The influx of refugees, especially in the past decade, has resulted in many states partnering alongside the government to support them and incorporate them into our society. Thirty-two states currently administer refugee resettlement through state government offices, while five other states use a public-private partnership to administer funds. Here in South Dakota, we participate in the alternative Wilson-Fish program, which means that the federal government contracts with nonprofits to distribute money. The Department of Social Services here only handles the refugee cash medical assistance through Medicaid while Lutheran Social Services of South Dakota administers the rest.

The current refugee population breakdown in South Dakota includes individuals from Myanmar, Bhutan, Ethiopia, Iraq, the Democratic Republic of the Congo, Somalia, Sudan, and several other countries. Lutheran Social Services helps connect thousands of refugees each year to counseling, residential help, foster care, and more. The Center for New Americans aided 30,821 refugees and families in 2017 alone, while the broader services were used 61,144 times. Just under half of the refugees they care for are 18 years old or younger, and many come to Sioux Falls to be connected with missing family members. One story about a Somali man, in particular, stands out: he has resided in Sioux Falls for three years after having escaped the violence in Somalia as a teenager and then living as a refugee in Kenya for some time. His goal is to become a naturalized citizen, and the services here in Sioux Falls are helping him do just that. In order to gain his citizenship, he has to be a permanent resident for five years and have a working knowledge of English, which he is gaining through the programs at LSS. There he takes English classes and citizenship classes to learn about the history and government of the United States. Alongside him, there are currently 120 former refugees working with the LSS on the path to citizenship.

Mothers and young pregnant refugees are still a concern here in Sioux Falls. Health disparities within refugee health and care have arisen everywhere, South Dakota is no exception. Care providers are working hard with patients who have uncommon diseases and complications, even with little to no background training. The largest problem, however, arises out of a lack of cultural competency. There is no class in medical school for learning about Somali or Bhutanese culture. A program dedicated to educating health care providers on pregnancy and birthing practices more reflective of other cultures will go a long way to alleviate some of the disparities being seen across the state, and there is a strong desire to learn and care for these women we are welcoming into our towns and cities. The outlook for the future is bright, and it is up to our nurses, doctors, midwives, and community to take the extra step to open minds and arms and incorporate culture and healing into their experiences here in South Dakota.

By: Natalie LeMoss | Cornell University | SURE Intern | Hanson Lab

A gentle blanket of clouds accompanied us on our way to the annual Fort Thompson Health Fair on the Crow Creek Reservation at the Indian Health Center, just outside of Chamberlain, South Dakota. I had been invited to join the excursion just a day before as part of my REU (Research Experience for Undergraduates) in Native American Population Health. IΓÇÖm from Connecticut and love to travel and embrace diverse cultures so this was an easy ΓÇÿyesΓÇÖ for me.    

I had done my research the night before the Health Fair so that I could learn about Crow Creek Reservation. I learned that the Crow Creek Reservation lies adjacent to the Big Bend Dam, which was constructed by the US Army Corps of Engineers in the 1960s as part of the Pick-Sloan Plan authorized by the Flood Control Act of 1944. The Pick-Sloan plan was enacted to utilize the water resources of the Missouri River Basin in order to provide a watershed to distant areas affected by drought and also to provide a source of energy through the use of a dam. The resulting reservoir, Lake Sharpe, subsequently created a series of issues for those living nearby causing members of the Crow Creek/Fort Thompson and Lower Brule reservations to become dislocated. The now water-covered fertile lands resulted in the loss of farming potential for these tribes and equally negatively affected economic conditions for those inhabiting this area of land which spans nearly 57,000 acres. The land had been previously used to produce food and medicine for locals. Overall, the size of the Crow Creek reservation was dramatically reduced.

As I entered the Health Fair at IHS, I was greeted by particularly happy and smiling faces as well as lots of color and warm, engaging and delightful personalities. I knew I found my niche and that I was in the right place. It was a very happy day indeed. The sun was shining the most it had in a long while. I was pleasantly surprised by how many attendees (local Fort Thompson residents and guests) were curious to find out what our booth was about. It was personally my first time visiting a Native American community so it was a particularly unique experience for me. The host humored us with his jokes and focused us with his wisdom as he blessed the day ahead and all those who attended that they be in good health. Attendees visited dozens of diverse booths and various buildings such as the Wowasake Wellness Center, which includes a full fitness room. Overall, the fair was information dense and prompted many conversations on diverse topics relating to health and wellness promotion.

In the end, I was left with profound feelings of hope and assurance that our research is moving in the right direction. Aside from political and sovereignty issues related to approving tribal research, I was amazed at how hungry individuals were to learn about and embrace novel topics of health and wellness. Ecstatic smiles thanked and commended the lead researchers at our booth (Char Green-Maximo and Jessica Heinzmann) for the work they do. We must continue to break the stigma of ΓÇÿWesternΓÇÖ research in tribal communities by showing our ΓÇÿhumannessΓÇÖ and connecting with locals. Forging long-term sustainable and healthy relationships is the foundation to solidarity. Again, itΓÇÖs the intentions one sets that determines the outcomes. I leave this post with one message, one I was reminded of as we began our trip back to Sioux Falls: to act with Dignity, honor and respect and to embrace those cultures that stand before us and to be inclusive of the values of all individuals especially those of the Native Americans who embody South Dakota.

By: Kelly Bielonko | Eastern Connecticut State University | SURE Student | Griese Lab

It is finally feeling like summer here in Sioux Falls; the sun is out, the humidity is making my hair frizz, and our summer students are here! We have 10 amazing undergraduates working within the Population Health Group until August 10. They are here through the Summer Undergraduate Research Experience (SURE). I, too, was a SURE student in 2011, and I really love being able to be back here in a mentoring role. We will have seven of the students located at our Sioux Falls office and three of them are off-site at our Pine Ridge and Rosebud sites.

While here, they will participate in everything that we do in our day-to-day work plus a few extra things (GRE prep, anyone?) and some of them will be able to gain hands-on experience with data collection and community engagement in our Native American and rural populations. They have already jumped in to their work and integrated themselves into our group. Writing a blog post was completely optional for them but I was able to convince a few of them that it would be the most fun they had this summer.

There are a variety of topics that they have picked out to write on, and I canΓÇÖt wait to hear their perspectives on things. Many of them are from out-of-state and some have never worked with or in Native American settings before; IΓÇÖve already had great discussions with them about their experiences thus far. They are here for just 10 weeks and will be working on various projects that we have going on in our group, and I thought it would be a great opportunity to bring some more diverse perspectives into the blogs. They all come from different places and have unique ideas and experiences that IΓÇÖm looking forward to sharing with you all!

Even though it is summer, we are all keeping quite busy! 

 By: Michaela Seiber, MPH | Sisseton-Wahpeton Oyate | Population Health Group

I know everyone has been eagerly awaiting the next blog post; this busy spring is melting into a busy summer, as IΓÇÖm sure many of you can relate to. There has been a lot going on here at Sanford Research with people traveling to conferences, writing grants, and most excitingly: preparing for our summer interns that will be arriving in a few short weeks! I hope to have some of them come up with ideas and try their hand at blogging ΓÇô so stay tuned for that.

For this post, I want to talk about how important it is for tribes and people working with tribes to be involved in national conversations. A few weeks ago, I spent five days in Boston attending conferences and workshops put on by the Public Responsibility in Medicine and Research (PRIM&R) and the Office for Human Research Protections (OHRP). In 2009, I spent the summer in Boston as part of the Four Directions Summer Research Program, so it was nice to be back and pretend as if I knew how to use the subway. Anyway, both PRIM&R and OHRP offer spaces for people involved in research to seek guidance on research ethics and regulations, with the OHRP providing support and guidance for all of the federal agencies that conduct research. I think these topic areas can be heavy and may be boring for some people, so I really was not sure what to expect by attending the conference and two days of workshops.

First, I had fun and I gained some new perspectives when it comes to conducting research with vulnerable populations, the Common Rule, and the informed consent process. The hosts of the events were so welcoming and accommodating and really, who would not enjoy hanging out in Boston for a few days? While I did have fun and had a great time, this was really an uncomfortable experience for me. I felt out of place and maybe a little over-my-head in some of these conversations.

IΓÇÖve been reflecting back on this to try to figure out why I felt this way when everyone there was kind and welcoming and I think it was simply because I was the only one there who worked with tribal communities. You might be wondering why this would make a difference or why it would affect my experience that much, and it really comes down to tribal sovereignty and the different lens that tribal research review boards look at research ethics and research protections. IΓÇÖm used to almost entirely thinking of research from this vantage point, so it was disorienting to be in a space talking about research ethics and regulations that didnΓÇÖt focus on tribal efforts to manage research.

The speakers that PRIM&R and OHRP brought in were obviously knowledgeable about research ethics and regulations but really only looked at research from a Western perspective. All of the conversations I overheard and was involved in left out the unique perspectives of tribal communities in reviewing research. This made me doubt myself at times but it also illustrated just how vital it is for those of us who are tribal members working in research or those of us who are researchers working with tribal communities to be a part of these bigger conversations. We must keep making ourselves visible and keep talking about research ethics from the perspective of tribal communities, even if it is a little uncomfortable.

By: Michaela Seiber, MPH | Sisseton-Wahpeton Oyate | CRCAIH Regulatory Knowledge Core | CHOPR READ Core | This email address is being protected from spambots. You need JavaScript enabled to view it.