RAPID CITY, S.D. – Emerging priorities in health care in Indian country are as diverse as Indian country itself and difficult to categorize. Federal and state health officials recently heard comments from tribal leaders and health care professionals who laid out a litany of concerns and complaints about health care.
Many offered solutions to some of the problems, which range from alcohol and drug use, diabetes, lack of dialysis units, cancer, heart problems and other diseases, suicide and mental health. For some tribes, the latter two top the priorities list.
Julia Doney, president of the Fort Belknap Tribal Council, lost one nephew to suicide; lost a granddaughter who was 20 days old; saved her son from suicide; and lost another nephew who is serving life in prison.
“He gets better health care [in prison],” she said.
This same nephew would jump off the bus on his way to Head Start disheveled, food on his face and overweight, Doney said, but he would jump into her arms when he saw her and hug her tight as if to say, “I’m safe.”
“I knew he didn’t sleep. His parents had a party. In a drunken and drug-induced stupor he shot a police officer. His health is now taken care of. He was not taken care of enough when he was young.
“There are children outside of their homes while parents fight inside. [The kids go outside] when [they] hear that the loud voices don’t bother them anymore. Our communities are hurting,” she said.
Tribal leaders, she added, have not found the answers to “stop the bleeding.”
“When I seen, them I ask myself, ‘What are you doing for them?’ I beg for someone who has more power than I to help.
“If we are not well mentally, all the good food won’t help,” Doney said.
More than one person told a story about a close relative – a son or daughter who committed suicide or who was addicted to alcohol or methamphetamine or other drugs. The stories brought a face to the priorities American Indian communities have in health care.
“When we talk about suicide, we see the bodies hanging from the ropes,” said Jesse Taken Alive, Standing Rock Sioux tribal council member.
State health officials from four states in Region 8 of the U.S. Department of Health and Human Services listened to the pleas for help. Many of those people were more than willing to partner with tribes to attempt improvements in health care.
“The region is willing to work with tribal governments,” said Joe Nunez, director of HHS’ Region 8.
Most people at the consultation have been to numerous consultations in the past, and all agreed that very little is being done. Nunez made a commitment to meet with tribes and states and tribal colleges to work toward solutions.
“I’ve been to four of these consultations, and I agree with much of what was said here,” said Hugh Baker, Three Affiliated Tribes, “but I also agree that people come and share our frustrations but nothing happens.
He said that Fort Berthold is funded at 10 percent of the need. “How do we talk about unmet needs when we are burying our people?
“We are using 2006 money to pay for 2005 bills. The saying goes that you can’t get sick after June. People get bills that ruin their credit. There is stress of not being able to pay your bills. A lot more needs to happen with appropriations; that’s where the movement needs to happen, otherwise we will waste our time today,” Baker said.
The Northern Cheyenne Reservation in Montana has experienced 87 suicides in the past few years. While working on a methemphatemine treatment facility, the tribe is pushing for a dialysis center and at the same time IHS is contemplating closing an emergency room.
Meth use is a growing problem on reservations. If a user gets treatment, the residual effect is some brain damage or mental disorder.
HHS is developing a program that will be a one-stop shop on meth treatment. Round table discussions will be held, first in the Southwest and then in the Plains on this topic, said Stacey Ecoffey, tribal affairs specialist with the HHS.
She said leaders will be brought to Washington, D.C., and partnerships will be created with the Department of Justice. A question arose as to whether the Drug Enforcement Administration, the FBI and the U.S. Citizenship and Immigration Services, along with the BIA, will work with the tribes to eradicate meth on the reservations.
The answer gave no assurance.
Meth addiction can be treated; however, the aftereffects will go on forever, said Ann Herron, of the Substance Abuse and Mental Health Services Administration.
“Meth is just as treatable as other drugs. Sixty percent remain clean six months after treatment. The impact on the brain is short-term memory loss and attention and judgment. The person doesn’t make good decisions, it’s like a forest fire in the brain,” she said.
Recovery is slow, she added; the treatment requires repetition in short increments because of the lack of attention span. People see meth as the answer to a problem and take the drug to get things done.
Most all meth users are adults of child-bearing age. Newborn children have shown the effects of the drug. Some tribal leaders said that meth is being laced in marijuana in order to create new customers for the drug.
Ninety percent of all meth comes from outside the country, mostly from Mexico; the Northwest is also a pipeline into Indian country.
All tribal leaders at the consultation said meth is a problem on their reservations and that education is needed to deal with the issue.
Building relationships with states and federal agencies is a step in the right direction to help alleviate the disparity in health care experienced by Indian country, tribal leaders asserted. The HHS’ Denver office, headed by Nunez, is willing to meet regularly with the tribes.