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Whiteclay: The health problems still linger

A stoop in Whiteclay, NE, that was occupied for decades by people drinking is now empty./Photo by Kim Greager

WHITECLAY, NE. – Last year, four beer stores in a small, northern Nebraska town were shut down after a ruling by the Nebraska Supreme Court. The Arrowhead Inn, State Line Liquor, D & S Pioneer Service, and the Jumping Eagle Inn each sold thousands of cans of beer every day, equaling approximately 4 million cans of beer a year. These beer stores were located in Whiteclay, Nebraska, an unincorporated town with only around eight residents. Most of the Whiteclay beer stores’ customers came from the Oglala Lakota Nation (Pine Ridge Indian Reservation), where alcohol is banned, which is just a few hundred feet away from Whiteclay on the other side of the South Dakota border.

For decades, activists protested the beer stores, citing moral and social violations, not to mention legal ones. With the nearest Nebraska law enforcement located 22 miles from Whiteclay, crime became commonplace in the tiny border town. Public intoxication, public urinating, fistfights, sexual assaults, and even deaths were everyday occurrences in Whiteclay. Most people who died in the streets of Whiteclay died from alcohol-related health problems like cirrhosis or heart failure, some from passing out in freezing temperatures, and others were murdered. At least four murders in Whiteclay remain unsolved, with only one currently being investigated.

The people who lost their lives in the streets of Whiteclay are not the only victims of what many refer to as a decades-long liquid genocide. The largest group of victims are the generations of innocent babies born addicted to alcohol. It is hard to deny the connection of a town that sold millions of cans of beer each year to residents of a dry reservation where babies are being born with Fetal Alcohol Spectrum Disorders (FASDs) at a disproportionately higher rate than the national averages. Known as “hidden disabilities,” FASDs are sometimes very difficult to diagnose, and many people live their whole lives without being properly diagnosed, if at all. FASD is an umbrella term that covers a range of conditions resulting from a pregnant woman drinking alcohol and can vary from mild to severe, including not just physical and health problems, but cognitive, behavioral and social problems as well.

While exact numbers do not exist right now, a 2014 study of Sioux Falls published by ‘Pediatrics’ and co-authored by Sanford Research’s Gene Hoyme, M.D., and Amy Elliott, Ph.D., estimates that nearly 5% of U.S. children may be affected by FASDs. In a fact sheet available on their website, the Center for Disease Control and Prevention (CDC) states “We do not know exactly how many people have an FASD. Few estimates are available. Based on community studies using physical examinations, experts estimate that the full range of FASDs among 6-7 year old children in the United States and some Western European countries might be as high as 2 to 5 out of 100 school children (or 2% to 5% of the population).”

Numbers for the Oglala Lakota Nation are believed to be much higher than that, however, with an estimated 1 in 4 infants (25%) born in Pine Ridge affected by FASDs. Some people believe the percentage is even higher than that, but no official study has been done in western South Dakota or on the reservation.

Nobody knows more than Nora Boesem, perhaps, about the epidemic of FASDs in Pine Ridge. Boesem is a pediatric nurse, FASD Clinician, Director of the Adoption and Maternity Department with Catholic Social Services, and a mother. Over the last 18 years, she and her husband, Randy, have been foster parents to more than 150 children, giving 12 a permanent home. Each and every one of their children have been affected by FASDs, and all were born in or around Pine Ridge. While she is keenly aware of the FASD epidemic in Pine Ridge, Boesem says there is a need for real data to be collected, “I believe that further study of the western half of the state would be eye-opening and is needed.”

Boesem’s children have struggled with a variety of issues because of FASDs: two have severe epilepsy and frequent seizures, five have Cerebral Palsy, four require feeding tubes, and several have mental health issues including diagnoses of bipolar, schizophrenia, attachment disorder, anxiety, depression, and personality disorders. One child has no properly functioning internal organs, and the hospitalization costs for the first five years of her life alone have equaled approximately $3.3 million dollars, on top of the regular health care expenses like medication and formula, which total more than $16,000 a month.

One of the first reactions Boesem gets from people when she talks about her children is anger towards the birth mothers for drinking while pregnant. But Boesem says this of them, “My children’s birthparents are some of the bravest people I know.” She says that she has never met a birth-parent who did not truly want the best for their child, and that the majority of her children’s birthparents have been affected by alcohol and suffer from FASDs themselves.

Not only do people with FASDs struggle with health problems, many find it hard to function in society. Boesem says, “We watch our children struggle to find acceptance as they feel their behaviors are seen as unacceptable by society… their bodies grow but their brains struggle to catch up with their peers.”

Behavioral and mental impairments contribute to the high number of people with FASD who get into trouble with the law. The National Organization on Fetal Alcohol Syndrome reports that 35% of people with FASD are incarcerated in jail or prison at some point in their lives, and 60% of people with FASD over the age of twelve have been charged with a crime.

Boesem believes funding is crucial to provide better resources and services to adults living with FASDs, “When you talk about little kids, people are a little more interested, but when it is adults, the doors just shut. We criminalize their brain damage and throw them away.” She says, “While there are dollars available for prevention work, there is very little available to do real life work with individuals affected by FASD and trauma. The work needs to be done so that we can affect better outcomes. Right now, people affected by prenatal alcohol and/ or meth exposure are ending up in our prisons, jails, mental institutions, and on the street. We can- and need to- do better.”

Boesem became a leading voice in the movement to close the Whiteclay beer stores along with other activists like Frank LaMere and John Maisch. A Native American activist and civil rights leader, LaMere has dedicated more than 20 years of his life to trying to close the beer stores in Whiteclay. Maisch is a Professor of Legal Studies at the University of Central Oklahoma, former prosecutor for the Oklahoma Assistant Attorney General and General Counsel for the Oklahoma Alcoholic Beverage Laws Enforcement Commission, and creator of the documentary film ‘Sober Indian, Dangerous Indian’.

Boesem, LaMere, Maisch, and others joined forces to close the beer stores, and were together again last month at the third annual Whiteclay Leadership Summit, exactly one year after the historical Nebraska Supreme Court ruling that essentially closed the four beer stores for good. One focus of the summit was the need for FASD services and a proposed trauma center. Boesem says, “There are ways of building a better future, and the hope is if we can get an FASD and trauma center up and running we will see those better outcomes. The fact is, it would save the state money if we had the right programming in place, and it would definitely save lives.”

Though the Whiteclay beer stores are now closed, the impact of alcohol will last a lifetime for the Boesem’s, their children, and thousands of Lakota people.

(Contact Kimberly Greager at

(Editor’s note: There are still plenty of stores selling alcohol in the other town bordering the reservation. Native Sun News Today has urged the Tribal Government to secure funding to build an alcohol and drug treatment center on the reservation)

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