Indian Health - SD clinics help urban Indians live with diabetes

By Dirk Lammers
Sioux Falls, South Dakota (AP) October 2010

Urban Indian health clinics in South Dakota are incorporating exercise and meal planning into their diabetes treatment to combat the prevalence of the disease among Native American residents.

Native Americans are three times more likely to die from diabetes, according to the Indian Health Service, and doctors and nurses often tell diabetes patients to exercise more and eat better, said Donna Keeler, executive director of the nonprofit Urban Indian Health Center.

“Well OK, we all know that,” Keeler said last week. “But unless somebody actually either helps us plan meals or shows us how to actually get on a treadmill, we typically don’t do what they tell us to do, and it’s not because we don’t want to.”

The Urban Indian Health Center, which is funded with Indian Health Services contracts and other federal grants, was founded in 1977 to provide health care to native American families who lost access to free health care provided by Indian Health Service when they moved to urban areas.

The organization has clinics in Sioux Falls, Aberdeen and Pierre that see nearly 7,400 patients each year.

Sen. Tim Johnson, D-S.D., toured the Sioux Falls location on Monday, which in South Dakota is celebrated as Native American Day.

Johnson said he’s impressed by the way the clinic provides complete wellness services by combining physical, spiritual, behavioral and mental health care.

He called the Sioux Falls clinic, one of 34 across the country, a model for the rest of the nation.

“The clinics deserve more money but they are doing as best they can, and I don’t see that there is more money to be forthcoming from Congress.” Johnson said. “But we should do better by the Indian people, and the search will be on for more money.”

To help its patients combat diabetes, the Aberdeen and Pierre clinics have fitness centers, and the Sioux Falls clinic within three months will add one that will also provide child care three nights a week.

The Pierre location features a full teaching kitchen with a nutritionist who helps with hands-on meal planning, shopping and preparation.

Keeler said most families cook the same 10 meals over and over, “and if those 10 meals are all bad or seven of those are all unhealthy, then you’re never going to get healthy. But you can fix those 10 meals in healthy ways.”

Tonya Benson, a certified nurse practitioner at the clinic, said if a patient comes in with a sore throat, they’ll treat that ailment but screen for other things, such as depression.

“If you’re a tobacco user, can we give you assistance with quitting with that,” Benson said. “The same thing with alcohol use, how much alcohol do you use and can we get you help with that.”

The clinic doesn’t check tribal enrollment records, so it winds up also serving other nationalities and ethnic groups. But Native Americans are made to feel at home at the center, said Karla Abbott, an Augustana College professor who serves on the center’s advisory board.

“Here, you’re treated by someone who’s most likely Native American or has a knowledge of Native American culture,” she said.4