Hi Fluidsmash,
Check this link:
http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp
I can't say with exact certainty how long the IHS has been around. It's under the guise of the DHHS but is an independent entity with rights of self-governance. What's very interesting about the IHS is its tremendous scope (at one time IHS had its own hospitals, clinics, residencies, especially geared to Native American peoples, but I'm not sure how many of those are still around). The fundamental goal was to provide comprehensive and culturally-appropriate total health care to Indian & tribal people.
My rotation in an IHS-affiliated (but tribally-run) clinic was interesting because while it benefited from IHS funding and affiliation, it was owned by the tribe (Confederated Tribes of Grand Ronde) and run by the tribe. It was Nepotism Central. It was frustrating in a lot of ways because there was a tremendous need in this very rural area to provide services but very often we ran into trouble getting things done because the tribe would get in the way. (I should be careful what I say here.) I learned from a very dedicated Alaskan-native PA who had trained with her husband in Oklahoma and spent several years on the reservation there but had moved to Oregon years later. This clinic burned out even this most dedicated Indian PA, and ultimately she, as the only Native American health care provider in the medical services of this clinic, was edged out.
Still, this is one situation in a particularly isolated locale where the tribe went from very poor to very wealthy in literally a decade. Probably a lot of these problems could be chalked up to growing pains. I don't believe that all IHS clinics are the same.
I think the mission of IHS is really noble and if someone has a love for the people (and so many of them are lovely people with a very rich heritage) it can be rewarding. Of course there are many frustrations especially domestic abuse, alcoholism/substance abuse, generational poverty, not to mention increased genetic susceptibility to diabetes and metabolic syndrome (although this depends somewhat on the tribe).
My grandmother is 1/4 Pima Indian and was born in Nogales, AZ. I look as Irish as my dad and you'd never guess I have Indian blood. My mom still looks quite ethnic although people usually think she's Mexican. I suppose by some standards we might qualify for some status (I remember many of the tribal members when I rotated there had as little as 1/32 Indian blood, but they could document it with a family tree) but we've never gone to the trouble.
OK, back to your original questions. The center I rotated at was primarily staffed by local/tribal members, but the professional staff was largely recruited (MD/DO, PA/NP, dentists, optometrists, psychologists, etc.) I think the centers definitely do what they set out to do; that is, to provide health care services to the tribal members. The center I rotated through served the local community as well and functioned very much as a "community health center", and in fact I believe had FQHC status. This clinic created jobs in health care for a community that was about 40 minutes away from the nearest hospital; if there was no clinic there, qualified people who lived in the area would have to drive 40-60 minutes to the nearest small town for work. I think there is a TREMENDOUS potential for growth in these places because there is a lot of infrastructure and steady funding; however, I also think options for non-natives are more limited because there is a great desire within the IHS to promote Native Americans to leadership positions. I can't argue with that really. And as far as "Indian" goes, I'll tell you this: all the "Native Americans" I knew at this clinic, and my PA mentor who was native herself, called themselves and other natives "Indians", so I don't think it's offensive in that sense.
Hope this helps.
Lisa
Primadonna I have a few questions for you. The Indian Health Centers are kind of an interesting phenomena to me. Who staffs the health centers? Are there a lot of Native Americans that work there? Do you think that they accomplish the goal of providing quality health the the local population? Do you think the IHS's help the local economy at all? Finally, is there a lot of room for growth in those organizations? Also are any of them offended that they are call Indian Health Centers instead of Native American Health Centers?
I am interested because I feel like a lot of US government efforts towards Native Americans are usually poorly thought out and poorly executed. It seems like government has their heart in the right place but they can never seem to really help. What are your thoughts about the IHS system?
