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CLASS OF 83
Writing a Prescription for
Tribal Health Care
Here in the echinacea capital of the world,
where medicinal herbs are harvested by the handful, Dr. Larry Sokolic
CGS83 coordinates the delivery of a scarcer resource: modern medical
care for 13,000 people scattered across 2,500 square miles of rural North
was hired by the Three Affiliated Tribes to set up an independent healthcare
system for its members, who belong to the Mandan, Arikara and Hidatsa
recently, the tribes had contracted with an outside corporation to provide
the service. Sokolic came out here from the Northeast three years ago
to work as a physician and has stayed on as medical director. (Rather
than take his children out of school, he commutes home to Livingston,
N.J., one week a month, and his family visits him during school breaks.)
been providing healthcare for the Three Affiliated Tribes for three
his new job, Sokolic finds himself blending modern medical practices with
aspects of traditional Native-American medicine, such as the therapeutic
use of echinacea, to gain the trust of his patients. But more challenging
than cultural differences is the geographic isolation that must be overcome.
The main clinic, the Minne-Tohe Health Center in New Town, is situated
approximately 80 miles from the nearest significant hospitalwhich poses
a problem when somebody is trying to die on you, Sokolic says. You
might have somebody with a heart attack or somebody with asthma who needs
to be intubatedor a trauma you have to stabilize, so you can either fly
them out if the weather is good or drive them out. Ive had experiences
where we were snowed in and we had to get the National Guard to take somebody
out with acute appendicitis.
long-term goal is to create a local hospital so such travels wont be
necessary; for now, Sokolic and the two other doctors are stretching their
resources to develop a system for 24-hour health care at the main clinic.
They also staff three other clinics in outlying communities on a part-time
half of the tribes members carry private health insurance. The tribe
also receives funding through the Indian Health Service and contributes
money of its own toward medical care. Even so, says Sokolic, Things are
pretty tight financially. There is a kind of overwhelming need. Were
always looking for equipment to be donated.
health center received about 35,000 visits last year, up 5,000 from the
year before. Over that time, Sokolic has watched cases of serious illness
and the mortality rate drop dramatically.
most rewarding thing, he says, is to see the improvement of health in
the community and know that the tribe is taking responsibility for the
health care of its nation here. Its no longer going to be dependent on
[the federal government] or an outside company to help run it for them.
In fact, Sokolic says, One day Id like to see [one of the other doctors,
a Hidatsa] take over, and have all the physicians here be tribe members.
Penn-affiliated people whod like to visit the
clinic or donate used medical equipment are encouraged to contact Sokolic
at (701) 627-4701, ext. 252 (phone), or (701) 627-2817 (fax).
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