TNV: First of all, what tribes are you from?
Dr. Jeffrey A. Henderson: I am a member of the Cheyenne River Sioux Tribe
Dr. Patricia Nez Henderson: And I am a member of the Dine’ Tribe or Navajo Nation. I am born for the Near of the Mountain People and I am related to the Big Water People.
TNV: If you don’t mind me asking, how did you two meet? How did this partnership come together?
PH: We met at an Association of American Indian Physicians conference in Portland, OR. I was a medical student and he was a physician. The Association is good at setting up medical students with native physician mentors who have previously gone through the program. Jeff would call me and check on how I was doing in medical school…this progressed into a friendship, we started dating, and eventually we got married in March of 2000.
TNV: How did this evolve into the BHCAIH?
JH: We had just started dating in the fall of 1998 when I moved to found the center here, the center was created in November of that year. In early 1999 I spent a lot of time living in New Haven where Patricia was going to school at Yale. I was a half time faculty member for the University of Colorado School of Medicine and I worked on the Strong Heart Study. This was after I left the Indian Health Service and I was grant writing and trying to lay the ground work for success here at the center. But, at the time the center was still just a virtual center, the address was my home address we weren’t living together yet. The corporation was at my home – it had zero in the bank account it was a real grass roots kinda thing.
Patricia finished medical school, I was continuing my work at Colorado, learning how to conduct research, and I was continuing as an investigator in the Strong Heart Study. When Patricia graduated from Yale Medical School, she had the option to do a residency and become a practicing physician, or to be part of the second group of doctoral degreed Indian people to go through the research training experience at the University of Colorado. With her masters degree in public health, she already had a background in how to do research. Patricia decided to [stay with research] and enter the program where she continues today as a full time faculty member. Patricia is our research physician.
By that time I had three grants in for the center; they were all pending. We still didn’t have this facility or any employees…About a year later we hit the pay line on all three grants.
TNV: I am intrigued by your vision of a whole paradigm shift in how the tribes relate to research becoming a more proactive, visioning process rather then a receptive sort of laid back process.
JH: The standard way that tribes become involved in research is to have a research team, usually from a university or college, develop a research idea. They then involve some graduate students and/or some junior faculty. A grant proposal is written up and submitted, often without identifying ahead of time what tribal groups they propose to work with. Only after the grant is reviewed favorably and is going to get funded does the research team go looking for the tribal group to work with. So [at that point] there is pressure on them to go out and identify a tribal group, a “target population” to work with or they can have their funding pulled.
Some researchers may have enough integrity to approach a tribal group before submitting a grant.
TNV: Are tribes in a unique position to have a say in how research is done on their tribal members?
PH: Yes. Tribes are implementing IRB’s (Institutional Review Boards) into their health departments that review all of the research proposals and are basically there to protect the people who are being researched, the “subjects.” this is a standard practice.
TNV: Do you have to go to IHS (Indian Health Service) for approval for a research project?
PH: Yes, they have different IRB’s [for research to be done on IHS patients].
TNV: How did your vision for the BHCAIH start?
JH: It started with my work in Eagle Butte, SD. I was living fifty feet from the emergency room door of the hospital. There were four of us physicians for a good size population, so it was very busy work. About six months before I decided to leave I kinda stepped back and took an objective look at whether what I was doing, you know, whether being the “Indian Marcus Welby” in the community was helping anything.
On the whole, socially, the reservation was no better off and probably worse off actually than when I had started – drug use was on the rise, alcohol use was unaffected by our work. There was no improvement in the number of direct services that were being provided; they weren’t limited because of manpower, they were limited because of funding. Once I realized this, then I began the process of trying to figure out what change needed to happen on the individual and tiyospaye and tribal levels to effect real change. What I proved to myself was that my two years of working on that individual level was like chasing my tail, and that what was really needed was population-based strategies that would influence larger numbers of people in the communities. This can help more than just one person at a time…But they don’t teach you how to do that medical school.
TNV: So you were looking for a better way to help your people?
JH: Yes. To [medically] treat, but also to find better ways to prevent some of the major conditions that our people encounter. Lots of these conditions are preventable but individual will power alone is not likely to work; there is pervasive history and a great amount of dysfunction that’s multi-generational that cuts across all fabrics of reservation life.
PH: While we bring [medical advancements, training and equipment] to Indian reservations and communities it is really frustrating for me that our communities don’t take health seriously. We say we live in harmony, but is that true? People are smoking in their homes around their children or drinking…Health really starts with the family and brings balance back into the family.
TNV: Give us an example of your vision, your philosophy.
JH: You need a vision to get things done. Most visions happen with just one person. You have to be able to imagine how things can be, able to envision how you would like things to be. A decade or so ago I was working with our tribal council (Cheyenne River) to try to envision a different Main Street in Eagle Butte, SD: How we would like to see it ten years from now? If we were to walk down Main Street blindfolded what kind of different sounds would we like to hear? What smells we would like to smell? What things would we want to feel around us? But that just wasn’t exciting for anybody because the needs are so great on the reservation that to ask a council person to envision these things is difficult if not impossible…a person needs to, be able to clear the mind (and clear the desk) to see the grand problem and therefore find grand solutions. You only have the ability to vision like that when you are in the center of the Medicine Wheel, when your mind is calm enough to see past the daily distractions, when you are balanced.
TNV: Thank you for your time it has been very insightful. We hope that your project, The Black Hills Center for American Indian Health, can benefit all native people.
JH and PH: Thank you.