Paddling toward shore

Northwestern tribe takes a new/old approach to stemming the Native health care crisis

 

Kitsap Peninsula, Washington

Near the shore of Agate Passage, where the silver waters of Puget Sound narrow, five Suquamish girls sit in a circle stringing glass beads. Red, blue, white, blue: A necklace slowly forms. The teens wear dark eyeliner and hooded sweatshirts, but they bead much as their great-great-grandmothers did, 150 years ago. The words of their conversation, however, are harder and sharper than beads, and they are strung on the dark wire of experience.

"She cut herself three times with a paper cutter," says Lauren, age 14. Her hair shines like crow feathers as she casually describes what happened today at Kingston Middle School -- another suicide attempt by a tribal member. "The blood was all dripping everywhere, and then she went to the office."

Sixth-grader Ashley adds that her older brother took a bunch of pills recently in an effort to "suicide himself." Another girl mentions her time in foster care, her mother who lives in Montana and the aunty with whom she lives now. Eventually, the talk rises above such heaviness, turns into teenage giggles about boys, cell phones and the preppy kids at school. But the reality these girls face is tough -- harder than the ground they sit on here, at their tribe's historic winter village in the heart of this scattered reservation.

Young Native Americans today grow up in the shadow of staggering health statistics. Indians are two to three times more likely to commit suicide and six times more likely to die of alcoholism than the general population. Native youth are twice as likely as other Americans to die before the age of 24. If and when they do get sick with a mental or physical illness, the health-care services available to them are mediocre at best.

The Indian Health Service is underfunded and dysfunctional. In late July, congressional investigators discovered that the government agency had lost at least $15.8 million worth of equipment and tried to cover it up by falsifying documents. The report reiterates what is common knowledge: The agency often spends its budget far ahead of schedule and simply can't provide adequate health care.

As a result, the Health Service can provide little more than emergency care and is unable to provide ongoing, quality psychiatric treatment, according to a 2003 report by the surgeon general. Some Native Americans must travel over 90 miles one-way to see a professional; waiting lists can be six months long. Since Native Americans are twice as likely to live in poverty as average citizens, few can afford private health insurance. Government reports describe the state of health care in Indian Country as "inadequate" -- "a quiet crisis." Others use stronger language.

"This is a black eye on the face of the country," says Michelle Singer of the Portland, Ore.-based One Sky Center, Indian Country's first national substance abuse and mental health center. The federal government, she points out, agreed to provide health care to Native Americans as part of treaty agreements. "There's this very wrong perception in America that all Indians are rich because we have these great casinos and shouldn't get funding for our programs, but Indian gaming isn't the panacea. The U.S. has a legal and moral obligation to provide quality and adequate health care to the first Americans."

Yet the lack of funding has inspired some creative thinking. Sick of waiting for federal help, a handful of Northwestern tribes have spent the past several years working to improve young people's health using a novel approach: bolstering immunity to addiction and mental illness with traditional values and tribal customs. A genuine connection to their culture, something that money can never buy, might prove the best defense for Native youth like these Suquamish girls.