Formed in 1953 when tuberculosis was running rampant among the Cheyenne River Sioux, the South Dakota TB Association became exemplary of the kind of response to be elicited from the American Indian grass roots when the need is Indian defined and the solution is Indian designed. Success of the Cheyenne River organization in combating TB brought about formation of the Lakota Tuberculosis Control Conference, a statewide health organization composed of 7 Sioux reservations. Assuming other health responsibilities and expanding beyond state boundaries, this organization changed its name in 1958 to the Lakota TB and Health Association and was formally chartered in 1968 when it adopted a consitution and by-laws. The Lakota TB and Health Association then became instrumental in creating the Community Health Representative (CHR) programs, programs administered under the Indian Health Service which provide training for Indian liaisons between the hospitals and the communities. CHR's have become indispensible to the Indian community, for as bilingual interpreters of doctor and patient information, they help bridge the gap between Indian cultural traditions and modern health education. Today 18 tribes are members of the Lakota TB and Health Association, and it is only via these kinds of community-based, Indian organized programs that Indian health education can be effective. (JC)