0 SEPTEMBER 1,2011
Smoke Signals
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By Ron Karten
Smoke Signals staff writer
The 40th annual meeting of the
Association of American Indian
Physicians pointed the way for
Native health care in the years
ahead.
Culture and tradition, partici
pants argued, should play a role in
the Native American health care
model. Longstanding barriers, they
said - from federal underfunding of
Native health care efforts to a his
tory of bogus research - should not
be allowed to hold up progress.
"Shared Visions: Blending Tradi
tions, Culture and Health Care for
Our Native Communities," drew
more than 200 in mid-August to
the ceded lands of the Confederated
Tribes of the Grand Ronde.
Attendees included Indian Health
Service Director Yvette Roubide
aux, American Medical Association
President-elect Jeremy Lazarus
and National Indian Child Wel
fare Executive Director Terry L.
Cross.
At the Jantzen Beach Red Lion
on the south shore of the Columbia
River, the Grand Ronde Tribe wel
comed the group in the program, at
the podium and from the river.
"I am so proud that I can see Na
tive American physicians rising up
in this day and age," said Tribal
Council Chairwoman Cheryle A.
Kennedy. "I know that this shar
ing of ideas will only lead us to a
better place."
Among the ideas to emerge over
the next few days were uses for
Native traditions in American
medicine today.
Oglala Sioux physician Donald
Warne encouraged physicians to
listen for the patient's perspective
and involve family and community
in the healing process.
Warne is director of the Sioux
Falls, S.D.-based Office of Native
American Health, a division of
Sanford Health, serving patients
in North and South Dakota.
R. Dale Walker, president of
AAIP and director of the Center for
American Indian Health, Education
and Research at Oregon Health &
Sciences University in Portland,
argued for "empowering the com
munity by establishing a broader
based network of community in
volved care."
OHSU Vice President Norwood
Richardson envisioned a practice
that is "both art and science" the
"art" referring to Native wellness
traditions. "It can't be practiced
without the art piece," he said.
Warne also made use of the Na
tive Medicine Wheel, with its four
directions keyed to healing. He
presented many examples of tradi
tions that ought to be included in
western medicine as it is practiced
today. One wheel brought together
mental, physical, spiritual and
emotional issues; another included
meditation, herbs, prayer and
counseling; a third valued decision,
action, values and reactions; and
a fourth joined wisdom, courage,
fortitude and generosity.
"We have much to learn from our
(traditional) teachers," Warne said.
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Photos by Michelle Alaimo
The Grand Ronde Canoe Family paddle by the Interstate
Bridga that spans tha Columbia Rivar connecting Oregon and
Washington after they sang and danced for attendees of the
Association of American Indian Physicians conference held in
Portland on Thursday, Aug. 1 1 .
Tribal Chairwoman Cheryle A. Kennedy gives a welcome
address during the Association of American Indian
Physicians conference held in Portland on Thursday, Aug. 11.
Showing a chart that put dia
betesdepressionalcoholism in a
circle, with one leading to the next,
Warne said that in the existing
medical model problems regenerate
themselves. Diabetes leads to de
pression; depression is self-treated
with alcohol; and alcohol worsens
diabetes.
Also in the existing model, dia
betes is treated with the so-called
medical model while alcoholism is
treated with a behavioral model.
"We don't treat disease holisti
cally," said Warne. "Medical and
behavioral specialists don't coordi
nate well. It's a failed system."
The extent of that failure is stark
in Indian communities. Native
American deaths from alcohol are
six times the national average; from
diabetes, they are three times; from
accidents, twice; and from suicide,
Native Americans succumb at a 60
percent greater rate. At the same
time, as a group, Native Americans
receive the fewest federal dollars of
any recognized group of recipients,
including the incarcerated.
"The inequities seem to be getting
worse," said Richardson.
For the Native American com
munity, argued Joe Robertson,
president of Oregon Health &
Sciences University, health care
reform means equal access to care.
Both Roubideaux and the AMA's
Lazarus said in their remarks that
they believe federal health care re
form passed last year will improve
access for Native Americans.
Roubideaux also promised an
Indian Health Service that is more
transparent in the future, that
improves its relationships with
Tribes and "how we deliver care."
She downplayed any hope of new
money from the fed
eral government.
"There's a ton of
need and a lot of bipartisan sup
port" for Indian health, she said,
but economic realities mean that
the Indian Health Service won't
see much more than its current $4
billion budget in the years ahead.
Tribes, she said, estimate that their
health care needs require some $22
billion in funding.
The service saw a 13-percent in
crease in fiscal year 2010 but only
a 0.4 percent increase made it into
the 2011 budget. President Obama
had proposed a 9 percent increase,
Roubideaux said.
Wilson M. Compton, director of
the Division of Epidemiology Ser
vices and Prevention Research in
Bethesda, Md., argued for "main
streaming addictions in medicine."
Between health care reform and
changing insurance requirements,
he said, there are new incentives
and successful research models
for addressing illicit drug use in
primary care settings.
Many OHSU medical students
attended the conference.
"We're blessed that our people
are reaching this level," Kennedy
said.
Kennedy's professional life grew
out of her early work in health care
for the Grand Ronde and other
Tribes. She is a national leader
in Native health care, serving on
U.S. Health and Human Services
Secretary Katherine Sebelius's
Tribal Advisory Committee and as
a board member of the Portland
based substance abuse specialist
One Sky Center, among many such
organizations.
"We have millions of dollars in
scholarships," said Roubideaux,
encouraging medical students who
would trade school financial aid
for years of service to Native com
munities. "The public health model is the
right approach," Kennedy said. "It
is very different from money-making
medicine."
The Grand Ronde Canoe Fam
ily arrived from across the river
on Thursday, Aug 11, singing and
rowing. Halfway across the Co
lumbia, skipper Bobby Mercier's
voice distinguished itself. Mercier
is a member of the Tribe and a
Language and Cultural specialist
for the Tribe.
The following Tribal members
also came in the canoe, and sang
and danced for the occasion: Cris
tina Lara, Kyoni Mercier, Tammy
Fisher, Brian Krehbiel, Nakoa Mer
cier, Izaiah Fisher, Madison Leno,
Andrea Grijalva, Zoey Holsclaw, Sh
antell Ulestad and SuSun Fisher.
As the canoe approached, dozens
from the conference ran down to
the dock behind the Red Lion to
greet them.
"How good it is to have a big
group of Native people gathered,"
said Mercier. Their first song,
"New Beginnings," was followed
by memorial and fun songs and
dances.
Tribal Council Vice Chairman
Reyn Leno and Tribal Council
members Steve Bobb Sr., Wink So
derberg and Chris Mercier attended
the Canoe Family celebration.
In describing to the group the
Grand Ronde Health Clinic's
many services, Kennedy noted
that the Grand Ronde Tribe is im
proving health care for its people
despite broken federal treaty
promises.
Richardson, an African-American,
said, "We never got our 40
acres and a mule, either. There may
be broken promises, but we won't
believe in broken dreams."