Health and the Urban Indian: An Interview with Ralph Forquera

TC:  Do you have a large homeless population?

RF:  We have a fairly large homeless population. We have a very transient population. About a third of our population turns over every year, which is about anywhere from 1,200 to 1,400 or 1,500 individuals. Frequently people will move out of the area, either go home, or they'll go to another city. And then they'll come back. It's not uncommon at all for us to get people that have been away six, ten years, and then they come back to, you know, they're flowing back through again. They're cycling back through again. So we keep records on all of our clients and we put them in storage and we're pulling them up all the time. I think the native population is, I don't know if this is true or not but my sense is that the native population tends to be a lot more transitory than other populations. This population tends to turn over a lot more frequently than the rest of the homeless population. You know, most of the homeless people here tend to be citizens of Seattle. They just happen to be homeless. We have a fair number of those. But we also get a lot of homeless Indian people who are from reservations or from other cities who are here for a period of time, and then we tend to lose them and we don't know where they're at and we assume that they're either back at their reservation or back home because that seems to be a pattern among that particular population.

TC:  Did the Seattle Indian Health Board basically come about because of the displacement and homelessness for urban Indians?

RF:  The evolution of this organization really started, a lot of it, because of the relocation program of the 1950s and 1960s. And the fact that there were a group of native women here who saw that there was a significant health problem, especially among the kids going to school here, and they kind of banded together back in the late '60s coming out of the civil rights movement and people kind of organizing. They took that same energy and turned it into an initiative to try to do something for Indian people here, and actually we started on the second floor of the Public Health Service Hospital right across the way from us here. That was a public health service hospital, a Marine Corps hospital. And because the Public Health Service was affiliated with the Indian Health Program, an Indian had to be able to get care up there, but it was primarily hospital care when they were really ill that they put them up there. So a group of Indian women got together and organized with a number of mostly non-native people to establish a clinic up there, a free clinic with volunteer doctors and nurses and, you know, drugs people were throwing away and so they were taking those kinds of things. And they started working three evenings a week up there. And that formed into the Seattle Indian Health Board and became the agency that we are today.

TC:  What's your relationship with Indian Health Service? Is that where you primarily get some funding, but you're independent?

RF:  Well, it's unclear. The law itself, the Indian Healthcare Improvement Act, which is a bill that originated out of Seattle, was granted to the Indian Health Service through the federal government, authorizing the development of a contracting grant program to provide some resources to these thirty-four nonprofit organizations around the country.