Northern Cheyenne I.H.S. Transportation System: life savers

LAME DEER, Mont. – Six days a week (Monday through Saturday) one of the five drivers for the Northern Cheyenne I.H.S. Transportation Program arises about 2:30 a.m.to prepare for an average 12–14-hour day. 

The mission is to transport Northern Cheyenne diabetics from the reservation to Billings for dialysis treatment, each going in three times per week. If not for that life-sustaining support, those people would eventually become sick and die, their kidneys would stop working. Presently, there are eleven tribal members in need of such treatment. In the past, the numbers were higher, but COVID took its toll from the most vulnerable.

(This writer’s mother, Teddy McMakin was one of them who rode that transportation service for seven years).

First stop is Birney, a remote outpost, at 4:15 a.m., then Ashland, finally Lame Deer and then off to Billings by 5:00 a.m. Because dialysis seats are limited, and the treatment for each requires from 3-5 hours, there is a long day of waiting for all to get finished. In the meantime, the drivers go around Billings, picking up supplies for the I.H.S. and specialized medication for other patients. Overall, it is at least a 210–250-mile round trip, a very long day for all concerned.

By about 4:00 p.m., the patients are loaded up for the return trip home, another two-hour ordeal. By then they are literally drained, having had their blood drawn, cleansed and re-infused. Thus, the driver stops on the return trip so they can get a healthy snack, very necessary. Often the patients are too worn out to even hobble inside an eatery, so the driver takes orders and carefully brings them back to the van for the patients. Many are even too weary to ingest that, saving it for later. On the return trip home, the driver turns on some soothing music so the patients can rest – quiet time. (This writer personally observed this, while catching a ride on the dialysis van from a different medial appointment in Billings. The transportation folks arranged that too, an exception. Sitting in the back was okay, but unsettling to observe the condition of the dialysis people).

If all goes well, the drivers arrive back at Lame Deer, drops off the last patient and their day is over about 7:00 p.m.  Until the next morning. The drivers work four shifts per week, obviously a staggered schedule so that each can refresh.

This goes on every week, all year long.

“It takes a very caring and compassionate person to do that work,” said Monte Haugen, Northern Cheyenne Transportation Director. “They do an amazing job every day. We often receive calls from grateful patients.”

Larry Flying Jr. one of the drivers, for example jokes around “Cheyenne-style” with his patients. “I try to build them up a little and make them laugh,” he modestly said. “After all, they are still alive. Cheyenne always respond to a good joke or two.”

In addition to the dialysis patients, the I.H.S. Transportation Service ferries other tribal members to off-reservation specialists, those eligible under the Referred Care Program. Many tribal members do not have the wherewithal to get to those appointments, said Sable Kerzmann, Acting CEO at the Lame Deer Service Unit. 

The program even includes long distance trips to locations such as the Denver Children’s Hospital and the Salt Lake City Burn Center, in which case motel rooms and meals are also provided for the patients.

In 2023, the Northern Cheyenne I.H.S. Transportation Service received a National I.H.S. Directors Award for excellence of service. (The awards are delayed, so they earned that in 2022, although those good folk have for many years observed that ongoing standard of service.)

“Transportation services and recruitment are our priorities,” said Kerzmann. “It would be ideal if we had local dialysis services, but water quality and recruiting necessary staff have been barriers.”

At present, the I.H.S. transportation program is staffed by five full-time drivers, an on-call driver and Director. The program has several vehicles to meet patient needs: a six-passenger van; wheelchair accessible van and regular vehicles for smaller passenger groups.

Kerzmann reported that a request for three additional drivers has now been approved, managed by the I.H.S. human resources program. “We hope this will happen soon. The need for additional drivers and staff is well documented. Northern Cheyenne is considered a ‘remote’ reservation with limited local health care services, due to budget constraints” she explained.”

In the past, Northern Cheyenne did try a dialysis center and the Tribe is looking into re-establishing that. “I hope so,” Kerzmann remarked. “It would make life so much easier for our dialysis patients. As it is, they spend a third of their lives centered around dialysis treatment. They go three days a week and spend the remaining days recuperating. That does not allow a high quality of life.”

In addition, the I.H.S. Transportation Service provides rides for other patients referred to sites such as Hardin, Billings and sometimes Miles City, MT.

In the experience of this writer, drivers are prompt, courteous, respectful, and helpful.  Sometimes, for example, they must assist wheelchair bound patients get on or off the bus, wheel them to their front doors, get them situated inside, making sure they are safe and comfortable, especially when those patients are in such a weakened state.

While the I.H.S. Transportation program provides services for off-reservation appointments, another part of the health care transportation problem at Northern Cheyenne is assisting tribal members to get to the reservation clinic for appointments.

The Tribe does have a public bus system “The Rez Runner” but is currently limited to regular routes, lacking the workforce or funding to provide individual rides to the clinic. “We are collaborating with Tribe to try and address that,” Kerzmann said. “It is especially important for elders, people with disabilities and others without transportation who live in districts outside of Lame Deer. Under our federal program guidelines, we cannot provide that service. Even if a patient, especially an elder, lives in Lame Deer, it can be a long walk to the clinic, sometimes faced with wild dogs, problematic for elders or the infirm. There is no taxi service here, even if people could afford it:”

The current transportation staff includes Monte Haugen, Director, and drivers: Henry Bigfire; Max Highwalker Jr., Tylen Tallbull, Trevor Old Mouse. Larry Flying Jr. and on-call driver Leah Lonebear. Lawrence Spang and Torry Darkenwald assisted in the past with coordination. Darkenwald made the nomination.

The following is paraphrased from that: “It is 4:00 a.m., dark and 30 degrees below zero. The road report has multiple closures with hazardous driving conditions. Local schools and offices are closed so people can stay home and be safe. But at the very moment the Transportation Drivers at the Northern Cheyenne Service Unit in Lame Deer, MT are at work, headed out to pick up dialysis patients as they do six days a week.”

Sometimes, in such conditions, they must shovel out driveways and sidewalks to get to the patients. They do that, knowing they hold people’s lives in their hands.

Transportation drivers have a full understanding of patient’s needs and seek effective ways to address the barriers which could impede treatment. Their consistent acts of compassion exceed the expectation of their position.

Thank you to the I.H.S. and individual drivers who provide such an important service to the Northern Cheyenne community.  We (including this writer) are grateful.

(Contact Clara Caufield at 2ndcheyennevoice@gmail.com)

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