Native Americans Health Care Even Worse

This is where all health care, other than for the wealthy is headed



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Posted: March 21, 2002
by: Kay Humphrey / Indian Country Today


EAGLE BUTTE, S.D. ? Patients and their relatives who have suffered
through Indian Health Service treatment rose and told their stories one by
one to Cheyenne River Sioux tribal officials in a series of hearings to
document the failures of a crumbling health care system. They told of a
system that has threatened and cost the lives of tribal members and left
others desperately trying to safeguard their health and going in debt to
private clinics to survive.

More than 80 tribal members gathered to give taped testimony about the
state of medical care on the northern South Dakota reservation.

Cheyenne River Sioux Health Committee Chairman Harold Frazier and
Tribal Attorney Rebecca Kidder sat and listened March 12 as tribal member
after tribal member tell of failures in critical situations at the Eagle
Butte IHS Hospital where time might have made the difference.

Tribal members detailed misdiagnosis, misconduct, failures by
physicians to examine charts, the dispensing of medications deadly to those
suffering from particular health conditions, pharmacy personnel dispensing
the wrong prescriptions to tribal members and tribal members being given
bags of Motrin and Robitussin to pacify them as a substitute for treatment.
Some said they were given the over-the-counter medicines even if they did
not need them.

Others complained of physicians refusing to see them when immediate
care was needed in life-threatening circumstances. Some said tribal members
sat waiting for hours before anyone would respond. Often the response was to
simply send them home. In some cases, just a few hours later they would have
to return for emergency care.

Frazier said the hearings were to provide testimony for the U.S.
Senate Indian Affairs Committee to assist the tribe in obtaining the
necessary funding for a new facility, provide more staff for the facility
and allow families to tell their stories to determine if their cases should
be further examined by malpractice attorneys.

While the tribal Health Committee has been looking at health care for
the past year, it was not until the death of a widely respected tribal elder
that it came to the forefront of issues facing Cheyenne River Sioux
officials.

Leonard Moses Fiddler, 66, of Green Grass, S.D. died on New Year's Eve
in the midst of confusion while an ambulance service was ordered not to take
him to the hospital. Although an Emergency Medical Technician pronounced him
dead at his house, the time and cause of his death has still not been
officially determined. (See related story on this page) According to written
reports by a deputy county coroner and a responding tribal police officer,
the doctor on call, who is no longer at the facility, told the ambulance
drivers to take him back to his residence or dump him in a ditch.

Tribal members have demanded investigations of the incident from Sen.
Tim Johnson, D-S.D., the IHS Aberdeen Area office and IHS director Michael
Trujillo, M.D. According to Tribal Chairman Gregg Bourland and Health
Committee Chairman Frazier, they have received no response.

"I have been on the committee for a year and half. There have been a
lot of horror stories. Enough is enough. It is time to stand up as a tribe
and our rights for what is owed to us," said Frazier.

Tribal Attorney Rebecca Kidder told tribal members their testimony was
important because most of the nation's congressmen are unaware of life on
the reservations.

"They are living in the big city have no idea what we live with every
day," she said. "This tribe is trying very hard to get a new facility. Not
only a new facility, but to staff it with the doctors."

Congress has only funded 40 percent of the need based on 1996 figures,
she said.

Meanwhile, she told tribal members not to fear retaliation from
hospital officials despite apparent threats some tribal members have
received that if they testified at the hearings they would be denied medical
care.

"They have no legal right to deny you health care. If they do, you
need to call us immediately," Kidder said.

Another tribal member told of a woman suffering from a brain tumor who
was denied contract care due to a lack of funds.

"The IHS hospital said, 'We're sorry Nina, we don't have the funds.
Come back next fall, and maybe we will have the money,'" she said. "Looks
like they are just letting all the elderly go."

Lois Spotted Bear, a retired nurse who returned to the reservation to
be near her relatives, said many tribal members receive poor medical care
because they do not know what questions to ask. Spotted Bear had a heart
attack in 1999. Although her emergency care at the hospital met with her
approval, the follow-up care she received in the clinic fell short.

"Everything was done because I knew what to ask and what medications
to take. When I got back to clinic there was a big mix-up," she said.

Spotted Bear said she saw nearly a dozen doctors, never seeing the
same one twice and her medications were changed, causing her to become
dehydrated. Her husband Danny suffers from diabetic neuropathy, a condition
that effects the nervous system.

"He's in pain, but they don't have any sympathy," she said. "The
ambulance workers don't want to transport him any more. The doctors hired
here are temporary. You are forever telling them the same story. They never
look at the chart."

Tribal members gave numerous accounts of people who came to the
emergency room with appendicitis only to be sent home until their families
made return visits to IHS. Many were not taken into emergency surgery until
the appendix ruptured.

Patients said they have been turned away for care because a doctor
employed at the facility says he has an allergy to latex gloves.

Betty Come Crow, who worked at the hospital for many years, said,
"They come and all they give them is pain killers," she said. Come Crow said
her son is suffering from leukemia.

"IHS wouldn't write a statement. He is suppose to be getting
medication, but he can't afford it because his wife divorced him and he
isn't on her insurance anymore," she said. "You are practically dead before
they admit you."

Germaine Means, 69, wondered how non-medical personnel could control
the decision on who would receive a referral. Those reviewing who should be
referred for further treatment, she said, are picked by non-medical
staffers.

"This is where it gets frustrating. Who allows for non-professional
people making these determinations when our doctors refer us? A lot of our
lives are at stake here," she said. "How can I diagnose this is life or
death? What is the criteria for priority or should there even be such a
measure? One person's needs can't outweigh another person's needs."

Simple lab services which help in diagnostic work and patient
treatment are contracted requiring patients to wait for days for the
results.

"We used to have lab services," said Raylene M. Lebeau. The
contracting of the services delayed treatment, LeBeau said. "They told me 95
percent of IHS budget goes for staff salaries. Somewhere we are getting the
short end of the stick. They somehow lose their compassion. Once they lose
their compassion, they may as well not be in the medical field."




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