Barack Obama isn't the only supporter Native Americans have in D.C. Among the politicians who have stepped up was Byron Dorgan, who represented North Dakota in Congress for 30 years -- first in the House and then in the Senate -- before retiring at the end of 2010. His father, Emmett, worked as a horse wrangler on Fort Berthold before the flood. The elder Dorgan "always respected the Indian culture," says his son. "He impressed upon me that our country had not lived up to the treaties and promises made to the American Indians."

This contributed to one of the few threads of good luck strung between the tribes and the nation's Capitol, since the construction of the Garrison Dam. Along with the rest of the North Dakota congressional delegation -- Sen. Kent Conrad, D, and Rep. Earl Pomeroy, D (who lost his seat last November) -- Dorgan spent years listening to the Fort Berthold people air frustrations about health care, exacerbated by the IHS's reported mention of a $99 million, full-fledged hospital, a vision that glimmered beckoningly before vanishing into thin air. (The IHS would not comment on this.) Dorgan, however, remembers the $99 million estimate with a sigh: "Typical of IHS estimates, it had no connection to reality," he says. "The IHS can't meet current needs, far less get on with new buildings."

The delegation started working to get a new health facility, which, while it wouldn't deliver a full-service hospital to Fort Berthold, would improve on what they had. Building on Tribal Chairman Hall's testimony that "the promise to replace the lost infrastructure, particularly the hospital, has not been kept," Conrad sponsored a bill in 2004 that authorized $20 million for a new clinic. Dorgan then found the money in the budget of the Army Corps of Engineers, the agency that built the Garrison Dam more than half a century ago. "I decided that it was the Corps' responsibility to build the hospital," says Dorgan, who then headed the Senate Appropriations subcommittee that funded it. "They promised they'd replace (the original Elbowoods hospital) and never did it." The money was designated in appropriations bills in 2008 and 2009.

The new clinic -- called Elbowoods Memorial Health Center after the inundated village and hospital -- is under construction just outside New Town and slated to open in August. It will be approximately four times the size of Minne-Tohe. Instead of the current six exam rooms, two doctors and four physician's assistants, Elbowoods will have 13 exam rooms, several rooms for specialty procedures, four doctors and four or five physician's assistants. The reservation currently has 90 medical staff spread between Minne-Tohe and four satellite clinics. That number is projected to go to 157 if the IHS appropriates the requested $8.3 million needed to staff and operate Elbowoods -- approximately twice the current operating budget for health care on the reservation. The requested budget would also provide for a staffed ambulance standing by 24/7.

The clinic is designed to someday be expanded into a hospital, which would likely be funded by the tribe. Project Director James Foote is proud of the design -- a "river wall" near the entrance emulates the banks of the Missouri, and the entryway is a rotunda, reminiscent of ancestral earthen lodges. The dialysis unit will stay at Minne-Tohe; the waiting list won't go away and some patients will still have to travel for the procedure. There will be no overnight stays at Elbowoods, no acute care.

Still, it's a move in the right direction, says Dorgan. "Is it everything they want? No. But it'll move substantially in the direction of good health care."

He adds, "I think the displacement (caused by the dam) had a lot to do with health consequences and diabetes. I've watched over decades the promise of adequate health care to Native Americans not be fulfilled by the federal government."

Lisa Jones wrote this story while participating in The California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communication & Journalism. She is the author of Broken: A Love Story -- the tale of her friendship with quadriplegic Northern Arapaho horse gentler and traditional healer Stanford Addison. Her website is lisajoneswrites.com.