Friday, July 20, 2018

Eagle Butte
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Bad Warrior weaves blanket of health care for Cheyenne River


The Second Annual Cheyenne River Health Summit took place on June 13 at the Cheyenne River Health Center in Eagle Butte.

“At Cheyenne River, our people die too soon,” wrote Margaret “Peg” Bad Warrior, who sponsored the event.

The “tribal health lawyer”, as she is often called, who after working years with the Tribal Health Department and Cheyenne River Sioux Tribe Health Educator Harold Tiger, created Tasina Luta, a public health foundation.

At the beginning of the health summit, Bad Warrior explained that Tasina Luta translates to “red blanket” in Lakota, and that the blanket is a symbol of warm, comfort, and security— a perfect representation of Bad Warrior’s health care plan.

The purpose of the summit, Bad Warrior said, was to meet the various health entities on Cheyenne River and to begin a coordinated and consistent plan to “create a public health infrastructure that connects our people to the health system and builds trust in our health programs and institutions.”

Bad Warrior explained that there are various health care centers on Cheyenne River—the Indian Health Service, the Tribal Health Department, and private medical centers—Upell Medical Clinic and Family Health Center of Eagle Butte.

“The health care systems on the reservation do not coordinate very well,” said Bad Warrior. 

She pointed out the lack of coordination and combined effort when the tuberculosis outbreak occurred last year.

“Care depended on who was in what position, not about coordination,” Bad Warrior said.

To help tackle that problem, Bad Warrior invited all the health care entities on Cheyenne River to the health summit, which she explained was the first step in the Tasina Luta health care plan.

Step two, according to Bad Warrior, was to distribute Healthwise Handbooks to every household. The handbooks are informative guides with information about first aid, managing chronic diseases, prevention, emergencies, and lifestyle choices to improve health and wellness.

With the Tasina Luta health care plan, these handbooks would be provided to patients by their medical providers. A special Healthwise book for elders would also be made available.

Bad Warrior then explained the unique outlook that she learned many people have about medical care on the reservation.

“The people themselves tend to have a different relationship with health care. There is a lack of trust from the Lakota families,” Bad Warrior said.

Some patients who live in remote communities, like Bridger, may not have the resources to travel to Eagle Butte for appointments, or are often left waiting for hours for ambulance services to reach them. Another common occurrence is emergency rooms filled with non-emergency cases, which in turn causes lengthy ER stays.

These occurrences have resulted in reluctance and indifference when it comes to seeking regular medical care, said Bad Warrior.

According to Bad Warrior, Step 3 of the Tasina Luta health care plan would help alleviate some of these issues with the implementation of the “Ask-A-Nurse 24/7 Phone Line.”

This phone line would give patients immediate and convenient personalized medical advice from a registered nurse trained in telephone triage.

“In our rural location, the Ask-A-Nurse phone line will connect geographically dispersed patients to immediate personalized health advice, information and referrals, and will service as the second level tool to promote patient health decision-making and self-care,” Bad Warrior said.

Lastly, Bad Warrior emphasized no only the importance of having annual physical exams, but also having proactive medical providers who remind their patients of the exam. 

These exams will help identify medical conditions, determine if the patient is high-risk for any health issues, ensure needed lab work is complete, and will serve an opportunity to address patient concerns and symptoms.

The exams are the perfect opportunity for the provider to distribute and discuss Healthwise Handbooks, and more importantly, begin establishing a trusting and consistent relationship between patient and provider.

After Bad Warrior’s presentation, an open and candid discussion began as directors of various health departments and medical professionals shared their opinions and concerns.

One medical doctor emphasized the need for a regional suicide hotline.

“There are national hotlines, and they’re great, but there are no regional ones that understand the unique culture and needs of the people here,” he said.

A department director spoke about the need for working together and team building within all medical centers on Cheyenne River.

“Many times we don’t work with each other because ‘This is IHS. This is not IHS. Or, this is private, not tribal. If we team build then it would help us become stronger and give better health coverage for our people,” she said.

The health summit ended with representatives agreeing that the Tasina Luta plan was much needed and would benefit patient care.

Bad Warrior said since the meeting, she has formed an implementation team with members from Tribal Health and the Indian Health Service. She said the team would meet later this month to strategize and plan.

“Giving patients home access to accurate medical information and immediate personalized medical advice, encouraging them to plan and take action towards health goals for themselves and their families, engaging them as participants and decision-makers in their health care, all while coordinating the community of reservation health providers in the service of these strategies: these are the components of the Tasina Luta. The plan will create a foundation for health at Cheyenne River so closely woven that not one person falls through” said Bad Warrior.