Henry Natonabah wants to greet patients in Diné. But before than can happen, the Navajo teen must complete his classes this semester at Santa Fe Community College on how to collect, process and test blood samples.
“I like drawing blood. I’m pretty confident doing it,” Natonabah said. “I would rather do hands-on work like taking blood than study books.”
Through a decade-old medical careers academy at Santa Fe Indian School, Natonabah, a senior, and his classmates can earn certifications to work as nurse aides, community health workers or in phlebotomy — the practice of puncturing a vein with a needle to take blood.
The career academy is designed to help supply Native American doctors, nurses, pharmacists and other medical professionals as part of the solution to what researchers and tribal leaders across New Mexico describe as a deep-rooted problem: Native communities experience more chronic disease and have worse health outcomes than other populations.
The Indian School’s medical careers academy, which teacher Yvonne John started in 2008, is a three-year program that now has 150 students enrolled. Nursing and phlebotomy students in the program gain clinical experience shadowing professionals at the Santa Fe Indian Hospital adjacent to campus and at Christus St. Vincent Regional Medical Center.
The program is having an impact in the state when it comes to encouraging Native youth to pursue medical careers — and to serve their own communities.
Data from the University of New Mexico shows 10 out of 423 students in its medical school this fall are Native American. The number might seem small, but it’s exponentially higher than average. According to the Association of American Medical Colleges, just 31 Native Americans graduated from medical school throughout the U.S. in 2017 — out of 19,000 total graduates.
“Once students do some clinical work in high school and begin to see themselves in that setting, it changes your outlook,” said Alec Lee, a sophomore nursing student at Northeastern University in Boston who graduated from Santa Fe Indian School in 2018. “The medical careers program creates a community of like-minded students that drives everyone to go on to college.”
Lee, who grew up in Shiprock and, like Natonabah, is a member of the Navajo Nation, said he spent this past summer working on a research project focused on childhood asthma on the Navajo Nation. Based out of a hospital in Window Rock, Ariz., Lee traveled to different federally funded Indian Health Service facilities, interviewing children and passing out surveys to them.
“Being in some of those health centers opened my eyes,” Lee said. “Once I graduate, it’s definitely in my interest to return back home and work at an [Indian Health Service] facility.”
There is a need for improved health care and more medical professionals to serve Native communities, most spread out in rural areas of the state.
According to the New Mexico Department of Health’s 2019 Health Equity in New Mexico report, more than 20 percent of Native American adults in the state have been diagnosed with diabetes, a rate three times higher than that of whites. Tribal communities here also wrangle with higher obesity rates — nearly 40 percent of Native adults — and a death rate from influenza and pneumonia that’s more than twice the national average, according to the report.
Norman Cooeyate, a cultural engagement liaison at UNM’s Center for Native American Health and a former governor of Zuni Pueblo, cited several reasons for the health crises aside from a shortage of doctors and nurses. Among them: a dearth of healthy food options, lack of affordable housing and poor wages.
His introduction to the health care limitations on rural pueblo lands came while he worked as an emergency medical technician at a hospital in Zuni in the late 1970s, Cooeyate said. In addition to answering 911 calls, he said, the short-staffed hospital taught him to administer an IV, set a cast on a broken bone and use an X-ray machine.
Four decades later, he said, underfunding continues to leave Indian Health Service facilities understaffed.
“It’s really not the IHS’ fault,” he said. “Congress has continually not allocated additional funding. Our populations have grown while the funding to support health care has not.
“Most IHS facilities can’t afford to provide specialty care,” he added. “They are lucky to have a pediatrician. They can’t bring in a podiatrist or cardiologist, never mind our population is being exposed to a lot of cardiac events.”
He’s encouraged by the prospect of tribal students returning home to fill the health care gap. But, he said, “As tribal and community leaders, we have to ensure we are ready for those students to come back to our communities. “If not, they go elsewhere.”
Natonabah said he hopes to attend medical school at UNM so he can one day work with patients from his cultural background.
“I’ve gone to IHS facilities and seen how they can be understaffed or how long the wait is or the language barrier,” Natonabah said.
“The chance to be a recognizable face for patients who can speak the language and relate, that’s one of my biggest motivating factors.”