By Claire Carlson for The Daily Yonder.
Broadcast version by Eric Tegethoff for Oregon News Service for the Public News Service/Daily Yonder Collaboration
A new public health clinic on the Grand Ronde reservation in rural Polk and Yamhill counties, Oregon, promises to address healthcare gaps and advance tribal sovereignty for the Confederated Tribes of Grand Ronde. The clinic, which opened May 17, 2024, will offer preventative services like vaccines, dental care, and nutrition classes to bolster the overall wellbeing of tribal members.
Officials working for the tribe say the new clinic will help the community take care of its own. "We're making sure that we can look after our own members and not be waiting on somebody else to provide some kind of help or service or something," said Ryan Webb, the engineering and planning manager for the Confederated Tribes of Grand Ronde, at a press tour of the new building on May 6.
The clinic will add to an already robust hospital system that offers basic and specialty care to the community, which means tribal members don't have to travel far distances (a minimum of 50 miles round trip to the nearest city) to access the majority of their healthcare needs.
Tribal members said this kind of self-reliance is nonnegotiable because of a long history of mistreatment by the federal government.
In 1857, the government forcibly removed the Tillamook people - a diverse group of Native Americans who lived up and down the Oregon coast in 29 distinct bands each with their own language - from their homelands and onto the original Grand Ronde reservation, creating the Confederated Tribes of Grand Ronde. Over 300 Native Americans were forced to walk more than 200 miles to get to the reservation, a journey that's remembered by tribal members as Grand Ronde's "Trail of Tears." Once they reached the reservation, services like healthcare and education were promised to be provided by the federal government, but tribal members say these promises were not kept.
Then, in 1954, Congress passed the Western Oregon Termination Act that ended federal recognition of 60 tribes in western Oregon, the largest number of tribes to be terminated under any single federal law. This meant that the Confederated Tribes of Grand Ronde, along with tribes like the Coos, Coquille, Siletz, Siuslaw, and Lower Umpqua, lost every treaty right they had with the federal government.
"Everything was taken," said Cheryle Kennedy, chairwoman of the Grand Ronde tribal council and former tribal health director. "There wasn't compensation or anything. It was, 'no, you're no longer Indian, no more identity. You can't receive any Indian service and all of your land is gone.'" It was the government's way of assimilating Native Americans into mainstream American culture.
The government was no longer required to offer any of the programs or resources extended to federally recognized tribes. Any property held by the tribes was taken by the government, which proved to be economically devastating, especially to the Klamath Tribes in southern Oregon who possessed valuable timberlands.
Eventually, after nearly three decades of lobbying, some Oregon tribes regained federal recognition, including the Confederated Tribes of Grand Ronde in 1983. Their current reservation is roughly 11,500 acres in size.
The tribe has been working to rebuild their nation since receiving federal recognition for the second time, and a thriving healthcare system has been central to this effort. The first health clinic in Grand Ronde was built in 1997, and the tribe has been expanding ever since.
Currently, tribal members can receive optometry, pharmacy, behavioral health, cardiology, opioid treatment, and naturopathy services on the reservation. Kelly Rowe, the tribe's current health director, is working to bring endocrinology, rheumatology, and nephrology services to Grand Ronde. All enrolled Grand Ronde tribal members can get free health services from the hospital.
"The whole thought behind the big clinic was to bring everything here to Grand Ronde so people could get it without having to travel," Rowe said.
The newly-built public health clinic expands the hospital's preventative health services by providing a permanent location for vaccine administration (a need the Covid-19 pandemic highlighted), dental care, and nutrition classes. It also features an outdoor fish pit where tribal members can learn how to prepare traditional meals.
The clinic was built with support from Energy Trust, a nonprofit that works with utilities, community organizations, government agencies and others to bring the benefits of energy efficiency and renewable energy to more people in Oregon, according to an Energy Trust spokesperson.
Energy Trust pointed the tribe to sustainability grants to pay for the solar panels that cover the building's roof, which the tribe said will enable them to be even more self-reliant in the face of natural disaster. If their electricity goes out, the new building will still be able to power itself, keeping vaccines that require refrigeration cool.
Along with the technical support from Energy Trust, the Confederated Tribes of Grand Ronde paid for the project using Covid-19 federal relief funds and tribal money.
"I think that [shows] the tribe's investment in healthcare for its people, because they're very committed to making sure that they're providing healthcare and providing as much as possible for the membership," Rowe said.
Claire Carlson wrote this article for The Daily Yonder.
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By Amy Felegy for Arts Midwest.
Broadcast version by Judith Ruiz-Branch for Wisconsin News Connection reporting for the Arts Midwest-Public News Service Collaboration
Patty Loew attended five screenings of a new film this year. She wasn't joining box office masses at Wicked or Inside Out 2, but Bad River: A Story of Defiance.
The independent documentary, directed by Mary Mazzio and released in March, drew in masses of its own. AMC Theatres put it up on select big screens across the United States. Peacock started streaming it last month.
The documentary highlights longstanding issues facing the Bad River Band of Lake Superior Chippewa in northern Wisconsin. Loew 'Waswaagonokwe' (Torch Light on the Water Woman) is a citizen.
She and other Band members are interviewed in the film, which explores tragic boarding school histories and how members of the Band have faced violence and racism.
The documentary heavily focuses on the Line 5 dispute between the Band and Canadian energy company Enbridge. Loew, who recently retired as director of the Center for Native American and Indigenous Research at Northwestern University (among many other titles), addresses it in the film.
"My little tribe is standing up and saying, 'We're protecting the water, not just for us. We're protecting water for the planet.'"
Behind the Struggle
As it stands, 12 miles of a crude oil and natural gas pipeline run through Bad River land, constructed in 1953. In 2017, Bad River's tribal council voted against renewing the company's rights to use their land. It led to years of protests and activism when Enbridge refused to leave. Last summer, a federal judge gave Enbridge three years to shut down the pipeline on the reservation.
That reservation includes just under 40 miles of Lake Superior shoreline, thousands of wetland acres, and hundreds of miles of streams, rivers, and tributaries.
The documentary shows its beauty. Think grandiose drone shots and stunning water imagery.
"Bad River is where I go when I need my batteries recharged, when I need time to reflect, when I just need to get back in touch with things that make me happy," Loew says.
Last month, the Wisconsin Department of Natural Resources issued construction permits for Line 5 to reroute 41 miles south of the reservation and exit Bad River lands by 2026.
But Loew and other Band members who are interviewed in the film say that isn't enough to protect Mashiiziibii land and nearby areas from a potential pipeline burst. They want it shut down.
Enbridge lawyers and the U.S. government say they can't, citing a 1977 energy treaty with the Canadian government. But Bad River citizens say Ojibwe treaties, which established reservations and land rights, predate that by over 100 years.
"If such a rupture were to occur, nearly one million gallons of oil would spill into the river, flowing into Lake Superior and devastating the wild rice beds and fishing populations central to the Band's way of life," stated 30 Midwestern Native Nations in a letter to the White House in February.
There have been over 20 spills along the Line 5's 645-mile route since 1968, including over 14,000 gallons in Bad River land in 1972.
Despite the continued debate, Loew has hope.
"The right thing will eventually happen," she says.
"I think everyone-whether you live in a red or a blue state, or whether you are Native or non-Native-[wants] clean water and clean air, not just for themselves, but for their children and grandchildren."
Amy Felegy wrote this story for Arts Midwest.
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Arizona State University has developed a new tool that they hope will help researchers analyze connections between illnesses and health determinants within Indigenous populations. The Indigenous Health Research Dashboard is an online repository of peer-reviewed, published studies that focus on medical conditions and diseases impacting Indigenous health since 2020.
Angela Gonzales, a member of the Hopi Tribe in Northern Arizona, and an ASU professor and director of the American Indian Studies Program, said it is important for her to be a part of an initiative that aims to move the needle for Indigenous health equity. She explains that she has seen firsthand the "devastating impacts" of limited access to health care in Native communities.
"By having it public available and accessible, when tribes are interested in trying to find out the latest research, for instance let's say on COVID-19 vaccinations, they have a one stop source to be able to access a lot of that information. You can search by keywords, can search by key topics, it breaks it down into regions," she said.
Gonzales added that the dashboard is what she calls 'bio-directional,' meaning it's an effort that is driven by what tribal partners have identified as major health concerns, and said the project has also allowed students to develop their research skills and learn to synthesize information. They are currently recruiting students to be a part of the team that will continue working on the initiative next year. She hopes they're able to capture a more 'holistic' and historical view of health trends and findings.
Gonzales says they're ramping up outreach efforts to ensure public health professionals and medical providers in Indigenous communities know about the useful resource. But she adds that Native communities have already expressed the need for such information.
"If you're a tribal health professional, the opportunity to do research, it takes away from your other responsibilities that are oftentimes more pressing. By having this dashboard available, they can go right to it," she continued.
Gonzales said that Indigenous health equity has been improving in recent years, but she says as an academic she hopes researchers do better to create a stronger 'knowledge bridge,' and develop resources that are use-inspired. She feels the dashboard is a step in that direction.
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The state of Washington is helping Native Americans access health care after decades of barriers.
Health insurers have made it difficult for tribal members to get care covered, despite state and federal laws that bar this.
Vicki Lowe is the executive director of the American Indian Health Commission, which has led efforts to remove hurdles for Native Americans.
She said health insurers would try to make tribal clinics charge out-of-network rates, and wouldn't honor their referrals.
However, the Washington State Office of the Insurance Commissioner has come out with guidance to prevent this.
"Not only will tribes have more money to help pay for services for their tribal members, tribal members will get care in a more timely manner," said Lowe. "So those two things just are really important, and insurance companies have been a barrier for that for decades."
Washington is among the first states to move forward with guidance for insurers and also enforcement of the law so that insurers will stop putting up roadblocks for tribal members to get care in the state.
Todd Dixon is the deputy commissioner for consumer protection and the tribal liaison for the Office of the Insurance Commissioner.
He said one reason for releasing the guidance was that the agency has seen an uptick in complaints - the number one compliant typically coming from billing managers at clinics.
"It says, 'Hey, we have an enrolled member. He or she was seen at our clinic. We billed the insurance company. They said we're out of network and so "we're only paying 60%." And then they send a bill to the enrolled member,'" said Dixon. "It's not how it works."
The Insurance Commissioner's office has been sending notices to insurers who violate protections for Native Americans.
Lowe said before they got involved, tribes fighting with insurers on their own were getting them nowhere. But it's different with the state backing them.
"Knowing that if somebody violates these laws that they're going to get that outreach from the insurance commissioner and that they have 15 days to respond," said Dixon. "Where if a tribe asked them, they would maybe not respond or respond in some convoluted way - it's a power shift to really have the state agency behind this."
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