Mekoryuk celebrates new clinic opening

Transcription

1 Volume IX IX No. No November December 15, 15, Mekoryuk celebrates new clinic opening Health Aide Supervisor/Instructor Elena Rothchild starts cutting a congratulatory cake with Mekoryuk Health Aide Sally Whitman as village guests join in the celebration. The new Mekoryuk Clinic was opened for business on Dec. 3. The new clinic in Mekoryuk was opened and dedicated December 3. The 2,400 sq. ft.facility, like most new clinics in the Delta, incudes exam rooms, a dental operatory, itinerate sleep-over quarters, a behavioral health office, administrative office and a pharmacy. They are built with energy-efficient foam panels and local laborers. (Photos by YKHC Public Relations Dept.) INSIDE: Board Work, p. 3 Diabetes Spotlight, p 4 Smokeout, p. 8

2 2 YKHC Board of Directors Unit 1 Joe Mike P.O. Box Kotlik, Alaska Aaron S. Kameroff P.O. Box 37 Alakanuk, Alaska Unit 2 Ray Alstrom P.O. Box 8 Marshall, Alaska James C. Landlord P.O. Box Mt. Village, AK Unit 3 Billy Morgan P.O. Box 72 Aniak, Alaska Angela Morgan P.O. Box 243 Aniak, Alaska Unit 4 Fritz George P.O. Box 62 Akiachak, Alaska Moses Peter P.O. Box 57 Tuluksak, Alaska Unit 5 Bill Kristovich P.O. Box 1037 Bethel, Alaska /2212 Henry Hunter, Sr. P.O. Box 632 Bethel, Alaska Gloria Simeon P.O. Box 308 Bethel, Alaska Joseph C. Bavilla P.O. Box 6011 Napaskiak, Alaska Unit 6 Chuck Chaliak P.O. Box 169 Nunapitchuk, Alaska Unit 7 Robert Enoch P.O. Box 8054 Tuntutuliak, Alaska Unit 8 James R. Charlie, Sr. P.O. Box Toksook Bay, Alaska James Sipary P.O. Box Toksook Bay, Alaska Unit 9 Reuben Hill P.O. Box 210 Hooper Bay, Alaska H: W: Moses J. Tulim P.O. Box 130 Chevak, Alaska Unit 10 Sam W. Alexie P.O. Box 57 Eek, Alaska Unit 11 Kathy W. Chase P.O. Box 09 Anvik, Alaska H: Honorary Board Member Paul John P.O. Box Toksook Bay, Alaska l4 Numbers to Call YKHC Public Relations Dept Media Services Office of Environmental Health & Engineering Technology Help Desk Human Resources Job Line Learning Center Administration Hospital Emergency Room Hospital Community Relations Social Services Clinic Appointments Dental Appointments Optometry Appointments Audiology Appointments Subregional Clinic Appointments Aniak Emmonak St. Maryʼs Public Health Nurses Pharmacy Travel Management Center WIC Program Health Services Village Operations CHAP Injury Prevention/EMS Community Health & Wellness Behavioral Health Services Phillips Ayagnirvik Village Services Home Care Services

3 YKHC Board meets Alstrom elected Chair Ray Alstrom of Marshall was elected as the new Chairman of the YKHC Board of Directors during the annual meeting held in Bethel Nov Alstrom follows in the footsteps of Bill Kristovich, Bethel, who served as Chairman last year. One new member was elected for Unit 9, representing Hooper Bay, Scammon Bay and Chevak Moses J. Tulim of Chevak. The Board made changes in its Governing Body, Executive Board and Committee line-up. The new officer roster is printed on page 13. Short summaries of some of the reports presented to the Board and resolutions passed follows Subregional Clinics (SRCs) The Toksook Bay Subregional Clinic has been under construction since last year and is now complete. The grand opening is set for the beginning of the new year. The next SRC project is Hooper Bay. The community is presently working with Village Safe Water and other agencies in developing a water and sewer system already underway. The next phase of the project is to order pipes for the system, which will most likely be delivered to the village next summer. Funds are already being obtained for Hooper Bay SRC construction. Village clinics New clinics in Eek, Marshall, Akiak, Napaskiak, Chuathbaluk, Tununak, and Chefornak are under construction. Grayling, Scammon Bay, Newtok and Mekoryak have been completed and opened for business. YKHC Drug Testing After a long delay, Human Resources is preparing to begin mandatory drug testing within YKHC. Persons selected for the testing will be done at random and under no prejudice of any kind. Telemedicine and wireless connectivity YKHC is preparing to move onto broadband wireless (and terrestrial) Internet for all of its facilities (mainly clinics) beginning sometime in the next year, and is working with United Utilities, Inc. toward that purpose. There are some funding issues yet to be worked out and, see BOARD MEETING, p. 13 The Messenger is a monthly publication produced by the Yukon-Kuskokwim Health Corporation as a report to Tribal Members. For questions, comments, submission of articles, or subscription information, write to Messenger Editor, Media Services, Yukon-Kuskokwim Health Corporation, P.O. Box 528, Bethel, Alaska michael_faubion@ykhc.org. Deadline is the last day of the month preceding publication. Publication is on the 15th of every month. Anchorage Office: 4700 Business Park Blvd. Suite E25, Anchorage, Alaska Please ask permission to reprint articles or pictures. 2004, Yukon-Kuskokwim Health Corporation. Hazel Julius, PA-C Hazel Julius, the daughter of George and Julia Nevak, was born in Bethel and raised in the coastal community of Toksook Bay. She became interested in medicine after working in Toksook Bay as a full-time Health Aide, where she devoted four years of service to her community. It was during those years as a working mom that she developed a yearning to advance in the medical field. I wanted more education, so I went to college, Julius says. My primary goal was to attend a PA (Physician Assistant) program, so I worked on my pre-requisites to get into the program. In 1998, after she had spent four years at the community clinic, Hazel moved to Bethel and enrolled in the Applied Science in Community Health program at the Kuskokwim College. She graduated on schedule, receiving a Community Health Practitioner Certificate. Today, Hazel Julius is a staff Physician Assistant for the Yukon-Kuskokwim Health Corporation. She recommends that anyone wishing to enter the PA medical program should first develop good writing/reading skills, good English skills, a support network, and realize that they will eventually have to move away from the YK Delta for training to obtain their goal in the health field. Volume IX No. 12 December 15, 2004 Physician Assistants are licensed to practice medicine under supervision of a licensed MD perform physical examinations, compile medical histories, order and interpret tests and prescribe medications complete at least two years of college prerequisites in science, math and English and have at least 2 years of full-time health care experience prior to applying for a PA program complete a 24-month PA program including coursework and clinical experiences work in hospitals and sub-regional clinics Hazel Julius began her healthcare career at the village clinic in Toksook Bay and, through her determination, support from her family, and educational opportunities, is now a certified Physician Assistant at the Yukon-Kuskokwim Delta Regional Hospital. Call The YKHC Learning Center:

4 4 Diabetes Prevention New Fitness Center opens The Bethel Teen Center has added new equipment to their former weight room and converted the facility into a Fitness Center that is open to the public. A grand opening was held on Wednesday, Nov. 24, when a small crowd gathered for a simultaneous ceremonial ribbon-cutting by Mayor Hugh Dyment and YKHCʼs Native Hire Coordinator Wally Richardson. The new fitness equipment, purchased through a grant from YKHCʼs Diabetes Prevention and Control Program, includes a new treadmill, recumbent bike, recumbent stair-stepper, and an elliptical trainer. There is also a new calf machine, leg extension machine, and new curl machine. This is a small example and a very good example of two organizations working together in these trying fiscal times, said Mayor Dyment. The more people and Norgaard check out some of the new equipment. Promoting Health: Kim Jung and Amber organizations can work together, the more it improves the quality of life for everyone in the community. I want to thank YKHC for this diabetes is a problem, and any more equipment where people can work on their health the better. Wally Richardson also thanked YKHCʼs Diabetes Prevention and Control Department for making the addition of the new equipment possible. YKHC s Native Hire Coordinator Wally Richardson and Bethel Mayor Hugh Dyment cut the ribbon on the new Fitness Center at Bethel s Teen Center. Diabetes in the YK Delta is on the rise, and itʼs really important that everyone stays active every day to prevent this disease, said Kim Jung, YKHCʼs Diabetes Outreach Coordinator. The Surgeon General recommends at least 30 minutes of physical activity every day to maintain good health, and this equipment provides another option for people to work on staying healthy. We are excited about the new equipment, especially the cardiovascular equipment, said Betty Twitchell, Bethel Teen Centerʼs Coordinator. There are four new commercial quality machines that we have never had before. You can get a good workout, itʼs low impact on your joints, and depending on your physical condition, we have something to suit everyone. The Fitness Center is open to everyone 14 years old and older. Youths 14 to 18 must have signed permission from their parents. The charge is $3 per day, which includes showers. It is open 9 a.m. to 6 p.m. on Monday, 9 a.m. to 9 p.m. Tuesday Friday, and noon to 9 p.m. on Saturday. The center is closed on Sunday. Mini-grants help schools purchase exercise equipment The Diabetes Prevention and Control Department would like to announce the winners of the Physical Activity Mini- Grants. These grants were open to YK Delta area schools to apply for $5000 to purchase physical activity equipment. This year the winners were Aniak Jr. and Sr. High School, Bethel Regional High School, Holy Cross School, Kotlik School, and Qugcuun Memorial School in Oscarville. Some of these schools are lacking appropriate P.E. equipment and will be able to use the grant funds to help solve that problem. In addition, some of these schools donʼt have a gym and have to be especially creative in their choice of equipment due to limited space. The Diabetes Department is encouraging schools to purchase fun and exciting equipment that will invite and encourage kids to stay active. Activity in children is normal, healthy and should be part of everyday life for all. If you are in one of the winning communities, stop by the school and see what they plan on purchasing with their grant funds. Thanks to all who applied. Remember to stay movinʼ and healthy! For more information, contact Diabetes Prevention & Control at or

5 Traditional ways help keep diabetes at bay by Kim Jung, Diabetes Outreach Coordinator In the past, Type 2 diabetes was considered a disease that affected people 40 years of age or older, but in recent years the disease has been found in children as young as 12. Type 2 Diabetes is definitely on the rise in the Yukon-Kuskokwim Delta and is beginning to impact the younger generation. Obesity, diet, physical inactivity, and genetic background are all risk factors for Type 2 Diabetes. Alaska Natives, American Indians, Pacific Islanders, and Americans of Asian, African, and Hispanic descent have a higher risk for this disease. In fact, Alaska Natives and American Indians are 2.6 times more likely to have Type 2 Diabetes as non- Hispanic whites that are a similar age. Type 2 Diabetes can cause many serious problems such as blindness, limb amputations, cardiovascular disease and kidney damage. Traditional foods like salmon strips contribute to a healthier diet. The exact cause of diabetes is unknown, but a scientist in 1962 came up with the Thrifty Gene theory. He thought that natives who lived through periods of feast and famine in the past had a thrifty gene. He believed this gene allowed natives to store fat during feasting times to help them survive through times when food was not plentiful. The scientist thought when western culture (kassʼaq) food began to be more available and lean times became less frequent, it upset the feast/famine cycle that worked so well in the past. He believed this happened to all cultures that have gone through many lifestyle changes over a short amount of time. For example, the Pima Indians of the Gila River in Arizona have gone from a farming culture to a westernized culture since the turn of the century. During this change the Pima began to eat more westernized food, less traditional food, and became less physically active. The effects of this lifestyle change can be seen as early as 1950 when diabetes began to be seen more frequently in Pima Indians. Today the Pima Indians of Arizona have the highest occurrence of Type 2 Diabetes and obesity in the world. Another group of Pima Indians living across the border in Mexico still live a subsistence lifestyle. They continue to grow their own food and work hard to survive in their mountainous environment. Type 2 Diabetes is very rare in this group. Type 2 Diabetes was not seen very often in Natives of the Yukon-Kuskokwim Delta 50 years ago, but it is quickly becoming a common disease. The rapid change of lifestyle over the last 100 years is a major reason for this. Since the early 1900s, lifestyles have changed a lot in the YK Delta. Alaska Natives who used to stay active daily gathering, hunting, and fishing for survival now see TRADITIONAL FOODS, p. 9 Volume IX No. 12 December 15, 2004 Healthy Holiday Recipes Gathered by Sarah Pearson of Diabetes Prevention and Control Try some of these low-fat or sugar-free holiday recipes at your next party or family dinner. They are a great way to eat healthy during the holiday season. Remember to stay active. For more recipies, see our website at Healthy Eggnog from Equal Ingredients: 2 cups skim milk 2 tablespoons cornstarch 3-1/2 teaspoons Equal for Recipes or 12 packets Equal sweetener or 1/2 cup Equal Spoonful 2 eggs, beaten 2 teaspoons vanilla 1/4 teaspoon ground cinnamon 2 cups skim milk, chilled 1/8 teaspoon ground nutmeg Note: Equal sweetener can be substituted with other sweetener products. Nutrition contents might be different from those listed below. Directions: Mix 2 cups milk, cornstarch, and Equal in small saucepan; heat to boiling; boil, stirring constantly for 1 minute. Beat eggs in medium bowl. Mix about half the milk mixture into eggs; then add this egg mixture to remaining milk in saucepan. Cook over low heat until slightly thickened, 1 to 2 minutes, stirring constantly. Remove from heat and stir in vanilla and cinnamon. Cool to room temperature; refrigerate until chilled, or until serving time. Stir 2 cups milk into custard mixture; serve in small glasses or punch cups. Sprinkle lightly with nutmeg. Yield: Makes 8 servings. Nutrition information per serving: Calories: 79 Protein: 6g Total Carbohydrates: 10g Total Fat: 1g Cholesterol: 55g Sodium: 79mg Exchanges: 1 Milk Healthy Old Fashion Corn Bread Ingredients: 1-3/4 cups self-rising white cornmeal mix 1/4 cup all-purpose fl our 1 egg 2 teaspoons corn oil 1-1/2 cups low-fat buttermilk Vegetable cooking spray Directions: Preheat oven to 450 degrees. Combine all ingredients in large mixing bowl. Generously spray 8x8-inch baking pan with cooking spray; add batter and bake 20 to 25 minutes or until corn bread is golden brown. Recipe makes nine servings. Nutritional information per serving: Calories: 142 Fat: 2.4g Cholesterol: 25mg Sodium: 412mg Protein: 4.7g Carbohydrate: 24.7g Diabetic Exchanges: 1-1/2 Bread, 1/2 Fat 5

6 6 FASD presents videoconference training An important part of YKHCʼs Behavioral Health Fetal Alcohol Spectrum Disorders (FASD) program is providing training and support for community partners who also provide services for children with FASD. To this end, Scott Sidell, FASD Services Coordinator, was scheduled to fly on November 2 to Mountain Village for a full dayʼs training the next day for teachers of the Lower Yukon School District (LYSD). But a raging and blinding snowstorm on Election Day put an end to that idea. Sidell says he had been working with John Hargis, Special Education Director for LYSD, and Christine Hunnicutt, YKHCʼs Village Clinician, to arrange this training. Since Hargis was planning on video-conferencing the training anyway to the school sites in his district by Internet, Sidell wondered if they could possibly do the training by videoconference from Bethel. They decided to try it at a later date. Sidell then worked with Allen Alirkar and Nick Perry of YKHCʼs Technology department, who arranged the virtual meeting with LYSDʼs staff on November 12. Equipment from Polycom, Inc., the leading provider of Unified Collaborative Communications or converged voice, video, web, and data solutions for emerging broadband networks was used for the videoconference. The equipment projected Sidell on a screen as well as his audience simultaneously, and allowed content sharing in this case, a PowerPoint presentation from his laptop all operated with a remote control. There were some glitches at the beginning of the session, but things got rolling after while. I found the equipment very easy to use, Sidell said. I was able to switch from the audience seeing me, then to my PowerPoint slides, and then back to me using the remote. Itʼs very impressive. But it took some getting used to, talking to a lens rather than to people, Sidell said. Observers on the other end saw Sidell looking at them. The audience consisted of staff from eight of 12 LYSD school sites in the Lower Yukon region, which stretches from Hooper Bay, then up the coast to Kotlik, and up the Yukon River to Russian Mission. Hargis said the reception was great. We had a full view of Scott standing behind a podium and delivering the training, he said. Sidell presented a basic training on FASD that included information on how alcohol causes brain damage during pregnancy, the behavioral and cognitive effects of prenatal alcohol exposure, and ideas and strategies for making the school experience more successful for students with this disability. Teachers from all over the Lower Yukon got the information, Sidell said. The only travel involved was his walking down the See Me See You. Scott Sidell projects himself and his training course via videoconference during a Lower Yukon School District training session on Fetal Alcohol Spectral Disorders. Right: It all shows up on a screen in the classroom. hall from his office to the CHSB Board Room, where the videoconferencing equipment was set up. YKHC and United Utilities, Inc., a local telecom, are developing this new system of communications, said Aaron Mute, YKHCʼs LAN/WAN Administrator. At this point, video conferencing is not available in every community. However, all Subregional Clinics should be on-line within the next year or so. It will eliminate the older dial-up system and make workload go faster, Mute said. Features will include voice-over IP (Internet Protocol), telemedicine, and video conferencing. But for LYSD, the method of video conferencing has been in place at least two years, said Hargis. We have video conferencing every day, for such things as staff in-service and daily online classes for students. The FASD program, entitled Ikayuqluci (ee-guy-yooq-thloo-chi, meaning help each other ), formerly run by Bethel Community Services, was integrated into YKHC on April 1. The term Fetal Alcohol Spectrum Disorders describes a range of birth defects caused by prenatal exposure to alcohol. The program is located at the BNC Office Complex and on the first and third floors of the CHSB in the Behavioral Health suites. The FASD staff consists of Clinician Valerie Warren, Services Coordinator Scott Sidell, and Diagnostic Team Coordinator Mary Whitaker. Three other positions are vacant at this time: FASD Case Manager, FASD Senior Psychiatric Technician, and Youth Behavior Technician. YKHC FASD Program: Fax:

7 Francis Charlie, McCann Center Elder Counselor. Elder grounds inhalant program in Native culture Thanks to the support of Yupʼik elder Francis Charlie, the youth who take part in the Inhalant Program at YKHCʼs McCann Treatment Center have a powerful cultural ally in their battle against inhalant addiction. Francis Charlie is the resident Elder Counselor for the McCann Treatment Center, where he has worked since he completed his tour of duty on the YKHC Board of Directors. He has been a tremendous asset and addition to the residential treatment program at the McCann Center, attending all clinical groups, directing a Drumming Group, which is also joined by the Girls Group Home. Francis, or Atsaq as he is better known, also sits in on the classroom activities, spends time with youth in the treatment units and works actively with the Subsistence Education Program to ensure that it has a solid foundation in the Yuʼpik culture. Atsaq is from Scammon Bay, but is well known throughout the YK Delta. The McCann Center staff are very appreciative of Francisʼ work at the Center. He was voted in as the November Employee of the Month. Health Ed staff gets wellness training by Wayne Morgan, CHR Aniak In mid-september, Stella Lake (Chevak) and I went back to class to begin the first of three Community Wellness Advocate courses offered by University of Sitka. This training will provide us with knowledge and skills to enhance our performance and better serve our communities as Community Health Representatives (CHRs). This course is the first of three courses developed to teach us to create and carry out health promotion activities. We are learning the basics of public health and health promotion. The course includes one week of lectures on campus in Sitka, weekly audio-conference discussions, weekly assignments, completion of an asset inventory map, a profile of the studentʼs community, and a final exam. There are 15 students from across the state taking the course. At the end of our first course we will, among other things, be able to: Gather health measurements for an area/community. Identify health concerns for Alaskans based on health measurements. Do an Asset Inventory/Community Profile for a community. List health issues and problems facing Alaskan Natives, adolescents, pregnant women, children, and elders. This is in addition to the on-the-job training from our Health Education Department in Bethel: Lisa Aguda, Debi Olick, and Alma Kanrilak. Various other CHR duties round out the day. Volume IX No. 12 December 15, 2004 Tips for maintaining a healthy body during the holiday season 1. Choosing foods that you have to shell or peel like peanuts and shrimp whether youʼre hosting the party or attending the party will help you eat less. If you have to work to get to your food youʼll eat less, and we know in terms of controlling weight there is nothing better than controlling calories. 2. Eat only the bottom half of the bread if youʼre having a sandwich, taking the top slice off. Eating food topless is a great way to reduce calorie consumption all year around. Bread is a high glycemic carbohydrate and in most instances can cause blood sugars to rise rapidly. This leads to an aggressive insulin response and causes your body to store excess amounts of glucose as fat. 3. Adult beverages, punches or eggnogs are very high in calories. Try to drink a glass of water in between drinks. If you can, dilute them by adding sparkling water. Learn to drink coffee with one lump of sugar. All of these are things that add up over time and will make an impact in your ability to control weight this holiday season. 4. Make sure that you eat before you go to the party. That way you wonʼt binge on what usually turns out to be high fat, high calorie foods without a lot of nutritional value. 5. You donʼt have to eat every bite of that pie or cake. Leave off the frosting and just eat the inside. 6. Remember, gravy is not a beverage; itʼs a garnish. From all of us at YKHC Pharmacy, Happy Holidays! 7

8 8 Smokeout encourages Quit for a Day By Caroline Nevak, Tobacco Education Specialist On November 18, 2004, Yukon Kuskokwin Health Corporationʼs Nicotine Control and Research Program encouraged the Delta to make an effort to quit using tobacco for a day, in observation of the Great American Smokeout/Chewout. Historically, this event has helped millions of Americans quit by proving they can stop using tobacco for a day. This one-day event is to let tobacco users know they can take an active role in protecting their health by quitting tobacco for one day, said Carrie Enoch, Nicotine Dependence Counselor at YKHC. One day can turn into one year. People just need to make that first step. YKHC celebrated the day by hosting a Quit Cold Turkey Raffle at the AC Store, raffling two turkeys. The turkeys were donated by the AC Store. Nicotine Control had a display with educational materials in the AC Store, where many people stopped by for information. To enter the raffle, a tobacco user had to sign a written pledge to quit for the day. Approximately 60 people pledged to quit and at least one tobacco user has entered the program to quit for life. Two lucky winners received turkeys for their Thanksgiving meal. The celebration continued with a one hour Tobacco 101 radio show on KYUK. Carrie Samuel Berlin, Senior Counselor behind the display table at A.C. Store, celebrating the Great American Smokeout. Enoch and Caroline Nevak, YKHC Nicotine Control and Research staff, along with Kennythia Steel, Public Affairs Producer with KYUK, and Lon Putnum, PA-C and Delta Tobacco Control Alliance (DTCA) Alliance member, participated. The radio programʼs purpose was to outline the history and origins of the Great American Smokeout Day, as well as provide information to the community about the dangers of tobacco use and how you can quit through the YKHC Tobacco Cessation Program. For more information, call Nicotine Control and Research Program at tobaccoprogram Download anti-tobacco hand-outs to post in your community

9 Aeromed International becomes K-300 Sponsor The Yukon-Kuskokwim Health Corporation (YKHC) and the Kuskokwim 300 (K-300) Race Committee is pleased to announce that Aeromed International, a critical care air ambulance service, will become a major race sponsor of the 2005 K-300. Aeromed will sponsor the K-300ʼs veterinary program. The K-300 race vets are responsible for the health and well being of sled dogs before, during, and after the 300 mile race. Aeromedʼs support of the K-300 veterinarian crew will insure that an excellent program will continue. Aeromed International, a division of YKHC, is the largest fixedwing air ambulance provider in Alaska. In operation since 1997, Aeromed performs over 1,500 medevacs each year and provides Areomed s critical care air ambulances are always ready to go any time, any where. Employment Opportunities Latest News Upcoming Events Messenger Back Issues Volume IX No. 12 December 15, 2004 unrivaled response time, state-of-the-art technology, and highly trained and experienced medical flight teams. Before the arrival of planes, snow machines and telephones, the only method of communication for residents in the Kuskokwim Delta was via dog team mail carriers. These mail runs were days long and often treacherous. Historians can find mention of the first mail runs within a few months after the arrival of Moravian missionaries to what is now Bethel in the 1880s The first regular monthly mail route between Bethel and Holy Cross began in 1906, when Oscar Samuelson acquired the mail route contract. Each month, Samuelson would go to Akiachak then turn north across the tundra to Holy Cross. The K-300 commemorates the sled-dog mail runs of the early 1900s, when dog teams were the only means of long-distance transportation available. Over the last 25 years, the K-300 has become the highest regarded mid-distance sled dog race in the world, annually attracting the sportʼs top mushers. Aeromed is no stranger to dog mushing, having been a major sponsor of the Iditarod Trail Sled Dog Race, held in March. Aeromed will once again be the official Critical Care Ambulance service for the Last Great Race when Iditarod times comes around this year. State adopts one-stop medicaid travel model Effective January 1, 2005, the State of Alaska will be making some significant changes for Medicaid recipients in the way their non-emergency patient travel is to be arranged. Just as it has been in the past, your health care provider will obtain approval for Medicaid-funded travel. When travel is approved, the travel arrangements plane reservations and ticketing must be made through the State Travel Office by calling Your YKHC health care provider may assist you with contacting the State Travel Office or you may contact them directly. After January 1, 2005, only the State Travel Office can arrange your Medicaid-approved travel. Other travel agencies and services, such as YKHCʼs Travel Management Center, will not be able to make reservation and ticketing arrangements for your non-emergency Medicaid travel. Another important change is that airlines will not accept the Medicaid forms for travel payment. All contact with the airline in regards to the reservations and ticketing will be handled through the State Travel Office. When applicable and authorized, patients will continue to receive Medicaid forms from their health care provider to assist with payment for lodging, meals and ground transportation. On December 1, 2004, the State starting sending out notification letters about these changes to Medicaid recipients. If you have received a letter and still have questions, you may contact the State Recipient Helpline at TRADITIONAL FOODS, from p. 5 also watch television, play video games, surf the Internet, sit at desk jobs, drive motorized vehicles, eat bigger portions, eat junk foods, and eat more often than they used to. Eating big portions and not being active can cause obesity. Obesity and not being active are two risk factors of Type 2 Diabetes. It is important to be active every day for at least 30 minutes to prevent Type 2 Diabetes. Studies have shown that even small amounts of physical activity throughout the day can make a difference in your health. It is also important to eat healthy foods. Many traditional foods such as moose, fish, seal, sourdock (quagcig), and berries are full of nutrients and vitamins. Eating subsistence food, fruits and vegetables, smaller portions, and take-out food only once in awhile, can all make a difference. It is impossible to go back to the way life was a hundred years ago, but it is possible to balance our lifestyles by staying active and eating nutritious foods whenever possible. This can help us stay healthy and prevent diabetes. It is time for us all to take control of our health by making an effort to eat nutritious food, stay active, and bring balance back into our lives. 9

10 10 New clinic shines in Mekoryuk YKHC Public Relations Health aide Sally Whitman joyously showed her new office to co-worker Harriet Shavings, a floating health aide, who just returned that day from a stint in Kotlik. Itʼs really cool, said Whitman. We have so much privacy. You couldnʼt even hear people talking on the phone next door, and we donʼt have to whisper. The doors even close! The two hugged and admired the brightly lit and expansive new facility, the crowd laughing along with them when the health aides giggled. These and another health aide, Debbie David, and more than 30 Mekoryuk residents gathered in their new clinic on Friday, December 3, and participated in a humble grand opening ceremony with a blessing, cake and juice. Heavenly Father, thank you for our new clinic, said Larson King, bowing his head in prayer. Thank you for your healing work that always goes on. Mekoryuk villagers, many of whom were young people, toured the facility and appreciated the roomy exam rooms and specialty areas, like the dental operatory. Is this where Iʼm gonna get sick? asked one young lady, joking with the health aides. No, this is the general office area and file room, was the response, given with a hearty laugh. Some villagers noted the little signs hanging next to the rooms. These are in Yupʼik we are Cupʼigs, said Ray Amos, a resident. A piece of paper with translations was handed to the Bethel staff with instructions to see if the signs could be in Cupʼig instead. Elena Rothchild, a Supervising Instructor based in Bethel, and Tillie Epchook, who supervises floating health aides, were in the village to assist in the grand opening. The moving took two days, said Rothchild, who had been in Mekoryuk since Tuesday. Boy, itʼs so much better than that old clinic. Weʼre just happy; but Iʼm tired. Also attending the grand opening was Ed DeMoss, Director of Field Supervision, who opened the ceremony with a short speech. I welcome you to your new clinic. Thanks for allowing us to build you a clinic, as it helps us work toward our mission of working together to achieve excellent health. Included in the new facility is an Urgent Care room, which doubles as a telemedicine office. Telemedicine is becoming the norm for the Mekoryuk health aides to work with doctors in Bethel on patients, showing them ailments and getting advice on the spot. There was no telemedicine in Kotlik yet, said Shavings, who spent a couple of weeks in that village. I sure wanted to show the doctors what I was talking about on some patients. The opening celebration of the Mekoryuk clinic followed the grand opening of the new clinic in Newtok the week before, on November 26, which no one from YKHC was able to attend because of weather. Me and Anna Simon (CHAT Supervisor) tried to make it but the plane to Newtok was canceled, said Rothchild. I had to talk to our health aides by phone. I told them to take a nice, deep breath when they moved into their new clinic. In October, Scammon Bay also opened their new clinic but they didnʼt have a celebration with YKHC staff either, again due to stormy weather. Three more clinics are scheduled to open in the near future, those being Tununak, Chefornak, and Toksook Bay. In Toksook, the facility will be a Subregional Clinic that will provide more advanced health care services to the surrounding villages. Sally Whitman and Harriet Shavings show folks around the clinic. Health Aide Debbie David shows the dental operatory room to visiting youngsters.

11 Working Together to Achieve Excellent Health Board approves new mission statement YKHC Public Relations On Thursday, November 18, the YKHC Full Board of Directors approved the redesign of the YKHC mission statement, as well as the vision statement, and other related items. Our previous mission statement has worked well for us for many years, said Gene Peltola, President and CEO. Let me make it clear we are not changing our mission, but we are tuning the wording to better reflect our current and future goals in a more concise way. The previous mission statement read, To achieve the greatest possible improvement in the health status of the people of the Yukon-Kuskokwim Delta Region of Alaska. We are committed to the development of culturally relevant programs for primary care, prevention, and health promotion in a setting that fosters Native self-determination in the control and management of health delivery. Mike Williams of Akiak, a former board member, said it took about three years to write the mission statement and involved many meetings in the early or mid-80s. YKHCʼs growth and transition to one that began to take over and provided our own services, such as the Bethel hospital later on, under the Self-determination Act required us to develop such a statement, said Williams. Williams said he was glad to have played a small part in YKHCʼs growth, but remembers Joe Lomack, Noel Polty, Joe Mike, Billy Morgan, Issac Hawk, Tim Kaganak, Paul Manumk, Peter Sakar, Jimmy Anaver and others were also involved in creating the earlier mission statement. The new mission is Working Together To Achieve Excellent Health. The vision statement will read, Through Native self-determination and culturally relevant health systems, we shall be the healthiest people. These changes reflect YKHCʼs present activity and work at achieving the highest standards of operations and health care service weʼve set for ourselves, Peltola said. The Board also approved a list of corporate values and goals. By better defining our values and goals, it helps us to share with all of our employees the ways we go about achieving excellent health for the people we serve, Peltola said. YKHC Mission Statement Working Together to Achieve Excellent Health. YKHC Vision Statement Through Native self-determination and culturally relevant health systems, we shall be the healthiest people. Corporate Values Optimism Compassion Pursuit of Excellence Personal Growth Value of Family Volume IX No. 12 December 15, 2004 World AIDS Day gathering 11 crowd gathered at Watsonʼs Corner (above) on December 1 A to recognize World AIDS Day. Participants held globes filled with lights to represent the number of people who have died from AIDS, and a large ʻribbonʼ in lights represented the number of people infected with HIV. Following the demonstration, the group met at the Yupiit Piciryarait Cultural Center to view a film about AIDS and HIV in rural Alaska and listen to a speaker who emphasized the need for people to get tested for HIV. The sooner people get tested, the better the chances are that they can live healthier lives with proper treatment, said a person called Tim. Tim, who tested positive for HIV in 1989, is healthy and active, working to spread the word about prevention to rural communities. I have had friends who have waited until they were very sick to get tested. The longer a person waits, the harder it is to maintain your health if you have the disease. Tim spoke of the need for people to protect themselves from the virus by using condoms and not sharing needles. It is your responsibility to protect your body, he said. The healthier we are as a people, the better our healthcare system will be. The gathering was organized by Bethel Aids Task Force (BATF), and joined a worldwide effort for AIDS and HIV awareness. For more information about getting involved with future events, call Dianne McEachern at To get an HIV test, you can contact YKHC, Public Health Nursing, or the Bethel Family Clinic. You can also contact Circle of Care at

12 12 DeltaNet promises high-speed communications in region During the Alaska Federation of Natives convention in October, organizations desiring the continuation of a broadband Internet project in the Y-K Delta, which began construction this summer, gathered at the Regulatory Commission of Alaska (RCA) offices in Anchorage and requested support for supplemental funding for the project. The presentation was before Ms. Kate Giard, program administrator for the Rural Alaska Broadband Internet Access Grant Program. Last year, United Utilities, Inc. (UUI), a Bethel-based telecom, was awarded a $2.5 million broadband Internet access grant to begin infrastructure development for a land-based wireless communications network in 11 Y-K Delta communities. The 11-community effort is the first phase in building a region-wide wireless network referred to as DeltaNet. But a report by UUI, which was presented during the testimony, stated that problems began arising during construction which were unforeseen when the grant application was first submitted. These included the discovery that permafrost was warmer due to global warming by as much as four degrees since the early 1970s, especially in the Kuskokwim River sites. Other factors included the escalation of world steel prices, a fuel surcharge increase due to higher energy costs, and regulatory reasons. Permafrost loses rigidity as it warms. To remedy such problems, state-of-the-art technology for placing structures on warm permafrost ( degrees) is being used to ensure the structural integrity of the DeltaNet towers, according to Steve Hamlen, President of UUI. This is the same technology that has been used during the construction of the transalaska pipeline, Hamlen said. The new tower design, increases in steel prices, and increases in transportation costs have more than doubled costs. UUI has requested $4.7 million in supplemental funding while contributing $5 million of its own funds to the project. Hamlen said that Phase I construction will link the 11 communities to Bethel and offer Broadband Internet and other services. The communities are Upper and Lower Kalskag, Tuntutuliak, Eek, Kwigillingok, Kipnuk, Kongiganak, Chefornak, Nightmute, Tununak and Newtok. UUI is also planning on adding Quinhagak, Mekoryuk, Toksook Bay, and Aniak. DeltaNet will support telemedicine, distance learning, emergency services, KYUK radio broadcasts, and other telecommunication services. The quality of terrestrial networking provides significant improvements in performance and reliability over satellite services, which suffers from latency (delay) and sun-outage problems, said Hamlen. UUI is planning on completing Phase I of the DeltaNet project by December, Our relationship with RCA is positive up to this point, Hamlen said. We are hopeful that the RCA will recognize the value of the entire DeltaNet project and approve UUIʼs supplemental funding request. Hamlen added that UUI is especially thankful to the stakeholders who traveled to Anchorage to give awesome presentations to the RCA in support of DeltaNet and UUIʼs funding request. Val Davidson, YKHCʼs Executive Vice President, was one representative of Y-K Delta agencies testifying before the RCA, who spoke on YKHCʼs need for improved communication capabilities. We support this project because we need better communications services to improve and maintain quality health services in the YK Delta, she said. We also have distance-delivery training needs and this project would support economic development in the YK Delta, added Davidson. We have many young people in our region, so it would create I.T. (Internet Technology) jobs for them as well as enable our people to sell arts and crafts on the Internet. Greg Moore, a professional engineer representing the Statewide Telecommunications User Group, said all nine Native health organizations in Alaska are experiencing some problems in communications. This project would be a model for the rest of Alaska and help telecommunications get off satellite, he said. DeltaNet will reach very remote areas of Alaska. Schools, clinics, colleges, agencies and governments will achieve services similar to those in the Lower 48. Carlton Kuhns, Director of Yuut Elitnarviat, said that one of the highest unemployment rates in the country, at 30.2 percent as of June 2004, is found in the YK Delta. We also have a 37 percent poverty rate, but the irony is that we have 350 job openings at the Bethel (state) job office but the skill level of applicants for those jobs is not adequate, he said. Kuhns explained what the YE partners are doing to address the issues of joblessness and the lack of skills by building the YE Center. We still wonʼt be able to bring in every person to Bethel because itʼs just isnʼt possible due to housing and travel costs. Weʼll need 2-way (video) teleconferencing to fill in that gap. Myron Naneng, President of the Association of Village Council Presidents, said DeltaNet is needed for tribal government work. Municipalities do not always have resources to deal with community issues and usually rely on tribal governments for support, he said. UUI is planning on completing the build-out of DeltaNet over the next five years. Once completed, every community throughout the YK Delta will have direct wireless connectivity to each other and Bethel within a communications pipeline that will support every imaginable voice, video, and data communication for years to come. Terrestrial wireless sites that already exist near Bethel include Kasigluk, Nunapitchuk, Atmautluak, Napakiak, Napaskiak, Oscarville, Akiachak, Kwethluk, Akiak and Tuluksak. Other wireless systems include Mt. Village, St. Maryʼs, and Pitkaʼs Point. When DeltaNet is complete, these sites will convert to the terrestrial system. After listening to the testimony, Giard said although the project is exactly what the grant program would be funding, she found that the supplement request was unusual. Therefore, RCA would have to follow a public comment process so that any additional award, whatever the amount, toward the project is made fair for everyone concerned, she said. Giard believed that the public process should take no more than 30 days before a determination is made on the request. She also added that $10 million is still available in the grant program.

13 BOARD MEETING, from p. 3 once cleared, progress will continue toward utilization of a YK Delta-wide wireless communications system. YKHC is working to get out of long distance costs (phones and faxes) that total about $70,000 a month. When the corporation reverts to wireless, that cost will nearly disappear. High volume clinics will be hooked up first. (see related story, p. 12) Cancer prevention and detection YKHC and the Alaska Native Tribal Health Consortium (ANTHC) are working on providing training for six PA and nurse practitioners in colonoscopy. Colorectal cancer is a leading killer in the YK Delta. It is hoped that YKHC staff will be able to attend training that teaches them how to detect cancers. This will help in early detection and treatment, which have been found to increase survival rates of cancer victims in the rest of the U.S., where death rates from cancer are dropping. Injuries were once the leading cause of death in the YK region. Since injuries are decreasing due to prevention efforts, cancer has now become a leading cause of death. Much of the cancer is related to tobacco use, so YKHC is working on behavioral changes in the Deltaʼs population with its Tobacco Cessation programs. Construction Seventy-nine duplex units for staff quarters are being built at clinic sites around the Delta. Units in Bethel at Kasayulie Subdivision are framed in, roofed and sided. Construction is halted for the winter. Malone Home is being replaced with a five-bedroom assisted living facility next to the Community Health Services Building. Hospital renovations The new lab is completed. OB Unit is being remodeled. SRC quarters Two fourplexes in Emmonak, one fourplex each in St. Maryʼs, Toksook Bay and Aniak are completed. Bethel Prematernal Home The transition of Bethel Prematernal Home to YKHC management was completed on October 30, All former BPH staff are now YKHC employees. Average daily census is clients, while average monthly census is 37.8 clients. Resolutions 1. # Confirms an intent to fund clinics in Atmautluak, Crooked Creek, Kongiganak, Kotlik, Napakiak, Oscarville, Stony River and Tuluksak with Denali Commission Rural Primary Health Care Facilities Program funds. 2. # Authorizes YKHC to participate in Community Development Block Grant Program for clinics in Kotlik and Napakiak in cooperation with their municipalities. 3. # Authorizes YKHC to participate in Community Development Block Grant Program for clinics in Kasigluk, Kipnuk, Kwethluk and Tuntutuliak in cooperation with their tribal governments. 4. # Amends YKHCʼs By-laws indemnifying directors and providing insurance against expenses incurred by legal actions and/or liabilities, except those caused by negligence or misconduct in the performance of corporate duties. Volume IX No. 12 December 15, 2004 Executive Board and Committees Executive Board Ray Alstrom, Chair Fritz George, 1st Vice Chair Robert Enoch, 2nd Vice Chair Joe Bavilla, Secretary Billy Morgan, Treasurer Henry Hunter, Sgt.-At-Arms Reuben Hill, 1st Additional Member Bill Kristovich, 2nd Additional Member Paul John, Honorary Board Member Gene Peltola, Ex-Officio Governing Body Gloria Simeon, Chair James Charlie, Sr., Vice Chair Sam Alexie, Sgt-At-Arms Moses Tulim, Treasurer Kathy Chase, Secretary Robert Enoch, Executive Board Representative Angela Morgan Joe Mike Moses Peter Gene Peltola, Ex-Officio By-Law Committee Joseph Bavilla Reuben Hill Billy Morgan Moses Tulim Moses Peter Aaron S. Kameroff Henry Hunter Policy Committee James Charlie, Sr. Gloria Simeon Chuck Chaliak James Landlord Robert Enoch Joint AVCP/YKHC/Calista Robert Enoch Ray Alstrom Gene Peltola James Landlord Finance Committee Fritz George, Chair Angela Morgan Billy Morgan Gloria Simeon James Charlie, Sr. Robert Enoch Joe Mike Ray Alstrom, Ex-Officio Gene Peltola, Ex-Officio 13 Board Appointments Behavioral Health Advisory Board Billy Morgan Health Aide Advisory Board Sam Alexie PA School Committee Kathy Chase Alaska Native Health Board Ray Alstrom; Fritz George, Alternate Home Care Liaison James Sipary, Sr. Alaska Native Tribal Health Consortium Ray Alstrom; Fritz George and Gene Peltola, Alternates Human Studies Henry Hunter, Gloria Simeon, Fritz George, Moses Peter, Ray Alstrom - Ex-Officio Inuit Development Diversified, LLC Ray Alstrom, Gene Peltola Housing Committee: Bill Kristovich James Sipary, Sr. Gene Peltola Corporate Compliance/ Quality Assurance Fritz George, Chair Bill Kristovich Robert Enoch James Sipary, Sr. Moses Peter Chuck Chaliak Gene Peltola, Ex-Officio Compensation Committee Fritz George, Chair Robert Enoch Joe Bavilla Ray Alstrom Gloria Simeon YKHC General Counsel Dan Winkelman presents during the Full Board meeting.

14 14 EMS CORNER Body Mechanics Emergency Medical Services Neighbor Helping Neighbor by John Dickens In EMS, one of the best ways to protect yourself from injury is the proper use of body mechanics Lifting people and equipment can be very demanding and you can hurt your back for life. Once injured, your back may never be the same. Body mechanics is the proper use of your body to prevent injury and to facilitate lifting and moving. Remember, if you drop the patient you can seriously injure or even kill them. You need to think about the following concepts before lifting and moving any patient: The Top half of a patient is almost always heavier than the bottom half. The size and weight of the patient: How big and how heavy? Do not be afraid to ask for more help. Your limitations: Are you hurt? Do you have anything affecting your abilities to lift? You need to match responders of equal height and strength if at all possible. Communication: Make a plan. Then talk about it with the people who are helping you. Make sure everyone understands and is ready. Keep talking throughout the lifting and moving. Usually the person at the patientʼs head is the leader, but everyone needs to talk. Use your legs when lifting, not your back. Use what is called the power or squat lift position body weight on or just behind the balls of the feet, back locked in. The upper body is raised before the hips. Use the power grip: Your hands should be palm up with as great an area of your fingers and palms as possible in contact with the object. All your fingers should be bent at the same angle. When possible, keep your hands at least 10 inches apart. Keep your elbows bent and arms close to your sides. Position your feet properly. They need to be on a firm, level surface and be shoulder width apart. Never turn or twist. Keep your back straight and locked. It helps to look up. Do not lean to one side. Keep the weight as close to your body as possible. The farther the weight is from you the greater the chance you will get hurt. Try not to reach more than 15 to 20 inches in front of your body. Push rather than pull whenever possible. Use a stair chair or a sturdy kitchen chair when carrying a patient on stairs. Remember to carry the patient head first up the stairs and feet first down the stairs. Flex your knees and lean forward from the hips, not the waist. If your are walking backward down the stairs, ask a helper to steady your back. There are all kinds of stretchers and backboards. When possible, it is almost always safer and easier to move the patients over distances with a wheeled device like a wagon or even a sled. I have used office chairs or even flatbed hand trucks or pick-up trucks to move patients. Carrying human beings is a tough but rewarding job. Your patients life is literally in your hands. Be careful, do not drop them, and watch your back! Video teaches adults about vaccines Most of us think that vaccines are for infants and young children. YKHC and the Alaska Native Tribal Health Consortium (ANTHC) have produced a video with Talking Circle Media to tell adults about vaccines they may need. Years ago, epidemics of measles, smallpox, hepatitis A and influenza caused serious illness and death in many villages and towns across Alaska. Now vaccines have eliminated many of these infections. For instance, we no longer see smallpox or polio. There have been no hepatitis A outbreaks since vaccinating children. Measles has become very rare. However, certain vaccines are still very important to prevent infections in adults: Td or Tetanus-diphtheria shot is needed by everyone every 10 years. The tetanus germ lives in the soil and can get into the body through a puncture or scratch. Tetanus causes lockjaw severe muscle spasms that can stop breathing. The diphtheria germ leads to a severe sore throat. Mucous can block breathing and cause death. Pneumococcus (or pneumo) vaccine is recommended for persons 55 years and older and younger persons with diabetes, heart failure, lung disease, or immune problems like AIDS, or alcoholism. The pneumo germ causes most cases of meningitis and blood infections in adults. It causes much pneumonia.. Pneumo kills 40,000 people in the U.S. each year. Influenza (the Flu) vaccine is recommended every year, especially for elders and people with chronic medical problems. The Flu is a very contagious disease. It starts with fever, sore throat, cough and body aches. It can lead to pneumonia, and even death, especially in elders and people with medical problems. For more information, contact your YKHC Immunization Program

15 Volume IX No. 12 December 15, Disadvantages of Infant Formula Most parents know that breast milk is the very best food for their baby. Many moms in the YK Delta breastfeed their babies. But what parents might not know is that giving infant formula exposes their baby to certain health risks. Oftentimes, parents choose to give their babies both breast milk and formula. They might be worried that their baby is not getting enough breast milk, or maybe dad wants to have a chance to feed baby too. Sometimes formula is necessary for medical reasons. Sometimes a mom really canʼt produce enough milk. But these cases are rare. Moms who breastfeed often, right from birth, almost always have more than enough milk for their baby. Newborns love to be held and cuddled and will often want to stay at the breast even when they arenʼt hungry. Sometimes parents think this means that their baby is still hungry, when he really just wants to be cuddled. The best way to tell if a breastfed baby is getting enough to eat is by the number of wet diapers he has a day and by how much weight he is gaining. Well fed breastfed babies usually have 5-6 wet diapers a day and gain between 4 and 7 ounces a week. Parents who are thinking about giving their baby infant formula should know about the risks of formula: Infant formula is easily contaminated by unsafe drinking water or unclean bottles Infant formula is made from inexpensive ingredients, and errors in manufacturing it are common Formula is made from two ingredients that babies are likely to be allergic to: cowʼs milk or soy protein Babies who receive formula have less protection against illness than babies who are completely breastfed. Breast milk has ingredients in it that protect a baby against illness. Formula doesnʼt. Babies who are fed infant formula are more likely to develop eczema or allergies Formula feeding as a baby increases the risk of a child getting diabetes or lymphoma Babies who are fed infant formula are more likely to get urinary tract infections Formula feeding increases the likelihood of getting celiac disease, a severe allergy to wheat Formula feeding is linked to lower IQ scores in children Formula feeding has been linked to increases in sudden infant death syndrome, or SIDS Breast milk is a babyʼs normal food. It promotes normal brain development and is always clean and fresh. Breast milk has everything a baby needs! YKHC s Women s Health Grant staff often go the extra mile to help women get cancer screenings. They recently devoted a Saturday to the effort. From left: Sandra Cook, RN; Jackie Owen, LPH; Heidi O Leary, LPN; and Dawn Davies, Data Manager. Women screened at weekend clinic On Saturday, November 6th, the Womenʼs Health Grant staff and Diagnostic Imaging staff partnered to provide clinical breast exam and mammogram services for women who needed Saturday appointments. As a result of the efforts of Claire Lewis, Brenda Walker, Audrey Van Wagner, Ronnie Fitzpatrick, Heidi OʼLeary, Dawn Davies, Jackie Owen, and Sandi Cook, 15 women received clinical breast exams, breast health education, and mammograms. Many employees donated their time, or gave up a week-end day to better meet the needs of our patients. The Breast Health Screening Day was so successful that both departments would like to sponsor another day in late winter. The date will be posted within the next few months. Great job everyone!

16 Volume IX No. 12 December 15, 2004 Happy Holidays! From the Yukon-Kuskokwim Health Corporation Board of Directors Working Together to Achieve Excellent Health Yukon-Kuskokwim Health Corporation P.O. Box 528 Bethel, Alaska Non -Profit Org. US Postage PAID Anchorage, AK Permit # 537