Audrey Martinez remembers the early 1980s when Native Americans received health care out of trailers on the San Manuel Indian Reservation near Highland.

Years later, tribal members went to a small clinic in San Bernardino.

But the building in which they leased space was in a crime-plagued neighborhood, and officials began looking for a better location.

They found it about 12 miles south, in Grand Terrace.

The $11.5 million San Manuel Indian Health Clinic opened Feb. 2 on a 5-acre property that formerly housed a charter school. Money to buy and refurbish the site came from a $2 million donation from the San Manuel Band of Mission Indians, as well as federal funds and grants.

The free clinic offers medical, dental, optical, laboratory, behavioral health and other care in two buildings totaling 38,000 square feet. Radiology, ultrasound and mammography services are planned in coming months. The center is expected to serve more than 8,000 patients a year.

“We’ve come a long way from where we started,” said Martinez, a San Manuel member who sits on the board of directors of the organization that runs the Grand Terrace clinic.

ATTACKING HEALTH PROBLEMS

Riverside-San Bernardino County Indian Health, Inc. is the nonprofit contracted through the U.S. Indian Health Service to operate seven Native American health clinics in Riverside and San Bernardino counties, including the one in Grand Terrace. The Indian Health Service is an agency within the U.S. Health and Human Services Department.

The nonprofit is a partnership of nine tribes that pool resources to run the clinics, which are open to members of the 566 federally recognized Indian tribes and their dependents. Tribes making up the coalition are Agua Caliente, Cahuilla, Morongo, Pechanga, Ramona, San Manuel, Santa Rosa, Soboba and Torres Martinez. Patients must show proof of residency in Riverside or San Bernardino counties to receive services.

“For a lot of our patients, especially the elders, this is the only system of health care that they’ve gone to, that they’ve trusted for their health care,” said Bill Thomsen, the clinic’s chief operations officer.

Clinic operators hope to make a dent in health problems that plague Native Americans.

American Indians and Alaska Natives have a shorter life expectancy and die at higher rates from diabetes and liver disease than other Americans. They use tobacco and commit suicide more often than other groups, and cancer and heart disease remain major issues, according to Indian Health Service data.

Poor health outcomes today can be traced to historical factors, experts say.

Western expansion into Indian territories after the Civil War led to tribes losing their original homelands. Putting them on reservations produced harmful health effects, and they stopped eating traditional foods such as rabbits, deer, cactus, mesquite and acorns, said Clifford Trafzer, history professor and director of the California Center for Native Nations at UC Riverside.

“Their bodies are biologically different,” he said. “That change was not good for them.”

Forced to abandon their former ways of life, Native Americans slowly came to accept western medical practices. They still feel more comfortable when they go to a place run by their own people, he said.

“To have a health clinic and health care providers that know Native Americans and how to treat Native Americans, it’s an extremely important element of modern society,” Trafzer said.

CULTURAL AWARENESS

While many doctors at the Grand Terrace clinic are not Native American, they get annual training on how to provide culturally appropriate care, said Jess Montoya, chief executive officer.

The clinic is set up so doctors and nurses work side by side, with diabetes and behavioral health offices located nearby. Patients can get drug and alcohol counseling and work out in the fitness center. Operators are in the process of getting state licensing to provide pharmacy services.

“We have everything that pertains to a patient’s care in one area,” said Dr. Karen Davis, clinical services director.

Visits are scheduled every 30 minutes to give doctors time to talk to their patients and understand their needs, she said.

To provide a stronger cultural link, Montoya said the clinic is thinking about adding a sweat lodge for spiritual cleansing.

“It doesn’t feel like a clinic, it’s more personal,” said Corona resident Lucille Nunez, 57, who was in the Grand Terrace facility one recent afternoon getting a referral for a mammogram.

Down the hall, Desiree Amers, 41, was waiting to receive dental work. She said she called in sick from work with a terrible toothache and got an appointment in less than an hour.

The Grand Terrace clinic is closer to her Jurupa Valley home than the former location in San Bernardino. It’s also much larger and in a better neighborhood, she said.

“We’ve been waiting for something as nice as this,” she said.

Contact the writer: 951-368-9292 or swall@pe.com