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Health Secretary vows improvements for IHS

PINE RIDGE, S.D. ? There are problems in the Indian health care system and Health and Human Services Secretary Tommy Thompson says he'll clear them up with help from the tribes.

No matter how modern the hospital on the Pine Ridge Reservation looks, it is understaffed and under funded, and Thompson heard that message throughout his visit to the facility.

Thompson toured the Pine Ridge Service Unit as part of a series of site visits to IHS facilities. It's a great place to work, but more staff and money is needed to serve the large reservation, Thompson was told over and over. He said he would try to improve health care for American Indians across the country.

The Pine Ridge Service Unit serves more than 40,000 people who live on the reservation with 10 doctors and 25 staff.

"That's not enough," Thompson said, as he added, "This is a well-equipped hospital.

"But there are shortages in health care all over the country," he said. The population of the reservation was a surprise to Thompson.

Diabetes, dialysis and prevention took up a great deal of the discussion between health care officials, Oglala President John Steele and Thompson.

The secretary was taken on a tour of the current dialysis center at Pine Ridge and given a look at the expanded center under construction. The new facility will be able to take care of 70 patients a week with 12 stations, while the older facility only has four dialysis stations.

"It's sad, so much could be prevented," Thompson said. He added that he would like to see the tribes get involved in more preventative health care instead of having to take care of the people after diabetes has taken its toll on the patient.

Steele told Thompson that there were at least 2,200 people on Pine Ridge that were under treatment for diabetes. All Thompson could say was it was "so sad."

To help with diabetes treatment and prevention, Thompson announced a $1.1 million grant was awarded to Pine Ridge. The money comes from the Special Diabetes Grant Program for Indians.

Also a $650,000 grant was given to the Flowering Tree program on the reservation. The program is a drug and alcohol treatment center for American Indian women and their children.

A program through Community Health on the reservation is reaching out to the people, but Kathy Wilson Ecoffey, director of community health programs told Thompson that it was difficult to do outreach because few families participated. She said there was limited staff to perform follow-up calls.

Limited staff and lack of funds for programs became a mantra throughout the tour for Secretary Thompson. The message came from nearly all departments of the hospital he visited. The Intensive Care Unit was non-functional because no registered nurses were available to staff the unit. The ICU in Pine Ridge was state of the art when the new hospital was constructed and still has the equipment.

"It's hard to draw physicians and their families to this area," said Dr. Andrew Hurst, director of clinical services.

"There is a shortage all over American," Thompson said. He added that he likes to promote what he calls "home grown," talent. He said he would like to see all American Indian tribes promote health care as a profession in their high schools.

Steele said that many of the schools on the Pine Ridge Reservation had limited science programs.

It wasn't just Pine Ridge that had a problem with staff and funding, Harold Frazier, vice chairman of the Cheyenne River Sioux Tribe told Thompson in front of a large group. He said his reservation was lacking a hospital altogether and had a revolving door with physicians. He said there were two full-time doctors to serve more than 16,000 people.

"We have such a shortage of staff people some patients are just told to go home and some are misdiagnosed. Diet is a problem on our reservation. We have 800 people diagnosed with diabetes," Frazier said.

Thompson said he didn't want the job he now has, but was asked by President George W. Bush. He said he always looked at the federal government as not working in the best interest of the states.

"Now that I'm here at HHS, this will be the department of compassion. We are given a tremendous opportunity to make change," Thompson said.

He said he met with tribal leadership and set some goals for budget consultation and ways to work with the tribes. Thompson said his plan was to continue consultation with the tribes throughout the year.

"I want to know what's working and not working and change it. I don't know of any HHS secretary that has visited the Indian nations, and don't be surprised to see me come back on a Harley," he said.

Thompson was quick to inform the tribal leaders and crowd that he can do only as much as Congress will allow. "I can make programs more fair. I can be a help. I need a list of your needs and we need to team up to go to Congress for more money," he said.

"There is no reason for Indian country to have more diabetes than the non-Indian community. We need to do preventive health care and make Indian country healthier."

Thompson was governor of Wisconsin in which there are 14 tribal governments. As governor, tribal leaders assert, his relationship was sometimes adversarial and at other times friendly.

"I had a good working relationship with all of my tribes," Thompson said.

Oglala tribal members gathered at the hospital to hear the secretary and offer comments said they have heard many government officials claim to bring hope and help in health care and other areas. Their fear, as expressed to Thompson, was that his comments would be forgotten and health care would not improve on the reservation.

A list of health care priorities given to the secretary from the Aberdeen Area Chairman's Health Board ranged from diabetes to drug and alcohol use to mental health and dental care.

The Chairman's Health Board stated that the Indian Health Service appropriates $1,655 per person and projected need is $2,980. The private sector spends $4,707 per person.

Thompson was on a four-day tour of reservation facilities in Michigan, Wisconsin and South Dakota. He called the health care of the Sault Tribe of Chippewa "one of the most successful programs.

"The Sault Tribe is doing an outstanding job. We will try to replicate what we have seen here."

Before he left the Pine Ridge Service Unit he told the crowd to "eat Wisconsin cheese and drink Wisconsin beer."