Medical reservists deploys to provide healthcare to Native Americans Published July 20, 2006 By Ted Theopolos 445th Public Affairs PINE RIDGE, S.D. -- Just on the spurs of the Black Hills in South Dakota is an Indian Reservation called Pine Ridge. The reservation is home to the Oglala Sioux Tribe, decedents from the Great Sioux Nation. The reservation covers about 2.8 million acres and has a tribal membership of approximately 17,775.One of the main cities, Pine Ridge, is just 50 miles east of the Wyoming border and on the Nebraska state line. There, nine members of the 445th Aeromedical Staging Squadron did their annual tour, helping Native Americans at the local hospital operated by the Indian Health Services. The small contingency of medical personnel was divided up into three areas: ambulance, emergency room and mental health. Master Sgt. James Hepp and Tech. Sgt. Anthony Gallela were assigned to ambulance teams. The ambulance teams were located not with the hospital, but up on the tallest hill in town next to the old hospital where they waited in a small dorm room until they responded to emergency calls. "We do so much classroom training but not enough real world hands-on training which is the best training," said Tech. Sgt. Gallela. "Both of us, as he refers to Master Sgt. Hepp, have desk jobs in the civilian world so we need this type of training." "We're working in only one of four ambulance locations on the reservation," said Master Sgt. Hepp. "Each ambulance housing location covers a vast area on the reservation." On average, both sergeants had 3 to 6 emergency runs a day. Each was assigned to different ambulance teams to provide more help. They even varied their work schedule to be available during peak calls during the evening shift. When the sergeants transported patients to the hospital, each saw others from their unit working in the emergency room. At the emergency room in the hospital, medical personnel listened to the ambulance radio frequency so they knew when someone was being transported. The ER has 5 beds and one trauma and casting room. The hospital itself has only 58 beds with an average of 5 full time physicians, 20 registered nurses and 9 licensed practical nurses. Because of its remote location it's difficult to recruit to the area. Four nurses worked in the ER and when it was slow two nurses would slide over to primary care, which was just across the hall, to help them out. That's where Maj. Michael Breitweiser worked most of the time to assist with the high volume of outpatient clients. "It's an uneventful day," said Lt. Col. Karen Turner who was the deployed commander for this trip. "But that's a good thing working in an ER." But it wasn't long before ambulances transported in two new patients. One patient was a young Native American with head trauma and another female patient for diabetes. According to the Indian Health Service, diabetes is the fourth leading cause of death to Native Americans and Alaska Natives. Tuberculosis, alcoholism and motor vehicle crashes top the list. 1st Lts. Jenice Brown and Tamara Thomas assisted the local physician on most cases coming into the ER. 1st Lt. Brown is a nurse at Ohio State University Hospital and 1st Lt. Thomas is a nurse at Doctors Hospital West, both located in Columbus, Ohio. Both were used to seeing ER injuries and ailments. Before the end of the nurses 11 to 7 shift, they prepared patients to be flown to Rapid City for further medical care. Both patients experienced seizures while being loaded into the ambulance and had to be brought back inside the ER to stabilize before proceeding to aeroevac. Col. Karen Nagafuchi was no stranger to an Indian Reservation. This was her fourth time to a reservation. The colonel was assigned to a mental health section with two other reservists. "I like coming to the reservations a lot," said the colonel. "I really feel like we make a difference." "Depression is very high here," said Colonel Nagafuchi. "About 73 percent of the diabetics also have some form of depression. Left untreated it gets worse which leads to suicide." According to the Indian Health Services statistics, suicide among American Indians and Alaska Natives is 62 percent higher than other Americans. Unfortunately for Tech. Sgt. Gallela, he saw that first hand. "We answered one call that was really far away," said Gallela. The call was for an attempted suicide, but when we arrived, it was a successful attempt." Master Sgt. William Fleming, who was also in mental health, stated he went right to work as soon as he got there. "I was put to the test the first day seeing several patients," said the sergeant. "One of the things I had to do right away with patients was to build trust because of the culture barriers. After I received their trust then we could proceed further for treatment." Colonel Nagafuchi tried to arrange for Sergeant Fleming, Senior Airman Christy Carter, and herself to visit home patients and community centers with some of the outpatients. The hospital was short on mental health professionals. They had two thirty-day hires and one position that has not been filled in three years mentioned Colonel Nagafuchi."Doing outreach service is where you see the great need for our services," said the colonel. "Because of the high gas prices, the outpatient load was down so we're going to them." One of the visits the mental health experts were trying was quite unusual. "Some of the trouble police handle the reservation is related to depression," said Airman Carter." So we're going to the jail on assisted visits there to see if we can help." Medical personnel have been at Rose Bud and Cheyenne River reservations and plan to be at one of them again next year. For the members of the 445 ASTS, it was valuable training that also gave back to the community.