Presented by Brenda S. Golden, BBA, MBA, J.D. 
Mvskoke (Creek)  
Take Root Conference 2017 

The Indian Health Services (IHS) was officially established 

as its own agency in 1956 to take over health care of

American Indian and Alaska Natives from the Bureau of

Indian Affairs (BIA) to the Public Health Service (PHS). 

Previously health care of indigenous people in the US

was provided through program of the Bureau of Indian Affairs in the US War Department.  IHS is fully a federally funded and federally run agency administered by officials of the United States federal government.  

The provision of health services to members of US federally recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article I, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders.   Numerous indigenous people signed agreements with the United States giving up certain rights to property, land, human and civil rights, as well as past and future claims in exchange for the US providing them with financial assistance, payments, health, education of welfare.  As you may know, treaties are considered by the US Supreme Court and rank right up with the Constitution as to legal precedence.   

The Indian Health Service currently provides health services to approximately 1.8 million of the 3.3 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states. As of December 2011, the agency's annual budget is about $4.3 billion.  HIS has not had an increase in appropriations from Congress in over 20 years, despite rising costs of treatment, services and products.  There has been no adjustments for inflation or the recession.   When the Affordable Care Act (ACA) was enacted, the Indian Health Service was folded into the provisions of the Act.      

IHS-run hospitals and clinics serve any registered Indian/Alaska Native, regardless of tribe or income. Tribal-contract health care facilities serve only their tribal members, with other qualified Indians/Alaska Natives being offered care on a space-available basis. This policy makes it difficult for an Indian who leaves their tribal home for education or employment to receive health care services to which they are legally entitled.  IHS covers 2.5 million Native Americans and Alaskan Natives for an average cost per person of $1,600, far less than the average cost of health care for other United States Citizens.  BUT it is in many many instances, the only source of health, dental, behavioral, and psychological care of native people in the US.  Due to socio-economic factors such as unemployment, disease, etc, this health care is the only care many people have and can afford.    If ACA is repealed in its entirety the IHS is at risk and untold numbers of Indian/Alaska Natives could lose the only health care they have and can afford.   

As stated earlier, treaties often guaranteed education to native peoples, but that education was not defined until the late 1800s.  The boarding school experience for Indian children began in 1860 when the Bureau of Indian Affairs established the first Indian boarding school on the Yakima Indian Reservation in the state of Washington.   The goal of these reformers was to use education as a tool to “assimilate” Indian tribes into the mainstream of the “American way of life,” a Protestant ideology of the mid-19th century. Indian people would be taught the importance of private property, material wealth and monogamous nuclear families. The reformers assumed that it was necessary to “civilize” Indian people, make them accept white men’s beliefs and value systems.   

BIA Superintendents and Agents, rounded up all the native children they could find in their area and bussed them to a Boarding School for almost 100 years.  Because of the expense and other reasons, the US granted religious organizations broad swaths of area in many states, to build, administer, run and provide educations to native children.   These schools run by Catholics, Methodists, and Baptists received funds from the US Government to operate.   By the 1880s, the U.S. operated 60 schools for 6,200 Indian students, including reservation day schools and reservation boarding schools.   These schools were run with military precision, children were housed in dormitory like settings, with daily chores to earn their keep, they marched everywhere on a daily regimented scheduled and ate in a chow hall.  The children were forbidden from dressing, acting or speaking native, nor were they allowed to acknowledge or speak to their own family members, including brothers and sisters.  Education at these schools taught the boys and young men how to farm, work with animals, husbandry and agriculture.  Girls and young women, learned how to be a home maker, maid, seamstresses, and laundry workers.   

Eugenics is the racist pseudoscience determined to wipe away all human beings deemed "unfit," preserving only those who conformed to an acceptable stereotype. The study of or belief in the possibility of improving the qualities of the human species or a human population, especially by such means as discouraging reproduction by persons having genetic defects or presumed to have inheritable undesirable traits or encouraging reproduction by persons presumed to have inheritable desirable traits.  Elements of the philosophy were enshrined as national policy by forced sterilization and segregation laws, as well as marriage restrictions, enacted in twenty-seven states from the early 1900s thru 1950’s.  Ultimately, eugenics practitioners coercively sterilized some 60,000 Americans, barred the marriage of thousands, forcibly segregated thousands in "colonies," and persecuted untold numbers.  Sterilizations of mentally ill, mentally retarded, Down’s Syndrome persons, physically disabled and outlawing interracial marriage are examples of the legal means the US practiced eugenics.   

Reports of forced sterilization of Native American women began to surface in the 1970s. A Government Accountability Office (GAO) study, involving Albuquerque, Phoenix, Oklahoma City, and Aberdeen, South Dakota, found that between 1973 and 1976 IHS facilities sterilized 3,406 Native American women. Of these, 3,001 involved women of childbearing age (between fifteen and forty-four).  Of the 100,000 to 150,000 Native American women of childbearing age, 3,400 to 70,000 of these women were involuntarily sterilized through tubal ligation or hysterectomy.    

During the investigation, it came to light that female children in boarding schools had also been sterilized.  In some cases, they recall having their tonsils and appendix removed at which time there were sterilized without their consent or knowledge. Many who were no grown, could not conceive, sought out a doctor to explain why or treat their infertility, only to find hey had their tubes tied already.  And they only operation they could remember having was at the boarding school.  Many adult females were not given a choice to refuse or accept to undergo the sterilization procedure as they were manipulated into thinking that they would risk losing their welfare aid or even their lives should they refuse to undergo a sterilization procedure. However, the procedure was most often done under the pretense of a checkup or abortion, and most of the victims didn't know they were sterilized until years afterwards. 

The world is appalled and outraged at the genocidal tactics of Hitler, in Bosnia, and Syria, yet Hitler’s ideas derived from the polices of the United States toward indigenous peoples.  Indian Health Service is a treaty and Constitutional right that almost all Native/American Indian people depend upon for health care.  The oath of all medical professionals is “to do no harm”.  Yet the national policy of the US to eliminate “unfit” and “undesirable” human traits in American society is contradictory to that oath.  This is a real-life example of men in public office making decisions about who has the right to life, liberty and death.   

What makes the sterilization of native females so outrageous and egregious is the subterfuge, lies and manipulations by the medical and health care professionals.  Sterilizing of native women prevented countless thousands of generations from having life.  Woman in many tribal communities and nations are the leaders in a matrilineal society, they are life carriers given deference in ceremonies, by carrying clans and being mothers.   These sterilizations amount to straight out genocide and cultural genocide at the very least.     

The Seneca Indian School was a Native American boarding school located in Wyandotte, Oklahoma. Initially founded for Seneca, Shawnee, and Wyandotte children, in later years it had many Cherokee students. The school operated from 1872 to 1980.   My mother, a full blood Mvskoke (Creek) female attended Seneca Indian Boarding School from about 1945 to 1960 at the height of the eugenics movement.  Reports of sterilizations of females that attended Seneca have been confirmed and she wonders if any of the girls she knew could have children.    In about 1973 I had an appendectomy at Claremore IHS.  In approximately 1974-75, my mother had a complete and total hysterectomy to treat her “uterine cancer” at Claremore IHS.  Whether that is true is unknown, the doctors told her she had it and she believed them, there is a distinct possibility that I could have more brothers or sisters, nieces and nephews, great nieces and great nephews   Reports of approximately 200 sterilizations performed at Claremore IHS have been confirmed by the GAO. 

I think about the trains packed with Jewish people arriving at the death camps, as they get off the trains, a uniformed Nazi soldier decides who is going to the gas chamber for death immediately or going to the work camp where death may come eventually anyway.   But instead of Jewish faces I see my native grandmothers’, mothers’, sisters’, aunties, great grandmothers’, my mother’s and mine.   



“Native American Women and Coerced Sterilization: On the Trail of Tears in the1970’s” by Sally J. Torpy 

“The Indian Health Service and the Sterilization of Native American Women” by Jane Lawrence 

“Forced Sterilization of Native Americans: Late Twentieth Century Physician Cooperation with National Eugenic Policies” by  Gregory W. Rutecki, MD 

 Photo Credit: Nora Moore Lloyd