Health and the Urban Indian: An Interview with Ralph Forquera

By Miles White
Tribal Connections

TC:  Can you tell me a little about the network of Indian health boards across the country and how they're organized?

RF:  There are thirty-four nonprofit Indian-controlled programs around the country having Indian majority boards of directors and that contract with the Federal Indian Health Service to provide assistance to urban Indians living in those metropolitan areas. The programs go by various names, and each of them provides a variety of different services. Some do provide direct-care services such as we do here at the Seattle Indian Health Board. And others provide primarily information and referral, access kind of assistance to Indian peoples in getting care at other health facilities that are in their area. So they vary quite substantially. The Seattle Indian Health Board is one of the larger organizations. We're also one of the older organizations. We're almost thirty-four years in Seattle here. And we're one of the first urban Indian programs in the country, established in 1970.

TC:  So, is the focus primarily tribal or native?

RF:  Native. Because one of the distinctions that we're continually making is, a lot of the native populations that we work with are not really tribal. I mean, urban Indians are people that have been displaced from their reservation sites, some of them by choice because they've come to the city for jobs and other kinds of things. But many of the people that we work with are products of the relocation and termination period of the 1950s and '60s. And so a lot of them no longer have a real tribal affiliation any more. If they're native people, they come from native backgrounds and a variety of different societies and cultures around the country. And still, many of them carry a lot of their native traditions, actually sometimes even more so than people that are living on the reservations. But, since they're no longer on a reservation the current federal policy is to concentrate most of its effort on Indians that are living on or near Indian reservations, so urban Indians get very little assistance from any source.

One of the biggest challenges that we have is trying to convince the powers that be that there is a population of people that are not being adequately served either by federal officials or by local officials. They're kind of one of those groups confined to the cracks.

You know, in Seattle there's only 33,000 Indian people in King County out of a population of nearly two million. That's not a very significant number of people. So, being able to garner attention, being able to influence resources and bring resources forward to be able to address problems of the population – there's a whole variety of unique challenges that urban Indians have but a lot of the tribal reservations have their own set of challenges. I'm not saying that they don't, but they tend to be different than ours. And, of course they're a lot more organized. They're usually tribal communities usually made up of relatively similar individuals, although there are a number of consolidations and consortia of Indian people that are now on Indian reservations, especially in Washington State. So there are some mixed cultural and historic orientations that are on reservations. There are a few, like Seattle, for example where there are well over 200 different Indian tribes from all over the United States represented in our service population across the street. And there are probably, dozens of other Indian people that are not really affiliated with a federally-recognized tribe.

And so, one of our biggest challenges is trying to get this point across to people that, when talking about Indian people you need to take into consideration the fact that there are these displaced to a great degree individuals out there that are struggling with their own issues of identity and their own issues of poverty, with their own issues of feeling left out and feeling neglected to a great degree. And it's even more difficult, I think, for a lot of urban Indians too because even if they are a member of a tribe, for example, but they live in Seattle, they sometimes are shunned by their own tribe. And so this feeling of no longer belonging somewhere has become a real trying element of the work that we do because it's really hard for people to find an Indian identity in a city like Seattle. Even though we're named after an Indian chief, there's not much Indian symbolism in Seattle.