Editor's note: This excerpt was lifted from a story originally published in NIMHD News, an online publication of the National Institute on Minority Health and Health Disparities.
When her young daughter died of the rare cancer neuroblastoma, Alma McCormick, M.A., wanted to channel her pain and experience toward helping others. She started working with a small project, encouraging other women in the Apsáalooke (Crow) Nation to get screened for cancer.
Through this work, she met Suzanne Held, Ph.D., a researcher from Montana State University. That meeting in 1996 sparked a longstanding community/academic partnership to address health disparities in the Crow Nation. Their initial project helped destigmatize discussions on cancer and increased cancer screenings among Crow women. It was so successful that the pair founded the nonprofit organization Messengers for Health to continue providing and expanding their services.
Messengers for Health originally started with a focus on cancer screening. Why did you expand to include chronic disease?
Around 2015, Suzanne said she’d like to do research with us again, but on whatever we felt we would like to address. She never said, “Well, I see there’s a high rate of diabetes,” although she is well aware of the issues of our community. She came and had an open discussion with our board. Our board decided on trying to improve self-care. Many of our people have diabetes or are dealing with several conditions, like chronic pain, and are struggling to manage them. They struggle to change their diet; they struggle to exercise.
How did you determine how you would help people manage their chronic illness?
I interviewed 20 people who have a chronic condition and were either Crow Indian or married to a Crow Indian. I asked them a big, open-ended question: “Could you share with me about your health from the time you were young until now?” And they just shared.
Then I asked about historical trauma and current trauma. I always say we opened up a can of worms. But it was a good can of worms, because really that was the key. From what has happened and has been passed down through the generations, many of our people are struggling today with substance use and other issues.
The introduction of commodities such as canned meat and pasta, brought into our communities because we were living in poverty conditions, was actually not good for us at all. But we had to eat that, and I grew up eating commodities. We also had the wild game, chokecherries, the buffalo berries, and pheasants, too. The implications of commodities, along with just modern society with the fast food and processed foods, has been detrimental to our health.
That was all brought out as people shared their stories. It was emotional. These people shed tears. And I shed tears with them.
After you listened to the stories, you had to design a program to help people with their health problems. What kind of program did you design?
From our conversations, we knew it was going to take a Crow person with a chronic illness themselves who is managing well and is resilient to talk with others, because in our culture, advice is wisdom. Elders share their experience; that’s how children are nurtured and reared. So we titled this project “Báa nnilah,” which means “go, give advice.”
The mentors bring people together to share words of advice in support groups. They facilitate seven sessions called gatherings held every other week. But the mentor is not taking the lead or doing all the talking. People are growing and learning together.
We recruited and trained five women and five men to be mentors. They recruited 200 people total, who were randomly divided into two groups. The first group started the sessions right away, and the second group waited before starting them.
Read more at NIMHD News
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| Alma McCormick |
Through this work, she met Suzanne Held, Ph.D., a researcher from Montana State University. That meeting in 1996 sparked a longstanding community/academic partnership to address health disparities in the Crow Nation. Their initial project helped destigmatize discussions on cancer and increased cancer screenings among Crow women. It was so successful that the pair founded the nonprofit organization Messengers for Health to continue providing and expanding their services.
Before Messengers for Health, there was no Crow word for cancer and saying this word
outloud was to ask for it to come upon you. Women did not talk with
other women about cancer screenings or share with others – including
family members - when they had a cancer diagnosis. Women received cancer
diagnoses alone, went through treatment alone, and often only at the
end of their life shared their diagnosis. There was a lack of
communication between mother and daughter relationships regarding sex.
It is difficult to convey the strength of these cultural taboos and the
efforts it took for Messengers to break through these barriers. Many
community members shared that the health care providers at the Indian
Health Service could do much better at building positive
patient-provider relationships.
Messengers for Health originally started with a focus on cancer screening. Why did you expand to include chronic disease?
Around 2015, Suzanne said she’d like to do research with us again, but on whatever we felt we would like to address. She never said, “Well, I see there’s a high rate of diabetes,” although she is well aware of the issues of our community. She came and had an open discussion with our board. Our board decided on trying to improve self-care. Many of our people have diabetes or are dealing with several conditions, like chronic pain, and are struggling to manage them. They struggle to change their diet; they struggle to exercise.
How did you determine how you would help people manage their chronic illness?
I interviewed 20 people who have a chronic condition and were either Crow Indian or married to a Crow Indian. I asked them a big, open-ended question: “Could you share with me about your health from the time you were young until now?” And they just shared.
Then I asked about historical trauma and current trauma. I always say we opened up a can of worms. But it was a good can of worms, because really that was the key. From what has happened and has been passed down through the generations, many of our people are struggling today with substance use and other issues.
The introduction of commodities such as canned meat and pasta, brought into our communities because we were living in poverty conditions, was actually not good for us at all. But we had to eat that, and I grew up eating commodities. We also had the wild game, chokecherries, the buffalo berries, and pheasants, too. The implications of commodities, along with just modern society with the fast food and processed foods, has been detrimental to our health.
That was all brought out as people shared their stories. It was emotional. These people shed tears. And I shed tears with them.
 |
| Mentors at the celebration ceremony at the end of the Báa nnilah project. |
After you listened to the stories, you had to design a program to help people with their health problems. What kind of program did you design?
From our conversations, we knew it was going to take a Crow person with a chronic illness themselves who is managing well and is resilient to talk with others, because in our culture, advice is wisdom. Elders share their experience; that’s how children are nurtured and reared. So we titled this project “Báa nnilah,” which means “go, give advice.”
The mentors bring people together to share words of advice in support groups. They facilitate seven sessions called gatherings held every other week. But the mentor is not taking the lead or doing all the talking. People are growing and learning together.
We recruited and trained five women and five men to be mentors. They recruited 200 people total, who were randomly divided into two groups. The first group started the sessions right away, and the second group waited before starting them.
Read more at NIMHD News