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Indian Health Services and Border Community Experiences

Potential Interview Questions for Border Community and Indian Health Services Experiences (8KB) [download]

Briefly describe the activity and its purpose.

The Tohono O'odham Nation covers 4,454 square miles in Southern Arizona.  It is the second largest reservation in Arizona and the third largest in the United States.  The nation is made up of 11 districts and claims 28,000 tribal members.  It is too large to explore in depth (there are many small communities spread throughout the expansive reservation), so trainees go to the larger communities of Sells and San Xavier to learn about many of the challenges faced by Indian Health Services (IHS).  Many of these challenges are the same ones faced by the border communities (extreme poverty, lack of services and service providers). Much of the O'odham nation is also on the US/Mexico border and there are challenges related to drug and human smuggling. Linguistic challenges are very different here.

What are the expected learning outcomes for trainees?

Trainees learn about the services and supports available through the Sells Indian Hospital and the IHS clinics located in San Simon, Santa Rosa and San Xavier. Trainees meet with hospital administrators in Sells to discuss the challenges faced with working within the tribal and Bureau of Indian Affairs systems, drug and alcohol related issues plaguing their communities, services in remote areas, the use of resources, traditional versus modern health beliefs, and linguistic challenges.

Trainees also tour the border communities of Douglas, Nogales, Somerton, and San Luis so that they can see first-hand the level of poverty in those communities. We meet with the administrators of the community health centers to discuss challenges faced with serving migrant and transitory populations; providing services in remote areas of their counties; the importance of grant writing; outreach programs and implementation of a medical home.

The importance of learning and being fluent in Spanish is stressed; one cannot work in these communities without a good grasp of the language both written and verbal. Trainees learn about Federally Qualified Health Centers, how they are operated; challenges faced; recruitment of specialists; use of resources; community networking, and more.

For each of these experiences, trainees generate potential questions that they might ask the administrators in advance. After the experience, trainees document their reflections in their journal and then the experience is discussed at the following seminar.

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