Sunday, August 11, 2013

Conversations with a Native Community

           With summer drawing to an end, I'm finally feeling the spark to write again.  It's been a busy couple of months with many ups and downs.  It seems that since I've set my journey into motion a couple of years ago when I first applied to midwifery school, I've spent a lot of time in transition. I've gotten used to the constant movement of my daily life and it seems like my family as adapted to it as well.  I find myself finally working closer to home, which has been yet another transition we are all adapting to.  The positive aspects of this change are obvious, spending more time with my family and actually not having to pack for overnight work weekends anymore.  I've also taken up running again, one of my favorite activities.  I know some women exercise to lose weight and like all women this too is a wonderful motivator for myself.  However, running is an opportunity to see how strong my mind is and how far I can push myself. It's also a reminder how lucky we are to live in the country where rock formations, sunsets, and dirt roads are what accompany me on my runs.
              There are many amazing experiences I would like to write about, however the presentation I gave in Jicarilla Apache on Native American women's health is what continues to come up in my mind.     I was delighted to finally have the opportunity to discuss our health statistics with a Native American community. It was actually the first opportunity I've had since becoming a midwife to finally share what I know with an Indigenous community. Upon arrival I was greeted with unfamiliar glances and a nod.  As that I have grown up on the rez, this sort of "hello" is what I'm familiar with.  I smile and find a place to sit and listen to a friend of mines presentation on depression in Native American women.  What strikes me many women are there.  I've never seen a larger crowd of Native American women at a health conference in their own community.  This is a topic of discussion with community health workers and educators.."How do we engage the community to attend health conferences we've brought to their own communities?"  In any case, I was happy to see a wonderful turn out.
                I first started with describing the varies women's health perspectives and why it's important to understand the differences, as that it will affect how we as women access, receive, and respond to healthcare. I also compared it to an indigenous perspective

A Feminist Perspective

A feminist approach to women's health care using a health-oriented, normalizing model allows normalcy to be validated.  This paradigm enables assessment, diagnosis, and treatment that is women-centered and that values her standpoint, background, ethnicity, and culture..

An Indigenous Perspective

To live in a manner that works towards creating and maintaining balance, harmony, beauty, and order.

          I asked the women if they new what the differences were.  Of course I didn't expect a lot of participation, however I wanted to engage these women to really think about this.  I did tell them one difference was that western medicine today typically concentrates on defining and treating illness, disease, and pathology.  Our indigenous perspective takes into account our own cultural perspectives on our own health, rather then someone else telling us what our health should be.
          I focused my next topic on health disparities and I asked the women if they have ever heard this term before or new what it meant.  I can tell you no body new what it meant or has every heard it before.  This I find interesting because we as healthcare providers hear it all the time, at conferences and at University presentations on rural health.  I told these women, that this term is commonly used to describe your health.  At all the conferences I've attend on Native American women's health this is a reoccurring theme as to why our health outcomes are not as good as they should be.  I was not surprised that our communities are not aware of how we as Native Americans are being described to the larger spectrum of healthcare intellectuals.  How are we suppose to make impacts on Native American health if the community them selves are not part of this conversation?  This is the problem I see with IHS, the way it is set up is not to allow for communities to empower themselves to make positive changes, it is set up to spoon feed our communities vaccinations, screenings, and health information.  

             I then talked about the top 5 causes of death in Native American women...and surprise, surprise, they never new this information about themselves.  I also made sure to compare it from 2003 and to 2009.

Leading Causes of Death in Native American Women

Heart Disease 19.6%
Cancer 17.6%
Unintentional Injuries 8.8%
Diabetes 6.9%
Stroke 5.1%

Cancer 19.4%
Heart Disease 17.1%
Unintentional Injuries 8.5%
Diabetes 5.4%
Chronic Liver Disease 4.9%

            I emphasized that Native American women are the only ethnic group where death from chronic liver disease is in the top 10 causes of death.  All of the leading causes of death are preventable and I described why community health programs are aimed at implementing certain health initiatives. Diabetes prevention, Get Fit, early intervention programs for children, smoking cessation, and alcohol prevention education & treatment.
             The more I learn, I feel like the curtain has been lifted and I can see the strings of the puppet show.  I have many moments of realization that the odds are stacked against us and it's no wonder we are not thriving.  I wonder how little old me fit's into this equation to make an impact on the communities that need it the most, while maintaining a level of humbleness and balance.  Some one has described me as a visionary, at which I know this to be true about myself.  I find myself scavenging for the tools necessary to do the work at hand and much of the time I feel like a novus to the business of midwifery and political agendas of my cohorts.  I search for honest friendships and deep conversations. I know deep down there is not enough of me to go around and that I need to save some of it for myself. 


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