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A welcome measure to improve Indian health

The $35 billion Indian Health Care Improvement Act passed the Senate on Tuesday. It will "renew and improve a broad range of Indian health programs . . . to combat the chronic shortage of health care services," according to a news release from th...

The $35 billion Indian Health Care Improvement Act passed the Senate on Tuesday. It will "renew and improve a broad range of Indian health programs . . . to combat the chronic shortage of health care services," according to a news release from the office of Sen. Byron Dorgan, D-N.D.

This all-important American Indian health care bill has been limping along at a coyote's pace for 16 years. It has been whipped and beat-up and is damp with tears, but it's now through the first and maybe the most difficult challenge, the Senate.

In Indian country, health care on some isolated reservations depends solely on Indian Health Service. Nationwide, there are 163 service units, 48 hospitals and 603 outpatient clinics. They serve about 2.78 million American Indian people and 562 tribes.

Dorgan, one of the sponsors of the bill and the chairman of the Senate Indian Affairs Committee, brought to Washington a story that shows the need for the bill. It's a typical story, this one about a 5-year old Crow girl from Montana who went to the local IHS clinic at Crow Agency, Mont., for more than three months in unmedicated, severe pain. The doctors, however, treated her for depression until she showed an extreme condition. She was then airlifted to Denver Children's Hospital and diagnosed with untreatable cancer.

The Make-a-Wish Foundation gave her a trip to see Cinderella's castle in Orlando, Fla., where she died in her mother's arms before she was to see the castle.

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A 14-year old girl from Spirit Lake reservation, Fort Totten, N.D., killed herself after having lain in bed in a fetal position for 90 days. Two years previous, her sister had taken her own life, and her father had taken his own life, too. The 14-year-old took her life because she felt no hope and no help, Dorgan told the Senate.

There are more stories that Dorgan and the Senate committee collected from Indian country, where health care can be one of the greatest needs.

I know things can get pretty bad on reservations. I also know there are some good IHS staff who try hard to overcome some very difficult situations they face day after day.

One of those health difficulties is diabetes. American Indian people came from lifestyles different than non-Natives. Many of us are susceptible to diabetes because our systems were accustomed to healthier foods, and we were more active historically.

In addition, poor eating habits and the lack of exercise has contributed to the high rate of diabetes on reservations. Diabetes contributes to cardiovascular diseases, cancer and other diseases. Alcoholism and substance abuse is common in our communities; and on some reservations, suicide is treated like any other kind of death because it is so common.

There are programs in place to combat the health problems on reservations, and they have made inroads by training nurses, physicians, physician assistants, therapists and others. Programs such as UND's RAIN (Recruiting American Indian Nurses) program and INMED (Indians into Medicine) physician-training program are putting more and more health care workers on reservations.

These new American Indian practitioners help alleviate the problem because many Indian doctors want to go home to practice.

Why do Indian people get funding for their health care when there is a health care problem in the nation?

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First, many American Indians otherwise would have no access to health care. Second and more important, when the tribal nations in this country gave up millions of acres of land to the federal government, the compensation was the government's promise that it would provide services such as health care, education, housing and so on.

During the early years, the federal government also signed legal agreements called treaties with tribes. In those agreements, the government agreed to provide services.

Dorgan compared the funding for American Indians to the funding for people in jail: "There is more funding for health care for prisoners, than that promised for American Indians," he said in the Senate hearings.

Sen. Sam Brownback, R-Kan., added something interesting to the bill: an apology to American Indians by the government for mistreatment. The resolution acknowledges the long history of mistreatment of Indian people.

As the read that, I wondered how many people would understand that part of the bill. Many massacres and stories of misdeeds by the government of Indian people are rarely on the best seller list. Many textbooks for classrooms don't have this kind of information.

Yet the acknowledgement in the bill is good. This is history that needs to be acknowledged, and then we need to move on.

The Senate sent the bill to the House with high hopes. But in Indian country, we won't sing the "thanksgiving" song until the president's pen makes the last turn.

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