the good health of subsistence living - yukon-kuskokwim health
TRANSCRIPT
The Good Health of Subsistence Living...The smelts have come and the salmon will soon be running. Not only the food, but the exercise of subsistence activity is good for you. Diabetes Outreach Coordinator Debbie Michael, with friends and family, prepared smelt for drying recently and will be out at their fishcamp through the summer. More on page 5
Photo by Julie Olick
Volume XV No. 6 • June 15, 2010
INSIDE: ALH Funded, p. 3 • SBIRT, p. 7 • Breast is Best, p. 11 • Lights Out, p. 12
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Board of DirectorsUnit 1Raymond F. Waska, Sr.P.O. Box 46Emmonak, Alaska 99581907-949-1514
Paula AyunerakP.O. Box 5Alakanuk, Alaska 99554907-238-3212
Unit 2Ray AlstromP.O. Box 8Marshall, Alaska 99585907-679-6320
James C. LandlordP.O. Box 32168Mt. Village, AK 99632907-591-2531
Unit 3Wayne MorganP.O. Box 234Aniak, Alaska 99557907-675-4264
George S. MorganP.O. Box 54Upper Kalskag, Alaska 99607907-471-2490
Unit 4James NicoriP.O. Box 41Kwethluk, Alaska 99621907-757-6837
Moses PeterP.O. Box 57Tuluksak, Alaska 99679907—695-6426
Unit 5Bill KristovichP.O. Box 1037Bethel, Alaska 99559907-543-4151/2212
Glen Watson, Sr.P.O. Box 1874Bethel, Alaska 99559907-543-4625
Gloria SimeonP.O. Box 308Bethel, Alaska 99559907-543-5676
Chris LarsonP.O. Box 6051Napaskiak, Alaska 99559907-737-7910
Unit 6Esai Twitchell, Jr.P.O. Box 121Kasigluk, Alaska 99609907-477-6309
Unit 7David O. DavidP.O. Box 78Kwigillingok, Alaska 99622907-588-8484
Unit 8James R. Charlie, Sr.P.O. Box 37012Toksook Bay, Alaska 99637907-427-7114
James SiparyP.O. Box 37134 Toksook Bay, Alaska 99637907—427-7816
Unit 9Patrick TallP.O. Box 196Chevak, Alaska 99563907-858-7613
Eric Olson, Sr.P.O. Box 163Hooper Bay, Alaska 99604907-758-4068
Unit 10Sam W. AlexieP.O. Box 57Eek, Alaska 99578907-536-5428
Unit 11Marvin DeaconP.O. Box 45Grayling, Alaska 99590907-453-5195
Honorary Board MemberPaul JohnP.O. Box 37067Toksook Bay, Alaska 99637907-427-74l4
Numbers to CallYKHC Main Operator ............................................... 543-6000 TollFree...............................................................1-800-478-3321PublicRelations................................................................. 543-6038MediaServices................................................................... 677-2232OfficeofEnvironmentalHealth&Engineering............ 543-6420TechnologyHelpDesk...................................................... 543-6070HumanResources.............................................................. 543-6060Administration.................................................................. 543-6020Hospital............................................................................... 543-6300EmergencyRoom.............................................................. 543-6395HospitalCommunityRelations....................................... 543-6350SocialServices.................................................................... 543-6225FamilyMedicineClinicAppointments.......................... 543-6442 1-800-478-3321AppointmentsDentalAppointments........................................................ 543-6229OptometryAppointments................................................ 543-6336AudiologyAppointments................................................. 543-6466
SubregionalClinicAppointments Aniak............................................................................... 675-4556 Emmonak....................................................................... 949-3500 St.Mary’s......................................................................... 438-3500 ToksookBay................................................................... 427-3500PublicHealthNursing...................................................... 543-2110Pharmacy............................................................................ 543-6382TravelManagementCenter.............................................. 543-6360WICProgram..................................................................... 543-6459HealthServices................................................................. 543-6024VillageOperations............................................................. 543-6160 CHAP.............................................................................. 543-6160 ICEMS............................................................................. 543-6080 CommunityHealth&Wellness................................... 543-6190BehavioralHealthServices............................................... 543-6100 PhillipsAyagnirvik........................................................ 543-6700 VillageServices.............................................................. 543-6740HomeCareServices.......................................................... 543-6170
Volume XV No. 6 • June 15, 20103
The Messenger Quarterly is printed in December, March, June, and September. The Messenger is published monthly online at www.ykhc.org 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, Public Relations, Yukon-Kuskokwim Health Corporation, P.O. Box 528, Bethel, Alaska 99559. E-mail: [email protected]. 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 99503. 907-677-2232. Please ask permission to reprint articles or pictures. © 2010, Yukon-Kuskokwim Health Corporation.
YKHC Board& Committee MeetingsJuly 21&22
Governing Body
Aug. 18&19Executive Board
Sept. 21&22Governing Body
Oct. 20Executive Board, Fairbanks (subject to change)
State budget funds Assisted Living Home, Sobering CenterBy Donna Bach, YKHC Public Relations
Alaska’sstatebudgetfor2011includes$8.3millioninadditionalfundingneededtobuildalong-awaitedlong-termcarefacility(AssistedLivingHome)inBethel.
TheFY2011OperatingBudget,FY2011MentalHealthOperatingandCapitalBudget,andtheFY2011CapitalBudgetweresignedintolawbyGovernorSeanParnellonJune3.ThefinalhalfmillionneededtofinishconstructionoftheSoberingCenterthissummerwasalsoincludedintheappropriations.
“Thefundingsecuredforthelongtermcarefacilitycouldnothavecomeatabettertime,“saidDirectorofHomeCareServicesLizLee.Thelong-timeYKHCemployeeandelderservicesadvocateadded,“thishasbeenafundingpriorityforover10yearsforouragingpopulation,andourelderswithlongtermhealthchallengeswhowishtostayclosertohomeandahospital.TherealityofthisfacilityhasfinallycomeanditwillbringsomuchcomforttosomeofourYKDeltafamilieswhowillnothavetotraveltofacilitiesallovertheroadsystemjusttobeclosertotheirlovedones.”
ThefundingappropriationthroughtheCapitalbudgetwillallowYKHC’sconstructionteamtobeginbuildingtheLongTermCareFacilityasearlyasspring2011.Aportionofthedesignandopera-tionalfundshavebeeninvestedwiththevisionoftheLongTermCareFacilityinmindoverthelastdecade,butithasbeentheworkofadvocacybyYKHCprogramstaff,andTriballeadershipintheCapi-talwhichhelpedseethisvisionsoonbecomeareality.
InaradiointerviewBethelRepresentativeBobHerroncreditedtheamountofadvocacyputintofundingpackagerequestsbylocalregionalleadersforeverythingfromschoolstowater/sewerandcapitalinfrastructureneeds.
“TheleadershipfromtheYKDeltahasdoneatremendousjobatgainingtheattentionoftheGovernorandstateleadershipandtheyshouldbeproudofthemselvesforthesefund-inghighlights,suchastheLongTermCarefacility,”Herronsaid.“Itreallystrengthensour(Rep.HerronandSenatorLymanHoffman)capabilitiesinsecuringfundsforruralAlaska,whichisreallygoodfortheeconomyandemploymentintheregion.”Representa-tiveHerronalsomentionedinhisnewsletter,“thereismoreworktodo,”inhisquesttocontinuesecuringfundingforcrucialinfrastructureprojectsinthefuture.
TheSoberingCenter,afacilityprojecttodivertpublicinebrieatesfromthehospitalEmer-gencyRoomtoasafeplacetodryout,receivedtheadditionalhalfmilliondollarsinfund-ingtoenableconstructiontobecompletedandoperationstobeginbeforetheendofthisyear.
Congressman Young visits Bethel
Congressman Don Young visited and met with YK Delta regional leadership with five of his staffers on Tuesday, June 1.
CongressmanYoungwasinBethelforapproximatelyfourhoursandhadachancetohearfromregionalleadersandrespondtoanyquestionstheyhadaboutwhatishappeningwithAlaskaontheFederalfront.
ThediscussiontopicsincludedtheHealthCareReformbill,transportationinfrastructure,Alaskanaturalgaspipeline,off-shoredrilling,andsubsistence.
BeforedepartingBethelhehadachancetoattendthenewArmoryGround-BreakingceremonyandaddresstheattendeeswithaspecialtributetothenumerousruralAlaskanswhopar-ticipateactivelyintheNationalGuard.
Congressman Don Young discusses with Gene Peltola Sr. and Jr. at a recent meeting in Bethel co-hosted by AVCP and YKHC at the Paul John Board Rm.
see BUDGET, p. 5
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YKHChonoredtheiremployeeswithaYearsofServiceluncheononWednes-day,May30,2010.Awardsweregivenouttoemployeeswithfiveormoreyearsofservicetoourcorporation.OfspecialmentionwehonorWillieLake,anOpticianTechnician.Mr.LakehasbeenwithYKHCfor35consecutiveyears!HefirststartedhiscareerwithYKintheFoodServicesDepartmentandthenintoOptometry.“WillieembodiesallofthepillarsatYKfromPatientCenteredExcellencetotheAlaskaNativeWorkforceDevelopment,”saidOptometristPamConrad.“HeisanamazingYKemployee,“shesaid.
Also,YKHCwouldliketocongratulateourownPresidentandCEO,GenePeltolaforhis20yearsofservicetoourcorporation.YKHCsalutesWillieLake,GenePeltola,andtherestofourYearsofServiceemployees.
Willie Lake, Gene Peltola among long-time honorees at Years of Service luncheon
Willie Lake, 35 years with YKHC.
Employees honored at last month’s Years of Service luncheon, from left: Richard Robb, Heather Johnson, Shane Welch, Gene Peltola, Mark Vrooman, Earline Wise, Elena Herrera, Martha Olick, Willie Lake, Christine Sassman, Melanie Gibson, David Friday, Lawrence Lewis, Melody Jordan.
35 YearsWillieLake,OpticianTechnician,Optometry
20 YearsGenePeltola,President&CEO,Leadership
15 YearsJackCrow,HealthServicesVP,LeadershipDr.K.JaneMcClure,MD,ClinicalServicesMarthaOlick,CHAP,KwethlukBillEggimann,MD,ClinicalServicesEarlineWise,CHAP,UpperKalskag
10 YearsMelanieGibson,PharmacyDirectorLawrenceLewis,ClinicalAssistant,BehavioralHealthHeatherJohnson,PhysicalTherapistMelodyJordan,LicensedPracticalNurse,InpatientDept.RichardRobb,BehavioralHealthClinicianShaneWelch,CaseManager,BehavioralHealthElenaLarson,CHAPOfficeAssistant,Kwethluk
5 YearsElenaHerrera,FamilyNursePractiitioner,ClinicalServicesJeanSnyder,MD,EmergencyRm.MarkVrooman,MechanicalAdministrator,FacilitiesRobertaCharles,OperationsManager,AniakSRCChristineSassman,RN,EmergencyRoomDavidFriday,ProfessionalRecruiter,HRNinaMenegak,RadologicTechnologist,DiagnosticImaging
Thank you for your years of service!
Volume XV No. 6 • June 15, 20105
Kipnuk clinic excels at immunization ratesTheKipnukclinicstaffwasrecognizedonMay26,2010forthevillagethathasshownthemostimprovementintheon-timeimmunizationratesforchildren3-27months.
SuccesswasdueinparttoateameffortwithhelpfromtheHealthAides,PublicHealthNursingandourImmunizationProgram.Thestaffhasworkedveryhardoverthepastyeartoincreasetheirratesby36percent—fromaslowas28percentatthebeginningof2009to78percentbythefallof2009.
Thisincreaseinrateshasbeensustainedoverthelastpartof2009throughthefirstfivemonthsof2010.Staytunedforfutureeventsthissummerhappeninginavillagenearyou.Congratulationsandkeepupthegreatwork!
Other clinics that have done a great job with immunizations:Clinics that have 100 percent for on time (3-27 months) immunization rates over the last month
ToksookBayCrookedCreekSleetmuteUpperKalskagNewtokPitkasPointSt.MarysAnvik
Villages with immunization rates over 90 percentKwethlukGraylingPilotStationChefornakMekoryuk
Keep up the great job!
Kipnuk Clinic staff: Kipnuk Health Aide Sharon Kanuk, SI Debbie David, PHN Petra Cupino, Kipnuk Health Aide Norma Evan, SI Martha Attie, and Kipnuk Health Aide Andrewski Toyukak.
Regional Legislators direct funds to DeltaThe26thAlaskaStateLegislaturesessionwrappeduponApril18,2010.The90daysessionsaw426HouseBillsIntroduced,101ofwhichpassed;aswellas313SenateBillsintroduced,82ofwhichpassed.AlaskaStateSena-torLymanHoffmanfinishedhis24thyearservingtheYKDeltaandplaysanimportantroleasCo-chairoftheFinanceCommittee.RepresentativeBobHerroncommencedhissecondyearwithflyingcolorsthroughresponsibledirectionoverstatepolicyinreducingenergycostsforHouseDistrict38.InadditiontotheCapitalFundingrequestsappropriatedbyGovernorParnell,SenatorHoffmanandRepresentativeHerron’sLegislative2010newsletterhighlightedtheirworkandcollaborationinsecuringfundingallocationsfornumeroustransporta-tionandschoolconstructionprojects,energyefficiencies,andfundingformorefisheriesresearch.
BUDGET, from p. 3
6
AsconstructiononBethel’snewSoberingCentergetsunderwaythissummer,YKHC’sEmergencyDepartment(ED)continuestoserveastheintakepointforinebriatedindividuals—adultsandchildren—whohavebeenpickedupbytheBethelPolice.
TheSoberingCenter’sThirdQuarterlyDataReport,availableinitsentiretyontheYKHCwebsiteatwww.ykhc.org,fortheperiodsbetweenJanuary1,2010andMarch31,2010,revealatotalof478individualswhoenteredtheEDforalcoholrelatedmatters.
ThisreportallowedforamoreaccurateestimationofthetypeofpatientlikelytoremainintheED(formedicalpurposesorsober-ingforunderagedrinking)aswellastheaveragevolumeofmedicalclearancesforRemandtransports.ProtectiveCustody(PC)patientsaretheindividualswhowillbecandidatesforthenewSoberingCenterFacilitywhenit’scompletedthisFall.Theywillhavetheopportunitytobecomesoberinasafeenvironment,andwillreceiveScreening,BriefIntervention,andReferraltoTreatment(SBIRT)servicesasneeded.
What is PC? IndividualsincapacitatedbytheiralcoholconsumptioninpublicplacesaretakenintoProtectiveCustody(PC)andtransportedbyBethelPoliceDepartment(BPD)personneltotheSoberingCenterlocatedintheEmergencyDepartment.ThisoccursafterBPDper-sonnelattempttotransporttheinebriateindividualtoasafeandfamiliar/knownhomeorrelative.
A summary of the data shows...• Thefrequencyofvisitsforpatientswithalcoholrelatedmatterswasmostlylimitedtoa1-timebasis.
• Patientsunder‘PC’and‘Medicalw/Alcohol,Non-PC’groupcat-egoriesshowedthehighestvolumes.
• BPD(forPCs)andPrivate(forpatientsrequiringmedicalser-vices)revealedthehighestratesoftransportmethodsforinebri-ates.
• WhilethemajorityofPCsweredischargedtoBPDpersonnel,inebriatesrequiringmedicalserviceswereprimarilydischargedtotheirhomesorafamily/relativemember.
• MostPCswerelikelytohavespentbetween0-29minutesintheED.Patientsunderthe‘Medicalw/Alcohol,Non-PC’categorywerelikelytohavespentmorethan5hoursintheED.
• Patientswereonaveragebetween21-31yearsofage.• Thereweremoremalethanfemaleinebriatepatients.• Morefemalethanmaleinebriatepatientsrequiredmedicalassis-
tance.• ThemajorityofPCs(includingminors)arrivedtotheEDbetween
11p.m.and1a.m.• Patientsarrivedandweredischargedprimarilyduringweekends.
Sobering Center Update: Trends emerge
Month PCPC w/
Medical or Trauma
Minor ETOHNon PC
ETOHNon-PC w/Medical or
Trauma
Medical or Trauma (ETOH 1-5 days ago)
Remand Remand Minor T-47 T-47 Minor
January 82 11 9 4 48 9 7 3 6 1
February 63 10 13 3 35 16 7 0 6 1
March 77 3 16 2 17 11 11 1 5 1
TOTAL 222 24 38 9 100 36 25 4 17 3
The majority of PCs arrived to the ED during midnight hours between 11 p.m. and 1 a.m.
There were more male than female PCs across the reported months. Both male and female PCs were on average between 21 – 31 years of age.
by Marisela Valesquez, SBIRT Program Coordinator
Volume XV No. 6 • June 15, 20107
What is SBIRT?Screening, Brief Intervention and Referral to Treatment(SBIRT)isamedicalapproachtohelpreducealcoholuseand/orpreventsub-stanceabuseanddependence.Thefirststepisscreeningforalcoholconsumption.
Screeningisafastandsimplemethodtoidentifyingpatientswhoaredrinkingaswellasthosewhoarealreadyexperiencingalcohol-relatedissues.
Brief Intervention focusesonincreasinginsightandawarenessregardingalcoholconsumption.Briefinterventionsprovidetheopportunitytoeducatethepatientabouttheiralcoholuseandalsofocusontheopportunitytochangebehaviortopreventprogression.
Referral to Treatment isthestagewherepatientsneedingmoreextensivehelpcanbereferredtoappropriatesupportservices,dependingontheirlevelofconsumption.
Some of the benefits of implementing the SBIRT Program:• ReduceoverloadofinebriatepatientsintheEmergencyDepart-
ment(ED).• Patientsarelikeliertoentertreatmenthavinghadabriefinterven-
tion.• Increaseinoutpatientmedicaltreatment.• Medicaldeclinecosts.
SBIRT at YKHCYKHC’smostessentialvisionoftheSBIRTProgramistoscreencorporate-wide:fromtheEmergencyDepartmenttotheupcomingSoberingCenterFacility,followedbytheoutpatientclinicstothesurroundingvillageclinics.
YKHClauncheditstailoredSBIRTProgramonMondayMarch1,2010.Priortolaunching,medicalstafffromvariousdepartmentsattendedtheSBIRT1-daytrainingsattheYuutElitnaurviatFacility.StaffwhoattendedthesetrainingsrangedfromEmergencyDepart-menttechsandnurses,toBehavioralHealthcliniciansandcasemanagers,tooutpatientclinicnurses.
ThesecondformalSBIRTTrainingsaretentativelyscheduledtobeduringthefirstweekofSeptember,2010.Weanticipatethatmedicalstafffromtheemergencydepartment,outpatientclinics,aswellassubregionalclinicswilltakepartintheseupcomingtrainings.
YKHC Emergency DepartmentScreeningsintheEmergencyDepartmentarecurrentlybeingadministeredfourdaysperweek,FridaythroughMonday.Patientscurrentlybeingscreened,typically,areminors,patientswithtraumaorinjuryrelatedtoalcoholuse,andthoseplacedunderTitle47*hold.SoberProtectiveCustody(PC)*patientsarealsoeligibletobescreened.
SBIRT model promises a more effective approach to alcoholism
Techsandnursesareresponsibleforscreeningminorsandpatientswithtrauma/injuryrelatedtoalcoholuse.BehavioralHealthon-callcliniciansareresponsibleforscreeningTitle47patients.
Screenedpatientshavetheopportunitytogaineducativealcoholinformation,thecommunity’sAAsupportgroupschedules,andarealsoaskedwhethertheywouldlikeareferraltobehavioralhealthservices.*Protective Custody (PC): Bethel Police Department (BPD) personnel (including Community Service Patrol/Officer) take individuals incapacitated by their alcohol co nsumption (in public places) into Protective Custody and transport them to the Sober-ing Center located in the Emergency Department. This occurs AFTER BPD personnel attempted to transport the inebriate individual to a safe and familiar/known home or relative.
*Title 47: A patient with suicidal ideations or are a threat to themselves or others.
by Marisela Valesquez, SBIRT Program Coordinator
Saturday, July 1710 a.m – 3 p.m.
Log Cabin parking lot at Pinky’s Park 326 Akiachak Dr. (City Sub)
Protect your pets— Get them vaccinated for Rabies
(dogs, cats and ferrets only)
Free Rabies Clinic
8
Imaginegoingouthuntingonthetundrainthemiddleofnowhereandbeinghitwithaheadachesotremendousthatyouneedtostop,liedownandwaititout.That’sexactlywhathappenedtoDanielBill,formerYKHCBehavioralHealthClinician,onMarch6,2010.
Danielhadabrainaneurysmbehindhislefteyethatcausedtheexcruciatingheadache.Ananeurysmisabulgeinabloodvesselcausedbydiseaseorweakeningofthevesselwall.Thisrequiresimmediatemedical
attentionsincethebulgemaybreakopenandleadtoothercomplicationsorevendeath.
Danielthoughtaboutcontinuinghiscaribouhuntingafterthepaininhisheadsubsided,buthe listened to his body andchangedhismind.Instead,hewentbacktoBetheltotheYukon-KuskokwimHealthCorporationEmergencyRoom.ACT-scanrevealedthathehadabrainaneurysmandwasimmediatelymedevac-edtoANMCinAnchorage,thentotheSwedishMedicalCenterinSeattle,Wash-ington,afewhourslater.
WhileDanielwasrecovering,thedoctorsaskedwhatheeatsandifheisphysicallyactive.Hisanswerwas,“Nativefoodsandyes,Istilldomanyofmytraditionalactivities.”TheprovidersacknowledgedthatNativemeatsarehealthierandleanerthanstore-boughtbeef,chicken,orporkandencouragedhimtokeepeatingthehealthierNativefoods.Thedoctorsaskedifheusedtobaccoandhereplied
thathequitusingtobaccoin1995.TheyalsoaddedthatkeepingphysicallyactivehelpedDanielrecoversoquicklyfromhissurgery.“Don’tbeafraidtoexercise,”oneprovidersaidatafollow-upexam.
DoctorsfromthreedifferenthospitalsagreedthatMr.Bill’shealthylifestyleandimmediateactionhelpedsavedhislife.Theynotedtheimportantstrengthsbelowasthereasonsforhissurvivalandswiftrecovery:
• Notwaitingtoseekhealthcare• Beingphysicallyactive• EatinghealthyNativefoods• Avoidingtobacco• Havingaverystrongsocialnetwork,includingspirituality
It’simportanttonotethatthesecharacteristicsnotonlyhelpedDanielwithhisbrainaneurysm,butcanalsohelpyouliveahealthierlifestyleandreduceyourchancesofotherchronicdiseasesliketype2diabetes,obesity,stroke,somecancers.
DuringthewholeordealDanielandhisfamilyreceivedmany,manyphonecallsfromfamily,friends,andfriendsoffriends.FromAlaska
Quyaviksuganka tamalkuita cingumastenkastory and photos by Debbie Michael, YKHC Diabetes Prevention & Control Daniel Bill pilots his boat on the Kuskokwim, in search of smelts. He attributes his survival
of a brain aneurism to living a healthy subsistence lifestyle—good food, plenty of exercise.
Volume XV No. 6 • June 15, 20109
Health Benefits of Subsistence LivingItisvaluableintheYukon-KuskokwimDeltatounder-standthatactivitiesofsubsistencelivingaremethodsofexercise.Fishing,gathering,andotherfishcampdutiescontributetohealthbyburningcalories,increasingstrength,andimprovingthefunctioningofthecardiovas-cularsystem.
Althoughhighintensityactivitiesburnmorecaloriesperunitoftime,mostpeoplecannotdothemforverylong.Engaginginlowerintensityactivities,suchashiking,gathering,netfishing,andtransferringwaterforlongperiodsoftimewillactuallyburnmorecaloriesthanshorterboutsofhighintensityactivities.
Musclesgrowstrongerwhenevertheyareconsistentlyrequiredtoperformheavywork,suchasliftingnetsandbucketsofwater.Furthermore,whenactivitymakestheheartbeatfaster,thereareimprovementsintheabilitytosupplynutritiontothebodyandgetridofharmfultoxins.Afasterheartrateandheavierbreathingaregoodindicatorsthattheactivityisintenseenoughtoactuallycausechangesinhealth.
Ourancestorsengagedindaily,consistentexercise,butpossiblyneverappreciateditsvalue.Whilemedicinehasbroughtimprovementsinhowlongwelive,alessactivecivilizationhasbroughtheartdisease,diabetes,andotherformsofchronicdisease.Byembracingthesubsistencewayoflivingtoday,wecanhonortheperfectbalancebetweenmoderntechnologyandancestralpractices.
toRhodeIsland,folkswerewishinghimaspeedyrecoveryandofferingtheirsupport.
Onnumerousoccasionsafterhissurgery,Danielwasstruckwithover-whelminggratitude,“PeoplefromdifferentpartsoftheUnitedStatesarecall-ingandtellingmethattheyareprayingforme.Anglilli yugni quyanaqvaa!”Tothisday,relativesandfriendswhohaven’tseenhiminawhilewillcomeuptohim,shakehishandorgivehimahugandsay,“Iamsoveryhappytoseeyouagain,Ihavebeenprayingforyou.”
It’sbeenafewmonthssinceDanielBill’sordeal.Hehascontinuedseeinghisproviders,beingphysicallyactive,eatinghealthyNativefoods,avoidingtobacco,andenjoyingbeingwithhisfamilyandfriends.
Whenaskedforhisfinalwords,Danielsaid,“Iwouldliketothankevery-onewhosupportedmyrecoveryduringmymedicalemergency.”InCup’ik/Yup’ik:Quyaviksuganka tamalkuita cingumastenka.
A Smelting ExpeditionYKHC’sDebbieMichael,DiabetesOutreachCoordinator,wentoutovertheMemorialDayweekendinsearchofsmeltswithfamilyandfriends.
“WewentoutandchasedthesmeltsuppastAkiakbecausewemissedthesmeltsbyaboutadayinBethel.Wecheckedafewplacesbeforewefinallyhitaplacewheretheywererunning.”
Aftergetting“about12gallons”theybeganthestringingprocess—simultaneouslybattlingsomeinvadingmosquitos.
“Igotsomesortofbranches—alderorwillow,I’mnotsurewhich(thebarkisreddishbrown,theleavesarelongandnarrow.)Toprepare,youtiethesmallerbranchesfromtwobranches/limbs,thenstartthreadingthemthroughthegillandoutthemouth.Wetrytodoitfromtherightgill,thenleftgill,thenrightgill—yougetthepicture.Whenyoureachtwotofourinchesattheendofthebranch,youbendandhookitthroughthelasttwotothreefish.Expertscandoitwithouttyingtheends,butwetieapieceofstringoverthehooked-overfishtokeepthemfromcomingoffwhenwehangthemtodry.Stringthroughmorefishontheotherside,thenhangtodry.Afterdryingtheywillbesmoked.Weusewillowwood,othersusecottonwoodoralder.”
Lynn Olick and Deanna Matthew string smelts for drying.
Lynn Olick and Daniel Bill haul in some smelts.
10
SUBSCRIBE to the Messenger! Online Messenger: Published monthly on our website: www.ykhc.org. Enter your email address in the “Messenger by Email” link.Messenger Quarterly: Published in March, June, September and December and mailed to all YK Delta village boxholders. Bethel residents and others: Subscribe by sending your name and mailing address to [email protected] or call Public Relations at 907-543-6038
Survey Results In: WIC Foods Make a Difference
by Renee Legan, WIC Program Registered DietitianTHANKYOU…toalltheparticipantswhocompletedtheWICsurvey.
The WIC program recently received ~300 completed surveys! Here are a few quotes from our WIC moms…
Question 1: What change in eating habits or physical activity has your family made?• Ieatmorefruits&vegetables.Ialsostoppedeatinganythingthat
isnotwholewheat.So,ThankYa!• Eatinghealthierfoodsotherthanjunkfood.Myfamilylikes
cheese,UHTmilk,fruits,andwholegrainbread,nowadays.• We’reeatingbetter,morenutritioussnacksratherthansweets.• WellwemovedfromAnchoragetoEEK.Livinginthevillagewith
nowater&sewerpipesishardwork.Wehavetopackwateranddumpthehoney-bucketandbelievemethebucketisnohoney.
• Mysonlovestoeateggs,cereal,bread,peanutbutter,milk,juice,fruit,cheese,orbeans.HereIthoughtthathewouldn’tlikeWICfoodsandhedoes.
• Weaddedmorefiber&moreathleticactivities.• Myfamilynoweatswholegraincerealinsteadofthosestore-
boughtsugarycereal.• Tryingtoeathealthy,lesskoolaidandmorewater&WIC
approved100%juice.• Cutdownonjunkfood.Noteatingoutasmuch.Myboysliketo
copymewhenIamdoingmyexercisevideos.• Wecookandeattogetherwhichbroughtmorehealthyeating
habits.Question 2: How has the new WIC food items changed how your family eats or shops?• ThechangeinthenewWICfooditemsisgood.Mysonstarted
eatingbreadandfruitbecausetheywereaddedtotheWICben-efits.
• Encouragesustoeatmorewholegrainsandfruit.• MakingsureeverythingIbuyiswholegrain.• WebuymorehealthyfoodtogowithWICitems.• My2yroldlovesfreshcauliflower.Iwouldn’thaveknownthat
withoutthefruit/veggievoucher.Thanks!
Question 3: Have you had problems purchasing the new WIC foods?• Storewasslowatgettingfruitsatfirst.• The2lbbreadisalwaysovermy16ozlimitsoIonlypurchase1lb
bread.• Can’tgettortillasatthelocalstore.• Couldn’tgetwholegrainbreadwhenthisallstartedinOctober
2009.Question 4: How helpful has WIC been in assisting you to suc-cessfully breastfeed your baby? • 93%indicatedthatWIChasbeenVeryHelpful.Question 5: Do you have any comments or suggestions?• Ilikethechangeinfoods.WhathappenedtoKix?• KeepupthegoodworkWICandthankyouverymuch!• Thankyoufortheprogrambecauseithelpsourfamilyalot.• Thanksforaddingwholegrains,vegetables&fruits!• TheWICfoodsareveryhelpfulformysonandthankyouso
much.Heisgrowingmorehealthynow…Wow!
Other Comments: From Larry Nutter, AC Branch Manager in Hooper Bay:“ThenewWICfoodsarehealthier,especiallythewholegrains,fruits,&veg-etables.Stockingthenewfoodswasachallengeatfirst.Wealwayscarriedwheatbreadbutonlyselling1-2loavesaweekandnowweareselling25-30loaves.”
From Shea Brumley RD, LD Clinical Diabetes Educator, Interim Coordinator, Diabetes Prevention & Control Program:“NowthatWICoffersfruits,vegetablesandwholegrainsthevillagestoresinourregionarestockingtheseitems.Thischangehasimpactedthediabeticsinourregionbyprovidingthemwithbetteraccesstonutritiousfoods.AndreaRuble,FNP,AniaSwiniarska,RN,andIrecentlyreturnedfromthevillageofTuntutuliak.Afteralongdayofseeingpatientswestoppedbythevillagestoreandtooursurpriseonewallofthestorewaslinedwithboxesoffreshfruitsandveg-etables.ThepicturebelowwastakenbyAniathatnightatthevillagestoreinTuntutuliak.”
Volume XV No. 6 • June 15, 201011
There’snoexcusetonotbreastfeedyourbaby
The Breast is Best
by Tania ThomasDorothyChase,OBSeniorUnitClerk,CharlyBairdORNurse,andSusanBotamanenkoOBnurseweregatheredaroundtherefrigera-torstoringtheirbreastmilk—freshlypumpedduringtheirlunchbreakwhentheydecidedtheywantedtosharesomeoftheirexperi-encesofworkingbreastfeedingmoms.Theyansweredsomeoftheirownquestionsofwhytheychosetobreastfeed.
Why should a mom breastfeed her baby?
• Itisthebestandhealthiestnutritionforbaby• Momandbabyareabletobondandconnectasbabygrows• Itdoesn’tcostyouanythinglikeitdoestopayforbabyformula• ItisnaturalandpureWith Breastmilk babies will:
• Getthenutritiontheyneed• BondwiththeirMom• Behealthierandhavelessillnessessuchasearinfections• Haveastrongerimmunesystemandwillbeabletofightoffgerms• Avoidrottenbabyteeth• DecreasesthechanceofpneumoniaandRSVWhat does it take to be successful with Breastfeeding:
• Decidethatyouwantthebestforyourbaby• Commityourselftodoingitanddonotgiveup!• Feedfrequently;themoreyoufeed,themoreyourmilksupply
keepscoming• Ifyoucannotfeedyourbabywithyourbreast,pumpit,either
manuallyorelectric
• Myths about breastfeeding:
Myth: It is not easyFact:itiseasy,itisproducedinyourbodynaturallyandyoudonothavetopurchaseitfromthestore.Ifyouhavedifficultiestherearewaystomakeitbettersodon’tgiveup.
Myth: I don’t have a milk supplyFact:youdowhenyouthinkyoudonot
Myth: I’m not producing enough milk;Fact:yourbodyproducesenoughmilkaslongasyoucontinu-ouslyfeedyourbabyorpumpyourmilk.Themoreyoufeedorpumpyourmilk,themoremilkyourbodywillmake.
Myth: I never have a private place to feed my baby. Fact:therearemanyplacesawomancanfeedherbabyprivately.
Myth: I can’t feed my baby because I work. Fact:Momscanpumptheirmilkwhileatworktocontinuetofeedtheirbabytheirmilk.
Itissomucheasiertopulloutyourbreastandfeedyourbabyratherthanmakingabottleofformula.Thisissotrueespeciallythrough-outthenight.Whowouldwanttogetupinthemiddleofthenighttomakeabottleofformulawhenyoucanjustputyourbabyonyourbreastrightthereinbed.Babiescansleepbesideyourbedandyouwontevenhavetogetup!
Also,whenprivacybecomesanissueandyoudonotfeelcomfort-abletobreastfeedyourbabyinpublic,itisoktopumpyourmilkinadvance.Youmayputitintoabottleandbringitwithyoutofeedyourbabywhenitistimeforfeeding.WhenatthehospitalyoucanbreastfeedorpumpatWIC!
Withthecostoflivingthesedays,whybuyformulawhenyou
See BREAST IS BEST, p. 14
YKHC “nursing” mothers who have continued to breastfeed—via breastpump—and keep working: Mary Devlin, OB Senior Unit Clerk Charly Baird, OR Nurse Susan Botamenko and Clinical Nurse Educator Joyce Ekamrak.
12
........?Who do I call911State Trooper 1-800-764-5525or Village VPSO
Life-threatening emergency...Active suicide attempt, overdose, incident involving weapons, possible serious harm to somebody, person threatening to kill or seriously hurt themselves or somebody else
543-6300or 1-800-478-2642YKHC Emergency Services for Behavioral Health on-call Clinician
Mental health situation...Somebody might need to be committed to psychiatric hospital in Bethel or Anchorage—acting bizarre, out of touch with reality, maybe seeing/hearing things that are not there, “talking crazy,” maybe talking about suicide
1-866-465-8930ComPsych Employee Assistance Program
Personal or family problems...A YKHC employee or family member needs help dealing with an alcohol or drug problem, depression, job stress, marriage or financial problems, grief issues, domestic abuse, or similar problems.
1-800-478-3321or 543-6093 in BethelBehavioral Health Critical Incident Stress Management Program
After a disaster or tragedyThere’s been a terrible event in my village—a suicide, bad accident with injuries, multiple deaths, etc. and we need help coping with all of this
Working Together to Achieve Excellent Health
What goes on when the lights go out?by Donna Bach, YKHC Public RelationsOnMay21,2010,BethelUtilitiesCorporationscheduledamainte-nanceupgradepower-outagefromFridaynightatMidniteuntil6a.m.ontheBethelpowergrid.Restassured,noonewasmorepre-paredthanthededicatedstaff,healthserviceprofessionalsandsafetymanagementatYKHC.
Inpreparationfortheoutage,allback-upgeneratorswerefueled,checked,andpreparedfortheevent.TheneighboringcommunitiesofOscarvilleandNapakiak—alsoontheBethelpower-grid—experi-encedtheseven-hourlongpoweroutageintotheweehoursofearlySaturdaymorning.
“Anextraordinaryamountoftime,energy,preparationandcoor-dinationisintegralinmanaginganemer-gencyorinterruptioninbusinessoperationsinvolvingthehospital,”saidShannonFreitas,
DirectorofSafetyandSecurityforYKHC.“DuringthiseventweexercisedourEmergencyOperationsPlan,apracticewhichwearerequiredtofulfilltwiceayearforcompliance.ThisexerciseincludedstaffingourEmergencyOperationsCenterwiththepersonnelnec-essarytomanagetheeventandprepareforanysystemfailures,”Freitassaid.
JohnMallone,theIncidentCommanderinpreparationfortheevent,andthehospitalfacilitiesmanagerworkedincollabora-tionwiththehospitalmaintenanceandfacilitiesteamtowarmupandbringonalloftheback-upgeneratorssotheEmergencyRoomcouldoperateasnormal.YKHC’sERkeptitsdoorsopenanddespitethelocalBUCpowerloss,hospitalservicesfunctioned
see OUTAGE, p. 13
Volume XV No. 6 • June 15, 201013
Insect Repellents – The Factsby Keisha Green, Pharm.D Candidate, Medical University of South CarolinaChoosingandusinginsectrepellentscanbeeasyifyouknowthefacts.ItisimportanttochoosearepellentthathaveactiveingredientsregisteredwiththeU.S.EnvironmentalProtectionAgency(EPA).TheactiveingredientsthatareregisteredwithEPAmeanthattheyareapprovedforeffectivenessandsafetywhenusedaccordingtotheinstructionsonthelabel.
Therearetwoactiveingredientsthathaveahighlevelofeffectivenessandpro-videlonger-lastingprotectionthanothers.Theyare:
• DEET(N,N-diethyl-m-toluamide)• Picaridin(KBR3023)Also,certainproducts,whichcontainpermethrin,arerecommendedforuseonclothing,shoes,bednets,andcampinggear,andareregisteredwithEPAforthisuse.
Howlonganinsectrepellentlastsdependsontheamountofactiveingredient,temperature,amountofphysicalactivityandsweating,andanywaterexpo-sure.Themoreactiveingredientaproducthasthelongeritprovidesprotec-tionfrommosquitobites.Forexample:
• Aproductcontaining23.8%DEETprovidesanaverageof5hoursofprotec-tionfrommosquitobites
• Aproductcontaining20%DEETprovidesalmost4hoursofprotection• Aproductwith6.65%DEETprovidesalmost2hoursofprotection• Aproductwith4.75%DEETprovidesalmost1hourandahalfofprotectionItisimportanttochoosearepellentthatprovidesprotectionfortheamountoftimethatyouwillbeoutdoors.Aerosolandpump-sprayproductsareintendedforskinaswellasclothing.Liquid,cream,lotion,spray,andstickproductsareusedfordirectskinapplication.Simplyre-applyrepellent,followinglabelinstructions,ifyouareoutdoorsforalongertimethanexpectedandstarttobebittenbymosquitoes.
How to Use Insect Repellents Safely• Applyonlytoexposedskinand/orclothing(asdirectedontheproduct
label).Donotuseunderclothing.• Neveruserepellentsovercuts,wounds,orirritatedskin.• Donotapplytoeyesormouth,andapplysparinglyaroundears.When
usingsprays,donotspraydirectlyonface—sprayonhandsfirstandthenapplytoface.
• Donotallowchildrentohandletheproduct.Whenusingonchildren,applytoyourownhandsfirstandthenputitonthechild.Youmaynotwantto
“asusual”withlittletozerotrafficovertheearlymorningoutage.TheYKDeltaRegionalhospitalaswellasotherkeyYKHCfacilitiesandclinicsontheBethelpower-gridwereabletofunctiononback-uppower,andthisisagoodthing.“Everythingwentsowell,itwasaseamlesstransi-tionofpower.TheX-Raymachinesandotherequipment(whichrequirealotofpower)stillfunctionedasexpected.WewantedtoseeiftheCT-Scanwouldoperateonourback-upgeneratorsandwearecertainitwouldhavebutnopatientsneededoneduringthescheduledoutage,”saidMallone.“Ohwell,maybenexttime?”hesaidwithasmile.
“The importance of effective preparation cannot be underestimated, especially when dealing with events that can be quite rare in the healthcare setting,” said Coryee Hamons, Director of Risk Management. “This is why the Emergency Operations Plan (EOP) must be activated, tested and evaluated on a regular basis so we are better prepared for those unplanned events that may disrupt normal operations. Taking a complex written plan and bringing it to life reduces the fear factor and provides confidence for the staff affected by the event,”
Back-upgeneratorswerekickedintogearattheMcCannTreatmentCenter,theCHSB“NewYK”building,andanothersatellitefacility.
“Allengineswereago,”saidJoeMoses,facilitiesmainte-nancemanagerattheNewYKbuilding.JoeMoseswasabletoprovideascheduledshiftchangeforhisstafftocomeinandworklaterFridayeveningintheeventtherewasaback-upgeneratorfailure.Fortunately,allenginesfunctionedasexpectedandthepoweroutagesoonbecameasomewhat“uneventful”event.
“Havingapowersourceisvitalfordeliveryofpatientcare,butitisjustasimportanttohaveanenergysourcetobackupourcomputersystemsandourmainserverforalltheinformationweneedtoretainforhealthrecords,codingandbilling,andotherpertinentinformationfortheadministrativefunctionsofoperatingahealthcorpora-tion,”saidSpencerHamons,LeadITcoordinatorduringthepoweroutage.
Back-upgeneratorsatYKHCfacilitiesstartedupat10:30p.m.onFridaynightinanticipationoftheoutageandonceBUC’spowergridcamebackon,thetransitionofftheback-upgeneratorstookplacearound8a.m.Saturdaymorning.Inadditiontothefacilitiesandmaintenancework,theHomeCareServicesunderthedirectionofLizLeewereabletocontactallhomecarepatientswhomayhavebeendependentuponelectronicmedicalequipmentsotheywereinformed.HospitalRespiratoryServicesstaffworkedtogethertoinformanypatientswhoweredepen-dentuponothernecessarybreathingequipmentwhichrequiredapowersupplywerealsonotified.
OUTAGE, from p. 12
see REPELLENTS, p. 15
14
Need a safety net?
Denali KidCare can help Denali KidCare is Alaska’s State-sponsored no-cost
health insurance for children and teens through age
18, and for pregnant women who meet income
eligibility guidelines.
ASK your enrollment specialist how Denali KidCare can help YOU!
For more information, please call 1-800-478-3321 ext. 6470
alreadymakeyourownmilk?Thinkofhowmuchmoneyyouwouldsavebybreastfeed-ingratherthangivingyourbabyformula.
WhenaMompumpshermilk,itdoestakecommitmentandpatience.Indoingthis,thebabygetsthenutritionthathe/sheneeds.Breastmilkiseasytopumpandstore.Itcanlastseveraldaysintherefrig-eratorandseveralmonthsinafreezer.Theawesomethingaboutpumpingyourmilkisthatyourbabycanhaveitfromabottle.ThiswillallowsomeoneelsetofeedyourbabyandforMomtotakeanap,shower,runanerrandorjusttakeabreak.WICcanassistingettinganelectricornon-electricbreastpump.
BREAST IS BEST, from p. 11
Babies who are breastfed have stronger im-mune systems and are better able to fight off germs. (YKHC file photo.)
With breastfeeding you will need to:• Eatwell• Drinkplentyoffluids• Getrest,takeanapwhenyoucan• FeedmorefrequentlyRemember,thehealthiestbabiesarebreastfed!Let’sraisethehealthiestbabiestogetherandpro-moteallMoms,newandexperienced,tobreast-feed.
If there are concerns, questions or tips you may have about breastfeeding, please feel free to contact the Irnivik; OB Unit. 543-6346, a baby friendly unit!
COMING SOONto upriver Kuskokwim villages:Donlin Creek Mine Health Impact Assessment
Public MeetingsWhat does regional mining mean to you and the health of your community?What human health effects do you think are related to the mine?
Collaborative Health Impact Assessment Agencies:
Yukon-Kuskokwim Health CorporationState of Alaska Dept. of Natural Resources &
Department of Health & Human ServicesAlaska Native Tribal Health Consortium
Look for notices posted in your village!
Volume XV No. 6 • June 15, 201015
Dr. Marcia Haggerty (right) with Christy Ticknor. (photo by Rhonda Vanover)
Christy Ticknor, AnvikYKHCcelebratesChristyTicknorasApril’sHealthAideoftheMonth.
ChristyworksintheAnvikClinicandservesasthevillage’sonlyHealthAide.Dr.MarciaHaggertynominatedChristyforflyingtothevillageofGraylingtoassistapatientinneedofcareandtransport.“Iamsogratefulforherdedicationandwillingnesstohelp,”saidDr.Haggerty.“SheisalwayscheerfulandknowledgeablewitheverycallandIamsoappreciativethatsheisoutthere,“shesaid.
YKHC salutes Christy Ticknor of Anvik as April’s Health Aide of the Month!
TheHealthAideworkforcerepresentsthesustainabilityofhealthcareintheYKDelta.Eachmonth,YKHCawardsspecialrecognitiontoanoutstandingHealthAide.IfyouwouldliketorecognizeaparticularHealthAide,contacttheFieldSupervisionInstructorbycalling543-6160.
Health AidesDeserve Your Appreciation!
Thank your Health Aide today for the work they do.
Your appreciation encourages health aides to continue their fine job caring for everyone in the village.
~ Stop by the clinic to thank your health aide~ Tell others to appreciate their health aides~ Bring them cookies or a small thank you gift~ Nominate them for Health Aide of the Month~ Have a community potluck celebration for all
the clinic workers~ Write them a nice thank you letter
Martha Constantine, CHP, in Kwethluk clinic checking the ears of a young patient. Photo by Carl Evans.
applytochildren’shands.DEETisnotrecommendedforuseonchildrenunder2monthsofage.
• Usejustenoughrepellenttocoverexposedskinand/orcloth-ing.Heavyapplicationandsaturationaregenerallyunnecessaryforeffectiveness.Ifbitinginsectsdonotrespondtoathinfilmofrepellent,thenapplyabitmore.
• Afterreturningindoors,washtreatedskinwithsoapandwaterorbathe.Thisisveryimportantwhenrepellentsareusedrepeatedlyinadayoronconsecutivedays.Also,washtreatedclothingbeforewearingitagain.
• Ifyouoryourchildgetsarashorotherbadreactionfromaninsectrepellent,stopusingit,washtherepellentoffwithmildsoapandwater,andseeyourdoctor.Whenyougotoseethedoctor,taketherepellentwithyou.
• Ifyouaregoingtousesunscreen,applysunscreenfirstthentherepellent.Donotuseproductsthatcombinesunscreenandinsectrepellentbecauseinstructionsforusearedifferentforeachprod-uct.
• Therearespecificproductsforanimals.Besuretoreadproductlabelscarefully.
REPELLENTS, from p. 13
Volume XIV No. 6 • June 15, 2010
Non -Profit Org.US PostagePAID
Anchorage, AKPermit # 537
Yukon-Kuskokwim Health CorporationP.O. Box 528Bethel, Alaska 99559907-543-6000
Getting on a Boat? Be sure to Float! Wear your PFD.Personal Flotation Device
Summer in the YK Delta means fishing, boating, swimming, travel, and recreation. This year, beat the odds; get a PFD and wear it.
Today’s PFD’s fit better, look better, and are easy to move around in. Some PFD’s are made to protect you from cold water. A PFD with bright colors is easier to see and may increase your chances of rescue.
A PFD must fit comfortably and snug. Make sure your PFD is made for your weight and size.
But, no matter which PFD you choose, the best PFD is the one you wear. Remember, spending a little time now can save you a lifetime later.
In Bethel? Stop by the YKHC Retail Store and see what we have!We are located in the lobby at the “New YK” BuildingHours: Monday–Friday, 7:30 a.m.– 11 a.m. / noon–3:30 p.m.
We also sell coffee and espresso drinks, so join us for a “cuppa joe”
Float Coats & PFDsInjury Control & EMS Sales
Safety Equipment at the Retail StoreYKHC’s Injury Control & EMS, Sales Shop offers a variety of
safety equipment such as: PFDs, ice cleats, off-road helmets,
snowmachine helmets, goggles, and first aid kits.
The products we purchase are directly from the manufacturer,
which means we purchase the items at wholesale cost and
consumers buy them for less than what the stores charge!
Call us today for product availability!
1-800-478-6599 or 907-543-6085