Oglala Sioux Tribe (OST) CHR Stories

Mark Butterbrodt, MD, FAAP – Commander (retired) US Public Health Service

It gives me great pleasure to reflect back on 27 years' experience working with the Oglala Sioux Tribe Community Health Representative Program. Twenty five years ago when the Oglala Lakota Nation Wellness Team embarked on ambitious community-based reservation wide primary prevention program to counteract the life style related epidemics on Pine Ridge reservation, it was the CHRs who were the backbone of that effort. This grass roots effort resulted in over 4000 school children being screened for health risk and resulted in over 1000 home visits to encourage families to make positive life style changes. it is impossible to imagine all this happening without the CHRs. Pine Ridge CHRs know the community and are respectful of both traditional and conventional healing practices. With the cut backs in public health nursing in the Indian Health Service, the CHRs role is even more vital in linking tribal members living in remote areas with the centralized medical services of IHS. This was never more in evidence than during the Covid 19 pandemic. Because this is a vast reservation with many people with complicating health issues our people were highly vulnerable to the effects of the pandemic. As expected, the CHRs were in the first people coming to the assistance of tribal members, especially those living in remote communities. As a frontline worker myself during the worst months of the pandemic, I was witness to the many ways the CHRs assisted with testing, getting food and medical supplies out to families in isolation or quarantine, and providing invaluable assistance to our contact tracing efforts. I cannot imagine my decades of experience practicing medicine in Pine Ridge reservation without the assistance of my CHR colleagues.

Jewel Moore – Eagle Nest District CHR

During my 24 years of working with CHR I've had numerous CHR trainings such as Basic and Advanced CHR, physical therapy trainings and other trainings provided to assist patients with their health, educational, social and basic needs. On a daily basis I'd do patient advocacy with referrals for food, medicals appointments, transportation for meds and patient delivery. I learned to cope with the loss of a patient, using my cultural beliefs helped me through my grieving process with prayers. I learned about a patient's health issues and how to educate them to take of themselves. I keep patient information confidential so the patient has trust in me to advocate and work for them. Having a caring and compassionate heart for the patient shows the patients they can trust me. During March 2020, the Covid-19 Pandemic hit the Pine Ridge Indian Reservation. I was asked to be a Contact Tracer and Investigator and work frontline as an essential employee. We worked 24 hours a day doing Contact Tracing and Investigation, placing people on quarantine, delivering meds, cleaning supplies, food and water for those in quarantine at homes or quarantine sites. This was one of the biggest health crises I've faced while working with CHR but a good experience to work with all these programs and patients for their health needs. We're out of the woods but I’ve learned to protect myself and others.

Arlene Tallman – OST Pass Creek District CHR

The CHR Program really helps our people on the reservation in our communities. The most important thing is making required home visits so we know the needs of our clients. It's really important to teach children's parents about immunization shots and provide health education for immunizations. I had MCH training in '82 taking care of Maternal Child Health and postpartum and education, teaching patients to take care of themselves and their babies before and after birth. Foot care and nutrition was a big part of health education due high number of people being diabetic or their blood sugar being high. People didn't take care of the feet, so they would get wound care and how to take care of their feet. During this time we had to speak Lakota and have a speaker/translator for most of our elderly patients.

Michael Moves Camp – Medicine Root District CHR

I learned to utilize resources to help people with health education, medication, medical equipment, food, and housing. I came to realize that there were more people that needed emotional support and help with coping with hardships in our everyday life. By becoming a CHR, I had the honor of helping two women with their children being born, cleaning the newborns up and getting to spank their babies just like in the movies. The hardest part was doing CPR on the very people I grew up around and them not making it. Praying for them with the families, I came to understand my own emotions.I like being a go-to person for everything. I am their friend, doctor, social worker, emotional therapist, and mental counselor so to speak. The only difference now from before is that I get paid to do what I've always done.

Bryan Hopkins – Medicine Root CHR

I went to the store for lunch and a woman came up to me and said 'Bryan, can you help me? I don't have anyone to help.' I asked her what was going on and she said she was planning suicide. I asked her to go with me to get her help for what she's going through, I would make some calls for her, and she agreed. I told her that I would do whatever I could to get her help. I then got ahold of one of her aunts and asked if she could stay with her and she agreed. It was 4:30 and the clinic was closed. I left the woman with her Auntie for the night, gave her my personal cell phone number, and told her to let me know if anything happened, she said she would. I had a restless night worrying about her. I didn't get any calls the next day. Soon as I got to work, I went and checked on her. Later her family members reached out to me and thanked me in person and on social media. To this day I see her around and see how she's doing, and she personally thanked me as well.

Isabelle Gaddie – OST Pass Creek District CHR (29 years)

I can speak my Lakota language, I use my cultural healing remedies and share those with my patients. I'd make appointments for elders that didn't speak English. I transport for dialysis patients to Pine Ridge. A lot of our patients didn't have cars, so we transport in our own cars. One time I was driving a patient and my car broke down and the older lady I was transporting got out and fixed the car! We protected each other during dangerous weather home visits and we got to do environmental checks. We also check blood pressure and blood sugar for elders, did a lot of referrals to IHS, and a lot of our patients depended on us to help them. Sometimes the elders needed someone to talk to, like they really didn't trust anyone. We all depended on each other to help our patients, especially the elders, who I helped get comfortable in talking to me. If something wasn't in the house during our visits I'd refer them and/or give them health education. If I didn't know how to answer a patient I'd ask the Public Health Nurse. During the powwows we had good turn outs doing health fairs throughout the Pine Ridge Reservation. I also did Maternal Health Training to talk to young pregnant mothers about the importance of prenatal care and how to take care of their babies. I have helped EMTs with CPR until more help came, we worked well together with the IHS/Emergency Room. I helped new graduate RNs on how to handle patients during a school bus accident and we checked to see which students were priority that needed blankets first and we worked well with dispatch. One time, dispatch called and said a person got shot, and when I got there I helped the EMT with the patient. We did our best to save her, but we lost her. It was traumatic and affected me a bit, so I used my cultural healing. We were trained to handle cancer patients. It was really sad, but we use our healing tradition to help ourselves with debriefing or grieving, and use our culture to help families deal with the loss of loved ones. We're CHRs helping but also kind of like counselors listening to families when we go into homes. I'd go into homes and assist in the house during our home visits. I feel really important and appreciated. I appreciate taking care of patients. It's really good to succeed at making them happy because it makes me happy. We've had losses but we've also saved a lot of lives and continue to help prolong the lives of others as CHRs. Being a CHR is one of the best things I've ever did.

Charity White Face – OST Porcupine District CHR

Working for the Oglala Sioux Tribe CHR Program has been an experience for me. Throughout the years I received a lot of training in health care along with my CHR certification. I learned to build trust and a relationship with each client. As a CHR I worked in my district to prevent disease and accidents through promoting proper education and awareness, including about alcohol, drugs, nutrition, immunization, teen pregnancy, and STDs. Being so spread out by districts with four health care facilities, the Pine Ridge Reservation CHR Program always provided transportation to those clients with no means of transportation to their appointments. The CHR Program is very essential for health care needs. Being a fluent Lakota speaker, it is easier to work with the elders. I especially enjoyed doing my home visits. I learned from the elders as well in traditional culture of health care.

Hermania Good Voice Flute – OST Pine Ridge District CHR

I always wanted to work health field and help people. When I started working, the Covid-19 Pandemic was here. I had an elderly couple that lived 45 minutes away on a dirt road. The lady was referred by IHS for me to do health checks/home visits due to a massive stroke. As Lakota family they used their culture's home remedies, she couldn't speak but when I talked to her in Lakota she'd understand with a nod. Her husband was 83 years old and didn't want his wife in a nursing home. Three months later she passed away, so I continued to do home visits with her husband. He didn't trust me, but after five attempts he let me in. I helped fill medicine boxes, brought exercise and healthy eating information, brought him his mail, took him to his heart doctor appointments, and helped him set up follow-up appointments. Eight months later he passed away. It was emotional for me when they both had passed away because I took care of them. I had to learn how to take care of myself so I can continue to take care of others. I used IHS and the Employee Assistance Program to help me through my debriefing process. Through the Covid-19 pandemic we still had provide services to all our clients. I was asked and agreed to help with the CHR program Covid-19 response . We got training for Contact Tracing and Investigations and Binex Covid-19 testing kits to test clients. We transported medicine, food, cleaning supplies, water, and health education materials for Covid-19. This was the biggest health crisis we faced on the Pine Ridge Indian Reservation. We did everything by telephone and the computer. We worked with different programs in all districts and covered each other when one of us we was out. This short time I worked here I've learned a lot and continue to learn. We just got to the E-learning website for IHS CHR, I'll be finished with my basic training for CHR certification.

Illa Lone Hill – OST LaCreek District CHR (25 years)

There are 2,418 members enrolled in the OST LaCreek District and they know me just as much as I know them. I was raised by my grandmas. It's beautiful to learn how people are and where they're from. Working with the elders, I made it an effort to make home visits at each of our communities. I didn't know a lot but I caught on to a lot through CHR trainings. If people trusted me, I knew I can trust them, and I established a good working relationship with my patients. I keep a book with me for all the appointments. I get a lot of referrals to pick up patients from IHS, prenatal, diabetics, heart and cancer patients. When the patient learns, we learn together so I can help or do reminders in case they need it. I do referrals for immunizations with the schools. I do referrals with IHS, Podiatry, Dental, Women's Clinic, Optometry, Pediatrics, Out Patient, Emergency Room, Behavior Health, Apetu Luta Otipi, Community Centers, Housing, Nursing Home, Energy Assistant Program, Women's Shelter and Elderly Meals. We don't have many elders anymore, I miss working with them, and they taught me as I taught them. They share home remedies for illnesses in our culture.

Tonya White Butterfly – OST Wounded Knee District CHR

Being a CHR has broadened my perspective of who and how many people are within this district. I have learned a lot about people and they in turn have gotten to know me as well. Since my time here I came in contact with people who needed help to make appointments and to be transported to them. I'm thankful to have worked with and to get to know the elders who rely on CHRs. I have been told many times that they are so glad that CHRs are around to help, especially with the on-call services. A lot of people said it was nice to get health information pamphlets from the CHRs. I have people come to me for band aids, an ice pack, bandages, and Tylenol. I stayed with a lady who was pushed by the wind; she turned and twisted her left ankle which she dislocated. I called an ambulance for her and it was a 40 minute wait for the ambulance to rush her to the emergency room. People call me to get to the Emergency Room because the ambulance is a long wait, and that makes a difference in people's lives when they need to get treatment. Covid-19 positive people cried to me on the phone because they were scared, I made contact with the covid positive people I delivered meds to, they appreciated the check-ups. I made home visits to people who didn't want to go to the hospital and just talked or to asked if their problem was big enough to go to the hospital. I like working with the people of the community even to visit because I get to know a little more about them every time. I am a CAN, and since 2013 I have worked at IHS, ERs, and nursing homes. I am a also a Nursing student, a sophomore in college. I have recently upgraded my major to a Bachelor's of Science in Nursing. I do value my Lakota culture and language. I can speak some, not fluently, although I do understand my Lakota Language very well.

Janet Tobacco – OST CHR White Clay District CHR

I have enjoyed working as a CHR, it gives me the privilege to know and meet people, families in the community. We've learned more about health, emotions, etcetera. We get to share in the results of people living a better life. We as CHRs work as frontline health workers and are trusted members of the community with understanding of the community, language and traditions. I share with clinical settings and the community how to better access health services and improve the quality and cultural competencies of services deliveries. I assist by increasing my health knowledge of patients and community members through activities such as transportation to home visits, outreach, community education, informal counseling, health visits, social support, and advocacy where we are needed. I have learned to care for patients with a strong heart, mind, and giving myself to where I'm needed.

Hilda Kills Small – OST CHR White Clay District CHR (34 years)

Being a CHR has given me lots of experiences working with the Oglala Lakota Oyate. I make home visits to check on a family, transport patients to and from their appointments, deliver refills on medicines, take medical supplies or equipment to clients and to people who have no vehicle. During one of my home visits, a family member said something was wrong with her brother, so I ran in and her brother was lying on the floor not breathing. I told them to call 911 and give info on what was going on. I started CPR and kept doing it until that person started coughing and was conscious when the ambulance got there. This experience had an impact on me. About three months later I was called to an OST Council meeting, where the family and CHR Program honored me with a Black Hills gold lifesaving pin, an OST Tribal flag and a star quilt. I was surprised because I was just doing my job and I was honored. Over the years, I've learned that being a CHR is always helping where you can such as by delivering food to families during a blizzard, standing by for First Aid after a tornado or during a fire. I enjoy my job and I have many more experiences working with the people.

Marilyn White – Red Elk OST CHR Secretary

I am very proud to have serviced my Lakota People since 1974. Through the years I've seen people start as CHRs and go on to become RNs, Lab Technicians, Dental Technicians, LPNs, Teachers, Environmental Technicians, and the list goes on and on. To me, these former CHRs, who went on to better their career to service the Lakota people makes me proud. They started as CHRs and just knowing I have been a part, impacted me in so many ways, and PROUD of them. I am proud to be a Community Health Representative/Secretary to the Lakota people, my people. They showed me each and every day how important it is to keep what they tell you in confidence and private. They trusted me with the stories and how things were going in how they live, young, elderly, no matter their age and their smiles tell me the trust is there. I have so many stories to tell and little time so for now I'll just thank the Lakota People for letting me service them and to keep their confidences private.

Sonia Whalen – OST Data Technician/CHR

My role in the CHR program is a rewarding and challenging work experience in that I get to assist CHRs in their scope of work and goals, to reduce and prevent disease on the Pine Ridge Reservation. More recently we have been through the Covid-19 pandemic that wreaked havoc on Native American populations. CHRs are considered front line health workers and when most employees were working at home we were at work in the community assisting IHS Personnel with Covid-19 testing events, delivering food and medication to families in quarantine, and performing telehealth services for the entire reservation. Throughout the pandemic I had the opportunity to help and provide the community with Covid-19 health education, emotional support, and socio economic support. It was definitely a time of learning, hands-on training, and long work hours that kept us from our families at home, but we made it through the storm and we are still here to help and accept the new challenges that face our staff and communities on a daily basis. We are prepared and ready to continue to give health education and implement the training provided to us to help all people across the reservation.I love my job! I love helping the CHRs help others and I love when I can assist CHRs with patient transports, deliver medication, and most importantly when I get the opportunity to build trust with community members.

Ronald Pond – OST CHR Animal Control Director

The OST CHR has a unique program under the Animal Control/CHR program and has the only CHR program that has Animal Control across the nation. The program assists the community by offering rabies vaccinations to cats and dogs to stop spread, and they've never had a case of rabies inside the Pine Ridge Reservation boundaries. During recent years they started the spay and neuter program for cats, dogs, and horses, and coordinated their efforts with the Rural Area Veterinary Services (RAVS) to slow the population of these animals. The program goes out once a year to provide services to the districts, and each year covering each of the nine districts. They also offer vaccination shots for distemper/parvo, deworming and mange at a small cost. During the West Nile outbreak, the program also gave vaccinations to horses. I assist with transports when the weather was very bad, and the vehicles could pass through to pick up patients or deliver medical equipment. I set up and take down medical beds, deliver portable toilets, wheelchairs, oxygen tanks, shower chairs, and walkers. I work with IHS/DSS to ensure patients have their medical equipment before coming home from the hospital. I show the patients and families how to use their medical equipment when needed.

Lisa Jumping Eagle-DeLeon – OST CHR Director

I decided be a CHR to help people get the health care they need. We have 19 staff, 16 of those are CHRs assigned to our 9 Pine Ridge Indian Reservation districts to ensure care of our Oyate. We had a crash course in disaster response due to the pandemic. In December 2019, news about Covid hit worldwide, so OST started a Covid-19 Task Force with meetings on how to slow or stop the spread of the virus. We purchased smartphones for all staff and upgraded the telecommunications systems and technology to do online training through zoom and telehealth and data collection. I asked staff to help with the contact tracing and investigations, and seven employees and I took a CDC crash course on contract tracing and investigation. We brought Covid-19 health educational packets, delivered food, medicine, cleaning supplies, and water to those in isolation/quarantine. We worked closely with the Health Administrator, IHS, ER, PHN, EMS, Dialysis, quarantine sites, Emergency Management, Department of Justice, OST Education, Local Community Centers, Elderly Meals, etc. Twelve remaining employees became telehealth workers (due to age or underlying health conditions) and assisted with the Covid-19 Help Line and giving Covid information by phone, dispatching patients to CHRs/Contact Tracers and Investigators. It was outstanding to be able to work 24/7. We worked endless hours to ensure our patients were taken care of. We did daily health checks on our positive patients, sometimes we'd have to suit up and go into homes but we did so safely and knew how to decontaminate. We had seven fluent speaker employees who interpreted/translated as needed. In April 2021, the Task Force took over the Contact Tracing and Investigations, so we were able to pick up our jobs with less stress, less hours. We learned how to rely on each other and all the programs within the tribe and IHS. Today we get compliments on how well we handled the outbreak, people wished we were still taking care of Covid-19 contact tracing and Investigations. We received a lot of complements and I'm honored to work with a great crew here at CHR, they stood up when most wouldn't. It's a reminder to always be diligent and work hard for the safety of our people. We were learning and collaborating with IHS in Dialysis, Dental, OBGYN, Women's Health, Pediatrics, Podiatry, ENT, Vision, Dietician, Behavioral Health, ER and other programs to help our clients/patients get needed services and it's a very good working relationship in all aspects. We do a lot of advocating and set up booths at health fairs around the communities, schools, community centers, colleges, pow-wows and even marches. It's good to have the heart and compassion to work with others, they in turn give that respect back and that's how we break down communication barriers and create healthy relationships in and and outside of work. Working for the OST CHR Program has been an honor and I enjoy working with our patients and staff and others to make life better for our Oyate. It's very satisfying to be able to help a person out when they have no one or no way to assist them. I'm glad to say we've had no outbreak within our office by diligently following protocols put in place to protect ourselves and patients.