I had the opportunity to fly by jet aircraft to Bethel, Alaska to spend a week at the Bethel Public Health Center. I was to be doing similar activities as I do at Mat-Su Public Health Center. I am staying at the health center. The staff kindly set up a roll out bed in an empty office. There is a shower/bathroom and kitchen area in the building. At night, I walked around and took pictures of the community. With it being much colder here than Wasilla, I typically didn’t stay outside for long periods of time.
Bethel is about 400 air miles away from Anchorage, Alaska. The estimated population is slightly over 6000. The population is very diverse. The majority living in Bethel are Alaska Native or American Indian. Throughout Bethel, there is 21 miles of paved roads. The rest are gravel. During the winter, the Kuskokwim River freezes creating a 100 mile ice road. The airport in Bethel is the third busiest in the state. This is due to small air taxi and propeller aircraft servicing 56 villages in the surrounding area. A nurse from the health center took me on a windshield survey of the entire community. All of the houses and buildings are built atleast five feet above the ground due to the ground being frozen. No basements. In order to enter most businesses or homes, it requires walking up flights of stairs. I did have the chance to enter a home. It was very small. There was one room in the house that eight or nine people shared. I have gained a greater understanding and appreciation for life from my experience in Bethel. Not having a vehicle, my means of transportation were by foot. As expected, my cell phone has no service. My communication to those outside of Bethel was via email. Since the cost is much higher in Bethel, I brought a suitcase of food and jug of water to feed me for the week. Currently, the gas prices are $7.05 a gallon.
While in Bethel, I had opportunity to be on the radio show called Wellness Wednesdays. The Public Health Center is assigned to every fifth Wednesday of the month. This time three other nurses and I discussed birth control methods. An expert doctor from Yukon Kuskokwim Health Corporation (YKHC) in Anchorage called in to join us during the hour show. I talked about abstinence, withdrawal, and natural family planning. It was extremely fun and engaging despite only having two callers.
TB is very prominent in Bethel. So I had the chance to go to the elementary school and place PPDs and then two days later go and read them. It is definitely different giving a preschooler a PPD versus an adult. Often times the children scream or move while trying to do the test. I went with the Public Health Nurse on a home visit to administer TB medication and met a client at the hospital for medication. The Public Health Center doesn’t offer the same services as in Mat-Su. The only form of birth control available is Emergency Contraception or Plan B. Most of the patients are referred to YKHC for birth control options. The health center does give immunizations, perform well-child exams, and does STD screenings. However, during the week I was in Bethel, I would approximate that only five to eight clients were seen. The nurses here have a bigger role and impact in the community, especially the villages, then operating a full time clinic like Mat-Su.
I also participated in a meeting about a Safe Needle Exchange program. Substance abuse is a major problem in Bethel. Users were addicted to oxycodone until it was no longer allowed to be prescribed. Therefore the oxycodone abuse decreased but the use of heroine increased. The users turned to heroine to satisfy the addiction. Currently Public Health and YKHC are trying to form a Needle Exchange program within the community like that of Anchorage. The group has funding available however there is some resistance in the community about developing this program. Since Bethel is so defined, everyone in the community is familiar with each other. This proposes a confidentiality issue with starting this program. The next steps for this group is to prepare a grant proposal and invite other stakeholders of the community (i.e. police station, Bethel Family Clinic) to join to group.
I had a great week in Bethel. It was quite an eye opener to other ways of life. I realized how dependent I was on the internet and my cell phone. The presence of the Alaska Native culture was fascinating to experience. It creates a diverse environment. The community members have different priorities and I appreciate that. I am very grateful that my preceptor took the time to contact the Bethel Public Health center and arrange a visit to work under the Public Health Nurses. I am looking forward to coming home soon.
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