Sometimes, making a difference in rural health means understanding how to reach your community.
Community Star Messengers of Health, in Boseman, Montana, works with members of the Crow tribe across the state to encourage cancer screenings in women. Getting Crow women to schedule mammograms and PAP smears took years of work to build trust, not only in the organization but also in the healthcare system, said Alma McCormick, Messengers for Health’s executive director.
For McCormick, growing up Crow and dealing with cancer, helped her to communicate with other Crow women about how important screenings are.
Messengers for Health started some 20 years ago, McCormick said, when a professor from Montana State University reached out about a possible community-based study to address cervical cancer awareness and prevention amongst Native American women. Together, the two women were able to create a program, funded by the American Cancer Association, that would overcome cultural biases against cancer screenings.
Those biases are rooted deep in the Crow people, McCormick said, where many believe that the Crow are a chosen people, protected by God. That belief leaves illnesses like cancer a topic that just isn’t discussed.
“We had to overcome very strong cultural taboos,” she said. “The Crow believe that our words are sacred and powerful. We can either speak life or we can speak death. So, the belief is that when we speak something we could bring that upon ourselves. Therefore, we did not use the word cancer. There wasn’t even a Crow word for it.”
Before they could even begin to discuss with Crow women the importance of screenings, they had to help people to talk about cancer and understand it is treatable.
“Even as a young girl, I would hear adults speaking in the Crow language about an individual that has that dreadful and awful disease,” she said. “I knew immediately they were talking about cancer, and I knew that this person was going to die. That was our attitude. It was a dreadful, awful disease, and when you ended up with the disease there was no hope for you.”
Years of mistreatment by the Indian Health System also led many Crow women to distrust the healthcare providers. A lack of privacy and a lack of respect left Crow women feeling that the system couldn’t be trusted. McCormick had to rebuild those bridges if she wanted to help Crow women understand how necessary screenings were.
Over time, Crow women began to listen to her, she said. Not only did she speak their language, but she spoke from experience. In the 1980s, McCormick gave birth to twins – a boy and a girl. Just a few days short of their first birthday, her daughter was diagnosed with cancer and given nine months to a year to live. Although treatments worked for a while, she said, ultimately her daughter succumbed to cancer.
Her daughter’s cancer diagnosis and treatment forced her to seek support from her community to get through the crisis. And her daughter’s death left her with a desire to help others battle cancer.
After years working in oncology as a social worker, her association with Christopher allowed her to reach women in her community to talk about the diseases they previously never talked about. Eventually, she formed their group into the non-profit, Messengers for Health. Currently, the organization advocates for healthcare screenings via one-on-one contact, as well as through Facebook posts and videos both in English and in the Crow language as well.
No longer focused solely on women, the group is talking about cancer with men and younger girls as well.
“We were hitting the schools because that’s something Crow women from the community, once they realized the risk factors of cervical cancer had a lot to do with sexual behavior and having sex at a young age, they said ‘You guys should be going to the schools,'” she said.
McCormick said Messengers for Health is currently working with researchers on a study about chronic illnesses in the Crow community and is continuing its work to address disparities in care for Native Americans. Recently the organization worked with the Montana Office of Rural Health to modify its Community Health Worker curriculum to better respond to the American Indian population, Montana’s most significant minority.