interviews
The Federal Government and Native American Health
by Sarah Stern
July 7, 2020
This interview with Sarah Stern, a Health Educator at John Hopkins American Indian Health (JHCAIH), was conducted and condensed by franknews.
frank | Native American populations have been disproportionately impacted by COVID. I am curious about what the current reality of tribal healthcare infrastructure looks like and the history that has played a role in shaping it?
Sarah Stern | The reality is that tribal healthcare infrastructure has been and remains underfunded and understaffed.
The Indian Health Services (IHS) has been vastly underfunded since it’s creation in 1955. The Snyder Act of 1921 was the first federal agreement to even allow Native people to receive medical care. We see facets of American history that are not even 100 years old. I stress this as a reminder that while Native people have always existed in the United States, there are far more years of physical and cultural genocide against Native people within American history than years of serving, protecting, and advocating for Native lives.
IHS remains the last in line to receive federal funding to aid the health and wellbeing of Native people. The National Indian Health Board (NIHB) released tribal budget recommendations showing that the IHS spends on average only $3,332 per capita on each patient, compared to a national average of $9,207. In comparison to the Veterans Administration (VA), which is also underfunded, the VA remains about 14 times as funded than the IHS. Highlighting these gaps creates dialogue for both Native people and allies to engage in political pressure to increase funding for healthcare and save lives.
From my understanding there was a "Self-determination Era," which came about in the 1960s, giving tribal governments greater control over local government operations, including healthcare and health clinics. Can you go into the history of that era?
The “Self-Determination Era” allowed Native people to use federal funds as they wanted, but the caveat was (and remains today) that Native people had to report how they wanted to use funds and keep records of the cash flows using systems developed by non-Native people. This created a newer opportunity to add in ‘western’, or non-Native educational programs. School-based teachings of Native cultural values or language were not allowed until 1975, which is less than 100 years ago. Public services, workforce creation, and health care facilities were more developed as Native people were granted the federal ability to allocate funds into these things, alongside education.
It is important to recognize Native people have always utilized the act of self-determination to keep community members, especially children and elders, safe from harm’s way, even before the “Self-Determination Era”. We have worked persistently to protect our land, people, and allies since time immemorial. As Native people proved in many ways to survive physical and cultural genocide, the United States eventually allowed Native people to use federal funding as they saw fit, which was not the case before the 1960s. Basically, the onslaught of Native people cost the United States so much time, money, and non-Native causalities that they eventually folded and decided to stop murdering on stolen land.
Native people also began to have more rights for self-governance, which allowed for leadership among the facets the people wanted funding applied to.
As we see in successful public health initiatives today, when communities have voices at the table representing what the needs and realities are, more positive opportunities take place.
Without Native leadership, the “Self-Determination Era” would not have been as successful nor propelled us to where Native communities are presently.
How can the federal government effectively help in this crisis while also ensuring levels of continued self-determination?”
The federal government can listen to Native leadership directly. Native community leaders have the means to communicate what their people need during this time. This is the most direct way for the federal government to help.
Another way that the federal government can help is to increase public health funding to health programs and educational opportunities. JHCAIH is committed to providing national leadership in training Indigenous scholars in health care and public health science. JHCAIH has awarded over 1,500 scholarships to people representing 45 tribal communities around the nation. Linked below is more information on the public health training programs and online application for scholarships.
Online Application for Scholarships
Is there a specific piece of that history and its effects that you are thinking about most right now?
Treaty rights, and the broken treaties this country participates in.
Broken treaties impact all aspects of Native American communities. Broken treaties account for the fact that some Native people are not federally or state recognized, which in turn impacts the ability to apply for education, housing, health, and infrastructure assistance. Broken treaties have taken away Native lands and water rights.
Broken treaties have created health disparities we see across Indian Country.
Broken treaties have fueled stereotypes against Native people and treaties continue to be broken to this day. For example, in February, the current administration demolished Tohono O'odham Nation’s sacred burial lands without consulting the tribe. Members of the Mashpee Wampanoag community are currently battling the federal administration for seizure of land granted by a federal trust. Land has life. Land connects to Native creation stories, it holds memories, it gives protection, and when land is seized, people hurt. I encourage you to find out what Native land you live on, who the Native people are in your area historically and presently, and how you can show allyship to Native people during this time. Allyship can help combat broken treaties.
How do the economic crisis and health care crisis particularly feed off of each other?
Both crises increase panic. Health care requires money. Lack of economic opportunities diminishes ability to pay for health care costs and decreases the ability to fund health care initiatives.
Collapse of economic ventures impacts everyone, regardless of whether the business is run by Native people or not. This will vary by community, but Native leadership works diligently to ensure that community members have the means to purchase essentials, like food and water, and as they are able, they create plans for how business can run with social distancing procedures at the foreground. Protecting the health and lives of people is the best practice to begin re-opening businesses during the pandemic.
interviews
Q&A with Catalina de Onís
by Catalina de Onís
February 8, 2019
Catalina M. de Onís is an Assistant Professor in the Department of Civic Communication and Media at Willamette University. Her research and teaching engage Latina/o/x studies, de/coloniality, race, environmental and energy studies, gender, and fieldwork. She is an affiliated faculty member with the Latin American Studies program and the Sustainability Institute.
How would you define Energy Democracy?
Energy democracy is essential for advancing energy justice, including by foregrounding the experiences, concerns, and needs of community members most impacted by different energy projects. A shift to renewable energy can replicate unjust power relations, so it’s important to be critical of “big green” projects that lack local community involvement and direction. For years, many Puerto Rican energy democracy advocates have been calling for roof-top solar and the need to have companies invest in local energy projects, rather than exporting the money to another place.
Elsewhere, I have defined “energy justice” as:
“Informed by environmental and climate justice, energy justice is concerned with how People of Color and low-income communities are impacted by global climate disruption, energy poverty, energy vulnerability, and decarbonization (i.e. transitioning from high-carbon energy sources, such as petroleum and coal, to low-carbon energies, such as wind and solar). Energy justice also struggles against the exploitation of indigenous lands and communities for high-risk and toxic energy development, from nuclear to fracked gas, and also recognizes the importance of sustainable jobs in the renewable energy sector and achieving energy security and sovereignty in relation to infrastructure, distribution, and access. Thus, this movement and discourse strives for direct community engagement to advance sustainable practices, including considerations of how, where, and for/by whom energy is produced, distributed, consumed, maintained, and disposed of (Sovacool & Dworkin, 2014).”
Is Energy Democracy inherently political?
Yes, energy democracy always involves politics and power struggles over energy sources and infrastructure, how that infrastructure comes to be, who decides, how it is maintained, and what policies advance or impede such projects. The political system in the United States, Puerto Rico, and in other countries throughout the world is entwined with energy industry interests that often have no problem with treating some communities as sacrifice zones to maximize their profits. There are large barriers to full participation in Puerto Rico, as evinced by the Fiscal Control Board’s website and the “public comment” process that requires submitting responses online and in English. As a result, the majority of Puerto Ricans in Puerto Rico are not able to participate in their preferred language. Furthermore, energy conversations among liquefied gas (LNG) industry officials, members of la junta fiscal/the control board, and local politicians are discussing lifting the suffocating 1920 Merchant Marine Act, or the Jones Act, only for the purposes of importing LNG. This exception epitomizes how corporate energy interests and their political allies are willing to waive one aspect of an arbitrary law only to the extent convenient for them, rather than addressing widespread calls from civil society to lift this act entirely to transform Puerto Rico’s dependence on US ships and imports. One of the LNG tankers making the route between Florida and Puerto Rico is “Taino,” named after the Indigenous peoples who faced the brutalities of colonization.
What does the history of energy operations look like in Puerto Rico? What sort of legacies are left?
Puerto Rico’s heavy reliance on imported fuel oil from South America and liquefied gas from Trinidad and Tobago and increasingly from the United States shows how energy sovereignty has been denied. During the height of Operation Bootstrap, in the mid-1900s, Puerto Rico was used as a test site for the petrochemical industry; the energy required was enormous to support this component of US-empire building. Local artist Rafael Trelles illuminates the problem of abandoned industries, job loss, and environmental contamination in his moving 2011 artistic piece: “Monumento al Fracaso” (Monument to Failure). Another artistic intervention against environmental injustice, titled “Contaminado,” emphasizes the problem of coal ash dumping and the impacts on human health in the southern region of Puerto Rico. These artistic efforts have unfolded synergistically with grassroots movements agitating for Puerto Ricans’ self-determination over their own energy futures.
How do you begin to move past them?
First, it’s important to call attention to the toxic legacies that scar Puerto Rico’s landscape and that harm the health of local communities. For example, a 2016 epidemiological study found that various diseases and respiratory problems are disproportionately high in communities that are nearby fossil fuel plants. So, instead of moving past these toxic legacies, it’s important to note that many communities continue to live with this contamination on a daily basis. Given this reality, it’s important to note the urgency of a just transition to grassroots, renewable energy alternatives that both improve human and environmental health conditions and create local jobs to grow struggling local economies.
Can you describe the grassroots led efforts for energy happening in Puerto Rico right now?
Numerous grassroots solar energy projects are unfolding throughout Puerto Rico. The longtime environmental justice group Casa Pueblo has been a large solar advocate and leader. Another effort, which existed pre-Hurricane Maria, is Coqui Solar in southern Puerto Rico, home to the two most polluting power plants in the Big Island, and yet many residents in this area often face power outages and were some of the last to have power restored after the 2017 hurricane season. The project involves already-installed solar panels on the community center and the development of resident-installed solar panels on surrounding homes. Service-learning with Drs. Efrain O’Neill-Carrillo and Marcel Castro and their engineering students has been at the heart of this collaboration. Also with university ties, El Instituto Nacional de Energia y Sostenibilidad Isleña (the National Institute of Island Energy and Sustainability, or INESI) is involved in many projects and has been a champion of energy democracy for years, including hosting “dialogue tables” with various members of civil society.
How have citizens responded to these efforts?
Those who are locally impacted tend to respond with excitement about the possibilities, but it’s important to not suggest that every Puerto Rican supports solar. It’s important to not treat Puerto Ricans as a monolith.
How has this work adapted since Hurricane Maria? Is resilience built into each energy project?
There’s now greater financial and academic support for these grassroots, roof-top solar projects from outside groups. For example, local Puerto Rican scholars and community activists have been supporting visits and collaborations of numerous university groups—from the University of Oregon to MIT. These collaborations can be helpful, if they are committed to a long-term, sustainable relationships and put the interests and needs of local communities first. Otherwise, colonial relational patterns can too easily develop.
What policy is central to this work?
Energy policy must center the realities of impacted communities. Too often in Puerto Rico, there’s the façade of public participation. However, from language to technology barriers, a dramatic transformation must be made before approaches to energy projects in Puerto Rico begin to be about the people instead of maintaining fossil fuel energy interests and their political cronies.
What sort of new policy would benefit your efforts and incentivize more participation?
The efforts of INESI create a vision for energy democracy, based on years of conversations that include diverse energy actors. Ayuda Legal Puerto Rico also is an important legal resource.