Indian Health Services Incompetence: Lack of Emergency Birth Control For Rape Victims

Every Native has a horror story about IHS.

Take the IHS dental clinic for example.  They use pliers more than a drill, just yanking the tooth, even when fixable, because its easier and costs them less than actual medical care.
This callous apathy is the IHS attitude about most things. Doesn’t matter if we smile with craters in our teeth, or maybe die while waiting to be seen in the ER, or suffer because we were prescribed out of date, watered down antibiotics. We’re just Indians, who cares, right?

People in the IHS pharmacy often steal the patient’s medications. The medications provided are also often expired, tampered with, or ineffective. I once had a tooth extracted by the IHS dental crew, and was prescribed vicodin by the dentist for the pain afterward. Somehow between the dentist’s office and the pharmacy, that prescription mysteriously got lost, and was changed to ibuprofen. This is not an uncommon occurance. I’ve even heard stories of elders being harassed in the parking lot for their arthritis medications, because someone on the inside informed thugs on the outside that the elders have the painkillers. There are also cases where IHS tricked Indian women into being sterilized against their will. A woman could wake up from having her appendix removed, to find she could no longer have children. I recall waiting in the IHS hospital once, next to a man who had been bitten by a poisonous rattlesnake. They let him sit there for two hours without helping him.

People with serious injuries, even with bones poking through their skin, are often made to wait enormous amounts of time before they are seen. Not many doctors want to come to the reservation, so the ones that do are often subpar. Sometimes they are even fleeing malpractice lawsuits elsewhere. Mistakes in surgeries have resulted in injuries, or sometimes death. The normal clinic often refuses to see patients. Doctors sneak out the back door for hours at a time or refuse to work. People go to the emergency room for normal clinical care. This makes it harder for the emergency room to deal with actual emergencies.

Indian Health Services is an organization that is rotten from top to bottom. It needs more money. It needs better staff. It needs more accountability. It needs better management. It needs changed in nearly every aspect.

Around the reservation, IHS is a place everyone fears. Its a place everyone distrusts, usually for good reason. Yet most of us can’t afford to get healthcare elsewhere. So IHS and its numerous failings are all we have.

Given it’s legacy as an oppressive institution among Native people, I wasn’t surprised when I learned IHS has been blocking emergency birth control on reservations. Though right in line with IHS’s own degrading, shameful history, this is unacceptable. It denies women a basic legal right they should be entitled to in this country.

As Sunny Clifford, a woman from my own Lakota tribe has to say in her petition, which you can sign here:

Stop Blocking Native Women’s Access to Emergency Contraception!

In the US, women age 17 and over have the legal right to get emergency contraception — sometimes called Plan B or “the morning after pill — over the counter and without a prescription at their pharmacy.

However, according to a new roundtable report by the Native American Women’s Health Education Resource Center, this right is often denied to Native American women who use Indian Health Services to access healthcare. The report surveyed service providers on reservations across the nation and found women are often told they have to see a doctor or have a prescription to get EC. Some find that the pill isn’t in stock on their reservation.

This is especially alarming in light of the fact that 1 in 3 Native American women will be raped in their lifetime. Under current Indian Health Services policy, there isn’t even a consistent mechanism to provide survivors of rape and sexual assault the medication they need to prevent an unwanted pregnancy.

There’s a simple fix to this problem. Dr. Yvette Roubideaux, the Director of Indian Health Services, can issue a directive to all service providers that emergency contraception be made available on demand — without a prescription and without having to see a doctor — to any woman age 17 or over who asks for it.

Please sign this petition to ask Dr. Roubideaux to issue this directive and to alert the Department of Health and Human Services, which has oversight over her and IHS, to the situation. Native women deserve and demand equal access to basic reproductive health care!

I see a bit of the old toxic paternalism in IHS’s policy on this matter. Our women can’t, like any other women in America, decide for themselves whether they need Plan B. Instead, they are made to wait to see a doctor. A procedure full of endless run around, that can take nearly an entire day at IHS. This treatment of our women is indicative of the heavy handed, authoritarian manner by which IHS deals with Native people. We can’t even ask for basic medications, can’t even receive basic healthcare, without having to plead our case before the jury of skeptical doctors, and a system that doesn’t care much for our well being.

More troubling is the lack of emergency birth control in the event of rape. 1 in 3 Native American women will be raped in their lifetime. The statistic quoted is harrowing. (This is an enlightening read if you have the time) The gargantuan incompetence of IHS being unequipped to offer medical treatment in such an event is astounding, despicable, and inexcusable. This is something everyone who believes its wrong to treat Native Americans in this country like third class citizens, should be on board to help change.

IHS constantly fails its duty to the health of Native people all across this country. The average lifespan of a Indian living on the Pine Ridge reservation is 48 for a male, and 52 for a female. Contrast that with America outside the reservation, which is 75.6 for males, and 80.8 for females.

At root of those discrepancies, you will find IHS. We do not have equal access to the healthcare most in America receive. This is an issue that has needed redress for many years. Much needs to change in the way IHS is run to give Natives a shot at a happy, long life. The same shot nearly everyone not living on a reservation, not dealing with IHS has. Women’s emergency contraception is as good as any place to start with reform. I urge everyone to take a moment out of their day and show support by signing Sunny’s petition.


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