A synthetic cadaver is helping Indigenous nursing students align school and culture

Brittney Ironmaker-Matt remembers her first experience with a human cadaver.

“The presence is really eerie,” she said. “I had a hard time.”

She could feel it spiritually, she recalls. And, as the only Native student in her class at the time, “Everyone else was like, ‘What is her problem?’”

Ironmaker-Matt is a Salish Kootenai descendant and is enrolled with the Sisseton-Wahpeton tribe. She's studying to be a dentist, and needs to know all the bones and organs of the body.

Ironmaker-Matt will be among the first graduates of Salish Kootenai College’s four-year nursing program; it’s the first tribal college in the country to offer one.

During a recent early morning biology class, she’s removing sutures from another cadaver — but this time, it’s a synthetic one. The cadaver — her name is Harmony — looks and feels like a real human body.

“This is exactly how they feel, even the mouth,” Ironmaker-Matt described. “Exactly how they feel.”

She says when she had to interact with the real cadaver years ago, it was just a few weeks after she had lost her grandmother. She was taught as a child that it was inappropriate to work with dead bodies because it's against her cultural beliefs.

She said the stress of having to go against her belief is an experience other Indigenous people have to navigate when maneuvering through higher education — and it’s a deterrent that could keep them out of the medical field.

“You don't just cut open and touch a body,” Ironmaker-Matt said. With Harmony, though, “you can do all that.

“It's crucial that we get the touch and feel because it helps with our learning process.”

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Harmony is one way that the Salish Kootenai College is trying to align instruction with its students’ cultural beliefs — not only to help with retention, but also to turn out much needed health care workers as the COVID-19 pandemic continues.

“That's important because otherwise they may choose not to pursue those fields," said Salish Kootenai College President Sandra Boham, "because they don't want to have that choice between living their values and their profession."

This year the school’s nursing students get to meet in person, unlike last year, when all classes had to be online and many students couldn’t meet Harmony.

Boham said Harmony is the only synthetic cadaver in Montana, and the only one at any tribal college in the country.

Instructors have to send Harmony to Florida for maintenance, or what they call her “spa treatment.” The cost: A whopping $82,000 up front, plus a $20,000-per-year warranty.

“But it's what students need today to be current and marketable,” Boham said.

Filling a community need

Boham says the college has maintained a 1% infection rate throughout the pandemic, and she attributes that to her students seeing masks and getting vaccinated as a health care responsibility, not just a personal choice. She says that makes their students equipped to be excellent health care providers.

“We just have to band together and be like buffalo and head into the storm,” Boham said. “When we come out on the other side, it will be, ‘We did it all together, and we'll be fine.’”

Tribal colleges are usually embedded within tribal communities, where health discrepancies can be especially stark. Almost 70% of residents living around Salish Kootenai College — tribal and non-tribal — have underlying health conditions, according to the Lake County Health Department.

Bernadette Corum is the medical director at the local tribal health department. She said rural clinics are in dire need of health care workers.

“I feel like even before COVID, we had a shortage of health care workers here and on the reservation, but I know it's happening all over rural areas as well,” Corum said.

According to the U.S. Department of Health and Human Services, around 46 million Americans are living in rural areas, and without proper transportation or access to well funded and well staffed clinics, the health of rural communities suffers. And those problems are exacerbated in tribal communities.

Health clinicians everywhere are experiencing burnout, but Corum says that rural tribal health care programs all over the country will be feeling the effects for much longer than clinics in more populated areas.

“I foresee that we are going to be in continued need for multiple years,” she said.

And while the need for rural health care workers is important, Kristine Hilton, the director of the nursing program at Salish Kootenai College, said the school is also focused on supporting the higher education journey of its students.

“We know that it's difficult to have to go to nursing school, even in the best of times, it's just not easy,” she said. “But during a pandemic it's even more difficult.

“Because we know that life happens and we don’t want them to quit school.”

Salish Kootenai College looks forward to graduating its first four-year nursing students in spring of 2024.

Hilton says having more Indigenous medical workers — ones like Brittney Ironmaker-Matt — can help build trust with Indigenous communities. But she remembers one local student last year who personally called up individuals for mammograms to great success.

“She said, ‘You're in line to get your mammogram,’ and because they knew who she was, when she introduced herself and everything... she had a higher rate of people making the appointments and then keeping the appointment,” Hilton said.

Taylar Stagner is Yellowstone Public Radio's Report for America Indigenous Affairs reporter.

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