On the back of Big Turtle
Or, how the UND Indians Into Medicine Program came into being.
Below is the first in a two article series on UND’s historic Indians Into Medicine Program. The following piece focuses on INMED’s early history. A forthcoming story will emphasize the program’s growth and change in the 21st century.
According to Ojibwe [Chippewa or Anishinaabe] tradition, the world was made when Woman fell from the sky to the endless sheet of water below. Two swans saved Woman from drowning and took her to Big Turtle, master of all animals. Turtle, who is at times described as female, called a council to determine how to bring up earth from the ocean to make an island for Woman. Many animals tried, but died in the attempt. Finally, Old Lady Toad dove down into the water and emerged with earth, which she put on Turtle’s back before dying of exhaustion. Turtle then supported the earth on her back as it grew into the island of the world we know today.
Various Lakota/Dakota/Nakota tribes in the Northern Plains— whose lore often includes a healing turtle named Keya— expound upon such a creation story by describing how during a time of great famine and sickness White Buffalo Calf Woman came to save the Indian people. The woman in white buck skin was sent by the Great Spirit to provide the people with a pipe “made from the blood stone of all who gave their lives that you might live,” former Chair of the UND Department of Indian Studies Art Raymond wrote in the book Medicine Woman, hinting at the pipe’s healing potential. “The Woman of the Clouds walked slowly and majestically from the camp out to the plain. There she disappeared without a sign, and in her place stood a white, female buffalo calf.”
These tales are recounted in Medicine Woman, the chapters of which were written predominantly by Raymond and the women who produced UND’s Indians Into Medicine (INMED) Program— Twila Martin Kekahbah, Lois Steele, Phyllis Old Dog Cross, Connie Jackson, and others—which this year turns 46 years old.
It makes sense that a program dedicated to cultivating American Indian health care providers of all types would see in Big Turtle and White Buffalo Calf Woman a model for its own founding, of course. As with earth, America’s premier Indian health education program, whose symbol for years was a turtle, was likewise built from nothing largely on the backs of the tireless women and men who dedicated their lives to finding solid ground for American Indian healers journeying far from home.
Just ask Kekahbah, a charter member of the INMED Advisory Board.
An enrolled member of the Turtle Mountain Band of Chippewa, the UND alumna (BS ’72) understood both the difficulty American Indians faced in trying to engage formal health education and hospital systems, and the need to change such systems that kept too many American Indians from attending college.
“When I started [at UND] there were only three identifiable American Indians in attendance,” Kekahbah noted over the phone from Belcourt, N.D., describing how INMED was the catalyst that generated sister programs like Recruitment/ Retention of American Indians into Nursing (RAIN) and Indians into Psychology Doctoral Education (INPSYDE). “Now, we can identify nearly 300 Indian physicians—and even more nurses and psychologists.”
Kekahbah’s colleague Deb Wilson agrees. The current director of the RAIN program began her career with INMED in 1982 before moving across campus in 1991.
“When I started at INMED, the University had just graduated only its third American Indian nurse,” Wilson explained, still astonished at the number. “Today, we can claim over 260 Indian nurses, many of whom have gone on to get master’s degrees and a few PhDs. INMED helped lay the groundwork for this.”
Kekahbah’s and Wilson’s efforts notwithstanding, dozens of hands helped get INMED and RAIN off the ground, say the women, including Raymond, former UND President Tom Clifford, then-dean of the UND College of Education and Human Development Vito Perrone, and education professor Don Lemon—all deceased—not to mention former North Dakota senators Quentin Burdick and Mark Andrews.
Also on this team was UND School of Medicine & Health Sciences grad (BS Med ’59) and former Chair of its Department of Family & Community Medicine Robert Eelkema, MD, who too saw the wisdom in creating a program that would recruit, train, and graduate American Indians into the health professions and send them off to practice on reservations or otherwise underserved rural communities in the region.
“We knew we had to encourage science and enrichment programs for grade schools and high schools, so we developed a program that incorporated extra help in schools on reservations and brought students in for a summer program and worked with the medical school for students,” said Eelkema, who did much of the heavy lifting locally and with North Dakota’s congressional delegation in Washington, D.C., and retired from the SMHS in 2000.
In Eelkema’s memory, although the program witnessed a lot of “storming and forming” early on, it started strong and has stayed so for nearly half a century.
Representatives of more than one federal agency “decided to come and visit us to see what we had,” Eelkema continued. “So we took them to the reservations—Spirit Lake and Belcourt. They supported the program. And we had a great president in Tom Clifford. He said, ‘It works—we’re gonna fly with it.’ So we put it all together and got the first grant.”
These administrators assembled a team to write the initial INMED grant, which Eelkema says was submitted to a federal agency then known as the Office of Minority Health Manpower. The team, which also included Gary and Nancy Dunn, won the more than $300,000 grant and the rest is history.
“After the season is over”
Once the group had secured funding for INMED, the next order of business was to find a strong director. And for those closest to the program, there was never a doubt about whom this person should be.
So did Eelkema, Raymond, and Dr. Lionel DeMontigny, Eelkema’s classmate and the first American Indian graduate of the UND School of Medicine & Health Sciences, visit Dr. Lois Steele at Dawson Community College in Glendive, Mont.
“They approached me right in the middle of basketball season,” recalled Steele, who was at the time teaching and coaching women’s basketball at Dawson. “We’d had two unbeaten seasons in a row at that point. So I told them I could be there in March—after the season was over.”
Steele’s first order of business was convincing all of the state’s tribes and some American Indians living on the reservations to jump on board with a program devoted to “white” medicine. Because this posed a challenge in some communities, Steele helped put together a so-called “travelling medicine show” with INMED grads Edwin Chappibitty and Richard Asher that featured an American Indian doctor, nurse, and other health professionals that road-tripped to reservations across the five-state upper-Midwest region.
“We wanted to show our people what a brown person in a white coat with a stethoscope looked like and what they could do,” added Kekahbah.
Herein lies the value of INMED as not only an educational program, but a cultural one. In most American Indian traditions, “medicine” is less something external to the human body that treats disease than an energy or spirit embodied in or demonstrated by a person, place, or object. For Steele, who left INMED after a year to enter a medical residency in Minnesota before eventually returning to INMED, it is this definition that many classically trained physicians were missing, at least in the past century.
“Too often, Western medicine asks you to take a few pills and underestimates the power of the mind in keeping you well or making you sick,” Steele said. “Indian medicine, in the traditional sense, recognizes that when you’re unwell, you need a lot of people to help you get well.”
The same could be said of INMED, which likewise was made strong with the help of so many healers in the more than 40 years since Kekahbah, Steele, Raymond, Eelkema, and others first laid soil on the shell of their own “Big Turtle.”
After the team’s initial grant expired, for instance, Steele and the INMED Board helped secure additional grant monies from the Health Resources & Services Administration’s Health Career Opportunities Program (HCOP). Then, former North Dakota Senator Mark Andrews helped write INMED into the federal Indian Health Service budget as a line item that today cannot be eliminated without an act of Congress.
In this way did INMED become practically indispensable.
“INMED is more important than ever,” concluded Steele, recalling just how hard it was for those first students in the 1970s and 1980s to come to Grand Forks from the reservation and succeed in school. “Looking back, it amazes me that so many did so well. I remember the tears and heartbreak at all levels, even in med school in older students. Students still see some of the same problems [today], but the causes are different.”
But that story—INMED’s evolution into the 21st century—will be explored in the fall 2019 issue of North Dakota Medicine.