Category: Health
Health Care Is Spread Thin on Alaskan Frontier
![Jim Wilson/The New York TimesA plane arriving with a patient at the airport in Bethel, Alaska.](http://www.tulalipnews.com/wp/wp-content/uploads/2013/05/29BETHEL-web1-articleLarge.jpg)
A plane arriving with a patient at the airport in Bethel, Alaska.
BETHEL, Alaska — Americans in some rural places fret at how far away big-city medical help might be in an emergency, or at the long drives they are forced to make for prenatal care, or stitches, or chemotherapy.
Dr. Ellen Hodges only wishes it could be so easy.
She oversees health care for a population of 28,000, mostly Alaska Natives, here in the state’s far west end, spread out over an area the size of Oregon that has almost no roads. People can travel by boat or snow machine at certain times of the year, but not right now: the Kuskokwim River, which wends through Bethel to the Bering Sea, is choked with unstable melting ice in late May, magnifying the isolation that defines everything in what may be America’s emptiest corner.
“If you have a road, you’re not remote,” Dr. Hodges said.
The complex machinery of health care is being reimagined everywhere in the nation through the combined prism of new regulations and shifting economics, even here on the continent’s frosted fringe.
The grandly named Yukon-Kuskokwim Health Corporation, for example, where Dr. Hodges is chief of staff, is scrambling this spring to install a new electronic medical records system. That is a hallmark of the federal health care overhaul, compounded out here by the fact that computers run by generators in far-flung villages are subject to brownouts and fuel shortages.
Cost controls are also the way of the medical frontier no matter where you look. In other places, such constraints may be driven by insurance companies; here, by sequester-driven budget cuts to the federal Indian Health Service. The agency is the 50-bed hospital’s main support in treating the tribes and villagers who have lived for thousands of years in the boggy crescent of lowlands where the Yukon and Kuskokwim Rivers carve their paths to the sea.
The 56 tribes in the region voted in the mid-1990s to bundle their health care money from the federal government to finance the hospital. Grants supplement the work.
But the one thing that shapes every care decision, from the routine to the catastrophic, is the map. Triage in medical decisions, logistics and money is all filtered through an equation of time and distance on a vast and mostly untracked land.
Is air transport justified for medical reasons? Too slow to make a difference? Too dangerous in bad weather to attempt? What should a health worker on the ground — in most villages a local resident trained by the hospital — be told to do, or not do?
“There are judgment calls that you never have to make in the lower 48,” said Dr. David Bielak, 31, a family medicine practitioner who started coming here last fall in temporary stints from his home near San Jose, Calif.
And many of those decisions, often based on telephone descriptions from a villager, can be weighty. None of the more than four dozen communities served by the hospital have a doctor in residence.
“It’s the middle of the night, and you get a call from a clinic way up in the middle of nowhere where something very, very strange has happened,” Dr. Bielak said. “A lot of it is dark: a lot of alcoholism, suicidal ideation, a lot of abuse.”
A lack of running water and sewer systems in many villages in turn compounds the struggle to make, or keep, people well in a place long marked by poverty and isolation.
Take a glimpse, for example, into Alexandria Tikiun’s world: At age 25, with four children at home to care for, she is a community health aide, the closest thing to an M.D. in her village, Atmautluak, population about 400.
The aide system itself is uniquely Alaskan. It was developed in the 1950s, during an outbreak of tuberculosis, when the first health aides were trained to dispense medicine. Now, in sessions here at the hospital, Ms. Tikiun and 150 other aides, mostly women, learn medical skills that include trauma response, pregnancy testing and vaccination, all based on a book that they call their bible, which walks them through a kind of algorithm of step-by-step questions leading to treatment protocols.
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This article has been revised to reflect the following correction:
Correction: May 28, 2013
An earlier version of this article misstated the number of tribes that voted in the mid-1990s to bundle their health care money from the federal government to finance a hospital. It was 56, not 58.
Our Last Best Hope to Save our Water, Air and Earth
By Clayton Thomas-Muller, climate-connections.org
![](http://canadiandimension.com/images/slir/w500-h400/images/articles/IMG_9006.jpg)
Years ago I was working for a well-known Indigenous environmental and economic justice organization known as the Indigenous Environmental Network (IEN). During my time with this organization I had the privilege of working with hundreds of Indigenous communities across the planet who had seen a sharp increase in the targeting of Native lands for mega-extractive and other toxic industries. The largest of these conflicts, of course, was the overrepresentation by big oil who work— often in cahoots with state, provincial First Nations, Tribal and federal governments both in the USA and Canada—to gain access to the valuable resources located in our territories. IEN hired me to work in a very abstract setting, under impossible conditions, with little or no resources to support Grassroots peoples fighting oil companies, who had become, in the era of free market economics, the most powerful and well-resourced entities of our time. My mission was to fight and protect the sacredness of Mother Earth from toxic contamination and corporate exploration, to support our Peoples to build sustainable local economies rooted in the sacred fire of our traditions.
My work took me to the Great Plains reservation, Three Affiliated Tribes of Fort Berthold to support a collective of mothers and grandmothers fighting a proposed oil refinery, which if built would process crude oil shipped in from a place called the tar sands in northern Canada. I spent time in Oklahoma working with Sac and Fox Tribal EPA under the tutelage of the late environmental justice warrior Jan Stevens, to learn about the legacy of 100 years of oil and gas on America’s Indian Country—Oklahoma being one of the end up points of the shameful indian relocation era. I joined grassroots on the Bay of Fundy, in an epic battle against the state of Maine and a liquidified natural gas (LNG) producer who wanted to build a massive LNG terminal on their community’s sacred site known as Split Rock. The plant, had it been built, would have provided natural gas to the City of New York for their power plants.
I worked extensively with youth on the Navajo reservation, in America’s Southwest, who were fighting the Peabody Coal mining company, to stop the mining of Black Mesa, a source of water and a known sacred site in the Navajo Nation. On the western side of the Navajo Nation, I worked to support Dine/Navajo that were fighting the lifting of the Navajo Nation ban on uranium mining, which would have seen the introduction of a dangerous form of uranium mining called in situ or “in place” extraction that would poison precious ground water resources in the desert region. Uranium had already left a devastating legacy on the Dine/Navajo from operations in the ’40s and ’50s. I worked in the Great Lakes region in the community of Walpole Island (Bkejwanong First Nation) to stop a oil company from drilling for oil in their fragile—a place where First Nations peoples harvest for wild rice, muskrat and fowl gains. It had also become a place of local economic importance as ecotourism from American duck hunters also providing income to the community. Walpole Island was already dealing with the impacts of 60 petrol-chemical facilities within 60 km of their nation. I worked to support groups in Montana’s Northern Cheyenne and Crow Indian reservations who were fighting massive expansion of Coal Bed Methane in their region. The encroachment was decimating local ground water resources. I worked in Alaska and was a co-founder of the powerful oil busting network known as Resisting Environmental Destruction on Indigenous Lands (REDOIL) which was created to take on the corrupt Alaska Native Corporations and big oil which had been running roughshod trying to start development in fragile places like the Arctic National Wildlife Refuge (ANWR). I worked with groups in British Colombia’s Northeast, where natural gas companies were ripping apart the landscape with massive gas developments in the region. I worked in dozens and dozens of other territories and places across the globe, many not mentioned in this story.
During my time as an IEN Indigenous oil campaigner for over five years (2001–2006) I observed that these fights were all life and death situations, not just for local communities, but for the bio-sphere; that organizing in Indian Country called for a very different strategic and tactical play than conventional campaigning; that our grassroots movement for energy and climate justice was being lead by our Native woman and, as such, our movement was just as much about fighting patriarchy and asserting as a core of our struggle the sacred feminine creative principal; and that a large part of the work of movement building was about defending the sacredness of our Mother Earth and helping our peoples decolonize our notions of government, land management, business and social relation by going thru a process of re-evaluating our connection to the sacred.
In the early years I often struggled with the arms of the non-profit industrial complex and its inner workings, which were heavily fortified with systems of power that reinforced racism, classism and gender discrimination at the highest levels of both non-profit organizations and foundations (funders). It was difficult to measure success of environmental and economic justice organizing using the western terms of quantitative versus qualitative analysis. Sure, our work had successfully kept many highly-polluting fossil fuel projects at bay, but the attempts to take our land by agents of the fossil fuel industry—with their lobbyist’s pushing legislation loop holes and repackaging strategies—continued to pressure our uninformed and/or economically desperate Tribal Governments to grant access to our lands.
The most high profile victory came during the twilight of the first Bush/Cheney administration when our network collaborated with beltway groups like the Natural Resources Defense Council and effectively killed a harmful US energy bill that contain provision in it that would kick open the back door to fossil fuel companies allowing access into our lands. The Indian Energy Title V campaign identified that if the energy bill passed, US tribes would be able to, under the guise of tribal sovereignty, administer their own environmental impact assessments and fast track development in their lands. Now this sounds like a good thing, right? Well, maybe for Tribal governments that had the legal and scientific capacity to do so, but for the hundreds of US Tribes without the resources, it set up a highly imbalanced playing field that would give the advantage to corporations to exploit economically disadvantaged nations to enter into the industrialization game.
Through a massive education campaign and highly-negotiated and coordinated collaborative effort of grassroot, beltway and international eNGOs—as well as multiple lobby visits to Washington DC lead by both elected and grassroots Tribal leaders—we gained the support of the National Congress of American Indians who agreed to write a letter opposing the energy bill to some of our champions in the US Senate most notably the late Daniel Akaka who was Hawaii’s first Native Senator. Under the guidance of America’s oldest Indian Advocacy group he would lead a vote to kill the energy bill in the Senate. This was my first view into the power of the Native rights-based strategic and tactical framework and how it could bring the most powerful government on Earth (and the big oil lobby) to their knees. Of course upon the reelection of the Bush/Cheney administration we lost the second reincarnations of the energy bill and the title V was passed.
What I learned in those battles was that because of the unique priority rights, the fiduciary obligation governments have to Native Americans—defined by the our sacred treaties and trust relationship and other unique legal instruments—we have an important tool as Native American and First Nations peoples. We are the keystones in a hemispheric social movement strategy that could end the era of big oil and eventually usher in another paradigm from this current destructive time of free market economics.
The challenge would be to get people with power, both real and falsely perceived, to understand this reality. It is a task not easily accomplished. For example with the passing of the US energy bill under the second US Bush/Cheney administration the US climate movement began to ramp up its attempts to have the administration pass a domestic climate bill. A massive investment by Washington DC focused on strategies developed by the foundations and individual donors, most of it was earmarked to policymakers instead of building an inclusive movement for climate justice that would take into account this environmental and economic justice frame in the struggle to force the US to lead the world in emissions reductions.
This movement saw the rise of mega-labour/eNGO coalitions like the Blue/Green Alliance, Apollo Alliance and mega-eNGO groups like 1sky and 350.org. Citizen groups like the US Public Interest Research Group (US PIRG) received millions of dollars to try and organize people to put pressure on President Bush and later President Obama to adopt some form of climate policy. However, the strategy screamed that age-old saying “what goes around comes around”…again. There would be no climate bill under Bush and, surprisingly to the people who voted for him, no climate bill under Obama (yet).
The groups that ended up receiving resources from a limited pot of climate funding did what they did best, which was to invest in top-heavy policy campaigns which did not focus on mobilizing the masses to get out in the streets; to target and stop local climate criminals and build up a bona fide social movement rooted in an anti-colonial, anti-racist, anti-oppressive foundation to combat the climate crisis. Instead it kept the discourse focussed on voluntary technological and market-based approaches to mitigating climate change, like carbon trading and carbon capture and storage. I would argue that this frame is what kept this issue from bringing millions of Americans into the streets to stop the greenhouse gangsters from wrecking Mother Earth. Groups like the Indigenous Environmental Network, Southwest Workers Union and others fought tooth-and-nail to try and carve out pieces of these resources to go towards what we saw as the real carbon killers, which were local campaigns being lead by Indigenous Nations and communities of colour to stop coal mining, coal fired power and big oil (including gas).
During the early hours of the Obama administration there was a massive effort to “green” the economic stimulus, this was a package of job creation funding that was to be doled out by the Obama administration to counter the Great recession, which had crippled the US economy. I had the opportunity to sit with some of the leaders of some of the biggest NGOs and foundations at a New York City roundtable, including members of the Obama White House team—high profile individuals like former Green Jobs Csar, Van Jones, and Energy Action/Mosaic Solar founder Billy Parish were also in attendance. At this table I told a story.
In the ’80s and ’90s America was in the grips of a recession, groups rose up from all sectors to create a strategy to combat the crisis. Alliances were formed between the trade unionists and the NGOs and social justice groups. When the negotiated target of funding was in sight and congress was about to write a check, groups became divided, and what was plentiful turned to scarcity and in the end AmeriCorp was born. Unions, NGOs and social justice groups, and more importantly, the unity they had created, was shattered. The political games and divisive tactics used by those in power who used race, class and gender politics to divided a movement. I said that we were in the exact same moment in time, that we were seeing big oil ram through an energy bill loaded with corporate welfare for the 1% during the collapse of Americas middle-class and the stalling of a US climate bill, would impact the most vulnerable to our rapidly destabilizing climate—poor communities of colour and Native American communities.
America’s wealth, and more directly, America’s energy infrastructure was built on our backs. Efforts should be made to invest locally first—from training green jobs workers locally to using local building materials to producing energy locally— which would close the financial loop will help revitalize Native America’s strangled economies, making them less vulnerable to volatile external costs while maximizing the positive impact of the new green revolution.
A green jobs economy and a new, forward-thinking energy and climate policy would transform tribal and other rural economies, and provide the basis for an economic recovery in the United States. In order to make this possible we had to encourage the Obama Administration to provide incentives and assistance to actualize renewable energy development by tribes and Native organizations and our allies.
I made the argument that we could use the attributes of a predatory economic paradigm, that had disproportionately targeted our communities, to flip the script on our enemies and that Native Americans, with our unique rights-based and trust relationship with the US government. It could be a strategic and tactical asset to a diverse social movement trying to lobby for an economic stimulus bill that would actually help empower the most vulnerable while not exacerbating an ecological crisis. For this to work we would have to make moral agreements and not, under any circumstances, be denied. On the table was $750 million earmarked for green jobs and the task at hand was to determine how to equitably share the pot. In the media, the numbers of jobs created versus the amount of workers unemployed went from one million to five million and then back to one million and again. Once we got to the point where congress was ready to write a check, we saw the downfall of mega groups like the Apollo Alliance and the absorption of the 1SKY by 350.org. Many groups who started off at the table fell, one by one, with the first being groups representing racialized constituencies. Meanwhile in Indian Country, tribes saw congressional allocations from this economic stimulus packaged in the billions (rightfully so) and kept on keeping on.
The point of the story was that if we could truly understand the aspects of our struggle that kept us united, and more importantly, understand what our unique contributions to a successful social movement paradigm, we could effectively expanded the pot from 750 million dollars to billions. By converging struggles in a solidarity framework rooted in anti-racism, anti-oppression and anti-colonialism and by creating economic and political initiatives uniting urban and rural centres, we could wield a power never seen by our oppressors and actually gain economic independence and community self-determination. We could develop economies that didn’t force people to have to choose between clean air, water and earth, or putting food on the table. I did not attend this meeting to ask for handouts, but rather as an ambassador of a strategic framework that I had come to know as the Native rights-based approach, which could be used to bring to an end what Native American activist, author and Vice Presidential candidate, Winona LaDuke described as “predator economics” and what activist and author, Naomi Klein rightfully describes as “shock doctrine” economics.
Little did I know that all of these experiences were preparing me for what would be one of the biggest battles of my life. During the IEN Protecting Mother Earth Summit in 2006 in Northern Minnesota, three woman from a small, mostly native, village called Fort Chipewyan, Alberta came to share their Dene peoples struggle—years later it would be known as the most destructive industrial project on the face of the earth, the tar sands mega-project. These three woman were related to each other and represented three generations of one prominent family in Fort Chip known as the Deranger clan. They listened to the dozens of stories told in the energy and climate group about the injustices happening because of oil companies and complicit governments across Turtle. They told us about a project so large, so devastating that you had to see it to believe it. They spoke of a wild west of sorts, one of the last bastions of Earth were big oil was ramping up, and they spoke of the deaths in their community from rare cancers, auto-immune diseases and boomtown economics that were plaguing their people who lived downstream from these tar sands. They said was that we needed to go up to Fort Chipewyan and help.
During this time I was taking time off from organizing and living in Ottawa with my wife and newly born son, Felix. My lifetime mentor and friend Tom Goldtooth, Executive director of the Indigenous Environmental Network took this invitation from the Deranger matriarch Rose Desjarlais very seriously. IEN immediately organized a fact-finding mission in the Athabasca region of the tar sands with our Native energy and climate director, Jihan Gearon, and Rainforest Action Network campaigner, Jocelyn Cheechoo, from the James Bay Cree in Northern Quebec. I was invited because of my experience in fighting big oil across Turtle Island.
When we flew into Fort McMurray, the boomtown in the heart of the tar sands, I was immediately struck by how much it reminded me of Anchorage, Alaska. That was the only other city I had ever been to that also reeked of oil money. The town had an infrastructure to support 35,000 people but was literally busting at the seams with a population of 75,000. Most were men between the ages of 18–60 and all working directly or indirectly for the tar sands sector. We took a tour of the infamous Hwy 63 loop to Fort McKay Cree Nation that carves thru man-made desert tailings ponds so big you could see them from outer space. We marvelled at the 24-hour life of the city and the incredible traffic jams at shift change. I think what struck me most was the level of homelessness in a town were there was six-figure salary for anyone who wanted it. To see the tar sands themselves was devastating, to fly over endless clear cuts, open-pit mines and smoke stacks surrounded by pristine Cree and Dene peoples homelands was gut wrenching. When we drove through and walked in the tar sands the smell of bitumen filled our noses and lent to the trauma that locals live with every day.
We got on a bush plane at the Fort McMurray airport and flew to Fort Chipewyan, we flew the route of the Athabasca River—a critical life path of the people of that land, a source of water, fish and transportation and a spiritual connection to a past. We were told of how the river had changed, become poisoned, was no longer safe and how every year the water levels became lower due to industry use. When we got to Fort Chip we were well taken care of, and we met many elders, the elected leadership and youth who all told the same stories of hardship, the untimely sickness and death, and the destruction of a subsistence way of life—all by the tar sands. We heard about the history of the peoples going out into the Athabasca Delta and on to Lake Athabasca for food and medicine and how that was becoming impossible due to the massive regional contamination by industry. Again we were told that we needed to help local grassroots people magnify this scandal to the world by amplifying their voices as the face of the issue.
After we took in the horrifying science fiction of the tar sands—and more importantly the power, beauty and resiliency of the people of this land they call Athabasca—Tom Goldtooth asked me to build the Canadian Indigenous Tar Sands Campaign. The first thing we did was raise funds for an action camp in Fort Chip where we could do a proper power mapping and skill share with community members who were leading local campaigns and wanted to scale them up. Our first action camp had around 15 community members, including tar sands warriors and climate movement folk hero’s like former Mikisew Cree Nation Chief George Poitras, local Dene activists Mike Mercredi and Lionel Lepine, Melina Lubicon Massimo, a Lubicon Cree activist, and Eriel Deranger, a Dene woman also of Fort Chipewyan.
We brought in resource people from the NGO sector. With the direction of local Indigenous leaders we organized a series of workshops on Aboriginal Law, organizing, campaign planning, power mapping and the Native rights-based approach. The outcome of the camp formed directives to launch a Native-lead campaign to stop the expansion of the tar sands; to utilize a treaty and Aboriginal rights-based framework; to ensure that Indigenous peoples on the front line were the face of the campaign; to raise the human health impacts as a moral issue; to follow the money financing the tar sands and to target those controlling it. Also, we were to advocate in the non-profit industrial complex that a meaningful proportion of funding and resources earmarked for tar sands work go directly to First Nations.
What came next would consume most of my waking time on Mother Earth for the next seven years. When IEN launched our tar sands campaign we knew that this issue was about to become one of, if not the most, visible campaigns on the planet. The local grassroots peoples were engaging with the most ruthless, powerful, well-resourced and just plain old evil corporate entities on the face of the planet. We knew that these companies had bought every level of colonial government, and many were in bed with our own First Nations governments. But we knew that if executed properly we would see victory. This multi-pronged campaign would contain elements of legal intervention, base-building, policy intervention (at all levels of government, including the United Nations), narrative-based story-telling strategies in conventional and social media, civil disobedience and popular education and a whole lot of prayer and ceremony.
Again, I found my self at a table of funders and eNGO directors discussing a massive campaign that would impact every segment of our society including our bio-sphere. I found myself viewed by my peers as without power and that perhaps I was at the table for handouts rather then with something to offer. The same old tricks of top-heavy, policy-focussed pitches by the usual suspects happened again. And I found myself repeating the need to take the time to understand and work in solidarity with the Native rights-based strategic framework. I talked about how in the last 30 years of Canadian environmentalism there had not been a major environmental victory won without First Nations at the helm asserting their Aboriginal rights and title. This included many of the victories that those in the room counted in their own personal careers. I argued passionately that we should agree on the fact that we needed to dedicate meaningful resources this approach and the decision would mean the difference between a fight lasting years or decades. During that meeting the facilitator representing the collective of foundations and donors that had contributed to a pot of money to fund anti-tar sands work became noticeably frustrated with our platform and things escalated to a point were he was yelling and swearing that our IEN campaign was “in the way” of plausible strategies that were actually going to work. Once the chastising was over I proceeded to say “Well, now that I know were your coming from and you know where IEN is at, how much of this funding are we going to get?” We walked out of that meeting with 50 000 dollars seed money to start our campaign.
From that moment to now, our Indigenous heroes, or should I say “‘She’roes” have successfully built an international movement to stop the Canadian tar sands. Supported by thousands of Native and non-Native allies, the campaign is now active in the United States, Canada and Europe with hundreds of First Nations, unions, NGOs, private-sector companies, municipalities, foundations and individuals participating and elevating First Nations and our rights-based strategic approach as the keystone to the campaign. Part of this success was achieved through some seriously gutsy moves, one being a visit of high-profile Hollywood director, James Cameron, to tour the tar sands right when his blockbuster movie Avatar had become the highest grossing film in history.
Cameron’s tour was done at the time when IEN was pushing hard for our Keystone XL campaign to be funded. It was an uphill battle since everyone knew that pipeline fights historically have usually been defeats. We had done an analysis on the viability of victory in a Keystone XL campaign for the funders, this was due to the fact that we were one of the only groups that had taken on the Keystone number one pipeline. Our analysis told us a couple things; in the US, the Oglala aquifer would be the primary ecological card, as millions depended on this source of water and the pipeline was right through the heart of it. We knew that the dozen or so US Tribes could be educated to use the power of their unique rights-based approach to fight the pipeline. We also knew that no one in the USA, especially in the heartland of the Dakota states, Nebraska, Oklahoma and Texas knew what the tar sands were. We knew by bringing James Cameron to the tar sands, and by having him talk about the human rights scandal unfolding in First Nations communities, during a time whenAvatar was on every theatre screen on the planet would be huge boost to our cause.
Jim Cameron came, he saw, he met with the tar sands industry, the Alberta government and with First Nations. He made a lot of promises about direct support of the legal strategies of First Nations against the oil sector and the government of Canada. As an avid supporter of technological remedies, he did not condemn the tar sands, he spoke highly of nuclear energy as an alternative—as well as the emerging theoretical carbon capture and storage technologies. What he did do, was to say in front of the international press “I did not make Avatar until the technology was available for me to tell the story right, and the Canadian government should not develop the tar sands until they have the technology to not poison and kill First Nations people with cancers.”
Avatar part two and three are set to come out in 2015, I have a feeling that Cameron and his commitments to First Nations about directly funding the rights-based strategic framework are yet to be tested. The fall out from his visit was every newspaper, television, computer and smart phone in America was comparing the story of Avatar to the real-life situation unfolding between First Nations in the tar sands. The end result was the emergence of the Keystone XL campaign as the lightning rod of the US environmental movement, a fight that’s still raging today and it was done so thru the lens of human rights.
The tar sands campaign of IEN started at a time when direct community funding was in the tens of thousands but over time and through pressure it is now in the millions. We’re still dealing with a non-profit industrial complex that is its own worst enemy. But Harper’s corrupt, totalitarian federal government—with their extremism—is pushing a larger base of non-Native allies to our side of the equation.
With the current Harper government and the passing of recent omnibus legislation, Canada has seen 30 years of environmental, social and economic policy thrown out. In response, we seen the rise of Idle No More, a catchy social media and education campaign launched—again by First Nations woman—and the result was a quickening of Canadian reconciliation with its own violent history of colonization as well as the rapid politicization of tens of thousands of Indigenous peoples occurring not just in Canada, but in all occupied lands across Mother Earth. Left without a pot to piss in, the conventional non-profit Industrial complex and their supporters are trying to figure out their next steps in dethroning Harper, a daunting task after the unsuccessful bid to elect the New Democratic Party in British Colombia.
The one area the Harper government has not been able to stack the cards is the courts, and a Native rights-based tactical and strategic framework—supported by labour, NGOs, students and other social movements scaled up to the proportions of the 1960s US civil rights movement—is what’s going to not only dethrone Harper, but is the last best effort save our resources from Canada’s extractive industries sector and the banks that finance them. This rights-based approach has been tested time and time again, it is enshrined in section 35 of the Canadian constitution, it has been validated by more then 170 supreme court victories, it is validated by all of the Indian treaties, it’s validated by the United Nations declaration on Indigenous Peoples, it’s validated by the ILO convention 169 and many, many other legal instruments. The racism that Idle No More has met in the media reminiscent of a 1950 Mississippi era toward Native peoples and our winning rights-based strategy has driven even the most conservative of Canadians to our side and even toppled some of the biggest architects of the free market neoliberal agenda such as the infamous US-trained lawyer and mentor to Canadian Prime Minister Harper, Thomas Flanagan. We have come too far as Indigenous peoples to give up who we are, we have always been kind and again we will share the wealth and abundance of our homelands with our relatives from across the pond. Instead of lessons on how to survive the harsh winters of our lands, today we are offering lessons on how to be resilient and to overcome the oppression from the archaic oil sector and in our own government who have lost their minds with power.
We are faced with tremendous odds, the end of the era of cheap energy, the loss of ecosystems to sustain unfettered economic growth and, of course, the global climate crisis. We must understand that these are all symptoms of a much larger problem called capitalism. This economic system was born from notions of manifest destiny, the papal bull, the doctrines of discovery and built up with the free labour of slaves, on stolen Indian lands. We have much to do in America and Canada to bring our peoples into a meaningful process of reconciliation. I have learned that our movement is very much lead by woman, this is something I am very comfortable with given the fact that I am a Cree man and we are a matriarchal society. There is a powerful metaphor between the economic policies of this country Canada and the USA and their treatment of our Indigenous woman and girls. When you look at the extreme violence taking place againsts the sacredness of Mother Earth in the tar sands for example and the fact that this represents the greatest driver of both Canadian and US economies, then you look at the lack of action being taken on the thousands of First Nations woman and girls who have been murdered or just disappeared, it all begins to all make sense. Its also why our woman have been rising up and taking power back from the smothering forces of patriarchy dominating our economic, political and social and I would say spiritual institutions. When we turn things around as a peoples, it will be the woman who lead us, and it will be the creative feminine principal they carry that will give us the tools we need to build another world. Indigenous peoples have been keeping a tab on what has been stolen from our lands, which the creator put us on to protect, and there is a day coming soon were we will collect. Until then, we will keep our eyes on the prize, organize and live our lives in a good way and we welcome you to join us on this journey.
Clayton Thomas-Muller is a member of the Mathias Colomb Cree Nation also known as Pukatawagan in Northern Manitoba, Canada. Based out of Ottawa, Ontario, Canada, Clayton is the co-director of the Indigenous Tar Sands (ITS) Campaign of the Polaris Institute as well as a volunteer organizer with the Defenders of the Land-Idle No More national campaign known as Sovereignty Summer.
Clayton is involved in many initiatives to support the building of an inclusive movement globally for energy and climate justice. He serves on the board of the Global Justice Ecology Project, Canadian based Raven Trust and Navajo Nation based, Black Mesa Water Coalition. Clayton has travelled extensively domestically and internationally leading Indigenous delegations to lobby United Nations bodies including the UN framework Convention on Climate Change, UN Earth Summit (Johannesburg, South Africa 2002 and Rio +20, Brazil 2012) and the UN Permanent Forum on Indigenous Issues. Clayton has coordinated and lead delegations of First Nations, Native American and Alaska Native elected and grassroots leadership to lobby government in Washington DC, USA, Ottawa, Canada, and European Union (Strasbourg and Brussels).
He has been recognized by Utne Reader as one of the top 30 under 30 activists in the United States and as a “Climate Hero 2009” by Yes Magazine. For the last eleven years he has campaigned across Canada, Alaska and the lower 48 states organizing in hundreds of First Nations, Alaska Native and Native American communities in support of grassroots Indigenous Peoples to defend against the encroachment of the fossil fuel industry. This has included a special focus on the sprawling infrastructure of pipelines, refineries and extraction associated with the Canadian tar sands.
Clayton is an organizer, facilitator, public speaker and writer on environmental and economic justice. He has been published in multiple books, newspapers and magazines and appeared countless times on local, regional, national and international television and radio as an expert advocate on Indigenous rights, environmental and economic justice. He has been a guest lecturer at universities, conferences and seminars around the world. He is also a member of Canadian Dimension’s editorial collective.
Follow Clayton Thomas-Muller on Twitter: @creeclayton
Celebrating Two Years of Let’s Move! in Indian Country
![Jodi Gillette at Chimney Rock Jodi Gillette at Chimney Rock](http://www.whitehouse.gov/sites/default/files/imagecache/embedded_img_small/image/image_file/matthew_mooney_jodi_gillette_and_dakota_lorenzo_at_chimney_rock.jpg?itok=5ROcJ7Pk)
I recently had the honor of attending an event to mark the 2nd Anniversary of Let’s Move! in Indian Country at Chimney Rock National Monument in southwestern Colorado. I hiked and learned about this magnificent landscape on our way to the top with fifty youth from the Southern Ute Montessori Elementary, the Deputy Undersecretary of Agriculture Butch Blazer, and a handful of youth from the Pueblos who work with the Southwest Conservation Corps, an AmeriCorps partner organization that engages and trains a diverse group of young women and men and completes conservation projects for the public benefit.
I had lengthy conversations with Aaron Lowden, an Acoma Pueblo, regarding the strength and resiliency of the ancient people who built and lived in that space, and how their journey is connected to his own. Below I’d like to share some of his thoughts:
Guwaatse howba tu shinomeh kuwaitiya eshte e Aaron Lowden madiganashia kuhaiya haanu stu da aakume’ haanu stu da! Hello everyone my name is Kuwaitiya in Acoma and Aaron Lowden in English and I come from the bear clan of the Acoma people. I am a program coordinator for the Southwest Conservation Corps’ (SCC) Ancestral Lands regional office in Acoma Pueblo, NM.
Our day began in the way I began this blog with a greeting to all attending the Let’s Move! in Indian Country (LMIC) 2nd Anniversary event and by saying a prayer. The prayer was done for the entire group before we entered the ancient Puebloan site of the recently designated Chimney Rock National Monument, CO. It is as a sign of respect for those who came before to let them know we were there to learn from them. When we started at the trail head we were joined by Southern Ute schoolchildren, the Southwest Conservation Corps, the US Forest Service and US Department of Agriculture to celebrate the 2nd anniversary of LMIC. We were also joined by Jodi Gillette, the White House Senior Policy Advisor for Native American Affairs and Butch Blazer, the Deputy Under Secretary for Natural Resources and the Environment at the Department of Agriculture.
Finally, we were ready to do what we all came there to do: get outside and get active. Led by the Chimney Rock Interpretative Association guides, we hiked with anticipation to see the ruins. Walking through the Great Houses on steep inclined trails the group gained knowledge by experiencing the difficult and active living conditions of the original occupants of these sites.
![Aaron Lowden Welcomes Hikers to Chimney Rock Aaron Lowden Welcomes Hikers to Chimney Rock](http://www.whitehouse.gov/sites/default/files/imagecache/embedded_img_small/image/image_file/aaron_lowden_welcomes_hikers_and_youth_to_chimney_rock.jpg?itok=AuG3ICqw)
We learned how every single bit of rock and mortar had to be transported up to the top of this steep peak. If you were to talk with one of the ancestral inhabitants today and ask them about environmental stewardship, exercising, and eating right it’s reasonable to assume that they wouldn’t know what you were talking about, it’s just how they lived.
Today, Native Americans – particularly youth – have one of the highest obesity rates in the country. Although progress can be a good thing and has made our lives extensively easier, it is imperative that we keep these reminders and retain our old ways to have a healthy future as indigenous peoples. I feel this is even more appropriate when on the subject of Native American issues of our health and environmental stewardship. After all, if we can’t take care of the haatsi (land), how can we expect it take care of us. By getting outside and being active in our country’s public lands, and by eating right and caring about where our food comes from, we can raise a healthier, more environmentally conscious generation.
After the group finished the hike, the Southwest Conservation Corps Ancestral Lands staff prepared a popular Pueblo dish: green chili stew. We were all ready to eat after our hike! Everyone enjoyed the nutritious meal and discussed the hike while the students played outdoors.
As the day winded down and once everything was finished, we all headed home thankful for the beautiful day we had been given.
Please click here to learn more about Let’s Move! in Indian Country.
Jodi Gillette is the White House Senior Policy Advisor for Native American Affairs
HHS announces the winners of the reducing cancer among women of color challenge
Apps help undeserved and minority women take control of their health
Source: Department of Health and Human Services
HHS Deputy Assistant Secretary for Minority Health J. Nadine Gracia, MD, MSCE announced the winners of the Reducing Cancer Among Women of Color Challenge. A first-of-its-kind effort to address health disparities among racial and ethnic minorities, the winning apps will help women of color prevent and fight cancer.
The winning apps, Big Yellow Star, Broadstone Technologies, Appbrahma, HW-Technology, and Netzealous, are designed to help women of color prevent and fight cancer by linking them to information regarding preventive and screening services and locations, including support groups and care services.
The apps all focus on providing high-quality health information in different languages to women and community health workers about screening and preventive services. The apps were developed to interface securely with patient health records and strengthen communication across a patient’s care team in an effort to better coordinate information and care.
“This challenge created an innovative opportunity to use new technologies and new platforms to engage women in communities that have too often been dismissed as ‘hard-to-reach,’” Dr. Gracia said. “Through these innovative tools, we are addressing disparities by reaching women where they are – and taking an exciting step forward in implementing the HHS Action Plan to Reduce Racial and Ethnic Health Disparities.”
“The Reducing Cancer Among Women of Color Challenge is a great example of the positive impact health information technology can make. Getting timely cancer preventive and treatment information to patients has always been an effective strategy. The winners of this challenge increase our capacity to empower women across a broad socioeconomic spectrum,” said David Hunt, M.D., F.A.C.S., medical director of health IT adoption & patient safety at the Office of the National Coordinator for Health IT (ONC).
In the United States, breast and gynecologic cancers are responsible for more than 68,000 deaths each year with over 300,000 new diagnoses made each year. Women of color are disproportionately affected due to various reasons, including the inability to access health care and preventive information, services, referral, and treatment.
The Reducing Cancer among Women of Color Challenge is a partnership between HHS’ Office of Minority Health and ONC. It challenged innovators and developers to create a mobile device-optimized tool that engages and empowers women to improve the prevention and treatment of breast, cervical, uterine, and ovarian cancer in underserved and minority communities and that can interface with provider electronic health records.
Submissions were reviewed and judged based on:
- Patient engagement
- Quality and accessibility of information
- Targeted and actionable information
- Links to online communities and/or social media
- Innovativeness and usability
- Non-English language availability
To learn more about the app challenge, the winners, and information on how to download the winning apps please visit:
http://challenge.gov/ONC/402-reducing-cancer-among-women-of-color and http://www.health2con.com/devchallenge/reducing-cancer-among-women-color-challenge/
Trauma therapist guides patients in a path of healing
![Jeremy Franklin JeremyFranklin](http://www.tulalipnews.com/wp/wp-content/uploads/2013/05/JeremyFranklin-e1368653374594-300x280.jpg)
Photo by Monica Brown
By Monica Brown, Tulalip News Writer
TULALIP, Wash. – Jeremy Franklin, the new mental health therapist at Tulalip Family Services specializes in helping those who suffer from trauma and PTSD (Post Traumatic Stress Disorder). He is from Eugene Oregon and brings with him an understanding in various cultures, spiritualities and psychology.
“I became interested in psychology during high school, but it was a journey to decide that I wanted to become a counselor,” said Jeremy. “In this field, you go through some difficulties and going through the journey of wellness was part of the process for me in my decision to become a counselor.”
Jeremy gained a portion of his experience from volunteering as a mentor at Rite of Passage Journeys in Bothell. A rite of passage is a significant moment in a person’s life when they transition from one stage of their life to another.
“Most cultures, at some point in their history, had a rite of passage which helped young people transition into becoming adults,” said Jeremy. A mentoring volunteer since 2003 at Rite of Passage Journeys, Jeremy enjoys going on the retreats and mentoring adults by guiding them through their struggles while backpacking through the Olympic Mountains. Rite of Passage Journeys is a program which trains mentors to honor life transitions through intentional rite of passage so that they may help people of different ages to make life–changing decisions by offering counseling in a dramatic change of scenery and emotional space so that the person can gain clarity and confidence.
“Sickness, of any kind, is the result of something being out of balance in a person’s life. As a counselor and client, together we can explore and discover what those imbalances are and seek out the way that they can be addressed. When we bring all the parts of our being into balance, we are moving towards wellness and wholeness,” said Jeremy.
For Jeremy, each of his Tulalip clients is different and unique and he is there to help the client on their journey and decide with them the best way they can begin to heal. He offers them a place where they can express themselves and feel confident that they will be treated with positive regard, respect, safety and non-judgment. He is knowledgeable in prayer, cultural and spiritual explorations if the client is interested in using those tools. One of the main tools Jeremy teaches is gratitude work.
“That is one of the things that helped me the most,” said Jeremy about gratitude work. To explain gratitude work, Jeremy told the story of the two fighting wolves that reside within everyone.
“The grandfather tells his grandson that there are two wolves that live inside of me, the white wolf and the dark wolf and they’re fighting. The white wolf is everything good and positive; its love, hope, faith and the dark wolf is all the things that are hard and hurtful; it’s anger, hate, greed and jealousy. These wolves are in my heart and always fighting. The grandson asks his grandfather, which one will win. And the Grandfather replies, “Whichever one I feed.” Gratitude work is the act of feeding the white wolf and listing the things that you are grateful for in life and looking at each day as a gift.
Jeremy is of Lakota and Irish descent. He earned his Master of Arts in Psychology at Antioch University of Seattle and began his internship in 2012 at Tulalip Family Services. In December he received his degree and in January became a regular employee. His work focuses on those who have suffered trauma and/or have PTSD and the ways they can heal. His hours are Monday through Friday 8:00 a.m. – 4:30 p.m. For more information on scheduling an appointment, please contact Tulalip Family Services Behavioral Health at 360-716-4400
NTSB: Get tougher on drunken driving
![Ann Heisenfelt/AP - NTSB Chairwoman Deborah Hersman at a news conference in Washington in February. Federal officials were weighing a recommendation that states reduce their threshold for drunken driving from the current .08 blood alcohol level to .05](http://www.tulalipnews.com/wp/wp-content/uploads/2013/05/Drunken_Driving_Zero_Deaths_JPEG-04204-144-300x243.jpg)
By Ashley Halsey III, The Washington Post Published: May 14
States may consider lowering the standard for drunken driving to the level of a single dry martini after a recommendation Tuesday from the National Transportation Safety Board.
The NTSB (National Transportation and Safety Board) wants state legislatures to drop the measure from the current blood-alcohol level of .08 to .05, about that caused by a dry martini or two beers in a 160-pound person. The .08 standard could allow the same person to drive legally after two beers or a couple of margaritas, according to a University of Oklahoma calculator.
“The research clearly shows that drivers with a BAC above 0.05 are impaired and at a significantly greater risk of being involved in a crash where someone is killed or injured,” said NTSB Chairman Deborah A.P. Hersman. “Our goal is to get to zero deaths, because each alcohol-impaired death is preventable. They are crimes. They can and should be prevented. The tools exist. What is needed is the will.”
The NTSB has no authority to impose its recommendations, but it provides an influential voice in the setting of safety standards. The board’s proposal got an immediate positive response from an organization of state highway safety officials.
“NTSB’s action raises the visibility of drunk driving and we will consider their recommendations,” said Jonathan Adkins of the Governors Highway Safety Association, while underscoring that the group continues to support the .08 level.
Advocates for the beer and liquor industry reacted negatively to the recommendation.
“While obviously the NTSB doesn’t make policy, states take their recommendations very seriously,” said Sarah Longwell of the American Beverage Institute, which lobbies for the industry on the state and national levels.
She denounced the recommendation as “terrible.”
“Between .05 and .08 is not where fatalities are occurring. This is like, people are driving through an intersection at 90 miles an hour and so you drop the speed limit from 35 to 25; it doesn’t make any sense,” Longwell said. “This is something that is going to have a tremendously negative impact on the hospitality industry while not having a positive impact on road safety.”
Longwell said the average blood-alcohol level in alcohol-related traffic fatalities is 0.16.
Almost 10,000 people are killed — and 173,000 injured — each year in drunken driving crashes, the NTSB said. Although improvements in auto and highway safety, as well as effective crackdowns on drunken driving, have produced a decline in roadway fatalities in recent years, about 30 percent of all traffic deaths continue to be alcohol-related.
“Most Americans think that we’ve solved the problem of impaired driving, but in fact, it’s still a national epidemic,” Hersman said. “On average, every hour one person is killed and 20 more are injured.”
The Insurance Institute for Highway Safety, a insurance industry research group, confirmed Tuesday that the risk of impairment to driving can occur well before a drinker reaches the .08 level.
“We would expect some effect if states lowered the threshold to .05, but since no state has passed such a law, it hasn’t been evaluated here,” said Anne T. McCartt, the institute’s senior vice president for research. “One difficulty in the U.S. is enforcement. Impairment begins well before the classic signs of impairment may become evident to a police officer, like a driver weaving. Since testing for impairment follows arrest, not the other way around, enforcing such a law would be a hurdle.”
The NTSB said almost 440,000 people have died in accidents tied to drinking in the past three decades.
In findings released with its recommendations Tuesday, the NTSB said that alcohol levels as low as .01 have been found to impair driving skills, and that a level of .05 has been “associated with significantly increased risk of fatal crashes.”
The board said a .05 limit would significantly reduce crashes and deaths.
In a recommendation made last year, the NTSB asked states to require ignition interlocks for all drivers convicted of drunken driving.
Longwell said the recommendation of a .05 limit for all drivers had implications for another emerging technology. A prototype vehicle expected to undergo testing later this year will be equipped with passive devices that eventually could be standard features in all vehicles, to test how much a would-be driver has had to drink.
“Where are they going to set this technology?” Longwell said. “They’ve been saying it’s .08. Well, the question is, if you lower the legal limit, where do you set the technology in all cars?”
New campaign to help parents talk to younger children about the dangers of underage drinking
“Talk. They Hear You.” a new national public service announcement (PSA) campaign that empowers parents to talk to children as young as nine years old about the dangers of underage drinking was launched today by the Substance Abuse and Mental Health Services Administration (SAMHSA). The kickoff occurred in conjunction with SAMHSA’s 2013 National Prevention Week—an annual health observance dedicated to increasing awareness of, and action around, substance abuse and mental health issues.
HHS Secretary Kathleen Sebelius on National Women’s Health Week
Source: U.S. Department of Health & Human Services, HHS.gov
Starting with Mother’s Day, we celebrate National Women’s Health Week. As a nation, we honor the women in our lives – our mothers, grandmothers, aunts, sisters, cousins, friends, and colleagues – by encouraging them to make their health a priority and to take steps to live healthier, happier lives.
Women are frequently the health care decision-makers in their families. We take time off from work to drive a parent to the doctor. We hold our children’s hands while they get their vaccinations. We make the appointments for our spouses’ checkups – and then make sure they actually go. We stretch and re-work our family budgets to pay the doctor’s bills. And too often, we put our own health last.
But the truth is unless we take care of ourselves first, we cannot really take care of our families. That means we have to eat right, exercise, and get the care we need to stay healthy. Unfortunately, preventive care has not always been easily accessible or affordable for everyone, including young women.
But the health care law is helping to usher in a new day for women’s health. The Affordable Care Act is making it easier for women to take control of their own health. For many women, preventive services like mammograms, Pap smears, birth control, and yearly well-woman visits are now available without cost sharing. The health care law improves women’s access to appropriate preventive health screenings, which can help detect diseases early, when treatment is most effective and least costly.
Starting next year, insurance companies will no longer be allowed to refuse us coverage just because we’re battling breast cancer or have another pre-existing condition – and they won’t be allowed to charge us more just because we are women.
If you’re one of the millions of women who are uninsured or who buy insurance on their own, more options are on the way because of the Affordable Care Act. Starting October 1, 2013, you will be able to visit a new Health Insurance Marketplace where you can compare and choose from a range of plans to find one that best fits your needs and budget. All of these plans must cover a package of essential health benefits, including maternity and newborn care.
To get more information about the Marketplace and to sign up for email and text updates to get ready for October, visit HealthCare.gov.
Being healthy starts with each of us taking control. So Monday on National Women’s Checkup Day, and during National Women’s Health Week, I encourage you to sit down with your doctor or health care provider and talk about what you can do to take control of your health.
There’s no better gift you can give yourself – or your loved ones.
- Learn more about National Women’s Health Week and find a health week event in your community.
- Follow #NWHW
on Twitter.
- For more information on how the health care law is addressing women’s unique health needs, visit http://www.womenshealth.gov/NWHW/activity-planning/NWHW-Infographic-508.pdf
Freedom of Information Act Used To Push IHS To Offer Plan B Over the Counter
By Eisa Ulen, Indian Country Today Media Network
Mainstream Americans continue to battle over the availability of Plan B. The U.S. Food and Drug Administration (FDA) determined that the emergency contraception, sometimes known as the morning after pill, must be sold over the counter (OTC) to any woman age 15 and older who asks for it. A strong contingent of Americans, including activists, health care providers and at least one federal judge, have criticized the FDA, saying that Plan B should be available to any woman of any age who asks for it over the counter. The FDA has countered that younger women of child-bearing age cannot safely use Plan B without the assistance of a healthcare provider. As this public debate rages on, too few media outlets have reported on the barriers Native women of all ages have had trying to access Plan B. Until recently, even Native women well past their teen years have been unable to obtain Plan B as an OTC at Indian Health Service (IHS) Units throughout Indian country.
Plan B is the emergency contraceptive routinely given to women after rape has occurred. Because 1 in 3 Native women will be the victim of a sexual assault in her lifetime, the Native American Women’s Health Education Resource Center (NAWHERC) has worked to secure Native women’s legal right to Plan B, so that women on reservations can access this emergency contraceptive in the crucial first 24 hours after sexual contact has occurred, when the pill is most effective in preventing conception of the egg and sperm.
![Charon Asetoyer](https://indiancountrytodaymedianetwork.com/sites/default/files/uploads/2012/03/Charon-Asetoyer-.jpg)
While the battle to make Plan B available over the counter to Native women at IHS units continues, progress has been made through the activism of NAWHERC. South Dakota-based Charon Asetoyer, CEO of the Native American Community Board, runs NAWHERC. In February of 2012, Asetoyer and Pamela Kingfisher published the NAWHERC Roundtable Report on the Accessibility of Plan B as an OTC within the Indian Health Service. This document exposed the inconsistencies between Native women’s legal right to Plan B, and the failure of IHS to provide this emergency contraception on demand and over the counter.
Indeed, given the fact that Native women experience rape at levels that are comparable to the rates of women living in war zones, NAWHERC identified the failure of IHS to make Plan B accessible over the counter as more than a legal issue. NAWHERC identified this failure to adequately protect Native women from conceiving a child following sexual assault as a human rights issue.
Much like the mainstream public debate regarding the availability of Plan B to younger American women, IHS has forced Native women of all ages to see a health care provider before they can access Plan B. Not only is this time- and cost-prohibitive for many women in Indian country, it too often demoralizes the woman seeking care. Asetoyer says she has heard of health care providers who, “in some cases, chastise a woman, blame her” for requesting a prescription for Plan B. No woman should have to answer questions about her use of birth control in order to access emergency contraception. As Asetoyer says, “that is extremely dehumanizing.”
Alexa Kolbi-Molinas, staff attorney for the American Civil Liberties Union Reproductive Freedom Project, says, “Certainly, the devastatingly high rate of sexual assault among Native women makes access to emergency contraception all the more critical, but even if that were not the case the inability of Native women to obtain emergency contraception at IHS facilities would be a violation of their basic civil and human rights: Every woman should have the opportunity to prevent an unplanned pregnancy and to decide whether and when is the right time, for her, to become pregnant. Moreover, the United States government is under a distinct legal obligation to ensure that Native women have access to comprehensive health care.”
While the Roundtable Report was published last year, Asetoyer says that as far back as 2005 her organization started “working and organizing women” around the subjugation of Native women who attempt to access Plan B. “IHS was extremely resistant” to the efforts of NAWHERC to liberate Native women from this dehumanization, Asetoyer says. “They just do not like standardization of any kind.”
Despite that resistance, standardization is coming. The 2009 omnibus bill mandated standardization of Sexual Assault Nurse Examiners (SANE nurses) within IHS. According to Asetoyer, $3 .5 million was allocated for the rigorous training required to be certified as a SANE nurse. These health care providers not only improve health outcomes for victims of sexual assault, they also aid law enforcement in prosecuting rapists. In addition, Asetoyer says the 2010 Tribal Law and Order Act signed by President Obama standardized sexual assault policies and protocols within IHS.
However, more needed to be done. IHS was still not making Plan B available over the counter. Asetoyer says she and her colleagues “realized we had to continue to work” on the availability of Plan B within IHS. NAWHERC contacted leaders in the community of reproductive justice advocacy and asked if they would upload the Roundtable Report and share it electronically with their followers on one day in March 2012 that would be called Push the Button Day. NAWHERC contacted the Boston Women’s Health Book Collective, the National Women’s Health Network, the National Black Women’s Health Project, the National Organization for Women, the Women of Color Network, and the Center for Reproductive Rights, among others. “They said yes,” Asetoyer says, and Push the Button Day was launched. Word about the realities of Native women “got out there, and it got out there fast, and it got out there not only in Indian Country but in the mainstream,” Asetoyer says. “People were shocked. They were appalled.”
In addition to disseminating information on Push the Button Day, Asetoyer and Kingfisher appeared with Dr. Susan V. Karol, chief medical officer for Indian Health Service, on the radio show Native America Calling. During the broadcast, Asetoyer says, Karol stated that emergency contraception was accessible at IHS units on-demand and “behind the counter.” (This term describes where the emergency contraception is physically placed and means women must ask the pharmacist for it.) But, as reported in ICTMN, Native women weren’t able to access Plan B without a prescription at all. “We really caught IHS not even knowing what was going on in their own service units out in the field.” (Read: Despite High Incidence of Rape, Women Denied Right to Plan B)
Asetoyer says that the story of Native women’s inability to access Plan B over the counter at IHS units started to appear in other media within 24 hours after the Native America Calling radio show aired.
As a follow-up with IHS, NAWHERC contacted Dr. Karol with a letter and asked her when emergency contraception would be available over the counter. Asetoyer says that, on May 21, 2012, her office received a response letter stating that IHS was finalizing policy to make Plan B available “behind the counter” and as an over the counter medication.
Frustrated that Native women could not access emergency contraception over the counter, while many college students in the mainstream were able to purchase it in an on-campus kiosk, Asetoyer began considering other options to pressure IHS. Asetoyer communicated with Senator Barbara Boxer of California and Senator Tim Johnson of South Dakota. Senator Johnson contacted IHS, Asetoyer claims, and received a letter from the Indian Health Service that was similar to her own. Senator Boxer, Asetoyer says, has been “working very diligently on access to emergency contraception.”
When Seantor Boxer’s office was contacted and asked to provide an interview for this article, Boxer spokesperson Peter True issued this statement: “Senator Boxer supports efforts to ensure that women, including women who rely on the Indian Health Service, can get access to the healthcare they need, including emergency contraception. She will continue to work towards that goal.”
In her last letter of communication with IHS, Asetoyer says she explained that NAWHERC would have to seek legal remedies if IHS refused to make Plan B available over the counter. In February of this year, the American Civil Liberties Union (ACLU) requested access to the policies IHS claimed it was working on to make EC available as an OTC.
Filed on behalf of NAWHERC under the Freedom of Information Act, this request spurred the IHS to action. “All of a sudden,” Asetoyer says, “IHS starts providing emergency contraception as an over the counter.”
“We decided, together with NAWHERC, to file the Freedom of Information Act because the government had been saying for too long that they were ‘working on’ a solution to this problem,” Kobi-Molinas says, “but no one was seeing any results. The purpose of the FOIA is to put an end to this stonewalling and force the government to explain what, if anything, it has been doing to ensure Native women could access EC OTC at IHS facilities.”
Asetoyer says her office has surveyed service units since the Freedom of Information Act was filed and has determined that over 40 IHS units, “almost all,” now provide emergency contraception to women who ask for it over the counter. This victory, Asetoyer says, is “based on a directive they received from area offices.” Asetoyer claims that, in response to the Freedom of Information Act, IHS Director Dr. Yvette Roubideaux was personally making telephone calls to IHS offices in order to make Plan B available over the counter.
When asked to provide an interview for this article, the IHS provided this official statement: “Emergency contraception is available in IHS federally-run facilities.”
Kobi-Molina explains: “A Freedom of Information Act request is essentially a tool for government accountability and transparency. This Freedom of Information Act does not directly make emergency contraception available, but it shines a spotlight on what the government is (or is not) doing to deal with this problem, and that sort of information is invaluable to advocates—democracy doesn’t happen behind closed doors, so a Freedom of Information Act makes sure those doors stay open.”
Despite the victories achieved in making emergency contraception available over the counter, Asetoyer says verbal directives can be rescinded, and NAWHERC wants a permanent solution put in place through written IHS policies. NAWHERC also wants 100 percent compliance at all IHS service providers.
To help more Native women understand their legal rights regarding Plan B, as well as its function in a woman’s body, NAWHERC is engaged in what Asetoyer calls “training in the community.” She adds, “we want to continue the process of demystifying emergency contraception.” NAWHERC has developed an Emergency Contraception Tool Kit to let Native people know that it is contraception, not an abortive, and so does not terminate a pre-existing pregnancy.
“The Tool Kit is a pack of information that will explain emergency contra: What it is. How it works. Your right to it,” Asetoyer explains. With a pamphlet, poster, fact-sheet, and PSAs for local radio stations, this Tool Kit will enable NAWHERC to launch the next phase of the struggle to make Plan B available – the public information phase. While the Tool Kit is aimed at school counselors, shelter advocates, those who work with victims of assault, and other professionals who work with women and girls, it is also intended for moms and other women to share at the kitchen table.
Asetoyer believes her office is charged with the task of informing Native women in part because the IHS suffers from paternalism and “old practices, old attitudes” that are hard to change. Citing past IHS protocols, like the sterilization of women without their consent, and inserting Norplant and refusing to remove it on demand, Asetoyer says the IHS still has “that old mindset: They know what’s best for us.”
Asetoyer notes that these are institutional issues and says that some providers within IHS have wanted to give EC OTC, but decision makers within IHS have had older ideas. Asetoyer adds that all those years of not providing EC OTC have communicated to Native women, and men, that “we don’t have the capabilities to make these kinds of intelligent decisions for ourselves.” Providing EC OTC, Asetoyer says, means acknowledging that “women know what’s best for their own bodies, their own reproductive health.”
NAWHERC is charging forward with two aims: to spread the word about the availability of EC OTC within IHS and to make this new situation within IHS permanent. In addition to informing women, Asetoyer says “we need to get this into policy. The struggle is not over.”
Read more at https://indiancountrytodaymedianetwork.com/2013/05/13/freedom-information-act-used-push-ihs-offer-plan-b-over-counter-149323