Caring for, and learning from, Indigenous communities

Situated in the middle of a pine forest covering more than a million acres of land sits the Whiteriver Indian Hospital, part of the Indian Health Service. The hospital is located on the Fort Apache Indian Reservation in Arizona and serves as a medical center for roughly 17,000 Indigenous people and tribal members. It’s here that Robin Canada, a professor of internal medicine in the Perelman School of Medicine, worked for years after her residency at Penn. Canada served as a physician of internal medicine at Whiteriver for two years and treated individuals from an ethnic population often forgotten.

Signpost outside of a building in Alaska indicating distance in miles to global cities.

“There is becoming an increased focus on marginalized groups of people, and rightly so,” says Ryan Close, a graduate of Penn Medicine, a medical officer and physician with the Indian Health Service (IHS) at the Whiteriver Indian Hospital, and a Penn Center for Global Health scholar. “The unfortunate and ironic thing is that among the marginalized, Indigenous people can be even more marginalized. If you just refer to ‘marginalized people’ in the United States, most people are likely not thinking of those who are tribal members. They are marginalized within the marginalized.”

Canada mentions another striking figure: life expectancy. According to the Indian Health Service, Native Americans and Alaska Natives born today have a life expectancy that’s five and a half years shorter than the average American life expectancy consisting of all ethnicities and races.

When Canada moved back to Philadelphia to work at Penn and be close family, she missed Whiteriver. With support of Penn’s Center for Global Health, she decided to start a clinical rotation program for Penn residents who wanted a taste of the experience she had. In 2015, Canada placed the first four Penn residents at Whiteriver. Since 2015, 45 Penn residents have completed clinical rotations at various Indian Health Service medical centers. The program has expanded to include four other reservations in the southwest and other IHS medical centers in more urban areas like Anchorage, Alaska. Additionally, Perelman School of Medicine students participate in rotations, too, and financial support for these experience comes from philanthropy like the McCracken/MacCracken Student Travel Award for Indian Health.

“Penn residents are experienced, professional, and valuable additions to IHS teams,” says Canada. “They learn about specific health conditions that disproportionately affect people of Indigenous backgrounds. They learn how to understand and deliver health across cultures. And they learn about some of the really impressive efforts and innovations made by IHS clinicians to successfully deliver medicine to people in remote locations but often with limited resources.”

Read more at Penn Medicine News.