Montana State University

Messengers for Health use traditional Crow relationships to teach about contemporary health

March 23, 2005 -- by Carol Schmidt, MSU News Service

Success of the Messengers for Health program is keyed to its membership. Respected women of the Crow tribe dispense modern-day advice through the most ancient of systems -- word of mouth. MSU photo by Linda Best.   High-Res Available

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Crow Agency -- Alma Knows His Gun McCormick slips in and out of speaking the Crow language as easily as she navigates the isolated roads that weave through the Crow Reservation. Both are important qualities for her role as project coordinator for the Montana State University-based project Messengers for Health on the Apsáalooke (Crow) Reservation.

Messengers for Health is a three-year-old program that educates Crow women about cervical cancer in a manner that is both comforting and traditional. McCormick leads 22 Crow women trained in cancer outreach. They call on friends and relatives to dispense the most contemporary of information and encouragement in the same way Crow women have learned about health and life for centuries - through tribeswomen that they trust and respect.

The Messengers are trained by Suzanne Christopher, professor in MSU's Department of Health and Human Development and principal investigator for the Messengers for Health program. This week, the American Cancer Society funded the program for another five years with a $1.52 million grant.

As a result of the two women's collaborations -- McCormick's savvieness about her people and Christopher's science and leadership -- the Messenger program works. While a few years ago the words "cancer" and "cervical" were verboten, discussions on the importance of screening are now commonplace. That's important considering that Northern Plains Indians have a statistically higher mortality rate from cervical cancer than their White neighbors, according to the Indian Health Service.

"Women here are beginning to feel empowered, comfortable enough even to schedule their own (cancer) screening appointments," McCormick says of the influence of the Messengers, who provide information and words of encouragement in many locations including homes, churches, the sweat lodge and grocery stores. "They are beginning to know the importance of a Pap test. We are overcoming barriers. Women are opening up, even admitting that they haven't had a screening, or even asking a question about their husband's health or about domestic abuse."

"Screenings are vital because most women who develop cervical cancer do not have symptoms and when it is found early (by a Pap test) survival rates are almost 100 percent" said Christopher, who has been working quietly on the Crow Reservation for more than nine years in developing a program that would best benefit the women of the tribe.

Christopher first began her research by meeting with Crow women, including Sara Young, a member of the Crow tribe and MSU's former director of the American Indian Research Opportunities program. Christopher learned that fear was a barrier to cancer screening and education on the reservation. Even if fear could be overcome there were other hurdles, such as lack of transportation or even and lack of childcare. That didn't even begin to scratch the problem of lack of female health care providers and a perceived lack of confidentiality at the Indian Health Service.

When they met, McCormick was a single mother-of-three then working for a state breast and cervical cancer prevention project that was in an early stage of development. Different in appearance and approach, the two women were bonded by passion for their work. McCormick is a tall, spiritual woman with an infectious Crow sense of humor who became involved in cancer work after her one-year-old daughter died of a neuroblastoma. Christopher, the scientist, is short, gentle and adept at listening. Christopher asked McCormick about an idea to train some of the Crow women to serve as the lay health workers.

"She told me about this idea she had and I told her I thought it just might work," McCormick recalled.

Christopher applied for an American Cancer Society grant three times before she received part of an $800,000 grant from the estate of the Margaret Ann Wise, formerly of Butte, for a project focused on cervical cancer.

"I don't see this just as a cervical cancer program," Christopher says. "The grant is so much bigger than that. This program gives women information on many health topics and sends the message that it's important for women to take care of themselves so that we can be there for our families."

"For four or five years before the project began, Suzanne had been meeting with the community," said Ronit Elk, scientific program director of research for the American Cancer Society. "She had the patience to wait and build trust before she started her research and built the program step-by-step. Because of the approach, the community has recognized her as an adviser. She has taught the Messengers how to listen and understand. She could write a paper on how to work with Native American nuances."

When it came time to finding Messengers, Christopher and McCormick surveyed Crow women about the sorts of women they went to when they needed advice. What were these women like? How old were they? Eventually, they considered 44 names of Crow women nominated by others as natural helpers in their communities. She and McCormick trained the first 25 Messengers for Health in July 2002.

"The program recruits women whom others turn to for support," Christopher said. "Everyone knows someone like this. If you go into their home or their office, the phone is always ringing and people are always stopping by, turning to them for advice and support."

In the last two-plus years, Messengers have taken their testimonial of health to hundreds of their neighbors' doors, to churches and grocery stores. Each are paid $60 a month and meet with Christopher and McCormick the first Wednesday of each month to share strategies for outreach, discuss problems they've encountered, and receive further education and information.

"They have covered everything from men's health to nutrition and domestic violence," Christopher said. ""I'm getting as much as I'm giving."

In addition to Christopher and McCormick, other Messenger for Health staffers include: Adina Smith, a psychologist who is also an MSU professor health and human development, who travels with Christopher to Crow Agency to help with the project. Several past and current MSU Indian student have also worked with the program, including Vanessa Watts, now at Harvard, Jana Smith, Victoria LaFromboise, Jewel Gopher, Shane Doyle, Samantha Allen, Shaleen Old Coyote and Jessyca Small.

McCormick says that her work has grown steadily, and she sees evidence daily that the work of the Messengers is making inroads. There is now a trusted female health care provider that will take scheduled screenings. And women increasingly are asking Messengers questions about a wide-range of health issues.

Future directions for the group, as decided by a community advisory board, will include working with the Indian Health Service on cultural competency issues as well as to continue with the Messengers' work.

And, as another sign of progress, McCormick points to the Messenger's first-ever float in last summer's Crow Fair. Christopher and the American Cancer Society's Elk, in Montana on a site visit, also rode on the float. McCormick says it was a golden day as the Messengers for Health received hugs and waves and other positive recognition from the people in the Crow community.

"It was just something that made me feel so good at how far we've come," McCormick said. "We have been able to encourage women for health and for other things. We are working for a good purpose."

Contact: Suzanne Christopher (406) 994-6321