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Centers for American Indian and Alaska Native Health
 
 
 

Healthy Nations Initiative

White Mountain Apache Tribe of the Fort Apache Reservation


About the Program

For the last two years, the White Mountain Apache Tribe has been preparing to wage its last war on a deadly perpetrator - alcohol and drugs. Its presence kills our people, soils our land, abuses our children, numbs our culture and violates our traditions. Not one of our 12,500 members has been spared.

The Robert Wood Johnson Foundation’s support of a two-year Healthy Nations planning phase has allowed us to develop wisdom about this enemy and a community vision for victory by the next millennia. To beat this elusive foe, we must release all defenses and drop all false shields. In turn, we envision four stages of recovery unfolding to us in the form of awakening, strengthening and healing, coming together, and uniting as a Healthy Nation.

The strategy we have devised for attacking our chemical dependency is multifaceted. Many have already been set in motion as grassroots community members joined with representatives from Tribal health and human services, the IHS, the BIA, and schools to form community task forces, or cluster groups, to draft and pilot test specific battle plans. An inner planning circle was formed, including Healthy Nations staff and a community Advisory Board comprised of all cluster group leaders.

As we moved into Phase 2, to implement our plan, we see our effort expanding from circle to sphere, as programs branch into the community in four directions:

  1. Public Awareness: We are launching a major Healthy Nations mass media campaign called N’dee Binadesh: The People’s Vision. All reservation media outlets are being tapped -- KNNB Radio, The Fort Apache Scout newspaper, special events, and a new media resource: APACHE TV & Video Production. N’Dee Benadesh messages seek to 1) stimulate awareness and action against the major stressors that weaken our Apaches to substance-dependent lifestyles, 2) nurture a sense of Apache identity to shift negative community norms towards sober, healthy lifestyles, and 3) publicize all programs and resources in the Healthy Nations network.
  2. Prevention: In the schools, we are gradually phasing in a Headstart through 12th grade culturally specific prevention curriculum. We will offer students peer counseling training; a parallel training program will be implemented for teachers. In the community, we are introducing an array of recreational alternatives for youth and families, including wilderness retreats, environmental restoration projects, and classes in fitness, video production, and Apache language, arts and culture.
  3. Early Identification: We are designing and piloting a computerized Healthy Nations Health Information System linking all agencies with contact or input into substance-abuse related issues. Its purpose is to strengthen referrals and facilitate continuous case management over stages of early identification, treatment and aftercare. In addition, adventure-based counseling alternatives will be offered to youth identified as high-risk, combining counseling modalities with physical, social, cultural and spiritual activities.
  4. Treatment: A centrally located Rainbow Center for treatment is being opened, designed to accommodate a new family-based approach to recovery. Increased numbers of outreach counselors and added programs will address the needs of the whole individual, his/her workplace and home environment. Parallel community-based treatment and aftercare options are being expanded, including support groups for women, strength groups for men, and New Directions Personal Development workshops taught by Apache guides in communities across the reservation.

In the year 2000, a Healthier White Mountain Apache Nation we shall be. We honor the Robert Wood Johnson Foundation in their devotion to our vision.

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Host Community/Organization

In earlier days, before white man dominated the culture, Apaches were intensely active people. Their nomadic life, hunting trips and traditional raiding parties demanded exceptional endurance, physical strength, exertion and cunning. Apache runners were legendary, and are remembered for their ability to run for over 13 hours, at a rate of more than 9 miles per hour, (Schwatka, 1974). With the acquisition of the Gadsen strip in 1853, the U.S. government took control of the lands of today’s southern Arizona and New Mexico, although Apaches continued to defend their independence for decades. Struggle ended in the 1880’s with the establishment of the Fort Apache reservation.

The ethnic breakdown of the population today is: 10,000 to 11,000 individuals are enrolled as tribal members. Membership is based on a constitutional requirement for an individual to meet the one-half (1/2) degree or more White Mountain Apache blood quantum to be enrolled. Approximately 2,500 are from other Indian tribes, primarily Navajo, and the remaining 600 residents are non-Indians employed by Indian Health Service or Bureau of Indian Affairs as health care providers, administrators, or teachers.

The population has been growing at a steady rate of almost three percent per year since 1980. Factors contributing to this increase include a significant decline in infant mortality due to health interventions introduced in the last decade, such as vaccination for the major childhood diseases and treatments for infant diarrhea that were causing pervasive death in the first year of life. In addition, the number of births per year recorded by the Whiteriver IHS Service Unit has increased approximately 61 percent over the last decade. Our current birth rate is roughly 2 1/2 times the U.S. average. Similar to the general U.S. population, the elderly population is living longer due to raised standards for sanitation and housing, better transportation and health care provision.

The White Mountain Apache Reservation is located in north central Arizona in portions of Navajo, Apache and Gila counties. It is 75 miles long and 45 miles wide, encompassing more than 1.6 million acres, with 25 fishing lakes, and at least 420 miles of river and streams.

The reservation has a wide range of topography and climate. The southwestern desert foothills with an elevation of 2,700 feet in the Salt River Canyon contrast sharply with the mountainous pine forests in the northeastern portions of the reservations, where elevations exceed 11,000 feet in the Mt. Baldy area. Whiteriver, the largest population center of the reservation and the seat of the Tribal Government, is located 35 miles southeast of Show Low, 95 miles northeast of Globe, and 190 miles northeast of Phoenix. At an elevation of 5,300 feet, Whiteriver enjoys a moderate four season climate.

The towns of Pinetop/Lakeside and Show Low are the nearest off-reservation communities from Whiteriver. Historically little social interaction existed between tribal members and off-reservation communities. Our members traveled up the hill to shop for clothing, dry goods, groceries and durable goods. Residents of Show Low and Pinetop are among the annual influx of tourists to the reservation who take advantage of the hunting, fishing, hiking or skiing area. BIA, IHS, Public School and Tribal employees who work on the reservation and live up the hill are bridging the gap between our community and theirs. Interestingly, alcohol and substance abuse support groups in both communities are serving to foster interaction. AA meetings in Show Low attract tribal members, while co-counseling sessions at St. Francis Church in Whiteriver and culturally integrative AA meetings at the Rainbow Treatment Center have begun to attract outlying community members.

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Accomplishments

Strategy 1: Public Awareness Campaign

The campaign entailed developing, producing and coordinating a mass media campaign via submission of articles, public service radio announcements, brochures, pamphlets, etc., on the harm caused by substance abuse for the entire reservation community.

Upon completion of Phase I, the media cluster group received a grant entitled “Healthy Nations, N'dee Benadesh: the People's Vision”, primarily focusing on a mass media campaign designed, developed and produced by community members. The grant allowed the program to increase its activities, hire additional staff and focus on development of mass media campaign. Some of the productions included local radio station public service announcements on spending time with your children. Billboard signs proved to be the most effective method of sending messages to community members. Additionally, televisions were displayed at prominent locations on the reservation including the grocery store, convenience store, post office and health clinics. At these locations, individuals watched videos written and produced by staff members who are Apaches. The first round of campaigns focused on parenting and spending time with your children. The second round of the campaign was on targeting the bootlegging and drug dealing on the reservation. The final round was on prevention of drug and alcohol abuse.
The cluster groups and staff members coordinated all mass media campaigns through the local radio station KNNB, which aired the anti-drug abuse public service announcements periodically throughout the year including new years eve, graduation night, prom night, holidays and tribal holidays as well as promotion of Healthy Nations events. Sobriety checkpoints in collaboration with the Whiteriver Police department and distribution of "don't drink and drive" flyers were handed out at the drive through window at the local liquor store located on the reservation. The youth cluster public service announcement that promotes a substance free lifestyle was aired throughout the year. The Shi'Kii' Apache Relatives Project distributed positive parenting educational material in the community. The tobacco prevention education project distributed educational material in the community. An educational booth was set up at the fair to target youth on anti-drug abuse messages, and over 30,000 people during the fair visited the booth. The Men's cluster designed and produced a brochure entitled “Apache Brotherhood” and used its content during presentations in the school and community.

Staff conducted the public awareness campaign through forty-four weekly adult shows and forty-four teen talk shows for a total of eighty-eight shows each year of the six years. Guest hosts of the show included the Rainbow Center, Healthy Nation's staff and cluster group members, the tobacco prevention education program, the Behavioral Health Center, Social Services and Tribal Health Authority programs. The talk shows provided an avenue to educate, bring awareness and update community members on all Healthy Nations events. Often times, the radio station did live remote broadcasts for events including the conferences and workshops. The Radio Talk show for youth and adults was a success due to reaching a wide variety of individuals. Adults talked about listening to the Youth talk show that featured local students and their own show. The open dialogue between the participants and guest created and nurtured the need to establish lines of communication with community people in the area of substance abuse awareness. The adult show provided numerous opportunities for local community members to express their concerns and views on a variety of topics.
Staff produced seventeen bi-monthly youth page in the Fort Apache Scout for three years, for a total of sixty pages. Each page typically contained information on substance abuse issues, self- esteem building and other positive pertinent information on Apache youth and their views on drugs and alcohol abuse on the reservation. Staff produced nine monthly newsletters to promote monthly themes. Each newsletter contained eight pages focusing on the themes of Healthy Nations, wellness issues, upcoming events, activity reports and facts on substance abuse. The newsletter had a circulation of 1000 each month and was distributed to the outlying communities, tribal programs and local schools.

Healthy Nations logo was designed during phase I and used during the life of the program. The materials designed, coordinated and implemented for use with the public awareness campaign featured the logo. The materials were an integral component in success of the awareness campaign.

The Healthy Nations program was visible at many community functions including health fairs, youth events, tournaments and conferences. A display was designed that featured the logo, photos, and newspaper articles related to the program, and was set up at various community events. The staff participated in the Tribal Fair & Rodeo exhibit booth for six years, with visitors to the booth exceeding 50,000 each year. Drug free youth party for parents and youth was sponsored, as well as an elderly get together to honor elders in the community. An outdoor horseshoe tournament for men was also sponsored.

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Strategy 2: Community-Wide Prevention

The prevention aspect of the grant entailed a wide variety of projects and programs by staff and cluster groups targeting community members.

With assistance of community and cluster members, seven men's conferences were held in Whiteriver, ten women's conferences in Whiteriver and two in Cibecue, six youth conferences in Whiteriver, and four parenting conferences in Whiteriver. An average of 1000 participants attended each conference annually.

Staff and cluster groups provided substance abuse prevention education, by means of cluster members speaking to the audience, by showing videos on alcohol/drug abuse and other educational material, at the nine schools and seventeen outlying communities for a total of forty educational sessions. The target population was youth and young adults, and service providers.

The Men's Cluster Group actively conducted presentations to Elementary, Middle and High School students at local reservation schools on an annual basis, with over 150 presentations completed and over 6,000 students and community members.

Topics covered the importance of being substance-free, the importance of education, and being proud to be a drug free Apache. Presentations were given at Whiteriver Elementary, Cradleboard Elementary, Seven Mile Elementary, Whiteriver Middle school, East Fork High School, John F. Kennedy school and AHS. The men who participated were college graduates, fathers, single fathers, and tribal employees, among others.

The Natural Helpers Peer Counseling and training Retreat was conducted for a combination of middle school and high school age youth for a total of 150 youth and twenty adults sponsors or volunteers. Upon completion of the training, students were able to provide one-on-one help in identifying assistance in the community and schools.

Twelve cluster groups provided monthly forums on substance abuse prevention and education for two hundred community members at community meetings or centers annually. Each cluster group was given the opportunity to address a topic specific to their group.For example, the men's group concentrated on pertinent issues such as the historical and contemporary role of the Apache men in the family, history of Apache Warriors, and the role of Apache adolescent males in the community, both historical and present. Eventually, the men’s cluster group forums continued through the entire grant period due to its popularity in the community and demand by the schools.

The cluster groups provided community and school presentations, for one to two hours, two times a month, for nine months, to promote a drug-free lifestyle, each year. Annually, forty-three presentations were completed at various schools and events held in the community including Whiteriver middle school, Whiteriver elementary school, Cradleboard, and Whiteriver Skill Center's GED program with over 1500 individuals. Other presentations provided focused on the importance of maintaining a drug-free environment by setting goals, and coming together as a community to work together to attain them.

The Parenting cluster group was identified as a potential grantee for a program in latter part of Phase 1. A submission of a grant entitled “Shi'kii' Apache Relatives" was awarded to the Parent Cluster. Staff was hired to oversee the development and growth of parenting classes on the reservation. Parent cluster groups conducted four ten-week parenting training sessions at six locations on the reservation for young parents, parents of adolescents, and court ordered parents. The Shi'kii' Apache Relatives Project through the Parent Cluster has managed the Nurturing Classes being held weekly in the communities of Whiteriver, Cibecue, and McNary, reaching individuals in high numbers. Additionally, ropes course sessions conducted for parenting classes involving intense hands-on training focusing on trust, communication, and cooperation, and how they apply to parenting skills. During the latter part of the grant period, the Social Services program of the Tribe agreed to manage and direct the program.

During the early part of the program, positive alternatives to drug and alcohol abuse was reviewed. One successful program was the overnight whitewater rafting for ten individuals ages twelve to thirty years of age. The groups went on field trips to the Salt River for white water rafting, spent the night along the river and continued their journey. At each trip, an elder and adults entertained and provided therapeutic sessions. Many of the youth were identified as high risk by local schools and behavioral health center.

The overnight campouts at the ropes course was integral part of reaching troubled youth. The campout included ropes course elements and initiatives, night games, campfire activities, and a hike to Blue Lake. Each session focused on healthy outdoor activities, teamwork, and abstinence from drugs and alcobol for close to two hundred participants.

A very popular and demanding program was an intensive ropes course for local schools and community members focusing on youth from ages nine to eighteen. An average of fifteen participants attended each session for a total of 10,000 participants during the life of the ropes course. Designed to provide opportunities for hands-on learning, overcome challenges and fears, learn teamwork and focus on inner strengths, the ropes course has been a valuable asset to the program.

During the winter months. due to requests for training for both school staff and students, an indoor ropes course presentation of alternatives to substance abuse was designed and implemented in the nine schools. These sessions included indoor therapeutic hands-on experiences and initiatives featuring the ropes course. The Ropes Course indoor activities concentrated on physical wellness, team building and giving the child a sense of accomplishments in certain games or elements. Approximately, two thousand community members participated in these indoor activities.

Environmental half day hikes were conducted with five hundred youth, both female and male, age ten to fourteen in each group, to discover and learn about native plants, the importance of maintaining a healthy ecosystem and a healthy lifestyle. The youth were selected based on personal interest by signing up or by referral systems at the schools or courts. The hikes proved to be beneficial for youth who otherwise would not have had an opportunity to explore the outdoors and participate in therapeutic sessions.

The Tribal Council, Whiteriver School District, 21st Century Afterschool Program, Johns Hopkins University, Tribal Health Authority and Healthy Nations sponsored the “Native Visions” sports camp which brought over 700 people, youth and parents, to Whiteriver. The educational program, both athletic and academic from professors and professional athletes, aimed at increasing a diverse experience and challenged youth in sports.

The Adventures team provided hundreds of sessions of outdoor training for thousands of tribal members, focusing on the facilitation of team-building activities in an outdoor setting and applying education in alcohol and drug prevention with all group sessions.

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Strategy 3: Early Identification, Intervention and Referral

The goal of intervention and early identification efforts included a wide variety of clientele from court ordered parents, juvenile offenders, service providers and adult members of the community.

Parent Trainers conducted ten weekly parenting education sessions per referral to twelve first time offenders. 348 parents participated during this project. The tribal court referred parents for neglect, child abuse or battery. The parenting education sessions focused on healthy family structure including cultural values in child-rearing and family unity.

Training was conducted with presentations on substance abuse and early identification for service providers and community members. The speakers targeted service providers that work directly with alcoholic clients or children affected by alcoholism or drug abuse. The presentations have been provided to the Whiteriver Police Department, Social Services, Health Authority Programs, Headstart, Hon Dab Casino, Museum, Tourism office, School District personnel, Alchesay High School, Northland Pioneer College, and the Rainbow Center with over six hundred participants.

Staff conducted early identification and intervention training, with the primary focus on various illegaJ drugs and its effect on body, mind, and spirit, and specifically targeting parents who gained knowledge on identifying early on the use and abuse of drugs. The drug paraphernalia as often used by youth and young adults provided insight to parents who were unaware. Parents and staff participated when the Healthy Nations made use of the DWEYE goggles at the session for Whiteriver Police Department. Topics included levels of intoxication, self esteem problems related to substance abuse, labeling, sensitivity and follow up procedures when making referrals. The response from the officers was overwhelming. They informed our staff that they were able to understand why offenders behave the way they do and they were able to learn new ways in dealing with them. Upon completion of the Walk Against Drug dealers and bootleggers, the local school showed a reduction in juvenile and liquor violations. The Tribal Council and government have taken a strong stand against drug and alcohol abuse and supported prevention education in the community .The community were exposed to positive alternatives to drug and alcohol abuse in the community causing change of attitudes and behaviors.

Conducted training to one of the largest employers on the reservation to identify problems associated with substance users and to educate these employers about the referral process to the Rainbow Center or other treatment facilities. Two parent advisory committee meetings at Cradleboard Elementary and at Whiteriver Middle School benefited from the substance abuse awareness presentations held at each school. Another presentation was completed with Rainbow Center, Healthy Nations and Health Authority sponsoring the event, with 100 participants attending.

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Strategy 4: Substance Abuse Treatment and Relapse Prevention

The goal of treatment/aftercare included both inpatient and outpatient adults at Rainbow Center, referral to off reservation sites and field trips.

The Healthy Nations staff members provided support by allocating airtime during the Healthy Nations talk show twice monthly to recruit adults for treatment. The staff designed, developed and produced educational material for use by Rainbow Center staff. The talk shows supplemented the Whiteriver Rainbow Center’s treatment and aftercare program by educating the community about substance abuse programs at Rainbow Treatment Center. Adolescent referrals for in-patient treatment to outside treatment centers each year proved to be a necessity for some who are at high risk. These programs will be sustained beyond the Healthy Nations funding.

Healthy Nations sponsored local church members to participate in weekly alcohol education classes in Whiteriver and Cibecue. Additionally, all Healthy Nations events or projects included staff members and in-patients of the Rainbow Treatment Center as participants or coordinators, such as Healthy Relationship workshops, community conferences or field trips. Many individuals and families have benefited from these sessions.

Ropes course sessions were an integral part of the client recovery program at the Whiteriver Rainbow Center. At each session, there has been tremendous response from clients who are dependent on drugs or alcohol. These clients have had low self-esteem and little confidence, and by participating in the ropes course, they gain confidence and take pride in their accomplishments. Over five hundred individuals participated during this program.

Alternative activities such as beading, cradleboard making, burden basketmaking, bow and arrow making or other cultural arts, were provided for recovering men or women in conjunction with formal alcohol treatment outpatient program at the Rainbow Center.

All clients of the Whiteriver Rainbow Center participated in the annual field trips, which incorporated the cultural aspects including recognizing the significance of beads left on Mt. Baldy, the correct and proper ways of traversing upon sacred Apache sites, what materials are necessary in the making of Apache cultural items, the types of plants necessary for the making of burden baskets, and hands-on demonstrations about making these items. The Rainbow Center has incorporated this objective into their weekly alcohol education classes held in Whiteriver and Cibecue, as well as evening activities.

Healthy Nations sponsored field trips each year to sacred locations on the White Mountain Apache Reservation. Mt. Baldy, which is one of our sacred mountains on the reservation, was one of these trips. The sacred Salt Banks located in the Salt River Canyon and Pumpkin Lake field trip were significant events for individuals who visited these places for the first time in their lives.

Ongoing weekly AA Meetings are held at various locations on the White Mountain Apache Reservation in Whiteriver and Cibecue. Daily sessions are held at the Whiteriver Rainbow Center as well as three evening sessions that also included a Narcotics Anonymous group. Community members were invited to speak on their personal sobriety journey at these sessions.

All clients of the Rainbow Center participated in a majority of the events sponsored by Healthy Nations including field trips, conferences, workshops, cultural activities, health fairs, and youth alternative activities.

Many, many people have been touched by Healthy Nations in its entirety. The personal stories of hundreds and hundreds of people cannot be written. They have stories to tell about their personal experience: in the wilderness with the rafting trips; sharing stories at women’s support groups and conferences; leaming about drug and alcohol abuse at training sessions that enable them to do their work more effectively; how basketball is teaching them a new level of the game - both on and off the court; what a boost in confidence they have as a result of riding the zip line at the ropes course; walking against drug-dealers and bootleggers with young and old alike; speaking on the radio; hearing public service announcements on the radio in their native language; learning about their culture; words and feelings that cannot describe individuals who are empowered to make change in their life.

The commitment and dedication of funds, staff support, administrative support has gone above and beyond its expectations. Change is inevitable. How a community deals and reacts to change determines its outcome. We are once again faced with a high rate of suicide, and the same problems remain, but our community has grown, learned and fostered itself to bring on healthy change. We are optimistic about the future of our people. Because of the Robert Wood Johnson Foundation and the direction and guidance of the National Program Office, we are facing a promising and hopeful future.

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Contact

White Mountain Apache Tribe of the Fort Apache Indian Reservation

 

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