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STOP – Securing Tohono O’odham Project – Has Never Stopped

   Don Williams is the Indian Health Services’ Injury Prevention Coordinator for the Tucson, AZ, area. He works with the Pascua Yaqui Tribe and the Tohono O’odham Nation, both of which are sovereign tribal nations. The Pascua Yaqui reservation is located just southwest of Tucson. The Tohono O’odham Nation, the second largest reservation in the country (the size of Connecticut), is comprised of 11 Districts, most of which lie 50-125 miles or more west of Tucson.

   Due to the physical size of the Tohono O’odham Nation and the very diverse needs of its largely rural population, Don spends much of his job working with first responder agencies that plan and implement projects to improve the lives of the residents. Most live in small communities which are spaced far apart throughout the desert land owned by the Nation, resulting in challenges that require creative, culturally-sensitive solutions.

   Don began his career as an Injury Prevention Coordinator in Utah in 1996. After moving to Tucson in 1998, he has found the job that makes him want to never leave. His credentials are impressive, and he works tirelessly to ensure that he is accomplishing the IHS goals for injury prevention through facilitating meetings for a program called STOP – Securing Tohono O’odham Project.

STOP’s mission statement emphasizes cooperation with other agencies:
STOP works in collaboration with the Tohono O’odham Nation’s departments and partners to prevent injury from motor vehicles through increased restraint and reduced distracted and impaired driving.

During STOP’s monthly planning meetings, the following Tohono O’odham Nation agencies collaborate to fulfill the goals of the mission statement:
   •   Indian Health Services
   •   Tohono O’odham Police Department
   •   Tohono O’odham Fire Department
   •   First Things First, a state-funded early childhood agency
   •   Tohono O’odham Nation Risk Management
   •   Tohono O’odham Department of Health and Human Services
   •   Tohono O’odham Community College

   Don’s work on the Nation takes him to all 11 Districts that comprise the reservation, which would typically mean many hours of driving to meet with the individual District Chairs who are responsible for the well-being of their rural communities. But through his collaborative efforts with the Nation’s rural first responder agencies, much of the planning takes place at the coordination meetings held in Sells.

   The project, which had no name at the time, started as a University of Arizona (U of A) grant funded for two years, with the purpose to increase seat belt use. Due to the size of the Nation, many residents drive long distances on unpaved roads, many in less than ideal driving conditions, in order to shop, visit family and conduct business. Cows and horses have free range, and drivers often have to swerve to avoid hitting desert wildlife. Vehicle crashes are the number one cause of injuries, and 1/3 of the Nation’s collisions are animal-related. Native Americans ages 1 to 44 die from injuries more than any other reason, even disease.

   The U of A grant funds were used to hire Coordinators, who were local community members, in 4 of the 11 Nation’s Districts. At the conclusion of the project, the U of A Public Health professor overseeing the grant gave a presentation showcasing its success, and encouraged the participants to keep it going. Don continued to meet with the community members involved in the project. Using crash data reports from the Nation’s police department to illustrate the crash problem, the group applied for a Center for Disease Control (CDC) grant that would fund activities focused on preventing injuries caused by lack of seat belt use and DUI incidents. The Tohono O’odham Nation was one of four tribes that were awarded the funding.

   Three of the four tribal grantees were in Arizona: Tohono O’odham Nation, White Mountain Apache, and San Carlos Apache. The fourth was the Ho Chunk Tribe in Wisconsin. The grant was funded for four years, with a set of implementation deliverables that were overseen by a CDC project officer, who was the mentor, and a University of North Carolina Chapel Hill Evaluator. These two people can be credited with providing the grantees with the culturally-relevant, criteria-specific guidance that enabled the participants to develop highly successful projects.

   Don and the rural first responder agencies meeting to implement the grant decided to name their project STOP, with the major goal being to stop predictable and therefore preventable injuries.

   At the end of the four-year proposal funding, each tribe was so successful with reaching their project’s goals that the CDC granted them funding for a fifth year. At the end of the fifth year, the four original grantees were no longer eligible to apply for the next funding cycle, but their success led the CDC to offer funding to eight more tribal applicants, instead of only four. Since the grant funding ended, the STOP program has relied on community resources as it continues to meet, plan and implement safety-related projects that meet the injury prevention needs of the rural populations being served.

The following two success stories are examples of how the ongoing efforts of this collaborative community organization have positively impacted the lives of the Nation’s residents:

   There are no street addresses for homes on the Nation; residents receive their mail through a post office mailbox address. Consequently there are no house numbers, which has resulted in delays when dispatchers try to explain to their first responders exactly where to go for an emergency call. The responders may try to find neighbors who can direct them to where the caller lives.

   Last year, STOP member Travis Bowser, who works with Indian Health Services, collaborated with Stanley Cruz, Chair of the Pisinemo District, on a pilot project. With the assistance of the Tohono O’odham Fire and EMS departments, Travis went to each house in Pisinemo and gave the residents a number to be displayed on the outside of their home. He then worked to develop GPS coordinates related to the assigned numbers. He told Pisinemo residents to use their house numbers in case of an emergency call to a first responder agency.

   As a result, rural first responders have been able to provide emergency services more efficiently and effectively; this has led to saving more lives. It also will provide STOP with the statistical data needed to encourage other Districts to replicate putting numbers on their houses.

   In a second success story, the efforts of the STOP collaborative agency members have increased the use of seat belts, reduced injuries, and saved lives. Don, former Tohono O’odham Police Chief Richard Saunders, and current Police Chief Joseph Delgado, formerly the Assistant Chief, made multiple presentations to each of the 11 District Chairs for several years. Finally, a primary seat belt law was passed on the Nation five years ago. Since it has become law, seat belt use has increased from 43% to 80%.

Don feels that the STOP collaborative community efforts continue to be so successful for a number of reasons:
   •   Coordination decisions are made at each meeting to determine which agency will take the lead and how the other agencies will provide support
   •   The project addresses injury at the community level
   •   The STOP members provide positive incentives to encourage people to be safe – for example, gift certificates for purchases at a local supermarket were given to people who were seen wearing their seat belts
   •   All of the STOP participants exhibit cultural competence.

   One model to ensure that comprehensive rescue and health services will be provided to a community is for mutual aid agencies to have formal agreements. The STOP model is another form of collaboration that allows departments to benefit from each other’s resources to accomplish a common goal.

A closing message that Don wanted to make sure was included in this article:

IHS initially developed the injury prevention program, but Native American communities have made it work.

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