KAET: Native Visions

Transcript The complete transcript of Native Visions follows: Ivan Makil: Welcome to Native Visions, a program focusing on the issues of vital interest to Arizona's Native American community. I'm your host, Ivan Makil, a member of the Pima and Maricopa tribes. There are 22 tribes in our state, each possessing their own unique history and traditions. Although we are a diverse group made up of many peoples, we share a number of the same concerns. Among them, education. Coming up, we'll look at some of the challenges faced by native students and educators. Later, we'll discuss Indian healthcare and what's being done on and off the reservation to promote health and well-being. But first, I'm joined by Senator John McCain, to talk about the origins and significance of tribal government. Welcome, Senator McCain. It's really a pleasure and an honor to have you here today. I know that you've been in Congress for 23 years, and that's quite a record. It would be nice to hear how you got involved in and interested in tribal issues. Senator John McCain: Well, Ivan, when I first came to the House in 1983 where I succeeded Congressman John Rhodes, who had been there for 30 years, I went on the Interior Committee. At that time, congressman Morris Udall was the Chairman of the Interior Committee. There was a significant Democrat advantage in those days in the House of Representatives, and I became the most junior member of the Interior Committee in the House, and there was some like 40 members, and for reasons I still don't quite understand, Mo Udall literally took me to educate and train and raise on a lot of the issues that I really didn't know much about, and the Interior Committee is responsible for Indian issues. One of the first things he did with me was we went around and visited all of the Indian tribes in Arizona. And Mo Udall loved Native Americans. There is a story -- he's from St. John's, a small town in northern Arizona, and on her death bed, Morris Udall's mother said, "Mo, take care of the Indians," and I think Mo took that admonition from his mother very seriously. He was a great friend of Native Americans, and he, as Chairman of the Interior Committee in the House, was responsible for a lot of legislation that was very helpful to Native Americans in fulfilling our treaty commitments. Ivan Makil: Speaking of that, it's really interesting, because a lot of people -- and there isn't a lot of written history about the treaties that exist between tribes and the federal government and what the status is, what it has been in the past, and what it is currently. Maybe you could enlighten us on that. Senator John McCain: Well, Ivan, to state the obvious, when the Europeans came to America, there was a clash of civilizations. Throughout history, the less mature civilization always suffers, whether it be in America, South America, Australia, New Zealand, wherever it is, and there was a clash of civilizations. As Europeans came west, Native Americans were driven from their homes and their tribal lands. Treaties were made; treaties were broken. It's not a very happy chapter nor a proud chapter in America's history. So we end up with one of our oldest territories, but one of our newest states -- a number of the tribes were moved into Arizona from other places, and they signed treaties, and these treaties guaranteed in return for the rest of the land that could be used by the non-Indian population, there were certain commitments made, healthcare, education, housing, et cetera. Those treaties I urge our viewers to some day look at. They are solemn treaties that the government of the United States entered into with the Indian tribes. So when people say, why are you giving the Indians the housing money, we're doing it because we took the land in exchange for certain obligations. Neither you nor I are ready to go rewrite history and lament, but at least we should at least keep to those obligations, and we haven't throughout our history, which also probably will bring us to our subject of Indian gaming, but the next time someone says, hey, we shouldn't be giving Native Americans all of this money for housing or education or healthcare, whatever it is, it was a promise we made. There is one other minor item. In the Constitution of the United States, there is a little clause that says Congress has a special responsibility to Native Americans. It's the only clause in the Constitution that identifies a certain group of our citizens that Congress has a special responsibility for. Ivan Makil: Do you think that's because these are really contracts? The agreements, the treaties, the executive orders are actually contracts with the tribes? Senator John McCain: They were solemn obligations and historians will say, the Native Americans got the short end of the stick, to say the least, but again, there is no point in revisiting history, but I think that all of us who live in this state, who want to understand that magnificent culture of our Native Americans and the magnificent heritage should also understand that we did have a contract, a treaty as signed between nations. If we signed a treaty between the United States and Mexico, then we're expected to keep our side of the bargain. Now, we all know that Native Americans aren't, quote, sovereign nations, because they are part of America. Their citizens are in our military and everything else, but we also know that there are certain obligations we have and certain status they have, which makes them different from the City of Chandler, or the City of Phoenix, and that really is something that sometimes -- people who don't know the history, sometimes blur those distinctions. Example, right now, the Department of Homeland Security money now goes through the State of Arizona. Every other funding to the tribes goes directly to the tribes. There is something wrong there, but there will continue to be friction, but I would argue that the relationships between Arizonans and Native Americans is excellent, is very, very excellent. Ivan Makil: And a lot of it comes from your guidance, excuse me for interrupting. Senator John McCain: You are a wonderful and generous people. One of the most interesting things to me, Ivan, when we had the gaming referendum before the people of Arizona, that a majority of Arizonans approve of gaming on Indian lands and not on non-Indian lands, which meant that that there is a certain sympathy and recognition, that conditions, economic conditions, on a lot of our reservations are not good and that they deserve -- Native Americans deserve to have that opportunity. Ivan Makil: Thank you. A lot of that has been -- as I said, leadership like yourself that have actually continued to help tribes better understand and help the Congress and help the general public better understand that we're all citizens here together, and the resources that we all have, that it takes a lot of work from both of the groups, all of the groups to create a better lifestyle, a better quality of life for all of our citizens, and I'm thankful that you have been involved in that quite to a large extent. Senator John McCain: This may sound a little too sentimental but, you know, there is no greater expression of citizenship than service in the military. A larger percentage of Native Americans have served and sacrificed for our country in percentage of population than any other group of Americans. If you go down to the Vietnam War Memorial, where I visit from time to time, you will see there is a very large number of Native Americans, who are some of our greatest heroes in our state and in America. The Navajo code talkers, these young 17-year-old kids, left the reservation up in Window Rock and Chinle and these places and had never seen anything, and they joined the Marines, and they went over and they were heroes. They are not only revered by the Navajo people, but also by all of us. So, sometimes when people get the impression that perhaps Native Americans aren't contributing as much, I would argue that the record shows that they have a great deal. I want to mention one other thing. I don't know how many of our viewers know that you led the Maricopa Salt River Pima Community for 20 years, and the relationship that was developed between the Maricopa Pima community and the cities of Scottsdale, Mesa, all of the surroundings of Phoenix, surrounding cities, has really been excellent, and the cooperation has contributed enormously to the economic growth and made it a very, very attractive and well-off part of our Valley, and that's not easy when you have kind of a clash of cultures sometimes of the -- this upscale kind of community where a lot of the people are from someplace else rubbing cheek by jowl with the Native American community. It's been an enormous success and thanks for your leadership. Ivan Makil: Thank you. You're very kind as well. In the current status today, so, do you think that that is a model that would be good for Indian country and for the rest of the country in terms of the relationships that can be established between tribes and communities? Senator John McCain: Small story. You came to me years ago and said, look, we want to have a provision in the law that allows us into binding contract agreements with people who come to our reservation who want to make investments, build shopping centers, many of the other things that are there, and it was tough. It was tough. We got it through the Congress, we got it signed into law, and now look at the economic development that has profited people on both sides of the boundaries of the reservation. I would argue that that kind of thing, when a tribe reached that level of maturity so they won't be exploited is something, among others, that would be a model. Ivan Makil: Thank you, Senator. It's really been a pleasure having you today. Appreciate all of your insight. Thank you. Senator John McCain: Thank you very much. >> End of transcript for Senator McCain interview. Education segment As in cities and towns across Arizona, education is an issue that is challenging Native American communities. This segment includes historical perspectives ranging from the Meriam Report and Kennedy Report to the Indian Education Act of 1972. Guests include: David Beaulieu, Professor and Director, Center for Indian Education, Arizona State University, and Ted Hibbler, Director of Indian Education, Phoenix Union High School District. The panel discussion in studio features: Peterson Zah, former president of the Navajo Nation, and Special Advisor to the President on Indian Affairs, Arizona State University; Vivian Juan-Saunders, Chairwoman of the Tohono O'odham Nation; Fred Ferreiri, Director of Education, San Carlos Apache Tribe. Transcript for Education segment follows: Ivan Makil: For over a century, many attempts to meet the educational needs of Indian students have been woefully inadequate. Despite numerous recommendations, legislation, and government programs, many of our children have not been provided the resources they need to make their way in the world. Reporter: The history of Indian education begins with an effort to assimilate Indian children into mainstream American society. Over the years, educators generally expected Native American students to fit into a system that was not only foreign to them, but in direct conflict with the ways of their people. David Beaulieu: They saw Indian children specifically as being without culture, being sort of empty vessels. And in order to have an influence with them, they needed to be removed from the influences of that culture, that community, the societies in which they were born, removed from the influence of their parents, particularly elderly members of their community, and taken off to go to school. Government implemented that in a lot of ways, but the major feature, of course, was the development of what was called the Indian -- the off reservation boarding school. Reporter: These schools systematically separated Indian children from their culture. Once away from their homes, their hair was cut. They were forbidden to speak their traditional languages, and their tribal identities were eliminated. David Beaulieu: The Meriam Report reacted against the idea of having a sameness across the entire curriculum all over the country. It recognized that Indian people were different in different communities. They had different cultures and so forth, and that curriculum that was uniform for all of these various communities and for all of these various individual Indian students didn't make any sense. Reporter: The report which was critical of government Indian policies overall found that no Indian School met any of the standard educational requirements. It also found that contrary to the opinion of many at the time, Indians were capable of an education and should receive all the benefits of one. But decades later, another report, which evolved out of concern for Native Americans by Senator Robert Kennedy, found that Indian education still had a long way to go. David Beaulieu: It was through his efforts that they formed what was called the Senate Subcommittee on Indian Education. And that subcommittee held its own hearings, and it ultimately moved to develop a series of -- a report, actually, and recommendations. That final report sort of set the tone, then, for what was to occur from that point. And the final report labeled Indian education a national tragedy, a national challenge. Whatever was going on there, it was not responding to the needs of Indian people, and it certainly wasn't working. Reporter: The Kennedy report found that on average, Indian students were one to two years behind their non-Indian counterparts. It also found that 60% would not graduate from high school and indeed, most were expected to fail. The report sparked renewed interest in creating reform, and several years later, the Indian Education Act of 1972 was passed. Although many innovative and worthwhile programs were generated under the Act, progress has continued to be slow. Ted Ironshell Hibbler: I think we have a long ways to go as far as academically getting our Native American students ready to enter into the work force and enter into four-year colleges and universities. Reporter: In an effort to better serve the particular educational needs of their native students, the Phoenix Union High School District offers innovative programs that are based on age-old traditions. Ted Ironshell Hibbler: In the Phoenix Union High School District, we have culture camps that we utilize to bring forward some of the social interactive styles of learning and a natural environment up in the mountains. Native people, a lot of times, learn through social interaction with their extended families. If that social interaction is brought forward from the home into the classroom, then that acquisition of knowledge of how our young people learn will be a lot more relevant to them. Consequently, they will pick things up at a quicker pace. Reporter: At Phoenix College, another innovative district program brings the Navajo language to urban students. Jennifer Wheeler: They are very excited coming into the program, and we try to do activities, you know, assignments that include family participation as well as community activities. They get a lot of the culture. We also include the government, Navajo government, in our lessons. I think offering this Navajo course serves as a very nice supplemental education. Reporter: Approximately 90% of Native American students in the United States are attending public schools, and with more Native Americans living off the reservation, an increasing number of these students will be attending schools off the reservation as well Ted Ironshell Hibbler: I think what our educators, our administrators and teachers need to understand is that they are going to be seeing more native people in their classrooms, and that these young people are coming in with sometimes different world views and different ways to learn, different ways to acquire knowledge, and they have quite a bit to offer society and the discussions in the classrooms as well. Ivan Makil: With me now to discuss the issue of Indian education is Peterson Zah, former President of the Navajo Nation and special adviser to ASU President, Michael Crow. The honorable Vivian Juan-Saunders, Chairwoman of the Tohono O'Odham Nation. And Fred Ferreira for the San Carlos Apache tribe. Welcome. Mr. Zah, the clip that we just saw, there was a great deal of discussion about boarding school. Tell us about your experience with boarding school. Peterson Zah: Well, I came in to Phoenix during the time that – the federal government had a policy that all the Indian people who were of a school age to go to the boarding schools because at that time, there were no schools on -- in the reservation on Indian land. And there were several states that were chosen by their government to construct and create Indian boarding schools. To begin with, I think a lot of people know that we had one in Pennsylvania, the Carlisle Indian School. We had the Phoenix Indian School here in Arizona. Some in Oklahoma, a couple of them in Oregon, some in Utah, and some in California. The whole idea was to get the Indian people off their land, the young people, and put them out there, and the plan was really to have them get their education and then to ultimately assimilate them into a dominant culture. That went on for several years. I'm a product of a boarding school. I went to school here in Phoenix, and depending on the students -- for me, it wasn't really a good experience. The academic achievement of Indian students was very low, because what the school was all about was trying to get rid of our culture, get rid of our tribalism. There were people who came in with long hair, and their hair had to be shortened, some shaved. You were forbidden to speak your own language, practice your own religion, some of those basic, basic things that's really, really important to the Indian people, they were being discouraged and people – the students were punished for having to resort to that to give themselves strength. Ivan Makil: Why do you think that position was taken by the boarding schools? Was it that they didn't understand? They didn't respect? Peterson Zah: I think it's a combination of those things, probably did not completely understand, and then at the same time, if you don't understand it, then you have no respect for it, but that was not the situation with the Indian people. The Indian people I think wanted that as part of their life, as part of their growing up process, and basically, many of the students that I went to school with were very resentful of that. That didn't work, boarding school system, and the Indian people then started demanding the building of their own schools back in Indian country on their own land where they could learn about their own culture, their own history, their own lifestyle. So that was pushed very, very hard, probably in the middle of the 1900s, and it was something that I think the Indian tribal leaders were really looking forward to, because the boarding schools weren't doing too good. There were students who were running away. They had some riots at some of those boarding schools, and tribal leaders just condemned the concept and decided to work in their own -- on their own reservation, begin building those schools. Ivan Makil: The system didn't work? Peterson Zah: The system did not work. Ivan Makil: The idea didn't work. We'll move this along to some of the issues and the challenges we have today. Fred Ferreira, what are some of the experiences you have to share with us about the current situation today or how it has evolved? Fred Ferriera: Well, I think there's several things. We talked a little bit about testing, the national testing, AIMS, the new system, No Child Left Behind. This is not a one-size-fits-all type of situation, and Indian tribes have uniqueness, so we have to address those issues. Part of those issues involve high poverty rates on the reservation. Families that have not had a higher education, it affects their children and the way they learn. On the reservations, teachers -- maintaining quality teachers is tough. Ivan Makil: Is that because of location? Fred Ferreira: Yeah, the location, recruiting them out to the reservation, you know, housing is an issue for us. We have to provide housing. There are not that many of these that you have like in the urban areas. So that's tough. We lose that continuity when we don't keep those teachers, especially good quality teachers. That's -- other things that we have a problem with is health issues, which, you know, the families have a whole lot of different variety of health issues from alcoholism, diabetes, you know, cancer, and the children are growing up with that, and you know, it's tough. So now you try to get them to go to school. We have a problem with attendance, absenteeism, and so many things happening at home, the children don't attend school. And of course, you know if they are not in school, they are not learning, they are missing that valuable lesson. Ivan Makil: So this issue, then, is really a much greater issue in terms of really dealing with education within a community. It's not just the issue of the educational system, or it is lack of resources is one of them, but also it's the other aspects of distances, transportation, all of those other kinds of issues? Is that – Fred Ferreira: Exactly. It's a very broad picture you look at. We can't just single out a couple little things here. It's the whole picture. It's the whole community that's going to have to deal with it. I feel that preschool is one area that we really need to look at to give those children a start. You know, we have Head Start, but Head Start does a certain part of it. Preschool will help. All-day kindergarten I believe is also important like the Governor is trying to get across. I believe that's another important stance. And if we can continue that on each grade and build upon that foundation, I think that's going to help us go a great way. Ivan Makil: So many challenges. Chairwoman Saunders, you are very familiar with many of these issues, as a matter of fact, not only a college graduate, but also a vice president of one of the community colleges. Tell us about that experience and tell us, also, if you would, about how you see this from the perspective of a tribal leader as well, because that really is important. Vivian Juan-Saunders: American Indians, like people in the State of Arizona and throughout the country, we want quality education for our children, and it's as if we're still trying to catch up for the last 200 years, and without adequate resources and despite the trust obligations that the federal government has with American Indians, we're seeing dwindling resources, especially in education, and despite the years of forced policies, the taking away of our identity, we value education today in the 21st century, and it's so important to have the adequate resources that are necessary. I view education as life-long learning, from the moment of birth to adulthood, whatever we want to pursue in life, and for the Tohono O'odham Nation, we've looked at tribal college and Tohono O'odham Community College, which over the last five years we've worked very hard to obtain accreditation, accreditation just like any other community college in this state, same requirement, same regulations. And we view tribal colleges as helping us to build Indian nations, Indian communities, and unfortunately, we're seeing dollars for tribally controlled community colleges dwindling. For example, our Head Start teachers, must become certified as a basis for No Child Left Behind. Well, we need our community college to train and to certify and to help our Head Start teachers obtain the college degrees, community college degrees, to meet the requirements of No Child Left Behind. And then as a government, we then respect the credentials that they bring to their job by increasing their salaries. And if we don't have all of the pieces in place, then, the quality of education that we want for our people, we still continue to struggle. We're never going to catch up. Ivan Makil Well, so basically what you have as a tribal leader, is you are looking and struggling to find additional revenue from your own resources as a tribal government, which you have a responsibility to provide for your people to supplement this so-called contract that we're supposed to have with the federal government. Is that accurate? Vivian Juan-Saunders: That's accurate. Not only do we have federal schools on the reservation, but because of geographic locations of our communities, our students attend school in nearby communities, and so what happens to public schools within the surrounding reservation is so important to what we do on the nation, and -- but it's taking control of our own destiny. It's identifying what we want for Indian education, for our own people, and that hasn't been the case historically, and so, I really look forward to having the adequate resources that we need, that the obligations call for. Ivan Makil: If I could ask you all, just a question or something to think about, what do you see as some of the challenges that are still out there forthcoming in the future of educating our people and what kinds of things would be helpful and also what do we hope as the ultimate outcome. I know that Chairwoman Saunders, you mentioned basically productive citizens is what I think I was hearing you say, but if I was to ask you all to have a brief response, because I know that time is short here, but if we could, brief response, if you have some thoughts about that. Vivian Juan-Saunders: I would say for the federal government and the state to increase their resources, and at the same time to allow the tribes to send many of their students to colleges and university where they get their education, cultural education, and whatever it is that the tribal people want. Educate them at those universities and then send them back over to the Indian communities and let them do their job of allowing the students to grow in their own way, learning cultural things, language and what have you, and let them be whatever it is that the tribe wants them to be. Ivan Makil: Great. Vivian Juan-Saunders: I'd like to add that the resources are very important. We're getting cut so much that it's really going to affect our tribe in particular. Right now we serve probably 125 students going off to college. However, we've got another two-thirds that we don't have funding for. So it makes it very difficult. One of the good things, though, with our local high school, one of the things that we'd like to do a little bit more on is our alternative school. We found that those students that we lose during the school year or from other schools, again like surrounding schools, they get dropouts. When we get them into our alternative school -- we had 10 more students graduate than would have graduated last year, and we'd like to continue that. But again, it's resources and funding. So we need to do more along those lines. Ivan Makil: Chairman Saunders. Vivian Juan-Saunders: It's developing productive citizens to play an important role in our economy and to bring that back to local Indian communities and to embrace our cultures, rather than taking away, and we still have our language and our songs and our philosophies today, despite all that we've gone through the last 200 years or so, and I'm very proud of that, because it makes us so strong today as we move forward in Indian education. Ivan Makil: Thank you all very much, because you all -- and I commend you all, and we're very honored to have you here today and to the leaders in the tribal communities for, again, promoting and helping our people with education. >> Transcript for Education segment ends. Health care segment The Native American community has a distinct set of health care concerns. Don Davis, Director of Phoenix Area Indian Health Service, Arizona Division of Public Health Services, and Dr. John Molina, Arizona Health Care Cost Containment System (AHCCCS) Medical Director, provide insight into the problems and possible solutions. The in-studio panel discussion will explore the importance of preserving traditional healing practices as a form of prevention and healthcare resources for Native Americans. Guests include: Donald Warne, M.D., Clinical Professor, School of Health Administration and Policy, W.P. Carey School of Business, Arizona State University; Marcus Harrison, CEO, Native American Community Health Centers; Johnson Dennison, Coordinator of Native Medicine for Chinle Hospital and Navajo medicine man. Transcript for health care segment follows: Ivan Makil: Native Americans are guaranteed healthcare by the federal government, but challenges, such as access to services in rural areas and cultural difference between patients and health professionals can be barriers to treatment. At the San Carlos Apache reservation, a diabetes education program has been developed to help fight a disease that is claiming many Indian lives. Lois Sprengeler: Is Thurlan in here? Thurlan?[ Speaks Native Language ] Reporter: Lois Sprengeler is the quality manager at San Carlos Hospital. She is talking to the patient advocate who takes complaints and provides Apache interpretation for patients. The hospital is located on the San Carlos Apache Reservation. It's run by the Indian Health Service, an agency within the Department of Health and Human Services. Sprengeler has worked at the hospital about 15 years. Five years ago, she suspected she had diabetes. Lois Sprengeler: I just kind of noticed that something wasn't right with me anymore. I didn't feel the way I used to feel. I told the physician that I felt as though my skin had become very, very itchy, and I've never had that before. So I said I want tests done to see if I am now diabetic. My mother was a diabetic, and she had a lot of complications due to her diabetes and ended up on dialysis. So being that I'm in the healthcare field, I knew that I probably would eventually become diabetic, so every year we'd get tested for that to see whether I had become a diabetic. So I was already mentally prepared for that. Lois Sprengeler: This is Lois. May I help you? Reporter: Sprengeler's suspicion was confirmed. She was diagnosed with diabetes. Sprengeler: At that time I was really motivated. I saw the dietitian, learned about carbohydrate counting, learned about how to, you know, watch what you're eating, saw the diabetic educator, Linda Clark. Linda Clark: But again, it's important to check your blood sugar because dizziness can also be that your blood pressure is out of control, or it could be something else. Patient: Oh, okay. Linda Clark: Does that help you out? Patient: Yeah, that kind of help me, but I like to make appointment with you -- Linda Clark: Okay. Patient: -- to learn more about it. Linda Clark: I can certainly do that. Reporter: Linda Clark is the diabetes educator at San Carlos. She's been at the hospital 23 years. Diabetes has reached epidemic proportions in Native Americans. Clark has seen the disease increasingly affect the young. Linda Clark: I've seen the struggles that patients go through. Dealing with a chronic illness, many of our clients are younger and younger. It used to be what I'd call an old person's disease, people would get it in their 50s. Many of my clients are in their 20s and 30s. How do you deal with a chronic condition that's going to be there my entire life? There is a lot of denial. Reporter: Two factors have contributed to the high incidence of diabetes in Native Americans. John Molina: Genetically, Native Americans are more prone to develop diabetes in their adult life. Culturally, the diabetes that we see in Native American people is also a result of lifestyle, you know, the changing lifestyle from a very sort of a hunter-gathering sort of a people, to one that's more sedentary. Clinic Assistant: So on the newly diagnosed patients, we're trying to get them into the IM clinic. Reporter: At San Carlos, Dr. Binoy Chandra says efforts to promote prevention have been successful. Binoy Chandra: Because of our diabetic program, the instance of some of the complications of diabetes has definitely decreased here, and also certain myths about diabetes that was prevailing before, it has also disappeared, though we still face some challenges in that regard. Reporter: One of the lingering myths about diabetes is that nothing can be done to prevent it, treat it or survive with it. Also the tendency toward acceptance sometimes interferes with prevention. John Molina: Native American people have always lived in our world accepting the world as it is. They sort of give themselves to the elements and for whatever might become them, they've learned to integrate themselves into the world, and they've come to respect this world in a very serene, spiritual way. In a sense it's almost like giving themselves to whatever destiny might befall them, and that's what becomes very acceptable. And I think this was sort of what the early colonies found here in the Americas, was a group of individuals, of tribes, who just sort of roamed the earth and lived off the earth and accepted whatever came to them. This is sort of an attitude I think that's not bad in itself, but it's just a different way of looking at the world. It's a way of saying to the world, you know, if I'm healthy, I'm going to accept my healthful state and I'm going to do as much as a can, but if I get sick, well, then that's my time in life. There is not sort of an apprehension. There is not a sort of fear of death itself. It's something that's very much acceptable. There's that idea of spirituality where we're on this earth for whatever reason, for whatever purpose and then we move on. So that sort of an attitude sort of makes it difficult to try to intrude into that attitude one of health prevention. Reporter: Sprengeler agrees that it's too easy to accept as inevitable things that can be prevented. Lois Sprengeler: You have to have the mindset -- a positive mindset that I can live with diabetes, or I'm not going to get to dialysis or have all of the complications like having an amputation of my foot done, those types of things. Don Davis: If you eat properly, not too many high fat foods and, you know, you follow a healthy diet, low in fat, and you watch your weight, and you do that by exercising -- exercise has to be a part of that -- if you practice that on a regular basis, more than likely you are going to avoid our top three diseases. Reporter: Like many on the reservation, Lois Sprengeler believes the key to solving many of the health problems facing Native Americans is to focus on the children. Lois Sprengeler: I believe that if we're going to make an impact with diabetic care right now or changing the course, we have to start with our children now. We've got to. The Apache people have a lot of capability, ability to problem solve. We have a lot of talent here. It's just that people aren't aware that they have it. And I believe that somehow we've got to get to that point where people see that they have that type of talent and the ability problem solve and the ability to make changes in their lives. Ivan Makil: Joining me to discuss Indian Health issues is Dr. Donald Warne, clinical professor at Arizona State University. Johnson Dennison, Coordinator of Native Medicine for Chinle Hospital. And Marc Harrison, Chief Executive Officer for the Native American Health Center in Phoenix. Welcome. Dr. Warne, we just reviewed, and for our guests, maybe you could give us an overview of Indian healthcare as it has been historically, and as it is today to help get things started this evening. Dr. Donald Warne: Well, looking at it from a policy perspective, when we think of healthcare in the United States, healthcare is actually not a right for people. People don't have a legal right to healthcare in this country, except for American Indians. We are actually the only population of Americans that has a legal right to health services, and that's based on treaties, which are essentially contracts between the tribal nations and the federal government, and in exchange for land and natural resources, the federal government is responsible for providing several social services to tribes, including housing, education and healthcare. The problem has been that the health systems that have been funded by the federal government for American Indians are severely underfunded. When you look at the funding, for example, for Veterans Administration hospitals, they get over $5,000 per person per year, for Medicaid programs, it's over $3500 per person per year, and Indian Health Service it's about $1800 per person per year. So we have very limited resources, and ironically, that's in the population, the only population in the country that has a legal right to healthcare. And when you look at this more from the perspective of Arizona -- I teach American Indian health policy here at Arizona State University, and when you look at the history of the health of the people here locally, the people, especially in the Valley that is now Phoenix and the Gila River Valley south of here, the people were very healthy. They had a year-long supply of water from the rivers, of course, the Salt River going through Phoenix and the Gila River south of here, and the people lived in a very healthy way. They had farming, primarily corn, beans and squash. They had fish in the river and wild game, and there was a lot of physical activity associated with farming, hunting, gathering and fishing, and the food was much healthier. Well, starting in the 1920s, the governments decided to dam the rivers, Salt River and Gila River. And prior to 1930, again, this is just 75 years ago, there was essentially no diabetes among the tribes in the southwest. And by the 1970s, we had among the highest rates of diabetes in the world. And a lot of that has to do with just changes in lifestyle. So we have terrible health disparities when you look at things like diabetes and lifestyle diseases. Unfortunately, we don't have the resources to adequately intervene. Ivan Makil: So the challenges that have evolved is not only in respect to changes in lifestyle but responding to those changes. Is that accurate? Dr. Donald Warne: Absolutely, changes in lifestyle have led to a number of preventable diseases. What I've heard from a lot of the local traditional healers is that not only did damming the rivers cause a change in lifestyle in terms of farming, it also changed the culture. There used to be ceremonies for harvesting and for planting, and if you've ever visited the Casa Grande ruins out by Coolidge, Arizona, they have windows on the walls that align on the summer solstice and on the equinoxes. That was to mark the changes in season, because you need to track those things when you are a farming culture. Well, when the rivers were dammed, all of those things changed. We really didn't need to track the seasons the way we used to, because traditional farming was no longer available. So a lot of issues arose, related to self-esteem and self-identity, cultural identity. And we've seen a resultant increase in things like depression and other spiritually based diseases, and the result has been, we have high rates of death due to things like diabetes, because the physical lifestyle changed, but also high rates of death due to alcoholism and substance abuse, and a lot of that has to do with the cultural changes that have occurred. Ivan Makil: Speaking of cultural changes, Mr. Dennison, here, could you kind of help us to understand a little more about some of the traditional healing, and when we talk about healthcare, we're really talking about a more holistic concept of healing. Is that accurate? Johnson Dennison: I believe so. That is accurate. As a native practitioner and native healers, who we call medicine men, medicine women, that has been providing healthcare or healing services for thousands and thousands of years that the Native American has been living in North America, especially in the southwest area, where in particular Navajos and other Indian tribes are all the same as well, that the practitioners have always been a source of healers and providers and the teachers. Not until -- it was in the last 40, 50 years that the dominant culture has been introduced more strongly in terms of healthcare. Since then, the traditional practicing of medicinemenship and ceremonials has been fading away and that -- the healthcare system has been developing on the reservations as well, and up to today that we have the state of the art facilities on the reservations, but at the same time, we have thousands and thousands of doctors and nurses that we have now, but then our health is not getting any better within the last 50 years. On the other hand, the medicine practitioners has been fading away. More and more of the ceremonies that we have had are becoming extinct. So very few number of medicine man practitioners that we have was in the Navajo Nations, still providing health services to the patients. Through the ceremonies that we treat patients, through prayers and songs and sand paintings and herbal medications, sweat and ceremonial procedures and processes, in a lot of ways when you look at it, the ceremonies still being practiced a lot more strongly. The issues and the challenge that we have for the native patient is when they are diagnosed with an illness such as diabetes or heart disease, they run around and turn around and go to the native practitioner, and they have a different diagnosis. So in healthcare, we always have dualities. There is the Navajo or native illness, and there's the western perspective of illness. Ivan Makil: Mr. Dennison, speaking of that, if I could, do you think that not as much practicing goes on in the traditional or has over the years, because we've been focusing more on the contemporary new technology, that kind of thing? I think that part of what you've been and the work that you do has been about combining the traditional healing process along with the technology, because the new technology is considered a tool? Is that accurate? Johnson Dennison: Yes, that is accurate. Through the educations and the dominant society of where we are accepting of becoming more -- technologies and new way and style of living and leaving the old concept of healing in the past. However, there is a trend right now, not only Native American, but many people begin to start looking for alternative medicine. They start looking at the native practitioners for healing, and when that comes about, and then that has developed a lot of awareness in such a way, because that native practitioner has always been there, and they are always there, and it's always available. According to the native practitioner, the western medicine is alternative medicine. Alternative practitioners consider as native medicine as alternative medicine. But within our own culture, when you begin to converse and talk with the ceremonial people, the western medicine is alternative medicine. Ivan Makil: That's right. And maybe just one of these days, people will all understand that perspective, that holistic concept of healing is very valuable, and particularly as we move forward, and I know that large portions of the tribal populations are now living in urban areas, and in the urban areas they have other challenges as well, in terms of looking at not only contemporary healing practices but traditional healing practices as well. So we have Mr. Harrison. Mr. Harrison, enlighten us. Marcus Harrison: You're right, Ivan, by saying that there is a large population that now resides in urban areas. Really, what you saw of this trend, historical perspective, is the 1950s was primarily policy oriented, the relocation policy that was part of the overall assimilation policy from the federal government where they provided opportunities for families to move off of reservation communities to urban areas, to provide housing and job and educational opportunities. I think in theory they meant well, but obviously there was some faults with it, but ultimately, that was the precursor for a lot of the urban Indian communities that you see in today's large metropolitan areas. From that standpoint, today, you really see a migration back and forth, but primarily from reservation to large metropolitan areas, primarily opportunity driven for more opportunities for jobs, employment and also for educational training. I think what you find from that standpoint is the development of the urban Indian health programs to help provide access to some type of healthcare or at least some type of patient advocacy or some type patient navigation for American Indians that reside off reservations in large metropolitan areas. So Native American communities, such as the agency I work for, start off as grassroots organizations, like many other urban Indian health programs in the United States, which there are 34 of them, has really grown exponentially in the last 10 to 15 years in terms of funding, to provide increased access to care as well as to help provide culturally competent care for the American Indian community members. Ivan Makil: So what's happened is a lot of our -- through this assimilation process that was basically forced on the tribes was then a lot of our people were moved into urban areas to become educated, and then the other part of that, I guess is for jobs, because they didn't -there weren't jobs always available on reservations, but along with that goes healthcare; is that correct? What are some of the programs that you all have in place that go to deal with some of those issues? Marcus Harrison: What we've really done, is our primary program or services are related around medical, dental, mental health, senior programs, as well as Aids health and medicine and also we're dealing with youth culture enrichment. From the standpoint of people moving to the urban Indian communities, which we see from that phenomena, I think as well, the mindset has to change regarding overall Indian healthcare delivery system. It's no longer just tribal health programs and also Indian health service programs. Now you have to really take into account the role that the urban Indian health program plays in providing access to care for the American Indian community members. I think more and more, we're playing more of a significant role from that standpoint, and I think the days of the other entities, all three, the Indian health service, Tribal Health Programs and Urban Indian Health Programs being on three separate islands, that can't happen anymore, especially from the advocacy standpoint, because I think what we're seeing here is not only a healthcare, I guess, standpoint of resource -- depletion of resources, but I think from that standpoint, we all need to have a singular voice in creating more access to funding opportunities. Ivan Makil: Thank you. Dr. Warne, you know, as we heard on the tape earlier, too, one of the comments was that tribal people view things in that more holistic way, and as healthcare has changed across this country and changed for tribal people, as tribal people start to move around a little bit, what do you see as the future and some of the challenges that we're going to continue to deal with as tribal people, and how does that work for us in this world today? Dr. Donald Warne: Well, I was very fortunate to grow up in a family with a lot of traditional healers and medicine men. I was able to understand a lot about the holistic approach to healthcare. For many of our tribes traditionally, the approach to health is very different than the modern scientific approach. In traditional ways, we understand that spirituality, the mental and emotional realm, along with the physical realm, are all very important when we're looking at the health of our people. That's not just in the individuals, but it's also in the families and the communities, and the health of the individuals is determined by the health of the families and the health of the communities. And what we need to understand is that it's not just tribal communities, we are also a part of the state. We're a part of this country. We have our tribal nations, our states and our national system we call the United States, but what I would like to see in the future is more understanding, more awareness and more cooperation. Because as we talked about, for example, the urban setting, the desert that we live in here in Phoenix was never designed by nature to support nearly three million people. The only reason we can have this many people in this region and the only reason we have seen such prosperity in this state is because we've dammed the rivers, and from that perspective, we need to recognize as a state and as citizens in this state that the prosperity of Arizona was really built on the backs of the health of the local tribes, and we need to recognize that, and we need to work cooperatively to reduce health disparities. And the local tribes have never been adequately thanked or compensated for their tremendous gifts and sacrifices that they have made to allow Arizona to be as prosperous as it is. Ivan Makil: So it has been the contributions of tribal people to the Valley in terms of understanding. It's that sharing of knowledge, if you will, that I think that is one of the contributions that tribes, I think, throughout the country probably have to make. Well, I know there is so much more to talk about in this area and so much more that I think that we'd like to talk about, so I want to thank you all for spending time with us and sharing your expertise with us and congratulations, and I really am honored to sit with all of you for all of the work that you do do for Indian country and not only for families, communities, tribes, but for all people. Thank you. Panelists: Thank you. Thank you. Ivan Makil: I hope this program has given you a better understanding of who we are as a people, the issues we face and what we all have in common. Thank you for joining us.	Native Visions Native American sovereignty Education Health care About the TV program Ivan Makil Profile From the General Manager Learn more about the Native American communities represented on Native Visions: The Hopi Tribe Inter-Tribal Council of Arizona Navajo Nation Salt River Pima-Maricopa Indian Community San Carlos Apache Tribe Tohono O'odham Nation Related Links Arizona State University American Indian History and Culture Center for Indian Education

Transcript

The complete transcript of Native Visions follows:

Ivan Makil:
Welcome to Native Visions, a program focusing on the issues of vital interest to Arizona's Native American community. I'm your host, Ivan Makil, a member of the Pima and Maricopa tribes. There are 22 tribes in our state, each possessing their own unique history and traditions. Although we are a diverse group made up of many peoples, we share a number of the same concerns. Among them, education. Coming up, we'll look at some of the challenges faced by native students and educators. Later, we'll discuss Indian healthcare and what's being done on and off the reservation to promote health and well-being. But first, I'm joined by Senator John McCain, to talk about the origins and significance of tribal government. Welcome, Senator McCain. It's really a pleasure and an honor to have you here today. I know that you've been in Congress for 23 years, and that's quite a record. It would be nice to hear how you got involved in and interested in tribal issues.

Senator John McCain:
Well, Ivan, when I first came to the House in 1983 where I succeeded Congressman John Rhodes, who had been there for 30 years, I went on the Interior Committee. At that time, congressman Morris Udall was the Chairman of the Interior Committee. There was a significant Democrat advantage in those days in the House of Representatives, and I became the most junior member of the Interior Committee in the House, and there was some like 40 members, and for reasons I still don't quite understand, Mo Udall literally took me to educate and train and raise on a lot of the issues that I really didn't know much about, and the Interior Committee is responsible for Indian issues. One of the first things he did with me was we went around and visited all of the Indian tribes in Arizona. And Mo Udall loved Native Americans. There is a story -- he's from St. John's, a small town in northern Arizona, and on her death bed, Morris Udall's mother said, "Mo, take care of the Indians," and I think Mo took that admonition from his mother very seriously. He was a great friend of Native Americans, and he, as Chairman of the Interior Committee in the House, was responsible for a lot of legislation that was very helpful to Native Americans in fulfilling our treaty commitments.

Ivan Makil:
Speaking of that, it's really interesting, because a lot of people -- and there isn't a lot of written history about the treaties that exist between tribes and the federal government and what the status is, what it has been in the past, and what it is currently. Maybe you could enlighten us on that.

Senator John McCain:
Well, Ivan, to state the obvious, when the Europeans came to America, there was a clash of civilizations. Throughout history, the less mature civilization always suffers, whether it be in America, South America, Australia, New Zealand, wherever it is, and there was a clash of civilizations. As Europeans came west, Native Americans were driven from their homes and their tribal lands. Treaties were made; treaties were broken. It's not a very happy chapter nor a proud chapter in America's history. So we end up with one of our oldest territories, but one of our newest states -- a number of the tribes were moved into Arizona from other places, and they signed treaties, and these treaties guaranteed in return for the rest of the land that could be used by the non-Indian population, there were certain commitments made, healthcare, education, housing, et cetera. Those treaties I urge our viewers to some day look at. They are solemn treaties that the government of the United States entered into with the Indian tribes. So when people say, why are you giving the Indians the housing money, we're doing it because we took the land in exchange for certain obligations. Neither you nor I are ready to go rewrite history and lament, but at least we should at least keep to those obligations, and we haven't throughout our history, which also probably will bring us to our subject of Indian gaming, but the next time someone says, hey, we shouldn't be giving Native Americans all of this money for housing or education or healthcare, whatever it is, it was a promise we made. There is one other minor item. In the Constitution of the United States, there is a little clause that says Congress has a special responsibility to Native Americans. It's the only clause in the Constitution that identifies a certain group of our citizens that Congress has a special responsibility for.

Ivan Makil:
Do you think that's because these are really contracts? The agreements, the treaties, the executive orders are actually contracts with the tribes?

Senator John McCain:
They were solemn obligations and historians will say, the Native Americans got the short end of the stick, to say the least, but again, there is no point in revisiting history, but I think that all of us who live in this state, who want to understand that magnificent culture of our Native Americans and the magnificent heritage should also understand that we did have a contract, a treaty as signed between nations. If we signed a treaty between the United States and Mexico, then we're expected to keep our side of the bargain. Now, we all know that Native Americans aren't, quote, sovereign nations, because they are part of America. Their citizens are in our military and everything else, but we also know that there are certain obligations we have and certain status they have, which makes them different from the City of Chandler, or the City of Phoenix, and that really is something that sometimes -- people who don't know the history, sometimes blur those distinctions. Example, right now, the Department of Homeland Security money now goes through the State of Arizona. Every other funding to the tribes goes directly to the tribes. There is something wrong there, but there will continue to be friction, but I would argue that the relationships between Arizonans and Native Americans is excellent, is very, very excellent.

Ivan Makil:
And a lot of it comes from your guidance, excuse me for interrupting.

Senator John McCain:
You are a wonderful and generous people. One of the most interesting things to me, Ivan, when we had the gaming referendum before the people of Arizona, that a majority of Arizonans approve of gaming on Indian lands and not on non-Indian lands, which meant that that there is a certain sympathy and recognition, that conditions, economic conditions, on a lot of our reservations are not good and that they deserve -- Native Americans deserve to have that opportunity.

Ivan Makil:
Thank you. A lot of that has been -- as I said, leadership like yourself that have actually continued to help tribes better understand and help the Congress and help the general public better understand that we're all citizens here together, and the resources that we all have, that it takes a lot of work from both of the groups, all of the groups to create a better lifestyle, a better quality of life for all of our citizens, and I'm thankful that you have been involved in that quite to a large extent.

Senator John McCain:
This may sound a little too sentimental but, you know, there is no greater expression of citizenship than service in the military. A larger percentage of Native Americans have served and sacrificed for our country in percentage of population than any other group of Americans. If you go down to the Vietnam War Memorial, where I visit from time to time, you will see there is a very large number of Native Americans, who are some of our greatest heroes in our state and in America. The Navajo code talkers, these young 17-year-old kids, left the reservation up in Window Rock and Chinle and these places and had never seen anything, and they joined the Marines, and they went over and they were heroes. They are not only revered by the Navajo people, but also by all of us. So, sometimes when people get the impression that perhaps Native Americans aren't contributing as much, I would argue that the record shows that they have a great deal. I want to mention one other thing. I don't know how many of our viewers know that you led the Maricopa Salt River Pima Community for 20 years, and the relationship that was developed between the Maricopa Pima community and the cities of Scottsdale, Mesa, all of the surroundings of Phoenix, surrounding cities, has really been excellent, and the cooperation has contributed enormously to the economic growth and made it a very, very attractive and well-off part of our Valley, and that's not easy when you have kind of a clash of cultures sometimes of the -- this upscale kind of community where a lot of the people are from someplace else rubbing cheek by jowl with the Native American community. It's been an enormous success and thanks for your leadership.

Ivan Makil:
Thank you. You're very kind as well. In the current status today, so, do you think that that is a model that would be good for Indian country and for the rest of the country in terms of the relationships that can be established between tribes and communities?

Senator John McCain:
Small story. You came to me years ago and said, look, we want to have a provision in the law that allows us into binding contract agreements with people who come to our reservation who want to make investments, build shopping centers, many of the other things that are there, and it was tough. It was tough. We got it through the Congress, we got it signed into law, and now look at the economic development that has profited people on both sides of the boundaries of the reservation. I would argue that that kind of thing, when a tribe reached that level of maturity so they won't be exploited is something, among others, that would be a model.

Ivan Makil:
Thank you, Senator. It's really been a pleasure having you today. Appreciate all of your insight. Thank you.

Senator John McCain:
Thank you very much.

>> End of transcript for Senator McCain interview.

Education segment

As in cities and towns across Arizona, education is an issue that is challenging Native American communities. This segment includes historical perspectives ranging from the Meriam Report and Kennedy Report to the Indian Education Act of 1972.
Guests include:
David Beaulieu, Professor and Director, Center for Indian Education, Arizona State University, and Ted Hibbler, Director of Indian Education, Phoenix Union High School District.

The panel discussion in studio features:
Peterson Zah, former president of the Navajo Nation, and Special Advisor to the President on Indian Affairs, Arizona State University;
Vivian Juan-Saunders, Chairwoman of the Tohono O'odham Nation;
Fred Ferreiri, Director of Education, San Carlos Apache Tribe.

Transcript for Education segment follows:

Ivan Makil:
For over a century, many attempts to meet the educational needs of Indian students have been woefully inadequate. Despite numerous recommendations, legislation, and government programs, many of our children have not been provided the resources they need to make their way in the world.

Reporter:
The history of Indian education begins with an effort to assimilate Indian children into mainstream American society. Over the years, educators generally expected Native American students to fit into a system that was not only foreign to them, but in direct conflict with the ways of their people.

David Beaulieu:
They saw Indian children specifically as being without culture, being sort of empty vessels. And in order to have an influence with them, they needed to be removed from the influences of that culture, that community, the societies in which they were born, removed from the influence of their parents, particularly elderly members of their community, and taken off to go to school. Government implemented that in a lot of ways, but the major feature, of course, was the development of what was called the Indian -- the off reservation boarding school.

Reporter:
These schools systematically separated Indian children from their culture. Once away from their homes, their hair was cut. They were forbidden to speak their traditional languages, and their tribal identities were eliminated.

David Beaulieu:
The Meriam Report reacted against the idea of having a sameness across the entire curriculum all over the country. It recognized that Indian people were different in different communities. They had different cultures and so forth, and that curriculum that was uniform for all of these various communities and for all of these various individual Indian students didn't make any sense.

Reporter:
The report which was critical of government Indian policies overall found that no Indian School met any of the standard educational requirements. It also found that contrary to the opinion of many at the time, Indians were capable of an education and should receive all the benefits of one. But decades later, another report, which evolved out of concern for Native Americans by Senator Robert Kennedy, found that Indian education still had a long way to go.

David Beaulieu:
It was through his efforts that they formed what was called the Senate Subcommittee on Indian Education. And that subcommittee held its own hearings, and it ultimately moved to develop a series of -- a report, actually, and recommendations. That final report sort of set the tone, then, for what was to occur from that point. And the final report labeled Indian education a national tragedy, a national challenge. Whatever was going on there, it was not responding to the needs of Indian people, and it certainly wasn't working.

Reporter:
The Kennedy report found that on average, Indian students were one to two years behind their non-Indian counterparts. It also found that 60% would not graduate from high school and indeed, most were expected to fail. The report sparked renewed interest in creating reform, and several years later, the Indian Education Act of 1972 was passed. Although many innovative and worthwhile programs were generated under the Act, progress has continued to be slow.

Ted Ironshell Hibbler:
I think we have a long ways to go as far as academically getting our Native American students ready to enter into the work force and enter into four-year colleges and universities. Reporter: In an effort to better serve the particular educational needs of their native students, the Phoenix Union High School District offers innovative programs that are based on age-old traditions.

Ted Ironshell Hibbler:
In the Phoenix Union High School District, we have culture camps that we utilize to bring forward some of the social interactive styles of learning and a natural environment up in the mountains. Native people, a lot of times, learn through social interaction with their extended families. If that social interaction is brought forward from the home into the classroom, then that acquisition of knowledge of how our young people learn will be a lot more relevant to them. Consequently, they will pick things up at a quicker pace.

Reporter:
At Phoenix College, another innovative district program brings the Navajo language to urban students.

Jennifer Wheeler:
They are very excited coming into the program, and we try to do activities, you know, assignments that include family participation as well as community activities. They get a lot of the culture. We also include the government, Navajo government, in our lessons. I think offering this Navajo course serves as a very nice supplemental education.

Reporter:
Approximately 90% of Native American students in the United States are attending public schools, and with more Native Americans living off the reservation, an increasing number of these students will be attending schools off the reservation as well

Ted Ironshell Hibbler:
I think what our educators, our administrators and teachers need to understand is that they are going to be seeing more native people in their classrooms, and that these young people are coming in with sometimes different world views and different ways to learn, different ways to acquire knowledge, and they have quite a bit to offer society and the discussions in the classrooms as well.

Ivan Makil:
With me now to discuss the issue of Indian education is Peterson Zah, former President of the Navajo Nation and special adviser to ASU President, Michael Crow. The honorable Vivian Juan-Saunders, Chairwoman of the Tohono O'Odham Nation. And Fred Ferreira for the San Carlos Apache tribe. Welcome. Mr. Zah, the clip that we just saw, there was a great deal of discussion about boarding school. Tell us about your experience with boarding school.

Peterson Zah:
Well, I came in to Phoenix during the time that – the federal government had a policy that all the Indian people who were of a school age to go to the boarding schools because at that time, there were no schools on -- in the reservation on Indian land. And there were several states that were chosen by their government to construct and create Indian boarding schools. To begin with, I think a lot of people know that we had one in Pennsylvania, the Carlisle Indian School. We had the Phoenix Indian School here in Arizona. Some in Oklahoma, a couple of them in Oregon, some in Utah, and some in California. The whole idea was to get the Indian people off their land, the young people, and put them out there, and the plan was really to have them get their education and then to ultimately assimilate them into a dominant culture. That went on for several years. I'm a product of a boarding school. I went to school here in Phoenix, and depending on the students -- for me, it wasn't really a good experience. The academic achievement of Indian students was very low, because what the school was all about was trying to get rid of our culture, get rid of our tribalism. There were people who came in with long hair, and their hair had to be shortened, some shaved. You were forbidden to speak your own language, practice your own religion, some of those basic, basic things that's really, really important to the Indian people, they were being discouraged and people – the students were punished for having to resort to that to give themselves strength.

Ivan Makil:
Why do you think that position was taken by the boarding schools? Was it that they didn't understand? They didn't respect?

Peterson Zah:
I think it's a combination of those things, probably did not completely understand, and then at the same time, if you don't understand it, then you have no respect for it, but that was not the situation with the Indian people. The Indian people I think wanted that as part of their life, as part of their growing up process, and basically, many of the students that I went to school with were very resentful of that. That didn't work, boarding school system, and the Indian people then started demanding the building of their own schools back in Indian country on their own land where they could learn about their own culture, their own history, their own lifestyle. So that was pushed very, very hard, probably in the middle of the 1900s, and it was something that I think the Indian tribal leaders were really looking forward to, because the boarding schools weren't doing too good. There were students who were running away. They had some riots at some of those boarding schools, and tribal leaders just condemned the concept and decided to work in their own -- on their own reservation, begin building those schools.

Ivan Makil:
The system didn't work?

Peterson Zah: The system did not work.

Ivan Makil: The idea didn't work. We'll move this along to some of the issues and the challenges we have today. Fred Ferreira, what are some of the experiences you have to share with us about the current situation today or how it has evolved?

Fred Ferriera:
Well, I think there's several things. We talked a little bit about testing, the national testing, AIMS, the new system, No Child Left Behind. This is not a one-size-fits-all type of situation, and Indian tribes have uniqueness, so we have to address those issues. Part of those issues involve high poverty rates on the reservation. Families that have not had a higher education, it affects their children and the way they learn. On the reservations, teachers -- maintaining quality teachers is tough.

Ivan Makil:
Is that because of location?

Fred Ferreira:
Yeah, the location, recruiting them out to the reservation, you know, housing is an issue for us. We have to provide housing. There are not that many of these that you have like in the urban areas. So that's tough. We lose that continuity when we don't keep those teachers, especially good quality teachers. That's -- other things that we have a problem with is health issues, which, you know, the families have a whole lot of different variety of health issues from alcoholism, diabetes, you know, cancer, and the children are growing up with that, and you know, it's tough. So now you try to get them to go to school. We have a problem with attendance, absenteeism, and so many things happening at home, the children don't attend school. And of course, you know if they are not in school, they are not learning, they are missing that valuable lesson.

Ivan Makil:
So this issue, then, is really a much greater issue in terms of really dealing with education within a community. It's not just the issue of the educational system, or it is lack of resources is one of them, but also it's the other aspects of distances, transportation, all of those other kinds of issues? Is that –

Fred Ferreira:
Exactly. It's a very broad picture you look at. We can't just single out a couple little things here. It's the whole picture. It's the whole community that's going to have to deal with it. I feel that preschool is one area that we really need to look at to give those children a start. You know, we have Head Start, but Head Start does a certain part of it. Preschool will help. All-day kindergarten I believe is also important like the Governor is trying to get across. I believe that's another important stance. And if we can continue that on each grade and build upon that foundation, I think that's going to help us go a great way.

Ivan Makil:
So many challenges. Chairwoman Saunders, you are very familiar with many of these issues, as a matter of fact, not only a college graduate, but also a vice president of one of the community colleges. Tell us about that experience and tell us, also, if you would, about how you see this from the perspective of a tribal leader as well, because that really is important.

Vivian Juan-Saunders:
American Indians, like people in the State of Arizona and throughout the country, we want quality education for our children, and it's as if we're still trying to catch up for the last 200 years, and without adequate resources and despite the trust obligations that the federal government has with American Indians, we're seeing dwindling resources, especially in education, and despite the years of forced policies, the taking away of our identity, we value education today in the 21st century, and it's so important to have the adequate resources that are necessary. I view education as life-long learning, from the moment of birth to adulthood, whatever we want to pursue in life, and for the Tohono O'odham Nation, we've looked at tribal college and Tohono O'odham Community College, which over the last five years we've worked very hard to obtain accreditation, accreditation just like any other community college in this state, same requirement, same regulations. And we view tribal colleges as helping us to build Indian nations, Indian communities, and unfortunately, we're seeing dollars for tribally controlled community colleges dwindling. For example, our Head Start teachers, must become certified as a basis for No Child Left Behind. Well, we need our community college to train and to certify and to help our Head Start teachers obtain the college degrees, community college degrees, to meet the requirements of No Child Left Behind. And then as a government, we then respect the credentials that they bring to their job by increasing their salaries. And if we don't have all of the pieces in place, then, the quality of education that we want for our people, we still continue to struggle. We're never going to catch up.

Ivan Makil
Well, so basically what you have as a tribal leader, is you are looking and struggling to find additional revenue from your own resources as a tribal government, which you have a responsibility to provide for your people to supplement this so-called contract that we're supposed to have with the federal government. Is that accurate?

Vivian Juan-Saunders:
That's accurate. Not only do we have federal schools on the reservation, but because of geographic locations of our communities, our students attend school in nearby communities, and so what happens to public schools within the surrounding reservation is so important to what we do on the nation, and -- but it's taking control of our own destiny. It's identifying what we want for Indian education, for our own people, and that hasn't been the case historically, and so, I really look forward to having the adequate resources that we need, that the obligations call for.

Ivan Makil:
If I could ask you all, just a question or something to think about, what do you see as some of the challenges that are still out there forthcoming in the future of educating our people and what kinds of things would be helpful and also what do we hope as the ultimate outcome. I know that Chairwoman Saunders, you mentioned basically productive citizens is what I think I was hearing you say, but if I was to ask you all to have a brief response, because I know that time is short here, but if we could, brief response, if you have some thoughts about that.

Vivian Juan-Saunders:
I would say for the federal government and the state to increase their resources, and at the same time to allow the tribes to send many of their students to colleges and university where they get their education, cultural education, and whatever it is that the tribal people want. Educate them at those universities and then send them back over to the Indian communities and let them do their job of allowing the students to grow in their own way, learning cultural things, language and what have you, and let them be whatever it is that the tribe wants them to be.

Ivan Makil:
Great.

Vivian Juan-Saunders:
I'd like to add that the resources are very important. We're getting cut so much that it's really going to affect our tribe in particular. Right now we serve probably 125 students going off to college. However, we've got another two-thirds that we don't have funding for. So it makes it very difficult. One of the good things, though, with our local high school, one of the things that we'd like to do a little bit more on is our alternative school. We found that those students that we lose during the school year or from other schools, again like surrounding schools, they get dropouts. When we get them into our alternative school -- we had 10 more students graduate than would have graduated last year, and we'd like to continue that. But again, it's resources and funding. So we need to do more along those lines.

Ivan Makil:
Chairman Saunders.

Vivian Juan-Saunders:
It's developing productive citizens to play an important role in our economy and to bring that back to local Indian communities and to embrace our cultures, rather than taking away, and we still have our language and our songs and our philosophies today, despite all that we've gone through the last 200 years or so, and I'm very proud of that, because it makes us so strong today as we move forward in Indian education.

Ivan Makil:
Thank you all very much, because you all -- and I commend you all, and we're very honored to have you here today and to the leaders in the tribal communities for, again, promoting and helping our people with education.

>> Transcript for Education segment ends.

Health care segment

The Native American community has a distinct set of health care concerns.
Don Davis, Director of Phoenix Area Indian Health Service, Arizona Division of Public Health Services, and Dr. John Molina, Arizona Health Care Cost Containment System (AHCCCS) Medical Director, provide insight into the problems and possible solutions.

The in-studio panel discussion will explore the importance of preserving traditional healing practices as a form of prevention and healthcare resources for Native Americans.
Guests include:
Donald Warne, M.D., Clinical Professor, School of Health Administration and Policy, W.P. Carey School of Business, Arizona State University;
Marcus Harrison, CEO, Native American Community Health Centers;
Johnson Dennison, Coordinator of Native Medicine for Chinle Hospital and Navajo medicine man.

Transcript for health care segment follows:

Ivan Makil:
Native Americans are guaranteed healthcare by the federal government, but challenges, such as access to services in rural areas and cultural difference between patients and health professionals can be barriers to treatment. At the San Carlos Apache reservation, a diabetes education program has been developed to help fight a disease that is claiming many Indian lives.

Lois Sprengeler:
Is Thurlan in here? Thurlan?[ Speaks Native Language ]

Reporter:
Lois Sprengeler is the quality manager at San Carlos Hospital. She is talking to the patient advocate who takes complaints and provides Apache interpretation for patients. The hospital is located on the San Carlos Apache Reservation. It's run by the Indian Health Service, an agency within the Department of Health and Human Services. Sprengeler has worked at the hospital about 15 years. Five years ago, she suspected she had diabetes.

Lois Sprengeler:
I just kind of noticed that something wasn't right with me anymore. I didn't feel the way I used to feel. I told the physician that I felt as though my skin had become very, very itchy, and I've never had that before. So I said I want tests done to see if I am now diabetic. My mother was a diabetic, and she had a lot of complications due to her diabetes and ended up on dialysis. So being that I'm in the healthcare field, I knew that I probably would eventually become diabetic, so every year we'd get tested for that to see whether I had become a diabetic. So I was already mentally prepared for that.

Lois Sprengeler:
This is Lois. May I help you?

Reporter:
Sprengeler's suspicion was confirmed. She was diagnosed with diabetes. Sprengeler: At that time I was really motivated. I saw the dietitian, learned about carbohydrate counting, learned about how to, you know, watch what you're eating, saw the diabetic educator, Linda Clark.

Linda Clark:
But again, it's important to check your blood sugar because dizziness can also be that your blood pressure is out of control, or it could be something else. Patient: Oh, okay.

Linda Clark:
Does that help you out?

Patient:
Yeah, that kind of help me, but I like to make appointment with you --

Linda Clark: Okay.

Patient:
-- to learn more about it.

Linda Clark:
I can certainly do that.

Reporter:
Linda Clark is the diabetes educator at San Carlos. She's been at the hospital 23 years. Diabetes has reached epidemic proportions in Native Americans. Clark has seen the disease increasingly affect the young.

Linda Clark:
I've seen the struggles that patients go through. Dealing with a chronic illness, many of our clients are younger and younger. It used to be what I'd call an old person's disease, people would get it in their 50s. Many of my clients are in their 20s and 30s. How do you deal with a chronic condition that's going to be there my entire life? There is a lot of denial.

Reporter:
Two factors have contributed to the high incidence of diabetes in Native Americans.

John Molina:
Genetically, Native Americans are more prone to develop diabetes in their adult life. Culturally, the diabetes that we see in Native American people is also a result of lifestyle, you know, the changing lifestyle from a very sort of a hunter-gathering sort of a people, to one that's more sedentary.

Clinic Assistant:
So on the newly diagnosed patients, we're trying to get them into the IM clinic.

Reporter:
At San Carlos, Dr. Binoy Chandra says efforts to promote prevention have been successful.

Binoy Chandra:
Because of our diabetic program, the instance of some of the complications of diabetes has definitely decreased here, and also certain myths about diabetes that was prevailing before, it has also disappeared, though we still face some challenges in that regard.

Reporter:
One of the lingering myths about diabetes is that nothing can be done to prevent it, treat it or survive with it. Also the tendency toward acceptance sometimes interferes with prevention.

John Molina:
Native American people have always lived in our world accepting the world as it is. They sort of give themselves to the elements and for whatever might become them, they've learned to integrate themselves into the world, and they've come to respect this world in a very serene, spiritual way. In a sense it's almost like giving themselves to whatever destiny might befall them, and that's what becomes very acceptable. And I think this was sort of what the early colonies found here in the Americas, was a group of individuals, of tribes, who just sort of roamed the earth and lived off the earth and accepted whatever came to them. This is sort of an attitude I think that's not bad in itself, but it's just a different way of looking at the world. It's a way of saying to the world, you know, if I'm healthy, I'm going to accept my healthful state and I'm going to do as much as a can, but if I get sick, well, then that's my time in life. There is not sort of an apprehension. There is not a sort of fear of death itself. It's something that's very much acceptable. There's that idea of spirituality where we're on this earth for whatever reason, for whatever purpose and then we move on. So that sort of an attitude sort of makes it difficult to try to intrude into that attitude one of health prevention.

Reporter:
Sprengeler agrees that it's too easy to accept as inevitable things that can be prevented.

Lois Sprengeler:
You have to have the mindset -- a positive mindset that I can live with diabetes, or I'm not going to get to dialysis or have all of the complications like having an amputation of my foot done, those types of things.

Don Davis:
If you eat properly, not too many high fat foods and, you know, you follow a healthy diet, low in fat, and you watch your weight, and you do that by exercising -- exercise has to be a part of that -- if you practice that on a regular basis, more than likely you are going to avoid our top three diseases.

Reporter:
Like many on the reservation, Lois Sprengeler believes the key to solving many of the health problems facing Native Americans is to focus on the children.

Lois Sprengeler:
I believe that if we're going to make an impact with diabetic care right now or changing the course, we have to start with our children now. We've got to. The Apache people have a lot of capability, ability to problem solve. We have a lot of talent here. It's just that people aren't aware that they have it. And I believe that somehow we've got to get to that point where people see that they have that type of talent and the ability problem solve and the ability to make changes in their lives.

Ivan Makil:
Joining me to discuss Indian Health issues is Dr. Donald Warne, clinical professor at Arizona State University. Johnson Dennison, Coordinator of Native Medicine for Chinle Hospital. And Marc Harrison, Chief Executive Officer for the Native American Health Center in Phoenix. Welcome. Dr. Warne, we just reviewed, and for our guests, maybe you could give us an overview of Indian healthcare as it has been historically, and as it is today to help get things started this evening.

Dr. Donald Warne:
Well, looking at it from a policy perspective, when we think of healthcare in the United States, healthcare is actually not a right for people. People don't have a legal right to healthcare in this country, except for American Indians. We are actually the only population of Americans that has a legal right to health services, and that's based on treaties, which are essentially contracts between the tribal nations and the federal government, and in exchange for land and natural resources, the federal government is responsible for providing several social services to tribes, including housing, education and healthcare. The problem has been that the health systems that have been funded by the federal government for American Indians are severely underfunded. When you look at the funding, for example, for Veterans Administration hospitals, they get over $5,000 per person per year, for Medicaid programs, it's over $3500 per person per year, and Indian Health Service it's about $1800 per person per year. So we have very limited resources, and ironically, that's in the population, the only population in the country that has a legal right to healthcare. And when you look at this more from the perspective of Arizona -- I teach American Indian health policy here at Arizona State University, and when you look at the history of the health of the people here locally, the people, especially in the Valley that is now Phoenix and the Gila River Valley south of here, the people were very healthy. They had a year-long supply of water from the rivers, of course, the Salt River going through Phoenix and the Gila River south of here, and the people lived in a very healthy way. They had farming, primarily corn, beans and squash. They had fish in the river and wild game, and there was a lot of physical activity associated with farming, hunting, gathering and fishing, and the food was much healthier. Well, starting in the 1920s, the governments decided to dam the rivers, Salt River and Gila River. And prior to 1930, again, this is just 75 years ago, there was essentially no diabetes among the tribes in the southwest. And by the 1970s, we had among the highest rates of diabetes in the world. And a lot of that has to do with just changes in lifestyle. So we have terrible health disparities when you look at things like diabetes and lifestyle diseases. Unfortunately, we don't have the resources to adequately intervene.

Ivan Makil:
So the challenges that have evolved is not only in respect to changes in lifestyle but responding to those changes. Is that accurate?

Dr. Donald Warne:
Absolutely, changes in lifestyle have led to a number of preventable diseases. What I've heard from a lot of the local traditional healers is that not only did damming the rivers cause a change in lifestyle in terms of farming, it also changed the culture. There used to be ceremonies for harvesting and for planting, and if you've ever visited the Casa Grande ruins out by Coolidge, Arizona, they have windows on the walls that align on the summer solstice and on the equinoxes. That was to mark the changes in season, because you need to track those things when you are a farming culture. Well, when the rivers were dammed, all of those things changed. We really didn't need to track the seasons the way we used to, because traditional farming was no longer available. So a lot of issues arose, related to self-esteem and self-identity, cultural identity. And we've seen a resultant increase in things like depression and other spiritually based diseases, and the result has been, we have high rates of death due to things like diabetes, because the physical lifestyle changed, but also high rates of death due to alcoholism and substance abuse, and a lot of that has to do with the cultural changes that have occurred.

Ivan Makil:
Speaking of cultural changes, Mr. Dennison, here, could you kind of help us to understand a little more about some of the traditional healing, and when we talk about healthcare, we're really talking about a more holistic concept of healing. Is that accurate?

Johnson Dennison:
I believe so. That is accurate. As a native practitioner and native healers, who we call medicine men, medicine women, that has been providing healthcare or healing services for thousands and thousands of years that the Native American has been living in North America, especially in the southwest area, where in particular Navajos and other Indian tribes are all the same as well, that the practitioners have always been a source of healers and providers and the teachers. Not until -- it was in the last 40, 50 years that the dominant culture has been introduced more strongly in terms of healthcare. Since then, the traditional practicing of medicinemenship and ceremonials has been fading away and that -- the healthcare system has been developing on the reservations as well, and up to today that we have the state of the art facilities on the reservations, but at the same time, we have thousands and thousands of doctors and nurses that we have now, but then our health is not getting any better within the last 50 years. On the other hand, the medicine practitioners has been fading away. More and more of the ceremonies that we have had are becoming extinct. So very few number of medicine man practitioners that we have was in the Navajo Nations, still providing health services to the patients. Through the ceremonies that we treat patients, through prayers and songs and sand paintings and herbal medications, sweat and ceremonial procedures and processes, in a lot of ways when you look at it, the ceremonies still being practiced a lot more strongly. The issues and the challenge that we have for the native patient is when they are diagnosed with an illness such as diabetes or heart disease, they run around and turn around and go to the native practitioner, and they have a different diagnosis. So in healthcare, we always have dualities. There is the Navajo or native illness, and there's the western perspective of illness.

Ivan Makil:
Mr. Dennison, speaking of that, if I could, do you think that not as much practicing goes on in the traditional or has over the years, because we've been focusing more on the contemporary new technology, that kind of thing? I think that part of what you've been and the work that you do has been about combining the traditional healing process along with the technology, because the new technology is considered a tool? Is that accurate?

Johnson Dennison:
Yes, that is accurate. Through the educations and the dominant society of where we are accepting of becoming more -- technologies and new way and style of living and leaving the old concept of healing in the past. However, there is a trend right now, not only Native American, but many people begin to start looking for alternative medicine. They start looking at the native practitioners for healing, and when that comes about, and then that has developed a lot of awareness in such a way, because that native practitioner has always been there, and they are always there, and it's always available. According to the native practitioner, the western medicine is alternative medicine. Alternative practitioners consider as native medicine as alternative medicine. But within our own culture, when you begin to converse and talk with the ceremonial people, the western medicine is alternative medicine.

Ivan Makil:
That's right. And maybe just one of these days, people will all understand that perspective, that holistic concept of healing is very valuable, and particularly as we move forward, and I know that large portions of the tribal populations are now living in urban areas, and in the urban areas they have other challenges as well, in terms of looking at not only contemporary healing practices but traditional healing practices as well. So we have Mr. Harrison. Mr. Harrison, enlighten us.

Marcus Harrison:
You're right, Ivan, by saying that there is a large population that now resides in urban areas. Really, what you saw of this trend, historical perspective, is the 1950s was primarily policy oriented, the relocation policy that was part of the overall assimilation policy from the federal government where they provided opportunities for families to move off of reservation communities to urban areas, to provide housing and job and educational opportunities. I think in theory they meant well, but obviously there was some faults with it, but ultimately, that was the precursor for a lot of the urban Indian communities that you see in today's large metropolitan areas. From that standpoint, today, you really see a migration back and forth, but primarily from reservation to large metropolitan areas, primarily opportunity driven for more opportunities for jobs, employment and also for educational training. I think what you find from that standpoint is the development of the urban Indian health programs to help provide access to some type of healthcare or at least some type of patient advocacy or some type patient navigation for American Indians that reside off reservations in large metropolitan areas. So Native American communities, such as the agency I work for, start off as grassroots organizations, like many other urban Indian health programs in the United States, which there are 34 of them, has really grown exponentially in the last 10 to 15 years in terms of funding, to provide increased access to care as well as to help provide culturally competent care for the American Indian community members.

Ivan Makil:
So what's happened is a lot of our -- through this assimilation process that was basically forced on the tribes was then a lot of our people were moved into urban areas to become educated, and then the other part of that, I guess is for jobs, because they didn't -there weren't jobs always available on reservations, but along with that goes healthcare; is that correct? What are some of the programs that you all have in place that go to deal with some of those issues?

Marcus Harrison:
What we've really done, is our primary program or services are related around medical, dental, mental health, senior programs, as well as Aids health and medicine and also we're dealing with youth culture enrichment. From the standpoint of people moving to the urban Indian communities, which we see from that phenomena, I think as well, the mindset has to change regarding overall Indian healthcare delivery system. It's no longer just tribal health programs and also Indian health service programs. Now you have to really take into account the role that the urban Indian health program plays in providing access to care for the American Indian community members. I think more and more, we're playing more of a significant role from that standpoint, and I think the days of the other entities, all three, the Indian health service, Tribal Health Programs and Urban Indian Health Programs being on three separate islands, that can't happen anymore, especially from the advocacy standpoint, because I think what we're seeing here is not only a healthcare, I guess, standpoint of resource -- depletion of resources, but I think from that standpoint, we all need to have a singular voice in creating more access to funding opportunities.

Ivan Makil:
Thank you. Dr. Warne, you know, as we heard on the tape earlier, too, one of the comments was that tribal people view things in that more holistic way, and as healthcare has changed across this country and changed for tribal people, as tribal people start to move around a little bit, what do you see as the future and some of the challenges that we're going to continue to deal with as tribal people, and how does that work for us in this world today?

Dr. Donald Warne:
Well, I was very fortunate to grow up in a family with a lot of traditional healers and medicine men. I was able to understand a lot about the holistic approach to healthcare. For many of our tribes traditionally, the approach to health is very different than the modern scientific approach. In traditional ways, we understand that spirituality, the mental and emotional realm, along with the physical realm, are all very important when we're looking at the health of our people. That's not just in the individuals, but it's also in the families and the communities, and the health of the individuals is determined by the health of the families and the health of the communities. And what we need to understand is that it's not just tribal communities, we are also a part of the state. We're a part of this country. We have our tribal nations, our states and our national system we call the United States, but what I would like to see in the future is more understanding, more awareness and more cooperation. Because as we talked about, for example, the urban setting, the desert that we live in here in Phoenix was never designed by nature to support nearly three million people. The only reason we can have this many people in this region and the only reason we have seen such prosperity in this state is because we've dammed the rivers, and from that perspective, we need to recognize as a state and as citizens in this state that the prosperity of Arizona was really built on the backs of the health of the local tribes, and we need to recognize that, and we need to work cooperatively to reduce health disparities. And the local tribes have never been adequately thanked or compensated for their tremendous gifts and sacrifices that they have made to allow Arizona to be as prosperous as it is.

Ivan Makil:
So it has been the contributions of tribal people to the Valley in terms of understanding. It's that sharing of knowledge, if you will, that I think that is one of the contributions that tribes, I think, throughout the country probably have to make. Well, I know there is so much more to talk about in this area and so much more that I think that we'd like to talk about, so I want to thank you all for spending time with us and sharing your expertise with us and congratulations, and I really am honored to sit with all of you for all of the work that you do do for Indian country and not only for families, communities, tribes, but for all people. Thank you.

Panelists:
Thank you. Thank you.

Ivan Makil:
I hope this program has given you a better understanding of who we are as a people, the issues we face and what we all have in common. Thank you for joining us.

Native Visions

Native American sovereignty

Education

Health care

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Ivan Makil Profile

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Learn more about the
Native American communities represented on Native Visions:

The Hopi Tribe

Inter-Tribal Council of Arizona

Navajo Nation

Salt River Pima-Maricopa Indian Community

San Carlos Apache Tribe

Tohono O'odham Nation