What COVID did in my family was try to separate us, even in the household that
we live in.
The coronavirus pandemic has disproportionately impacted American
Indians and Alaska Natives.
One in 390 indigenous persons in this country has died from COVID-19. And I
mean, that's just an incredible number. A 747 airplane seats about 400 people,
so it's kind of like every time you load that plane, one person dies out of that
crowd.
One of the reasons indigenous Americans were hit so hard by the pandemic is
because their communities lacked basic resources to take preventative measures.
We have communities that don't even have running water, when the CDC put up the
recommendations that said you needed to wash your hands for 20 seconds in warm
water. My question to them was, where are we supposed to get this warm water
from in places where there has been no infrastructure built to bring water to
our communities?
My youngest was breastfeeding at the time, and my fear was touching her
touching my mask, reaching out wondering what was going on. Why Why was I so
sick? Why couldn't I play with her? Why couldn't I get up and take care of her.
It was very difficult
Tribal nations and the US government negotiated treaties as a result of the
atrocities the government inflicted on Native people. Part of the treaty rights
included federally funded health care for American Indians and Alaskan
Natives. But according to experts and indigenous leaders, the government has
never fully funded the programs leading to a lack of resources and inadequate
care. Here's how federally funded health care for American Indians and Alaska
Natives works in the US and what reforms tribal communities want to see.
The United States government has a horrific history when it comes to
American Indians throughout US history. The government forced indigenous people
from their land and stripped them of resources and rights.
As a result of that our treaties say that we have a right to health care
provided by the federal government. This is meant to be quality health care
provided to enrolled members of federally recognized tribes to health
care free of charge, in that we already paid for it with the land that the
United States has on
The Indian Health Service or IHS was established in the mid 1950s as the
fulfillment of those treaty rights.
IHS provides funding and services for basic clinical care for American Indians
and Alaska Natives. There are three different models that I just facilities
may fall under direct service, compacting and contracting. Direct
service is where the Indian Health Service operates a facility as a
government run system, tribes have no control and how the program is run.
Compacting, on the other hand, is when the federal government provides tribal
nations with the money to run their own programs. It is completely under tribal
control.
Contracting is a combination between the two models where federally recognized
tribes will work with the IHS to plan, conduct and administer programs that the
IHS would otherwise provide. With contracting IHS provides more oversight
of the programs or facilities than a compacting model and must approve
substantial changes to any contract between the IHS and the tribe. A tribe
is allowed to combine these three models to best meet the needs of its community.
There are also urban Indian health programs that serve indigenous Americans
living in cities. These programs are supported by IHS but are given a minimal
amount of money. Most supplement their funding through federal, state, local
and private sources.
These programs are key they provide what is generally the only culturally attuned
medical care, resources and services to urban dwelling American Indians and
Alaska Natives.
According to a 2018 report from the independent and bipartisan Commission on
Civil Rights, the US government has not adequately funded federal programs for
Native Americans. The Commission found that in 2016, IHS received less funding
per person enrolled in the program than Medicare, Medicaid and Veteran Affairs.
In 2016, IHS healthcare expenditures per person were around $2,800 compared to
approximately $10,000 per person for federal health care spending nationwide.
As a result of the chronic underfunding of the Indian Health Service. These
facilities very often are not be able to provide more than primary medical care
if we don't get the resources that we need. It's always going to be a struggle
for us to begin to address the underlying health conditions that were
built as a result of the colonial oppression and suppression of both our
health and our economic prosperity within Indian Country. So until we see
full funding of the Indian Health Service, we're always going to be
struggling to do more than just provide the immediate needs of our people.
The Indian Health Service did not respond to CNBC's request for comment.
My name is Sarah Stronghorse Sanderson. I'm an enrolled member of the Esselen
Tribe of Monterey County. I work at the Seattle Indian Health Board as a patient
care coordinator today. Indian Health Board is a federally qualified health
center we provide care around an indigenous knowledge and informed system
of care. Everything surrounded with traditional medicine.
While it does receive some funding from IHS, the Health Board is independently
run,
We advocate for ourselves, we go out there and we get grants, we use our data
to prove what we need.
In addition to being an employee, Sarah also received care from the Seattle
Indian Health Board when she came down with COVID and April 2020.
The care that we received at the Seattle Indian Health Board, it was holistic it
was it was fulfilling it. It made me feel valued and cared for I was in my
home. I wasn't in the clinic. And yet, I still was monitored, I was still treated
with care. My provider called me on my phone to see how I was doing. The
clinical team made sure that I had O2 sat monitors to make sure that none of
us were in dire need of critical medical attention. And because of those things
and that care, we found out that there was a point where we did need that.
Sarah said when her family called an ambulance to take her and her partner to
the hospital, the EMTs refused to transport them.
We took ourselves and I was admitted and he was admitted. And even that care, as
careful as the hospitals were with us, with COVID. with being so sick, we
didn't know what was going on. No one was telling us what was what was going
to happen next. If we were going to get better. If we could see each other. I
just will never forget the difference in care that I saw between my clinical care
at Seattle Indian Health Board, my family clinic, and the care that we
received by the 911 staff and the hospital. I'm not discrediting their job
as clinicians, but I felt it. I felt a difference. I felt that we had to
advocate for ourselves and we had to fight or something terrible could have
happened to us.
In addition to advocating for health care reform, tribal communities have
also been calling for the creation of more infrastructure in Indian country.
The Commission on Civil Rights wrote in its 2018 report that broken treaties
have left many reservations without adequate access to critical resources
such as clean water, plumbing, electricity, internet, cell phone
service, roads, public transportation, housing, hospitals and education.
It's just sad that in today's 2021 that we have tribal communities that lack
this basic infrastructure. This is not an onus on the Indian Health Service, or
the Bureau of Indian Affairs, but on the federal government, and it's inability
to uphold the treaties and the treaty obligations that it's made with
indigenous populations.
Activists and experts say putting control of the system in the hands of
indigenous people themselves makes a big difference in efficacy of initiatives.
Let's give the power of our tribal nations to self determine their own
fate. Let's give them the money. Let's give them the government contracts.
Let's let them have the opportunity of programs to fit their own needs.
They also advocate for more representation of Native people at
federally run organizations such as the CDC,
We cannot have very junior CDC epidemiologists who are not Indian going
to Indian country and try to figure out how do we work with this population
during a pandemic. This is not on the job training.
Covid-19 highlighted the strengths and the resiliency of indigenous communities
that the rest of this country should be learning from. These strengths and
resiliency of our communities is because we're what this nation has been trying
to build: a public health community where we think about ourselves not only
as individuals but as individuals who have a responsibility to the whole of a
community. That's what public health is.