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Trahant: ‘Docs or cops?’

WASHINGTON – It’s trite to say, “everything is connected.” It’s a phrase that comes up in the context of family, the environment, or perhaps, philosophy. When the subject is reservation violence, however, that same notion could be rewritten as a blunt question: Docs or cops?

Cops are getting most of the attention after the signing of the Tribal Law and Order Act. At a White House ceremony on Thursday, Lisa Marie Iyotte introduced President Barack Obama. She is an enrolled member of the White Clay People, her father’s tribe, but grew up and lives as a Sicangu Lakota or Rosebud Sioux. She had the most difficult task: Describing her own brutal assault and rape that was witnessed by her children. The attack was never prosecuted because of the jurisdictional maze that complicates criminal justice in Indian country.

“All of you come at this from different angles, but you’re united in support of this bill because you believe, like I do, that it is unconscionable that crime rates in Indian country are more than twice the national average and up to 20 times the national average on some reservations,” the president said. “And all of you believe, like I do, that when one in three Native American women will be raped in their lifetimes, that is an assault on our national conscience; it is an affront to our shared humanity; it is something that we cannot allow to continue.”

The president cited what will happen next: The hiring of more U.S. attorneys, more victim-witness specialists, a national training coordinator who will work with prosecutors and law enforcement throughout Indian country, and more cops. Already the Interior Department reports a 500 percent jump in applications “the largest increase in history,” the president said, “and we’re working to deploy those officers to the field as quickly as possible.”

The bill boosts tribal authority, making it easier for local government to prosecute violent crimes and the Justice Department will collect and disclose data, including those crimes not prosecuted. The new law will also provide more resources for tribal courts, police departments as well as programs to combat drug and alcohol abuse or help at-risk youth.

The new law is worth celebrating. But we should also remember: This law is just one step forward. This effort will not succeed unless Congress and tribes also recognize, support and fund the public health side of this equation. This is not a problem that can be solved by law enforcement alone.

Last month, the Family Violence Prevention Fund and other health agencies (including the Indian Health Service) released a report that documents significant improvements in the public health approach. ?The new report: “Building Domestic Violence Health Care Responses in Indian Country: A Promising Practices Report” represents the other element in this story. As Eileen Hudon, a domestic violence and sexual assault activist, says in the report: “The medical field is a good place to build a response to violence against Indian women because there is a high ethic to confidentiality, privacy, and patient’s rights. The thinking embedded in the medical field closely aligns with an advocacy approach to addressing violence against women. So it has the potential to be a safe place to build an effective response to helping and protecting women.”

Some examples of model programs include: A Warm Springs initiative that focuses on coaching boys about healthy relationships; a Cherokee Indian Hospital group operating with the strategy of explaining to the community that violence is not just a women’s issue; and a Utah Navajo outreach effort in the schools and in churches.

President Obama is right when he said this violence is “something that we cannot allow to continue.”

So what is it, docs or cops? Sorry, it’s the wrong question. If we are to remove the blight of domestic violence from Indian country it has to be docs, cops, community people, public health, government and tribal leaders, basically, everybody. Then, this is as good a time as any to make it so.

Mark Trahant is a Kaiser Media Fellow examining the Indian Health Service and its relevance to the national health care reform debate. He is a member of Idaho’s Shoshone-Bannock Tribes and writes from Fort Hall, Idaho. Comment at His new book is “The Last Great Battle of the Indian Wars,” the story of Sen. Henry Jackson and Forrest Gerard.

Additional resources:

A White House blog by Lynn Rosenthal says another aspect of the effort is that the Indian Health Care Improvement Act requires “a standardized set of practices be put in place for victims of sexual assault in health facilities. Now, more women will get the care they need, both for healing and to aid in the prosecution of their perpetrators.”

The New York Times editorial: “The possibilities of the new law were glimpsed at the Sioux reservation after an earlier experiment in which the understaffed patrol of the Bureau of Indian Affairs was increased to a more reasonable force of 38. There have since been hundreds of arrests in the sorts of cases that have long gone unprosecuted.”

Centers for Disease Control on a public health response to violence: The public health approach is a four-step process that can be applied to violence and other health problems that affect populations.