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Mohawks take lead in pandemic plans

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ST. REGIS MOHAWK RESERVATION, N.Y. – The Akwesasne Mohawk community is used to relying on itself in emergencies. With about 25,000 members stretching on both sides of the U.S./Canada border, its two governments support each other when cut off from outside help. With experience in being isolated, they’ve put a remarkable degree of advance planning into the potential disaster of an avian flu pandemic.

“I think we’re further along than other First Nations,” said Sarah Lee Diabo, director of Emergency Planning for the St. Regis Mohawk tribal government on the U.S. side. She is one of two tribal members who have already received U.S. government training for a pandemic response. They are planning to expand the training to other tribal members and to share their expertise with other tribes.

Diabo said their planning focused on keeping flu victims in home quarantine, to avoid a spread of the disease through visits to medical centers. Nurses and other responders, she said, would make home visits. The tribe was working out a way of marking which homes were healthy and which had the illness, possibly through flags to be placed on mailboxes. Emergency Planning, she said, was keeping and updating maps of the location of tribal elders with special needs, such as oxygen or dialysis. The tribal office was advising members to stockpile water and canned goods, in case of home confinement. “We’ve got to try to educate people,” Diabo said, “but not get them in a panic.”

Diabo said the tribe had completed a population count for the federal Centers for Disease Control and Prevention for distribution of flu vaccine in the event of an emergency. The count, she said, included the Mohawk communities on both sides of the border. Her counterpart, Larry White with the Akwesasne Mohawk Council on the Canadian side, had done the same, she said. “Whoever gets the vaccine first,” she said, would arrange shots for both sides.

The planning also has a dark side. “We have to think of the worst scenarios,” Diabo said. Health officials estimated a very severe pandemic could cause a possible casualty rate of 10 to 20 percent among the very young and very old, so the tribe also had to arrange a “mass morgue.” Diabo said the planning also included religious observances, both Christian and traditional.

The Mohawk community had learned to value emergency preparedness during the ice storm of 1988, Diabo said. The lesson was reinforced, she said, during the World Trade Center attacks of Sept. 11, 2001. Around 100 Mohawk ironworkers were in the Manhattan area at the time, and the tribal council and Ironworkers Local 440 set up an information center on the reservation so family members could make sure that each was accounted for.

The St. Regis Council has also tried to reach out to tribes less advanced in their planning. It scheduled a conference in June on Avian flu preparedness but had to cancel it because of low registration. “We’re going to try again,” Diabo said. “We’re looking at October or November,” she said, when officials might be more focused on the flu season.

In heavily populated Connecticut in southern New England, the Mohegan Indian Nation is taking a different tack. It has closely coordinated its pandemic planning with state and local health and emergency services. “We already interact closely with the state at multiple levels,” said Tribal Vice Chairman Lynn Malerba. She said the tribe had signed a Memorandum of Understanding with the state on an emergency response and had already participated in a large Department of Homeland Security drill on dealing with a biological incident.

Like several other Eastern tribes, including the nearby Mashantucket Pequot Tribal Nation, the Mohegans have an added concern in a pandemic because of the high level of human traffic through its casino. As an international crossroads with a large Asian clientele, the tribal casinos rank high as a potential transmission point for a global epidemic.

Malerba said the tribe was planning to use casino facilities to support emergency workers and would set aside a place to quarantine sick people. The likely place, she said, would be the Mohegan Sun Arena, now the site for headliner concerts and home games of its WBNA basketball team, the Connecticut Sun.

The Mashantucket Pequot Tribal Nation is centering its Avian flu planning on the IHS clinic located on its territory 10 miles from the Mohegan Reservation. The IHS clinic, a separate building with its own parking lot a short distance on the main road from the Foxwoods Casino Resort, serves enrolled Indians throughout the southwestern Connecticut region. It is run by Amarlilly Rodriquez, M.D.

The clinic, said Mashantucket Pequot spokesman Arthur Henick, would follow federal and state planning, including the dispensing of medicine provided by the federal government and distributed by the state and tribe.

Mashantucket Pequot personnel, Henick said, had participated in a health emergency drill earlier this year “that was partially geared to an avian flu response.”