"Probably we are not doing enough by just declaring t unsafe," Dr. Werner Janssen, a medical microbiologist from F. Det warned. "Contaminated or infected fish can, of course, infect any the fish directly through wounds or abrasion. But the biggest deg m. Į fish exposed to contaminated water is the possibility that they may actively infected with the human disease-producing organsty a with sewage and spread them to areas thought to be safe" Pollution from untreated sewage not only strangles sh! Potomac and threatens to spread human disease. It also substantia). —use of the river for recreation because of the stench and un Those who want to use the river for boating are beginning to pris vigorously each year against the conditions. Once a promising kkan" sailing and other recreational use of surface water that has berm popular throughout America, the Potomac is rapidly losing its aroun for such sport. Further loss will seriously restrict the opporatie enjoyment of a once beautiful river. While domestic sewage is the greatest factor in the pollution Potomac, other sources also contribute. These include: dumping into the river, soil erosion, pesticides, sewage from ships and por kë tanks of waterfront homeowners. "These problems continue to enst, a resident complained, "because the developers of the land don't conse one moment the results of their development, and the government is f them keep on building and polluting." At an afternoon session, we heard representatives of local citizens • aided by interested scientists, as well as spokesmen for local, tata Federal governmental authorities. For years, residents and public officials have been making recomme tions and plans to clean up the Potomac. A series of Federal Entr Conferences since 1957 has led to some improvements in sewage plants but effective treatment has not been accomplished The Ders Columbia, along with Alexandria and Fairfax County in Virņina, ↳ failed to meet the schedule to improve treatment plants, as set our 2 1957 Federal Enforcement Conference. Spokesmen for citizens. our session demanded clean-up, and particularly assailed the of local government to control land developers. Federal authorizes that local people were putting the sewage into the river and bet government carried responsibility for treatment facilities Spokesma local and state governments, however, called for greater Federal para in financing support of treatment facilities and noted that the Federal g ment is the "big industry" of the Metropolitan area. Since industry is called upon to pay for pollution control, local officials say the Fe government should assume responsibility in large measure for clean the Potomac. This discussion emphasized governmental failure to solve a probier which technical solutions are available, in spite of the fact that his under continuing official consideration for 12 years. "It does seem a sh one observer remarked, "that men can't enjoy, and fish can't be nation's river." indians who leave the reservation great falls, montana "Indian reservations should never be terminated. But Indians -JOHN VANCE, MEMBER INDIAN CLAIMS COMMISSION THE INDIAN WHO HAS LEFT THE RESERVATION is in many ways a forgotten man. He has cast aside the dependent status of a reservation Indian to make his way in a world for which he is basically unprepared. Yet in making this transition, he can expect little, if any, help from the very institutional system which preordained his lack of preparation. Federal programs designed to serve reservation Indians can no longer meet his needs. State and local health and welfare programs, ill-conceived to meet the general needs of the poor, are utterly unequipped to deal with the special problems arising from the Indian's prior dependent status and from his culture and language. Caught in this institutional gap, he may if he is lucky come to eke out a marginal existence off the reservation, but more likely he will return to the reservation where at least he can get the bare necessities of life. We met with off-reservation Indians in Great Falls, Montana, a town of some 60,000 people. About 3,000 are Indians. Situated on the Missouri River just northwest of the center of the State, the town is a satire ? settling place for Indians leaving the seven Montana reservats in the tradition of Great Falls as a home for off-reservation at established over a century ago when the ancestors of many of the present residents came to settle along nearby riverbanks rather to herded onto reservations. Once an Indian leaves the reservation, he becomes inelighe sistence benefits. The Welfare Department of Cascade County, when .... Falls is located, requires a year of residency in the county before an an is eligible for state or county welfare benefits. Thus, for the first y coming from a reservation, an Indian has no access to any welfare at county, state, or Federal, even though it is then that his need may be acute. As the Indians we met knew only too well, "It takes time a job, and it takes longer to have enough money for food and a place si So the Indian must start his new life away from the reservation d. 3 brink of economic disaster. During this initial period off the reservation, an Indian's health care s are supposed to be met by the Indian Health Service (IHS) ac have left the reservation ordinarily remain eligible to receive care at t facilities. But because the IHS was established primarily to serve reservat Indians, almost all of its facilities are located on reservations. From Falls, the nearest reservation is Rocky Boys, which is well over away. To expect people to travel over 100 miles in a non-neg situation is unrealistic. To ask people to travel that far in an emerges situation is inhumane. For many the trip is still longer. One young told us of taking her child to her home reservation, For Bekaan. 17 extensive medical attention, since there would have been no place fr to stay at Rocky Boys while the child was convalescing. Besides, ste friends and relatives at the reservation could take her in. Fort Beca nearly 200 miles from Great Falls; if she had been from Fort Peck ~ ! Northern Cheyenne, she would have had to travel 350 or 400 mile her child could receive care. FOR AN INDIAN IN HIS FIRST YEAR OFF THE RESERVATION, the 5 made some attempt to mitigate the harshness of this situation. It has lished a policy of reimbursing local hospitals or doctors for emergey given an Indian who is less than one year off the reservation. But provided by this policy is largely illusory. According to Emery A M.D., Acting Director of IHS, "Constraints of Federal policy and the tion of resources do not permit the Service to provide them with the hensive health services which are available to Indians on reservations significant improvements have been made in the health status of reserve Indians served by the Indian Health Service since 1955, it is re that many Indians living in urban and non-reservation communices not fully shared in these advances." Thus, if an Indian, newly arrived in Great Falls, receives treatme a local doctor, he may well discover that he is stuck with a bl refuses to pay. Under these circumstances, many Indians choose not t responsibility for a large medical bill and simply do not seek help 1 emergency, others may discover the IHS will not cover their expenses and, as a result, suffer the humiliation and inconvenience of having to leave the local facility and make the long trip to an IHS facility. We met an Indian girl who told of being turned away from the county hospital when she was ready to have her baby. Presumably, the hospital learned the IHS would not cover the costs of the delivery. "They told me that I didn't qualify for welfare and should go back to my reservation." Her baby was born over 100 miles away at the Rocky Boys Reservation. Recent court decisions, however, indicate some relief may come. Similar residency requirements elsewhere have been struck down as unconstitutional. If the Cascade County requirement could be proven invalid, newly arrived Indians would have the same opportunity as older residents to qualify for welfare benefits, and some health care services might then become available under government programs. Long-term residents, too, have serious problems qualifying for welfare assistance. Many cannot meet the arbitrary eligibility requirements promulgated by the County Welfare Department. Others are able to obtain coverage on only a fluctuating basis. Families with able-bodied men, for instance, are able to receive general assistance payments only during the winter months. The county presumes able-bodied men can find at least ranchwork during warm weather months. Consequently, it stops payment during this period. Machines, however, now do much of the ranchwork. Several Indian families, who receive general assistance during the winter, told us of being unable to find ranchworkor any other work—-during the summer. Yet under the County's presumption, they are ineligible to receive general assistance. Those who do qualify for welfare, however, must settle for the health care provided by the County Welfare Department. We met few who relished the thought of having that Department responsible for meeting their health care needs. They saw the County clinic as being understaffed and overcrowded. The care provided, they said, was poor and neglectful. "If I had to go to the County doctor, I just wouldn't go," a 35-year-old Indian mother told us. "I went once because both my baby and I had a fever. When the doctor called my baby a brat, I bit my tongue because I wanted the medicine. Then he just looked at my eyelids and told me I had syphilis. I went home and cried." The next day she was able to scrape together enough money to go to a private doctor. He treated her for an abscessed tonsil, which he removed a few weeks later. EVEN THOSE INDIANS WHO ARE FORTUNATE ENOUGH to get construction work or a job at the Anaconda Company plant are far from secure in their ability to obtain health care. Several who were so employed told of having to declare bankruptcy as a result of medical bills. One Indian obtained employment as a construction worker for $115 a week shortly after leaving the reservation. He hurt his leg, however, and was unable to work for several months. During those months, his wife had a baby. His unpaid medical bills soared to $2,200. “As soon as I started to work, my creditors pounced on me. Without more time to earn some money, I couldn't pay my bills and buy food for my children. But they wouldn't give me more time, so I had to declare bankruptcy." We visited an Indian ghetto called Wire Mill Road, just outside the or limits of Great Falls. The 12 families comprising this small community D on a hill overlooking the smokestacks of a large industrial complex. The st of the hill is used as a junkyard by city residents; year by year the pe junk automobiles and other trash grows bigger and moves closer homes of the Indians. One of the residents of Wire Mill Road is a 53-year-old World We T veteran of the South Pacific. He receives a monthly veterans disability pensot which covers only his rent and utilities. His utilities include a p situated 50 feet from the house near an enclosed cistern which contains the entire water supply for a month. The cistern pump was defective wher were there. For the 500 gallons of water delivered each month, appro the amount used in one day by the average family of four, he pos A waterline runs under the hill, but is controlled by the neighboring mctu complex. Residents of Wire Mill Road are not permitted to use it In the winter, it is nearly impossible for him to remove the garbage, the road to his home is not graveled. On the day of our summer vist garbage had been removed for a week because his only truck nceded repar He does not qualify for general assistance because of his veterans pense Nine years ago, he had a colostomy for cancer of the bowel. He said th had never returned for the second operation, to close the colostomy, because he could not afford the time away from work. Work for this World W veteran is salvaging auto parts from the junkyard on the side of the hill on a good day, he earns about $2. "If I can find junk to sell, then I can feed family. If I can't find any. ... Feeding the family has become more expensive since the wood-burning oven broke down and it became necessary to purchase bread. His fa includes a wife, six children-one of whom is partially blind-and one gran child whose father is in Vietnam. Food stamps are an impossible dream, cannot afford the lump sum payment of $36, the monthly amount reque to purchase stamps for a family his size. We asked his most pressing health problem. "A job," he replied |