Keynote: Healthy, hopeful, vibrant rural communities

Blandin Foundation CEO Kathy Annette’s keynote presentation to the Direct Services Tribes National Meeting, July 11, 2018.

Healthy, hopeful, vibrant rural communities

Hello everyone! It’s great to be here with you all. I see many familiar faces, and I am honored that you have invited me back to share some thoughts today.

Before I get started, I am going to ask you to indulge me for a few minutes. Please lean back, take a deep breath, close your eyes. Think you a minute and answer this question- “What brings you hope?”

Now, take another minute and share this with someone next to you. Tell them what gives you hope.

Great. Thank you.

Welcome to the state of Minnesota home to 11 tribal nations. Minnesota is also proud of our Twins, Vikings, 10,000 lakes and—this time of year– awesome fishing!

I have lived here my entire life (with the exception of about a year when I was assigned to the wonderful Oklahoma area) and have experienced and seen much change.

Personally, one of the biggest changes was deciding to marry (for the first time mind you) at the ripe young age of 53 years.

I had been married for about 6 months when my new spouse, Tim, was sitting at the breakfast table and lifted his cup for a refill. I said, “Tim, the coffee pot is behind you”.

I heard him grumbling about how things sure had changed since we were courtin’ to which I replied in words I knew he would understand— I was trolling then honey and you are in the live well now.”

It’s been seven years since I made the jump from IHS to philanthropy, to a different kind of community health. And it’s been 40 years since I entered medicine as a student.

Yet I remember my first day of med school so clearly!

Carrying so many expectations—from my community, my family, all those who had helped me to get to that day, all those who were waiting for me at University of Minnesota Duluth. Because it had not been done by a female member of my tribe before. I was starting down a path of health care delivery that, back then, few Anishinaabe had ventured down. Of course, we had healers at home; this journey was a different way to healing.

Learning Western medicine and direct clinical care was what I expected. The ever-changing legal and regulatory requirements were not.

I remember when bugs were just mosquitoes; then bacteria and viruses; and, now, technology glitches.

So much has changed in medicine, and yet—in many ways—we have come back to a place where we see health more holistically. Strong communities understand health in the context of the whole person, the whole community.

Blandin Foundation has, as its mission, to be a trusted partner and advocate for strengthening rural Minnesota communities. Here’s how we think about what it takes to be a health community:

A community is made up of 9 distinct, yet related, dimensions – from economic opportunity to life-long learning to spirituality and wellness.

It is the balance of these dimensions that leads to a healthy community. A strong community.

But I think the great Lakota warrior Sitting Bull may have defined strength best: “Nothing is so strong as gentleness, nothing so gentle as real strength.”

…”Nothing so strong as gentleness, nothing so gentle as real strength.”

On the occasion of this, the 15^th national meeting of the Direct Service Tribes, congratulations on the theme of “Utilizing People, Partnerships, Quality and Resources to Strengthen our Communites.” On the many, many quiet and gentle ways you can and do make our communities stronger, more resilient, hopeful.

I know I was at the very first of these national conferences in Phoenix, Arizona. I participated on a panel discussion — “Building Opportunities, Networks & Partnerships–Expanding the Relationship.”

I attended all of the Direct Service Tribes conferences until 2011. The common themes always included healthy communities, tribal communities, rural communities.

All of my career – whether as a practicing physician, as area director with IHS or now as CEO of Blandin Foundation – has been focused on people in rural places.

Places where communities are facing shifting demographics, challenging economies, aging infrastructure, health challenges-old and new, the rise of opioid addiction.

And these, our homes, are places of great resilience. And beauty. And unique wealth—connection to the earth, connection to each other, connection to our ancestors.

Strong Indian and rural community leaders are figuring out how not just to survive, but to work with whatever the community’s assets are, and to help their communities thrive. Because leaders are those who do whatever it takes, as long as it takes. And in rural places, especially tribal communities, we wouldn’t dare give up.

Indian health care absolutely is community leadership. To be effective–to be relevant–we must see ourselves–our gifts, our challenges and how much we care–in the context of the whole community.

You are standing with your communities as they design and claim healthy, hopeful, vibrant futures.

I would like to pause, to recognize your hard work. So, take a deep breath, and just for this moment, soak it in. Be still. Believe that you know what you need to know, and that you have the ability to get everything that your community needs for its future.

I don’t know that my community had everything that it needed for its future on the night that I was born.

My mother told me the story of how, at the White Earth IHS Hospital in April 1955, two women went into labor. She and the other mother woke up in the middle of the night, I was the infant that survived, the other didn’t.

My mom always stressed to me how I was given the gift of life-another infant wasn’t. Back in those days many, many of our babies died.

Just think of how far we have come when it comes to infant mortality!

And I grew up always knowing someone who was diabetic and on dialysis or blind or had lost a limb to amputation due to diabetes. I remember driving through our reservation and seeing ramp after ramp after ramp that added to people’s homes.

Fast forward to now, there are far fewer amputations and big decreases in diabetes-related kidney disease!

And what I wouldn’t have given for some of the tele-health that is possible today with broadband technology! To be able to access expertise in emergencies!

Things are changing, and it’s all about leadership!

I was very proud to have been part of Indian Health Service. To see improvement in health care delivery and health outcomes. To see leaders who would not accept status quo. To see emphasis on public health and community relationships and partnerships.

I also can see, now in my role at the Blandin Foundation, how community leaders in general can make so much difference.

In Minnesota more than 600 tribal community leaders have participated in our reservation community leadership training program over the past 17 years.

We have had the honor of spending more than 3,000 hours in retreats and workshops with tribal and Indian community leaders–those who are making things happen for their communities.

Some things that really stand out for me as I think about these leaders

Leadership is something that you have to do yourself and you can’t do it alone

I am a member of the White Earth Band of Ojibwe. It was Giishanakad who was my wen’enh and gave me my Indian name, “Annakubeday”-to tie together.

And it took me many years to understand the importance and power in my name. To live into my identity as one who brings differences together. Partnerships and relationships… so key to leadership.

I think of the Navajo, who, in my experience, have done a beautiful job of being a welcoming and inclusive nation. Appreciating differences in a way that makes their communities a place that providers want to invest their careers, raise their families, make their home. Their communities are stronger, healthier, because they bring people together.

The second thing that stands out to me about great leaders, is vision. Thinking about what’s ahead, and helping others to see it too.

I think of Roger Jourdain, Red Lake Band of Chippewa’s longtime tribal chairman. Roger could see how critical it was that his people had access to quality health care, that it was a core promise that had to be fulfilled. He was among an alliance of American Indian Leaders who 30 years ago strongly advocated for self-governance.

Roger passed in 2007, and at the time his niece was quoted as saying that he was very proud of the fact that his first act in office was to reopen the Indian Health Service hospital at Red Lake.

Vision. And partnership. Keys to leadership.

And great leaders are also hopeful. Because, in order for a community to change, it has to have hope.

Hope is believing that a different future is possible, for ourselves, those in our care, our communities.

Hope is being able to imagine what that future might be. Wise leaders know that creating a shared vision for the future, a vision arising from and embraced by the community, is the engine that powers change.

When people have hope, they can accomplish amazing things.

Sometimes hope emerges from unlikely places. From tragedy.

As some of you may remember, thirteen years ago a student at Red Lake High School shot many people. He killed his own grandfather, a teacher, a school security guard and five other students before killing himself afterward.

Because of my role at the Indian Health Service, I was assigned to help coordinate the local response for the Department of Health and Human Services.

At the time, I was the most senior federal official who was geographically close. Plus, I happened not only to be Anishinaabe but was raised on the Red Lake Reservation. That was my high school.

I knew the families of so many who experienced losses that day, and the teacher who was killed. Being a physician and having worked with the Red Lake reservation leadership for years helped. I trusted the tribe would coalesce and lead and they trusted me.

There was so much to organize, but my most immediate role was to be there, to be home. I remember being so very sad, attending so many funerals.

Even in those days of terrible tragedy were the seeds of hope: the absolute commitment to protect the children, the urgency to get the school back together, to create a promising future.

Red Lake communities established youth leadership councils and strengthened the local Boys and Girls Clubs. The tribe and partners took on drug and alcohol problems, youth leadership, even cancer prevention.

All elements of the community came together—tribal leadership, fire department, educators, the health care system–everyone. We used what we’d learned about leadership during this horrendous tragedy to support the community as they healed and emerged stronger than before—resilient and hopeful.

Red Lake reservation has since made me an honorary member of the tribe, that’s my community too–now and always. I’m very proud of that.

The poet Emily Dickinson once wrote that, “Hope is the thing with feathers – that perches in the soul. And sings the tune without the words – and never stops at all.”

Speaking of never stopping at all, here are some of the things that today I see Indian leaders, alumni of our community leadership training, doing in their communities that give me hope for their health and resiliency….

One group organized a smudge walk to combat addiction
At another reservation they worked together to connect the SNAP program to community gardens, greenhouses, outdoor learning spaces, cooking classes and even piloting an indigenous foods program for Headstart.
Another group formed the partnership behind a new alcohol and drug treatment facility.
Yet another group partnered with other tribes to support Alzheimer’s education, how it’s impacting our people, and what we can and should do.
And at another reservation they worked to make their college campus tobacco free.

These are all examples that give me hope and show us all just how important our local leaders are. It is within you to continue to deliver hope. Hope that we can and are building healthy communities.

We know that leadership is best when it considers the impact on our future generations—7 generations.

Even today, when things on the national level are so complex and unpredictable, we know we can we made a difference at a local level. And, in fact, if we want to really make change, it’s going to have to happen at a community level.

When people arrive at our leadership training retreats, we tell them, “YOU are the leaders we’ve been waiting for.” I remember how I felt when they said that to me. What a wonderful and awesome sense of challenge there comes with hearing it.

“You are the leaders we’ve been waiting for.”

You recognize that it takes a healthy community to move forward—healthy in all
You recognize that change can happen from anywhere, and that we need to actively invite all sorts of people to be leaders.
You recognize that leaders can be grown and developed; leadership is an unlimited resource and we need to tend to our emerging leaders. We need to teach them the importance of being grounded in community because in community we know and sustain ourselves–who we are and what we can do.
You see quality and diverse connections sustain progress. We need all sorts of partners
Your hope leads to change. Ultimately, hope leads to change.

You are the leaders we have been waiting for. Miigwech!

Because, no matter what our roles, we all are in the hope business.