The brightly painted wards of the government-run hospital serving the Pagago Indian tribe here are empty this weekend, because doctors say personnel shortages caused by lack of funds made the hospital unsafe for patients.
The 40-bed facility, operated by the Rockville, Md.-based Indian Health Services (a division of the Department of Health and Human Services), is the only medical facility serving more than 15,000 Papagos living on the Connecticut-sized reservation on the Mexican border. The doctors' decision not to admit in-patients means that the seriously ill have to travel as much as 150 miles to hospitals in Tucson and Phoenix.
The decision came after the hospital's six doctors said that chronic shortages of and poorly qualified nurses, lab and X-ray personnel meant they could not guarantee the health of their bed patients. The hospital admitted more than 1,000 patients last year.
But the Pagago Tribal Council sees the decision as an arbitrary one, made without the approval of IHS or the council, and has asked Sen. Dennis DeConcini (R-Ariz.) and Rep. Morris K. Udall (D-Ariz.) either to come up with adequate funding or to lead a congressional investigation into the closure.
Scores of Papagos answered a call by the Tribal Council last Friday to air their complaints about the closing of the hospital at the beginning of a four-day public hearing.
"President Carter talks about human rights, but where are Papago rights?" asked Max Norris, Tribal Council chairman. "He's giving $30 million to help refugees from Cuba but we get nothing, even though this is a congressional mandated program of health services."
Charmaine Gargia of the tribe's executive health staff said that, while the doctors may have been sincere in their concern, "they don't understand what this means to the tribe. Mothers can't go with their child all the way to Phoenix, because they may have other children to take care of. Old folks are putting off health care because they don't speak English and won't know what is happening to them in a non-Indian hospital. We are worried some people may die."
Speaking for the physicians, Dr. David M. Logan, clinical director, said they felt "we couldn't work without proper support. We can't treat patients without X-rays and lab tests. We can't help them without nursing staffs. IHS pay is so low that even if we do hire people they aren't qualified."
Logan cited examples of "blood tests with clearly inaccurate results, IVs (intravenouses) that were all wrong, screwed-up X-rays that endangered patients' lives. We decided not to admit any more patients after we ran into a situation one afternoon in which we had four seriously ill patients and we could not find anyone to take X-rays or anyone in the lab to check their infections."
Dr. Herb Belin, service unit director, said that staffing problems have become "commonplace" at IHS. It is unfortunate because it results in low morale among doctors who either volunteered to work on Indian reservations or who elected to come here because of government scholarship obligations.
"This has resulted in a bad situation. Indians complain that they don't want doctors who only stay two years (the usual contract length). They want family doctors who live and die with them. The doctors are committed, but with an average $26,000 salary we can't even compete with small-town doctors earning twice that much. We can't get nurses when local hospitals offer incredible incentives to attract them."
Art Chapa, district representative for Udall, said he was working with IHS officials to try to improve hiring practices. "Funding is a whoe different matter," he said. "This is one of many worthy programs in trouble in Congress this year."
The IHS, which grew out of medical help given by old frontier Army posts, operates 51 hospitals and has been credited with reducing the tuberculosis rate among Indians from one in eight in 1955 to one in a thousand in 1976. Infant mortality in the same period was down 69 percent, and influenza and pneumonia down 59 percent.
Staffing remains almost entirely non-Indian, despite a declared goal of Indianizing most staff positions. Not one Papago is in training to become a doctor, said Norris of the Tribal Council. "If these doctors were Indian, they would have been more sensitive to our needs. Sure, there are problems, but we want to be treated in our own hospital."