Alaska Natives Commission

Recommendation

1. The State of Alaska should assist local residents in predominantly Native areas of the state to further establish local control of schools by recasting advisory boards as policymaking boards and by enabling, over a five-year period, the Regional Education Attendance Area (REAA) system to delegate the authority for schools to tribal governments in partnership with the Alaska Department of Education.

Discussion

The Native community, including parents and community leaders, needs to achieve a compelling voice in the direction of the formal education system. In village Alaska, Natives must assume true "ownership" of the schools. New forms of empowerment in this critical area need to be appreciably different than what exists today. Natives should not be relegated to the role of just electing local advisory school boards. Those advisory boards that do exist should be policymaking boards with control over hiring, curricula, and educational program plans, at a minimum.

Alaska Native villages must be willing to actually take over control and direction of their schools and school systems, even if it means having to create the smallest and poorest school districts in the nation to achieve it. And the State must be willing to make changes in policies and in the system to facilitate true local Native control.

A tribal government entering into a partnership with the Alaska Department of Education as an alternative to participation in the REAA system should be required to participate in the funding of the school to the same extent as similarly situated Alaskan municipalities operating local school systems. Tribal governments unable to meet this financial obligation, if any, should be provided federal financial assistance through special appropriations to the Bureau of Indian Affairs for such purposes.

Recommendation

2. The State of Alaska and local school districts need to markedly increase the number of Native teachers and administrators to meet the particular needs of Alaska Native students through affirmative hiring, alternative certification, and other means.

Discussion

In most schools in predominantly Native communities, there remains an entirely inadequate representation of Alaska Native school teachers, administrators, and other school employees. Alaska’s education system needs to supply teachers and administrators knowledgeable of, and with respect for, Native cultures. Teachers, by and large, still come from places foreign to students and their families. The language of information transfer remains English, and the pictures painted as the backdrop for learning are still from another world. High teacher turnover, which is directly related to the "import" nature of the work force in rural schools and results in unnecessary discontinuities in instruction and learning, is another argument in favor of increased levels of Native teachers and administrators.

The personnel in rural schools must be equipped to take advantage of Native ways of learning. And they need to understand who Native children are, the social environments in which those children live, and the culture of the family and community. The importance of Native teachers and administrators as role models for Alaska Native students, many of whom have low self-esteem and fatalistic outlooks on life, is another crucial aspect that needs to be clearly recognized and appreciated by Alaska’s educational system.

The cultural gap between Native children and their teachers has narrowed, but the chasm that has existed for a century is still unacceptably wide. It must finally be bridged. The Alaska Legislature can do its part by resisting the political pressures that have held it immobile on this issue for far too long.

Recommendation

3. The Congress and the State of Alaska should help to increase social and cultural linkages between schools and the villages by creating an Alaska Native Heritage Trust, the funds from which would be granted to Alaska Native tribes for (1) programs to develop parent and village government involvement in the schools and school systems;. and, (2) use in schools and villages for enhancing Native languages and cultures.

Discussion

Notwithstanding the relatively recent construction of modern school facilities in most Native communities throughout the state, these educational institutions fall far short of providing adequate cultural bonds to the Native community and social linkages to families. At the same time, many family members (including parents) and village leaders fail to understand or fully appreciate the critical importance of education to Alaska Natives’ collective survival as healthy peoples with strong cultural foundations. Because their parents and many other village members and leaders do not always appear to consider education important, Native children. are not pressed to perform at a level consistent with their inherent capabilities. Parental and community involvement is crucial to students’ education.

Also critical to the educational success of Alaska Native children is an integrated education, one that gives them the skills that will lead to success in life as well as the understanding that will continue the community’s values. An integrated education will give children both Native and Western values so that they are empowered in both cultures. The skills and values are inseparable, for mastery of one cannot be obtained without mastery of the other.

Native children need to know, understand, and be comfortable with who they are as members of distinct races and cultures. The burden for ensuring that this happens rests firmly on the shoulders of Native people. But the schools, with important roles to play in the development of children, must share the responsibility together with families and community members.

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Attempting to understand why Native children are at or near the bottom of academic achievement charts is a topic of concern and debate for parents, educators, and policymakers alike. Certainly, some of the emerging arguments and theories have merit, and some of the remedies that have been tried have improved various aspects of the educational system for Alaska Native children. There have been many changes in curricula. Multimillion dollar schools have been built in virtually every village in the state. Rural school districts with Native board members have been created. But the fact remains: Native children are still not learning.

Having ceded the responsibility of educating Alaska Native children to missionaries and territorial school teachers during the early part of this century, most Native families and villages have never reassumed that responsibility. Consequently, education is now perceived as being someone else’s job. Native villages and their governments remain, if not disinterested, then certainly disengaged with respect to schools and the school systems in which their children are immersed.

In order to fully understand the current situation, it must be understood that, in spite of the long history of attempted acculturation of Alaska Native peoples and tribes, Alaska Natives remain culturally different from the rest of Alaska and the United States. In other words, the ideas, methods, and languages used to teach Native children are still alien and, therefore, still difficult for students to grasp.

Transferring information and ideas from one culture to another is complex. Among Alaska Natives, the social and economic conditions of the families and villages make educational success even more difficult. Many children come from homes where there is chronic abuse of alcohol and the frightening reality of family violence. They come from homes that have a near-total dependence on government for economic survival. Many of these homes are steeped in spiritual and economic poverty where the parents and other family members are too preoccupied with their own problems to pay adequate attention to the child and how he is doing in school.

All too often, the school is a place of rest for a child who does not sleep well and does not get the nurturing she needs at home. The school, then, is a place not for learning but instead a place to temporarily escape the less than fortunate realities of home. These children — distracted by problems in the home and village — will not learn. Without doubt, this is one of the major reasons why Alaska native children are not learning in school. The problems of village and home are robbing them of their most receptive and inquisitive years . . . their childhoods.

Government must bear some of the blame and responsibility for the inadequacy of the formal education being delivered, or not delivered, to Alaska Native children. But Native villages and families are responsible, too. While many Native parents and extended family members might themselves lack the formal Western educational grounding to teach the children algebra, chemistry, grammar, and the like, they can certainly give active and positive support to their children and the teachers. They can look after the nutritional needs of their children, and they can make sure they are getting enough rest. In many cases, they also have the tools and the knowledge to teach their children the Native language, history, and traditions. They can help the children understand who they are as members of distinct cultures. Though Native societies and cultures have gone through transformations from the ancient ones, Alaska Native people still stand as the best conduits through which education of young Natives can be successfully realized.

Recommendation

1. The federal and state governments should support and fully fund improvement of water and sewer facilities in rural Alaska, following the recommendations of the Alaska Sanitation Task Force, and in conformity with the basic premise of encouraging and supporting local participation in project funding, construction, and maintenance and repair.

Discussion

Statistically, the condition of water and sewage systems in Alaska Native villages is deplorable. Over 50% of the Alaska Native population resides in communities that do not have running water and flush toilets. Although more than $1.3 billion has been spent building water and sewer systems in rural Alaska, a very large number of villages still require major work. An Indian Health Service study conducted in 1992 determined that 378 separate projects are needed, with a price tag of $1 billion. Furthermore, the costs of maintaining these systems, if they were in place, are expected to exceed $40 million annually.

Solutions imposed upon Alaska Native villages are inconsistent with the principles established by the Commission. Rather, village councils and communities should be empowered and assisted in developing, implementing, and maintaining their own solutions to village-specific environmental problems and hazards. Funding must be made available from both federal and state sources, but Native villages, in furthering self-reliance and self-determination, must accept the responsibility for action.

Recommendation

2. The entire health care system for Alaska Natives should be shifted toward health education and primary prevention, with community-based activities that inform, change attitudes, and encourage healthy lifestyles; both the federal and state governments need to provide funding to support these efforts — and the resource allocation of the Indian Health Service should simultaneously be revised to reinforce effective primary prevention and health promotion rather than orienting its funding only toward the provision of secondary and tertiary care.

Discussion

It is important that the sources of the drive toward primary prevention reside within the Native communities themselves, reversing a long-standing governmental tradition of designing programs and then "placing" them in the villages. Empowerment is key to overcoming the negative health trends among Alaska Natives, and empowerment must be the fundamental consideration in the implementation of this recommendation.

A wide range of chronic health problems, including cancer, cardiovascular disease, diabetes, tooth and gum disease, hepatitis, and sexually transmitted diseases, including HIV and AIDS, appear to be steadily increasing among the Alaska Native population. These same diseases and health problems also have behavioral antecedents which make them, to a large degree, preventable. But programs that have been developed to inform and "direct" Natives in proper health behavior have not shown resounding effects because they have not encouraged Alaska Natives to accept the responsibility for change. Nor have they adequately provided Natives with the tools for developing their own approaches to improving health-related behavior.

When communities have conceived, developed, and implemented procedures that are based on their own self-determination efforts and steeped in their own Native culture, the results have been positive. Instead of devising new external programs and increasing funding to implement them, state and federal health agencies should redirect existing funds by offering grants to those Native communities that have taken the responsibility to create health promotion and disease/risk prevention plans that they direct from within, compatible with the cultural traditions of the village.

Recommendation

3. The Indian Health Service should establish an internal program ensuring improved and more timely diagnoses and screening for Alaska Natives who do acquire serious diseases or medical complications. To accompany this, the Congress should appropriate sufficient funding for patient travel — to the level authorized in the Indian Health Care Improvement Act — for those in need of screening and treatment not available in their villages.

Discussion

Health agencies of both the federal and state governments need to immediately increase the availability of equipment and trained personnel throughout Alaska. In a country that prides itself on having one of the most technologically advanced medical systems in the world, it is inconceivable that the federal government would continue to offer inferior services to Alaska Natives, even if that failure is due to lack of funds. The myriad system failures that became apparent during the course of the Commission’s work represent problems that can and should be remedied.

When village clinics simply cannot provide the health care needed, Alaska Natives must travel, sometimes at very high expense, to a regional hub or city to receive services. The federal and state governments should provide relief to offset these expenses, which are now borne by rural Natives who are effectively penalized for living where they do.

Recommendation

4. Funds being spent on the diversified and ineffective data gathering in which the federal, state, and municipal governments now engage should be refocused and coordinated to support a single, comprehensive statewide system that will incorporate health needs assessment, health status, and service evaluation information for all Alaska Natives.

Discussion

In the course of the Commission’s review of health conditions among Alaska Natives, it became evident that there are currently no statewide health needs assessment of health status data collection programs on which health care system reforms can be made. A single, coordinated data system should integrate the efforts of the Alaska Area Native Health Service, the Centers for Disease Control and Prevention, the State of Alaska, Native health corporations, and other providers. Current funding from the fragmented non-system now in place could be redirected to support the single system.

Finally, an annual survey should be conducted that includes behavioral health risk assessment information, as well as health status and needs, to provide direction to new community-based primary prevention efforts and to ensure adequate support for evaluation of new efforts designed to improve the health of Alaska Natives.

Recommendation

5. Approaches to substance abuse treatment for Alaska Natives must be reconstructed to emphasize community-based, family-oriented, and culturally relevant strategies developed at the village level where maximum discretion with respect to regulation of program designs and outcomes is fundamental to new treatment strategies. To this end, federal and state appropriations for alcohol programs in predominantly Native areas of the state, where feasible and appropriate, should bypass governmental agencies and instead be redirected as grants to Alaska Native organizations and village councils that have developed, or are developing, projects aimed at lessening alcohol abuse and its resultant Native criminality and social pathologies.

Discussion

The pervasiveness of alcohol abuse and alcoholism among the Alaska Native population is a contributing factor in many of the health conditions reviewed -by the Commission. Substance abuse is both a symptom and a cause. It is a symptom of the sense of powerlessness and frustration that many Alaska Natives feel as s result of their culture and traditional way of life having been so quickly removed without viable alternatives being made available that protect roles and engender pride. It is a cause, directly- or indirectly, of other. diseases, unintentional and intentional injuries and deaths, and high-risk behaviors in general.

The results of many years of study have repeatedly suggested that, in many cases, Native drinking differs significantly from that of the chronic alcoholic. Regardless,. the entire treatment system of the State of Alaska continues to be oriented toward the chronic non-Native alcoholic. The federal government and the State of Alaska should sponsor research directed at establishing the types of drinking patterns of Alaska Natives for purposes of establishing effective treatment programs that are Alaska Native specific.

Additionally, the Commission, consistent with the orientation it -has taken throughout this report, sees an overwhelming need for the emphasis in all substance-abuse prevention and treatment efforts for Alaska Natives to be directed at families and entire communities. Family-centered and family-life techniques that have produced positive results in indigenous populations need to be examined for possible application in the Alaska Native context. Likewise, it is essential that institutional care approaches (such as half-way houses and "spirit camps") be established at the local level and significantly greater support for in-village aftercare be provided by both the Indian Health Service and the Alaska Department of Health and Social Services.

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Many of the physical ailments found in Native families are preventable, stemming from living in less than sanitary conditions and a seeming inability to make wise choices about personal well-being. The infections and diseases still prevalent in Alaska Native villages and among Alaska’s Native population in general arise when people don’t wash their hands and when houses are not cleaned. They arise when people are not eating well-balanced meals, when they are not getting enough rest, and when there is an over-consumption of alcohol, tobacco, and, other chemicals.

When the health condition of Alaska Natives is compared, as it often has been, to that of Third-World countries, the comparison applies only to the types of infections and diseases from which people suffer. On a per capita basis, the level of government expenditures on Alaska Native health outstrips what most people in the world receive. Yet, Alaska Natives continue to experience ailments in categories that could be prevented — even by such simple means as appropriate use of soap and water.

The question remains: Why are Native individuals and families not taking better care of themselves? Certainly, lack of knowledge is part of the answer. But a fact that must be recognized and dealt with is the psychological and spiritual condition of these individuals and families. Simply stated, many Alaska Natives exhibit distinct signs of depression;.people psychologically, emotionally, and spiritually preoccupied with troubling or unfulfilling lives. This "anomic depression" — characterized by a perceived loss of control, loneliness due to social disintegration and rapid cultural change, and a feeling of frustrated expectations — is further aggravated by poverty and by lack of economic opportunities aside from government anti-poverty assistance.

The Commission has come up with a number of findings regarding the health status and needs of Alaska Natives. For instance, safe water supplies and appropriate means for human and toxic waste disposal for Alaska Native villages are imperatives that must not be overlooked. Greater efficiencies in overall health delivery have to be realized, and a focus must be put on preventative health measures and health education. For the government to expend additional money, however, on health services, including massive sewer and water public works expenditures, without. also addressing the cultural, social, and economic needs of Native families will only add another layer of bandages to those already wrapped around Alaska Natives.