Kristen Monroe didn’t experience much of her Native American heritage while growing up. Although she is a member of the Little Traverse Bay of Odawa Indians, Monroe grew up hundreds of miles away on the other side of Michigan.

“I grew up in the Detroit area where there were not a lot of Native American activities,” said Monroe, who identifies as one-quarter native. “We did attend a few powwows as I was growing up, but my tribe wasn’t federally recognized until the 1990s, even though we had many treaties from a century past that weren’t honored for one reason or another.”

But, at 41, Monroe is getting a chance to reconnect with that part of her background. She works on a clinical rotation as a Family Nurse Practitioner DNP student at the Gun Lake Tribal Health Center, located about 30 minutes south of Grand Rapids. The Gun Lake Tribe is a band of Potawatomi, which operates as a sovereign nation with self-government. 

“I wanted to do a clinical rotation here because, with a native background, it is important to me to learn more about the diverse needs of the Native American community,” Monroe said. “We face a lot higher rates of chronic disease such as diabetes, heart conditions, as well as substance abuse and intimate partner violence concerns.”

Treating native men, women and children has given Monroe a unique perspective on healthcare. For example, non-traditional remedies like rubbing bear grease on the eyes for macular degeneration can sometimes go hand-in-hand with more traditional Western medicines. In addition, spirituality can play a central role in some treatments.

“It really varies from patient to patient, so you have to be aware of their spirituality and be aware that their upbringing might be different than yours,” Monroe said. “Even mine, being a native woman, I grew up in the Detroit area, I’m Catholic, I went to church — I didn’t really have that more traditional native spirituality in my upbringing.”

One of the big issues when treating this population, Monroe said, can be mistrust of white caregivers.

“Some of the challenges that health care providers face treating the native population really goes back to a lot of the mistrust that it has of the government and of white people, who took children generations ago and sent them to boarding schools where their culture was taken from them, their names were changed and their braids were cut,” she said. “That’s a very traumatic thing for those with native blood.”

Monroe’s great-grandmother and great-uncle were taken from their home in Bay Shore, south of Petoskey, Mich. as children and sent to a boarding school in Carlisle, Penn. No one in the family knows what happened to the great uncle, but her great-grandmother and great-uncle had to complete three years of indentured servitude to pay off their “education” following school.

That mistrust can be hard for some patients to get over sometimes, Monroe said, but as a health care provider, she works hard to listen and to ask any necessary clarifying questions. Monroe also said her MSU education is preparing her for her future role as an NP; she also is on a rotation at Sparrow Health in Lansing, Mich.

“MSU has helped prepare me for my role as a nurse practitioner with coursework on acute and chronic medical conditions and their treatments, as well as having provided me a variety of clinical experiences, so we get a really well-rounded education,” she said.

Partnerships with universities and other creative ventures are increasingly important in recruiting and retaining health care providers, according to Phyllis Davis, a tribal council member. Still, Davis noted finding providers can be a challenge, with pay ranges in tribal areas often not being as competitive as those in urban areas, like Grand Rapids, which is a short 30-minute car ride away.

“We’ve found many tribes in Michigan have found very creative ways through joint venture projects, cooperative agreements and MOUs (memorandums of understanding) to practice and care for our citizens,” Davis said. “We have universities that have shown an interest in doing the same and I see this as an outcome, especially in the past two years with the pandemic.”

Davis is proud of how far health care has come for her tribe, which has a physician and nurses on staff in the clinic, as well as regular visits by dentists and mental health professionals. The clinic opened in 2014.

“The ability to reduce those health conditions and to create healthier communities has been one of the goals for the tribe,” Davis said. The tribal government and tribal council members have the authority and responsibility to take care of their people.”

Monroe is proud to be caring for her people while rediscovering her roots. She hopes, one day, to also make her heritage a bigger part of her children’s lives.

“We have talked about how we are Native American, but especially the last few years, there really haven’t been a lot of opportunities to attend powwows, or to go to different events because of COVID,” she said. “It is something that is important to me, that I do want to take them to these events and have them experience those different parts of our heritage.”