The Chemawa Indian School
Transcending institutionalized racism and working for the future
The Chemawa Indian Health Center was established in 1979, but next door is the Chemawa Indian School, established in 1880 and the oldest continuously operating Native American boarding school in the United States.
My first day with the Indian Health Service was the start of a two week duty period at Chemawa in May a year ago when I took this photo. I had retired from twenty years of suburban private practice to join the IHS.
At the time of its founding by the Bureau of Indian Affairs (which was part of the Department of the Interior), Chemawa was based on the flawed theories of Brigadier General Richard Henry Pratt who believed that Americanizing the Native Americans was the only way they could be proper citizens. Boarding schools like Chemawa were established to remove children from reservations and strip them of their culture. Make no mistake, it was institutionalized cultural genocide. Students were punished for using their native languages or customs.
The federal government’s prior philosophy was that no amount of education could “civilize” Native Americans.
The school’s first location was in Forest Grove west of Portland, but in 1885, the school was moved to its present location in Salem. Peak enrollment was in 1926 with nearly a thousand students.
The new campus was built at the same time the adjacent Indian Health Center was established in 1979. The old campus buildings were razed and all that remains of the old campus is the Chemawa Cemetery immediately to the west of the current school and health center. There are approximately 425 students at the Chemawa Indian School.
In 2016, Marsha Small, a graduate student from Montana State University, used ground penetrating radar to survey the site of the original school and discovered hundreds of unmarked graves despite there are only 200 marked graves in the cemetery.
In the first half of the 20th Century, infectious diseases like influenza, tuberculosis, and pneumonia exacted a tragic toll on boarding school students. Her research work was published in her thesis “A Voice for the Children of Chemawa Cemetery”. For the Native American community, they are the students who never came home.
The Native American cultural revival movement postwar and increased activism in the 1970s led to a shift in philosophy at schools like Chemawa to tribal recognition, self-determination and education, casting aside generations’ worth of a policy of assimilation. However, many Native Americans for good reason are still distrustful of the Bureau of Indian Affairs.
It wasn’t until 1921 with the passage of the Snyder Act that health care was provided to Native Americans under federal oversight. The Indian Health Service was established in 1955 and it was followed by the Indian Facilities Act of 1957 which provided for construction of community clinics and hospitals and the Indian Sanitation and Facilities Act of 1959.
When the IHS was established, the Transfer Act moved the responsibility of Native American health care from the BIA/Department of the Interior to the Department of Health and Human Services and the US Public Health Service.
But it wasn’t until the 1976 Indian Health Care Improvement Act that serious funding came through for the IHS and it was that funding that was used to build Chemawa Indian Health Center where I have done two duty periods so far and am looking forward to returning to help them out this summer.
Believe it or not, it wasn’t until the Affordable Care Act of 2010 that funding for the Indian Health Service was formally authorized in perpetuity. Previously, each year, the IHS was vulnerable to defunding; the Trump Administration attempted to defund the Indian Health Service in 2018. When foes of the ACA talk about repealing it, I cannot even begin to express how catastrophic that will be to the Indian Health Service and the many patients we treat. For many Native Americans, the IHS is their only source of health care access.
The historical legacy of the Bureau of Indian Affairs and the Indian Health Service is checkered at best with generations of institutional racism to be remedied and there is still much work to do.
When I was considering joining the IHS, I asked an fellow family medicine physician who went from private practice to the VA that “despite the issues of the VA, why did you do it?” He told me “there’s something about being the one person who can change the face of the VA for that one patient.”
During one of my duty periods at Chemawa last summer, we had a meeting and the CEO of the Chemawa clinic told all of us “With all that is going on in the news now, let’s not forget that we can be an example to everyone else on how to grow past a negative historical legacy and work daily to shed institutionalized racism.”