KYKOTSMOVI,-Cancer is one of the primary health care concerns on the Hopi Reservation. It is joined by child abuse, domestic violence, elderly abuse and teen pregnancy as the top five concerns as revealed through 600-plus completed surveys from the Hopi villages.
The survey was followed by the third Health Care Summit since the opening of the Hopi Health Care Center in 2001.
Captain Daryl Melvin of the U.S. Public Health Service, top administrator of the Hopi Health Care Center, explained that each of the community planning sessions had very different topics.
"They have been very successful at solving the concerns of the community," Melvin said. "We ask members of the community to tell us what their concerns are about health issues, and they tell us. The top concern for this summit was cancer-we ask them, 'Tell us what it is about the cancer that concerns you.'"
Patty Wells led the work group on cancer, where community members did just that.
The group quickly identified a need to expand on the women's wellness program as well as expanding that program to include men.
"Cancer education here is directed at women only," someone said. "How can we establish a campaign for men?"
"To educate men you have to come out of this vacuum," one man said. "Hopi men with cancer still want to be men!"
He went on to explain a need to find out if cancer is affecting certain parts of the reservation only, and expressed his concern about the down-winders situation, as well as uranium found in the groundwater near his home at Moenkopi.
"Has research been done on cancer at Hopi? I know we say we've been researched to death, but we need to find money for this," he said.
Other concerns included early detection, misdiagnosis, specialty physicians and fear.
Another person demanded a focus on the positive approaches to cancer care, saying that using the scare factor on patients could drive them away from care.
Wells explained her vested interest in cancer.
"I went through the process with my father," she explained. "Most Hopi who need cancer care face a two-hour drive to Flagstaff's Northern Arizona Cancer Center to receive treatment. Afterwards, they must return home. A lot of times people are tired. Many suffer side effects from their treatment, like sick stomachs and diarrhea. Many have to make this journey two to three times a week."
Beatrice Norton led an emotionally charged group on elder abuse. A box of tissue made the rounds as Norton encouraged community members to share their stories and concerns.
"You may be the one abused. You may see your neighbor being abused. You see it in our community," Norton said. "Elderly abuse comes in different forms. It is not just physical-it can be verbal or through neglect. What are you seeing? What can we do as a tribe?"
One woman who takes care of elderly people explained how difficult it is for one person to take care of an elderly person.
"It can't be done," she said. "It is tiring, exhausting. We should not have to ask other family members for help, but sometimes even suggesting that someone should help causes people to get upset."
She suggested contracts among family members; asking people to take a night, or a weekend and making an agreement to help.
"They took care of us," she said of the elders. "It is time that we take care of them."
Another woman agreed, explaining how alcohol had kept her from caring about anything; however she overcame her drinking problem and took care of her father.
"I enjoyed being with him," she said. "I look at it as pay back to society."
One elder spoke about the frustrations of not knowing how to take her medication. Another sobbed as she spoke about children and grandchildren not having respect for her, asking her for money or to care for young children.
Stan Yaiva asked when Hopi would have its own elder health care center.
"It's abuse that we have to send our parents off-reservation to health centers. They are tired of staying there. They want to come home," Yaiva said.
The teen pregnancy work group recognized that Hopi has a higher teen pregnancy rate than other teens in Arizona, and that teen mothers are 40 to 50 percent more likely to later see their own children have babies in their teens. This problem also leads to high dropout rates, high unemployment and a high rate of grandmothers raising their grandchildren.
Carrie Onsae, who facilitated this group, noted that education is important in addressing this issue.
"We first talked about the need to educate our children, but we have stepped away from that and are back to a need to educate parents," Onsae said. "Education is number one, but how will we do that? We have children asking about sex, and parents are not educating them."
"Why don't we take this to the schools and ask the youth for help?" Andrea Secakuku asked. "We should ask them, 'who would you respond to if you aren't responding to your teachers or your parents?'"
Lisa Lomavaya's domestic violence group quickly identified a long list of problems, including drug and alcohol abuse in the home, a lack of cultural teaching, too much television, an increase in the intensity and dangerousness of violence and that men often feel neglected and suffered from constant criticism and little emotional support.
They also examined the effects of gossip in the villages, resulting in violence in the home.
The group identified objectives that included a decrease in intensity and impact of domestic violence and holding offenders accountable for their actions.
Child abuse, a topic addressed by a group headed by Laverne Dallas, resulted in the observation that children needing counseling, a service needing improvement at Hopi.
One participant pointed out that children are witnessing abuse in the home-both verbal and emotional. Many parents lack parenting skills. Another comment was that parents don't want to grow up and are becoming parents too early.
After a lunch break, the groups planned objectives.
Melvin said that information gathered at the summit will be analyzed in a report to the hospital board, which will be shared with the tribe's agencies and partnerships in February.
The surveys also revealed which programs the community likes, which will also be useful to the hospital board.
"We use their responses in the redirection of funding. We don't take funding from the services they like," Melvin said.
Melvin recognized the work of Andrea Sekakuku and Bruce Talawayma who co-chair the multi-agency Hopi Regional Care Network that consists of the Hopi Tribe, the Hopi Health Care Center, Hopi Indian Health Services, the Veterans Administration Hospital in Prescott, Flagstaff Medical Center and the Tuba City Regional Health Care Corporation.
"No where else would you find these groups coming together every three months to address how we will come together to address the health care concerns of a common population," Melvin said.