“Where the grass is green and the river is flowing” -update from Bois Forte

“Did you pass by the accident on route 53 this morning? “ That was one of the first things that we were asked this morning as we stopped by the gas station for breakfast, and when we arrived at the clinic. This was concerning the accident that we passed half-way to the reservation. News travels fast in the Bois Forte band. Everyone in the community knows each other’s news, and know one another from childhood. For example, the clinic manager Ray Hawk, gave nurse Terry her immunization when she was a baby. Now they work side by side at the Bois Forte health clinic. The Bois Forte health clinic was established around 2006 to fill a gaping hole in health care for the reservation. Until then, members of the reservation had to drive 20 miles to get to the nearest health clinic. Since opening, the clinic has expanded twice, and they just installed their x-ray machine last September.

When we arrived at the clinic, we were separated into two groups. Two of us got to shadow a doctor, a physician assistant and the diabetic educator at the Health Clinic. The clinic facilities are located in a new building. They are actually attached to the head start and elementary school, making it easier and convenient for children to make it to their regular checkups and appointments. We had the opportunity to meet several patients and get a good insight about what rural health is all about. It was very interesting to not only get the cultural experience, but also to open our perspective on what healthcare is all about.

One of the most compelling aspects about working in this small community is the fact that the clinic staff is not only there providing services to the people, but they are also family members and close friends with their daily patient population. Thus, the doctor-patient relationship and communication is built on multiple dimensions. Patients are more open to their providers, and because of this, they are able gain a better understanding of the disease processes.

The other two of us went to the human services portion of the clinic. Mai talked to Teri, the public health nurse to see the WIC (woman infant care) in action. Unfortunately, both the scheduled patients cancelled for the day. This gave us time to talk more about the WIC program and the issues attached to them. The most recent challenge seen in the program is that a few women in the program used the vouchers to buy baby formula only to return the formula for money. The nurses are now considering the possibility that domestic abuse is the reason why these women are not keeping the baby formula. Domestic abuse is an issue on the reservation that is present, but not addressed.

Sara spent most of Tuesday morning with Laurie, a Community Health Representative (CHR). Laurie is one of two CHRs at the Nett Lake community health center. They do Elder home visits, deliver medications and transport patients to medical centers. There are days when she easily puts 250 miles on her car driving back and forth. There is also an Elder Nutrition Program that provides meals for the Elders. Elders want to be independent, live on their own for as long as possible before entering nursing homes. It was amazing to see how much the people at the reservation tried to help the Elders be as independent as possible. There was a strong community feeling, very different from what we are used to seeing. It wasn’t just the children taking of their own elderly parents but the whole reservation taking care of them as one big family.

Throughout the morning, the four of us got stared at whenever residents passed us on the street. In this small village, we are unfamiliar visitors. During lunch, we were approached by Brandon Benner. News that there were four Dartmouth Medical students were touring the clinics today had spread to the tribal council, and Brendan approached us to invite us to see his dancing regalia and visit the government building.

In the afternoon, Terry gave us a tour of the headstart program and the school. The school houses grades K-8, with about 12 students for every grade. All the students start learning the Ojibwe language from a young age so that the can be fluent when they grow up.

Bois Forte is possibly one of the warmest and friendliest places we have ever had the privilege of visiting. The people here are very welcoming. After our serendipitous meeting during lunch, we took Brandon’s invitation to the tribal council. Brandon took us on a tour of the Bois Forte government center, giving us a small taste of the extremely rich Native American culture. Brandon presented to us the costumes used during Native American dances, such as his war bonnet as well his plethora eagle feathers. In addition, Brandon demonstrated a wise Native American value through the use of torn eagle feathers. He explained that although one torn eagle feather may be imperfect, when combined, they become flawless—a metaphor for the importance of teamwork.

After giving us gifts of Bois Forte T-shirts and mugs, Brandon showed us photos of generations of brave Native American veterans who fought for America, from World War II to the Gulf War, including our own Shawn O’Leary’s grandfather, Thomas O’Leary. Afterwards, we went outside the Government Center, where in the back there is a memorial for the Native American veterans with the engraving “Forever Warriors”.

Bois Forte is also referred to as “Nett Lake,” and the reservation is located on the shore of the lake. We took a walk around the lake and listened to stories from Shawn O’leary’s father. We are lucky to have come during the winter while the lake is still frozen, because the Bois Forte code is that stories are not allowed to be told when the lake is thawed. At the lake we saw Spirit Island, which is a sacred island for the Bois Forte band. The golden stems of wild rice that was not harvested at the peak season was able to be seen in the distance.

In the evening, we had the opportunity to have dinner with two elders, Marybelle and Loretta. Both of them were born on Bois Forte, but moved away after high school. They both returned back to the reservation in the last 10 years. The two gave us insight on reservation life and told us more Bois Forte stories. They also described how life was for their parents who were forced into boarding schools and were banned from using the Ojibwe language. As a result, they never learned the language or many of the tradition as they were growing up. Their parents did not want to pass on knowledge that can harm them.

We still have a couple more days in this reservation, and hopefully we will get an even deeper insight on the Indian Health Services. We are looking forward to shadowing nurses in maternal services, and taking a look on what dental care in Bois Forte is all about.

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