Dialysis Clinic, Inc. - DCI Serves Native Americans for More Than 25 Years
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DCI Serves Native Americans for More Than 25 Years

Posted in Articles by Dialysis Clinic, Inc.

During Native American Heritage Month, Dialysis Clinic, Inc. (DCI) is proud to highlight its collaborative care with and for Native American pueblos, tribes and nations in Arizona, Montana, Nevada, New Mexico and Wyoming. 

Native American leaders are invested in providing essential healthcare for their tribal communities, and DCI supports their efforts through its patient-centric nonprofit mission. This demonstrated commitment has led to a strong relationship between DCI and the tribal communities where clinics are located dating back more than 25 years. 

“Tribal leaders have a commitment to serving their people and approached DCI when they saw there was a need for dialysis in their community,” said DCI New Mexico Area Operations Director Charmain Madero. “Everyone I’ve come in contact with throughout all of the pueblos has the desire to see that all of their people receive care.”

Caring for her own community has driven Sherri Howeya, DCI ACL Patient Care Technician in Acoma, N.M., to pursue her nursing degree. “I love working with my people, as I am from the Pueblo of Acoma,” she said. “My cultural beliefs are definitely woven into my work. My shared beliefs create trust, better communication and understanding of Native American patients.”

Sherri Howeya, DCI ACL Patient Care Technician in Acoma, N.M., visits a pueblo watering hole to recognize the need for water.

Howeya has worked for DCI since 2018 and will graduate from New Mexico State University next month with a Bachelor of Science in nursing.

DCI’s commitment to caring for underserved populations guides clinic openings, and the health disparities Native Americans face create a need for End-Stage Renal Disease (ESRD) care. DCI operates 17 dialysis clinics in Arizona, Montana, Nevada, New Mexico and Wyoming located on or near Native American reservations including:

  • ACL clinic in Acoma, N.M., celebrating 20 years of providing patient care to Acoma, Canoncito and Laguna pueblo members as well as nontribal populations. 
  • Cuba, N.M., clinic serving patients that travel from the surrounding area.
  • Grants, N.M., clinic serving the Acoma Pueblo.
  • Santo Domingo, N.M., clinic serving the pueblo of the same name, as well as the Cochiti and San Felipe pueblos.
  • Taos, N.M., clinic serving the Taos Pueblo and surrounding areas.
  • Big Sky, Mont., clinic serving Crow and Northern Cheyenne tribal members.
  • Billings Clinic in Montana serving the Crow and Northern Cheyenne tribes.
  • Blackfeet clinic in Browning, Mont., serving members of the Blackfeet tribe.
  • Polson, Mont., clinic located on the Flathead reservation serving the Salish and Kootenai tribes.
  • Elko, Nev., clinic serving Western Shoshone Newe and the Elko Indian Colony, and was originally located on tribal land.
  • Carson City, Nev., clinic serving Wa She Shu, Washoe/Steward Indian Community and surrounding areas.
  • Gardnerville, Nev., clinic serving the Dresslerville Indian Colony and surrounding areas.
  • Douglas Dialysis in Douglas, Ariz., serving the Tohono O’odham Nation, a significant donor for the clinic’s creation, and the Pascua Yaqui Indian Reservation.
  • Green Valley clinic in Sahuarita, Ariz., serving the Pascua Yaqui Indian Reservation and the Tohono O’odham Nation from the San Xavier Reservation.
  • Tucson, Ariz., clinic serving the Pascua Yaqui Indian Reservation and the Tohono O’odham Nation from the San Xavier Reservation.
  • Tucson South, also in Tucson, Ariz., clinic serving the Pascua Yaqui Indian Reservation and the Tohono O’odham Nation from the San Xavier Reservation.
  • Watt Dialysis Center in Sheridan, Wyo., serving Crow and Lame Deer tribal members.

DCI’s remaining New Mexico clinics occasionally serve Native American patients as well. 

With limited access to healthcare, transportation and fresh foods, Native Americans are at a higher risk for ESRD largely due to diabetes. Native Americans also have the highest rates of kidney failure caused by diabetes among any other race according to the Centers for Disease Control. In recent years, Indian Health Services initiatives are helping these numbers steadily decline.

To encourage each patient’s optimal health outcomes, DCI teams create a holistic care plan. For Native Americans, this may mean adjusting the renal diet to incorporate more native foods or adjusting treatment schedules for individuals to participate in their cultural events and celebrations. 

“So many things that are important to them, whether it’s a pow wow (gathering with traditional dancing and singing) or a sweat (prayer and purification ritual in a sauna-like teepee or hut), or the Battle of the Little Big Horn or hand games they’re participating in, whatever they’re doing, we’re getting them treatment around their schedule,” said DCI Area Operations Director Shelly Seidel of her patients near Billings, Mont.

“Each tribe is very different in regards to their specific traditions, learning about that over my 30 years (as a nurse) has been interesting because it gives you insight…into your patients,” said Seidel.

“Each pueblo has different days of significance,” Madero said, such as St. Estevan’s/harvest feast for the Acoma pueblo, All Souls’ Day, and other observed days.

Native Americans’ respect for their elders, the land and cultural activities is a commonality among various tribes. When the DCI clinic in Polson, Mont., opened four years ago, tribal elements were incorporated into the celebration, including a Salish tribe blessing and Salish and Kootenai tribal members dancing with local elementary students.


Salish and Kootenai tribe members dance during DCI Polson, Mont., 2018 open house.

DCI’s Native American patients often live in vast, rural areas and may cross mountains and face adverse weather during their commute to the dialysis clinic. The time and financial commitment to transporting patients to care has been the catalyst for some clinic openings due to the local need for dialysis treatment and the distance to the nearest clinic.

“The shortest amount that a Native American patient drives from a reservation is one hour each way,” said Shelly Seidel of Crow and Northern Cheyenne patients. “Otherwise, it’s probably an hour and a half to two hours one way, three days a week.”

“Native American employees sacrifice a lot to get to work and make sure the clinic is open,” said Kevin Donahue, DCI Blackfeet and Polson Area Operations Director. “Especially in Browning, on the east side of the divide, they deal with significant weather, with 60- to 80-mph winds coming off the mountain, but they find a way to get things done. It’s pretty remarkable to see how the community comes together to get patients to the treatment they need.”

“DCI was founded 50 years ago with the belief that patient care is always our first priority, and we are grateful for the relationships we’ve built within Native American communities to serve our patients and support our employees,” said DCI Vice Chairman Doug Johnson. “We are proud to provide care for Native Americans closer to home.”