and was willing to commute from his Mountain Home-based obstetrics and gynecology practice to the Duck Valley Indian Reservation to meet the needs of underserved expectant mothers. “I think they needed care desperately,” Brininger said. Before Brininger took the Duck Valley assignment, which had him commuting nearly 200 miles round-trip on a weekly basis, he saw expectant mothers from the reservation show up at the Elmore Medical Center in labor and in crisis. “They had no prenatal care,” Brininger said. For five years, Brininger cared for the reservation’s mothers-to-be and delivered their babies. But Brininger recently stopped making the commute to Duck Valley when the money that funded his contract dried up and the community lost its only OB/GYN. He worries that a Life Flight medic or EMT may be the first and only medical care provider to serve the area’s pregnant women. “My concern is for the care of the girls. The risk is pre-term labor,” Brininger said of would-be mothers who delay or never receive specialized medical care. And that could translate into highrisk pregnancies, which turn into emergencies once labor sets in. “Even if they’re not paying me, they’re paying for a Life Flight. And the cost of two Life Flights is how much I made in a year.” But when the government makes funding cuts, the tribe cuts health care. “The way I see it is, if you have a landlord, the very first thing you do on payday is you set aside your rent, you set aside for things that need to be paid. And I feel that’s the way it should be with the tribes and the government. That’s the agreement that they made. But that’s not what happens. If there are cuts, it’s the tribes that will take the hit first,” Howard said. “And we don’t appreciate that.” Tribal leaders and health care officials didn’t respond to Boise Weekly’s request for interviews, and residents of this tight-knit community reluctantly chatted about health care and medical services at the deli, outside the gas station and in the aisles of the local hardware store, but shied away from giving their names. Everyone knows everyone, they said. And they don’t want to complain. But they pointed to health care barriers. Some delay going to the local clinic as long as possible by using traditional medicine. Hours are sparse and once they get to the clinic, they know they’ll likely end up with a referral to a Boise specialist, then face the burden of finding transportation for the daylong round-trip commute. Some worry about the next emergency that might land them in a Mountain Home, Elko or Boise hospital, and the friends and family forced to figure out how they’ll make the drive to pick them up after discharge. “Transportation is a big problem. A lot of people don’t have good cars,” said Rose Dick, who raised her children on the reservation but now takes comfort in their good Boise jobs and the health insurance that comes with them. Dick and her neighbors say it’s hard to ward off those Life Flights and Boise medical visits. Preventative health isn’t an easy practice on the reservation, they say. Limited jobs on the reservation translate into an unemployment rate of 40 percent and not a lot of extra cash for staying healthy and eating right in a town that watches cars whiz by a scattering of bare-bones rectangular tract homes and the local grocery that sells more varieties of chocolate chips and hot dogs than fruits and vegetables. While other reservations fund their health care systems and supplement incomes with
14 | APRIL 24–30, 2013 | BOISEweekly
casino revenues, Howard reminds people to visit a nearby reservoir next time they’re in the area, which counts the tribe, hospital and school as the biggest employers. It’s stocked with fish, he said. Howard tells stories of a time when the Shoshone-Paiute could canvas the high desert and walk the banks of the Boise, Snake and Owyhee rivers and find everything they needed for subsistence and good health. Rituals spawned remedies in the Bruneau and Boise valleys of the past and medicine grew and bloomed in sync with the seasons. The Shoshone-Paiutes enjoyed good health through tradition, culture and the natural wealth that sprang from the land. But for some, those traditions faded, culture morphed and they became surrounded by a society that no longer measured wealth by what was left for those yet to be born. And their health began to change. “This is certainly a special place to us because it’s where our people have survived for centuries. Everything that we needed was here,” Howard said. “Traditional people are connected to their land, to their environment,” he added. “When people are not connected to their environment, it’s more about them. They don’t really have a connection to anything. Mainstream society today is that way. It’s about making a profit today, and it doesn’t matter what you leave behind. We’re always concerned about what we’re leaving for the next generation. We don’t own this land. We’re borrowing it from our children. So we want to leave it better than we found it.” The glimmer of gold slammed against those traditional values when prospectors discovered their first nugget below the surface of the Boise Basin in 1862. Where Native Americans saw a loan, gold diggers saw a profit. “They wanted the Indians out of the way. We were in their way. So we were forced out of there,” Howard said. The Shoshone-Paiute who once scattered across the high desert of Oregon, Idaho and Nevada and followed the salmon migration into the tributaries of the Snake River were squeezed beyond the far northeastern reaches of the Treasure Valley, along parts of the Boise River now submerged beneath the reservoir water of Arrowrock Dam. The lure of natural resources wrestled away that last hold, and in 1877, the U.S. government corralled the Shoshone-Paiute onto the barren borderland desert south of Bruneau. The tribes entered into two treaties with the U.S. government, but Congress never ratified them, leaving southern Idaho technically in the hands of the tribes. “The Boise Valley and the Bruneau Valley were never given to the United States. There’s no legal exchange of land title. We still hold title to those lands,” Howard said. Treaties and loose agreements brokered land deals and the beginning of an introduction of Western medicine to Native American life. The first full-time physician joined the Duck Valley reservation in 1882, and in 1897, the reservation erected a one-room infirmary that later gave way to a hospital, compete with 20 beds, a laboratory and X-ray facilities in 1937. That facility operated until 1976, when the reservation opened the Owyhee Community Health Facility, which still operates today under limited hours. The unratified agreements between the Shoshone-Paiute make the tribe a self-governing entity, meaning it doesn’t fall under jurisdictions serving treaty-bound sovereign nations, including Indian Health Services. The tribe lobbies directly to the government for health care funds, and how
EMT Mark Sope forges a close bond with his patients. He calls most of the sick and injured he cares for friends and family. “Sometimes we forget their legal name,” he said.
Marissa Dick, pregnant with her first child, has had limited access to prenatal care.
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