Valora Tom
Clinical
Dietitian in a Rural Setting
Valora Tom, Navajo, RD,
is a clinical dietitian at the Tuba City Regional Health
Care Corporation. She spends about three-quarters of her
time caring for ambulatory patients and one-quarter of her
time caring for hospitalized patients. Most of her patients
are Navajo, Piute, and Hopi.
Tom
and her beloved dog, KoKo, who is known to the Tuba
City community because he is always by Tom’s side
during public health education events and community
volunteer activities
Tom says that
it’s challenging for local residents to prepare and serve
healthy diets. Most of them, particularly the elderly, have
no refrigeration, electricity or running water. Food is
expensive at the one little, local grocery store. The
larger grocery stores are one to two hours away by car.
Growing food locally is also almost impossible because of
the exceptionally dry land and the scarcity of water.
Because of their many challenges, the local people eat a
lot of canned foods and fast foods. Many people fry such
foods as bread, potatoes, spam and corned beef. Tom is
encouraging them to do more baking, grilling. and broiling.
When Tom is counseling patients, often the patient’s spouse
and the grandma and children join her and the patient. “We
have a big family discussion about making healthy choices.
I tell people that I can tell them about nutrition, but
it’s up to them to decide whether to continue down the same
road or make a change. Change won’t happen over night. You
have to take little steps at a time.”
“I also recommend exercise,” she says. “The Navajo way,
traditionally, was to wake up when the sun rose, stretch
and then run. The philosophy behind this was that you were
running toward a new day, full of opportunities and
challenges. You were preparing yourself to tackle anything
head on.”
Little
Valora Tom with her maternal grandmother
Long
Time Interest in Science and Medicine
“My family is
originally from Beclabito New Mexico, which is equal
distance between Shiprock and Cortez.” says Tom. “When I
was in second grade, my parents wanted better opportunities
for the family, so we moved to Cortez, Colorado. However,
every weekend my parents took us back to our grandparents
on the reservation. My grandparents taught us our
traditions and our culture.
“I was always interested in science and medicine. In
preschool when we were asked to draw ourselves as a
professional, I drew myself as a doctor, wearing a white
coat with a red cross on my chest. During high school I
spent three summers in the University of Colorado Upward
Bound Program based in Boulder, Colorado. While studying
there, the other participants and I lived like we were in
college. We lived in a sorority house, and during schools
sessions we were taught by professors. It was there that I
got more involved in the sciences.
“Graduating from college was always important to me because
most of my family members are not college graduates. I
wanted to make them proud of my achievements because I
thought of my achievements as their also.
“I entered Ft. Lewis College as a pre-med student. However,
I changed my major to general biology and then to molecular
and cellular biology. I was intrigued by the infiniteness
of the molecules and cells within the human body. I also
had a heavy load of chemistry and math classes. I remember
being the only Native person in my classes. I’m so
appreciative that my professors were very supportive and
challenged me as much as they could.”
Over a two-year period, starting during her final year of
college, Tom lost her four grandparents. Both of her
grandmothers and her maternal grandfather passed away
because of the complications of diabetes. “Their loss
compelled me to help my Native people, particularly to help
prevent diabetes,” says Tom.
Tom was aware that her grandparents had not receiving
optimal care: “When I used to go with my grandparents to
their healthcare appointments, health educators would give
them a handful of handouts with a lot of words on them.
These handouts made little sense to my grandparents because
they didn’t have much of a formal education. They needed
someone who could explain to them and demonstrate for them
what to do. My grandparents weren’t willing to speak to
people of another culture. They felt it was a little
intrusive. I felt that if the health professionals were
like my grandparents, my grandparents would have been able
to open up to them.”
In the autumn following her college graduation, Tom worked
for two years as a bilingual paraprofessional in an
elementary school. (Tom is actually trilingual because she
speaks English, Navajo, and Spanish.) In this school, Tom
helped the Spanish-speaking children learn to read in
English. Tom remembers, “When I asked the cooks at the
school why the kids were so rowdy, they said, “The kids are
bouncing off the walls because of what we’re serving them.
Val, you’ve got to come in here and do something.”
Val wasn’t sure how to help. She started having potlucks
for the students. She asked each student to bring something
from his or her culture and talk about it and write about
how it was made. Val realized that she was having a
positive impact on her students’ lives, but she wanted to
do more.
She knew that she loved food and science and wondered how
she could combine these interests. In researching this
question, Tom discovered Texas Women’s University, which
she says has one of the best programs in nutrition and
dietetics. She applied to the program and was accepted.
Although she had to help some students there learn that
Native American Indians don’t still wear loincloths and
live in teepees, she felt accepted and learned a lot. She
also taught her professors and cohorts about her Native
traditions by incorporating the Navajo culture into the
presentations she gave and the papers she wrote.
Southwestern
Dietetic Internship Program
Tom did her
dietetic internship at the Southwestern Dietetic Internship
Program. “It exceeded my expectations,” she said. “I would
highly recommend it.” During the first part of her
internship, Tom was based at Phoenix Indian Medical Center
where, under the supervision of preceptors, she interviewed
and cared for patients. My preceptors watch me interview
the patients. When we stepped out of the room, the
preceptor would say, “What happened? What does this person
need? We’d look up the labs and medications and piece every
thing together. Then we’d come up with a plan.
At the rural part of the experience in Kayenta on the
Navajo Nation, Tom saw many traditional people wearing
moccasins and velveteen dresses and shirts. “One tall man
wearing a velveteen shirt and moccasins came up to me and
shook my hand. My preceptor explained that many local
Navajo elders welcome people to their home land. The Navajo
elders also saw me as part of their family. They called me
“shiyazhi”, which means “little one” in the Navajo
language.” Being called “shiyazhi” touched Tom because her
grandparents had called her “shiyazhi”.
When Tom returned to Phoenix, in addition to working at the
hospital, she joined a preceptor in visiting Native
communities around the Phoenix area. “I gave nutrition
presentations at the senior centers,” she said. “The people
there were very open. We joked and laughed a lot. The
preceptors are very well known in these communities. I
realized that building good relationships within the
community is very important.”
Tom completed the internship and is now working hard,
sharing her gifts and skills with her people.
This
article was originally published in the Summer, 2009
issue of
Winds of Change. Tom updated
the article in February 2010. (The cover artist is William
Rabbit, Cherokee.)