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Yvette Roubideaux recognized the problems with Native health care and they sent her on a path to make things right.

As a child growing up in Rapid City, S.D., Dr. Yvette Roubideaux hated waiting in the cramped lobby at the local Indian Health Service Clinic.

So she would bring a backpack full of books to keep her preoccupied during the often four-hour-long waits to see one of 10 staff physicians.

Year after year, the clinic was chronically underfunded and overstressed.

As she got older, she heard her relatives complain about the long waits and how they never saw the same doctor. Eventually, those complaints helped motivate the 46-year-old Rosebud Sioux to become a physician.

More on Native health

Established in 1955, the Indian Health Service provides preventive, curative and community healthcare to approximately 1.9 million of the nation’s 3.3 million Natives in hospitals, clinics and other settings throughout the United States.

Dr. Roubideaux served as co-director of the Special Diabetes Program for Indians Demonstration Projects, in which 66 Native communities are implementing diabetes prevention and cardiovascular disease prevention initiatives.

Socioeconomic factors – availability of healthy food, ability to exercise and keep active, education and the way communities are set up – factor into the difficulty of providing overall healthcare to many Native people.

Hundreds of medical jobs remain vacant within IHS, including 21 percent for doctors’ jobs, 24 percent for dentists and 26 percent of openings for nurses, according to IHS. There is not enough funding to pay for staff.

Natives die at higher rates than other Americans from:

  • ·Tuberculosis (750% higher)
  • ·Alcoholism (550% higher)
  • Diabetes (190% higher)
  • ·Unintentional injuries (150% higher)

“I heard a great metaphor for IHS: It’s a really good car. It just needs more gas,” said Dr. Roubideaux, who, in 2009, became the first female Native American director of the Indian Health Service. “The system is so stretched. I was visiting an area office, and everybody who introduced themselves had three or four jobs that normally you’d expect one person to do.”

The circumstances hadn’t changed much once she began working at a rural Arizona IHS clinic after graduating with a master’s degree in public health in 1997 from Harvard Medical School. She always had ideas about things she could change about health care, about the system, but there wasn’t much she could do as a physician.

Now, she’s calling the plays.

It wasn’t long before she realized she had inherited an agency that chronically underfunded, yet is responsible for a population that suffers far higher rates of diabetes, alcoholism, tuberculosis and suicide than the general population. Natives born today have a life expectancy that is 4.6 years less than the general U.S. population, according to IHS (72.3 years to 76.9 years, respectively).

It’s even shorter for those living on rural reservations. There, residents can expect to live only 66 years because care often is delivered by overtaxed medical staff working with outdated equipment in aging buildings.

But Roubideaux isn’t hitting the panic button yet.

The budget is the biggest obstacle, according to IHS officials. They say the current $3.6 billion is a little more than half of what they need to fully fund the agency’s mission – which is to provide comprehensive health care to 1.9 million American Indians and Alaska Natives.

It’s common knowledge around the rez to “don’t get sick after June,” when federal money often runs out until the new fiscal year begins on Oct. 1.

But Roubideaux, the eternal optimist, is taking pride in the improvements to health care thus far – like the fact that life expectancy for Natives has increased nine years since 1973.

She said more change is needed and she has met with tribes and asked them to recommend those changes.

“Instead of coming in and saying we’re doing X-Y-Z, I’m asking the tribes, ‘If we’re going to improve the Indian Health Service, where should we start? What are your priorities?’” she said.

Gerald Hill, president of the Association of American Indian Physicians, commended Roubideaux during her confirmation hearing as someone who “not only understands Western medicine but how to apply this knowledge in Native communities.”

“We have all the elements in place to really address these health disparities,” Roubideaux said. “It’s just that we need two things: If we can begin to address the problem of resources, we can do a lot. But the second area is how we’re providing that care and making sure we’re doing it in the best way possible.”

  • http://www.komyo-reiki.ca Chris de Feyter

    Under-funding is a great challenge to health care and education around the world, unfortunately. When it comes to care, it would be beneficial to people is they start to learn how to take better care of their own physical and emotional wellness. A good complimentary way of learning how to do that is by using spiritual healing such as Reiki (http://www.learnreiki.ca). A holistic approach to wellness can help de-stress care systems if done correct.

  • Jenna

    powerful kumar, I still laugh every time I think of my former ex (now fiance). I had the adult dysfunctions revenge spell cast on him and got to hear the stories come in. He couldn’t figure out what had happened to him. He tried pills, creams, anything over the counter or under to help his situation. After watching him suffer a bit, I was sympathetic and we talked, ended up working out our differences and I reversed the spell. He still doesn’t know what happened and I still laugh when I think about it…thanks powerful kumar(powerfulkumarspell@yahoo.com)

    ~ Jenna, Alberta, Canada

  • Cupnit7

    As a healer, you can be certain we pray daily about these disproportionalities within systems that were created within a certain box and Nativeness does not necessarily fit within that BOX.  We are mindful of this during Undoing Racism trainings (Peoples Institute, New Orleans LA) and I realize more and more how critical it is for all of us to be doing our part to undo racism, in order to fully fight the injustice of these funding challenges our IHS faces.  The people in “power” that create policies all would benefit by looking critically at how inadequate the system is and helping Native Nations find solutions.  This year is the year for spirituality to move mountains and that spirit-spirituality is so much bigger than the problem.  We can find a way by first naming and addressing the underlying issue:  racism and anti-Indianism (thanx Liz Cook Lynne for the vital term).  Looking at everything through these lenses of NAMING really goes a long way towards helping to heal self too.  (so grateful to Creator for creating such movements that address this imbalance by creating visionary anti-racists where we can come together out of love for all and undo what history has done to us all).

  • Kathleenhickey

    Dr. Roubideaux clarifies the fact that no matter how old you are you can still get things done.  That she doesn’t get overwhelmed and looks at the bright of things really is an asset to her.  instead of blanketing the whole program she individualizes each tribe and their needs, this is an asset to each tribe.

  • Sandy

    First Of All.. Who The Hell Is The Government To Tell Native Americans They Are Wrong For Their Up Brining And Belief System? I Was Born Here And I Am Against The System Here. I Am All For Native American Medicine And Herbs. I Am A Naturalist. I Seen And Heard MANY>>> Including Myslelf Whom Doctors Killed My Mother, Friends, And Others For Profit Over Humanity. I Will Move With A Tribe.. OR To Mexico Before I Allow The Government Take Over And Brain Washing To Continue.

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