The Senate Committee on Indian Affairs has gotten around to taking a look at the state of Indigenous health in what is now the Great Plains Region. This is five years after the release of the Dorgan Report that roundly condemned the deplorable conditions and practices at Indian Health Service hospitals and clinics.
While reading the Dorgan Report and the ICTMN article by Tanya H. Lee I couldn’t help notice that this report could be done for the Bemidji Area and only the names of people and institutions would have to be changed, but the content stays the same.
I started referring to the I.H.S. as the Indian Homicide Service a number of years back because there wasn’t, and still isn’t, a month or so that goes by that we don’t hear about another atrocity, a mis-diagnosis, a death or other example of gross malpractice occurring at the hospitals or clinics.
I haven’t been in an I.H.S. facility in about 20 years. The last time I was I went in for some cold medicine and while waiting for my prescription I was talking with two friends who had gone there for different reasons. We got our scripts and continued talking then one of them looked at his bottle and remarked, “Must be a special on blue pills. My wife got the same ones last week.” My buddy and I looked at ours and sure enough we had been given the same pills he had. I threw mine in the trash and haven’t been back.
Then there was the incident five years ago when I had undergone surgery to remove a cancerous tumor. Unfortunately the thing had grown so big they had to remove my left kidney as well. I had been home from the hospital for about three or four hours and there was a knock at the door. There stood some young person I had never seen before and asked them what they wanted.
“You got any pills for sale?” I told him to get the hell off my porch and slammed the door.
A few days later I was telling a friend about what happened and he laughed. “I had the same thing happen after I got home from my surgery. How the hell did they know about it?”
Well that was the key question – how did they know. A couple of months later we found out. An employee in the I.H.S. pharmacy was telling friends about people coming home from hospital and had pain pills. They would then go over and try to get the pills. This came out through an F.B.I. investigation of the I.H.S. hospital and the inside person was arrested.
We also found out that it was common practice on the part of the area hospitals to send an Indigenous patient’s prescription to the I.H.S. I had been getting mine at the local pharmacy but my script was still sent to the I.H.S.
Another glaring problem is the lack of consistent medical treatment. For whatever reason, the I.H.S. in our area uses an extraordinary number of contract doctors and nurses who rotate through so quickly you barely get to know their names. Friends have told me they rarely see the same doctor twice and there seems to be a high turnover in nurses. So the continuity and quality of care is severely compromised.
Along with this high turnover is the disturbing reality that a doctor can be practicing at the I.H.S. even if they’ve lost or had their license suspended by a state. Indigenous governments could address this situation by passing health regulations requiring any doctor practicing in their territory to be currently licensed and in good standing.
A consistently chronic problem has been severe underfunding all across the I.H.S. It has only been during the Obama administration that there has been some increase but a lot more is needed to meet the current costs and expenses of health care in Indian Country.
One reason for the high costs are the inordinate numbers of federal doctors and nurses, most of whom are part of the Commission Corps. These are incredibly high paid persons and if you let them into your health system can cost you a ton of money. We learned this in 2008-09 when two of them somehow got posted to work with the Nation health division. Their combined salaries, travel and other associated expenses cost the Nation over $400,000 a year. This money came off of the 638 Self Government contract.
In addition to having to pay these costs it was learned that the I.H.S. was billing for their services which precluded the Nation’s health division from getting these payment. All together it was estimated that these two people cost the Nation more than $1 million.
None of this has to be this way. To change it begins with each Nation deciding that they’re going to get control of their health care system. And it’s very important to recognize and understand that this is a system and that one needs to address each element of the whole system. This can’t be done piecemeal.
There are successful models out there where Nations have taken control of their system, reduced costs, increased quality of care and are producing positive impacts. There is no magic wand for achieving success. What’s required is a long term vision of what can and needs to be. This vision needs to championed by committed, innovative and trained people. Most importantly, the people who are the intended beneficiaries of this system need to be involved, consulted and engaged on a continuous basis.
Successful systems are holistic and achieve a significant integration of traditional and western medical practices. An elder once told me, “You know when they came here they brought their diseases with them. They brought things we’ve never seen before so when we get sick from that we have to go to them.”
But I’m also reminded that our Teachings tell us that when an illness or imbalance occurs it doesn’t just affect one aspect, it affects everything. Irrespective of the source, the impact ripples out and so the healing that’s needed must address all aspects of the disruption. Our word for this translates to “Making it right with Creation”.
Each of our Ways of Life have their particular way of saying the same thing. What is important is that amongst Indigenous civilizations we developed and nurtured systems of care and wellness that served our needs for generations. The invasion and colonization we’ve experienced has caused us to lose some of our experience and confidence. Things that we can reclaim and once again take great care and nurturance of ourselves, families, communities and nations.
Mike Myers is the founder and CEO of Network for Native Futures, a Native non-profit that works with Indigenous nations, communities and organizations internationally. The network's mission is to support sustainable development and nation re-building through providing of technical assistance, training and consulting.