chinle
TRANSCRIPT
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Chinle Service UnitNavajo Area
Indian Health Service
Updated: -1/15/08508 compliant
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Chinle Hospital
Tsaile Health Center
Pinon Health Center
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Spider Rock-Canyon De Chelly
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The Navajo Reservation
• 25,000 square miles in size
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Traditional Cradleboard
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The Navajo Nation
• Second largest federally recognized tribe in the United States (Cherokee being first)
• Approximately 298,000 members nationwide• 168,000 members reside on the reservation• Half of the population is under age 25
-Growth rate is nearly 4x that of the U.S.
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Hogan
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Census Information1990
• 50% without running water/electricity
• Less than 20% have a telephone
• 40% speak English less than “very well”
2000• 70% with access to
clean running water.• 40% of homes now with
telephone access– Greater number if
cell phones included
• 25% speak English less than “very well”
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Canyon De ChellyNational Monument
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Census Information
1990• 55% of population
below Federal Poverty Line.– Unemployment rate
of 30%• 40% over the age of 25
have a high school degree
2000• 40% of population
below Federal Poverty Line.– Unemployment rate
of 25%• 56% over the age of 25
have a high school degree
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2000 Census InformationNavajo
• Median Age 24• Annual Per Capita
Income $7,269• Persons Living Below
Poverty Level: 42.9%• Unemployment Rate:
25.1%• Persons with HS
Diploma >25 years old: 55.9%
US• Median Age 35• Annual Per Capita
Income $21,587• Persons Living Below
Poverty Level: 12.4%• Unemployment Rate:
5.8%• Persons with HS
Diploma > 25 years old: 80.4%
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2000 Census InformationNavajo
• Language spoken at home other than English: 93.2%
• Housing lacking plumbing: 31.9%
• Housing lacking phone: 60.1%
• % Using Wood for Heat: 54.3%
US• Language spoken at
home other than English: 17.9%
• Housing lacking plumbing: 0.6%
• Housing lacking phone: 2.4%
• % Using Wood for Heat: 1.7%
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Canyon De Chelly
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Chinle Service Unit• Centrally located on the Navajo Reservation
– Northeast Arizona– Canyon De Chelly
• Indian Health Service site since 1955– Chinle Comprehensive Health Care Facility
dedicated in 1982
• Serves roughly 34,000 patients• 716 Full Time Employees• Many patients travel 100 miles round trip to
clinic
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Chinle Hospital Entrance
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Chinle Service Unit
• Chinle Comprehensive Health Care Center
• Tsaile Health Center
• Pinon Health Center
• Adolescent Clinics
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Chinle Comprehensive Health Care Facility• Full Service Community Hospital• 60 beds
– 12 bed Pediatric Care Unit– Nursery– 24 bed Adult Care Unit– 4 bed Special Care Unit (Adult)– 16 bed Obstetrics Care Unit
• ED – 25,000 visits per year / staffed 24hrs / 9 beds
• Admitting facility for several area clinics
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Chinle Comprehensive Health Care Facility
• 2005 Statistics– 179,407 Outpatient Visits – 124,285 Primary Care Visits – 14.5 Physicians Per 10,000 census
population– 2,795 Adult / Pediatric Discharges – 592 Newborn Discharges
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Chinle Hospital ER Entrance
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ER Trauma Bay(one of two)
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Internal Medicine and Family Practice
• Outpatient– Adult and Family Practice Clinics– Mixture of acute and continuity care
• Inpatient Hospitalist– One week every 1-2 months– 2 Adult providers on service each week
• Call– One night per week– One weekend per month
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Family Practice
• Full Spectrum Practice• Family Practice Clinic
– Adult– Pediatrics
• OB/GYN (not required)
• Labor and Delivery
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Our Population is Growing
0
5
10
15
20
25
30
35
Birth RatePer
100,000
1990-1992
1991-1993
1992-1994
1994-1996
1996-1998
NAIHSUS
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Specialty Services
• Exercise Treadmill Testing• Chest Clinic (Latent and Active TB)• Pacemaker Clinic, Fracture Clinic• Acupuncture Clinic• Clinical Services for the Extended Care
Facility and the Home for Adults / Children with Exceptional Needs
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Sub-Specialty Services
• Visiting MDs from Farmington, Gallup, Flagstaff, Phoenix, Tucson– Nephrology– Rheumatology– Cardiology– Neurology– Orthopedics– Pediatric Pulmonology, Genetics, Cardiology,
Neurology
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Leading Causes of Mortality
• Unintentional Injuries 22%
• Heart disease 16%
• Cancer 12%
• Pneumonia/Influenza 6%
• Diabetes 6%
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Diabetes Prevalence
13.814.7 15.5
17.1 17.418.3
02468
101214161820
1997 1998 1999 2000 2001 2002
Year
Rat
e P
er 1
00 U
sers
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Age Specific Diabetes Prevalence
05
1015202530354045
Rate Per 100 Users
All Ages Under20
20-44Yrs
45-64Yrs
Over 64Yrs
FY 1998FY 2004
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Behavioral Health
19.7
8
16.8
10.6
49.8
6.3
0
10
20
30
40
50
Rate per
100,000
Homicide Suicide Alcoholism
NAIHS 1996-1998
US 1997
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Unique Pathology
• Infectious Disease– Hantavirus Pulmonary Syndrome– Plague– Black Widow & Snake Bites!
• Chronic Lung Disease (not COPD)• Uranium Exposure• Rheumatic Disease• Navajo Neuropathy
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Medical Education
• Up to 6 students or residents per month
• IM/FP/OB-GYN Ambulatory Rotations
• Allied Health Students (Pharmacy, Rehab, Midwifery, Nursing)
• Housing, travel stipend provided
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CME• Weekly noon conference
• Monthly journal club (adult and pediatrics)
• Noon lectures by visiting specialists
• Teleconferencing capabilities with University of Arizona for Grand Rounds
• 2 weeks per year with stipend
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IHS Employment• Salary
– Civil Servant– Commissioned Officer
• Leave– Annual Leave– Sick Leave– Educational Leave
• Loan Repayment Opportunities
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Canyon De Chelly National Monument
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Life in Chinle• Elevation Range 5,500 – 9,000 ft
• Semi desert plateau with wooded mesa, mountain ranges, canyons and valleys
• Temperature range 0 – 90 degrees F (with low humidity)
• Annual rainfall 8.5 inches
• Seasons: Winter, Wind, Sun, Monsoon
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Three Turkey Ruins
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Life in Chinle
• Activities:– Ultimate Frisbee– Book Clubs / Film Nights– Wellness Center– Potlucks– Hiking, biking, kayaking, fishing, rock
climbing, skiing
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The Flying Goatheads(Ultimate Frisbee)
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Chinle “Window Rock”
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Life in Chinle• Services
– Basha’s Supermarket / Tucson Co-op– Restaurants
– Garcia’s, Junction, Thunderbird, fast food – Wells Fargo Bank, US Post Office– Video Rental– Churches – DSL Internet
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Some of our government housing…
Chinle Pinon
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Checking out the ball field
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Puebloan Ruins
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Native Culture
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Native Culture in Chinle• Rodeos, pow-wows, ceremonies
• Dine Community College – weaving classes, language classes and Native literature classes
• Native food
• Native crafts and craft fairs
• Hiking the canyon with a Navajo guide
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Tsaile Health Center
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Pinon Health Center
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Pinon Health Center
• Outpatient Clinic• 15 exam rooms • 4 Optometry exam rooms• 14 Dental bays• Large Physical Therapy area• Large Pharmacy Area
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Pinon Outpatient Department
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Life in Pinon• Elevation Range 5,500 – 9,000 ft• Semi desert plateau with wooded mesa, mountain ranges, canyons and valleys• Temperature range 0 – 90 degrees F
(with low humidity)• Annual rainfall 8.5 inches• Seasons: Winter, Wind, Sun, Monsoon
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Life in Pinon• Activities:
• Book Clubs / Film Nights• Potlucks• Gardening• Fire pits• Hiking, rock climbing, camping, biking, and cross country skiing all in the backyard • Downhill skiing, kayaking, rock climbing, and fishing are all within a few hours
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Pinon Health Center Departments
IM, FP, PedsOB/GYN, CNMsCounselingDietary and Community NutritionDental Health PromotionsLaboratory and X-rayNative MedicineOptometryPharmacyPhysical TherapyPodiatryPublic Health Nursing
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Navajo Rug
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Navajo Wedding basket
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Petroglyphs
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Life in the Four Corners• Skiing
– Southern Colorado: Telluride, Durango, Wolf Creek– Northern New Mexico: Taos– Salt Lake City, Utah: Park City– Northern Arizona: Snow Bowl
• Mountain biking – Moab, Durango• Ice climbing – Ouray• Hiking/canyoneering – Grand Canyon• White water rafting – Green River, Colorado
River, San Juan River
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Hanging Ladders Trail!
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Twin Trails – Canyon De Chelly
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Telluride, Colorado
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Life in the Four Corners
• National Parks – Canyonlands, Arches, Mesa Verde, Bryce, Zion, Capitol Reef, Monument Valley, Grand Canyon, Chaco Canyon, and MORE!!
• Hubbell Trading Post Historical Site
• Nearest Cities – Flagstaff, Albuquerque, Phoenix, Sedona, Las Vegas
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Grand Canyon
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Hubbell Trading Post
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Spider Rock
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Contact Info
• Heidi Arnholm – Physician Recruiter
928-674-7607 [email protected]
• Jaime Begay – Department Secretary
928-674-7609 [email protected]
• Personnel Department
928-674-7020
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Contact Info• Joe Salay, MD – Chief of Family Practice,
[email protected]• Scott McGarvey – Chief of Internal Medicine,
[email protected]• Melissa Lee – Internal Medicine/Peds,
[email protected]• Sean Meade, MD – Chief Medical Officer-Pinon
[email protected] 928-725-9533