Sunday, October 13, 2013

Health Care for the Oglala Sioux Nation

This letter concerns the plight of the Lakota Sioux Native Americans who are ravaged by a systemic health care problem on the reservation. A friend of mine is involved in the efforts to bring greater attention to the hardships they face daily.

Concerned Catholics of the Oglala Lakota Nation
Post Office Box 140
Oglala, South Dakota 57764

7 July 2013

The Acting Chief Executive Officer
Pine Ridge Hospital
Post Office Box 1201
East Highway 18
Pine Ridge, South Dakota 57770

Dear Sir:

We, the undersigned Concerned Catholics of the Oglala Lakota Nation, write to express a grave concern: Pine Ridge Hospital, Pine Ridge, South Dakota, administered by the Department of Health and Human Services through the Indian Health Service, has failed utterly to provide meaningful comprehensive care for its adult patients—and has contributed to abysmal life-expectancy statistics for Oglala Lakota women and men living on the Pine Ridge Reservation.

On 8 March 2000, while addressing the Senate Committee on Indian Affairs, Dr. Michael Trujillo, who was then Assistant Surgeon General and Director of the Indian Health Service, observed that the mission of the Indian Health Service is “to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.” He added that the goal of the Indian Health Service is “to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to the service population. He affirmed: 

“Our foundation is to uphold the Federal government’s obligation to promote healthy American Indian and Alaska Native people.” This obligation is enshrined in the Snyder Act of 1921 and the Indian Health Care Improvement Act of 1976, Public Law 94-437. The Snyder Act authorized appropriations for “the relief of distress and the conservation of health” of Native peoples. The explicit intent of the Indian Health Care Improvement Act was to fulfill the federal government’s responsibility to provide “the highest possible health status to Indians and to provide existing Indian health services with all resources necessary to effect that policy.”

The promises of this legislation contrast sharply with the reality on the Pine Ridge Reservation. Narcotic analgesics, especially hydrocodone, flow from the hospital’s pharmacy like a toxic river, at times depleting the pharmacy’s monthly drug allotment before month’s end.  Patients complaining of chronic pain, often addicted to narcotic analgesics (because of poor continuity of care) or collecting them for diversion, flood practitioners’ schedules each day and prevent the more seriously ill elders from receiving needed care for conditions like type 2 diabetes, chronic essential hypertension, coronary artery disease, and chronic liver and kidney disease. Patients who need to be treated by specialists and subspecialists fail to receive that level of care while the hospital’s Contract Health Department—pleading helplessness because of limited funding—denies patients, including the elderly, needed resources for “comprehensive care.” Competent practitioners—frustrated by impotent, constantly-changing leadership and harassed by patients seeking narcotics—leave the institution, and are replaced by locum tenens nurse practitioners and physician assistants who are unable to provide adequate continuity of care. The emergency room sags under the weight of too many patients and the imminent threat of heavy sanctions for incompetence exposed by the Centers for Medicare and Medicaid Services. This is hardly the “comprehensive care” proclaimed by the government’s sign prominently displayed outside the hospital. This is hardly the road to providing the Oglala Lakota with “the highest possible health status.” By some estimates the average life expectancy of a man on the Pine Ridge Reservation is 56 years; for a woman it is 66 years. How is this possible in the United States of America?

In the Catholic Church there is a long tradition of social teaching—animated by Scripture and informed by reason and experience—that cherishes the care of the sick. In the Gospel according to Matthew, Jesus reminds his followers: “Come, you who are blessed of my Father. Inherit the kingdom prepared for you from the foundation of the world. For I was hungry and you gave me food, I was thirsty and you gave me drink, a stranger and you welcomed me, naked and you clothed me, ill and you cared for me” (Matthew 25.34 – 35). Building on the Gospel of Jesus Christ, Pope John XXIII in his encyclical Pacem in Terris, or “Peace on Earth” (11 April 1963), not only affirms health care as a human right (section 11), but calls upon governments to insure its adequacy (section 60).

In the light of our Catholic Christian tradition we are bound by our consciences to serve as advocates for the dignity of the vulnerable in our midst. And so we ask you: How can the health care offered to the First Americans of the Pine Ridge Reservation be so inadequate for so long? It is out of our deep concern for the welfare of the Oglala Lakota, who are made in the image of God, that we now call upon you as a federal official responsible for the operation of Pine Ridge Hospital to set aside time to meet with our working group to address our deep concerns about the quality of care offered in the Pine Ridge Service Area. We will contact your office to schedule an appointment.

Respectfully submitted,
Concerned Catholics of the Oglala Lakota Nation


America Magazine
106 West 56th Street
New York, New York 10019

Mr. Bryan Brewer, Sr.
Oglala Sioux Tribe
Post Office Box 2070
Pine Ridge, South Dakota 57770

Ms. Dixie Gaikowski
The Deputy Area Director of Field Operations
Aberdeen Area Indian Health Service
Federal Building, Room 309
115 4th Avenue SE
Aberdeen, South Dakota 57401

The Most Reverend Robert Gruss
Bishop of Rapid City
606 Cathedral Drive
Rapid City, South Dakota 57701

Health and Human Services Committee
Oglala Sioux Tribe
Post Office Box 2070
Pine Ridge, South Dakota 57770
Attention: Ms. Dawn Black Bull, Secretary

The Honorable Timothy Johnson
United States Senate
136 Hart Senate Office Building
Washington, D.C. 20510

Susan V. Karol, M.D.
Medical Director, Indian Health Service
The Reyes Building
801 Thompson Avenue, Suite 400
Rockville, Maryland 20852

Mr. Nicholas Kristof
The New York Times
620 Eighth Avenue
New York, New York 10018
The Honorable Kristi Noem
United States House of Representatives
226 Cannon Office Building
Washington, D.C. 20515

Mr. Bart Pfankuch
Executive Editor
Rapid City Journal
507 Main Street
Rapid City, South Dakota 57701

Yvette Roubideaux, M.D.
Director, Indian Health Service
The Reyes Building
801 Thompson Avenue, Suite 400
Rockville, Maryland 20852

The Honorable Kathleen Sebelius
United States Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201

The Honorable John Thune
United States Senate
511 Dirksen Senate Office Building
Washington, D.C. 20510

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