Aides work to help Native Alaskans have better health care: Alaska's Community Health Aide Program is a model for other states.

• Author: Morgan, Barbara
• Position: Alaska Native Business News

Alaskans in remote villages are getting significantly better health care than ever before. In a state where the most dangerous jobs on earth exist--fishing, crabbing, logging, hunting, whaling, working on an oil rig and where snow machines are a way of life ... perils abound. Health aides in Alaska villages work daily with a population that thrives on seasonal and subsistence lifestyles. And these are not your usual 9 a.m. to 5 p.m. office jobs.

"There is lots of death," says Leslie Fox-Leyva, hospital education director at Alaska Native Medical Center. "It's not as if you are only six minutes away from tertiary care like in most cities." It can take days to evacuate someone. The weather, geographical isolation, time and distance are all factors.

Lucy Shy of Noatak, Ann Kosbruk of Gulkana, and Jennifer Moe of Larsen Bay attended a month of health aide training in Anchorage in December. Moe, who has been in the Alaska Community Health Aide Program (CHAP) for two years, said, "It saves the corporation lots of money having health aides in the village so patients don't have to fly in for every little sniffle."

Kosbruk comments that Glenallen is 14 miles away from her village. Their policy now states that Native patients have to come to the local CHAP clinic first for a sore throat or cold, or a urinary tract infection that can be treated with antibiotics--acute things.

Community Health Aide/Practitioners (CHA/Ps), unlike licensed health care providers, are dependent practitioners. They operate under the supervision and license of the doctor assigned to their community.

Four health aides in Noatak, 80 miles north of Kotzebue, population of 500, chart how many strep throats and ear infections a patient has. The doctor looks over the patient's history and, if necessary, faxes a referral for that patient to come to Anchorage. Physicians travel to Noatak and other small villages every six months. Meanwhile health aides monitor villagers' health. If there is a need, a medevac takes patients to Kotzebue; more serious problems are referred to ANMC in Anchorage.

THE MODEL

Dorothy Hight, training coordinator for CHAP at ANMC, also supervises the continuing education program so that it meets with current objectives. A family nurse practitioner with 19 years experience with CHAP, Hight explains that countries from all over the world send representatives, with visits that last from one hour to one week, to look at Alaska's program. Consultants came from Australia, for example, as part of a nurses' extending function program. Interest has come from Jamaica in the Caribbean Islands, New Zealand, Saudi Arabia, the Northwest Territories in Canada; also Peace Corps/development/missionary workers, doctors...