Health care at Holton IHS comes under fire

HOLTON, Kan. – A peaceful demonstration was staged outside the Holton Indian Health Clinic to bring public attention to allegations of inadequate management of funding for the clinic as well as inadequate patient care.

“Since they have a new manager, he’s appointed a new management team … and there have been numerous complaints from patients,” said Arlene Wahwasuck, member of the Prairie Band Potawatomi health council.

Wahwasuck said protesters want problems patients have at the clinic addressed by the Indian Health Service.

“I stopped doctoring here,” Wahwasuck said. “I think a number of other patients have also stopped using the services here. Some of them go to Kickapoo. There is a competent physician there … a caring person.”

Wahwasuck said the doctor in charge of the Holton clinic doesn’t come to the Health Council meetings. “He said he would come on a quarterly basis. But the patient needs, as far as I can see, aren’t addressed at the meetings. They are not listened to. I know some of the staff has come to the meetings and it sounds like the management is tyrannical here. Staff are getting written up for little things that don’t amount to anything.”

Wahwasuck said she believes staff members are stressed and because of that are unable to provide good quality health services. “Because they are thinking about whatever management is doing to them, the pressure makes it hard for them to give good care to patients. Our tribal council needs to take some action here.”

A retired IHS public health nurse, Wahwasuck worked her last five years before retirement at the Holton clinic. She said that while she was working there were none of the disruptions and oppression she sees now.

Myra Matchie said she was protesting because she was concerned about people’s health. “I can speak for myself because I have had knee problems,” Matchie said. “I have had it for over 10 years. They have had me on pain pills, but I have only had two X-rays in those 10 years. This last time I went in and I demanded that they do something about it and I finally got my surgery on the 12th of June. They see you and they put you on these pain medications … laziness that is what that is. We need a doctor here, somebody that cares rather than somebody who won’t see patients.”

Asked if the doctor at the Holton clinic was refusing to see patients, Matchie replied, “No, no, he refused see, like different people. I’ve only seen him one time since he came here. I went in for pain pills and he said he was going to refer me to another doctor. I took the slip into the contract health office and the woman asked me why I was going to be sent to that doctor. I told her it was for my pain. She told me that the doctor on the referral slip was a psychiatrist. And here my knees were so bad that I had to have a knee replaced. That is the kind of care everybody up here gets. That is why I have been in pain for 10 years.”

Horror stories continued. One woman stated that the doctor at the clinic refused to do pap smears for women, but would do colon and rectal examinations for male patients.

“I just don’t like the way some things are going on inside that clinic,” a man outside the clinic said.

Others said they were there to support Josephine Bellonger, patient service worker, because they were afraid she was going to be fired because she was standing up to the new management on issues of patient care.

“It’s a bad day in Indian country, what’s happening here today,” John Pewamo said. “I’m here supporting Josephine because she has been a great help to me over the years and still is. Maybe it can be fixed, but like I say it is a bad day for us today

“I used to go here when there was another doctor here, but now I go to Kickapoo and the VA. I am here to stand up for the Vietnam veterans because I know they got steered in the right direction because of Josephine. She has been a great help to us. If she gets fired, I won’t know what to do again.”

Josephine Bellonger, a clinic employee, joined protesters because she said she believed that patients and staff alike were not being treated fairly. When the IHS Area Office in Oklahoma City was contacted, Deputy Director Dale Keel said that he was unaware of any problems at the Holton clinic, adding he had seen some early news reports on it. He went on to say that Bellonger was not in danger of being fired as far as he knew.

“I’ve been here for approximately eight years,” Bellonger said. “I have always advocated for people. My real concern is what we should have which is excellently handled care, that was the promise to us. I am doing this personally, this is my opinion. I am doing this risking my job, but I am an advocate of people and I will suffer the consequences.”

Bellonger said that retaliation against her has begun, but she didn’t go into detail about exactly what retaliation there had been.

“When the people here have a concern here, I help them write them up and tell them where to send them,” Bellonger said. “In my previous role, I was always able to do this quite freely … always in the past I have been free to do that. In fact, administrators would send the people to me and say that if there was a problem here, we need to correct it. That is what we are here for. If it wasn’t for the patients, we wouldn’t have jobs here. I think that people forget that, that this exists because of the Indian people.”

Bellonger said she would continue to be an advocate for American Indian people and that although she is not being formally censured, she is starting to receive write-ups from superiors she feels are merely excuses to get back at her.

An elderly patient came to Bellonger because she was concerned about medicine that she had received from the clinic. Two different bottles had the same labels on them, Bellonger said, so she took them to another health care provider to have them checked out.

“I opened them and they were both different,” she said. “I took them to another health care provider and I asked her if they were the same medicine, she said no they weren’t so, I had to alert one of the other health providers on that.”

Other concerns brought up included the fact that many who qualify for health care live out of Jackson County and have to travel, at their own expense, to the Claremore Indian Hospital in Oklahoma for services that are contracted by the Holton clinic for Jackson County residents.

“We’re just trying to make a living and many who live in Topeka (in Shawnee County) are elderly people,” Mildene Oliver said, citing the fact she had to drive back to the Claremore Hospital just to have staples removed following a hysterectomy.

Clinic Director and Acting Service Director, Dr. Richard C. Harris said many of the problems brought up by protestors happened before he came to the Holton Clinic and he noted that many of the protestors were relatives of a recently fired clinic employee.

“There are some changes that had to be made and people are being made more accountable,” Harris said. “I would say there is nothing that can’t be overcome.”

Harris said he believes much of the problem is just patients and employees getting used to a new management style, but he said that after a few months, as the clinic began meeting its new set of goals, patients and employees alike would be happy with the changes.

Part of the new, short-term goals will include redirection of the diabetic program to a staged diabetes management approach, providing additional training to CHS personnel, upgrading the clinic’s computer system and establishing a greater partnership with the Potawatomi, Iowa and Sac and Fox tribes by encouraging tribal support through use of tribal personnel in the clinic.

The IHS Clinic in Holton is not the only one under fire. In a related story, Indian Country Today discovered a tort claim has been filed against the IHS following the death of Janice Ware on Nov. 22, 2000, at the Fort. Thompson , S.D., IHS clinic. Ware went to the clinic with chest pains and was told by the physician on duty to go to a psychiatrist. Ware died of a heart attack at the clinic, a source close to the family said.

The office of attorney Rick Johnson in Gregory, S.D., confirmed that the family had filed a tort claim against Indian Health Service for an undisclosed amount in Ware’s death. No further details on the claim were immediately available.


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Health care at Holton IHS comes under fire