The new health center would replace an old one built by the Army Corps of Engineers, which, according to the article, was in sorry state. For example:
The Corps of Engineers built a health center to serve this grassy sprawl of distant towns and often-rutted roads, but as the only one of any size on the reservation, the center could not keep up with the growing population. The tribe began working on a plan for a better, larger operation that would also make it eligible for more money to improve services.
It clearly had the need, with higher rates of births and deaths, including infant deaths, than the region’s non-Indian population. The birthing unit had been closed because of quality-of-care concerns, the bathrooms could not accommodate wheelchairs, and recruiting efforts often died as soon as, say, a nurse from out of town saw the drab efficiency apartments set aside for the staff.
And there was the familiar matter of location, location. When tribal members require anything more than modest medical attention, they must be taken by ambulance or plane to hospitals far from the reservation — in Rapid City, S.D., or maybe Bismarck, N.D., both about 180 miles away.
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Some people gradually developed a distrust of the health center, and not only because its brick facade recalled the time of forced relocation. It was understaffed, it had become a patchwork of renovations and additions, and there was nothing native about the place beyond the staff. “It has no flow,” Mr. Hunt said.
The Tribal Council has been lobbying Washington for a new health center for years. The new center is supposed to also include better housing for health care personnel, and be designed with Native American spirituality in mind. Some residents are skeptical of the whole thing, having endured years of disappointments. But here's what is planned:
This $111 million health center will have an American Indian feel; it will be theirs, and not someone else’s. It will have a larger emergency room, two beds set aside for births, new medical equipment, and such basic, almost-forgotten amenities as a staff break room. It will also have that healing room, specially ventilated; no longer will mourners have to clog the bottoms of doors with towels when they burn sage.
But again, this is Indian Country. There are some basic health services the center will not provide; a CT scanner, for example.
Thomas Sweeney, an Indian Health Service spokesman, said the decision not to include this equipment was based on a formula that takes into account several factors: staffing, workload and population size. The agency receives slightly more than half the financing it needs, he said, which means “there’s always tough decisions.”
One step at a time, said Mr. Hunt: the building first, and then more visits to Washington to fight for more improvements — a CT scanner among them.
Until then, it remains a three-hour ambulance ride to Rapid City.
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