Across the street from the site of the former Phoenix Indian School – one of hundreds of government-funded facilities focused on forcibly “assimilating” Native American children in the 19th through mid-20th centuries – stands the Central facility of Native Health.

That’s not a coincidence. “We’ve all traditionally lived north of McDowell [a Phoenix neighborhood], up to the Indian school,” explained Walter Murillo, a member of the Choctaw people and Native Health’s CEO, of the area’s Native American communities. “There are pockets of communities of American Indians within the valley…That’s why we have our centers there, and that’s why we have our services there.”

Native Health is an Urban Indian Health Program, a private, nonprofit agency that receives partial funding from the Indian Health Service. The organization provides a vast array of healthcare services, social support, and community health and wellness programs, through four healthcare facilities and a mobile medical unit, to members of approximately 300 U.S. Federally Recognized Tribes living in the Phoenix Metro area.

“We understand each other and we know each other,” Murillo said of Native Health’s essential role in local Native American life. The health center features an Elder Talking Circle and Community Talking Circle, both led by a local traditionalist; cooking classes featuring Native American recipes; a healthy-living and activity program for Native children called Wellness Warriors; a Traditional Garden, which employs traditional Southwest tribal irrigation and agricultural techniques.

Kimberly Dutcher, an advisor to Direct Relief on governmental affairs and Native American health, is Diné and serves on Native Health’s board. She explained that the health center provides an essential source of both culturally appropriate care and community engagement for the Phoenix area’s Native American population.

“A lot of the time, when we leave the reservation, there’s a loss of community, there’s a loss of social ties,” Dutcher explained. Growing up on a reservation, her own health care came from the Indian Health Service, and she said health services designed with tribal communities in mind offer an important benefit: “They understand me and my background more. I don’t have to explain.”

But while Native American health and cultural needs are an essential priority, Native Health is also a Federally Qualified Health Center and an Urban Indian Health Program whose range of programs – from health, behavioral health, and dental care to healthy cooking, a family literacy and cooking program, emergency assistance, and much more – are available to anyone.

“Every service we offer is eligible to every person who walks through our door,” Murillo explained of the dual designation. “We knew that when a person walked in the door seeking services, we couldn’t make them eligible for some services and not for others.”

“Needs and wants”

Each of Native Health’s array of programs was a direct response to community needs, explained program manager Susan Levy. For example, the Central site is a designated National Voter Registration Act site – the first at an Indian Health Service facility and the first in Arizona. Every person accessing medical, dental, or behavioral health services is asked if they would like to register to vote.

Indigenous civic engagement is an essential rights issue – Arizona was one of the last states to allow its Native citizens the right to vote, and voting access remains an issue for Native communities, said Levy. Large civic engagement events began when she noticed that young interns from Arizona State University, who volunteered in Native Health reception areas, weren’t interested in voting. Native Health staff and volunteers have worked to increase civic engagement through programs like Frybread for the Future, which registered eligible community members to vote and explained the importance of the Native vote.

That responsiveness is key to earning trust in an area where many feel wary of large systems, Murillo said: “We keep our word, we do things in the community, and we offer things that the community needs and wants.” Native Health’s staff work with patients to prevent health and dental issues; help them manage copays and deductibles; and offer health care to patients regardless of insurance status or ability to pay.

The health center’s extensive food support options – they work with local food banks and government programs, but also purchase food to distribute to people experiencing a financial emergency; supplement patients’ diets with produce and other nutritious food; and feed children while school is out over the summer – are a perfect example of meeting those needs and wants.

“People in waiting rooms told us in surveys they were hungry,” Murillo explained. Staff members asked the question they so often do when learning about a community need: “What are we going to do about that?”

Native Health is in the process of adding chiropractic treatments, and financial and legal assistance, to its roster, responding to growing local demand.

Levy is proud of the holistic way Native Health often helps patients, who may be drawn to the health center when searching for healthcare or looking for a healthy cooking class, but who end up benefiting from many of the services on offer. She recalled doing outreach at a nearby federal prison, then receiving a call from a woman who’d been newly released a few weeks later.

The woman began receiving medical, dental, behavioral health care, and support services at Native Health. Through the health center’s partnerships, she trained as a truck driver and found employment, leased an apartment, and received legal assistance. She reunited with her daughter and began helping with childcare for other family members.

“She really wanted to turn her life around,” Levy said. “Look what she did, and look what Native Health did for her.”

Not all interventions bring an uplifting story. In 2023, the public became aware of a massive fraud and trafficking scheme focused on Native American people in Arizona. Sham treatment programs for substance use disorders had recruited thousands of Native people – some of whom needed treatment for substance use disorders, some of whom didn’t have disorders and thought they were just moving to new housing, Levy explained – into “sober living” facilities for years. More than 40 Native people died in these facilities, and many others described being held against their will, often without care or even basic necessities like food and toilet paper.

Because the object of the scheme was to fraudulently collect insurance payments, the crisis launched a government investigation and crackdown that has made much-needed care less accessible to Arizona’s Native communities.

Levy recalled widespread need during and after the crisis, beginning with a phone call from a local official who asked Native Health staff to assist members of the White Mountain Apache tribe who’d been sequestered at a hotel. Staff members helped people who’d been trafficked find new treatment centers and housing; booked bus and plane tickets for those who wanted to return home; and provided healthcare and other services to those who remained in the area.

“We had so many victims in our offices every day, and we are still seeing them,” Levy said.

“Their Names, Their Stories, Their Families”

Cultural connection and nutrition are often a community member’s first link to the health center, said Britney Joe, Native Health’s community health and wellness director.

Joe began her Native Health career on the medical side but transitioned to working on Native American youth programs a few years ago, focusing on mental health awareness, suicide prevention, and cultural connectedness. “I was able to get more creative, use my cultural knowledge,” said Joe, who is Diné, of the transition.

Community volunteers may decide to get involved when they pass by the Traditional Garden, which uses a variety of Indigenous agricultural methods, such as the Three Sisters planting technique of combining squash, corn, and beans. Approximately 300 community volunteers work in the traditional garden, which covers about an acre, Murillo said.

A family that comes in for cooking and literacy classes may need a connection to a medical or mental health provider. They may also benefit from access to WIC, the federal nutrition assistance program for women, infants, and children that, at Native Health, is supported by the Inter Tribal Council of Arizona and available to all who qualify. Their WIC program currently supports about 1,400 families each month.

“We get to know their names, their stories, their families,” Joe said.

In Joe’s experience, many people like learning about essential health topics – such as maintaining good mental health, preventing suicide, and cooking healthy meals – in a larger context of Indigenous culture and practice.

A program focused on Native American painting offers a valuable opportunity to talk about art’s role in building mental health. A cooking class focused on healthy winter soups might incorporate traditional stories of winter from tribal nations. The diabetes prevention camp for children doesn’t just teach prevention techniques – it also helps get kids out of the city during the heat of an urban summer, and gives them the space to play outdoors and connect to nature.

“Just the Right Time”

Native Health is a long-term partner of Direct Relief’s, and has employed cold-chain storage equipment, vaccines, and personal protective equipment from the organization into its diabetes prevention camp and healthcare services.

Now, a new Direct Relief Power for Health award for over $950,000 will outfit Native Health’s Mesa facility with a resilient solar power and battery system that will protect and support the care they provide. The Phoenix area is highly vulnerable to extreme heat, interruptions to the power grid that can cause rolling brownouts, and destructive monsoons.

“They’re violent storms in Arizona that move through quickly, but they can do tremendous amounts of damage,” Levy explained. A storm may pass through in a matter of minutes, but the damage to local power systems can leave a patient stranded in a dental chair mid-procedure or destroy vaccines and insulins quickly in heat as high as 120 degrees Fahrenheit.

“If your grid goes down or your line goes down, [a resilient power system] is what’s going to save tens of thousands of dollars of vaccines,” Levy said.

Extreme heat, dust, and wind storms, and monsoons have become ever more serious concerns for the area’s health resilience, Murillo said: “Power for Health came along at just the right time for us.”