ALASKA NATIVES COMMISSION
JOINT FEDERAL-STATE COMMISSION
ON
POLICIES AND PROGRAMS AFFECTING
ALASKA NATIVES
4000 Old Seward Highway, Suite 100
Anchorage,
Alaska 99503
TABLE OF CONTENTS
Witness List | PDF
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COMMISSIONER SEBESTA: The next person that is on our list for testimony is Dr. Ted Mala, who is Commissioner of the State Department of Health and Social Services. And so, Dr. Mala, I would invite you to give your testimony to the Commission.
DR. MALA: Thank you, Mr. Chairman, members
of the Commission, ladies and gentlemen. My name is Ted Mala.
I am the Commissioner of Health and Social Services. By training,
I'm a physician. My specialization’s in public health, preventative
medicine, and I'm Alaska Native from the NANA Region.
Today I would like to respond to the request from the Commission for us to present some observations, that I've had, at least, in my two years as tenure as Commissioner of our Department, which is a very large department. We have 2,000 employees. We cover literally the whole state, and somehow are involved with the Indian Health Service, the federal government, private sector, and the health of all Alaskans all over our state.
In our Department of Health and Social Services, we include the Divisions of Medical Assistance, Public Assistance, Mental Health, Family and Youth Services, Alcohol and Drug Abuse, Administrative Services, and Public Health, so we cover a very, very broad spectrum of people and their problems all during their lives; and we actually even are involved with people when they die. So our department can -- goes from the cradle to the end of life, one way or the other.
When we talk about Alaska Natives and rural problems, this is certainly an area that has been very close to my heart for all of my life, probably starting with my family involvement; but moreso with looking at the needs of the rural communities, not only in our state, but also all over the Arctic and the north -- the circumpolar world. And I have traveled over ten years in all the northern countrie: Sweden, Denmark, Finland, Iceland, Greenland, Norway, Canada, Russia, and Alaska, looking at and for solutions to a lot of the problems that have plagued our people for many years.
And I feel that the world is divided by geo-political imaginary lines, and that ail peoples of the north need to work together to look for common problems; because, as you wander around the north, you see that a lot of people in the north have a lot of the same problems, and that we're all humans, and that a number of people are even -- especially Native people -- are related in the north, following the Bering Land Bridge and other theories. Certainly, we share a lot of the same concerns, and we are one northern family.
We see that programs that are brought from
the Lower 48 and other places, a number of times, don't always
work up here, because they rely on roads, and communications,
and other things that we necessarily don’t have. Some even
rely on sunlight and easy conditions; and so we begin to look
to the north, to look for more of -- solutions to different
problems.
In our work in circumpolar health, we've actually divided the problems of the north into four groups. We look at Native people; we look at newcomers to the North; people that have lived here for a long time; and seasonal or transient workers. These four groups of people really have unique kinds of problems that we have to look at; and I think part of the problem is that a number of programs have not succeeded because everyone is lumped together, as, oh, everyone has the same problems and the same needs.
And as we begin to dissect the north and look at the groups of humans in the north, we begin to see that there are different approaches to problems; and there are many roads to health, and many roads to mental health and physical health, and what's good for some people is certainly not good for others. And there is no one way that cures everyone. If there were, then everyone would be cured. So, we have to look at this; and especially with Native people, we have to look at traditional medicine, and we have to look at traditional ways as part of the solution.
I am a very strong believer that alcoholism and other drug problems are like icebergs on the surface; and that they are very deep underneath, and you're only seeing a little bit of it. And the problem is, in my opinion, not just a genetic problem of maybe some enzyme like alcohol dehydrogenase, that that is not found in people of Mongolian origin, that metabolizes alcohol, I feel that just saying it's a genetic problem is a copout, and that there are deeper, deeper problems.
And the Commission, I'm sure, is hearing much testimony about that; but I personally feel a lot of it is involved with changing from a subsistence economy to a cash economy; the lack of jobs; the different value systems people have; and people being judged now not being as good hunters or providers for their family, but how much money they have. I think that's part of it. Certainly, influence of television; a number of other things. And dominant cultures imposing their lives on other people is part of this equation.
So I'm saying this to preface this to say that we're a very big department. We have a number of different philosophies; but we are, hopefully, trying to sensitize our people to look at these particular questions and also to bring more Native people into our department. I personally am very discouraged that we don't have more Native people. This year at AFN, we've brought a display down the hall here, and we have actually brought some of the Department of Administration, with a big pile of applications, hopefully to recruit more Native people to help us to work with many of our people in these approaches that I feel are terribly necessary.
We not only work in rural areas, but we also work in urban areas; and the previous testimony, which talked about the many serious problems of Native people, is absolutely true and one that we absolutely support.
We actually feel that there are a number of things that make people invisible sometimes; and the department often is approached by people saying they want to do a number of studies on Native people; but I hypothesize that non-Native people have a lot of the same problems in Anchorage; but maybe know how to hide better.
And so that is certainly -- we see that certainly with our social workers. We see a l -- one of our unfortunate duties is going into homes and protecting those that cannot care for themselves; and we see a lot of it behind closed doors -- more than we'd like to see. So, I think that a number of these problems affect lots of people; just some people know how to hide it better than others. But, nevertheless, as a state and as people in general, we have a number of problems.
Our public health nurses, especially in our clinics, are involved with a number of infectious diseases that we see around the state. Villages still have problems with tuberculosis and hepatitis, and a number of other problems certainly connected to water and sanitation, also included and affected by education; and, in some cases, so much turnover when there is a sanitation system that not enough trained people are involved in those areas to keep those systems up. We're certainly very, very concerned with that and have a very close relationship with the Department of Environmental Conservation, and the Indian Health Service, and the Native Health Board, working on those problems also.
The question of substance abuse is one that I've talked about. In this past year, our department has done something I don't think that's been done very often before, and we spent a lot of time traveling -- and we still do -- all over Alaska, and going into villages, where they have never seen anyone from the administration of Health Department.
And we spent time this year in. northwest Alaska, in the Interior, and on the Kenai Peninsula; and all of our directors have gone out into these villages. And we've had public hearings and talked to people to try to sensitize our decision makers to see what are the problems of people; what are not being addressed; what can we do better; what are we not doing well enough?
And one of the main concerns that we heard from lots of people is that there's a group of people, especially of Native people, that are not being addressed, that are in their early teenage years, and that's with the very terrible problem of inhalant abuse. We have concentrated for a long time on alcohol and drug abuse, but have not really done that much in terms of inhalants; and our department now is not only looking at this very closely; we have sponsored several conferences on it, and we plan to actually include this in our approach for the future.
We are especially pleased to see some efforts by certain regions, such as Kotzebue and their Spirit Camp, and the Search group. I was able to visit Ravens Way, which is on -- is a very important program sponsored by the Indian Health Service and the State of Alaska down in Sitka, where they are taking young people and putting them on an island re -- and connecting them again to nature.
And I believe that a lot of problems happen, especially with Native people, when people lose their connection to nature; when people forget about how to touch the earth and connect: again; and this program actually connects people. And it's a lovely model of going in the right direction.
Our department has a new logo. If you have a chance, you'll go out and see it out there in the hall, and it's the family. And we have tried to put a lot of emphasis on keeping the family together. Rather than just going in and trying to dissect people and families, what we're trying to do is come up with a new approach that basically says all our support services are to support the family and to keep people together as much as possible.
One of our projects is called Project Choice;
and, basically, this is a program where we are trying to keep
elders in their communities, elders in their villages, rather
than going to nursing homes. And so if a person is going to
a nursing home only because he or she can't clean, their house,
or can't take some medicine, or can't haul water or cut firewood
or whatever, we are actually paying people to go in and do
that for them, so they can stay home and be with their families,
rather than have to go to a nursing home far away.
Actually, if you think about it and traditional values, people shouldn't be paying anybody to do this; people should just be doing it. But, nevertheless, perhaps it's a reflection of society today; but we are paying people to also stay at home and take are of elders.
Our department is also involved with public assistance, food stamps; we have a JOBS Program. We are actually taking people in as a condition of Welfare, saying that you have to go through some job training; you have to actually finish your high school diploma and learn a trade that you can go out and make a living with. It's a -- kind of a frightening phenomena nationally that we are se -- seeing second-generation people on public assistance right now. When I started two years ago, we were paying two and a. half million dollars a month in food stamps, and now we're up to four million a month, and public assistance is growing phenomenally by 15 percent every year. This year we're up another 15 percent. The Formula Programs, which are 50 percent match between the state and federal government are going up nationally.
The cost of medical care, we are paying
five to ten million dollars a week on medical care payments
in the state through Medicaid. And nationally, the nation is
facing some type of bankruptcy if we don't control medical
care a little better. We are working very close with the regional
health corporations. In fact, we have invited a -- hopefully,
all of them to come to Juneau and spend time with our program
officers to work with us to see how we can work with them better.
And it's in our interest that they succeed. We’ve had some
problems this past year with some of the Native corporations.
We have sent our people in. We've made various trips in to
shore up the administration; and I think we' re seeing that
come around again, so we're pleased with the response of our
people that have come back and really worked on that closely.
Our Division of Family and Youth Services is one of our largest divisions. We run McLaughlin Youth Center, as well as the juvenile detention homes -- the juvenile corrections, as well as social services. We're very involved with tribal adoptions. The ICWA different types of agreements we have -- Indian child Welfare Act agreements -- we have signed a number of these, and we believe that Native children should stay with Native families when possible. We always have a group of children that -- in terms of adoptions, both Native and non-Native, that the State has to take care of, with special needs, developmentally disabled, crack babies, these kinds of things, that are very high-cost kinds of things. But we have special programs actually to place them into homes and actually subsidize the homes a little bit more to take care of these babies.
We -- within Family and Youth Services also, we are developing the Social Worker Associate Program; and, basically, what we want to do is take people from local communities and start entry-- level types of social work positions, so that people can kind of work their way up in the system, rather than have to bring people in from other cities to provide local social services. So we have one -- usually a supervisor and an associate, and we've started that in several communities, and it's very, very well received. And it's our hope we will continue that also.
The area of circumpolar health, we have, in the department, worked in circumpolar health. We have meetings with Canada and also with Russia. Do you know that we have visa-free visiting now for Native people? In circumpolar health, we have to work on looking at a number of problems that the Russian people have -- Russian Native people that are related to our people. There's a lot of tuberculosis over there, and there are different kinds of diseases that could potentially be coming to Alaska also, so we have to monitor that. And we've been sending epidemiologists out into the field to look around what's out there, and we plan to continue to do that to make sure that different types of problems are not going back and forth also.
In circumpolar health also, one of the major
initiatives of this department has been emergency medical evacuation,
especially out in the Bering, working with the Russian government
to -- especially when Native hunters are lost out there, to
try to come up with a joint kind of a response/so that it doesn’t
matter who's out there and what nationality, it's a human being;
we should all be responding.
We have a special section in our mental health area that's involved in developmental disability special needs children.
Also, suicide prevention grants, which we give to a number of communities. These are small grants to come up with different types of projects in the community that will keep people busy, and, hopefully, work toward the prevention of suicide.
Just like alcohol and drug abuse, a lot of this is a very complicated problem; it's involved with self-image, and certainly the will of individuals to change. We can put thousands of millions of dollars in all these villages; and, if people don't want to change, they're not going to. So we have to empower the communities as much as possible; and we do that through the regions and the elected representatives of local people, and give them different types of grants to involve grassroots-types of people to make all these things work.
And, finally, the State is developing a State Health Plan. We are developing the framework of a health plan that we are going to, hopefully, get out very, very soon and -- for the whole state to respond to, with the idea that we want to leave, as a legacy to our Department, kind of a blueprint of where we're going as a state and what our goals are.
These are difficult times, with funding being cut back. Certainly, in the state level, we have a deficit this year of $500 million, and we have to somehow make that up. One of the unfortunate things is that when you have a deficit, you have to hold your core programs together; and some of the prevention things, we can't fund as much as we'd like to. It certainly doesn't make sense; but we only have a certain amount of dollars, and we have to try to make the best decisions we can with our regions.
So, in a nutshell, this is some -- these are some of the things that our department is doing, and I'd be delighted to answer any questions or give you further information. And also, I direct the attention of the audience to the exhibit of the department out here, which is being sponsored by -- and staffed by different divisions from the department all the days of AFN. Thank you.
COMMISSIONER SEBESTA: Okay, thank you very much, Dr. Mala. One question I had, it's kind of associated with what we're doing, too; and you mentioned that, for the first time, your department conducted hearings in various places throughout Alaska, and in the northwest, and in the central, and the Kenai area, and so on. And are the -- do you have any, let's say/ results of those hearings that have been made from the grassroots -- very definite solutions to the problems that, you know, you've outlined?
DR. MALA: Well, what we are doing is -- and this is a very big state, as you well know -- are going around and se -- in my opinion, sensitizing the top managers of the department to the needs of local people. I feel personally that those needs will be translated in the development of a state budget and looking at priorities of health. Different communities have different priorities. For example, we were at Point Hope, and the main concern there was cancer and radiation. We go to other villages, and they're concerned in Southeast Alaska in some places about why the sewage system doesn't work; or in other places, why do we have all these honey buckets, and we need a safe place to dump them.
The needs vary by -- all over the state, and somehow we need to just sensitive decision makers so that, in my opinion, people are not influenced just by lobbyists, but actually going our and meeting people and seeing them.
I've -- always have believed that, all my life, that a hands-on kind of approach is very important. There are a number of statistics still showing that Alaska Natives have a birth rate higher than other people; that our people also have a higher infant death rate than the rest of the population; and that very low birth weights are also endemic in the Bush. So there are serious problems that have to be covered, and they vary by different regions, although there are certain things that join everyone together.
But there are different cultures, and people have to take advantage of the opportunity to work with different cultures and traditional healers to go towards the final goal of, in my opinion, getting people to take responsibility for themselves and wanting to change.
COMMISSIONER SEBESTA: Would any of the other Commission members like to question Dr. Mala?
COMMISSIONER ELLIOTT: I have a comment, if I may?
COMMISSIONER SEBESTA: Father Elliott.
COMMISSIONER ELLIOTT: Doctor, I'm -- I notice
that you, in your statement, that alcohol is just the tip of
a -- of the iceberg. You sort of agree -- in fact, you do agree
with the report by the Calista Corporation that -- "A Gentle People, a Harsh Life" --
that seems to be -- Martin, I think you recognize that as their
statement as to the co -- the reason for alcoholism, drug abuse,
and so on, I don't know what the answer is to that, but I'm
sure your department doesn't either; but I'm also very glad
to hear from you that you are now trying to keep people at
home, rather than send them off to nursing homes away from
home.
Now, many, many y -- well, some over thirty years ago, the Episcopal Church had a hospital at Fort Yukon; the Hudson Stuck Memorial Hospital. It was closed. It had to be closed, because whenever we had a patient diagnosed as tuberculosis, we would immediate get orders to send them to Anchorage; and eventually they would wind up in Colorado, or Oregon, or somewhere else, far away from their people, far away from their Native food, and all the other things.
Are you considering -- oh, I understand there's the -- there are plans, and, hopefully, they will develop for a new Alaska Native Medical Service Hospital in Anchorage; but have you ever thought that -- because that will still bring people away from their Native villages as they are now. I visit the Native hospital regularly, and I find people from Point Hope, and Fort Yukon, the Lower Yukon, and so on. Have you thought of reopening, for example, the hospital at Tanana, which was a Native Service Hospital, so that if people of the Interior, for example, will still be -- although away from home, perhaps that has to be -- but still will be within their own culture and their own people, rather than developing a gigantic hospital here, which will still take them away from their home?
DR. MALA: Well, I would like to respond
with official statements and personal statements; but, basically,
the hospital that's being built here is part of the United
States Public Health Service and not the state government,
so we are -- this is not our hospital per se. Although an interesting
part of this that has fascinated me in the building of this
hospital has been that there is no mental health section in
that hospital, and that the State hospital is going to continue
to do all of the psychiatric care for Native people. I haven’t
figured out how that's happened, and it's certainly something
I've inherited; but I would have opposed that, had I known
that earlier on.
There is, in the Alaska Psychiatric Hospital -- which we are also planning to rebuild, because of great system failures on a regular basis, not to mention asbestos in the Hill-Burton Hospitals of those days -- a lot of problems with our hospital. We looked at the possibility of what mental health is going to look like in the year 2000 and beyond. When we work with the Native Health Heal -- the Alaska Mental Health Board and the Native Health Board, who is chaired, by the way -- the Mental Health Board is chaired by an Alaska Native, Alecia Ivan (ph.) -- at how to actually dehospitalize a number of people and keep people near their homes through a number of community mental health centers. The reality is that we don't have the money to do it as a state. The reality is that I have had several requests from communities to replace existing hospitals in the state; and the question right now is -- in the minds of consumers, is: number one, does every place need a hospital? What about a rural health care center?
We need to rethink a few things in terms of health care delivery, because people mostly think that, well, good health care will come with a hospital and a doctor; and I disagree. Certainly, a system is terribly important; and it was our hope that in the building of the new mental health hospital, and in all these other hospitals, that more would go out to the communities; but as budgets go down, and we can't afford to build all these things, we go back to some sort of centralization. Again, it goes against logic and theories of public health, and preventative medicine, and so on; but the reality is that you have a shrinking dollar, and how do you sustain them?
For example, I've also had a request to build some nursing homes in different rural communities, and the problem is not so much the building/ but the maintenance and the operation, of those places. Right now, we are facing terrible questions within the Department of Health and Social Services of what programs we have to close; what people we have to lay off. And, certainly in a perfect world, we need all those people there. And we are looking at ter -- very, very hard decisions programs that are in rural areas that might have to be closed and moved into a central area. Again, it doesn't make sense. Again, it goes against every grain of prevention that's in us; and yet, the fact is that you have a $500 million deficit, and if we can't support them, then what are we going to do? These are some of the very difficult questions before government that we are publicly hoping to work with the Legislature to see how we are going to resolve.
COMMISSIONER MOORE: Commissioner Mala, as a Commissioner myself, I would like to learn as much as I can from the people on policies and programs affecting Native people. As I learned from you, your department has conducted some public hearings, trying to find out, just like we do, what are the problems; help me decide what those problems are. And as you -- your department, different divisions, I see that you've experienced a lot of different programs under the Department of Health and Social Services, have you heard something from these people that testify that would like to change a policy or a program that stands out in your mind that could - - that you could direct me, so that I could take a close attention to that particular problem? Any policy or any -- or something in the divisions of the program?
DR. MALA: Well, I've --
COMMISSIONER MOORE: What is the most outstanding thing that I should know about --
DR. MALA: When I first came on --
COMMISSIONER MOORE: -- to correct a policy?
DR. MALA: When I first --
COMMISSIONER MOORE: Yea.
DR. MALA: When I first came on as Commissioner,
I have traveled and tried to reach most of my department. It's
so big, I don’t know if I'll ever see all of it; but one of
the first questions I asked even some of the people that are
in the room right now is what policies do we have that we can
get rid of (laughing), and what rules do we need to change?
One of the biggest problems of government, in my opinion, is that it's kind of like a brick-laying effect; so that these rules started, and then another administration comes in, and puts another layer of bricks, and another layer, and another layer, and nobody canceled the old ones. So people -- I'm seeing in our department, in my opinion, people doing paperwork and not social work. And I'm trying to work with different technologies to see how I can get them out of the office, and out in the street, and out in the field. But people are just overwhelmed by these federal and state regulations.
One of the things that a federal commission needs to do is -- in the words of President Bush, was to stop non-funded federal mandates. Stop all these unnecessary regulations from the state and the federal government that are just overwhelming people that can't do their work. So I talked to the providers and to the recipients of all these places, and the providers are just getting more and more work.
For example, right now the state is about
to be hit with something called blood-borne pathogens -- OSHA
regulations that are going to require an incredible amount
of money and -- to implement. Americans with -- disabled Americans
-- the handicapped people is going to require a lot of -- these
are all very good acts, but the problem is that they’re all
unfunded mandates. Changes for handicapped people, what are,
again, very important; but you have to take the existing programs
dollars and now make them even thinner, because the federal
government is giving us these things we call unfunded federal
mandates, which means we are small as it is; and now we have
to pay for them out of the little money we have left. So we
need to work on figuring out how to cut regulations down. If
you've ever seen the booklet for getting public assistance,
it's almost like a federal tax return. It's very difficult;
and, in my opinion, anyone that fills it out, certainly deserves
something (laughter), because it's a lot of work. And
it's mind boggling just for our people. You know, when our
public assistance people have to spend months just trying to
figure out the regulations and how to fill out the forms, and
now the computer system's overwhelmed, and we have to spend
a couple of million dollars now to reprogram the whole things,
because it won't even hold all the information anymore. Ordinary
recipients also have said to me that we want people to listen;
to come out and talk to us. That’s what I hear a lot as I go
to the villages.
I testified to the AFN Board two days ago, and I told them we are starting to actually take our top managers and going to -- I mentioned a number of villages we were in. And immediately many more hands came up and said:
“We want you out here. We want you to come
here.”
And I know I could spend all of my years just in an airplane (laughing); and I think; that people just want to be listened to. People want them to visit them.
You know, in Juneau, for example, in my
opinion, very few ordinary people can come' down there, because
it's so expensive, to hear concerns of people. I spend a lot
of time in Anchorage in my office, because people can’t afford
to fly down there; and I meet with lots of people in Anchorage
and Fairbanks, trying to listen to their concerns, because
not everyone can afford four or five hundred dollars to fly
down there, plus, you know, to find a hotel. So, I think the
big message has been that ordinary people want people to go
and listen -- listen to them and speak for themselves. And
I think that the town -- the idea of your Commission going
around and listening to people is very, very important; because
a lot of people just cannot come to -- even to Anchorage. And
they need access, and they have needs, but they don't know
how to get them around.
I met with one man in a village, where my
family’s from even, that has been paying child support for
a child that most people feel isn't his; but he didn't know
how to fight the paperwork to put in the thing to charge it
so that it could be adjusted. I mean, there are just terrible
problems out there that people are just overwhelmed by the
system that people have created, that has been a wall everywhere
for people.
Government needs to be more friendly. We have a Public Information Officer now and -- who's sitting here, Ed Wicher, who I hired just to talk to people. We have out there a list of 800-numbers that cost nothing to call, so people can at least -- don't fail in the Black Hole, and find out how to get a response; and government needs to be a little more friendly and a little more receptive, And I think the big message is people want to be heard, but they just don't know how to get their voice heard all the time.
COMMISSIONER MOORE: In your testimony, you made some statements that are very important, as far as the health of the younger generation is concerned; the fact that these younger people that are coming into town are using these drugs, and eventually they're going to return home; and they're going to maybe be part of the community.
Is there any way that we could get some funds from your department to the Education Department just on chose kinds of things?
DR. MALA: Well, again, our department is involved in alcohol and substance abuse, and drug abuse, and we give grants to communities, to village corporations --
COMMISSIONER MOORE: I mean to have in the school districts --
DR. MALA: We also do --
COMMISSIONER MOORE: -- taught in the schools --
DR. MALA: -- jointly things with --
COMMISSIONER MOORE: -- for --
DR. MALA: -- the Department of Education to educate people in the schools. We do have those programs, and we also support programs in the Court System; so we are doing that as much as we can; but there is more -- we need to do more. And I think more state agencies and federal agencies need to work together more to make a team effort.
COMMISSIONER MOORE: I think that these things that he brought out are real. They're --
DR. MALA: Absolutely.
COMMISSIONER MOORE: -- not something -- we should be aware, and the people at home -- the parents at home should be made aware, probably by your department with some of the moneys that you have to go into the school districts.
DR. MALA: We started an effort to tell people what the Department is. Most people -- even when I went around the Department and asked them about divisions, they didn't know what they did. And so we had the first time ever in our history of our Department, I brought everybody from Anchorage together. We have a thousand employees in Anchorage to teach them what the other divisions do, much less teach other people what our department does. It's such a big department, and we are trying as much as possible to teach people about the resources that are out there to serve Alaskans. So it's a big education process. We've started; but it's -- it -- we have to undo a lot of things that were done over many years.
COMMISSIONER MOORE: Thank you. I have no more questions.
COMMISSIONER SEBESTA: I think Dr. Rowen has a question for you.
DR. ROWEN: Dr. Mala and Commissioners, I
was asked to be part of this to give a, quote, "different perspective." And
I'm sorry that Mr. Boyko is not here this morning. I heard
the last questioner ask directly:
"What programs can we get rid of that do
not work, and what things can we implement?"
I'd like to make some observations then ask you some questions. In my time in the Indian Health Service, which spanned five years, I saw diseases occur in Indians and Natives that never before were seen: heart disease, hypertension, cancer, immune system maladies. In fact, in some of the Aleutian villages, 90 percent of the people I attended had high blood pressure. I couldn't believe it. I had always thought that Native people were immune to vascular disease.
Now, one of the things I -- one of the conclusions I came to after I left the Health Service and got into the type of medicine I'm doing now, preventative medicine, is the impact of diet and nutrition, as you know very well. And I've seen what the Native people are eating; what they're bringing in; what they're flying in; and I have seen virtually nothing done in terms of education or information presented to them. Every study that has been done on cultural impact of what I describe as the White Man's food entered into cultural people, has destroyed their health, destroyed their teeth, led to heart disease, led to cancer, and nothing is done about it.
We have a system now where we're dumping fluoride into the mouths of children, and there are no good studies showing that fluoride does prevent tooth decay; and I can present dozens of studies showing that it's highly toxic, causes osteoporosis, cancer, immune defects, birth defects, among other things. And we've recently had deaths due to fluoride. I admit, higher than recommended; but I don't want to drink two percent of a lethal dose of arsenic every day, and one part per million is two percent of a lethal dose of fluoride.
My comment is we’re driven by a profit-driven
sickness industry, with no impact on health and healing, cultural
values. We're dealing with bodies that cannot heal, because
they are not properly nourished with essential nutrition; and
toxins and poisons are being dumped in them. We're dealing
with a system that cannot repair itself -- this is my opinion
-- because the body cannot heal. It's not given the things
that God has mandated for the body to heal. Now, you ask for
one program that could be cut. I don't know whether I'm supposed
to be asking a question or giving some ideas; but I'd cut fluoride
right away.
Now I have a question for you. What can we do, or what can the state do, to get some of this basic information out there that's published, documented, re-documented, so the people can get a little bit more enlightened. You mentioned yourself, individuals need to take responsibility. If we have government doing everything for us, the ball game's up; and we're going broke seeing what government's doing for us. So my suggestion is what can we do to get this information out, and let individuals take responsibility?
DR. MALA: I think your point is well taken, Dr. Rowen; and I feel that one of the problems in Native villages is based on this trust relationship with government. I always have. And for a long time, in my opinion, government said:
"If you have a problem, come to Big Brother.
You have a problem with your child, call a social worker. You
have a problem with your neighbor, call the police. You have
a problem with another child, maybe talk to a teacher."
Always take the problem and give it away. Now, as fundings get cut in different programs, all of a sudden those people aren't there any more. And, all of a sudden, the problems are there, but the people are gone. And, all of a sudden, people are starting to realize that they have to take responsibility for their own selves.
Now, we have a very close relationship with the Indian Health Service and the federal government; and we work with them in funding nutritionists in different regions around the state. And I have seen a number of materials and posters that have advocated traditional foods; and, again, I believe that we -- our role in government is to educate people to make healthy choices; but, essentially, it's up to the individual; and our role is to say:
"Here it is. This is what's going to happen
if you smoke, or if you excessively smoke, or excessively drink,
or eat these kinds of different foods."
Fluoride, I have told you personally, and I have stated publicly, is a decision
of each community of what they want in their water. I always have believed
that people have the right to clean air; and clean water, and clean everything
they want. And it's our -- and, in fact, the state government has said that
-- in their Department of Environmental Conservation Plan, that people have
the right to safe sanitation and clean water, and that we are working to
make that happen. But, again, the fluoride question, which is really a water
question, which is Department of Environmental Conservation, but health,
because it -- certainly, it's a chemical in the water, is a decision, of
every community; and they need to be educated and make their own mind up
where they want to go with
it. That’s my opinion.
DR. ROWEN: Unfortunately
though, they just receive one-sided
opinions from government; and
government has not been giving us -- as you know, and the people here know -- has not been giving us truth and honest opinions in what's out there.
DR. MALA: We have a lot to do in government. Government is a nebulous kind of a cloud out there that is very hard to nail down. But I believe that efforts by local communities, working with the Native Health Board, working with the Indian Health Service, and ourselves, we'll get results; but people have to get concerned enough to do it. And we welcome -- for our part, we welcome that involvement.
And we need the help of the Commission to recruit and get more Native people into the health department and social services, so that people can take responsibility for their own lives, and get involved, rather than abdicating it to government.
COMMISSIONER SEBESTA: Dr. Mala, thank you very much for your testimony. I think that, certainly, it's the -- part of this Commission to take a very serious look at some of the problems that Dr. Rowen has brought up also and find out some of the recommendations that are coming from other quarters. I really appreciate your testimony and in seeing all the various things that the state is trying to do to address issues, and especially the problems of, you know, alcoholism and the dysfunctional effects that it has among village people.
Thank you very much for your testimony.
COMMISSIONER ELLIOTT: Thank you.
DR. MALA: Thanks.
COMMISSIONER MOORE: Mr.
Chairman, just one question?
COMMISSIONER SEBESTA: Yes.
COMMISSIONER MOORE: Could
you make the information on public
hearings available to this committee?
DR. MALA: Certainly.
COMMISSIONER MOORE: Thank you.
DR. MALA: What we've done already, and --
COMMISSIONER MOORE: Yes.
DR. MALA: Sure, absolutely. Mr. Wicher’ll
do that. Thank you.
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