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Wednesday - July12

   Today I was able to go to an "off-site" and meet with a social worker who was part of the Analenisgi program and worked specifically with pediatric patients. Initially we were going to be able to observe an assessment, but the client ended up not showing up for the appointment. Instead, we were able to discuss different issues faced by children within the boundary. Over these few days, we have learned much about child rearing in this culture. One thing that has been explained is that children can, at times, have poor role models and end up developing unhealthy habits themselves, which may then be passed on to their children as well. Other times it may be grand parents raising a child, as the parents may have lost rights to the child as result of abuse, neglect, or substance abuse. Other family members may help in raising a child as well.
      The Cherokee are a matriarchal society and as such, native women, particularly older women are very well respected in this community. This has been evident in many areas during our clinical time, both in the hospital and urgent care clinic as women seem to be the primary care takers (and seekers of care) for family members. Elders are also highly respected in this community as well. It was explained that a person is expected to take time off from work to care for a parent should they become ill.
      During these days we were able to observe many types of family structures. Obviously, there was the "normal" family of parents and child. More commonly it would be a single parent (mother) with a child or children when seeking healthcare. There were times when a grandmother would bring in a child to be seen and close friends of a family may be taking care of children as well.
      Fortunately, there are many support systems in the community for at-risk individuals. Individuals going through detox in the hospital may be referred to specific programs for aftercare to continue substance or alcohol abuse treatment. For younger individuals, the family support services (FSS) agency can help families having difficulty carving for children, or investigating abuse and neglect claims. this agency will usually try to work to keep families together, but can remove a child from an unsafe or unhealthy home if the conditions are bad enough. The hospital can play a large support for the family as well. Parents can bring their child to the hospital as it will usually have most of the services needed to care for children. The hospital also does care coordination and can refer the parent or family to another program or agency for further follow-up.
     When considering resilience in this community, it is evident that some individuals are more resilient than others. We have learned over these few days that the Cherokee struggle with substance abuse, especially during per capita payments. This can be for any number of reasons given an individuals history or life experiences. When learning some of the history of the Cherokee, there were several times when they had to endure through some very tramautic events as a culture. It was described to us that some members of the tribe can have difficulty dealing with and addressing this historical trauma and may instead allow it to effect many facets of their life. Others, however, may be able to persevere despite this and move forward, going to college or taking an active role in different parts of the tribe.


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