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Indian health clinic could face financial crisis

A health clinic near downtown San Diego that cares for American Indians could be facing a financial crisis. In his proposed budget, President Bush would eliminate federal funding for Indian health clinics in the nation's urban areas. The president says other community health centers or tribal clinics could pick up the slack. The proposal would cut about half of the annual budget of San Diego's urban clinic. KPBS Health Reporter Kenny Goldberg has the story.

On a Wednesday evening, there's an ancient healing ritual underway at San Diego's American Indian Health Center.
It's called the Talking Circle. To American Indians, every element of it has deep meaning.

Rob Anderson facilitates the ritual. He's a member of the Navajo tribe.

Anderson says the Talking Circle is about coming back to balance. He says these traditional instruments help American Indians get closer to the creator.

Rob Anderson: "So when we hear the drum or the flute and we see the sacred eagle feather, it's a positive note, knowing that we're in sacredness. And our innermost self comes out verbally in a positive way. And we do let go of some emotional insecurities that are part of this spiritual solutions, and talking and letting it go and giving it to the sacred altar of the creator."

The Talking Circle is also part of a recovery program that helps people break the cycle of alcohol and drug abuse. It's just one of the culturally sensitive services that the American Indian Health Center provides.

You get a sense of another one when you walk into the Behavioral Health building.
A strong sweet smell permeates the place. Substance Abuse counselor Robin Amsden explains she burns sage between clients.

Robin Amsden: "And we use it to cleanse the office from any bad spirits that may be left behind. We also use cedar, Native American tobacco, which is very different from commercial tobacco."

San Diego's American Indian Health Center sits on 1st avenue in the Banker's Hill section of town. The clinic offers a wide array of services, from dental care to pediatrics. All on a sliding scale.

Anyone is welcome, but about 70 percent of the patients are American Indians.
Most of the staff is, too. The Center has been in operation since 1979. But now, it's facing a potential crisis.

And it's not the first time. In the 80's, President Reagan repeatedly tried to cut the program. Today, President Bush wants to shift federal funding from all urban American Indian Health clinics. Instead, he'd like to put the money into healthcare on tribal lands and in rural areas.

The Indian Health Center in rural North County, for example, treats ten times as many patients as the downtown clinic.

But, Crystal Tetrick, who runs the urban center, says the County's tribal clinics are too far away for her patients.
Crystal Tetrick: "If you're living in the city of San Diego, there's transportation issues, not everybody has a car, and with gas prices going up, it's a barrier to drive out to one of the tribal clinics."

Tetrick contends moving the money to rural clinics would hamper progress in treating diabetes and other chronic health problems that plague Native Americans.

Tetrick: "This government proclaims to want to make improvements in health disparities to elevate the health status of Indian people. And I just don't understand how they're planning to do that by making this budget cut."

Staff member Franny Garvey puts it more bluntly. She's a member of the Narragansett tribe. Her ancestors greeted Garvey says American Indians are legally entitled to these services.

Franny Garvey: "So for Indian people in America, the way that we keep our spirits up, is to keep our dignity and our pride, and to say yes, we're supposed to have these things, they are ours, give them to us. I think a lot of people misinterpret that as being hostile, or again like we're holding our hand out for welfare, when in fact there's legal precedence for it."

Pam Andrews has been coming to the center for 15 years. Andrews says doesn't want to go anywhere else.

Andrews: " feel comfortable coming here. I feel like they're really taking care of my needs, they know my charts, they know me by name. These people care about me, and I care about them."

At this point, it appears the House doesn't care much for the president's proposal.

A House subcommittee has reinstated federal funds for the Urban American Indian Health Centers. The House Appropriations committee is scheduled to take up the matter this week. Kenny Goldberg, KPBS News.

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