In a New York Times op-ed, former South Dakota Democratic senator James Abourezk recently called for President Obama to restore the town land of Whiteclay to the Oglala Sioux of Pine Ridge, which would effectively render alcohol sales illegal. In the late 1800s, President Chester Arthur, issuing an executive order, created a 50-square-mile buffer zone on the reservation’s southern border, in Nebraska. Its intent was “to prevent renegade whites from selling guns, knives and alcohol to Indians living on the reservation.” Teddy Roosevelt, with the liquor industry in his ear, overturned the order in 1904.

Abourezk argues that Whiteclay’s liquor sales contribute to “murders, spouse beatings, child abuse, thefts and other undesirable consequences of the free flow of alcohol into the reservation.” His op-ed came a few months after the release of Battle for Whiteclay, a documentary that follows a group of activists as they try to abolish alcohol sales in the town. The film’s website states that the liquor stores regularly flout Nebraska laws by “selling beer to minors and intoxicated persons, knowingly selling to bootleggers who resell the beer on the reservation, permitting on-premise consumption of beer in violation of restrictions placed on off-sale-only licenses, and exchanging beer for sexual favors.”

Abourezk ended his column by writing that “President Obama could right a century of wrongs by re-establishing the buffer zone. It would alleviate the overwhelming social ills that result from easy access to alcohol, and help end the violence tribal members too often visit on each other and on their families.”

While it is indisputable that the liquor stores are preying on a vulnerable population, the problems at Pine Ridge go beyond drink. There are, for example, the reservation’s crushing poverty, sky-high unemployment rates, dismal health statistics, and treatment options (or lack of) for those suffering from addiction. Would presidential redress that restores the buffer zone be enough to “right a century of wrongs”? And while it may be a start, is it the right one?

Unemployment at Pine Ridge stood at 89% of the labor force in 2005. Located in Shannon County, one of the poorest counties in the nation, average family income on the reservation is $3,700. Just under 95% of the county’s citizens are American Indians, and 45% of families and 52% of individuals live under the poverty line. The director of Oglala Sioux Lakota Housing said a few months ago that the reservation needs 4,000 new homes for its 40,000 residents. And men on Pine Ridge have, after Haiti, the lowest life expectancy in the Western Hemisphere (48 years); for women, it’s 52. Half of Pine Ridge residents over 40 have diabetes.

Another challenge is that of providing access to culturally appropriate treatment and rehabilitation centers to help prevent the well-documented alcohol-related deaths among community members. This paper points out that the behavioral health care network for American Indians is both complex and fragmented. Pine Ridge, for example, doesn’t have a treatment center. And while over 90% of customers at the Whiteclay liquor stores are from Pine Ridge, if they are jailed in Nebraska for drinking-related offenses, they aren’t eligible for Nebraska’s subsidized treatment centers — those are for state residents.

Abourezk’s op-ed garnered a response from journalist Stew Magnuson, author of The Death of Raymond Yellow Thunder: And Other True Stories from the Nebraska-Pine Ridge Border Towns. Magnuson wrote, “[T]hose with even a passing familiarity with the situation in Pine Ridge know that the president will not be able to wave a magic wand, create a buffer zone and alleviate the social ills there,” emphasizing that “what is really needed on Pine Ridge and in many other places in Indian Country [are] [b]etter schools, more jobs and alcohol and drug rehabilitation centers.”

Magnuson’s point is an important one: the problem must be attacked on all levels. Certainly re-establishing the buffer zone may be a significant and symbolic step. But attacking the root causes of the area’s widespread alcoholism — poverty, unemployment, lack of culturally appropriate treatment centers, and lack of positive opportunities — is just as crucial, if not more so.

For more information:

Youtube.com: Battle for Whiteclay

The Oregonian: Native American doctor focuses on problems of addiction

Associated Press/Nebraska.TV: Organizers of Whiteclay blockade encouraged

Nebraska Statepaper: A different perspective on Whiteclay

Lincoln Journal Star: A place called Dewing

USA Today: Battle over beer brews on border

OpenForum: A “historic failure”: American Indian health care suffers

American Journal of Public Health: The persistence of American Indian health disparities

One day before Sebelius’s interview, another AP piece detailed the shortcomings of the painfully underfunded IHS. Operating with half the necessary funds, some understaffed clinics can’t provide preventive care services, and others can’t handle the high disease rates. Patients recount what they rightly see as subpar care: clinicians dismissing a patient’s pain from advanced frostbite until she threatened suicide; being unable to make appointments; diagnosing a five-year-old who had complained of stomach problems with depression. (After many months, several more clinic visits, and a collapsed lung, she was diagnosed with terminal cancer at a Denver hospital and died weeks later.)

The dismal statistics of American Indian health disparities are well documented (go here, here, here, and here for starters). President Obama cites a couple of the more startling ones on his website, including that men living on South Dakota’s Pine Ridge and Rosebud reservations have the second-lowest life expectancy in the western hemisphere. The health disparities are, as Sebelius says, “unconscionable.” But so are the funding disparities.

This report from the U.S. Commission on Civil Rights compared spending on American Indian healthcare to other groups for whom the government provides care. The numbers are telling: In 2003, the government spent $6,000 for each Medicare recipient, $5,200 for every veteran using the VA, and $3,725 for federal prisoners. American Indians: $1,600 per person. IHS spends less on its patients than any other group providing public care – and about 60 percent less than average per capita healthcare costs nationwide. From the report: “This disparity in spending is amplified by the poorer health conditions of many in the Native American community and represents a direct affront to the legal and moral obligation the nation has to improve Indian health status.”

That “legal and moral obligation” dates back to 1787. Many treaties and much legislation has been passed to ensure healthcare for American Indians, notably the Snyder Act and the Indian Health Care Improvement Act, which states, “It is the policy of this Nation in fulfillment of its special responsibilities and legal obligation to the American Indian people, to assure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy” [emphasis added].

The 2010 HHS budget is $828 billion ($872 billion after additional funding from the American Recovery and Reinvestment Act of 2009) - the amount spent on American Indian healthcare will make up approximately 0.5% of that. And if we funded the IHS at the levels officials say it requires – around $7 billion – that would still make up less than 1% of the entire budget. Obama’s $454 million bump provides the IHS with just over half of “all resources necessary”- ensuring that our historic failure isn’t coming to an end anytime soon.

For more reading:

Native Health Needs and Federal Apathy Are Told at an IHS Conference

Indian Health Care Needs Patient Information and Funds

Tribal Leaders Seek Health Care Reform

State Treasury Must Help Pay What Indian Health Service Doesn’t Provide

The History and Politics of US Health Care Policy for American Indians and Alaskan Natives

Redeeming Hollow Promises: The Case for Mandatory Spending for American Indians and Alaskan Natives

“If You Knew the Conditions”: Health Care to Native Americans

CDC Office of Minority Health and Health Disparities

Office of Minority Health

U.S. Senate Committee on Indian Affairs

Watson’s Atlas Map of Indian Territory (1886)

A startling 1 in 3 American Indian women will experience rape in her lifetime, according to the US Justice Department. Yet only federal attorneys can prosecute felonies like rape committed on tribal land – attorneys that are also responsible for terrorism and drug cases. The result: US attorneys decline to prosecute 75% of American Indian rape cases every year, according to NPR. Even if tribal authorities were able to prosecute rape cases, they would still only be able to prosecute members of federally recognized tribes. This poses a severe dilemma, since 86% of assailants are reported to be non-Indian. To address these issues, Congress is now attempting to strengthen the control of tribal authorities and increase the accountability of responsible federal agencies with the Tribal Law and Order Act of 2009.

While tribes maintain sovereignty through tribal police departments and tribal judiciary systems, the federal government holds the purse strings, and federal law still preempts tribal law in civil rights and criminal jurisdiction. Tribal law enforcement officials can’t prosecute non-Indian offenders, and even if a crime is committed by an American Indian, they can’t prosecute felonies like rape. Underfunding has also led to inadequate tribal law enforcement; in 2007, the Standing Rock Sioux Reservation had only 5 Bureau of Indian Affairs officers patrolling an area the size of Connecticut.

This may change — if the new bill passes. Introduced by a bipartisan group of senators, the bill would increase the authority of  tribal police by allowing them to make arrests for all crimes committed on tribal land, and to transfer prisoners to the Bureau of Prisons where the tribal government reaches an agreement with the Bureau.  It would also increase the accountability of federal agencies by establishing an “Office of Indian Country Crime” dedicated to enforcing federal criminal law committed on tribal land, among other provisions.

The bill specifically addresses the epidemic of domestic violence and sexual assault in that it would require the Indian Health Service (IHS) to implement policies and procedures for victims, establish concurrent jurisdiction to prosecute sexual assaults at the request of a tribe, and require the development of victim training programs for law enforcement and IHS personnel. The bill may not be a panacea, but giving tribes the authority to arrest non-Indians for federal crimes such as rape is an essential step in the protection of American Indian women against sexual violence.

See more links below the fold:

Summary of the Tribal Law and Order Act of 2009 – US Senate Committee on Indian Affairs

Blog post: Combatting Violence Against Indigenous Women - Native Legal Update, Apr 2009

Pt 1: Rape Cases On Indian Lands Go Uninvestigated – NPR, July 2007

Pt 2: Legal Hurdles Stall Rape Cases on Native Lands – NPR, July 2007

Maze of Injustice: The failure to protect Indigenous women from sexual violence in the USA – Amnesty International, 2007