American Indian communities have significant resources to offer, despite the sometimes formidable barriers they face and the traumatic history they have endured.
Native Healers . American Indian women sometimes have available native healers who can offer assistance in dealing with sexual victimization as well as other problems. Despite the very different philosophies espoused by Western health and social service providers and native healers, American Indians may feel comfortable seeking both kinds of counsel (Kim & Kwok, 1998) . A survey of medical patients at a clinic on the Navajo reservation indicated that 62% had seen a native healer in their lifetime and more than a third had consulted one in the last year (Kim & Kwok, 1998) . The most common barrier to seeking care from native healers was cost. Still, those seeking help for the aftereffects of victimization may still find, as one respondent put it, that “the doctors give me pills for my body, the medicine man gives me songs for my spirit” (Kim & Kwok, 1998, p. 2248) .
Spirituality and Cultural Resources. Most, if not all, American Indian communities have unique cultural ceremonies that can be important resources for women healing from sexual victimization (Senturia et al., 2000) . These include sweat lodges, talking circles, and other healing ceremonies. Native advocates may be able to offer more support than non-Indians to American Indian women healing from victimization. These ideas were well-expressed by one native woman:
“…That helped me a lot, … smudging [ritual purifying with the smoke of sacred herbs such as sage] and just doing a lot of different things about being strong and protecting myself, you know. The Native person can teach me how to protect myself in a Native way, like smudging, and not cutting my hair, and just leaving it on the ground so someone can stomp on it! And you know, just things like that, little things. And the music, powwow music was a big healing for my heart and made my heart strong again” (Senturia et al., 2000, pp.114-115) .
Tribal Justice Forums. There are alternative tribal justice forums in some American Indian communities. These family or community forums emphasize restorative and reparative approaches to justice rather than the adversarial system found in the U.S. court system (Pecos-Melton, 2002) . Although safety must be protected, these forums are often more focused on meeting the needs of victims and community members and may offer a useful resource to some women seeking justice for their sexual victimization.
Free Western-style Health Care . Members of federally recognized Indian tribes are eligible for services at IHS facilities or at tribal facilities that receive IHS funding. IHS services are most easily accessed for American Indians who live on or near reservations, but some facilities serve American Indians in urban areas (Indian Health Service, 2002) . Unfortunately, many IHS facilities do not have specific programs for sexual victimizations, but American Indian women can get treatment for injuries, sexually transmitted diseases, pregnancy, and other consequences of sexual victimization with fewer financial concerns than some U.S. women. American Indian women also have access to free psychotherapy, if they can locate an IHS therapist with expertise in dealing with sexual victimization trauma.
Outreach by Advocates and Other Providers. Positive experiences between American Indians and staff have been found, including showing respect for patients and elders, participating in the community, and easy availability (Fifer, 1996) . Some victim advocates and their organizations make consistent efforts to be culturally sensitive, in part by ensuring that staff mirror the ethnic composition of the community as much as possible, literature is appropriate for all community members, and outreach is done at organizations and churches that are frequented by members of all ethnic groups (Donnelly et al., 1999) .
Financial Assistance . Many tribes offer financial assistance to tribal members. Housing assistance is probably one of the most common benefits (although there may be a waiting list). Some agencies find this resource useful when assisting victims (S. Locklear, victim advocate and Lumbee tribal member, personal communication, October, 2003). Some tribes also offer educational grants and may have discretionary funds available for emergency travel or other needs. Some victims may find these resources helpful, either in dealing with the immediate crisis or on the path of healing.
Federal Funds . The Violence Against Women Act and other Federal resources sometimes earmark funds specifically for American Indian tribes. Although these funds are allocated in part to redress generations of federal neglect, tribes or agencies willing to collaborate with tribes may still find them helpful in efforts to expand programs targeting American Indian women.
The unique obstacles and resources of American Indian victims will need to be considered before services or prevention efforts can be effective. There are several ways that an understanding of these issues can enhance services and help eliminate violence against future generations of American Indian women.
Incorporate Culturally Congruent Processes Into Services and Programs. There can be pressure to provide quick fixes to pressing problems, but community stakeholders need time and resources to establish viable working approaches in each native community. Traditional native formats, such as talking circles, can be helpful for organizing community coalitions to address social problems, including sexual victimization and other violence. Talking circles allow each member of a group to speak uninterrupted in turn, guided by a facilitator who is typically an elder or other important figure. Members of the Sault Sainte Marie tribe of Chippewa Indians recently used talking circles in a federally funded project as a key part of decision making and consensus building (McBride, 2003) . Talking circles, prayers, ceremonies, and the involvement of elders or traditional healers may not be typical components of many federally funded prevention projects, but can be critical for developing culturally congruent programs in many native communities. Additionally, the images in illustrated materials, including videos and pamphlets, should be culturally congruent; merely adding images of native women to otherwise culturally insensitive materials is not sufficient (Hamby, 1998) .
Although cultural congruence is important, communities should also have access to service and prevention models developed for other groups. Tribal communities need not start from scratch in some outsider’s interest of developing a “native” approach. Taking the time to develop an entirely new program instead of adapting an existing one may seem like a luxury that cannot be afforded by people without privilege (Hamby, 2000) . People working with American Indian victims should borrow from existing programs if they choose to do so.
Make Services and Programs Accessible to Community Members. Any structured training or program will need to address logistical issues such as transportation, meals, and childcare for participants and for trainers (McBride, 2003) . It is important to make sure that women will have access to information about available services. The best way to disseminate information will vary across communities, but local cable access channels, local radio stations, bulletin boards in frequented offices and stores, parent teacher meetings at schools and Head Start, public restrooms, pow-wows, and other community events are all good places to advertise. It is unlikely that many victims will approach advocates in such public settings but these strategies raise awareness. Home visits are also an important component of many successful programs. Agencies and programs should have community members and survivors as part of their staff.
Adapt Language and Communication Styles to the Audience. Tafoya (2000) recommended replacing or supplementing explicit, Western-style communication with culturally congruent forms of communication, such as metaphor and storytelling. Advocates and prevention specialists should avoid the use of jargon when possible and clearly explain all specialized terms. Providers should also learn any terms or phrases unique to the community they serve, especially those related to victimization, health, or psychological states.
Offer Choices To Protect Confidentiality and Reduce Stigma. American Indian women should have options to seek services where they choose. Some may prefer to seek help from outside of the community to protect their confidentiality.
Implications Regarding Law Enforcement and Criminal Justice. Advocates and prevention specialists can work to address problems with law enforcement and criminal justice on several fronts. First, they can make sure they are empowering victims to make their own choices about involvement of the legal system. Additionally, they can provide young American Indian women an honest appraisal of these institutions in their own community. They can work to build relationships with law enforcement and criminal justice personnel. There are grants available specifically for increasing collaboration between these agencies and victim services, such as the STOP Violence Against Indian Women Discretionary Grants Program. Go to: http://www.ojp.usdoj.gov/fundopps.htm or http://www.fedgrants.gov/Applicants/DOJ/HQ/postdate_1.html for an updated list of grants. Advocates should also work with alternative justice forums, when available, to give victims the maximum amount of choice in deciding whether and how to prosecute their case.
Funding Issues . Political activism may be the best way to ensure better funding for American Indian victims and ensure that tribal members are receiving all resources to which they are entitled. Native women have successfully advocated governments for better treatment (Prindeville, 2003) . Although gambling has had both positive and negative effects on native communities, Indian gaming earns more than $10 billion in annual net revenues (Gonzales, 2003) . Although some of this money has gone to programs for victims, advocates and survivors could lobby for more to be directed towards social programs.
Make Use of Community Strengths. Much of the literature on services for American Indians focuses on deficits and problems, but there are strengths that can be taken advantage of in these communities, too. The strengths addressed thus far–native healers, American Indian spirituality, alternative tribal justice forums, free Western-style medical care, housing and other financial assistance, and Federal funds earmarked for tribal efforts to reduce violence against women–are not exhaustive. Individual communities have unique strengths that will best be appreciated by those living and working in those communities.
American Indian women have proven their resilience and strength through centuries of oppression and violence. Although many outsiders may think that the mistreatment of American Indians is entirely historical, the reality is that there are still many institutions and systems that perpetuate the problems of most American Indian communities and tribal members (Duran et al., 1998; Duran et al., 1993; Snyder-Joy, 1995) . American Indian women who are sexually victimized must contend with these systemic and cultural barriers in addition to the barriers that face all victims of violence. Despite the long-term effects of racism and violence, the spirituality and traditions of many American Indian communities offer the potential to help victims heal. Advocates who are sensitive to these issues can make a real difference in helping victims and in creating organizations that will bring these communities into greater balance and move towards the elimination of sexual victimization.
1 Sexual victimization is the nonconsensual touching or penetration of genitalia, breasts, mouth, or anus. Non-contact acts such as voyeurism are also forms of sexual victimization (Basile & Saltzman, 2002) . “Rape” refers to sexual victimizations that involve penetration of the vagina, mouth, or anus.
Author of this document:
Sherry Hamby, Ph.D.
Research Associate Professor, UNC-Chapel Hill
Laurinburg, NC 28353