The AET Proved We Could Be The Best

In 1979-80 Akwesasne was in a state of turmoil. Officials within the St. Regis Tribal Council had lost control over their police force as the community became frustrated by the clashes between those who were advocates for integration and the more traditional minded residents. Added to this was the secret negotiations by tribal officials to cede all of Mohawk territory for a few million dollars and the “return” of the Hogansburg triangle. The Mohawk Nation Council was also on the rise as it challenged the Tribe on key issues such as jurisdiction, economic development and land claims.

The lack of communication between the Nation Council and the Tribe culminated in an incident at Racquette Point when the late Joe Swamp and Loran Thompson caught a tribal work crew clearing trees on disputed land. When the two men confiscated the equipment of the work crew the tribal cops were sent to arrest the men for theft which in turn led to a series of protests leading to the occupation of the tribal offices in May of 1979. This resulted from a demand by the Mohawk people that the tribal police resign. When the police refused their headquarters were invaded and the cops evicted.

Akwesasne came perilously close to all out war during the occupation but the Mohawk Nation leaders had their people withdraw from the tribal offices. The bitterness felt by the police and the supporters of the Tribe was not so easily reduced resulting in the decision to form an encampment at Racquette Point, which would last for 18 months. In June of 1980 the New York State police invaded Akwesasne to serve arrest warrants for many of the Nation advocates only to face the likelihood of a shooting war with those at the encampment. On the very brink of the state trooper attack, the governor of New York, Hugh Carey received a warning by the Haudenosaunee Confederacy that an assault on the Mohawks meant an assault on all Iroquois and the response would be immediate and occur on every Native territory across the state.

Carey ordered the troopers to withdraw but other public services also left Akwesasne including emergency squads from Massena, Malone and Cornwall.

Akwesasne was left without a vital part of our health care needs. This act of cowardice left those who needed access to the region’s hospital emergency rooms at a loss. Mohawk lives were at risk but the perceived fears of the outside rescue teams were deemed by them more important then the needs of our people.

Never very good in any instance those external rescue groups took a very long time to arrive at a residence or accident scene. The crews were often confused by the territories roads and found it challenging to find an address or to communicate with the people. From initial call to actual arrival at the emergency ward could take as long as two hours or more.

As we learned later there is a thing called the “golden hour” which is defined as follows:

“Cases of severe trauma, especially internal bleeding, require surgical intervention. Complications such as shock may occur if the patient is not managed appropriately and expeditiously. It therefore becomes a priority to transport patients suffering from severe trauma as fast as possible to specialists, most often found at a hospital trauma center, for definitive treatment. Because some injuries can cause a trauma patient to deteriorate extremely rapidly, the lag time between injury and treatment should ideally be kept to a bare minimum; this has come to be specified as no more than 60 minutes, after which time the survival rate for traumatic patients is alleged to fall off dramatically.”

All too many Akwesasnorons died or suffered considerable physical harm because it took far too long to respond to the need for urgent care. When the local rescue squads withdrew their services entirely the risk of death increased dramatically but no one outside of Akwesasne seemed to be concerned about this. The response internally was to create our own emergency responders. We were fortunate to have a connection with a community called “The Farm” in Tennessee. Those people came to Akwesasne led by one remarkable man with emergency medical training. That was the late Gary Rhine, a native of San Francisco and a filmmaker. He not only gave formal instruction in emergency care but also brought a used ambulance with him. That vehicle, and the resultant group called the Akwesasne Emergency Team, the historic AET, had its office in the rooms vacated by the St. Regis Tribal Police which had been disbanded in 1982 as the result of a public referendum.

The Akwesasne Emergency was staffed by mostly women, a novelty in a region where most rescue squads were males. The AET was completely volunteer. It had a group of emergency medical technicians (EMT’s) whose skills were superior to those in the region. The Akwesasne community trusted its members; they knew the people and the culture. They were of us, by us, for us.

In terms of the “golden hour” the AET was able to receive calls of distress, arrive at the place of need, prepare the patient for transport and arrive at the emergency rooms within that time. The goal was 45 minutes from call to the ER and that was met. I know this as truth for I was a member of the AET for six years and drove every one of our ambulances. We were efficient, reliable and very good. We provided the highest level of care then available. The community responded by actively supporting the AET throughout the decade it existed.

Because we were well trained and trusted we saved lives, hundreds of them. We transported car accident patients, people who were in cardiac distress, women in the advanced stages of delivery and elders who had problems breathing. We cleared airways, did CPR, stopped bleeding, supplied oxygen, consoled those in pain. We realized that having our own emergency team made a vital difference in the survival rates of our patients since reliance and trust was critical in times of distress. We refused to believe that the external rescue teams were in any way better than us and in truth our standards for care were superior to what they offered. Our people felt more secure when they knew that in their time of need that the emergency responders were relatives and friends from Akwesasne who were naturally more sensitive and caring-they trusted us and were held that trust as central to everything we did as a team.

That is what is missing in having an alien emergency organization enter Akwesasne. They don’t know us, they have deep rooted apprehension and ignorance about the people they are treating, they don’t know the topography, our customs, our traditions. It is that lack of knowledge which impedes the care they are supposed to deliver. It is self defeating and has a direct, harmful effect on the people aside from the insinuation that somehow the Mohawks are inferior, that we lack the skills to take care of our own.

The Akwesasne Emergency Team proved otherwise. It was itself a response to an urgent need by the community and worked for as long as it did because it was trusted by the people to provide them with the highest level of care during the most vulnerable instances of our lives. That trust cannot, and must not, be breached because of a paper contract, a bidding competition, political differences or someone’s ego. When one’s life is at risk nothing should matter other than having the best and most immediate care from home to the ER and that can only come from the Mohawk people themselves.