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
We're Teaching Our Kids Too Late
by frank
April 19, 2019
This interview was originally published on November 18, 2018 in our Civics issue.
This interview with the students of The Young Women's Leadership School of East Harlem was conducted and condensed by frank news.
From left to right: LaShay Fernandez, Morgan Carter, Javeria Amir, and Fargana Alden.
Morgan: Right now, we're learning about how to take an issue that we feel passionate about and see how we can impact our local government - legislative, the mayors, governors. To see how we can change the issue, or see if we can get more engagement so people will pay attention. The issue we all picked was sexual assault in schools, from colleges, middle schools, high schools...
Why did you choose that?
Morgan: At first, it was separated for a week. Some people wanted to do education and the other side wanted to do sexual assault. We were debating for a week or two and none of us wanted to do it together, and then eventually we just had to decide - why don't we just put them together? Now we're doing sexual assault in schools. And how education and money affects why we don't have sex ed.
That's amazing.
Javeria: There's this thing that there's enough about raising awareness for it. It's time for us to take action and the way we can take action is contacting our local office members rather than just going for the governor or the president. We're saying oh my god the President's doing this and what are we doing? We know we can't directly affect what the President is doing himself, but we can work at a local level which is what we're going to do now.
Who are your local officials?
Javeria: Our mayor and our city council members. We would start contacting them rather than the governor.
LaShay: We did a whole thing where we sat down with people in our neighborhood or district to look up all our local members and see what they're doing and see if they're good. We looked them up and really tried to see if our representatives are everyman or superman. To see how much of our representation is actually what we want, or actually accurately depicts the people that are there - us.
What's the conversation around sexual assault? What are the things you want to see done and what are the sort of modes of getting those things done?
Morgan: Today we learned about root causes and systemic causes. We're starting in elementary schools and high schools. People have sex ed, but we realized that a lot of the problem is that people don't actually know what counts as sexual assault. No one has consent classes. You can't just start at high school, because by that time a lot of people are already having sex. We said that maybe we could start with 7th and 8th graders and give them sexual education - maybe not assault, but basic knowledge so that later on they can know - this is what we do, this is how this works.
LaShay: It's very hard because since people are so young and it's such a fragile thing even though yeah, you should learn about it, we're also talking about different ways to tackle the situation. Instead of just saying "consent" and just straight talking about sex with 12 year olds, it's using different methods. There's this video that a college made about tea and offering people tea and it's really weird, but it really pushes the message of consent and not forcing people to do what they don't want to do.
Fargana: To add on, some parents don't have a lot of knowledge on sexual assault or how to to keep safe, or they feel uncomfortable talking about it. For us to teach kids at a young age about safe sex and just making sure everyone's using protection, what no means if someone is saying no to sexual intercourse. It's very important for us, and also since we are young teens, it'll be easier to talk to students because we're in the same generation in a way. We would just be considered like their older sister, we'll have that bond if they ever need something, we can help them out.
Are you learning about how to communicate with your representatives directly? How can you make sure your voice is heard outside of the classroom?
Javeria: We haven't gotten to that point yet. We're trying to figure out what part of the issues are we focusing on, what are the factors that are leading to such issues, and once we have those down, then we can go and be like this is what's wrong with our system, and this is what we have to fix. Once we get that correctly done, then we'll be approaching them, but we haven't learned how to do that yet.
Morgan: It's hard because sex ed is like - a lot of parents don't want their kids learning about that and it's not just girls, it's boys that have to learn about it, too. It's kind of hard knowing exactly what we want them to do because it's often a societal thing. It's hard for them to say, oh we want a rule against this. You have to make something specific.
Do you guys feel empowered by the class?
LaShay: Yes, I was just talking to a friend about it today because I think a lot of times we sit in our class, and especially going to TWYLS, we talk about this stuff, like since freshman year we've been talking about this stuff, and it's such a big issue and we always talk about it, but we never talk about what we're going to do about it. And I think sometimes when you're just in your little city, you think this is huge and this is happening in the government and I can't do anything about it.
Even if you're starting small, it's a ripple effect. I think that's what the class has really done for me. I can do stuff, even if it's really small, it's important.
Javeria: People talk a lot and they don't do anything about it. We have a social justice club and I feel like that has empowered us in general and then having Generation Citizen - being able to take action now, instead of just talking about it. What should we do? I feel like it's a wonderful opportunity for us to have.
Fargana: In addition, compared to other schools, TYWLS really prepares you. We're really thankful to be offered Generation Citizen because in other schools, again, they would talk about it - or not even, the topic wouldn't even come up in their conversations - it would just be ignored rather than at least being talked about it and seeing different ways how we can help. For us to talk about it and see how we can fight as young teens, it really impacts us.
Can you tell us more about the social justice club?
Javeria: The social justice club is led by Jessica Taylor, our 10th grade global history teacher. In that club, anyone - I think it's mostly high schoolers - can come in the beginning of the year, we focus on an issue and advocate for the issue we think is affecting our community right now. We're in 10th grade and we raised some funds for the Syrian refugees, that was around $500 by doing food sales. It's just the little things we're doing. We're seeing what current issues are affecting the people around us. It's giving back and even though our school doesn't have that much, we're trying to take initiative.
Fargana: We donated a bunch of toiletries to a women's shelter as well. Every year we would do something - I think of it as a main project and then a mini project. So the mini things are some local things - like donate toiletries, donate money, and then our main project is what all of us are mainly focused on and how we can help.
That's amazing. Have you guys learned about civics anywhere other than Generation Citizen?
Morgan: I think some of us learn it at home, but in school, other than government or AP US History, not a lot. I think as a whole, they always push us to change something or if you feel something, talk about it, try to change it so not directly, but I think that we all get encouraged throughout our years of being here to try to change something.
Javeria: Our government class is coming senior year, it's important, but other than that we're not used to having that - what policies are, how they're made. It's senior year and Generation Citizen. For me, even if we're in AP Government, you're getting that in senior year which is a little late, but.
How early do you think civics should start?
Javeria: I feel like middle school. They're going into that 9th grade year where they're like we're going to be like high school, and they're already empowered so you might as well give them another boost.
Fargana: Yeah, it would really impact a person if you're starting in middle school. It would be perfect to teach them about the government issues and who's your local representative, what does it mean? Then when you're in high school, as the years go by, you'll have more knowledge. Each grade, we can all come together and create a bond within us and be able to go out and do something. For seniors, since we're capable of doing it, we can continue it in college and teach others that really didn't have this opportunity when we were in high school.
Are any of you about to be 18?
Yes, yes.
Are you planning on voting?
Javeria: Yes! I was going to say that. Us turning 18 - I feel like this is encouraging me at least to vote. That's one of the ways my voice can be heard, so why not? I feel like that's part of the issue. We need to tell them - yeah, voting may seem like your voice is not heard at all, but we're the people and you're one person so we need all the people to make that voice be heard, so vote, please.
Are you excited to vote?
Javeria: Yes, I'm really excited. I've been waiting. I've been waiting to turn 18 so I can vote.
LaShay: I think it's so funny that she's acting like that because my parents don't vote and it's really weird. I'm always like why don't you vote? "Well it's not gonna matter." I'm really glad I took this class because you're influenced by your political socialization - you're influenced by the people that you're around, and you inherit these ideas and you're kind of conditioned to believe this one thing and I think before I came to TYWLS, I kind of did have that mindset of well, I can't make a change, I'm one person. I'm so excited to vote now and it's so weird because before I didn't think it would matter.
Fargana: I don't turn 18 until another year, my parents are immigrants - they're both US citizens - so it's for them, the only main election they worry about is presidential because that's the big one, but I feel like now that I have more knowledge on this, I'm literally waking my mom up early so she can come with me to go vote. Well, for her to vote, I'm just gonna be there making sure she's there.
Morgan: I'm the exact opposite. It's weird because my mom has always been - my mom is the kind of person, even if she doesn't like anybody on the ballot, she'll still vote. She's always told me to pay attention to what's going on and vote. And I was always just like, I don't really care, but I think Generation Citizen has made me really want to do something now because every single thing counts. I kind of wish, like a lot of things, that we would've learned it in middle school.
I think the problem is we underestimate young people. They think they're not old enough to understand it. When a lot of times, the middle schoolers know more than you think they do. Like a lot more. And I think that they need to start encouraging them and teaching them because I feel like 11th graders and 12th graders, we're about to leave, there's no point. I feel like if I would've heard it in 8th grade, maybe I would want to vote more. I can change a lot more things than I thought I could have.
Never underestimate the youth.