“Who do you see when you go to the emergency room here?” she said. “It’s 95 percent Native Americans. I felt like I represented them.” She said staff morale at the hospital was at an all-time low, and many Gallup residents were frightened about the possibility that the hospital could shut down altogether. There is an IHS facility across the street, the Gallup Indian Medical Center, but both hospitals are needed.

“This was the community hospital,” she said. “Where were we going to go if this one was gone?”

Jackson’s efforts made her anything but popular, especially since the 15 or so members of the hospital board were prominent Gallup socialites.

“I was in the crosshairs of the Gallup social club,” she says now.

Enduring Hope

Eventually, Jackson and other like-minded community members – including editorial writers at the local newspaper, the Gallup Independent – finally put enough pressure on Conejo that he moved to Gallup in mid-2014, along with William Kiefer, the shrewd chief operating officer who had been working for him in Texas.

In 2015, the first year that reflects the new leadership, the hospital reversed a years-long trend of multi-million-dollar losses, and grew by $3 million.

“Now every department has experienced growth,” Kiefer said.

Conejo, Kiefer and Jackson are just three of dozens of community members who are behind a coordinated effort to band together for a holistic solution to Gallup’s ongoing substance abuse problems. Rehoboth has resurrected its own residential treatment center, and hopes to add 40 beds to NCI’s 25. NCI hopes to add more beds of its own. Part of the answer is sending sober people back out into the community, where they can lead increasingly productive lives and help others, Conejo said.

Even some bar owners have changed their tunes. Gone are most of the fall-down saloons of decades past. Patrons have come to realize that they make better money if a lot of people come in for a couple of drinks – and inebriated customers scare those people away. A prominent symbol of the change is Sammy C’s, a pub that stretches a full city block and includes Gallup’s Starbucks. On a recent Friday afternoon, the place smelled of good food, not booze – and one customer sat studying in a brightly lit common area.

Members of the greater Gallup community have also been pitching in, in individual ways. Attorney and former Gallup mayor Bob Rosebrough, for example, initiated the city’s effort to clean up the abandoned site of the Gallup Brick Plant, which shut down decades ago. The former plant was located in a canyon spanning about six acres, where drunks used to hang out – and it was exactly the sort of place where they were likely to doze off and freeze to death.

Now, thanks to the efforts of Rosebrough and like-minded community members, the Brickyard Bike Park is a network of trails where kids can go and practice jumps and hilly descents.

Rosebrough said he’s oscillated on more direct involvement with Gallup’s substance abuse problems, partly because the issue gets divisive and exhausting, too often creating finger-pointing between the Navajo Nation and city officials, as well as foot-dragging by the community’s long-established liquor businesses.

As a case in point, the recent Navajo Nation press release pointed out that the liquor industry “has usually blocked efforts to limit liquor licenses and for closure of bars and package liquor establishments. Furthermore, these same bar owners have never sat down at the table to find solutions for the exposure deaths and alcohol related problems drowning the city.”

And Vice President Nez said the city of Gallup has failed to do its part: millions of dollars are funneled into the city from Navajo patronage, he said, but only a small percentage is being returned in needed services, such as those provided by NCI.

The long-term rifts are a source of frustration for people driven to address the issue.

“There’s too much discrimination on both sides of the fence,” Jackson said. “These are our people who come from all over the Four Corners area. It’s a human problem, and we all have to address it together.”

Rosebrough tried to push for more liquor controls when he was mayor from 2003 to 2007, and he still thinks tighter regulation would be a good idea.

“For example, it would help in Gallup if we limited early morning sales of packaged liquor,” he said. Meanwhile, he is rooting for Conejo’s collaborative, community-based approach to address the treatment angle.

And despite the fact that NCI, Rehoboth and even the city of Gallup could receive funding for detox and other services, NCI’s Foley declines to see it as a competition.

“NCI was never supposed to be the whole solution,” he said. “Our role is being a participant in the collaborative and helping to bring all of the services together to meet the need. The purpose of the collaborative is for everybody to work together.

It’s what the community needs.”