Founded 25 years ago at Washington State University, Na-ha-shnee has given Native American high school students hands-on experience of the health care professions.
Many graduates of the Na-ha-shnee summer camp have gone on to successful health care careers, including Sarah Burke, Cheryl Ellenwood, Shian Kelly, Rhonda Martinez-McFarland, Shoshannah Palmenteer, and Hailey Wilson.
Sarah Burke: You are capable
Sarah Burke graduated with her bachelor’s in nursing from Washington State University in 2018—just in time to be greeted by a coronavirus pandemic.
“It’s been crazy!” says Burke of her nursing job at EvergreenHealth Medical Center in Kirkland. “I work on the floor that was designated to be a COVID unit. I’ve been a nurse for one year now. It’s been a lot, but we’re all learning together. It’s a weird time for everyone. We were hit pretty hard when it first started, but the process became smoother pretty quickly.”
Raised on the Lummi Indian Reservation near Bellingham, Burke was initially drawn to teaching. “I am drawn to education,” she says, but after attending Na-ha-shnee in high school, “I realized I was drawn to nursing.” As a nurse, she adds, she is definitely a public health educator, too, as educating people about personal and community health is part of what nurses do.
Like a lot of Na-ha-shnee participants, Burke found herself in the midst of a large community, a kind of family of students, health care professionals, and camp counselors all focused on caring for others.
“I went to camp three times,” Burke offers, “and then was counselor for two additional summers.” She learned about Na-ha-shnee through a school counselor, and through Emma Noyes, who was an interim director of Native American Health Sciences, the WSU program that hosts Na-ha-shnee, when Noyes visited her school.
“It was intense,” Burke says. “We were up at 6, to bed at 10. Two weeks is a long time and they squeezed in lots of stuff. We got to experience a lot of professions. I loved being on campus, staying in the dorms, getting to meet people, especially other Native American students, who came from all over.” Native students from across the United States regularly participate in Na-ha-shnee.
“I enjoyed the camp so much. Having that support was really helpful, so being a counselor was a way to give back. If I hadn’t gone to healthcare related. I wasn’t thinking about college.”
Burke gets quiet for a moment, and then, with great emotion, she adds, “We had a talking circle and were saying what the camp did for us. When it was my turn, I said that when we started, I didn’t think I was capable of doing any of that, going to college. And Robbie looked me straight in the eye and said, ‘You are capable.’ It’s so small, but it felt like a lot. She was a really good role model.”
Robbie Paul is the Nez Perce woman who, before retiring from WSU after 22 years, started Na-ha-shnee. She recruited hundreds of Native high school students to come to the camp as well as dozens more who went on to become nurses, nurse practitioners, and doctors.
“Tradition makes it more comfortable,” Burke says, referring to the fact that Paul and others share Native stories and ceremonies to help ground the camp in a shared cultural context. “I went alone, so going across state was a bit of culture shock. So having time to reflect and listen to Robbie’s stories gives you a sense of home and family. And after two weeks with strangers it’s like you’ve known these people you’ve been with forever.”
“Sometimes,” she adds, “people just need to be told that they can do it. They don’t realize it because all they hear is that they can’t.” One of the great strengths of Na-ha-shnee is that it brings together students and professionals who together overcome what Paul calls the “dumb Indian” stereotype. The camp empowers a kind of collaboration that frees the spirits of young people and encourages them to seize their potential.
Native Americans contend with disproportionate levels of poverty and disease, exacerbated by centuries of racism. Camps like Na-ha-shnee, which empower Native students to wear the paint of healers, scientists, and leaders, is “the only way we are going to fix some of these problems, not just in health care,” Burke insists, but in every aspect of life.
“I’ve seen this camp work. Even if students don’t go into healthcare, they go into something else. I see people going from camp to college all the time. I was just talking to one of my campers and she is applying to nursing school right now.”
Cheryl Ellenwood: Fierce warrior
Cheryl Ellenwood is clear about what she sees as the role of Native Americans in contemporary society. “By gaining skills that complement their traditional knowledge,” she says, “we can become fierce warriors across all areas of society.”
In December, Ellenwood will earn her doctorate in public management at the University of Arizona. “My work is focused on asking policymakers and researchers, what are you missing by excluding hard to reach populations.” Native Americans are often left out, or “erased” from social science, policy, and other forms of research. “There’s a reason for exclusion and there’s an injustice done by excluding them,” Ellenwood adds.
“My role in academia is to serve students who are often at the margins in major disciplines. There’s a lot of disconnect between Western knowledge and more culturally grounded Indigenous knowledge. I see a lot of erasure in texts, research, courses, and papers. So I try to include Indigenous perspectives in public management and criminal justice. And with the Native students I mentor, I’m equipping them with tools to combat Native erasure: from research agendas to projects that include hard to reach populations, we need to be including American Indians. I’m looking to shift the framework” from methodologies that exclude Native peoples because they are hard to reach “to finding methods that are more inclusive.”
One of Ellenwood’s mentors is Robbie Paul, who for many years ran Na-ha-shnee.
Ellenwood grew up in Kamiah, Idaho, the daughter of a Nez Perce father and a Navajo mother. She went to a very small high school: “We had about 180 students,” she says. Her graduating class consisted of 28 students.
Ellenwood participated in Na-ha-shnee in her last years of high school. “Coming to Pullman, to the cadaver lab, even in a program with people I knew—it was overwhelming!” But it gave her a sense of what college life would be like. She attended a large community college in Pasco. But, coming from tiny Kamiah, “it was culture shock. I needed that gradual progression to a larger school.”
Na-ha-shnee and similar programs “serve to connect people, especially those who don’t have the opportunity to visit a campus.” Visiting a college campus, and especially living on one for a week or two, makes it much easier to imagine yourself successfully attending university. “Mostly, though, it shows there’s a way to incorporate indigenous knowledge in any profession. That you can work to indigenize and disrupt these Western ideas and concepts while drawing from your strengths.”
Teaching from an indigenous perspective not only benefits Native students but “are valuable to all the communities we care about—we need indigenous people in all careers.” Ellenwood points out that even though she is not directly involved with health care, “much of my work is about creating healthy communities.” She is also working with researchers at the University of Washington and University of New Mexico, on new research that examines contextual factors in the spread of COVID-19 across Native Nations.
A fierce warrior for inclusion, Ellenwood clearly articulates a future in which researchers and others stop patronizing Native communities by claiming to know what’s best for them. “We have to consider the knowledge that extends from local communities. So, I look at moving from a deficit approach,” where so-called experts tell locals what they are lacking, “to a more strength-based approach,” where the community leads efforts to identify solutions that are culturally appropriate. This asset-based approach can serve as a foundation for empowering a healthier community.
She also wants to see more equitable and responsible approaches to philanthropy. There has been “a giving agenda that is paternalistic,” she says donors set funding criteria that serve their bottom line and are often not appropriate for Native communities: “We’ve defined poverty in this particular way, and you need to align with our definition. Only then will you be eligible for our money. There’s been this great conversation about decolonizing wealth and thinking critically about the transfer of wealth that stems from the taking of indigenous unceded land.”
How non-Native people interact with and support Native people and communities needs to be carefully rethought. “Instead of bringing outside consultants in to tell locals what the solution is, let’s turn to the communities that have survived since time immemorial. There is a wealth of traditional knowledge in these communities: they know what is needed so how can we help serve that in a collaborative way?”
Shian Kelly: A blessing at her side
It was at a round dance at Washington State University that Shian Kelly met Robbie Paul. A nursing student at the time, Paul offered Kelly a summer job as a camp counselor at Na-ha-shnee.
Kelly worked as a counselor for two summers, 2013 and 2014, before returning to western Washington. After being certified as a nursing assistant, she went to work in elder care “and loved every minute of it,” she says. “I’m excited to go out and help with COVID.”
She’s struggled to get into a nursing school, she says, because most admissions counselors “didn’t know who I am, they just look at a piece of paper.” Many under-represented groups in healthcare contend with the same challenge, which is why WSU is moving towards a more qualitative assessment of applicants. Instead of looking strictly at grades and test scores, qualitative assessment looks at passion, life experience and, as in Kelly’s case, determination and persistence.
And Kelly has known what she wanted to do since she was a child. “When my brother was being born, I would pretend to listen to his heart. I’d play with Band-Aids, pretend to stitch up my animals–so I wanted to get into this forever!” Her struggles with college—classes not transferring, long waiting lists—were, she says, a “reassurance that this was what I wanted to do.”
As a camp counselor at Na-ha-shnee, Kelly says, she went to classes with them and, the second year, taught a course for a day.
“I gave them an introduction to chemistry, as that is a winnowing class and I wanted them to know what they’d be in for,” she says. “The camp was more intensive than I realized: they were taking classes; it was very academic. They were being prepared for college. When we were at the Pullman campus, we visited the cadaver lab. That’s so incredible for high school students! A lot of the students were really chill about it–they handled it really well.”
One of the big advantages of participating in Na-ha-shnee, Kelly says, is that students “get a real sense of what this is going to be like before spending thousands of dollars on a few classes and finding out they don’t like it.”
Kelly has been grateful to know Paul. “She’s such a wonderful woman for spearheading this. She makes a connection with every student that goes through. She friends them on social media and is a great supporter and source of encouragement.”
Kelly herself has befriended some of her former camp students and says, “One of them just started nursing school this year.”
Na-ha-shnee is about discovering what’s possible—and then forming the network of support to realize the potential. “I’ve had a lot of people who told me no,” Kelly says. “Even college counselors and teachers have told me to pick another profession, that I wasn’t cut out for nursing. But Robbie said, ‘You can do this. It might take a little longer than you’d like, but you can.’ It has been a blessing to have her on my side.”
Rhonda Martinez-McFarland: Heeding the call
What Rhonda Martinez-McFarland recalls thinking about Na-ha-shnee is “Wow, I wish this had been available when I was in high school.”
Martinez-McFarland worked as a Na-ha-shnee counselor, sharing her experiences with younger colleagues.
Martinez-McFarland graduated with her nursing degree from WSU in 2000. The next year, she joined the United States Public Health Service—a 200-year-old uniformed service that has a wide-ranging role in keeping the public safe. Now a commander, Martinez-McFarland says that the service deploys to many places and for many reasons: during disasters, pandemics, and to provide medical services to the underserved. One experience impacting her own ethnic identity was deploying to the southern border to care for immigrant children.
“I am Native and Hispanic,” says the Spokane tribal member, and working in the area where her family is from “was very personal. My father was an immigrant from Mexico. I cared for those children like they were my relatives, met their needs, no matter where they were from.” All were simply looking, she adds, for shelter and a better life.
Prior to admission to nursing school, Martinez-McFarland had been working as a nurse’s aide in an elder-care facility. She recalls thinking how “nurse’s aides have a heavy load, they’re underpaid, and are often not treated well by nursing staff. I thought, ‘You know what, this is not right! I’m going to get my RN and be a better nurse and be better to nurse’s aides and help people understand the importance of elder care and what it means for our communities and the future generations.’
“It has been a strange journey for me! Because I was a teen mom, I didn’t graduate from high school—I got my GED. So testing was not always my strong point but in a clinical setting? It was like I was home. It was natural to me. I share as a mentor and interested in becoming nurses, is if you feel innately that you belong, then go for it. If I can do this, you can.”
In her Native language, Npoqínišcn, Martinez-McFarland’s name is Wamnee Wañaxay Weya—Spirited Eagle Woman. Martinez-McFarland gives a lot of credit to Robbie Paul for giving wings to the woman she is now.
“What Robbie offered was a gateway to helping us young woman understand ourselves as Natives,” Martinez-McFarland says. A nursing student at WSU at time she served as a counselor, she says “we were there to share our experiences and Robbie helped us envision ourselves as nurses and stronger Native woman. I think the experience brought me closer to my own spiritual journey of culture and spirituality, which I share with the women I work with now.”
Martinez-McFarland says that some students, including herself, didn’t have a connection to their Native culture. “What Robbie shared opened our eyes to what it is to be a Native woman. I know my great-grandmother was a very traditional woman, but I didn’t know that because my mother grew up in the boarding schools, ran away from it, and had children at a very young age. So, she never talked about that tradition.
“Part of my healing for me and my family is when I received my native name. It gave me my identity, something I never had before. As well, other elders in my life have taught me to go back and learn about my family to see who and why I am who I am today. And that’s how I learned about my great-grandmother. She was a fluent Plains Salish speaker, and participated in her traditions and cultural practices, which I was never aware of as a young woman. Over the years, I learned that my family were strong medicine leaders. It helped bring me to a place of knowing that I have the skills and courage to reckon with this innate feeling that I am where I am supposed to be.”
Connecting with the deep traditions of her Native culture “helped me to reach deep to complete this journey as a mother, as a fulltime worker, and what I needed to help me understand who and what I was to become as a person.
“In college, I learned how to maneuver the system,” she says. “I figured things out: how you get a GED, how to apply to a college and find the classes you need. And I got help from my tribe. So when I got to WSU, there was Robbie, and other Native students who helped each other by studying and working together. It became our community and our community supported our potentials as Native students.”
Martinez-McFarland says she’d like to see more opportunities like Na-ha-shnee—and not just in health sciences. Whether a young person wants to be a scientist, an engineer, a lawyer, “whatever someone is led to do. Most Native students don’t consider health care an option unless they’re in a household where it is actively being promoted.” Young Native people certainly don’t often see other Natives in the media—not as doctors, lawyers, or much besides a few well-worn stereotypes.
In addition to her long service to the public health of all Americans, Martinez-McFarland also works in private practice. “Now, as I become an elder, it is my responsibility to help young women and men. I teach them our traditional ways of healing using sweat lodges, spiritual brushings, and provide support when asked. My elders, mentors, and teacher would call me a medicine woman, but I am a woman who has earned the gifts I share with those who ask for help. I work with others to heal past and future generations—wherever they come from.”
Shoshannah Palmenteer: Full circle
At the end of third grade, Shoshannah Palmenteer’s teacher put together a book with a page for each student in the classroom. Each page had a photo, a bit of information about the student, and a what-do-you-want-to-be-when-you-grow-up section.
“I knew I wanted to be either a doctor or an artist,” Palmenteer says. “My artistic ability has not improved since the third grade, so my ultimate goal is to be a pediatrician.”
A member of the Colville tribe, Palmenteer is hoping to enroll in the WSU Elson S. Floyd College of Medicine in the near future. For now, though, the former Na-ha-shnee participant is director of the Rural Health Care Clinic at Coulee Medical Center in Grand Coulee. In her community, Palmenteer is a force of nature—and perhaps that’s why she was given the name Kamuli, which means Volcanic Mountain in English.
When Robbie Paul came to Colville High School looking to recruit students to the camp, Palmenteer was intrigued. She applied and was accepted for the camp in 2000—and liked it so much she went back every summer of her high school career.
“In my second year, in 2001, we named the camp,” Palmenteer says. Na-ha-shnee is an acronym for the Native American Health Institute. “We drew pictures of the logo and voted to pick the feather logo.”
“Robbie was amazing,” she continues. “Na-ha-shnee felt like a family. Robbie is an amazing storyteller. She invited us to her home where we’d make medicine bundles from things we gathered in her home and garden.”
One of the best things about Na-ha-shnee, Palmenteer says, was meeting “so many different people from different reservations. And a lot of them had the same stories as me, so finding people with the same plans was great.”
Held at WSU Spokane each summer, Na-ha-shnee also takes students to WSU’s Pullman campus. “Going to WSU, seeing campus,” Palmenteer says, was formative. “And the cadaver lab! We saw cadavers, brains, livers—big eye-opening experience for a teen.” And important early experiences for young people considering a career in health care.
After graduating from Eastern Washington University in 2008, Palmenteer volunteered to help out at that summer’s Na-ha-shnee. “It was full circle: going to camp all four years of high school, then going to college and coming back to camp to see all those young kids who might follow in my footsteps.”
One of the things she loved most about Na-ha-shnee was the traditional knowledge and ceremonies that are incorporated into the camp curriculum. Talking circles, for instance, help ground students in a deep tradition while also creating a sense of community and family among participants from diverse Native backgrounds.
Palmenteer uses ceremony and traditional knowledge at the clinic she directs. She is open about the lack of trust Native people feel towards white doctors and western medicine and is actively works to repair that trust. Native people are often “reluctant to go to seek care,” she says, after centuries of trauma. “There is a lack of trust in systems in general” but, because she is a daughter and a niece to many people in her community, “they trust me” and are more likely to seek care.
But Palmenteer wants to expand the circle of trust beyond her own extended family.
“There’s a big cultural gap in the medical field,” she says, “and we’re trying to figure out how to bridge that gap.” When she interviewed at the clinic she now directs, she was asked that very question. “And I said, ‘Have a pow wow.’ People love to come to pow wows and socialize.” Soon after hiring her, clinic administrators asked her, “‘How can we make the pow wow happen?’ And that September we held our first annual Gathering of Wellness Pow Wow at Coulee Medical Center. This year would be the fifth annual. It gets bigger and bigger. Everyone is invited.”
Palmenteer continues to heal the divide with her work in her community and at the clinic. “Having providers who understand the cultural differences,” she says, is key. “You have to take the time to earn trust”: it doesn’t come automatically when a doctor puts on her white coat.
The other important piece that will bridge the gap is “having more Native health care providers. Just having me here brings my aunties” into the clinic. “They say, ‘My niece works here!’” Palmenteer says that she’d like to see more Natives in all areas of health care provision, from lab techs to nurses and doctors.
“That’s our culture: we take care of our own people.”
Shoshannah Palmenteer wants young Native Americans to know there are many opportunities for them. “The Association of American Indian Physicians,” she says, “has a pre-admission workshop that I attended when I was in college. They help you practice for medical school admission interviews, MCAT tests, and there are American Indian providers who share their stories and answer questions.”
Hailey Wilson: Rooting for you
Hailey Wilson wants Native American young people to know one thing for sure. When it comes to a career in health care, “there are a lot of opportunities. And there are a lot of us who want you to succeed. It’s not a competition between you and the next student.” Wilson says that she and other Natives American in the field “are rooting for you.”
Wilson is a family practice physician. She works for the Indian Health Service on the White Mountain Apache Reservation in eastern Arizona. “I do a little bit of everything. From the birthing center to elder care, as well as hospitalized patient care and the emergency room,” she says.
A Nez Perce woman, Wilson was born in Lewiston but grew up in the tiny Idaho town of Lapwai. She heard about a program at WSU called Na-ha-shnee.
“When I was in high school,” Wilson says, “my sister and I both attended. At the time, I was pretty focused on nursing and Na-ha-shnee increased my interest in that field. There were students from all over: across Washington, Idaho, from the Navajo Nation. Even this many years out, I still have connections with people I met at the camp.”
When she was an undergraduate, she says, “Robbie Paul asked me to come back and be a counselor, so I did that.”
“Then, a few years ago, I spoke at one of the final dinners,” Wilson says: in fact, she was the keynote speaker at the celebratory dinner for the twentieth anniversary of Na-ha-shnee.
“The camp has evolved,” she explains, “from nursing to all health fields. And that’s helpful because a lot of people don’t know all the fields involved in health care. Even when I was a counselor, I learned stuff about physical therapy and occupational therapy. It’s so important to open students’ eyes to all the career paths! I know only a couple Natives who are physical or occupational therapists.
“It’s essential to have Natives in these areas,” Wilson continues, “and programs like Na-ha-shnee are critical. I was fortunate in having been able to participate in several programs. The year I graduated from high school, I did a program at the University of New Mexico, where I earned some college credits and met like-minded students. And the University of North Dakota has a great MCAT prep program, which I participated in. They also have other programs” under the umbrella of Indians into Medicine.
Wilson says there are lots of programs specifically for Native young people but, she says, “We need to do better at letting high school counselors know these programs are out there. My college advisor was great: she knew what I needed to do to get into medical school but she, obviously, hadn’t had a lot of Native pre-med students. I was fortunate enough to find some programs on my own. I did a summer program at Harvard University doing academic research, and it was specifically for Natives.”
Always intent on serving Native communities, Wilson aimed high. Her first-choice medical school was the University of Washington. “I was a little intimidated, not knowing what I was getting myself into, but also seeing test scores and GPAs—super intimidating! And being from a small town, and wondering if my education was good enough to get me in. But UW was high on the list as I wanted to go into primary care.”
Now she’s practicing medicine on a reservation where, according to recent reports, more than an eighth of the residents have tested positive for COVID-19.
“Native people are more vulnerable” to illness, she says. “There’s a lack of resources, even clean water, and there are lots of chronic medical conditions, lots of people living in the same homes. So we are encouraging people to stay home.”
Her friends from medical school are still in touch, she says, and that helps ground her and keep her going.
“We had a close family at UW. It helps us all stay sane.”