Dire emergency
Isolated Navajo community finds ambulance service is fleeting

By Karen Francis
Diné Bureau

NAZLINI — The president of the Navajo Housing Authority organization in Nazlini has concerns with emergency response when residents call 911 and they are “ping-ponged” back and forth between Ganado and Chinle.

Irene Bahe blames at least one death on the lack of timely response from the hospitals. She said that the community recently lost a 35-year-old man when ambulances did not respond quickly enough. The death has been the subject of recent meetings for the organization as the residents try to figure out how to get life-saving services to the entire community.

Bahe said that she also had first-hand experience dealing with the problem when her husband suffered a heart attack in March.

“I called to Ganado and they said that it was Chinle’s responsibility. We called to Chinle and it (ambulance} never arrived,” she said.

Bahe and her son had to rush back from their jobs in Chinle and transport him to meet the ambulance themselves, she said.

“Then the doctor told us we brought him in just in time — that if we had brought him in a little longer we would’ve lost him,” she said.

Bahe wants to know how to improve the situation for the safety of the community members.

While Sage Memorial Hospital is located in Ganado just about 16 or so miles south of the Nazlini area — all on paved road — the Chinle Comprehensive Health Care Facility is at least 23 miles away, much of it on unpaved road depending on what route is taken.

Multiple problems arise when a 911 call is made from Nazlini. First of all, the call goes to Window Rock where it is then dispatched, Tomicita Gorman, chairwoman of the Sage Memorial Hospital board of directors, said.

“From Window Rock, they connect to us at Sage thinking that we are the closest,” Gorman said.

The call could also be sent to the Ganado Fire Department, which is staffed almost entirely by volunteers, or to the Action Medical Service, which is the contracted ambulance service that Sage hospital utilizes. Both organizations have limited staffing and at times may not answer the phone either.

However, many times the caller is eventually referred to the Chinle facility.

Adding to the problem is that the boundary appears to be unclear. Gorman said that the boundary line separating the Chinle and Fort Defiance Service Units exists just north of Nazlini Chapter House, while the director of Emergency Medical Services at the Chinle Comprehensive Health Care Facility  Dennis Charley, said that all of Nazlini is under Chinle coverage area for ambulance services.

Such disparities among the service providers are the reason why Nazlini NHA residents are frustrated with the current system and want something to be done about it, Bahe said.

The problem goes deeper than boundary lines as both entities, like all of the hospitals and clinics on the reservation, lack adequate resources.

Sage Memorial Hospital has not had an ambulance unit for its hospital for about 20 years now because it was too expensive, Gorman said.  

Sage now utilizes Action Medical Service for ambulatory services, but even that is only one ambulance serving eight chapters, she said.

And with only one ambulance also running day and night in Chinle covering an even larger area than Ganado, Charley said, “We always get complaints from communities.”

Gorman added, “It’s not so much that we’re denying services but that there’s limited resources, limited manpower.”

No one had an answer when asked how the Nazlini NHA residents could resolve the problem and possibly change the boundary line so that it could be served by Sage Memorial.

However, Gorman said, “When it comes to lives, boundaries shouldn’t be an issue, but we don’t own the ambulance services ... We service individuals from the Nazlini community. I can’t answer for what the ambulance does.”

Martha Ellison, the legislative advisor for the Navajo Nation Health and Social Services Committee, also did not know immediately how the boundary issues could be resolved.

She said that the Nazlini community members who are affected need to go before the Sage Memorial board of directors and maybe to the HSSC if that does not work.

Repeated calls last week by the Independent to Indian Health Services Navajo Area public information officer Genevieve Notah were not returned.

In the meantime, Sage Memorial Hospital is seeking $10 million from the Navajo Nation to build a new hospital facility complete with a veterans administration clinic.

While the Nazlini chapter has been asked to support the funding request, Bahe said that the entire community does not receive full service.

“Why should we vote for it because some of us are just turned away?” she asked.

Navajo Nation Council Delegate Willie Tracey, Ganado/Kinlichee, who is sponsoring two pieces of legislation requesting funding, is hoping that the construction of a new facility will help alleviate the problems that the Nazlini community is having.

“Ganado has its own line of questions why Sage is not an effective service provider as it should,” he stated. “We have many people relying on Fort Defiance and/or Chinle health care facilities, but once a new hospital is built, we strongly hope people will rely heavily on the new facility.”

On Tuesday morning, the HSSC endorsed Tracey’s request for $10 million from the Land Acquisition Fund for the construction of a new facility. It must also go before the Transportation and Community Development Committee, the Resources Committee, the Intergovernmental Relations Committee, the Budget and Finance Committee and finally the Ethics and Rules Committee before consideration by the full Council.