BELCOURT Dialysis patients here on the Turtle Mountain Reservation were ready, with ceremonial golden shovels in hand, to break ground for something that would help them survive.
On Sept. 26, ground was broken for the Melvin Lenoir Dialysis Center, which will help accommodate the growing number of diabetics on the reservation in need of dialysis treatment.
"The affliction of diabetes on our people is terrible," said tribal chairman Merle St. Claire, at the groundbreaking ceremony.
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James C. Falcon/MDN - - Dialysis patients on the Turtle Mountain Reservation had shovels on hand to break ground for a new dialysis center Tuesday. Earlier this year, the Trinity-Lenoir Dialysis Center flooded and had to close, so patients had to travel elsewhere for dialysis.
The statistics are staggering.
Shirley Butts, diabetes educator and coordinator at the Quentin Burdick Memorial Health Care Center, in Belcourt, keeps a register of anyone with diabetes who passes through the hospital. According to her recent statistics, there are more than 1,200 active diabetics who are enrolled members of the Turtle Mountain Band. Butts said she is unsure how many live on the reservation proper, as some might use the Indian Health Service but live in surrounding communities or elsewhere in the state.
"We have one of the highest number of diabetics within the Indian Health Service in the surrounding area, per population," Butts said.
She estimated that there are 22,000 enrolled members. About 25 percent of the diabetics are 64 years of age or older, Butts said. She also noted that younger and younger people are getting Type 2 diabetes, something that is usually found in the "older crowd." A medical audit that was conducted in April said that of 1,060 diabetics the list did not include, for the most part, diabetics who were diagnosed with the disease within the past year only eight have Type 1, or juvenile diabetes; the rest have Type 2. Of those, the majority were within the ages of 45 and 64 years of age. Two hundred and twenty-three were within the ages of 15 and 44 years, and 268 were over the age of 65.
In regards to kidney function levels, the majority 853 of the 1,060 are within the first two stages of diabetes. There are 112 who are at Stage 3, in which there is a moderate decrease in kidney function. Nineteen have a severe decrease, or Stage 4, and 10 have complete renal failure.
"If you look at all these stats, you're looking at big-time problems down the road unless things change," she said. "If you're looking at long range I look at this and I get scared there are going to be a lot of people on dialysis."
Control
Lifestyle changes, such as losing weight, are a big part of diabetes.
"When people start getting the weight off, they could go off medication, and they feel much better," Butts said. "If they are pre-diabetic, they can put off the diagnosis of diabetes, but they have to get their weight under control and they have to exercise. Exercise is really the key to all health."
The Trinity-Lenoir Dialysis Center currently services the reservation, although it has suffered some setbacks since it was established about 22 years ago. In February, the building flooded after Ox Creek, which runs through Belcourt, flooded, due to a large amount of melting snow. During his remarks at the groundbreaking, St. Claire noted how the center was forced to close. Dialysis patients were, in the interim, sent to Minot for dialysis. He noted that the tribe scraped money together to transfer the dialysis patients from the reservation to Minot, a 113-mile round trip.
"A life is more costly, so we as the tribe found ways to pay for it," said Curtis Poitra, the tribal vice-chairman and the lead of the dialysis center project.
While the center re-opened eight weeks later, Trinity-Lenoir cannot accommodate the growing number of diabetics on the reservation.
"We have an overflow," explained Wendy Armstrong, assistant nurse manager for the Trinity-Lenoir Dialysis Center. "At one time, we had 11 patients that were traveling to Minot for dialysis. Currently, we have two people. There is a lot of talk (at the
hospital) that approximately 100 people will be needing dialysis in the next five years. We have a high patient count, and our building is just getting old. It's getting used, and we need something new."
The Trinity-Lenoir Dialysis Center currently has six dialysis machines and 18 patients. To accommodate them, the patients are treated in shifts.
"Generally, patients go for three days a week, at three to four hours each time," Armstrong said. The new center will have 12
dialysis machines.
Unless diabetics get a kidney transplant, dialysis is something that is done for the rest of their lives. She noted that most people "come to the end of their life" before getting a transplant.
"Diabetes has touched our families," said Poitra, who said that he lost his mother last year to complications of being diabetic. "This is a great day for our people."
He said that the tribe hopes to have the center open by June.
Background
Shortly after the February flooding, the council, recognizing that the reservation needed a dialysis center, took action. Poitra and St. Claire, along with councilmen Jeff "B.J." Delorme and Larry "Sheepman" DeCoteau, traveled to Rockville, Md., where they met with Dr. Yvette Roubideaux, the operating division executive. There, the delegation from Turtle Mountain pleaded their case, talking about the need in the community and the diabetes epidemic "knowing we were going to have more people on dialysis in years to come," Poitra said.
"Her reaction was good. She was understanding," he added, in regards to the discussions with Roubideaux. "It was a really good talking session (with her) and her staff. At that time, she committed to something, but didn't say how much."
Following their success at the top of the Indian Health Service, the delegation made up of Poitra and Delorme went to
Aberdeen, S.D., where the Aberdeen Area Office of the Indian Health Service, which serves the upper Midwest region, is based. There, they met with Charlene Red Thunder, the area director.
"We pretty much did the same thing," Poitra said. "We showed the need and she showed a lot of compassion for our people."
Poitra said that Red Thunder, who is Native American herself she is a member of the Cheyenne River Sioux Tribe understood the epidemic of diabetes in Indian Country. On the second-to-last trip, Red Thunder said that $250,000 would be committed by Aberdeen, and "Roubideaux was going to give us $370,000."
"We were working on other grants and we thought we had one, but it fell through," Poitra explained.
Two weeks before the groundbreaking, Poitra, Delorme, and tribal councilwoman Zelma Peltier, traveled to Aberdeen again.
"We explained that our other funding source fell through and we were short for the project," Poitra said. "She asked us, when we left, to submit a proposal for our shortfall to complete our dialysis center."
Red Thunder, who was present at the groundbreaking ceremony, said that Roubideaux came through with an additional $350,000.
Red Thunder said that the new center acknowledges diabetes in the community. The new location, located on the north end of the Quentin Burdick Memorial Health Care Center, minimizes disruption in services as it is located outside of the flood plain, she said.
The tribal council "wore a path from here to Aberdeen" to secure funding for the dialysis center, she said, adding: "And they were successful."
According to Poitra, the regional and national levels of the Indian Health Service have contributed $970,000 toward the center.
"(Director of the tribal Master Health Program) Blaine Malaterre worked long and hard with us on reprogramming some of the carryover money in the Master Health Program," Poitra added, noting that through Malaterre's efforts, an additional $250,000 was allocated for the center. The estimated cost of the center is $1.2 million.
"It just shows when a council gets together and you do aggressive lobbying that they will listen," Poitra said. "All those trips, they were well worth it."
The birth of the first dialysis center on the reservation began about 22 years ago, also by tribal government intervention.
The Melvin Lenoir Dialysis Center is named after Melvin Lenoir, a former member of the Turtle Mountain Tribal Council, who St. Claire described as "a real proponent of establishing this center."
"When there was no dialysis center and patients had to travel to Minot," Armstrong said. Lenoir's daughter, Laurie, had childhood diabetes and, as a young woman, ended up with kidney failure. "He did not want to see all these people traveling to Minot for dialysis. He got this dialysis center running."
Lenoir's daughter, Lynn Allick, was also present at the groundbreaking.
"I know how hard it is on families," she said, noting that she lost a sister and two brothers to diabetes-related illnesses. "My dad would be very proud."