A revolutionary health care system run by and for indigenous people and incorporating indigenous healthcare perspectives has become an international model for health care reform.
Since Southcentral Foundation (SCF) began overseeing healthcare provision for Alaska Native and American Indian people in Alaska, emergency room visits have dropped by 36%. Deaths from cancer, heart disease, and cerebrovascular disease have dropped by 26%, 47%, and 59%, respectively and infant mortality has also dropped by 58%. This has all been achieved while also cutting costs.
SCF serves a population of 136,000 native people spread out over 108,000 square miles, including more than 200 native villages, many of which are only accessible by boat or air. The system involves partnerships with 51 village health clinics, medical teams who regularly travel to villages and tele-medicine, and is centred around the Native Primary Care Centre in Anchorage, where nearly half of the entire population of Alaska lives.
The health centre has the feel of a community centre and is decorated with indigenous art and craft, which increases pride and self-confidence in its ‘customerowners’ (as users of the clinic are called). It also has open offices and offers integrated treatments including complementary and traditional medicine, support with substance abuse, mental health, and home health. This all forms part of a preventative approach which aims to deal with the root causes of illness and to encourage healthy lifestyle choices.
“Emphasis on prevention and integrated healthcare delivery results in less demand for specialty care and fewer emergency room visits. Equally important is the understanding that physical health is bound to social and spiritual wellbeing. Wellness, in this model, comes from facilitating cultural connection and strengthening families and communities.”
SCF recognises that indigenous people are at particular risk of health issues because of their history, with the fallout from years of epidemics, high levels of child abuse in missions and boarding schools and the loss of culture, community and identity all contributing to current high levels of domestic and child abuse and drug and alcohol misuse. To counter this, the effects of multi-generational trauma are treated by tribal doctors along with current health issues in an integrated, holistic process.
Preventative, holistic healthcare would seems to make sense for us all, but the Nuka System of Care developed by Southcentral Foundation has particular relevance for indigenous communities because of the specific issues those communities face and the way it leverages the rich traditional knowledge that is already present.
SCF offer training, site visits and consulting to share this system with other healthcare providers worldwide.