once grew, workers in hard hats now pour the foundations that will cement buildings to dusty earth.

Perhaps somewhere else this might be just another construction site. But here on the Cheyenne River Sioux Indian Reservation, in what may be the poorest county in the country, people sometimes stand at the edge and watch, as if to convince themselves of at least this promise being kept.

They come to witness the rising of a health center triple the size of the one it will replace: a tired building whose very bricks, mortared in place long ago by the Army Corps of Engineers, recall displacement and loss. The site will also include dozens of houses to accommodate all the nurses and doctors the reservation expects — or hopes — will come.

“This right here is your entryway,” a tribal member named John Hunt says with pride, pointing to some churned-up soil. And here, the expanded dental clinic. And here, the traditional healing room, where those mourning a death will be able to burn sage in a ritual of assisting passage to the next life.

Mr. Hunt’s thick body is built to take a fall; he spent years as a rodeo cowboy, saddling broncos, before giving it up to work first for the tribal government and then for the contractor developing the site. He understands what this construction represents:

Better health care. More jobs. The culmination of years of determined advocacy by tribal leaders. And the concrete manifestation of that abstract concept known as federal stimulus money, coming from the even more abstract American Recovery and Reinvestment Act.

Even now, with the water tower built and the basement dug, some people here are so accustomed to disappointment that they don’t have much trust in the project. “A lot of disbelief,” says Mr. Hunt, 37. “A lot of — ‘I’ll believe it when I see it.’ ”"

Get the Story:
A Rising but Doubted Dream on a Reservation (The New York Times 7/13)