WORD COUNT 597                                                                                                                                                                            APRIL 29, 2009

INDIAN HEALTH SERVICE PERFORMS DISMALLY ON RAPE – by Renata Rendón 

Last week the Senate held a confirmation hearing for Dr. Yvette Roubideaux, President Barack Obama's nominee to lead the Indian Health Service (IHS). As the first Native American woman nominated to this position, Dr. Roubideaux faces an urgent challenge -- to combat shocking levels of sexual violence against Native American and Alaska Native women. 

If confirmed, Dr. Roubideaux, a member of the Rosebud Sioux Tribe, has an opportunity to reverse this appalling public health crisis. 

The Indian Health Service is the principal, and in some areas sole health care provider for Native peoples. And President Obama has stated clearly his belief that health care should be a right, not a privilege. 

But the IHS is critically underfunded, which results in disparities in care. Dr. Charles Grim, the former director of the service, said in 2005: “If you compare per capita federal appropriation to other federal health expenditure benchmarks, such as Medicare, IHS is at the very bottom -- even below prisoners in the United States” 

Native American and Alaska Native women are more than two and a half times more likely to be raped or sexually assaulted than women in general in the United States, and more than one in three will be raped in their lifetime. The attacks are frequently brutal and perpetrators usually escape prosecution, largely because quality and accessible health care -- including forensic exams that could help put criminals behind bars -- are lacking.  

In this situation, poor health care stands in the way of law enforcement, since without forensic exams following sexual assaults, key evidence is lost and prosecutors cannot move forward. In addition, the facilities lack clear and standardized protocol for treating victims. 

A 2005 survey also found that 44 percent of the facilities lacked personnel trained to provide emergency services in sexual violence cases. Workers who have been trained can play a critical role in bringing rapists to justice by collecting evidence, and by testifying in court. 

But even when a Native woman does receive a properly administered forensic examination, it is difficult for health service employees to serve as expert witnesses in criminal cases. In part, this is due to complicated federal guidelines, which the Department of Health and Human Services could change if it decides to address firmly the epidemic of sexual assaults against Native women. It is also due to the simple fact that the Department of Health and Human Services doesn’t deem prosecutions of perpetrators of sexual violence to be part of its mission.  

Lack of care after sexual violence is but one example of the huge disparities in health care that exist for Native American and Alaska Native peoples. If we truly believe that health care is a human right, then we must ensure that standards of care and access to it are equal between communities.  

Currently, federal spending for health care for Native American and Alaska Native peoples is "discretionary." This means spending can change from administration to administration and from Congress to Congress. 

By contrast, Medicare and Medicaid are "mandatory," with guaranteed funding independent of what the president may request and the Congress may pass from year to year. Discretionary spending on health care for Native peoples has resulted in ongoing and clear health disparities.  

And in the case of sexual violence, this disparity has eroded their basic right to justice.  

Congress should unequivocally state that health care is a human right and that the Department of Health and Human Services and the Indian Health Service need to be committed to combating the epidemic of sexual violence against Native American and Alaska Native women. 

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Renata Rendón is a government relations Director based in Washington, D.C., for Amnesty International USA. Founded in 1961, Amnesty International is a Nobel Prize-winning grassroots activist organization with over one million members worldwide. Amnesty International USA (AIUSA) is the U.S. Section of this international human rights movement. -- www.amnesty-usa.org 

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