Sanders spoke from a stage near the Rushmore Plaza Civic Center, with a giant American flag draped to his side. His voice was hoarse and he put on a ballcap partway through his speech to shield his head and face from the direct sunlight, which made the air feel hotter than the mid-60s temperature.

At Pine Ridge, Sanders not only spoke but also listened to remarks from members of the audience, prompting them with questions about education, health care and other aspects of tribal life.

Anjeliqu Lopez, an 18-year-old student at Pine Ridge School, spoke up when Sanders asked the youths in the audience to talk about issues that matter to them.

Lopez said she and her friends are among those who occasionally turn to drugs and alcohol to get through the harsh realities of life on Pine Ridge.

“A majority of us have seen the worst,” Lopez said. “A lot of times we have hard home lives that force us to go there.”

Speaking after the event, Lopez said five of her friends have died this year alone, either by suicide or in drug- and alcohol-related accidents.

The sobering reality of life at Pine Ridge drew a sympathetic response from Sanders.