Wednesday, December 29, 2004

Indian Residential Schools Resolution Canada

 Indian Residential Schools Resolution Canada


 "In addition to allegations of physical and sexual abuse, which are found in 90% of the legal claims, allegations relating to such things as cultural loss, breach of treaty, loss of education opportunity, forcible confinement and poor conditions at the schools are also alleged.   Now over 5,000 cases representing nearly 12,000 individuals make claims against the Government. Seventy per cent of claimants themselves also name a church institution in addition to the Government.   There have been over 630 settlements and 11 court judgements."

Thursday, December 9, 2004

Improving Cancer Care for Native Americans

Fri Nov 19,11:47 PM

FRIDAY, Nov. 19 (HealthDayNews) -- A research project designed to increase access of Native Americans in South Dakota to cancer clinical trials and new cancer treatments has received a five-year, $5.4 million grant from the U.S. National Cancer Institute (news - web sites).

 Native Americans have higher cancer death rates than the general population, largely because the disease is often more advanced by the time they are diagnosed.

This project is being conducted by the Rapid City Regional Hospital, the University of Wisconsin Comprehensive Cancer Center, and the Mayo Rochester Comprehensive Cancer Center. It focuses on the Lakota (Western Sioux) population in South Dakota.

There are three main objectives. The project will attempt to identify major factors that cause health-care disparities among Native Americans served by Rapid City Regional Hospital. It will also assess whether shorter, but equally effective, courses of treatment will improve acceptability and completion rates of radiotherapy among the Lakota.

The project will also explore whether there is a genetic basis for anecdotal reports that Native Americans suffer greater side effects when they undergo radiation therapy.

"Traditionally, Native Americans have been less likely to benefit from the progress being made in cancer research because of a multitude of barriers," principal investigator and radiation oncologist Dr. Daniel Petereit said in a prepared statement.

"To address these barriers, we are working closely with the Sioux Nation to develop innovative approaches that will ensure Native Americans have equal access to the best possible care," Petereit said.

The project is outlined in the Nov. 15 issue of the Journal of Clinical Oncology.


Friday, November 12, 2004

Nike Supports Native American Wellness

Nike Supports Native American Wellness

By Jill Glomstad

Approximately 2.5 million Americans—about .9 percent of the population—identify themselves as American Indians or Alaska Natives, according to the 2000 U.S. Census. While there are more than 560 federally recognized tribes, those who claim Native American descent share an unfortunate bond: higher-than-average rates of some chronic health conditions, including diabetes, and lower-than-average life expectancy.

The high incidence of diabetes in the Native American population was what first piqued Nike employee Sam McCracken's interest. According to the American Diabetes Association, diabetes is an epidemic in this group. Native Americans are 2.2 times more likely to have diabetes than non-Hispanic whites.

"I had a general idea that diabetes was very prominent in the Native American community due to some conversations I had had with the health director of my tribe," recalled McCracken, a member of the Ft. Peck tribes (Sioux and Assiniboine tribes). McCracken spoke to his superiors at Nike, and in 2000 the company launched a diabetes prevention program aimed specifically at Native Americans.

Since then, McCracken, now Nike's manager of Native American business at Nike world headquarters in Beaverton, OR, has overseen the development of several initiatives designed to promote health and fitness in the Native American population. In recognition of his contributions, McCracken this year won the company's prestigious Bill Bowerman award, named for Nike's co-founder. McCracken's contributions to the Native American community include work on several programs.

Diabetes Prevention

"One in three members [of this population] has some form of diabetes," McCracken explained. After a few conversations with his own tribe leader, he realized that Nike could lend visibility and recognition as well as Nike products to diabetes initiatives within American Indian communities.

Diabetes program participants can access Nike products at wholesale pricing to facilitate the fitness aspects of their health programs. According to McCracken, the tribal diabetes programs were looking for incentives that would get more people into the programs. In 2002, Nike received an award from the National Congress of American Indians for the program.

"[The program] brings together Nike's business structure and the tribal community structure," he added. "We now work with 72 tribes that have direct access to our product."

Collaboration with the Indian Health Service

In 2003, Nike and the Indian Health Service signed a landmark memorandum of understanding to work together on promoting healthy lifestyles and healthy choices among American Indians and Alaska Natives. McCracken believes the agreement, some seven to eight months in the making, is the first such relationship between the government and a for-profit company.

"[This collaboration] lends our brand to those communities to promote physical activity," said McCracken.

One platform for that promotion was a train-the-trainer event held at Nike's world headquarters, Feb. 11-12. McCracken reported that 85 fitness leaders from Native American reservations in Oregon, Washington and Idaho came to the event to learn new knowledge and strategies to implement fitness and nutritional programs for their communities. Dr. Charles Grim, IHS director, now wants to expand the train-the-trainer program to all 12 regions within the IHS.

Nike will also participate in the IHS's Indian Health Summit in Washington, DC, in September. The summit will coincide with the grand opening of the National Museum of the American Indian in Washington during the same week. "This is very exciting because of the number of people who will be there and be made aware of the health disparities that exist in the Native American community," said McCracken. "This [will be] a big week for our Native people."

Basketball Invitational

2003 marked the first annual Native American Basketball Invitational, with Nike as a major sponsor. The tournament invites boys and girls teams affiliated with Native American tribes across the country. "Basketball is very important to the native community," McCracken explained. "But these kids are mostly from rural areas. How many recruiters are traveling out there to find them? [NABI] put together this tournament to showcase some of the top Native talent in the U.S. for both recruiters and the general audience."

The first tournament, which took place in July 2003, featured 12 boys' teams and 12 girls' teams. In the 2004 tournament, which took place last week, 24 boys' teams and 26 girls' teams participated.


The NikeGO program was launched in 2002 as a nationwide grassroots effort to increase physical activity in children and adolescents. One of the major initiatives of the program is a partnership with the Boys and Girls Clubs of America to supply funding, product and resources for after-school activity programs.

In collaboration with IHS, Nike selected six Boys and Girls Club sites to participate in the NikeGO program. Each site receives a $25,000 product grants, a program evaluation and training in the SPARK curriculum. SPARK (Sports, Play, and Active Recreation for Kids) and Nike developed a program that includes a research-based curriculum, equipment, staff development and follow-up support.

McCracken, who is a board member for Boys & Girls Clubs on Native lands, said Nike plans to expand the program participation from 6 to 25 clubs within the next fiscal year.

Additional Programs

Nike also has collaborated with the Office of Indian Education Programs to create a sales program that enables schools to seek Nike bids and purchase Nike products at wholesale cost, similar to the diabetes prevention program. Nearly 200 Native American schools throughout the country participate.

For 10 years, Nike has sponsored WINGS of America, a program fostering leadership, self-esteem, cultural pride and wellness in American Indian youth through running. Nike provides financial and product support and serves as a sponsor for training programs for running coaches, program workers and athletes.

In conjunction with this support, Nike in November 2002 provided a $50,000 grant to refurbish the running track at Sequoyah High School in Tahlequah, OK. Sequoyah was started by the Cherokee Nation in 1872 as a school for Cherokee orphans of the Civil War. The school is administered by the Office of Indian Education as one of eight off-reservation boarding schools for Native Americans. The school currently serves well over 300 students representing more than 20 tribes from 10 states.

Sequoyah, whose track team won the 2001 WINGS National Championship, has opened the new track for community use and hosts track meets for area feeder schools.

For more information:


The Native American Basketball Invitational:

WINGS of America:

The Indian Health Service:

The National Museum of the Native American:


Jill Glomstad is on staff at ADVANCE. She can be reached at

Tuesday, September 28, 2004

Another article by another paper on wolf death

Drug suspected in wolf’s death
Reaction to recalled heartworm medication linked to 600 dog deaths among possible causes

Staff Writer

A drug linked to the deaths of dogs across the country may have killed a rare red wolf that federal wildlife managers were counting on to help save the endangered species.

One of just a few hundred red wolves in the world, the young adult female died at a Charleston nature preserve last month after the members of the U.S. Fish and Wildlife Service injected it with a heartworm-prevention drug that since has been recalled.

A Clemson University autopsy report released last week did not pinpoint a reason for the death, but the report said the wolf might have died from heat stroke or a reaction to the heartworm medicine, ProHeart6.

The U.S. Food and Drug Administration on Sept. 3 recalled ProHeart6 after receiving more than 5,000 reports of side effects in pets, including bleeding, vomiting and death. The agency’s recall, citing reports of “unexplained” adverse reactions to the drug, urged veterinarians not to use the medicine for dogs until further study is completed.

Fort Dodge Animal Health, which produced the drug, was unable to assess whether ProHeart6 could have killed the wolf, but the company maintains few dogs have bad reactions to the medicine. Wolves and dogs are closely related biologically.

Nonetheless, biologists at the Cape Romain National Wildlife Refuge, where the wolf died, will stop using the drug on wolves, refuge manager Matt Connolly said. Connolly said he was unaware of concerns about ProHeart6 before the wolf received a shot. The wolf died Aug. 25, more than a week before the recall.

“We didn’t find out it had been recalled until after,” Connolly said of ProHeart6.

ProHeart6 prevents heartworm in canines for up to six months. Since receiving federal approval in 2001, it has been touted as an easier way for pet owners to protect their animals from heartworms because only two shots are needed each year, as opposed to monthly medication.

That’s why the Fish and Wildlife Service injected a family of wolves last month in preparation for their release into the wilds of Bull Island at the Cape Romain refuge.

But hours after injecting the wolves with ProHeart6, U.S. Fish and Wildlife Service biologists found the female dead in her pen. That left two pups without a mother and the male without a mate.

Federal biologists had planned to release the wolf family from a temporary holding pen as part of a program to help the species rebound. The remaining wolves have not been released, but federal officials expect they will be.

The federal red wolf program is important, biologists say, because the shy animal is one of the world’s most endangered species, numbering no more than 300. Red wolves are Southern cousins of gray wolves found in the West but are smaller, with a reddish tinge to legs, heads and ears. Red wolves almost became extinct in the early 1900s because of hunting and habitat loss.

For more than 15 years, the government has released mating pairs of red wolves at Bull Island to raise pups in the wild. The program has allowed young wolves to learn survival skills before being transferred to the government’s main red wolf recovery site, a wildlife refuge in northeastern North Carolina.

In recent years, however, the Fish and Wildlife Service had trouble getting wolves to mate at Bull Island, so officials were excited when the young female produced pups this spring.

Clemson’s autopsy report says that while there was not conclusive evidence of the cause of death, a reaction to the drug “cannot be excluded from consideration in this case.” The report goes on to say the “significance of the treatment must be evaluated.”

The report, however, also said heat stroke could have killed the red wolf. The animal struggled and panted heavily after wildlife managers captured it in a pen. After the injection, it lay on the ground for up to 45 minutes before a veterinarian injected it with the stimulant epinephrine to revive the animal. Later in the day, the animal was found dead.

Clemson University animal pathologist Pam Parnell declined to discuss the autopsy she conducted.

Bud Fazio, the wildlife service’s red wolf recovery coordinator, could not say this week how many wolves have been injected with ProHeart6 at zoos andrefuges across the country, or how the agency would proceed in those areas.

Connolly said other red wolves, including the female wolf’s mate and two pups, had been injected at Cape Romain without any adverse reactions. The refuge also has several animals it keeps in captivity.

The FDA had given signals for two years that the medicine posed hazards to some animals, records show. A July 22, 2002, letter from the manufacturer to veterinarians said a new warning label would be added to ProHeart6 about adverse reactions. One concern was cardiac arrest.

Up to 600 dogs treated with ProHeart6 have died, the FDA said last week.

Rami Cobb, a veterinarian with Fort Dodge Animal Health, said she did not know how the drug could have affected a wild animal, such as a red wolf.

“I am no expert on wolves,” she said, “but I am really grieved to hear we have lost any animal, especially an endangered species.”

Reach Fretwell at (803) 771-8537 or


Thursday, September 23, 2004

For Those who wish some links

The Pet Guardian info and Reddy's survivor story - Bulletin Board - Death in dogs after Proheart 6 shots

Fort Dodge to Comply with FDA's Request to Recall Proheart 6 Injectable Heartw

Important Drug Information about ProHeart® 6

CBS4: Could your pet be in danger? An I-Team investigation

CBS 2 Chicago: For Your Pet's Sake

Charleston.Net: News: State/Region: Heartworm drug may have killed endangered

It is a frightening thought, the innocent killing of our brother animals. This battle to keep dogs alive and stop the use of Proheart 6 has been ongoing for a couple of years now, but thanks to all the Ancestors for hearing my prayers, the drug has been pulled for now.

I wrote a letter to Ft. Dodge and to the VLS vet board saying that although they may "no longer conduct studies and tests on animals prior to releasing a new drug, they now seem to be testing when they put it on the market." (on animal or human!)

The FDA site has warnings sent as early as 1999 to Ft Dodge about the contamination of their drug production methods. They sent repeateded warnings.

If this is what Wythe would do with their animal drug production, how careful are they with their production of the human drugs?


Wednesday, September 22, 2004

Heart Worm drug kills Red Wolf

Story last updated at 7:04 a.m. Monday, September 20, 2004

Heartworm drug may have killed endangered red wolf
Associated Press COLUMBIA--A report on the death of federally protected red wolf suggests a heartworm-prevention drug may have led to the adult female's death.The medicine, ProHeart 6, has been recalled by the Food and Drug Administration after reports of negative side effects in treated dogs.The rare red wolf that federal wildlife managers at a Charleston nature preserve were counting on to help save the endangered species had been injected with the drug last month by members of the U.S. Fish and Wildlife Service.The Clemson University autopsy report did not pinpoint a cause of death, but said the wolf might have died from heat stroke or a reaction to the heartworm medicine.Fort Dodge Animal Health, which makes ProHeart 6, was unable to assess whether the drug could have killed the wolf, but the company maintains few dogs have bad reactions to the medicine.Biologists at the Cape Romain National Wildlife Refuge where the wolf died will stop using the drug on wolves, refuge manager Matt Connolly said."We didn't find out it had been recalled until after," Connolly said.


For those of you who may not be aware of all the fighting about the Pro Heart 6 heart worm injection and the fact the FDA has demanded the recall of the drug, I need to share this with the Native community.

On my other site I have mentioned almost losing my Italian Greyhound dog, Reddy, to the Pro Heart 6 injection. His reaction was within 24 hours and almost killed him several times before the drug cleared his system six months later.

After my vet finally called the Ft Dodge/Wyeth company and made an FDA adverse drug reaction report, I became aware of the actual  number of deaths that resulted from the use of this canine drug, and that the FDA had been sending written warnings to the company with reprimands concerning drug contamination during production.

Now it has killed a brother wolf. If you would like more information concerning the investigation of the Pro Heart 6 injection for canines to protect against heart worms let me know and I will post the various sites or send you more information. Thanks.


2004 Indian Festival Omulgee Park

I wanted to share the pictures that I have developed thus far. These are from a Native American Festival that is an annual event at nearby Indian mounds.


Wednesday, August 25, 2004

When Warriors Weep ... a poem

When Warriors Weep

Brave young warrior
where have you gone
Into the hills
to mourn your song

The breaking heart
knows no ache
like that of the warrior
when it breaks

The raging waters
know not how deep
the tears of the warrior
when he weeps

From umber hills
the plaintive yell
the heart of the warrior
breaking all to hell

Come now the spirits
to calm from within
the tears of the warrior
for his lost friend

At end of day
the tears have ebbed
the tear-spent warrior
none left to shed

On morning's light
quietly he comes
to bury the hatred
that was done

He carries the dead
within his heart
warriors weep
when loved ones part

His jaw now set
in stern reprove
when warriors weep
the world is moved

~Marge Tindal~© 2000


Tuesday, August 10, 2004

Back from Cherokee Land



 I am back from vacation, and when I have the pictures developed of the Cherokee Reservation I will try and scan them and share.  


  I was a little saddened by all the commercialism that I saw and the number of outsiders from up north managing many of the stores on Cherokee land.  

The Ballad of Kokopelli


A strange lonely figure stares out of the past
where engraved by an artist in stone
Held firm by the sand in which he is cast,
these last thousand years quite alone.
Could he be listening, trying to hear
moccasins scuffing the butte?
Bringing the people once again near
to hear Kokopelli's sweet flute? His image inscribed on a thousand rock faces
from east to the great western sea;
From Sonora's hot sun to the north glaciers bases,
proclaiming this loved tutelary.
Though powers possessed and methods employed
are often in open dispute;
One thing is agreed, the people did love
to hear Kokopelli's sweet flute. This stick figure man, with a hump on his back
seemed always to cast a good feeling;
His magic perhaps, taken out of his pack
would comfort the sick and do healing.
Whatever his talents, they surely were grand,
a fact no one cares to refute,
As people would come from afar in the land,
to hear Kokopelli's sweet flute. 
   More Kokopelli from the site: The Shaman's Rattle #1


Wednesday, July 21, 2004

To the Reservation

Just to let you know, I am going to Cherokee North Carolina soon to see where the Trail of Tears began in the southern areas. I have heard that there is an outdoor play they do about the Trail of Tears so I am looking forward to it.

I hope to have some pictures to share later.

May your heart soar with joy.


Diabetics Fight Hidden Enemy

Diabetics fight hidden enemy

By Judy Nichols
The Arizona Republic
Dec. 8, 2002

The Pima Indians on the Gila River Reservation south of Phoenix have the highest rates of diabetes in the world.

Nearly 50 percent of all Pima adults are affected by Type II diabetes, the most common form. They die of it at almost seven times the rate of other Americans. And their children are diagnosed at younger and younger ages.

The disease, marked by high blood sugar and insulin resistance, turns a body against itself, destroying it piece by piece, sometimes claiming limbs, eyesight, kidneys.

But researchers are close to unlocking the code to reveal the disease's genetic hiding place. The knowledge could mean new and better drugs or even genetic intervention for the disease ravaging the tribe and growing numbers of people around the world.

Most of what is known about Type II diabetes - how it attacks a body, how it can be treated and, soon, where it lies in the genetic map - is owed to researchers at the National Institutes of Health on the fifth floor of the Phoenix Indian Medical Center and to the Pimas, who have offered themselves for study for the past 40 years.

The guillotine

Surgeons took Richard Wood's first leg with a guillotine amputation, a procedure that sounds medieval but is actually humanitarian in its attempt to save the knee and enough stump for a prosthetic.

Native American health
Slideshow: Pimas fight diabetes
Slideshow: Dealing with accidents

For diabetics like Wood, who is Pima, amputations are always the last resort, and the guillotine is used when the foot or lower leg is badly infected, usually gangrenous, and there is worry the infection may spread and possibly kill the patient.

It is what it sounds like.

"They chop it right off at the ankle," Wood explained.

The foot is severed and the wound left open while the infection is treated. Eventually, the leg is cut to the proper length, the stump sewn shut.

Wood's battle to save his leg had begun in 1996 when he stepped on a cactus spine that went through the sole of his tennis shoe and deep into his foot. He pulled it out, thinking he got it all; but the tiny barb on the end broke off, and the wound began to fester.

Surgeons almost cut off his foot then but were able to take just the middle toe. It was Christmastime and Wood spent it in the hospital.

A year later, again at Christmas, a second infection cost him two more toes. And the third year, it was an infection on the top of his foot. Nothing could be done. That year, at Christmas, they amputated the lower part of his leg.

"I remember thinking, 'Why did it happen to me?' "

A tissue scraping

Up four floors from the operating room at the medical center, Ruben Zepeda, 21, grimaces as Dr. Joy Bunt shoots anesthetic into his healthy left leg.

When it is numb, she uses a scalpel to cut through the skin, the layer of fat and the tough membrane surrounding the muscle. Then she inserts a large needle encased in a metal sheath. As she turns the needle, it scrapes off muscle cells.

Zepeda is Tohono O'odham, closely related to the Pima, from Pisinimo, and everyone is interested in his tissue. He is lean and sensitive to insulin, the opposite of those succumbing to diabetes.

Biochemist Karen Stone takes some for her experiments with insulin conducted down the hall. Barbara Vozarova, a doctor and research fellow from Slovakia who is studying the relationship between diabetes and inflammation, drops some tissue into a small metal bowl dipped in liquid nitrogen.

Clumps of cells freeze into tiny balls and Vozarova places them into vials that will be sent by overnight mail to the Joslin Diabetes Center in Boston. It is this kind of research that shows the risk factors for diabetes, which include being overweight, having a parent with the disease and having high insulin levels in the blood.

Researchers have found that there also is an environmental factor; babies of diabetic mothers have an increased risk that is related to their intrauterine environment. They also have found that kidney complications are increased with high blood pressure.

All these things were learned in Arizona. And they have led to many now-standard treatments: strict management of high blood pressure, better care and control of blood sugar during pregnancy and a new prevention trial program of diet, exercise and medications.

A new diagnosis

Still, the disease moves forward.

Earlier this year, Francis Crosby, 51, felt dizzy when he stood up, so he went to the doctor.

His blood sugar was 234, far higher than the normal 120.

Diagnosis: diabetes.

"It was depressing," said Crosby, of Phoenix, an engineering drafting specialist for the Maricopa County Flood Control District.

But Crosby is controlling his disease through diet and exercise.

"I eat a lot of veggies, and I read all the labels in the grocery store," he said. "It takes a lot longer to shop. And I cycle and walk an hour and a half every other day and half an hour on the off days."

He has lost 20 pounds and reduced his blood sugar to 103.

Looking for arthritis

The National Institutes of Health came to Arizona in the 1960s to see whether arthritis is more common in cold or warm climates, comparing the Pimas with the Blackfeet of Montana.

What researchers found was an epidemic of diabetes.

A formal study in 1965 found the highest rate ever recorded, and researchers began an in-depth analysis of the community. Since then, each tribal member has been given a detailed exam every two years beginning at age 5.

To do its work, the NIH paid for a fifth floor at the Phoenix Indian Medical Center, built in the early 1970s, for its research facility.

More than 100 people, including 30 M.D.s and Ph.D.s, work there, and they conduct clinical investigations and lab-based research in biochemistry and genetics.

Researchers are working on 15 large-scale studies, including one on diabetic kidney disease, one on women who were diabetic during pregnancy and their children, and one on the differences in brain function of overweight people.

They study insulin resistance, how nerves react after meals, and metabolism rates.

Each Friday afternoon, at what they jokingly call the "gray-haired scientist hour," one of the researchers gives a report on his or her latest findings.

"The world owes a great debt to the Pimas for what we have learned through these studies," said Dr. Clifton "Bo" Bogardus III, who heads the facility.

The team is looking toward what may be its most promising finding, one that carries the most hope for improvements: isolating the gene or genes that cause diabetes.

Bogardus' team was the first to locate a span of genes on one chromosome that predict diabetes. The team's work has since been duplicated for several other races: White, Asian and Black.

They also have targeted a span on another chromosome that marks a person for obesity. That, too, has been duplicated in Whites.

They recently met with an international group of scientists from the United States, China, England and France, and are preparing a multimillion-dollar proposal that would pool DNA data from the different groups and look for the specific diabetes gene.

Bogardus said narrowing the span of genes could be done quickly, then the real work would begin to find the actual gene or genes, which could take a couple of years or a decade.

A family connection

Wood learned he was diabetic during his annual firefighter physical in 1988. He was 30 and the third generation to fall victim; his grandparents got diabetes in their 60s, his parents in their 30s.

Wood's father, an athlete who watched what he ate, didn't smoke and didn't drink, had to have dialysis twice a week and eventually died of a heart attack while on the dialysis machine.

Wood likes good times. He likes family reunions, where everyone in his sports-crazy family plays basketball. He likes playing pool and darts. And dancing a country two-step or a fox trot.

He likes to eat. And he has been known to have a few drinks.

But he works hard, too.

When he recovered from his first amputation, he went to work for the U.S. Census Bureau, helping prepare for the 2000 census and later working on cold files, where census workers couldn't get residents to fill out the forms.

"They gave me 70 cases, places where they couldn't get answers," he said.

He was working on his cases on Sept. 11, 2001, when the planes hijacked by terrorists flew into the World Trade Center and the Pentagon. A few days later, he was so depressed that he went with a friend to have a few drinks at a pool hall.

On the way home, he wrecked his truck, scraping his stump.

For several months he doctored it and watched it, thinking it was OK.

And he worked. Sometimes 18 hours a day. Driving, climbing stairs, and walking, walking, walking. He was exhausted, but chalked it up to his caseload.

All the while an infection was festering in the bone of his stump, unknown to Wood, and it was attacking his good leg.

"It looked OK on the outside, but I kept getting sick," he said.

By April, he finally gave in.

"My legs were throbbing, my foot was glowing red. I said, 'Take me to the hospital.'

"I told my surgeon, 'I think I pushed it too far.' They showed me the X-ray, showed me how much tissue had died. I was heartsick."

It would be the guillotine again. And they had to cut off infected bone on his other stump, too.

This time, he would stay in the hospital for three months fighting the infection, three months before they could close up his stump.

"Our upbringing is that we're not supposed to show weakness. But I was depressed, sick; I didn't talk to the nurses."

Memories of injections

Victoria Dawahoya, 35, remembers watching her grandmother inject herself with insulin. And the insulin bottles in the refrigerator.

It seemed everyone in her family had diabetes. Her grandmother. Her grandfather. Her mother. Her father. And her uncles, aunts and cousins.

Her grandmother told her about the big river that used to run through the land the Pimas lived on. She told her how they ate fish and rabbits, and the vegetables and beans they grew. How they were physically active, working on the harvest, dancing, playing sporting games.

She told Dawahoya how the dam had changed everything, taking away the river, the fish, the plants.

And she told Dawahoya to take care, eat well and drink lots of water, because too many of the Pimas were always at the hospital.

"She told us that the size of the chumauth (frybread) we made would be the size our underwear will be," Dawahoya said.

Dramatic change

Dr. Charlton Wilson, associate director of the Phoenix Indian Medical Center, said the increasing level of diabetes over the past 100 years is dramatic, "from a condition that was not apparent to some very bright people . . . to a chronic disease."

"It's a mixture of heredity and environment," Wilson said. "The change from non-existent to widespread is too fast to be only heredity. There has also been a great change in the environment. They have moved from a time with fewer food calories and a more strenuous active daily life to a time of abundance of food calories and a sedentary life."

The appearance of diabetes in young children also has changed the view of the medical community, he said.

"We used to think diabetes was the result of someone not eating right over a long period of time," Wilson said. "We don't lay that same guilt on children. It's not 30 years of not eating right."

Wilson cautions against categorizing blame.

"When you say it's 'just a gene,' it becomes a fault, an error, a mistake." he said. "It becomes a helpless, hopeless issue.

"When you say it's 'just the environment,' you say they should not eat modern food, that they should be hunters, gatherers, go back to their traditional ways, that they've fallen from that which they are supposed to do, that it's a failure.

"Specifically, diabetes is a factor of calories, exercise and insulin sensitivity."

Finding adaptations

Dawahoya developed gestational diabetes with her second pregnancy and had to inject insulin.

"When they told me I was diabetic, all I heard was 'die,' " she said.

She remembers that her son was about the same age she had been when she watched her grandmother give herself injections.

She told him about the Pimas and the dam, but she added her own part of the story: How when she was born there were Golden Arches, that fast food was a way of life for her, supersize portions, bigger cups of soda.

Now she controls her diabetes with diet and a pill that helps her pancreas produce insulin at night.

She has adapted traditional recipes to lessen their fat, like baking frybread. She walks an hour every day. She has lost 20 pounds.

Dawahoya's older brother, Edward "Tony" Allison, 40, found out he was diabetic when he emerged from his alcoholism in 1991.

"After I stopped drinking, I drank a lot of Coke," Allison said. "I wasn't feeling right. I was sleepy, tired, had anxiety."

And his diabetes is now complicated by a second diagnosis of fibromyalgia, a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown.

"I was a runner," Allison said. "Now I get pain from whatever I do." So he meditates, and does tai chi and yoga. When he's up to it, he walks the mall at Arizona Mills.

Allison said the health problems of his tribe are depressing.

"I think about it every day, hearing the life expectancy for men here is 55," he said. "I saw a friend of mine in the mall. . . . He just recently had his toes cut off from diabetes. It seems we're digging our own graves with our teeth."

Standing tall

When Wood first stood on his two new prostheses, he could see the top of the refrigerator, compliments of the man who fitted him for the artificial limbs.

"I was 5-10," Wood said. "I told him to make me 6 feet."

In the morning, when he first puts on his legs, they always hurt a little.

He prefers cowboy boots but wears tennis shoes now because they grip the ground better. He has given up the fancy footwork of the country two-step.

But he still can feel his phantom toes, feel them pushing down as he walks. Sometimes the top of his phantom foot itches, and he has to scratch around on his stump, looking for the corresponding area where a nerve is sending the itch signal to his brain.

Sometimes when he kicks something, he'll instinctively say, "Ouch."

And sometimes when he wakes from dreams where he has legs, he rolls over to get out of bed forgetting they are gone.

Reach the reporter at or (602) 444-8577.

Indians Living in Danger

Indians living in danger

By Judy Nichols
The Arizona Republic
Oct. 13, 2002

For most Americans the leading cause of death is heart disease, then cancer.

For Navajos, it's accidents.

The unintentional injury, or accidental, death rate for Navajos is 138.5 per 100,000 compared with 30.1 for all races.

It's the highest of all Indians.

Chuck Thomas remembers being 8, standing on the side of the road near Gallup, N.M., watching his grandmother walk across.

He saw the drunken driver who hit her. And he was with her at the hospital when she died two hours later.

They had been driving from their home on the Navajo Reservation to celebrate the Fourth of July in Gallup, but hit a cow that had strayed onto the road. Thomas' grandmother was going for help.

"It changed my whole childhood," said Thomas, 29, who earlier this year attended an alcohol treatment program in Gallup. "Every year around July 3rd I visualize the whole thing, every moment of it."

Motor vehicle accidents kill the most. The death rate: 87.2 per 100,000 in the Navajo area compared with 15.9 for all Americans. Almost a third of the Navajo accidents involve pedestrians.

"It impacts greatly on our community," said Nancy Bill, Navajo-area injury prevention specialist for the Indian Health Service. "The deaths are mostly young Navajo males, so it leaves families without a means of income. And most of them could be prevented."

But Native Americans also die in falls: from mesas in northern Arizona, from ice floes in Alaska, from poorly built stairs, from rodeo horses, and even from trips to outhouses at night.

They die of exposure.

And drowning.

And burns, because wood is used to heat homes and for cooking.

"Living a native lifestyle is a high-injury, hazardous situation," said Paul Sherry, chief executive of the Alaska Native Medical Center. "In our area, people travel by snow machines, in boats, in four-wheelers, by small, charter aircraft. All of these have inherently higher rates of injury and death."

"The 'Golden Hour'?" Bill asked, referring to the optimum time to receive needed medical attention. "It doesn't exist. I know people who have waited many hours. Even cellphones don't work in lots of places."

One factor in the carnage is poverty, said Alan Dellapenna, deputy director of the Indian Health Service Office of Environmental Health and Engineering and an expert on accidental deaths.

That means poorly built housing and older, poorly maintained vehicles, or no cars at all, which means people walk along the roads, Dellapenna said. And there are long miles of poorly built, poorly lit, sometimes-unstriped roads.

"You have an odd mix: The tribal roads are less developed, and they convey a high-risk population with low socioeconomic and alcohol problems," Dellapenna said.

Heartbreaking knock

For Robertson Preston of Bylas, on the San Carlos Apache Reservation, the knock on the door came one June evening just as he was about to go to bed.

"I had one boot off," Preston said. The police said they needed him, something about someone with his last name.

He and his wife, Veronica, drove about six miles to where the police cars were stopped.

Officers asked if he knew someone named Henson Preston.

"I said, 'Yes, that's my boy,' " Preston said, patting his chest over his heart. "They said, 'There's a body over there. Can you see if you can identify it?'

"They pulled back the sheet, and there he was."

Preston, who was recovering from heart surgery, collapsed on the side of the road. His wife crumbled, too.

Henson, 23, had been coming back from Phoenix, about 120 miles, from the hospital where he had been holding vigil for a sick baby in the family. Witnesses said Henson's white pickup truck ran off the road and flipped. Maybe he fell asleep. No one knows.

Now, twice a year, on Memorial Day and on Henson's birthday, the family tends the small white cross draped with blue flowers and crepe paper on the side of the road where he died.

The death robbed Robertson Preston, a medicine man, of a son and of one of his Crown Dancers, who perform in the most sacred Apache ceremonies.

In April, Preston performed the Sunrise Dance for his granddaughter, a dance for a girl coming into womanhood, a dance Henson had been urging his father to do soon.

"About halfway, I almost ran out of voice," Preston said. "That's when Henson would keep me going."

Dangerous roads

Federal money for improvements usually is targeted for the most dangerous roads, Dellapenna said. But tribes, which are sovereign and have their own police forces, often don't report fatalities to the state, so the roads don't get on the priority list. And Native Americans rarely are represented on regional and state transportation boards that decide where to spend money.

Dellapenna points to Arizona 86, which crosses the Tohono O'odham Reservation heading from Tucson to Sells.

"It's like driving back in time," Dellapenna said. "Before you get to the reservation, the road has wide lanes and a median. When you get onto the reservation, it's basically the paved old stagecoach line. It's never been upgraded from the '50s."

Nearly every mile, there's a white cross signifying a death, Dellapenna said.

The roads on the Navajo Reservation are no better.

"They're two-lane with narrow or no shoulders," Bill said. "It increases the number of head-on collisions. And there's no safe place to walk. A lot of the pedestrians killed are children."

Tribes are trying to stem the losses. They have put up fences to keep horses and cows off the road.

The Navajo Nation passed a seat belt law in 1988, even before Arizona did, and has instituted an internationally recognized program promoting child safety seats.

The death rates are half what they were 30 years ago. Still, the toll is high. Bill said one safety project focused on a four-mile stretch of U.S. 666, near Gallup. Some call it the Devil's Highway, in part because of the number and in part because of the death toll: eight people in one year.

In 1994, streetlights were installed, making it easier to see pedestrians. The death toll in following years: zero.

But it cost about $1 million a mile to install the lights, prohibitively expensive for the hundreds of miles of roads on the reservation.

Alcohol is another factor in the deaths, Bill said. Because liquor is not sold on the reservations, people walk or drive to border towns to drink, and some are killed returning home. Bootlegging also is a problem, she said.

And the situation is complicated by too few police to cover 25,000 square miles.

"There is a lax attitude about drinking and driving," Bill said. "I have seen people drinking and driving at all times of the day."

Hard lesson

Freddie Hale and his friends were partying hard on a Thursday night last April, driving a convertible down the back roads between Window Rock and Fort Defiance.

It was payday. They'd been drinking beer and a concoction of 7-Up, whiskey and peppermint schnapps they call Hop 'n' Schnapps.

"I was standing up in the back seat," Hale said. "I figure we were going about 100.

"The driver held his hands up and said, 'Watch me.' I think we gave him too much of that Hop 'n' Schnapps. We started sliding and the wheels caught. I remember flying through the air and hitting the ground hard."

Hale landed on his head. His brain started bleeding.

One of Hale's friends found his mother playing bingo at the tribal offices and told her about the accident.

"I ran out to the hospital," April Hale said. "It's right across from the hall. He was on a respirator and there was a big cut on his head. I thought we were going to lose him.

"I said, 'God, don't take my son yet,' and I held his hand."

Freddie Hale was flown to St. Joseph's Hospital and Medical Center in Phoenix. He was in a coma for more than a month. Then he began to come around.

Keeping faith

For weeks, Hale stayed at Barrow Neurological Institute in Phoenix, getting therapy, learning to walk again, brush his teeth, eat with a spoon.

Therapy included shooting hoops. Hale, who was on his high school's championship basketball team, can sink a lot.

But he spends most of his time in a wheelchair, and it's unlikely he'll regain enough balance to return to his job as a plasterer for La Plata Stucco, where he stood on scaffolding to stucco buildings.

Hale, his mother and teenage sister, live in a hogan with no electricity and no running water. They have three horses, 15 cows and 30 sheep. Hale was the only one with a job.

"We're behind on things, bills," April said. "It hurts the family. There's not enough to eat, (or to) buy supplies. We have car problems, and it takes a long time to buy parts, putting them on layaway."

The Hales can reel off a long list of friends and relatives who have been involved in car accidents: an aunt whose hip was broken when she was run off the road, a friend who can't walk after a head-on collision with a diesel truck.

Bill said disabilities, such as head injuries, are expensive for the tribe, and often force tribal members off the reservation to Phoenix for better services. Freddie hopes to return to school to learn about computers.

"I have faith in God," April said, relating a premonition her pastor had. "My pastor said he saw Freddie getting out of the wheelchair and coming to church."

Reach the reporter at or (602) 444-8577.

Friday, July 9, 2004

Part 2: Doctors find a way to bridge the cultural gap

Doctors find a way to bridge cultural gap

By Judy Nichols
The Arizona Republic
July 21, 2002

TUCSON - Albert Bighorse is lying on the operating table, his eyes taped shut, a machine breathing for him, another circulating his blood. His chest has been cut open. Inside, his heart lies gray and motionless.

Dr. Jack Copeland's gloved hands are in the chest cavity, gently positioning a vein from Bighorse's leg. The vein, speckled with black where tiny offshoots have been cauterized, will serve as a new route for blood, bypassing blocked veins.

The remarkable meeting of these two men, one a traditional Navajo rancher and medicine man from one of the most isolated parts of the United States, the other an internationally renowned heart surgeon, is the result of the Native American Cardiology Program, a partnership of government, university and private sources.

The program is the lifework of Dr. James Galloway, who saw the explosion of heart disease in Native Americans and found a creative way to help.

Galloway joined the Indian Health Service in the early 1980s as an internist working with the Hopi and White Mountain Apache tribes. For decades, he and others had been told that Native Americans were immune from heart disease, and even into the 1970s the incidence was low. But in the '80s, Galloway saw the beginnings of an epidemic fueled by diabetes, obesity and high blood pressure.

Although heart disease was declining in other populations through diet, exercise and aggressive treatment of high cholesterol and high blood pressure, it was on the rise in Native American populations, only recently exposed to fast foods, high-sugar sodas and sedentary lifestyles.

Some heart disease was hard to detect because diabetes, another epidemic among Native Americans, affects the nervous system, masking the pain normally caused by heart problems.

The Indian Health Service wasn't ready for the onslaught.

"When they started seeing heart disease, they referred it to the private sector," Galloway said. "But there were deficiencies."

It was expensive. Sometimes unnecessary tests and treatments were ordered. There was no continuity of care. If a patient was sent to Phoenix for care, the doctor back home often didn't know what had been done.

"Sometimes we didn't even know if someone had a pacemaker put in," Galloway said. "There would be no discharge summaries, and if the patient spoke only Navajo, they often didn't know exactly what had been done because there was no interpreter. There was no long-term vision, no cultural sensitivity, no prevention activities."

So Galloway decided to change things.

Solution in partnership

Galloway went back to school, to the University of Arizona, to specialize in cardiology.

As he was finishing his studies, he proposed a partnership among the Indian Health Service and the University of Arizona Medical Center, a teaching hospital, and its non-profit Sarver Heart Center.

The result is the Native American Cardiology Program, housed at the Medical Center since 1992. Today, it has four cardiologists, two nurse practitioners, two nurses, two translators and one traditional healer. It has a budget of about $1.5 million, about half of which comes through the Indian Health Service. The rest is paid by the other partners. The program serves nearly 500,000 Native Americans at the center in Tucson and through "house calls" to 38 hospitals and clinics in Arizona, Nevada, Utah, New Mexico and California.

Galloway is setting up a second site for the program at the Flagstaff Medical Center to better serve patients in the northern part of the state.

The team in Tucson performs more than 200 bypasses a year and thousands of cardiac catheterizations, echocardiograms and stress tests. Doctors have done eight heart transplants. The program charges private insurance or Medicare or Medicaid, when applicable.

Long journey

For Bighorse, the journey began in Cameron, about 40 miles north of Flagstaff on the Navajo Reservation, where he has cattle and horses. Bighorse, who has been a dancer in Navajo healing ceremonies, began suffering shortness of breath, coughing and fatigue. Traditional ways no longer were helping him, he said.

Doctors in Tuba City referred him to the cardiology program in Tucson, where he underwent a cardiac catheterization, in which dye is injected into the veins of the heart. It revealed blockages.

Bighorse speaks only Navajo, and Phyllis Sanderson, the program's translator, helped him understand what was going on.

"Navajos have hand tremblers and crystal gazers," Sanderson said. "I tell them the White doctors use different things for diagnosis. The EKG is like a hand trembler, the large crystal is a catheterization and the small crystal is the echocardiogram. Then they understand that nothing will be done until the doctors decide what's wrong."

She tells them the treatments are like the ceremonies and prayers, actions taken to heal.

The translations are crucial, said Dr. Eric Brody, a cardiologist with the program.

"In other places, sometimes patients don't get procedures because they don't understand what's going on and don't give their consent," Brody said. "When they have someone like Phyllis explain things to them, there is no resistance to care or recommendations."

Bighorse said he wants to get better to teach his sons and grandsons and other boys from his community how to handle livestock.

"I'd like to take care of my sheep," he said. "My wife has been doing that. There are horses and cattle that need to be rounded up, branded and castrated. I want to be useful around the house. Right now, I can't walk far or carry a bucket of water or chop wood."

Carol Locust, the traditional healer, walks with Bighorse to the first floor, where nurses wait to prepare him for surgery. Locust says prayers in her native Cherokee language, and uses items recognized by many tribes like eagle feathers, cedar and tobacco to give a blessing before surgery.

Earlier, Copeland, known for using the first artificial heart to keep a patient alive until transplant, reviewed films of Bighorse's heart. In a small notebook, Copeland draws the heart and its spidery vessels, marking blockages with tiny Xs to help him remember which portions to bypass.

Soon, Bighorse is on the table, his heart slowed by cold, saline water, then stopped altogether, the blood routed to the machine.

Heart failure

Edward Setalla, 60, a Hopi from Keams Canyon on the Hopi Reservation in the northeastern corner of Arizona, had the same surgery in 2000. He'd had a cardiac arrest two decades earlier while working as a painter. Earlier this month he was back with a potassium overdose and fatigue.

Setalla said he didn't know how serious his heart problem was when he went to see Galloway in Flagstaff two years ago.

"He had me walk on the treadmill for five minutes," Setalla said. "Then he said, 'You flunked.' He had me lie down on the bed. My wife came in and asked if we could go get breakfast. Dr. Galloway said, 'That's as far as he's going.' "

Setalla's grandfather was a Hopi medicine man, and Setalla said he learned the Hopi religious ways and dances, but gave it up seven years ago when he became a Christian.

"I put my faith in God," he said.

Tsosie Bedoni, 73, of Chinle near Canyon de Chelly on the Navajo Reservation, had a valve replacement and a pacemaker installed.

"I was digging postholes with a pitchfork, and I couldn't finish," Bedoni said. "They cut a big incision in my chest and put a device on my left shoulder."

Despite being told to take it easy, he was back on his horse in two days, said his niece, Ella Singer.

Bedoni sheepishly admits the transgression, but said he "misunderstood."

A mother, daughter

Sanderson said she sometimes has influence because of her relationship to patients through the Navajo clan system.

Bedoni's father is Bitter Water Clan, the same as Sanderson's mother. So others from that clan are parents to him.

"To him I am like a mother," Sanderson says. "He listens to what I say."

Bighorse also is related to Sanderson through the Towering House Clan, the same as Sanderson's father. So, to him she is like a daughter.

The night before his surgery, he didn't want to sleep in a hotel.

"It was overwhelming to him," Sanderson said. "He couldn't register. He didn't know how to order meals, or request the shuttle in the morning. He said, 'Why don't you let me sleep in your sheepskin, daughter. I'm sure you have a corner you're not using.' "

Sanderson took him home, fed him. He told her he slept better than he had in weeks.

Strong, steady beat

In the operating room, at 6:05 p.m., Copeland has finished attaching the vein and has taken off the last clamp. Blood begins to flow through Bighorse's heart again.

Bathed in warm saline, it begins to beat, slowly and somewhat erratically at first, then a strong, steady beat.

Soon Bighorse will return home.

Galloway and Brody both say that, as tribes stress nutrition and exercise, and as doctors aggressively treat high cholesterol and high blood pressure, they expect to see great improvements and lower death rates.

Earlier this month, Galloway was on the Navajo Reservation, at the hospital in Chinle, where he examined Thomas Tsosie, 56, an electrician having trouble breathing, and swelling in his legs. Sometimes Tsosie's heart races and he wakes up sweating. An echocardiogram shows Tsosie's heart is pumping out only about 10 percent of the blood it collects, compared with about 60 percent in a healthy person. Galloway is worried about blockages in the veins, which can make the muscle weak, and tells Tsosie he should come to Tucson for a cardiac catheterization.

But Tsosie has used up all his sick leave and wonders if he can wait until he gets more in January.

"If you were my brother, I would have you go next week, not January" Galloway tells Tsosie.

"How bad is my heart?" Tsosie asks quietly, his head bowed.

"It is serious," Galloway says, his hand on Tsosie's back. "But there are things we can do."

Reach the reporter atjudy.nichols@arizonarepublic.comor (602) 444-8577.

Indian Health Care...separate/unequal

Indian health care: Separate, unequal

Federal care spending low, death rates high for tribes

By Judy Nichols
The Arizona Republic
April 14, 2002

Native Americans are dying at shocking rates. Of alcoholism, tuberculosis and diabetes. From accidents, suicide and homicide. At rates up to seven times higher than other Americans.

In Arizona, the average age at death for Whites is 72, compared with 55 for Native Americans. That's younger than for residents of Bangladesh.

The federal government, which promised in treaties to provide health care for Native Americans, spends less than half as much per tribal member as it does for programs covering other Americans. Private health plans spend more than twice as much per person.

"If this were happening in any other part of America, there would be Senate hearings, commissions," said Sergio Maldonado Sr., an Arapaho who is a program coordinator in the American Indian Studies program at Arizona State University.

They would be asking, 'Why are these people dying? Is it the water? The air? Anthrax? But because it's Arapaho, Sioux, the border towns around reservations, no one blinks an eye."

Maldonado said the lack of health care and differences in life span are a sign of continuing discrimination.

The leading causes of death for Native Americans are heart disease and cancer, the same as for other populations. But while those rates are closer to the norm, they are increasing as other populations are seeing improvements.

Native Americans die in accidents at more than three times the rate of other Americans, a fact so discouraging that federal officials say facetiously they wish for more disease.

"We'd love to have higher cancer rates," said Alan Dellapenna, deputy director of the Indian Health Service Office of Environmental Health and Engineering in Rockville, Md. "That would mean young people were living long enough to develop those kinds of diseases."

Promise made

In the early 1800s, the push for westward expansion resulted in war between the United States and many Native American tribes. Treaties, which stripped Native Americans of more than 400 million acres of ancestral lands, promised health care, as well as peace.

"When people say, 'You get free health care,' I say, 'Bear sweat,' " Maldonado said. "There's no 'Free.' Blood was spilled."

Today, the Indian Health Service, part of the U.S. Department of Health and Human Services, provides care for about 1.5 million Native Americans, living on or near reservations, some of the most remote and impoverished parts of the country.

But it has never been fully funded.

This year's budget is $3.2 billion. But according to a study conducted by a group of tribal and Indian health leaders, more than $7 billion annually would be needed to provide care similar to that other Americans receive. And $15 billion would be needed to add and improve facilities to make the system equal.

The Indian Health Service spends about $1,920 per person annually. That compares with more than $4,390 that private insurance budgets for most Americans' health plans, or the federal government's $3,859 for Medicaid, $5,600 for Medicare and more than $5,700 that veterans receive.

"Health care for Native people has never been a high priority nationally," said U.S. Sen. Ben Nighthorse Campbell, R-Colo., a Cheyenne chief and the only Native American in the Senate.

Campbell, a member of the Senate Committee on Indian Affairs, said most Americans feel a moral debt of gratitude to veterans, but do not understand the "unique legal, moral and historic relationship with Indian tribes."

Funding also has suffered because of the evolving misconception of the "rich Indian," the mistaken belief that Native Americans were raking in money first from land and oil, and now, from casinos, Campbell said.

"These headline-grabbing myths lead policymakers to conclude that most Native Americans do not need federal assistance for health care," Campbell said. "Of course, the opposite is true. The vast majority of Native Americans remain mired in poor economic conditions and continue to suffer from significant health problems."

Sen. Tom Daschle, D-S.D., whose state has some of the highest death rates for Native Americans, is so concerned that he plans to request an additional $4.4 billion for the Indian Health Service this year.

"While Congress debates how to allocate trillions of dollars, medical treatment for American Indians and Alaska Natives is being rationed," said Daschle, who called the situation inexcusable.

Dr. Craig Vanderwagen, chief medical officer for the health service, acknowledges that the system is seriously flawed.

"We don't feel good about the number of patients who need care who are rejected because their problem is not life-threatening," said Vanderwagen, based in Rockville, Md. "It's rationing. We hold them off until they're sick enough to meet our criteria. That's not a good way to practice medicine. It's not the way providers like to practice. And if I were an Indian tribal leader, I'd be frustrated."

But there is little or no support from others in Congress, said Dr. Stephen Kunitz, a professor of community and preventive medicine at the University of Rochester School of Medicine who worked for IHS and has studied it for many years.

"Virtually no one has an interest in funding it except the Indians themselves," Kunitz said.

The bulge was small at first. Just a bump, really. Sticking out near Felipe Robles' backbone. But it grew. It grew until it was the size of his fist. Until he had to struggle to get out of bed. Until he couldn't stand without his carved rattlesnake-head cane.

At first, doctors thought it was cancer. They were wrong.

The disease lodged in his spine, gnawing away at his vertebra, was something you expect to see in someone's lungs: tuberculosis.

The rate of TB in Native Americans is more than five times greater than for other Americans.

"I got it three years ago, when I was in jail," said Robles, 46, a Pima. "I was stuck in a cell for three days with a guy who was coughing a lot. I finally asked him what was wrong and he told me he had TB. I called the guards and they pulled me out of there, but I guess it was too late."

When the lump appeared, Robles went to a clinic in Guadalupe, but was turned away because he had no insurance. Eventually, he ended up at the Phoenix Indian Medical Center, where his name is on a growing list of patients who are closely monitored, watched each time they take their medication, for one year. Any less, and the TB might not die, might spread to someone else.

Robles can't work any more and may need surgery to stabilize his spine.

"I'm scared," Robles said. 'I'm afraid a slight move in the wrong direction and I'll be paralyzed from the waist down."

For now, he spends his days reading the Bible at the Phoenix halfway house where he lives.

"I'm not proud of my past," said Robles, who has been in prison for drug charges. "But I'm born-again now. I'm trying to do the right thing."

The first health care for Native Americans, provided by the U.S. Army, was designed to protect Whites from uncontrolled epidemics of smallpox, measles, diphtheria and malaria. The diseases, brought by Whites, devastated the Native populations, which never had been exposed, and threatened to boomerang into the ranks of the military and the settlers.

Eventually, health care was taken over by the Bureau of Indian Affairs, then moved to the U.S. Department of Health, Education and Welfare, now Health and Human Services.

Model of efficiency

The blueprint for the Indian Health Service is seen as a model of efficiency, studied by countries around the world. It offers cradle-to-grave care and one-stop shopping at its hospitals, where medical, dental, podiatry, psychiatry, optometry and even pharmacy services are available. And its public health arm builds water and sewer systems on far-flung reservations.

Through efforts to reduce infectious disease, increase immunizations and improve water system, the service greatly upgraded Native American health in the 1950s and '60s, significantly reducing infant mortality rates and deaths from gastrointestinal diseases.

The system has been less successful dealing with behavioral health problems like alcoholism, drug abuse and obesity.

Native Americans have the worst diabetes rates in the world, nearly four times greater than other Americans, and the worst alcoholism rates in the country, more than seven times greater.

"When you're dealing with these conditions - consuming food, alcohol, tobacco - you're dealing with people's beliefs, values and behaviors," said Kunitz,of the University of Rochester. "It's very hard for the health system to address these as effectively as they could address the contaminated water supply."

Some Native Americans say they must do more for themselves, eat right, exercise more, restore balance, all teachings of their elders.

"We have a moral imperative to take care of ourselves," said Maldonado, of ASU. "We can't point all the fingers at the Indian Health Service."

Inequalities exist in the system, sometimes for logical reasons, sometimes because of politics. For example, in Alaska, where it costs more to deliver care to remote Native villages accessible only by plane, IHS spends more than $6,080 per person annually for health care. But in the Kayenta area of the Navajo Nation, it spends only $766 per person.

The limited funding, isolated locations and lack of support staff all make it difficult to recruit and retain doctors, nurses, dentists, pharmacists and other health professionals.

Many in the system call the pay abysmal, offering examples like ophthalmologists, who make $100,000 at IHS, but can make twice that in private practice. And there are high vacancy rates - 17 percent for nurses at Phoenix Indian Medical Center.

"The people who are here are not here for the money," said Dr. Ken Steward, head of the Emergency Department at the Gallup Indian Medical Center. "They're hardworking, conscientious. Money is a secondary consideration."

The tight budget also forces the system to focus on primary care. Patients needing specialists, for things like heart operations, hand surgery and neurology, must be referred to doctors and hospitals in the private sector. The service has limited funds for this "contract" care, however, and the money runs out each year.

So the service often guarantees payment only for people who may die. Others must pay for the care themselves, or qualify for Medicare, Medicaid or other private insurance.

Lita Piffero quit worrying about her dignity long ago.

"I was down there at the clinic crying, literally begging for help," said Piffero, 48, who lives in Southern Bands, near Elko, Nev.

When Piffero's 14-year-old daughter hurt her foot in gym class in November, Piffero took her to the Indian Health Service clinic near Elko because there are no IHS hospitals in Nevada.

An X-ray revealed a deformity of the bone, Piffero said, and the doctor recommended magnetic resonance imaging, possibly surgery, services not available through the Indian Health Service. Piffero was told her daughter was being referred out, but that the service wouldn't pay for it. Piffero, who is unemployed, was told to apply for Medicaid.

"Medicaid took the full 45 days to decide," Piffero said. "We had to wait."

Her daughter limped through school on crutches.

When Piffero finally was approved for Medicaid, Piffero said the private doctor refused to do the MRI, saying he would lose money on a Medicaid patient. He referred them to Elko Hospital. Piffero said they still are waiting for an appointment. "I worry about what else they won't do because it's Medicaid," said Piffero, crying.

"She's only 14. She doesn't deserve to be treated any less than anyone else. This is her foot. I don't want her to be deformed.

"It just seems like unless you're on your deathbed, you can't go for services."

Her legs, which peek out from her traditional three-tiered calico skirt, are wrapped in cotton stockings, but they're still cold. She has high blood pressure and thyroid problems, but otherwise Nettie Yazzie, 92, who lives on the Navajo reservation, is remarkably healthy.

She gets B-12 shots from a public health nurse who visits her home, and occasionally sees a doctor for a check-up. But she attributes her longevity to eating lots of corn, the symbol of life for many Native Americans, and childhood visits to medicine men who taught her to make medicinal teas from herbs.

In fact, Native civilizations had extensive knowledge of diseases and medicines, knowledge that has contributed to Western medicine. And many still use a combination of Native and Western medicine.

As part of a move toward self-determination, many tribes are taking over their own health care, running their hospitals and clinics and deciding how to spend federal dollars.

More than 40 percent of the system now is run by tribes or the non-profit groups they have hired. In February, the Navajo Nation rejected a takeover of its $500 million system, but is considering running the programs in three small communities.

"IHS is going to continue to exist," the University of Rochester's Kunitz said. "What is unclear is whether it will increasingly be a pass-through program or continue to be a provider of services."

Either way, more money is needed.

Although the Native American population served by the Indian Health Service is growing by about 2 percent each year, and medical costs are rising at about 10 to 12 percent a year, the agency's budget has remained nearly flat, which means services fall farther and farther behind.

"If Congress in its wisdom, or malevolence, or thoughtlessness holds funding constant or at a 1 to 2 percent increase, things will get worse," Kunitz said.

Reach the reporter at mailto:judy.nichols@arizonarepublic.comor (602) 444-8577.


Wednesday, June 2, 2004


I wish to comment on the article presented here by adding what I personally believe and have been taught.

The article does teach many good and true aspects of Shamanism, however, following the ways of Shamanism and being a Shaman are not the same.

Shamans are spiritual beings in human form with the power to heal, work with Earth energies and 'see' visions, among many other things.  One does not "up and decide" to become a Shaman by learning the ways of the earth energies, healing, herbology, taking vision quests, staying a "real" native sweat lodge, or any other aspect of the Native culture. 

Being a Shaman is not in the study of natural healing and wholeness, nor in it's "practice."  I have clarified on this site when it was started that the New Age practices and others belief systems, such as Wicca, are NOT the Natvie American belief system, which has existed longer than there are records of man on the earth.
  It is a spiritual heritage that is passed through bloodlines and taught from the ancients and the elders to those who are chosen and are younger. It is, to me, what maintains all of earth's balance in the physial world that we see and know with our five senses.

The power of the Shaman is not in a book with formulas and rituals that can be read and memorized and performed repeatedly so that after a few years one can "become" a shaman.
  Learning to follow the ways of Shamanism brings wisdom and healing to any who will study and learn. I do include this article to help us all learn more, but there are times we have to read things and sort through them for the balanced truth. Thanks.                                                                                                                       CheyFire



How Does The Shaman Heal?

 By Susan Keiraleyn, Ph.D.

The spiritual healing methods of shamanism are now receiving increased and significant attention in our culture as a result of the widespread search by many for effective, efficient, and non-invasive assistance in healing and personal growth. Because shamanic healing affects the energy field of a person, it may be appropriate in a wide variety of circumstances and can be used for problems throughout the lifespan - even during and after death.

To better understand how the shaman heals it is important to understand some of the fundamental concepts of what shamanism is. Some people mistakenly believe that shamanism is a religion. In fact, however, it is not a religion but a specific set of methodologies for accessing the spirit or energy field of anything or anyone. The shaman heals by working in unseen/inner/spiritual reality to create changes there, which in turn create changes in seen/physical/ everyday reality.

The essential perspective of the practicing shaman is this:

1. Everything is alive. Everything has spirit and awareness.

2. Energy and matter are the same. Everything is vibration. Everything that exists is an energy system within a greater energy system.

3. Everything that exists is connected to everything else in a web of energy or life.

4. Unseen/inner/spiritual reality affects visible reality.

Working within this system of perceptions. the shaman strives to create balance or harmony or free flow of energy or spirit. This work typically focuses on the individual human, but traditionally also often was applied to social groups such as an entire tribe. The same kind of healing energy work can be applied to anything that exists - animals, plants, geographical locations - even to ideas.

What distinguishes a shaman from other types of healers are her/his methods. The central technique used by the shaman is what has been called "soul flight" or journeying." To journey, the shaman enters a particular kind of trance state sometimes called the "shamanic state of consciousness" or SSC. Entry into the SSC can be accomplished in a variety of ways; drumming is one very widely used induction method.

While in the SSC, the shaman sends out part of his/her consciousness/ spirit/energy to obtain information or do work in the realm of spirit or energy. The information obtained by the shaman's journeying consciousness may come from a variety of sources, including communication with nonhuman beings and the shaman's own visions or "second sight." This information is retrieved and used for insight and healing.

The work the shaman may do while in the SSC has to do with directly affecting the presence or flow of energy in one or more energy systems. For example, a shaman might help a person heal a broken bone by opening up increased energy flow to the affected area; a shaman might help a person heal from emotional depression by restoring emotional energy lost as a result of a traumatic event.

In summary, the practice of shamanism involves making conscious connection with that which is spirit or life - that which is sacred - in all things. Healing can be accomplished through this connection by working directly to create greater balance and harmony of energy or spirit, and by bringing back to the "ordinary" world transformative awareness from sacred space and time.

To do healing work of any kind, a shaman typically will first make a journey to learn (through "seeing" or through communicating with helping spirits) the spiritual cause of a given problem. A particular problem in everyday life (such as depression) might have very different spiritual causes in different people. In other words, illness that looks exactly the same symptomatically in two different people might be the manifestation of very different underlying situations. In one person, for example, depression and fatigue might be caused by spiritual injury to the heart; in another person, identical symptoms might be caused by habitual thought patterns of intense rumination and worry.

The shaman seeks to address the underlying spiritual cause that creates observable symptoms. Therefore, treatment of identical symptoms might be very different in two different people, depending on the spiritual cause. This concept is similar to ideas of traditional Chinese medicine, in which it is understood that "anything can come from anything."

Once the shaman gains an understanding of the spiritual cause of a given problem, she/he may use a variety of healing modalities to resolve it. Although there are a number of specific techniques employed, they generally fall into three broad categories:

1. Taking things out of the energy field that don't belong there.

2. Restoring lost energy or power to the field.

3. Altering the balance or flow of energy within the field.

In all of these methods, the shaman is a mediator between physical and non-physical reality, between the seen and the unseen.

We will consider each of these categories in greater detail in Part 2 of this article.Susan Keiraleyn, Ph.D., is a counselor and shamanic healer in private practice in Portland. She is a former research faculty member at Oregon Health Sciences University, and has taught, guided and done clinical research on shamanic journeying techniques and related processes since 1978.