American Indian Month 2020 - COVID-19 Response in Native Communities

May 27, 2020 00:46:41
American Indian Month 2020 - COVID-19 Response in Native Communities
American NDN Month on KFAI
American Indian Month 2020 - COVID-19 Response in Native Communities

May 27 2020 | 00:46:41

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Show Notes

Alfred Walking Bull and Melissa Olson welcome Anthony Stately, Ph.D. (Ojibwe / Oneida) & CEO of Native American Community Clinic, Kari Rabie, MD, Chief Medical Officer of Native American Community Clinic, and Angela Erdrich, MD (Ojibwe) Pediatrician with the Indian Health Board of Minneapolis to discuss how two Native American clinics are responded to the needs of Minneapolis’s urban Native American communities during the COVID-19 pandemic.
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Episode Transcript

Speaker 0 00:00 Okay. Speaker 1 00:02 <inaudible> Speaker 2 01:04 And you are listening to fresh air community radio KFH 90.3 FM, HD, Minneapolis and on the web at <inaudible> dot org radio without boundaries. And today we have a special panel. I am happy to have Melissa introduce everybody. Speaker 0 01:22 Thanks Alfred. I am Melissa Olson. I'm a volunteer here at cafe and I will be your cohost for today. Of course Alfred is in studio and we're so glad that he is. Um, cafe as people know, has, is 42 years old as of this June and or most, if not all of those years has offered special programming in celebration of American Indian month in Minnesota. Um, American Indian month has been celebrated for the past 51 years and this month feels special in part because KFA is helping to broadcast, um, in-person gatherings, um, that would have happened in person. Um, and shift those, um, who on air gatherings through these of zoom that we can broadcast over the airwaves. And I do have, um, some special guests with me in this zoom call today, but I just wanted to let folks know we have two very special hours planned. Speaker 0 02:19 In the first hour we're going to be talking about healthcare and urban American Indian communities here in Minneapolis and st Paul. Our guests are from the native American community clinic and the Indian health board of Minneapolis. And in the second hour we hope you'll stay with us. We're hosting a panel discussion in collaboration with all my relations, arts on art impact and isolated isolation, moderated by all my relations curator Angela, two stars with panelists chilling tapa and Hillary Tempa. Nick, and we hope you stay with us for the better part of the afternoon. Um, I do want to introduce my guests and I want to give you a little bit context. American Indians living in Hennepin and Ramsey counties make up about a fourth of the entire population of native people living in Minnesota. And the twin cities are of course the homelands of Dakota people and home to a large community of native people from all across turtle Island. Speaker 0 03:16 And Minneapolis has been home to this large sort of pan Indian community for more than 70 years. And while many native people have moved from South Minneapolis, the East Phillips neighborhood and what is now known as the American Indian cultural corridor remains an important home place. And our community is, um, here in um, East Phillips community, um, and around Minneapolis and the twin cities, um, are of course very important to us and, and you know, are served by two community clinics, the Indian health board of Minneapolis and the native American community clinic and together the two clinics, um, really do a lot of great work. And we're joined today by Dr. Anthony Antony stately who is Oneida. No Jaguey. He is the CEO of the native American community clinic in South Minneapolis is Phillips neighborhood. He is a licensed clinical psychologist and has worked for American Indian and tribal and urban communities for over 30 years. Dr Karrie. Robbie is chief medical officer for the native American community clinic specializing in family practice, practice and medicine and uh, dr Angie Airdrie, a member of the turtle Island band of Ojibwe is a certified board certified pediatric. He's been working with me for the majority of her career and has been working for the Indian health board of Minneapolis thousand and 10. Good afternoon to all of you. Uh, thanks for joining us. Speaker 0 04:50 I want to get started with a question for dr stately. Um, I would like to S to start by asking you to tell us a little bit about clinic in the Phillips name and a little bit about your mission, the rest of the panelists. Um, and listeners, I'm really honored and privileged to be invited to this conversation and um, to, to, um, to talk about the work we do. Um, there for about 17 years, a little over 17 years. Um, our mission is to, um, deliver high quality, um, culturally centered, um, uh, services to the native American community and living in and around Minneapolis, Saint Paul. Um, we have a specific mission to provide, um, Speaker 3 05:58 Services, uh, for anyone and everyone who comes to our clinic regardless of their ability to pay for those services. And we, um, we have a mission to improve, um, the health equity or just decrease health inequities and they're tracking in our native community in the Minneapolis st Paul area, and specifically to address the, um, mind, body, spirit and cultural needs of native people so that we can improve their health. Um, and we, we provide a range of primary care services, um, uh, that are preventative and, uh, um, cradle to grave. So we serve people who are, um, born zero, zero months, zero days, all the way to, um, and all the way to the end of their lives. Um, and we do that, um, through an integrated model that brings in, um, cultural healing practices and, um, a broad range of mental health services and substance abuse services into the work that we do, um, across the dental clinic, the medical clinic and the behavioral health clinic. Speaker 3 07:10 So, dr Staley, I want to follow up with a question. Um, we hear a lot about, um, native communities and COBIT 19, uh, right now, um, either, you know, in the news or on social media that really in terms of vulnerability during, um, during the pandemic. Um, can you give us a brief overview about sort of what some of those health inequities are, some of those disparities are that that are particularly important to understand as well? Sure. I think what, I think the, broadly speaking, I think, um, tribal people, native people are at significantly greater risk for, um, contracting and um, uh, and potentially dying from Cobra 19 because of the, uh, um, high disparate rates that we have around a range of chronic diseases that, um, that that impact, um, that, that are underlining our health conditions that make us more vulnerable. Um, those things include, um, diabetes, obesity, um, uh, pulmonary problems, lung disease, asthma. Speaker 3 08:28 We have some of the highest rates of asthma in our communities. Um, uh, any number of, of, of, uh, related disorders. Of course diabetes comes with circulatory problems and all kinds of other issues. Um, we have some of the highest rates of lung cancer and other related pulmonary conditions or diseases that impact our, the um, the health and wellbeing of lungs, the cardiopulmonary sort of like, um, uh, um, system in our bodies. And then related to that we also have a range of other kinds of conditions that make us at significant risk for not being able to protect ourselves from forward 19 and, and the transmission or the, the contraction of that, um, that virus. Um, we have some of the highest rates of mental health disorders and some of the highest rates of, of substance use disorders as well. Um, that contribute to a range of other conditions that end up, um, making it more likely that we as a community won't be overrepresented in things like the unsheltered homeless population. Speaker 3 09:39 Um, uh, we have significant, we have significant rates of poverty and all these other things that prevent and make it difficult. Sorry, my kids are hobbling like wolves, um, that, um, make it difficult for them to obtain and get access to. Um, good healthcare. Right? All of those things sort of collectively make it much more difficult for us to protect our communities, um, in the midst of it, even within sort of normal sort of conditions, but certainly within the, within the context of a pandemic of this nature. Um, it makes us, it makes it doubly, if not triple more difficult to do. Speaker 3 10:23 Dr Staley. Can you tell us a little bit about, um, what makes uh, the native American community clinic unique in terms of its approach in providing healthcare? In terms of some of the cultural considerations? Um, um, well I think one of the things that make us unique is that we, um, I think there, it's partly our mission and it's also partly sort of like, I think the way in which our, our, um, our, our organization, um, sort of responds to crises a couple of years ago when we had the wall, I forgotten natives and a couple of years before that when we had the opiate crisis and pandemics or epidemics or kind of like crippling the native community native, um, in South Minneapolis, native American community clinic. I think in each one of those instances, like this incidents, incidents has with sort of like, um, you know, with nimbleness and with a commitment to sort of living its mission, we step into those spaces and places that are oftentimes very difficult for other organizations and other health systems to sort of function, um, um, who, who may sort of kind of step back for a little bit. Speaker 3 11:42 And I think it's, um, it's predicated I think mostly upon the nature of our relationship that we've crafted and developed with, um, with our community over the last 17 years. I like to tell people that our community, you know, our community, our clinic, um, doesn't have the name community in it by accident. I think the community feels that, you know, that moniker, um, by nature means that it's theirs. And what I mean by that, it's not like an ownership thing, but it's more like, you know, there's that, there's that level of trust and commitment that I think they can, that they've been able to rely on, um, where they haven't been able to rely on that type of a relationship with larger health systems. Where they might experience things like racism or cultural insensitivity and a number of other things. I think we put a lot of effort in our clinic to sort of, um, provide culturally centered work. Speaker 3 12:37 And, um, what we've done with that. We, we've invested greatly over the last couple of years to amplify that. I think we've always sort of been culturally respectful, but we've also, with intention over the last three years made a real significant effort to actually, um, culturally center our work. So we've hired cultural, um, healers and, um, and elders and residents to serve who sort of lead that work across our clinic. And we've centered a lot of our newer programming, like our intensive outpatient treatment program, which is called winnowed away at means re indigenizing the spirits are, we centering our spirit. Um, we also launched a dosing clinic called we do, we do Kodak away, um, uh, which is we will take care of it. They take care of each other in Ojibwe is what that word means. And I think one of the things that, those two sort of programs and those sort of, uh, that approach to, to working that way with um, with centering culture and cultural healing, um, access to traditional medicines and traditional healers is um, with intention, um, communicating to our patients that we value, um, the things that they've grown up and trusted in their lives to help to help promote healing and wellbeing. Speaker 3 14:01 Um, integrate those, integrate those into our Western practices as well. And we really, we really tried to sort of change the culture of the clinic and the organization to sort of, um, be one in which everything we try to do, we try to practice from the principle of being a good relative, right? Like establish relationships, put effort into maintaining those relationships and taking care of one another. We take care of one another as a clinic with our staff. We take care of our relatives and we encourage people to, to, to come to the work in that way. Ramping up the fortnight activity back. There were some, hold on one second. While you're doing that. And we certainly were broadcasting from our homes and we want to emphasize that. Certainly that's a part of, uh, the safety Speaker 0 14:52 Of what we've been doing at cafe. While he's doing that. Dr Edrich, I would like to ask you, um, questions along that same line. Can you describe, um, your work at the Indian health board of Minneapolis? Um, and a little bit about how the health board is responding? Um, yeah. My name is dr Angela Hardrick. I'm a pediatrician. I've worked my whole career for Indian health service and then now for the Indian health board in Minneapolis since 2010. And, uh, our, the, the Indian health board of Minneapolis serves the Phillips neighborhood, um, since 1972. Our mission is to serve native American community. We are a federally qualified health center, so we serve all commerce just, just as Actos, um, including people who are uninsured or under insured. We have a medical clinic, a dental clinic, uh, counseling support services, uh, health and wellness programs that focus on, uh, things like diabetes. Speaker 0 15:51 You have a diabetes program at my men's health program. Um, a program for cultural practices and traditions. And, um, we have medical providers, um, have a family practice doctor who also does prenatal care, nurse practitioner, another family practice doctor who specializes in it, does more diabetes care. I'm a pediatrician. And then we also have a psychiatric nurse practitioner. Uh, we have a garden across the street that's a neighborhood favorite that focuses on, it's a place of wellness and healing. And we have a medication assisted therapy program, uh, with, uh, I think we have four different medical providers who are certified to prescribe Suboxone, myself included as a pediatrician. And, uh, that's really an important program that we offer to the community as does NAC. Um, and it's, um, real pleasure to be here to answer your questions about our, um, Indian health board and just to be on this in the same conversation with NAC is wonderful. Speaker 0 16:50 And, um, Melissa, I know when we go way back from when I first moved to Minneapolis and upper blocking bowl, uh, I know you've been focused on, uh, the arts and programming radio programming now for many years. So thank you for inviting us. Uh, the Indian health board has done a really wonderful job mobilizing care for coven 19. Um, of course it came as a very big shock when it first, uh, you know, you really don't even know what you can offer people when, um, you want to keep people safe coming into your clinic. You want to keep your employees safe. And as really impressed as a small clinic, uh, that almost like we were uniquely qualified to sort of switch gears and change some of the things that we did to serve people in a different way. Um, we quickly got tele medicine, um, support from one of our it people who was just this amazing worker, uh, TIAA and she got us all on to telehealth very quickly. Speaker 0 17:54 And then, um, we are building a sort of this like old fashioned, I don't know, in California type building with a garage. The whole bottom floor is a garage that totally lifts in the wintertime. It just lets the cold air into our feet. But it turns out it was really pretty good for, um, this kind of drive up, um, testing where we can see someone through telehealth and then offer them a very quick, uh, testing, which we're doing in conjunction with NAC. So native American community clinic and Indian health board have been, um, doing telehealth visits and then scheduling testing where people can quickly drive up in their car. We do the testing we're having, we're all prepared for them, you know, if you do it in advance and it's, um, I thought really streamlined and efficient. Um, we're lucky as a federally qualified health center that we have enough PPE because each time you test you have to weigh, um, you know, you're using episode of PPE. Speaker 0 18:49 But the way that we're doing it, we can, um, kind of, uh, batch people together in a quick way. And then, you know, everything that we're doing is sterile, um, to do our testing. But, um, we can do many people at the same time. Um, and we're just, we're just getting started because, you know, this is going to drag into the winter and, uh, years. Who knows. But like, I can see that we're really thinking on our toes and, uh, have got gotten equipment. You know, we're trying to do more pulse oximetry with people on, in addition to the testing because Pell extra machinery is so important. Uh, it's, there's a silent hypoxia that's hurting people and they don't know how low their oxygen is. So, um, we're trying to offer that to people and, um, we even have this really cool booth that has these, uh, rubber gloves that that'd be ordered to be, to make ourselves more agile in the future when we're maybe having to test people for the flu, for strep and Colvin. Speaker 0 19:51 You know, like sometimes you can take more of a step wise approach, um, and not use up a whole set of CPE. So I think, uh, I'm proud to say that, um, we're, we're really switching gears and doing what we need to do to serve the community. And it's, it's fabulous that it's a good pandemic for napkin. I used to need to do this together, you know, but I think it shows that, that we can, uh, collaborate in ways that serve our mutual community. So thank you guys. Yeah. Dr Robbie, I want to bring you in to the conversation. You again are of course the chief medical officer at native American community clinic. Dr Edrich mentioned that of the Indian health board of Minneapolis as a small clinic is in some ways able to respond quickly and to be more agile. Has that been your experience at NAC? Absolutely. I think that, um, I think that being small allows us to Speaker 4 20:48 Make quick decisions and to give ourselves up pretty quickly. When something like this happens. We first experienced, I think we first experienced this in crisis, um, at with a wall of forgotten natives last year. Um, uh, we were able to pivot pretty quickly and then when this, when this hit and the big in mid-March, um, we were, we, and I know that it didn't help board was as well. We were doing telehealth within the same week that at first hit. Um, uh, because a lot of, a lot of our patients are very anxious about coming into the clinic and rightfully so. You know, we, um, we just, you know, so we were able to offer the telehealth right away and just completely gear that, I'm not gonna lie. The first couple of weeks were extraordinarily stressful, difficult. Um, as we, as we sort of tried to recruit, we create everything. Speaker 4 21:31 Um, and we purpose how we did everything. But I, I think that, um, we have a pretty intensely dedicated team and everybody worked really hard. And, um, I was, I keep knocking on what, every time I say it, I feel like we've, we've found our feet a little bit in this new normal and, um, kind of been able to, you know, use, use the telehealth to serve our patients. We always try and start with telehealth, but we also have an option for people to come into the clinic. Um, we're able to, we've, um, we've created tele-health stations in the clinic and we actually also have tele-health stations elsewhere outside of the clinic. Um, and we've, we've been able to offer to, to computers, to certain patients. And so some of our programs who don't have access to technology and also so we've gotten some burner phones and some phone cards so that we're, we're trying to address the need for our patients who are not able to access technology or don't have technology or internet or things like that. Speaker 4 22:24 And I have to say it's, um, it's, it's worked extraordinarily well. And just the, just the, just from front to back, you know how when the PR person works for us first walks into the door, just sort of how we stratify ourselves to do a screening and, and go through that process and still try to be humanistic about it and make sure that the paper people who, like I for example, people come in, we ask them to wait in their car and then we have another process for people who don't have a car. And you know, we ask people to do tele-health first so that we have another process for people who don't have access to technology. So it's trying to think of all, try not, try not to leave anybody out trying to, trying to meet the needs of everybody who's coming to the clinic, um, under whatever circumstances. And I think that, uh, we also use harm reduction as a huge, a huge model for how we do all the care we do. And I think that way of thinking like what, you know, when you have the two choices, like how, how do you create the least amount of harm and how do you meet the patients where they're at with what they need and not constantly think what you as the system needs. Speaker 0 23:24 I have, I have two questions and I want to sort of give both, um, sort of equal time here. One is just a very, um, um, asking for a little bit of information and that is, um, and I'll tell you both questions and then we can sort of, everybody can kind of chime in. What has the dr Robbie, has the, the, the community that you serve been particularly hard hit by Kobe? Are you seeing, uh, a lot of positive cases and if not, um, what other kinds of, of of issues have emerged as a result of the pandemic? That's one question. Um, and then I do want to make sure we talk a little bit about, um, a subject that we've raised here, um, during Indian month on cafe. And that is, um, the services for unsheltered relatives, um, particularly at the new encampment on 28th and we can talk a little bit first about, um, sort of the, the state of, of health with regards to COBIT 19 and then we can talk a little bit about unsheltered communities. Speaker 4 24:26 Okay. Absolutely. So, um, I, it seems just, just anecdotally we don't have the, we don't have the actual, you know, we don't really have access to the actual data. But, um, with the testing that we've done with Indian health board, we have not, we've not seen as much as many positives as say, some of our neighbor community clinics have seen. And so we've had a lot of speculation as to why that w that would be in. And, um, and I think we wish we were talking the other day and, um, and I think that one of the things is that I think that I perceived that the native American community is far more family oriented and community oriented and therefore it's not difficult for them to make the decision to shelter in place and to do things to protect their relatives and to protect their elders and their family members. Speaker 4 25:05 So it's, um, of course just purely a speculation, but I think that that seems to come to place where come come into play. And, um, and I remember impressed by that in our, in our community, their ability to make decisions, um, that are caring and loving to their community members. Um, the issues that I've seen being very difficult for for our patients is a, you know, moving through the world as, um, as people, people who are at, um, who feel, uh, health inequities that, um, that like, like the, the is put into place by, by, uh, protect against Kobe. Like not allowing family members to the hospital, things like that. Um, uh, put people in a particular, that people feel particularly vulnerable when they move into those larger spaces and they can't bring their allies within the camp, bring people to help them, to advocate for them. Speaker 4 25:56 I mean, when even when my parents, when my parents go to the hospital, I, um, I always make sure that I'm there with them to advocate for them. And when you're a person who's suffering health disparities and, and, and has the tar is having the microaggressions of race, you know, racism and all of that, I think that that's even that much more triggering and difficult to navigate. So I kind of want to make sure I make that point. Um, I think that in, when you're talking about people who are, um, who are unsheltered and have less access to resources, it becomes very difficult to navigate their covert, um, covert pandemic in that. Um, I feel if you are positive or if you have symptoms, you become barred from accessing a lot of resources. Um, and, and even like, like you, if you're couch surfing and you have a potential to have covert, you're, you're, you're less, you know, you're not going to be as welcome of a guest in the, in that context. Speaker 4 26:52 Um, so I think that that, that's a huge issue. I also, I'm going to say I am the say this, um, the Minnesota department of health has obviously been trying to figure all of this up, but I spent, I spent, um, I got transferred like six or seven times today to six or seven different departments because it just as you're trying to figure out things like what do you do with somebody who's positive, who doesn't have shelter, um, you know, w where can they be that, that there's this, the, we haven't figured all the pieces out and neither have the bigger systems figured all the pieces out of, of exactly how to do with, with every situation and the smaller the situation like unsheltered homeless people, um, that, that particular situation has not been fully figured out. And I know there's a lot of people working hard at it, but it's, it's certainly not. It's certainly not instill. Speaker 3 27:42 I see. Dr stately, you're nodding your head. Um, what concerns you about being able to deliver healthcare to unsheltered populations or unsheltered or relatives who are unsheltered at this time? Well, I think there's a lot of concerns I had. So I just read this star trip article this morning in the paper about the significant number of cases that are um, uh, Cedar Western. How's the housing high rise? Um, and you know, we had a conversation I think with some leadership at the city and at the state about our concerns with respect to, um, people living in very close quarters to each other with limited access to transportation, limited access to be able to get to places to get testing and those kinds of things. Um, an example of that is our, our relatives who live in the liver housing, housing, um, complex, which is, um, you know, over I think two or four square blocks in South Minneapolis. Speaker 3 28:40 The majority of those individuals do not own cars themselves. They can't do drive of testing, um, if they're ill. Um, and wearing face masks are presumed to be ill, maybe relatives and other people wouldn't be willing to take them to get tested. Um, there would be concerns about them if they didn't have a face mask and, and he couldn't get on, uh, on public transportation. Now, um, what's Minneapolis requiring face masks and people don't have access to those things. They might not be able to get on public transportation to go and get and seek healthcare. So there's all kinds of conditions and challenges I think that are facing our community. And I think one of the things that I think that we also have is that our community tends to sometimes I think in these types of situations like turn inward and become very, you know, they kind of turtles, right? Speaker 3 29:29 They get, they, they turn inward and they get really protective. Um, and some of that is because like, sometimes the information that is shared about, um, these, um, you know, if you watch the nightly news, you can hear over the span of an hour, you can hear like so many contradicting, contradicting statements about COBIT 19. And if you listened to the leadership from the top administration all the way down, you'd think that there wasn't a big issue. And so it's like, it's really hard sometimes for our family, our relatives to understand, um, something of this nature. And it's hard for them to discern what's true and what's not true. It's hard for them to understand how to keep themselves and their family members safe. And in the context of something like this, this isn't the first time native people have had this type of large scale pandemic sort of, um, or other types of events that have significantly impacted our communities. Speaker 3 30:26 And, and just, you know, um, you know, crippled them if not devastated them or, um, um, decimated them. We have a long, rich history of that sort of activity happening within our communities. And so sometimes there there's a, there's a reluctance to sort of, you know, a healthy ambivalence to sorta like question what's true in question, what's real. Right. And I think what, what I want to say is that what NAC is trying to do both in its clinical work and then also what I, as the CEO of NAC has been trying to do within public policy and in conversations with the leaders in the governors, um, cabinet, um, their had their health policy folks and, and tribal policy individuals. My conversations with County and city leadership has been like, let's, you know, we learned a couple of years ago, um, on the, the wall of forgotten natives, what we were able to accomplish fairly successfully within a very short period of time when we all got on the same page fairly rapidly headwind. Speaker 3 31:43 And when these organizations are where the government entities that are big, huge systems that have sometimes um, take really long times for things to happen. When you trust community, who knows community well and organizations like NAC and Indian health board and all of the other um, urban, urban serving, uh, um, native urban serving organizations in and around South Minneapolis and st Paul to be able to partner with you and help you figure out how to solve a problem. Cause we know our communities well, we know them best. We know what are some of those barriers. We know some of the, some of the most basic solutions and if we don't know them ourselves, we can probably find that information fairly rapidly. Much certainly much faster than larger systems can figure it out. And so I think in the same way on what I'm hoping we can do is I'm hoping that, you know, I've been encouraging the state and the city to allow smaller health systems like NAX and IHPs and other folks if they want to, to do things like partner with the state on things like contact tracing. Speaker 3 32:56 Right. Um, help let us help you figure out how to do some of this message driving. Let us help you figure out how to, you know, um, provide good sound health information to our community so that they're knowledgeable. They, it's coming from a source that they trust. Um, and what they, what they know is that we, we have a good, you know, NA NAC has 17 years of good, solid history of providing quality health services to native community. IHB 40 plus. Those are good tracker cause they're gonna trust us to sort of kind of help them with, with this problem. Um, what native people have had from, from governmental agencies, time and time again have had multiple barriers, confusing messaging, um, if not, um, straight, right. I'm still meeting our, um, our stonewalling. And what we want to do is we want to be good partners and good relatives in that way as well, and help them amplify the capacity to be able to do this work. We know it's a heavy lift. We absolutely know that we've been in this fight for two months now or more. Um, but we're, but we're nimble and we're smart and we're creative and we're innovative and we are passionate. We love our community, we love our relatives. And, um, and, and you know, we lead with our heart and our spirit and I think there isn't any better approach to doing that work then then that way we want to be able to do is have a much stronger partnership in some of those conversations. Speaker 3 34:36 Um, ask a little bit about that. Um, I think there is always, as dr Robbie mentioned, that tension around how to build trust and how to keep trust and I know, you know, they need health service has always, you know, um, you know, had to, to work at trust. But I think part of the story of the Indian health board of Minneapolis is that it really has been long serving and it has been the community a long time and it is an institution. Um, and in keeping with what, um, dr stately just said, I'm wondering for you, um, and, and you are a parent, you've worked, um, with native communities for a long time. You are a pediatrician. What are, what is for you some of those lessons that are coming forward right now that you would like partners to hear? Well, I'd like to, um, dispel some of the stereotypes about, um, clinics like ours that serve a native American population or that Indian health services throughout the country, all the different clinics and hospitals because, Speaker 0 35:38 Um, there there's some strengths that are not identified that are just not known, but we have a really public health focus. And I know that from, you know, working on reservation communities where we would do things that, um, other places wouldn't do, like go give, um, offer flu shots to an entire employee population. You know, almost like being a public health nurse service or really keep track of, um, people in ways that other, um, private practices aren't really not able to do. And, you know, even on as it's worth date, worst days and some of the, um, things that the Indian health service gets criticized for, I would say that we are better at public health than any day compared to a private practice because, you know, we've had to be that way, uh, to S to save lives. And, um, so yeah, I see that Indian health board is kind of, we are partially funded by the Indian health service and we think of, you know, one of the great things about working in a place like this is you feel like you're serving a microcosm in a way. Speaker 0 36:43 Like, you know, this is my community. Something you don't get if you're working for a big system and it's inspiring, you feel like you can make a difference in a community. And that's something I've always loved about my job. Um, one thing I also wanted to mention about our communities is that, um, as a pediatrician, I tend to know, you know, several generations of the family and I'm sure dr Ravi and dr Sally as well, you know, you maybe the, um, either the mother of the children is Lee maybe living with the grandparents or their great grandparents or sometimes they're in the care of those people. And it's really puts this Kobe 19, it really puts the older generation at risk because there's so much interaction, multigenerational living and interaction. And, uh, what I've seen is that the native community is, they're hunkered down, you know, the people I talk to, they are, they are really taking this seriously with the, um, sheltering in place. Speaker 0 37:43 The people who have a shelter to stay in place. You know, I think you've already been talking about, there's another group of people who don't have the shelter, but, um, they are, there's people who are like, you know, they're talking about on the phone and they haven't talked or gone outside barely for two months. Um, you know, talk to a relative of mine yesterday who came by to drop something off. And he was like, um, other than my mom, you're the only person I've made physical, you know, talking to physically in two months and he's just hunkered down with his wife and child and I see it over and over. And these are young people who, you know, in other instances around the country, we see young people being, you know, going for their individual freedoms. But I just think people really in the native communities are very concerned about their elders and, um, they, they really are doing, you know, they're like a really, um, saving lines with the decisions they've made about canceling events and, um, you know, doing things that they wouldn't normally have done to, um, to stay isolated. So hats off you people have saved lives and it's very impressive to be working in this community. Speaker 0 38:58 I think one of the, you know, and I, we got a little bit of a late start today, so we've got just a few more minutes before the end of the hour and before we wrap up. Um, but I know one of the, one of the reasons cafe is so invested in, in shifting some of our programming on air is because, you know, we're just not seen in, in media a lot. We, we do suffer some from invisibility as a community, um, or you know, being depicted in one dimensional ways or being depicted as a community. That is, that is lacking. Um, we've talked some about cultural resiliency, um, as we move towards the end of the hour, I just want to check in with all of you and talk a little bit about what you're seeing in terms of, um, cultural resiliency, like, you know, for yourself and your own families at your clinics and in your, in your communities. And I think dr, uh, stately, we'll start with you. We have just maybe another five minutes. Speaker 3 39:54 Um, yeah, I'm so glad that we're talking about this because I think that's a lot like Angela was our doctor Edrich was mentioning, like, sometimes we focus on sort of the like, you know, all of the, um, all of the, uh, deficits in our community, right? We focus on like, you know, um, all of the, all of the poor this or poor that, right. And, um, focus and then we don't, we, we overlook the ways in which we sort of like show up as, um, you know, with love and compassion and good relatives and, and with strengths and resilience. Um, I think that that's a good, Angela offered a really great example of like how we're sort of dealing with that resiliency and we're like going back to sort of like fundamental understanding of like, you know, um, I was talking with somebody last a couple of weeks ago and I said, you know what, this, um, this pandemic has done. Speaker 3 40:45 Yes, it's, it's stripped away sort of like, you know, people talk about the pandemic as being the great leveler. It is not a great level of what it has done is shipped and stripped everything to its bones and been able to show like the deep disparities across our nation in so many different ways in different communities. Um, those who have been most vulnerable and marginalized and disenfranchised, um, are, are bearing the, the burden of this pandemic because, um, because, because of the, those disparities that have been in place for a very long time. But the other thing that it's done is it's shown the incredible, um, um, creativity and ingenuity and the, um, the beautiful sort of way in which we show up as relatives to one another. The willingness to do things like so masks and drop them off. But we have knack and I'm sure IHB has had the same experience. Speaker 3 41:38 We have had people just, you know, so many people in our community just randomly dropping off masks, um, dropping off food, um, doing, taking care of ourselves and taking care of their other relatives that are taking care of us and taking care of their relatives in the community as in lots of really creative ways. We've been, um, we have example over example of people in our community doing things like taking elders who are sheltered in place, who can't leave their homes or maybe they're afraid to leave their homes for all kinds of reasons because they're one of those vulnerable populations, cooking meals for them and taking those to them and dropping them off. Um, one of the ways that NAC has tried to do that by functioning as a good relative, as we continue to really, um, uh, try to show up in those, um, in those most difficult spaces to show up and support people. Speaker 3 42:29 Um, um, we work with, um, a lot of harm reduction patients. We still meet with our patients. Um, how can we members who are struggling with addiction, who are struggling with mental health disorders, who don't have a shelter in place, who are transitioning living are, they're struggling with all kinds of things and they wouldn't have normal access to, to any type of support or outreach workers. And our staff are continuing to do those things. And, um, the partners that we work with continue to do rep. And so, um, those are those, those are really important ways in which we, um, we, uh, we operate, um, from a, from a very strong set of principles that are deeply in grounded in who we are as indigenous people. Um, this pandemic has taught us, if anything, we are all related. So the, the idea of Nataki Elise and our, you know, we are all connected. Speaker 3 43:25 It's shown us exactly how we're all connected, right? And what we also see is that we as individuals, as spirits walking this earth and trying to understand this human experience, um, we get to wake up every single day and make the choice of how we're going to show up in that way. Um, how we're going to show up in that relationship that we have with each and every person on this earth and the way in which we're related to them, that we get to choose whether we're going to act out of love and compassion and concern or the word that we're going to act out of fear and ostracize and walk away and let people sort of function on their own. And what I've seen time and time again with my staff, with the staff at IHB, um, the relatives in my community is that they step into that space that's really hard to operate and they act, make actions and decisions that have love and concern and compassion and, um, and that is uniquely a indigenous principle, a way of acting and behaving in relationship to each other. Well, I want to thank you all for taking the time afternoon. Speaker 0 44:32 Um, the hour flew by. I want to just say thank you so much for, for, for taking some time to be on air with us. Um, and because we at KPI, um, really believe in also being a good relative, um, uh, dr Staley, I think you'll appreciate, you'll, you'll, you'll recognize as I hold up and our listeners can't see this, but I'm holding up, um, some B2B or sabers, um, that were made by a community member. Her name was Deanna Bolio who would be dr stateless niece. I believe she has. She's been working hard on these for the past couple of weeks. We'd like to be able to send these to you in the mail safely. Um, they're all wrapped up. Um, as just a gesture of thank you. Um, from us at cafe I and our team at at, um, cafe who is producing American Indian month to say thank you and we appreciate so much what you do. Speaker 0 45:23 Well, thank you so much. Um, we appreciate all that you do as well. So I want to think of how to thank you. That's, that's a really cool gift. Yeah. Yeah. We're, we're, we're really, uh, it comes from the heart where we're so pleased to be able to also provide this programming for the community here in may, uh, during American Indian month. We are wrapping up this hour. We've been talking about the state of healthcare providing health care to urban American Indian communities here in Minnesota, in Minneapolis and st Paul. Um, again, want to thank our guests. We are going to be welcoming some guests, um, from all my relations including Angela to stars and artists totaling Tahoe and Hillary campaign. Nick, uh, for our coming hour, we are going to be moving forward with a panel on arts impact in isolation. Um, so stay tuned everybody. You're listening to cafe fresh air community radio, 90.3 HD in Minneapolis and streaming [email protected] Speaker 1 46:24 <inaudible>.

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