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Alberty: Hope for Indian health: 'Just do it'

As the communications executive of the National Indian Child Welfare Association, I find myself traveling many miles to conferences all across Indian country to station myself at our exhibition booth and explain the importance of the work we do for American Indian/Alaska Native children and families.

It was a relief, therefore, to simply travel across town to attend the National Indian Health Board's 24th annual ''Consumer Conference,'' held in Portland, Ore., from Sept. 24 to 28. The conference theme was ''HOPE for Mental Health, Substance Abuse, and Addiction Recovery in Indian Country.''

As someone with experience in promoting breast health education and annual mammograms, I have lived some of the challenges in distributing public health information to bring about lasting changes in Indian communities. Can the spirit of hope exist alongside underfunded programs, staffing concerns, the emerging methamphetamine crisis and personal struggles to keep your head above water?

Hundreds of Indian men and women listened to presentations about different funding opportunities, staff appointments to key positions in federal public health administrations, and workshops on a wide array of issues such as dental health, youth outreach, clinic administration and suicide prevention.

One of the high points was the presentation by Nike Inc. to unveil the Nike Air Native N7 athletic shoe. After two years of consulting with 70 tribes, IHS offices and podiatrists, this shoe was presented to the NIHB conference attendees with public service announcements, background, and a guest presentation by four-time PGA winner Notah Begay III.

You know you're at an Indian conference when, during the background speech about the N7 shoe, the presenter noted that the shoe was designed specifically for the ''Native foot, which is different.'' I heard a comment. ''Yeah, it's shorter and fat,'' a woman behind me said, eliciting low laughter and smiles all around her. But her comment wasn't too far off when I examined the N7 close up. The design is truly wider and, for lack of a better description, thicker in the laces area, or center, of the shoe.

An information center was set up for people to try on the N7 shoe, to be sized properly, and to examine the difference. An IHS staff person told me that the N7 was an excellent idea ''especially for the diabetic population and people who want to continue walking, the older people, the heavier people, or just the people who have real Indian feet. It's so hard to find the perfect shoe.''

She added, ''We're still seeing amputations on the reservations, quite a few - within the month of September we've probably seen four amputations, and one of those individuals passed away. That's reality, people that either are not aware of how to take care of their own feet or they constantly wear the wrong shoes, and it creates calluses and foot problems.''

It was hard for me to believe that a more strategically designed athletic shoe could make a measurable difference in Indian health, but there was strong enthusiasm for the N7. The shoe will be available starting in November, mainly through IHS offices, and a portion of sales revenue will go into a grant fund for tribal community exercise/sports programs.

Obesity, once it has occurred in childhood, is harder to overcome than obesity levels created in adulthood. The increasing levels of unhealthy weight gain in youth were on the mind of one participant I talked to, although the reasons were not due to bad footwear.

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This grandmother is, for the second time, raising a granddaughter as her primary caregiver, a situation NICWA knows happens often when substance abuse or tragedy disrupts families.

But the worry she shared with me is that her granddaughter is ''eating through her grief'' after the death of her father, and she has gained much weight. She shared her frustration with finding counseling to help her granddaughter cope with her loss and ease her depression; meanwhile, her granddaughter states she can't do certain things anymore or go to certain places because, she says, ''I'm too fat.'' The granddaughter is 8 years old.

As a new tribal health clinician, she expressed great enthusiasm for the conference and the information she would take home to her tribe in Washington state. ''Everybody comes together because you do want a better way of life for our Indian people and you hear from a lot of these people who want to help our young children, and to keep them healthy,'' she said.

She had also learned about the Substance Abuse and Mental Health Services Administration's ''Circles of Care'' program to help tribal communities design mental health service models for serious emotional/behavioral disturbances among Indian youth and families, and thus became acquainted with NICWA, which provides technical assistance for tribes in that program.

Did anyone else feel hope for the future health status of Indian country?

Roanna Stump, CHR manager for the Shoshone-Bannock Tribes, said about the conference: ''I think it's everything that involves hope, because that's all that you sometimes have, is the hope to stick together. And you have the hope to advocate and be a liaison, and to have input.''

Against the backdrop of hundreds of NIHB conference health walkers streaming past us, Cecelia Fire Thunder, coordinator for Native Women's Society of the Great Plains, hesitated while she pondered the question of hope and said, ''Hope is always ... hope is a given.''

''The Indian population has grown at a tremendous rate,'' she added and mentioned the upcoming 2010 census as a reason to advocate now for adequate tribal funds and thus accurately report our communities in the census. Because, like it or not, services will depend on what the numbers tell us.

Even from my own jaded perspective of ''if there's an issue, then someone will hold a conference for it,'' this event was filled with determination, spiritual and personal strength in advocating for others, and an abundance of hope that was felt by every conference attendee, from the tops of their heads to the soles of their wide Native feet.

Kristy Alberty is a mother, the executive communications manager for the National Indian Child Welfare Association and a member of the Cherokee Nation of Oklahoma. NICWA's programs and information are accessible at