Angels of Mercy in Remote Alaska

In the 171 tiny, remote native villages scattered across the vast expense that is Alaska, there are medical clinics staffed by health aides. The 400 aides, 95% of them women, are the village equivalent of doctors.

They provide emergency care and treat gunshot wounds, poisonings, head injuries, shock, fractures. They deliver babies, suture wounds and care for patients with impetigo, strep throat, toothaches. They give shots. They keep lab records. You name it, they do it.

Last year, the health aides took care of 250,000 patients in communities with populations ranging from 30 to 700.

Yet many of them have only eighth-grade educations, others a few years of high school. Some are high school graduates. A few have had some college.

Their medical training amounts to 10 weeks at one of four Alaska Native Medical Centers, here in Anchorage, in Bethel, Nome and Seward.

They are Eskimos, Aleuts, Indians, products of the tiny communities they serve, selected for the difficult job by village councils.

Health aides save lives daily in their villages, which are accessible only by boat and plane. There is nothing like them in the Lower 48, although the workers sometimes are compared to the barefoot doctors of China.

“They diagnose and treat illnesses, start IVs, put splints on legs. (They) care for patients with heart attacks. They take care of all the routine medical attention and do everything required in emergencies until an airplane arrives to take the seriously and critically ill patients to hospitals,” explained Barb Benner, 44, who heads up the health aides’ training program at the Alaska Native Medical Center in Anchorage.

The weather is unbelievably harsh in Alaska’s great outback. Daylight is minimal this time of year. Often several days pass before a storm or ice fog lifts and airplanes can fly safely to the villages to evacuate the ill or injured.

“Physicians over the telephone tell the health aides step by step what procedure should be followed in emergency cases. Without the health aides there wouldn’t be anything,” said Benner.

He described health aides as “very special people doing the kind of job most of us would be extremely uncomfortable doing. Their scope of practice is a lot greater than a nurse. They perform medical treatment every day that (registered nurses) and practical nurses would never do elsewhere in the United States.”

The Alaska Native Medical Center in Anchorage is a busy hospital with 62 physicians, 10 dentists and a total staff of 500. Medical treatment for Eskimos, Indians and Aleuts is provided free of charge by the federal government here, as it is at other native hospitals and in the remote villages.

Physicians, dentists and staff are members of the Indian Health Service, a part of the U.S. Public Health Service.

Dr. Robert D. Burgess, 43, is medical director of Alaska’s Community Health Aide Program (CHAP). Frank Williams, 37, is the program administrator. Their offices are in Anchorage’s Alaska Native Medical Center.

“Health aides, who take care of 80% of the health problems in rural Alaska, have the most difficult and most important job of any health-care provider in this state,” said Burgess, who took 4 1/2 years to write the 475-page, easy-to-read Community Health Aide-Practitioner Manual, the bible of health aides published in 1987.

The book, written at the sixth-grade reading level, takes the health aide step by step through standard protocols followed in treating patients, just as physicians do over the phone.

“Health aides are the eyes and ears of the doctors in those faraway villages where they live. Physicians and others in the Lower 48 think only physicians can do the things they do every day,” noted Burgess.

He and many doctors in the Alaska Native Medical Centers in Anchorage, Bethel, Nome and Seward take calls over the phone from health aides when medical emergencies occur.

He recalled a recent call he received: “A health aide named Lucy from a village called to report that a mentally ill man was shooting out of his window at passers-by. She asked him what she should do. I told her to get the policeman. ‘The policeman is hiding from the man,’ she replied. The doctor said the mentally ill man needed a shot of a certain kind of medication to calm him down.

“The health aide left the phone and called me back a few minutes later. She said she took care of the matter. She gave the man a shot. ‘Lucy, weren’t you scared to go up to his house?’ I asked her. ‘Naw, I knew he wasn’t a very good shot,’ she answered.”

Alberta Vent, 49, an Athabascan Indian from Huslia, enrolled in the current health aide class here in Anchorage, told of a search she went on for a lost trapper:

“We found him. His snowmobile broke down. His feet were frozen. We got the wet clothes off of him and got him as warm as possible. People freeze to death in the bush in winter. It’s a major problem. We always worry about it.”

Julia Chingliak, 32, another health aide student, an Eskimo from the village of Good News Bay, told how she helped save a shooting victim: “That’s the best part of being a health aide, helping people. You know how it is in these little villages. We’re all related to one another. It’s one big family.”

Alicia Roberts, 66, a Plingit Indian, has been a health aide in Klowack 26 years. Everybody in the village calls her “Doctor.” The 5-foot-3 health aide said she never kept an exact count of all the babies she delivered, “just about everybody in Klowack 26 and under I guess,” she said with a laugh.

Health aides are on call 24 hours a day, seven days a week. Their average salary is $23,000 a year.

One health aide had two emergencies on her hands during a fierce, recent blizzard that reduced the visibility to zero. A patient had a collapsed lung and a woman six months pregnant was in labor. The snow subsided but severe crosswinds prevented a plane from landing at the village.

For four days, the health aide cared for both patients. She mobilized villagers to create a snow-packed airstrip perpendicular to the existing runway. That enabled the rescue plane to land. Thanks to the health aide the man with a collapsed lung recovered, the young woman was able to carry her baby to term and delivered a healthy child.

No wonder they call health aides in Alaska’s remote native villages “Angels of Mercy.”