When Wendy Ross gashed her thumb opening a can at work recently, she had someone drive her the 10 miles from her job in Commerce to the American Indian Clinic in Compton.
Ross, a member of the Sisseton-Whapeton Sioux tribe, said she did this because she is comfortable at the clinic, which offers free and immediate service to American Indians.
The nonprofit clinic is meant for Indians like Ross, who may not have insurance or who may simply prefer medical treatment specifically for them.
The clinic is the only one for Indians in Los Angeles County, Director Joan Freeman said. There are about 12,000 American Indians living in the Southeast and Long Beach areas, the largest concentration of the estimated 70,000 Indians in the county, according to the Southern California Indian Center in Garden Grove.
Treatment is free for American Indians, but the clinic also serves patients of other ethnic groups for a nominal fee. The clinic served approximately 10,000 to 12,000 patients last year.
In December the clinic, which has been in Compton for 20 years, is moving to a larger, two-story building in Bellflower because of a need for more space and the desire to have more programs.
The clinic's dental and Saturday programs have both been increased substantially to serve the increasing number of patients, Freeman said. Saturday service was doubled in the past year, and dental service was increased by 15%.
Indians gravitate to the clinic because they do not trust the county system of clinics and hospitals, Freeman said. There are several reasons for this. Many Indians are new to the area from their reservations and do not know how to use the county system, complete the medical forms, or endure the five- to six-hour waits, Freeman added.
To smooth the transition from rural to urban life, the clinic tries to make the process of getting health care as painless as possible. Patients walk in, fill out a one-page authorization form and are treated almost immediately.
This is different from the county system, which asks for evidence of income, residency, insurance coverage and family member information, Freeman said, adding that many Indians are uncomfortable answering those questions.
If the clinic did not exist, many American Indians in the area would do without health care rather than use the county system, Freeman added.
Indians are especially distrustful of long forms because of their people's history of signing land away without realizing it. Freeman, a member of the Seminole tribe, remembered her grandmother's advice to her: "(My grandmother) said: 'Don't sign anything because you are going to give something away.' " Even today this fear causes Indians to be "reluctant to seek services," she added.
On reservations, the local clinic or hospital was part of the community, and Indians grew up knowing exactly where to obtain treatment, Freeman said. "It is information almost all Indians know," she added.
This shared knowledge is no longer available when American Indians move to the cities and disperse. Because Indians in Los Angeles County do not cluster into a special community or barrio, the clinic becomes the source of information, Freeman said.
An Indian staff is also comforting for patients, said Michael Arfften, executive director of the American Indian Health Care Assn. Arfften said a study done in Seattle showed that 90% of the American Indians in that area chose the Indian clinic over a neighborhood free clinic.
About 80% of the Compton clinic's staff is Indian, according to clinic officials.
The American Indian Clinic offers primary walk-in care. Although California has the largest Indian population of any state, the nearest Indian hospital is in Phoenix, Ariz. Consequently, the staff refers those patients who need surgery or X-rays to local health facilities and fills out the forms for them beforehand, Freeman said.
The clinic provides medical, dental and prenatal care, family planning and two residential alcohol programs, one in Compton and the other in Long Beach.
Freeman said that alcoholism is the leading cause of death among American Indians. The clinic also reports a high incidence of diabetes, hypertension and kidney problems.
Freeman said she would someday like to see the clinic offer health programs using traditional medicine men and a holistic approach that is not found elsewhere in the county.
This is especially important with alcoholism, which often is linked to emotional stress. "Alcoholism has got to stem from someplace else. That's the reason we need a very good mental health program," Freeman said.
An additional long-term goal is instituting a breast and cervical cancer screening program.
The staff publicizes the clinic through public service announcements and at weekend powwows, churches and ballgames, said Corine Tanon, health educator at the clinic.
The American Indian Clinic is partly funded by the Indian Health Service, a bureau of the U.S. Public Health Service. There are 36 urban Indian clinics in the country and eight in California. Other funding comes from the state and county governments.