"Northwest tribal health advocates say the rising cost of fuel is exacerbating budget shortfalls at tribal and IHS clinics, and it is increasing the suffering of Indian people who need health care.

Andy Joseph Jr., the vice chairman for both the Portland Area Indian Health Board and an elected member of the Colville Confederated Tribes business council, believes the time for talk is over.

''We're not just maintaining status quo,'' Joseph said. ''We're losing ground. We're losing our elders.''

''The time for talk is over,'' he said, ''I am thinking of declaring a state of emergency in the Indian Health Service because of fuel prices. They're not only affecting us, they're killing our people.''

Wilder who was still at the microphone, said ''I don't know who you call to declare a state of emergency?''

She mused, ''Do you call the county or the state or FEMA?''

But Joseph was ignoring her. He knew that most of the health board delegates were elected leaders in their nations, who could take a declaration back to their councils for enactment.

''I move,'' he said, ''that a state of emergency be declared because of all the deaths.''

A second came from somewhere in the audience. The vote when called was unanimous. A few delegates made supporting comments, and then the meeting moved on as if nothing had happened."

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