At Risk For Trauma

‘We could see horrific things but we couldn’t do anything’

Bottom Line: As protests against the Dakota Access pipeline grow, so does the likelihood of post-traumatic stress disorder.

Activists were recently doused with water amid subfreezing temperatures.

Adam Alexander Johnson/sacredstonecamp.org/blog

For water protectors opposing the Dakota Access pipeline in North Dakota, both in the camps and on the front lines, the atmosphere is not unlike that of a combat zone.

In addition to facing rubber bullets, pepper spray and aggressive arrest tactics, protectors are constantly on edge from the stress of continuous surveillance and the threat that agent provocateurs may be living among them. The sound of helicopters and planes buzzing overhead gives pause to prayer and conversation as people anxiously gaze toward the sky. Heavily armed police line the hills surrounding the camps, watching protectors with binoculars. Even the most mundane tasks of camp life feel dangerous here.

“I was singing a prayer song when they started hitting us with batons,” said Dan Namakin, a youth advocate from Nespelem, Washington, who was wearing a headdress and traditional regalia when he was attacked. “The sound of wooden batons striking our people was sickening. I had my eagle staff in one hand and a rattle in my other hand as they forcibly removed us.

“They pulled me behind the police line and zip-tied my wrists, then took us to a processing area and put us in vans with no ventilation. We could see the horrific things they were doing to our people, but we couldn’t do anything about it.”

Increasingly, experts say, water protectors like Namakin are at risk from post-traumatic stress disorder (PTSD).

As recognized by the Department of Veterans Affairs, PTSD occurs when persons experience so much stress in a situation that they find themselves “stuck” in that moment, even when the danger has passed. The nervous system is unable to return to its normal state of balance, keeping people from moving on.

“The young people especially seem unable to de-stress after experiencing police violence,” observed Melanie Stoneman of the Sicangu Lakota tribe, who with her family has been living and volunteering at the Oceti Sakowin camp for several months.

Many combat veterans who served in the military have expressed shock at the level of force and militarized weaponry being used against unarmed civilians.

“It’s like a war zone out there,” said human rights attorney Joe Heath, a veteran with 45 years of civil rights experience who also represents the Onondaga Nation. “This can’t happen again. We have to wake people up in this country to what is happening. You have mass troops of mostly white guys armed with adrenalin, guns, pepper spray, concussion grenades, militarized weapons—like Star Wars—and it’s bound to go bad. There is no respect for the rights of these unarmed, peaceful citizens.”

There is also the lurking shadow of “historical trauma,” which researchers have tied to high rates of addiction, suicide, mental illness and sexual violence among Native peoples. This condition, said Michelle M. Sotero of the University of Nevada, has three aspects:

1. A dominant culture perpetrates mass trauma on a through colonialism, slavery, war or genocide;
2. The affected population shows physical and psychological symptoms in response;
3. The initial population passes these responses to subsequent generations, who in turn display similar symptoms.

Some people at the camps may have pre-existing mental health problems associated with this syndrome, noted Elicia Good Soldier, co-coordinator of the Tiospaye Sakowin Youth Healing Camp on the Pine Ridge Reservation in South Dakota.

“I think many [water protectors] are experiencing those historical traumas, unexpectedly, on top of the traumas they are experiencing firsthand,” Good Soldier said. “We need to be there to help them process that.”

In response, Good Soldier and mental health professionals from Indian country are coming together to help the protectors respond. Earlier this month, Oglala Sioux tribal Chairman John Yellow Bird Steele asked mental health professionals from the Pine Ridge Reservation to organize an emergency deployment to travel to the camps to offer assistance.

Several mental health care professionals from the Pine Ridge Reservation are on hand. They include Ethleen Iron Cloud-Two Dogs, longtime Lakota tribal mental health program specialist and traditional healer; Yvonne “Tiny” DeCory, suicide prevention and outreach coordinator for the Sweet Grass Project and the BEAR Program; and Eileen Janis, also of the Sweet Grass Project. They are working with Margaret Gates, tribal health care director for the Standing Rock Sioux Tribe, and Monique Runnells, director of the Standing Rock Sioux tribe’s Wellness Program. Their aim is to bring Mental Health First Aid training and other resources to the water protector camps.

Mental Health First Aid is an eight-hour course that gives people the skills to help others who are developing a mental health problem or experiencing a mental health crisis. Created in Australia in 2001, the training is listed in the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices.

The mental health care professionals are also working closely with volunteers such as Michael Knudsen, a non-Native public health master’s student. “We’ve had some people with chronic mental health issues such as bipolar disorder and schizophrenia,” he said.

Medics have been reluctant to call for help from emergency medical services from Morton County because the ambulances will only come to the camps with police escorts. “The presence of police only seems to add to trauma for those in acute mental health distress,” Knudsen said. (Metro-Area Ambulance Service, the company that serves Morton and Burleigh Counties did not respond to ICTMN’s request for an interview.)

Janis has visited the camps several times. She has observed signs of domestic violence, suicide ideation and alcohol withdrawal among some of the people there. “People at the camps are working together, everybody has a role like we did a long time ago in our traditional culture,” she said. “But right now they are bringing in their past traumas too.”

Pain from past trauma adds the to anger and frustration with police and the pipeline.

“We don’t want what we have on the reservation in these camps. We want the people to have focus have prayer and be peaceful,” Janis said. “The biggest thing we are doing is teaching them to believe in our prayer and helping them to let past trauma go.” http://bit.ly/2gcMU34

Better Days For Indian Health?

‘We are committed to providing quality care’

Bottom Line: Following widespread criticism of the Indian Health Service, its top officials pledge that reform is on the way.

Indian Health Service Principal Deputy Director Mary L. Smith (at podium) has announced institutional improvements.

Regina Garcia Cano/AP Images, File

The Indian Health Service (IHS) has a new plan to provide high-quality, patient-centered, safe medical care to the 2.2 million American Indians and Alaska Native it serves.

The Indian Health Service Quality Framework, 2016-2017 and Quality Framework Implementation Plan were issued November 16 following the October release of two more in a decades-long series of reports on deficiencies in the federal agency’s performance.

Under the new plan, IHS will establish a Quality Office at headquarters, overseen by a Deputy Director of Quality, who will report to the IHS Director. IHS Principal Deputy Director Mary L. Smith said the agency is working to fill the position as soon as possible.

“We are committed to providing quality health care so we are our patients’ first choice for health care even when they have other options,” she said.

As part of its renewed effort, IHS will increase its efforts to recruit and retain highly qualified medical and administrative staff and improve data collection, analysis and reporting. It will also employ a single accrediting organization for all IHS direct service facilities.

In July, IHS entered into a $700,000 contract with the Joint Commission on Accreditation of Healthcare Organizations to improve the quality of care and patient safety at IHS hospitals in eight states—Arizona, Minnesota, Montana, Nebraska, New Mexico, North Dakota, South Dakota and Oklahoma. Under the new framework, by 2017 all 26 IHS-operated hospitals will be evaluated by one accrediting agency.

The agency will also standardize credentialing of medical staff. “The goal of the Quality Framework credentialing standardization objective is to ensure a consistent and efficient process across IHS that facilitates the hiring of qualified practitioners,” said an IHS spokesman.

In addition, the agency will survey patients to find out what they think of the service they are receiving.

Improving patient safety is a high priority and the agency has pledged to address the severe safety lapses that sometimes occur at its facilities. It intends to do so by educating and encouraging staff to report incidents consistently, and by having a centralized system for monitoring risks and adverse events. The framework also calls for decreasing the incidence of healthcare-associated infections using measures such as increasing staff compliance with hand-washing regimes.

In October, the Office of the Inspector General for the Department of Health and Human Services (under which IHS operates) issued two critical reports about the agency. They were titled “Indian Health Service Hospitals: Longstanding Challenges Warrant Focused Attention to Support Quality Care” and “Hospitals: More Monitoring Needed to Ensure Quality Care.”

The reports found that IHS exercised limited oversight of its hospitals due in part to inadequate data collection and review and difficulty with electronic health systems. Quality of care suffers, according to the reports, because while more and more people are turning to IHS for their care, the agency offers only a limited scope of services. Inadequacies that were cited included little access to specialists and outdated equipment and facilities.

IHS hospitals in the Great Plains area in particular came in for scathing criticism when the Senate Committee on Indian Affairs took testimony on their conditions. These hearings took place in Washington and in the field beginning last February.

Since then, Smith told ICTMN, “We have been working aggressively to improve the conditions at the hospitals in the Great Plains and actually I’m pleased to report several significant things that have happened.

“First, two of the hospitals that were cited by CMS [Centers for Medicare and Medicaid Services] are currently operating under Systems Improvement Agreements, which are long-term agreements to get at the root cause of the problems at those facilities. We are making considerable progress working very closely with the CMS on those agreements.

“A second major initiative in the Great Plains is the contract that we announced in July with the Joint Commission, which is doing assessments at all the Great Plains hospitals.”

Also, in September, IHS awarded a telemedicine services contract to Avera Health to provide services to the seven hospitals and other health centers and facilities in the area. The Indian Health Service has 12 area offices and 170 IHS- and tribally managed service units, which provide nearly 40,000 inpatient admissions each year and more than 13 million outpatient visits. The 2016 federal appropriation for the agency was $4.8 billion.

IHS spent $3,688 per patient in 2015, compared with an average $9,523 per year per patient expenditure for the nation as a whole. http://bit.ly/2g5MPO1

The Education of Natives

‘Right now we are in the middle of our reform’

The new director of the Bureau of Indian Education, Tony Dearman, is emphasizing sovereignty.

Courtesy U.S. Dept. of of the Interior

Editor’s Note: Tony Dearman (Cherokee) was appointed director of the Bureau of Indian Education (BIE) on November 2, taking over a troubled agency in the midst of radical reforms. He talked to ICTMN about where the BIE is headed and how he plans to make it a student- and school-focused organization.

* * *

What are your priorities as you take the helm at BIE?

We’re going to continue our support efforts and continue to build partnerships with tribal leaders and educators to improve services to our students to produce positive student outcomes. We really need to let people know that we exist, get out there and get some support and create partnerships and collaborate with a lot of organizations inside and outside the department to bring attention to our system—to our kids.

When you talk about partnerships and collaboration, are you mostly talking about having tribes take over schools?

I’m talking about within the BIA [Bureau of Indian Affairs] because in our system—our facilities, for example, everybody knows that we’ve struggled with the facilities aspects of our schools in some locations—we have to work with BIA because they control the money.

If a tribe decides that they want to take over the schools, then we will be there to provide technical assistance so they will be successful. This is not a push to make all the tribes take over the schools. But it is to promote sovereignty, and if a tribe does say we can do a better job, we want to run our schools, it’s our job to help. That’s our trust responsibility. We’ll be there to help walk them through it.

What do you see as the biggest challenges facing the BIE?

Right now we are in the middle of our reform and we’ve got to get all of our positions filled. But it’s more than just hiring. It’s about changing the mindset. We want to change the way we do business. We want to be a service organization and really have a student and school focus.

When you talk about changing the mindset, could you go into a little more detail?

In the past we’ve had a one-size-fits-all type system. At the school level, [regulations] have been pushed down and we had to make them fit us. Right now what I’m saying about a change of mindset is that we need to have individual plans for our schools, for our tribes, because not everybody has the same needs.

We’ve had some great, hardworking employees. They’ve been working extremely hard to do these reorganization and reform efforts. And a lot of our employees have been pulling the load of two and three people. We have strengths within our organization that we really need to utilize instead of jumping to contractors outside our system.

Is there still a problem with getting enough good teachers into BIE schools?

We do have some remote locations. We’ve been working with a contractor to help us go out and recruit. And that’s one of our efforts as far as training our principals. In the past we’ve hired them and given them a key and said good luck. We really need to spend some time with them and let them know what their authority is in terms of recruiting and retaining our staff, our teachers.

What would you like people to know about you as a professional as you begin this job?

I’d like the people to know that I’ve worked in several different levels in our school systems. I’ve been a science teacher, a coach, a principal at a tribally controlled school. I’ve been a superintendent at a bureau-operated boarding school. At Riverside Indian School we had grades 4 through 12 from about 23 different states and anywhere from 70 to 80 different tribes depending on the time of year.

So I’ve been on the inside as far as being in our schools. I’ve also been an acting educational line officer for the tribes in the Northwest for Seattle and an educational line officer in New Mexico South in Albuquerque. And I’ve been an associate deputy director [of the BIE], so I have a lot of experience on a lot of different levels in the system and I really feel like it gives me an advantage in knowing how our system works and areas that we can improve.

Can you give us an example?

At a boarding school like Riverside Indian School, for example, the students were our children. We were responsible for clothing, medical care, emotional needs, everything. We would have our kids on our campus seven days a week 24 hours a day, so we had to come up with activities, and purchase things like movie tickets.

But when we submitted our purchase orders we’d get a lot of pushback. The federal government doesn’t pay for movie tickets. We would have to explain we’re a school [and fight to get those things for our kids], so I’ve experienced the positives and the negatives at different levels of our system.

I will say, on a positive note, under this administration the relationship between BIA and BIE has really improved. We do have people that understand the schools now and it’s only going to get better. http://bit.ly/2giAPtW

How Did I Miss That?

Post-racial America, fistfights in Ukraine’s parliament and that viral Chili’s incident

First Look showed video of a fistfight interrupting a debate in the Ukrainian parliament. My cousin, Ray Sixkiller, was excited because he mistook the incident for the rivalry between Stephen Bannon and Reince Priebus over who gets the last whisper in President Trump’s ear.

* * *

Pamela Ramsey Taylor, director of the Clay County West Virginia Development Corporation, wrote on Facebook, “It will be refreshing to have a classy, beautiful, dignified First Lady in the White House. I’m tired of seeing a [sic] Ape in heels.”

The good news is that Clay Mayor Beverly Whaling responded right away. The bad news is that she said, “Just made my day, Pam” [sic]

“Just another day,” Cousin Ray observed, “in post-racial America.”

* * *

Within the week, Reuters reported, both Taylor and Whaling had resigned. No comments by Taylor were reported, but Whaling denied being a racist.

“Sounds like she was pretty tolerant of other people’s racism,” Cousin Ray grumbled.

* * *

On another day in post-racial America, Chili’s Grill & Bar was offering its usual free meals for veterans on Veterans Day. Army veteran Ernest Walker of Cedar Hill, Texas, was about to leave Chili’s when an elderly man wearing an American flag shirt with a Trump sticker complained that Walker was wearing his cap indoors, could not be a veteran, and should not get a free meal.

The manager asked for Walker’s DD 214 (“Certificate of Release or Discharge from Active Duty”), which he showed. The manager also complained that Walker’s service dog was not a service dog. The dog had a red service vest and certified service tags.

Walker caught the conversation on video as he surrendered his to-go food and left Chili’s. He posted the video on Facebook, where it quickly went viral. Eventually, Chili’s apologized and fired the manager.

* * *

The veteran had served with the 25th Infantry but was wearing a uniform without insignia because he did not want to be mistaken for an active duty soldier. The lack of insignia must have been the reason for the trouble, because in post-racial America it could not possibly matter that the veteran was black or that his service dog was named “Barack.”

Cousin Ray tried not to crack a smile when he cited this story as “one more reason names matter.”

* * *

Speaking of names, Utqiaġvik, Alaska has voted by referendum to take its name back. Frederick William Beechey stole it in 1825 and gifted it to Sir John Barrow. The city formerly known as Barrow is the oldest permanent settlement so far discovered on the real estate claimed by the U.S.

When the colonists showed up, the area was inhabited by the Iñupiat, who had names for everything worth naming, so naturally the invaders had to steal some to celebrate having frozen their butts off to “discover” lands that would eventually be proven to contain gold, both yellow and black. “Utqiaġvik” means “place for gathering wild roots.” Not “gold.” Not “oil.” But “wild roots.”

Cousin Ray observed that if you lived there, you might find wild roots more useful than gold or oil. Then he posed the question on everybody’s mind: “How do you say it?”

Lisa Demer of the Alaska Dispatch News responded, “Say it this way, with guttural back-of-the-throat sounds for the representative “k” and hard “g” in the middle: oot—kay-ahg—vik.

Cousin Ray and I agreed that that is almost as hard as conjugating Cherokee verbs.

 * * *

Wal-Mart is discouraging its employees from downloading an app called WorkIt, which offers advice on employees’ legal rights and Wal-Mart policies and the opportunity for workers to chat among themselves about workplace issues. Cousin Ray wanted to know how an employee could assert legal rights against a transnational corporation with a GDP bigger than that of Belgium.

The answer is carefully. Very carefully.

* * *

Robert Wise was a staff member for two secretaries of the interior, Cecil Andrus and Bruce Babbitt. The New York Times published a letter from Wise criticizing the “Bundy Gang” acquittal and suggesting it is not okay to “destroy Native American cultural assets.” Wise concluded, “Make no mistake, these outlaws want beautiful federal lands, the endowment of every American, sold to the highest bidder or given to them free of charge.”

It was good to ring the tocsin about the intersection of history for halfwits and guns for all. But it would have been nice to see some awareness that the Northern Paiutes have a bigger dog in the fight than the public generally. http://bit.ly/2fcDdzV