Category: Health
Native American health insurance enrollment surges in South Dakota, but some remain skeptical
![In this July 10, 2014 photo, Denise Mesteth poses outside the powwow grounds in Pine Ridge, S.D. Mesteth is a member of the Oglala Sioux Tribe, born and raised on the Pine Ridge reservation. She has signed up for health insurance through the federal marketplace. (AP Photo/Nora Hertel)](http://www.tulalipnews.com/wp/wp-content/uploads/2014/07/inline_527729329520-e1405963576322.jpg)
By NORA HERTEL Associated Press
PINE RIDGE, South Dakota — Denise Mesteth signed up for new health insurance through the federal Affordable Care Act, despite concerns that it may not be worth the money for her and other Native Americans who otherwise rely on free government coverage.
Mesteth, who has a heart murmur and requires medication and regular blood work, said she’s cautiously optimistic that the federal insurance will be superior to what she has now. Many other American Indians have been more reluctant to enroll, choosing instead to continue relying on the Indian Health Service for their coverage and taking advantage of a clause in the federal health reform law that allows them to be exempt from the insurance mandate if they meet certain requirements.
“If it’s better services, then I’m OK,” Masteth said of ACA. “But it better be better.”
Mesteth and other American Indians in South Dakota account for 2.5 percent of the people in the state who have signed up for insurance under the federal health care law, according to the latest signup numbers. The state, with nearly 9 percent of its overall population Native American, ranks third for the percentage of enrollees who are American Indian among U.S. states using the federal marketplace.
The Great Plains Tribal Chairmen’s Health Board, which provides support and health care advocacy to tribes, received $264,000 to help Native Americans in South Dakota navigate the new insurance marketplace.
Tinka Duran, program coordinator for the board, said people are primarily concerned about the costs of enrolling. Insurance is a new concept to most because health care has always been free, she said.
“There’s a learning curve for figuring out co-pays and deductibles,” she said.
During a U.S. Senate Indian Affairs Committee hearing in May, tribal leaders chastised IHS as a bloated bureaucracy unable to fulfill its core duty of providing health care for more than 2 million Native Americans and Alaska Natives. IHS acting director Yvette Roubideaux said changes were underway but that more money will be needed than the $4.4 billion the agency receives each year.
She noted that federal health care spending on Native Americans lags far behind spending on other groups such as federal employees, who receive almost twice as much on a per-capita basis. Meanwhile, American Indians suffer from higher rates of substance abuse, assault, diabetes and a slew of other ailments compared to most of the population.
Native Americans and Alaska Natives are exempt from the health insurance mandate if they meet certain requirements. ACA also permanently reauthorized the Indian Health Care Improvement Act and authorized new programs for IHS, which also is starting to get funds from the Veterans Affairs Department to help native veterans.
When American Indians do obtain insurance, it means fewer people are tapping the IHS budget, said Raho Ortiz, director of the IHS Division of Business Office Enhancement.
“If more of our patients have health insurance or are enrolled in Medicaid, this means that more resources are available locally for all of our patients,” Ortiz said in an emailed statement. “This, in turn, allows scarce resources to be stretched further.”
Those who sign up for federal health care can still use IHS facilities but have the option of seeking health care elsewhere, Ortiz said.
State Democratic Sen. Jim Bradford is among the skeptics. The Oglala Sioux member lives on the Pine Ridge reservation, home to two of the poorest counties in the nation.
The U.S. government provides health care to Native Americans as part of its trust responsibility to tribes that gave up their land when the country was being formed. Bradford and others object to the shift in health care providers on the principle that IHS is obligated by treaty to supply that care.
Harriett Jennesse, a member of the Lower Brule Sioux Tribe who lives in Rapid City, said she already has seen the benefits of the new health insurance and doesn’t mind paying a little out of pocket.
Jennesse said she put off treatment for a painful bone chip in her elbow after IHS denied a doctor’s referral to a specialist on grounds that it wasn’t an urgent enough need. She’s now seeing a specialist for dislocation in her other elbow and will also try to get the bone chip fixed when the other arm heals.
When is it more than old age?
The truth about dementia
![Photo: Alzeheimer disease, you and I.http://alzheimer-gcmrs.blogspot.com/2012/06/musica-arte-e-alzheimer.html](http://www.tulalipnews.com/wp/wp-content/uploads/2014/07/images1.jpg)
http://alzheimer-gcmrs.blogspot.com/2012/06/musica-arte-e-alzheimer.html
By Andrew Gobin
I will forever remember the night 12 years ago when my family was plunged into the world of dementia. It was late one night when my father, sister, and I arrived at Providence Colby Campus hospital in Everett. My grandma had just had back surgery and was out for recovery. At 12 years old, I was fairly familiar with the hospital hallways, not at all afraid or uneasy about visiting people in the hospital, having been there many times to see family friends and relatives. I thought this was just another routine visit. Even so, I was not prepared for what I was about to see.
My Uncle Joe had arrived shortly before we did. Grandma was upset and confused. She did not know me or my sister, she barely knew her sons. She had been given Vicodin for the pain as part of routine recovery. Grandma didn’t have a drug tolerance, never taking anything much stronger than Tylenol. Anyone who has experienced the effects of Vicodin can tell you, it messes with the mind in inexplicable ways. As grandma’s pain management drugs were changed, trying to bring her out of her delusion, the hard reality was that grandma had changed overnight, permanently.
After a few years trying many different care options, including a detox and psychiatric analysis, we were told that grandma suffered from dementia. And so began my family’s journey through territory none of us knew anything about, having to learn how to navigate the tumultuous seas of grandma’s mind.
Many families in the Tulalip community face dementia in one form or another. The condition affects people in different ways, often leaving the families caring for their grandparents and parents, feeling left with nowhere to turn for advice and support. On Thursday, August 19, Tulalip Behavioral Health, along with the Tulalip Karen I. Fryberg Health Clinic and Tulalip Family Services, will be hosting an event for people to come and hear what medical professionals have to say about dementia, what assistance programs are available at Tulalip, and to share their stories and concerns in a quest to better understand the condition. I know for me, I had many questions, and still do today.
Family Services psychiatrist Dr. Grosskopf will discuss what exactly dementia is and how it is different from normal aging, in addition to general symptoms, how dementia is treated, and how patients and their families can cope.
For grandma, the change came literally overnight. She went to the hospital as her same old self, and woke up an entirely different person. It’s hard to comprehend how such a drastic permanent change can happen so quickly. We had to adjust suddenly, learning how to care for grandma, how to interact with her and live in her world. I was not me, at least not in her world. I was my father or my brother, or sometimes no one at all. But every once in a while, I was myself.
Rosemary Hill, mental health therapist at Family Services, has some insight on this, as dementia has touched people in her life.
“I’m not comfortable lying to them,” she began, “but trying to understand the world and the time that they are living in, sometimes playing along or deflecting is best. My husband has dementia. He never really has been able to grieve the loss of his son. He asks where he is. Or he will say he knows something is wrong with his son, but he doesn’t quite know what it is. How many times can you really tell someone their son died?”
The same was true for grandma. My Auntie Cherie was developmentally challenged, and lived with my grandparents for much of her life. She passed away the year after grandma’s dementia developed. Grandma would ask about her, where she was, who was watching her, and we had to respond as if she was in her room watching TV, or out on a drive with one of her brothers.
Hill will present on how she helps patients to manage their lives. Symptoms are so different and individual. There are those, like grandma, who change at the flip of a switch. For some, the diagnosis seems to have no effect until a rapid decline near the end, and yet others see a steady regression. Hill helps people to learn how to care for all of these, regardless of a diagnosis. With grandma, we cared for her for a while before she was diagnosed with dementia, and there were times when she was so upset she would fight everyday tasks.
Hill said, “How do you care for someone refusing to eat, bath, or clothe themselves? These are the behaviors I help people manage.”
Sometimes, it’s not about the loss of function at all, it’s about feeling insulted or embarrassed. Grandma refused to eat, unless we were all eating. And, she would refuse to eat if what was on her plate was different than everyone else, or if her food was all pre-cut into bites. But she could still feed herself, often stealing food from my plate when she thought I wasn’t looking.
There is a point where people do need help. As the condition progresses and people lose memory, they also lose their ability function normally. It seems that too often dementia goes undiagnosed, untreated, and denied or ignored out of embarrassment. Alison Brunner, who manages the caregiver program, explains many people’s attitude towards admitting that they need help. Admitting they can no longer live alone and need someone available for 24-hour assistance is a loss of independence.
“People don’t want to talk about it. They don’t want to admit that their memory is slipping. The Tulalip people are a strong people, a proud people,” she said.
Even today, now four years after grandma’s passing, it is still difficult to write about. My grandma was General Manager of the Tulalip Tribes, asked to return from retirement twice to help keep the tribal government operations on track. Growing up, I knew her to be a strong woman, sharp, and high-functioning. She cared for my aunt, my grandfather, and anyone that needed help. To lose her to dementia so quickly was devastating, and though we lived through it, I don’t remember ever really talking about it.
The seminar that will be on August 19 at the Tulalip Administration building is intended to inform, but also to share in experiences and gather support and strength. There is so much to understand about dementia, but even a simple understanding can bring reassurance with such an uncertain and inconsistent disorder. I know for my family, working to understand dementia seemed to make caring for her easier. Hopefully, families that attend the seminar will have the same realization.
Andrew Gobin is a staff reporter with the Tulalip News See-Yaht-Sub, a publication of the Tulalip Tribes Communications Department.
Email: agobin@tulalipnews.com
Phone: (360) 716.4188
Abuse and Neglect: The Toxic Lives of Drug Endangered Children
An 8-month-old baby drowns in the bathtub while his father gets high smoking marijuana with friends. A baby girl is barricaded inside her playpen, ignored while her parents party with friends. A grade school boy wanders the early morning streets alone in his Halloween costume, not knowing how to get to his school party because his mother is at home, passed out on drugs.
In her 20 years of experience in law enforcement, Lori Moriarty has seen heartrending stories of children like these caught in the cycle of substance abuse—the root cause of child abuse and neglect.
Moriarty spoke to a gathering of about 150 tribal officials, law enforcement officers, educators, attorneys and victims’ advocates on developing a successful collaborative response to drug endangered children at the 2014 Indian Country Conference, July 16-17 at Prairie Band Casino and Resort in Mayetta, Kansas. “I’m going to tell you today,” Moriarty said, “children plus drugs equals risk.”
Today, Moriarty serves as vice-president of the National Alliance for Drug Endangered Children in Westminster, Colorado, an organization working to break the cycle of child abuse and neglect by empowering practitioners to identify and respond to children living in dangerous drug environments.
The NADEC defines drug endangered children as children who are at risk of suffering physical or emotional harm as a result of illegal drug use, possession, manufacturing, cultivation or distribution. They may also be children whose caretaker’s substance misuse interferes with the caretaker’s ability to parent and provide a safe and nurturing environment.
In Indian country, American Indian/Alaskan Native children experience child abuse and neglect at much higher rates than their non-Native peers, according to the U.S. Department of Health and Human Services.
![](http://d1jrw5jterzxwu.cloudfront.net/sites/default/files/default/files/uploads/child_endangered_by_drug_abuse.jpg)
“Why are we not looking for the kids?”
Moriarty said one of the biggest challenges of substance abuse and drug endangered children has been competing goals between law enforcement and child welfare advocates. While the goal for child welfare advocates may be family reunification, law enforcement’s primary focus has been arrests and seizures. “Why are we not looking for the kids?”
After a parent is arrested, children are placed in foster care, which can also prove traumatic for the child. “I want us to have a common vision,” Moriarty said. “Where do we come together?”
Moriarty pointed to FBI statistics that indicated an illegal drug arrest is made in the U.S. every 21 seconds. In 2011 alone, 1.5 million drug arrests were made. For Moriarty, the big question is this: How many children were associated with the arrestees?
In 2005, for example, Moriarty said the North Metro Drug Task Force in Adams County, Colorado made 88 arrests. Of those 88 arrests, 137 kids were associated with the arrestees.
According to a 2005 study by the National Center on Addiction and Substance Abuse, 9.2 million children live in homes where parents or other adults in the home engage in substance abuse. Substance abuse in the home is a huge stressor in a child’s life, Moriarty said. “It’s called toxic stress.”
The Center on the Developing Child at Harvard University defines toxic stress in kids as frequent, prolonged adversity, such as exposure to violence and substance abuse, without adequate adult support. This can have long-term negative consequences in children’s lives.
Drug endangered children are at risk to develop emotional, behavioral and cognitive issues such as problems with language development, poor memory and the inability to learn from mistakes. They also have a higher risk of becoming substance abusers themselves.
Moriarty said children who suffer child abuse and neglect are 59 percent more likely to be arrested as juveniles, 28 percent more likely to be arrested as adults, and 30 percent more likely to commit violent crimes.
A Collaborative Mindset
Early intervention and developing a collaborative mindset increases the likelihood of breaking the cycle of abuse and neglect. Moriarty told conference attendees that a collaborative mindset involves the exchange of information between law enforcement, child protective services, judicial, emergency and medical providers to make each other stronger. “Let’s not have that next generation wanting to use,” she said. “We have to start sharing information,”
On that note, Daniel Goombi (Kiowa-Apache), Tribal Victim Services advocate for the Prairie Band Potawatomi, said good communication and knowing the cultural dynamics of small, Native communities is crucial. “Everything we do is about relationships,” Goombi said. “You have to know the people you’re working with.”
Although social change may take decades, Moriarty said the goal in Indian country should be 100 percent healthy, happy and safe children. “These kids are resilient. Don’t ever forget that. We can make a difference in their lives.”
Read more at http://indiancountrytodaymedianetwork.com/2014/07/21/abuse-and-neglect-toxic-lives-drug-endangered-children-155953
Tulalip Great Strides raises $44K for cystic fibrosis
![More than 300 walkers complete a 5K course through Tulalip to raise funds for the Cystic Fibrosis Foundation July 12.— image credit: Kirk Boxleitner](http://www.tulalipnews.com/wp/wp-content/uploads/2014/07/57605marysvilleM-GreatStrides.2014.Kirk_-300x199.jpg)
— image credit: Kirk Boxleitner
By Kirk Boxleitner, The Marysville Globe
TULALIP — More than 300 walkers turned out to help raise $44,000 and counting for the Cystic Fibrosis Foundation during the Tulalip Great Strides Walk July 12.
Anna Lester, development manager for the Washington and Alaska chapter of CFF, explained that the top three teams in the Tulalip walk’s sixth year generated nearly $20,000.
“Those are some amazing numbers,” said Lester, who recalled the Tulalip walk’s totals growing from $10,000 to $24,000 in its first and second years, before generating $30,000 and $40,000 in its third and fourth years. “We took in close to the same amount this year that we did last year, which is still amazing.”
Lester credited the day’s warm, sunny weather with inspiring more walkers to step outside, and expressed her appreciation to the Tulalip Tribes for their support over the years.
“The Cystic Fibrosis Foundation is the largest funding source for a cure for CF,” Lester said. “Just about every new drug in the fight against cystic fibrosis has been made possible, at in part, by CFF fundraisers like Great Strides.”
Lester touted Seattle Children’s Hospital as among the top researchers of cystic fibrosis, and identified research and treatment as the primary recipients of Great Strides, whose goal for 2014 is to raise $43 million through 600 walks nationwide.
Proponents fight for change so Alaska Natives covered by VAWA
![Ishmael Hope, left, and other Alaska Native representatives at the 2013 Choose Respect rally in Juneau, Alaska, asking legislators to address issues with the Violence Against Women Act.Heather Bryant/KTOO Public Media](http://www.tulalipnews.com/wp/wp-content/uploads/2014/07/src.adapt_.960.high_.1405938520312-e1405964865716.jpg)
Complicated history sets Alaska Native women apart from Violence Against Women Act
By Kayla Gahagan, ALJAZEERA America
Opponents of the reauthorization of a federal law passed last year say it has created a dangerous situation for Alaskan domestic violence victims and are urging lawmakers to support a repeal.
Proponents of the original 1994 Violence Against Women Act say it was signed into law with the purpose of providing more protection for domestic violence victims and keeping victims safe by requiring that a victim’s protection order be recognized and enforced in all state, tribal and territorial jurisdictions in the U.S.
According to the White House, the VAWA has made a difference, saying that intimate partner violence declined by 67 percent from 1993 to 2010, more victims now report domestic violence, more arrests have been made and all states impose criminal sanctions for violating a civil protection order.
Last year the law was reauthorized, clarifying a court decision that ruled on a case involving civil jurisdiction for non–tribal members and amending the law to recognize tribal civil jurisdiction to issue and enforce protection orders “involving any person,” including non-Natives.
But almost all Alaska tribes were excluded from the amendment, with only the Metlakatla Indian community from Alaska included under the 2013 law. The rest of Alaska remains under the old law.
The change has created confusion, opponents say, particularly in cases when there is a 911 call about enforcing a protective order.
“The trooper is waiting, because he’s not sure who has jurisdiction,” said David Voluck, a tribal court judge for the Central Council of Tlingit and Haida Indian Tribes of Alaska. “We need to get rid of those exceptions that create confusion.”
An ongoing debate
The reauthorization highlighted an ongoing debate about Native communities and tribal courts’ and governments’ jurisdiction, particularly in cases of policing and justice.
The reauthorization made sense, according to Alaska Attorney General Michael Geraghty, who noted that Alaska has always been treated differently because of the 1971 Alaska Native Claims Settlement Act. In exchange for 40 million acres of land and about $1 billion, he said, tribes forfeited reservations and the notion of Indian country to form Native corporations.
He said the state needs to find better ways to collaborate with institutions in small communities to provide better protection and justice but disagrees with giving pockets of tribal authority throughout Alaska.
“We do have an issue with violence and domestic violence,” he said. “We have a challenge in providing safety.”
But Geraghty said he has never heard of a situation when a victim was in danger because of confusion over jurisdiction.
“There’s nothing in the act that expands or retracts the jurisdiction of tribal courts,” he said. “If tribal courts had jurisdiction before, they do now. Troopers are not lawyers. If they are faced with a situation, they are going to protect the public. These concerns are overblown.”
‘A cloud over Alaska’
Lloyd Miller, an attorney who works on Indian rights and tribal jurisdiction litigation, disagrees and said things did change with the 2013 reauthorization.
“What he’s saying is that an Alaska village only has the authority to issue a protective order if that man is a member of the tribe. They can’t if he’s from the neighboring tribe,” he said. “Why would we not want to have Alaska villages have all the tools to protect women from domestic violence?”
Voluck agreed. “Does it really matter if a woman is hit in a mall somewhere or the south corner of where the tribe lives?” he said.
Opponents of the Alaska exemption recently urged a task force convened by Attorney General Eric Holder to study the effects of violence on Native American children to support the repeal of Section 910 of the law.
“VAWA creates a cloud over Alaska, and the last thing women and children need is a delay in an emergency,” said Voluck. “A matter of minutes can mean life or death. It’s unequal protection under the law for a very vulnerable part of the population.”
Lack of law enforcement
Voluck was one of a number of experts who testified last month before the Task Force on American Indian and Alaska Native Children Exposed to Violence about the special circumstances surrounding Alaska Native domestic violence, including geography, a lack of law enforcement and difficulty for victims to travel to safety.
Experts attested to a number of facts, including that Native American and Alaska Native women are 2.5 times as likely to be raped or sexually assaulted than other American women. About 140 villages have no state law enforcement. Eighty have absolutely no law enforcement. One-third of Alaska communities do not have road access.
It’s a serious issue for communities, said Valerie Davidson, a task force member who lives in Alaska. “Even if you only have 300 people, you still need law enforcement,” she said.
The debate continues, this time in Congress as the Senate Indian Affairs Committee works on legislation, which includes a provision repealing Section 910 of the 2013 reauthorization. Geraghty and the governor oppose a repeal, but the U.S. attorney general’s office has voiced its support.
Associate U.S. Attorney General Tony West attended the Alaska task force hearing and said arguments about the scope of authority of Alaska Native villages and tribes shouldn’t get in the way of protecting Native children from harm.
“If there are steps we can take that will help move the needle in the direction for victims, we need to do it,” he said. “When a tribal court issues an order, the state ought to enforce it. If not, the orders are worth nothing more than the paper they’re written on.”
More than just symbolic
Repealing the law won’t resolve the multilayered issues of jurisdiction, but it would be a step in the right direction, West added.
“It is more than just symbolic,” he said. “Repeal of Section 910 is an important step that can help protect Alaska Native victims of that violence and, significantly, the children who often witness it, and it can send a message that tribal authority and tribal sovereignty matters, that the civil protection orders tribal courts issue ought to be respected and enforced.”
The Task Force on American Indian and Alaska Native Children Exposed to Violence will make a recommendation to Holder by late October.
“Alaska is frozen in time,” Voluck said. “Why in the world would you hold the worst state when it comes to domestic violence in the old law? Forty-nine other states have figured out how to work with their tribal courts. Let’s work together. People are getting hurt and dying. That’s why I’m upset.”
Nisqually Tribe’s garden program cultivates tradition, community
![Nisqually Community Market Production Supervisor Carlin Briner helps a customer July 10th at their stand next to the tribal administration building. The tribe's community garden and weekly farm stand provides fresh produce for tribal and community members each week as members work from 8 a.m. until about noon on Thursday mornings in preparation for the afternoon garden stand which is set up at the tribal administration building near Yelm. STEVE BLOOM — The Olympian](http://www.tulalipnews.com/wp/wp-content/uploads/2014/07/pVtOg.AuSt_.38-300x191.jpg)
By: Lisa Pemberton, The Olympian
The Nisqually Tribe’s Community Garden Program isn’t just about food.
It’s about youth, elders, health, jobs, culture and community.
The program, which is based at the tribe’s 250-acre culture center off Mounts Road near DuPont, produces enough fruits, vegetables, berries, herbs and flowers to support two weekly farm stands for members of the tribe and reservation community.
The farm’s crops, grown on about five acres of the land, also are used at community dinners, the elder’s program, nutrition classes and other efforts.
“We work with our own people, and we have sovereignty to feed our own people,” said garden field technician Grace Ann Byrd. “And we do it with love and prayer.”
Production supervisor Carlin Briner said the Nisqually tribe has a long history of community gardens.
About five years ago, it launched the community garden stand program, which is funded by the tribe and offers an array of produce that’s free or by donation-only for tribal and community members.
In 2013, the garden program harvested and distributed more than 5,000 pounds of produce to the tribal community, Briner said.
This year, for the first time, the program is producing enough bounty to support two weekly garden stands — one at the farm, and one at the tribal administration building.
“At this point, we aren’t selling produce to the wider community, though we may start at some point,” Briner said.
On a recent day, the farm stand at the administration building offered several baskets brimming with beets, peas, beans, lettuce, carrots, kale, potatoes and several types of herbs.
Beverly Owens, an executive secretary for the tribe, picked up some kale, bok choy and greens. She said she loves shopping at the stand.
“I know where it’s coming from,” Owens said. “When you go to the grocery store, you don’t.”
Briner said the garden program has planted smaller kitchen gardens elsewhere on the reservation, including at the tribe’s preschool and daycare.
Every fall, its workers organize a harvest party for the tribal community, featuring cider pressing, foods and gifts.
And throughout the year, the garden workers help lead or organize workshops on canning, cooking, nutrition and traditional medicine making.
Garden field technician Janell Blacketer said one of her favorite recipes is nettle pesto — as in stinging nettles.
“They’re so good for you,” she said.
The program’s goal is to serve as a hub for all of the tribe’s programs, Briner said.
“Food is relevant to everything,” she added.
Byrd said she enjoys working for the garden program because it’s about supporting the tribe’s future while helping preserve many of its age-old traditions.
“We always laugh, and joke and have a good time,” she said. “They say you never go around food angry, and you’re not supposed to work around food in a bad way.”
That way, when items are being served from the tribe’s garden, “you see the transference of those good times around the people,” Byrd added.
Number Of Gonorrhea Cases Increasing Outside Urban Hubs
By: Jessica Robinson, NW News Network
Public health officials in the Northwest say they’re seeing gonorrhea infections at levels they haven’t seen in years. Three counties in Washington state are now in the midst of an outbreak. Parts of Oregon and Idaho are set to top even last year’s high numbers.
And health departments are seeing some unusual trends in the data.
Washington public health officials say King County often drives statewide trends, just through the sheer heft of Seattle’s urban population. But the 31 percent increase in gonorrhea cases over last year has largely been from spikes in Snohomish, Spokane and Yakima counties.
Oregon is seeing increases in unexpected places too.
“We’ve seen during the last year and a half increases in counties that are more rural than our metropolitan area of Portland,” the Oregon Health Authority’s Dr. Sean Schafer said.
That includes places like Jackson, Douglas and Lane counties. Schafer said he hasn’t seen such a high overall gonorrhea in Oregon since the early ’90s.
Idaho’s usually low gonorrhea numbers have risen dramatically as well. The infection rate around the Boise area has more than doubled since just two years ago.
North Idaho, far southwest Idaho and the Magic Valley have also sharp increases. The cause remains a mystery. One theory is the cyclical nature of the disease, another points to the higher rate of meth use in some rural areas.
Health departments are working with doctors to increase screening for the disease and are encouraging people to practice safe sex.
The Northwest’s rates – at around 20-50 cases per 100,000 people – are still better than the rest of the country, which hovers around 100 per 100,000 people. But health officials say the increase comes at a time when there are signs gonorrhea bacteria could become resistant to the last remaining oral antibiotic treatment.
People who get gonorrhea — and women in particular — may have few symptoms. If left unchecked, it can cause pelvic inflammatory disease in women and increase the risk of tubal pregnancy. In both men and women, it has lead to infertility in rare cases.
Can we have our sustainable seafood and eat it too?
By Amelia Urry, Grist
You know the feeling: You’re standing in front of the seafood counter, running down the list of evils you might be supporting when you buy one of those gleaming filets. There’s overfishing, but also pollution from fish farming, not to mention bycatch, marine habitat destruction, illegal fishing … and that’s before getting to the problem of seafood fraud, and the fact that 1 in 3 seafood samples in a massive study by Oceana was served under pseudonym.
Programs like Monterey Bay’s Seafood Watch and the Safina Center’s Seafood Guide are helpful when it comes to sorting seafood’s angels from its demons, but only if you can be sure the red snapper you’re looking at is actually red snapper (hint: It probably isn’t).
Meanwhile, third-party certification outfits — the ones that slap their seal of approval on seafood that’s harvested responsibly — are not without their flaws. In fact, the current demand for certified “sustainable” seafood is so high that it’s driving, you guessed it, overfishing. Someone get Poseidon in here because that, my friends, is what the Greeks called a “tragic flaw.”
Still, these third-party groups may offer the best hope for ocean-loving fish eaters like myself, so it’s worth paying attention to how they operate. And while these certification programs are very much a work in progress, they’re getting better.
****
The largest of the third-party labeling groups is the Marine Stewardship Council (MSC). Born of a partnership between the World Wildlife Fund and Unilever, the MSC was designed to bring market-based solutions to the kinds of environmental problems capitalism usually takes the blame for. It motivates fishermen, grocery chains, and restaurants to care about sustainability — because they can charge more for their product if it has MSC’s approval stamped on it.
MSC’s certification standards are based on the health of the fish population in question, the wider environmental impacts of fishing for it (such as habitat destruction and bycatch), and the quality of the fishery’s management. If fishermen want their fishery to be certified, they must pay hefty fees to independent assessors, who gather testimony from scientists and stakeholders, then submit a draft report which is peer-reviewed by other scientists, followed by public comments, more revisions (I assume you’ve tuned out by now), and so on — all adding up to an intimidating tangle of checks and balances. (If you like to geek out on this stuff, you can read all the reports of all the committees at every step of the process yourself.)
Once a fishery is certified, it receives yearly audits for five years, at which point the certification lapses and the whole process starts over again. Somehow, hoops and all, the MSC has managed to certify over 220 fisheries since 1996. According to MSC, its certified fisheries, along with about a hundred currently under review, make up over 10 percent of the global seafood catch, worth around $3 billion. Meanwhile, many companies are getting generous returns on their investment in sustainability: The wholesale value of MSC-labeled products rose 21 percent in 2013 alone.
But as MSC has grown, it has broken bread with larger and larger partners, whose appetites may outstrip the ability of certified fisheries to sate them. Critics claim MSC has slackened some if its rules to keep up with the demand from retail chains such as Walmart. Al Jazeera reported on the company’s struggle to keep buying Alaskan salmon after the fishery’s MSC approval lapsed:
Jennifer Jacquet, an environmental studies professor at New York University … said Walmart’s allegiance to MSC put a lot of pressure on the nonprofit to certify more fish.
“You have two options,” Jacquet said of MSC’s situation. “You can make seafood sustainable or you can redefine the word ‘sustainable’ to match existing resources.”
Likewise, when McDonald’s pledged to sell only MSC-labeled Alaskan pollock in the U.S., it strained the ability of the fishery — with only a mediocre sustainability score from Seafood Watch — to keep all 14,000 restaurants in Filet-o-Fish sandwiches.
Furthermore, NPR’s excellent in-depth series on MSC’s sustainability (or not) focused on a few fisheries the group had certified despite less-than-cheery evidence on the ground, er, sea. These included a swordfishery in Canada, where sharks are snagged more often than actual swordfish, over- and illegally fished Chilean sea bass, and volatile sockeye salmon populations in Alaska:
“Originally I thought [MSC] was a good idea,” says Jim Barnes, director of the Antarctic and Southern Ocean Coalition, a network of dozens of environmental groups around the world. … [But] the controversy over Canadian swordfish illustrates why the booming demand for sustainable seafood actually threatens to hurt the movement more than help it. “The bottom line is that there are not enough truly sustainable fisheries on the earth to sustain the demand.”
One result of that skyrocketing demand is that new, less stringent certification programs are popping up. After allowing its MSC’s certification to lapse, a powerful salmon fishery in Alaska persuaded Walmart to make room for a new certification, Responsible Fisheries Management, which puts less emphasis on sustainability and comes with no logo-licensing fees. Walmart still carries some MSC certified goods, but the company reneged on its all-MSC-all-the-time pledge.
You can imagine how this could quickly become a race to the bottom: If Alaskan pollock stocks continue to decline, the fishery may no longer meet MSC’s standards of sustainability. And if that happens? MSC could drop the pollock fishery and risk losing the McDonald’s account, too. Or it could lower the bar, in hopes of improving fishery practices down the road.
MSC has insisted that it never loosened its standards, and that those standards and the oversight that comes with them are high enough to guarantee sustainability — although it does offer a provisional certification for fisheries that are working toward sustainability, but aren’t quite there yet.
When I talked to MSC’s CEO, Rupert Howes, a few months ago, he told me that MSC has taken the global seafood scene a long way: “When MSC started, it really was innovative. There wasn’t really a sustainable seafood movement,” he said. “When you get leadership within the industry and within the market saying, we want sustainable seafood, we care where it comes from, we want to be part of the solution — it really is a huge, powerful force.
“I hasten to say: MSC is part of the solution,” Howes added. “Overfishing is a huge challenge — you need public policy reform, you need the work of advocacy groups to raise awareness of the issues, and then you need a program like the MSC that’s actually going to empower consumers, you and I, to use our purchasing decisions to make the best environmental choice.”
And like a good overseer, MSC is turning its eye on itself this year, in a thoroughly documented (naturally) self-review of its “chain of custody” program, which assures that MSC’s fish can be traced through the supply chain, from the water all the way to the seafood counter at the grocery store.
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It’s worth pointing out that none of this controversy is unique to seafood. Other food labels, from USDA’s widely applied “organic” to “fair-trade” to the virtually useless “all-natural” have at some point come under fire for being less idealistic in practice than they are in theory. The same is true of green building standards. Things get messy as any system gets bigger.
Of course, with billions of people eating from the sea, any movement toward oversight and accountability is almost certainly better than nothing. At the very least, by making sustainability visible, and desirable, to consumers, MSC has raised the stakes for the supply chains that serve them.
But what to do if the MSC’s logo isn’t enough for you? Here are a few tips for getting sustainable seafood, certifications be damned: 1) Eat as local as possible and many other concerns become moot; 2) eat low on the food chain, as in, more oysters and, seriously, no more Bluefin tuna; and 3) stick to restaurants or markets whose mission you trust instead of trying to decode the signage at your city’s everything emporium.
Did I miss anything? Uh, yeah, definitely. This whole labeling thing is a sticky issue, but it only works if producers know what the people want. So, by all means, weigh in.