Learning Community Reflections: Tribal Health

“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.” – Lilla Watson, Aboriginal activists group, Queensland, 1970s

In September, our learning community ventured up to northeastern Wisconsin for an engaging two-day monthly meeting where we learned about the culture and health of the Menominee and Oneida tribes.   

An important theme was the powerful role that the US history of colonization and systematic oppression of native communities has played in causing the current health concerns of these communities today. Just as salient was the resilience and innovation of the Menominee and Oneida peoples and how they incorporate their culture for improved health and wellness. Jerry Waukau and Diane Hietpas of the Menominee Tribal Clinic explained how compulsory boarding schools, in which Indian children were forced by law to attend government and church run schools for assimilation, caused loss of language, culture, disrupted family ties and community structure, and often resulted in child neglect and abuse (aka ACEs) which is at the root of some of the cyclical family trauma in community. The work that the clinic and its partners are doing around culturally appropriate and person-centered trauma-informed care is making a huge difference in the community, has drastically improved their high school graduation rate, and led to their Culture of Health Prize recognition by the Robert Wood Johnson Foundation. At the Menominee Cultural Museum, Dave Grignon informed us of the success of ongoing family culture camps in improving substance abuse issues in the community. He also told us about the unjust Termination (I.e. loss of sovereignty) of the Menominee Tribe in 1961 and the major losses of land control, jobs, access to health care, and wealth that resulted, taking a major toll on their quality-of-life. I find it an atrocious abuse of power how the Federal government has stopped recognizing the sovereignty of tribes or forced them off of their land whenever the existence of the tribe was inconvenient for government or corporate profits.

Fellowship Learning Community learning about food sovereignty, heirloom seeds and community rebuilding from Menikanaehkem.

Fellowship Learning Community learning about food sovereignty, heirloom seeds and community rebuilding from Menikanaehkem.

Personally, I was most inspired by our visit with the grass roots, culture-centered group, Menikanaehkem. I was moved by their guiding philosophy when planning community events, which is, “Is this event going to bring hope, belonging, meaning, and purpose to this community?” As a way to resist the deficit-minded, consumerism culture of our time, this group is refocusing on their traditional cultural practices, values, and spirituality that guided their way of life for thousands of years. Guy Reiter of Menikanaehkem embodied that traditional spirituality with his peaceful presence and conviction to do what is best for the community. He verbalized this mindset when he said things like, “the creator loved us so much that he gave us our language and culture,” “we’re adding to the beautiful story of our people,” and “what matters more than everything is that we connect with each other right here in this moment.” It was easy for me to see how reconnecting to a mindset of gratitude, beauty, and connection with the land and their ancestors can build personal and social resilience and improve the health of their community.

Our discussion with Menikanaehkem has got me pondering. In many ways, Menikanaehkem is the opposite model of governmental public health: grassroots vs. hierarchical institution, culture vs. science, personal connection vs. systems and processes. How should authority, decision-making power, and resources be distributed among these models? How can our rigid institutions be more responsive to the needs of the people in the way that grassroots movements are? What can governmental and academic agencies learn from grassroots groups, whom are closest to the largest inequities, about how to improve the social and physical environment of the communities we live in and serve? How can those of us who work in governmental public health support or collaborate with grassroots groups like Menikanaehkem in a way that honors their history, expertise, culture, and way of life?

Mr. Dave Grignon at the Menominee Cultural Museum as the Fellowship Program is hosted by the Menominee Indian Tribe of Wisconsin.

Mr. Dave Grignon at the Menominee Cultural Museum as the Fellowship Program is hosted by the Menominee Indian Tribe of Wisconsin.

I don’t anticipate having all of the answers anytime soon, but we were able to discuss that last question a bit more than the others. During our visit with Menikanaehkem, one memorable piece of advice was that “if you don’t understand us, recognize our strengths, and know your own, then you can’t help us.” Melissa Metoxen from the Native American Center for Health Professions (NACHP) and the Oneida Reservation gave similar advice. She said that the key to working with tribes is to enter into relationship with members from the tribes. That means building trust over time by putting the tribes’ interests first, meeting face-to-face, and working hand-in-hand.

~ Cory Steinmetz

365 Days Later...

We have all heard the phrase “time flies,” but man does it! Lately, we have found ourselves asking “where did the year go?” As first--almost second year--fellows, this question has forced us to pause and reflect on the ups, downs, and everything in-between. Over the span of this seemingly fast-paced year, we have gained insight intothe interdisciplinary and multi-sectoral world of public health, become more intimately acquainted with the communities we serve, and grown as public health professionals. Therefore, as the first year fellows get ready to jump into year two, we wanted to share some insight with the upcoming cohort and give others a snapshot of how the fellowship encourages growth and stimulates learning in the first year. 

What tips do you have for incoming fellows?

  • My tip for first years would be to be vocal about what sounds exciting (or not) to you! If you learn about an initiative at your placement that sounds really interesting, ask about what you might be able to contribute. More likely than not, they will be grateful for your enthusiasm and contributions.

  • I found it helpful to make a short list of what I want out of the fellowship. This meant prioritizing Core Activities of Learning (CALs) and thinking about areas I’d like to improve on. I have this list in the back of my mind and think about it often when taking on new projects. Knowing what you want is the first step to thinking about how to get where you need to be at the end of the fellowship. It sounds very Stephen Covey, but “beginning with the end in mind” has been helpful for me.

  • I learned that the fellowship community--particularly the staff-- are on your side. They want you to fully explore the world of public health and find your fit. Make a wish list that includes everything you would like to do over the 2 years, no matter how extreme the items may seem. The fellowship staff, faculty, and other fellows are great at helping you figure out how to get the experience/skills that you want and need.

  • Try to temper expectations about how quickly you will feel integrated into the work. Learning the organization and projects takes time, but you'll get there! Eventually you will feel ownership over your work, and in the meantime-- fake it til you make it! Show up, offer your time and effort, and show interest. Soon enough, everyone will be asking for your ideas and input.

What opportunities should fellows take advantage of during the first year?

  • Think outside of the box and take advantage of UW classes, trainings, or seminars that interest you. I mean when else will you have a full time job that encourages learning and experimentation as much as the fellowship! You have time and funds, so use them.

  • If possible, be a discussion section leader for a public health course! Leading a discussion section this spring was one of my favorite experiences in the fellowship thus far. Not only will you gain experience in facilitating discussions and teaching others but I guarantee you will also learn a lot from your students. Plus, it is just fun! Dr. Remington typically offers a course in the spring. I would suggest talking to him about other opportunities.

Is there anything else you would like to tell first years OR that you would have liked to know before you started?

  • Conduct informational interviews with people who are doing work that interests you. Learn how they got to where they are now, what they do on a daily basis, what motivates them to continue the work, etc. This is a great way to explore public health careers and to give you ideas for work you can do during your fellowship to prepare you (and your resume) for future employment!

  • Be flexible and adaptable – more likely than not, your outlined project plan from when your site applied will morph over the course of the fellowship and in some cases, may even look entirely different by the time you’re done.

  • Get involved with projects outside of your site such as fellow driven projects. It’s a great chance to interact with other fellows, give birth to an innovative idea, or even dive into an area of work not associated with your site projects.

Curious to learn more? One of our fellows could not have said it any better -  

“Have coffee with a former Fellow! Our fellowship community is very welcoming and wants you to succeed. Meeting with former Fellows was helpful and encouraging.” 

The invitation is always open - We hope to connect with you! 

Stevie and Janine