Rural doctors in southern Oregon are scarce. Clinics struggle to maintain adequate staffing, and mental health programs are closing. In a county where 45% of the population lives in financial hardship, the Coquille tribe is providing a vital option to the dire health conditions many endure.

“Finding a primary care provider can be challenging for patients, especially those on Medicare and Medicaid. The Ko-Kwel Wellness Center provides another option to help relieve the strain,” Brenda Meade, chairman at Coquille Indian Tribe, said.

The 22,000-square-foot Ko-Kwel Wellness Center (the tribe’s name spelled phonetically) located in Coos Bay, includes primary care, a dental suite with seven stations, a cutting-edge substance abuse recovery program, a pharmacy, and onsite public health services. In addition to serving Coquille tribal members and their families, along with tribal employees, the center also provides care to the general public as capacity allows.

When the clinic opened in 2021, funded through a combination of loans, grants, and new market tax credits, the Coquille became one of the increasing number of Oregon tribes that offer care to the general public while staying rooted in their cultural heritage and potlach (community focused) tradition.

From the moment you enter the clinic, it’s clear that Ko-Kwel Wellness Center is not your typical rural clinic. From above, the arrow-like design resembles the shape of a leister forked fishing spear, a common symbol of the Coquille Tribe. Once inside, corridors wrap around the building. Culturally significant art including a lineage wall with photographs of current and ancestral tribal members fill the hallways.

Kathryn Halverson, the chief executive officer of the Health and Wellness Division at Coquille Indian Tribe, explained the importance of the center’s architecture.

“The building’s nearly circular design demonstrates that no one department is above the other in terms of the importance in our holistic model. If you’ve come for a doctor’s appointment and we identify additional needs like housing, substance abuse counseling, or nutrition, we can do that at the same time. There’s no hierarchy and issues. You enter this way, or you enter that way. Everything wraps around the other.”

Brady Scott, a tribal member whose 87-year-old mother has Hodgkin’s lymphoma, appreciates this culturally driven approach, where the center is located across the street from his house in Kilkich, the tribe’s reservation village that feels like a suburban neighborhood. The center’s location provides not only easy access to care, but also a team of providers who can immediately assess his mother’s needs and provide resources to aid with home care.

Halverson described the purpose of this medical model.

“Unlike most for-profit models, we reinvest all resources back into our center to prioritize the long-term health of the tribe, rather than short term gains. This commitment creates a robust system that you don’t see in a lot of places. Additionally, when you talk about historical trauma in terms of Native Americans, it’s easy to underestimate the impact that has on their overall health and what it’s done to an entire population. That makes it even more important that the center provides services to offset some of those historical traumas.”

In considering the care provided to his mother, Scott reflected on Congress’s 1989 federal restoration of the tribe and the impact it still has today. “Being a restored tribe, as opposed to one that didn’t lose its land base, didn’t get scattered far and wide, and didn’t have to try to come back together and figure things out, the upside was we got to create the community we wanted from the ground up. But it’s not just buildings and the infrastructure, it’s how our tribe takes care of people, both its own and the community around us. I feel extremely fortunate. It’s something I wish everybody in the world had.”

According to Halverson, outsiders are surprised by the scope of Ko-Kwel Wellness Center services.

“There are often misconceptions about the quality of tribal healthcare. As a Title V tribe, we have our own health services where we can choose to supplement federal funding with revenue from Medicare, Medicaid, and private insurance. With this model we can provide excellent care to both tribal members and the general public to create a healthy, thriving community in a region where healthcare options are limited.”

– Carolyn Campbell, a former leadership & business coach, left city life four years ago to better understand the rural/city divide. Today she lives and works in rural regions to experience first-hand the issues these communities face and the innovative approaches to solving complex issues.