INSIDE: Health Ed, p 4 • MUDD Day, p. 5 • Care Managers, p. 6

Dental Health Aides trainfor village-based oral care

Dental disease is rampant in the YK Delta. With Dental Health

Aides learning to do check-ups, cleanings and screenings,

dentist will be able to concentrate on fillings, crowns and other

procedures.

Story on page 9.

Dental Health Aide trainee Jenilee Kiunya of Kongiganak tests her skills with Gerilyn Fitka of Marshall. Photo by Chris Ho.

Volume IX No. 11 • November 15, 2004

2

YKHC Board of DirectorsUnit 1Joe MikeP.O. Box 20269Kotlik, Alaska 99620907-899-4756Aaron S. KameroffP.O. Box 37Alakanuk, Alaska 99554907-238-3125

Unit 2Ray Alstrom P.O. Box 8Marshall, Alaska 99585907-679-6320James C. LandlordP.O. Box 32168Mt. Village, AK 99632907-591-2119

Unit 3Billy MorganP.O. Box 72Aniak, Alaska 99557907-675-4457Angela MorganP.O. Box 243Aniak, Alaska 99557907-675-4413

Unit 4Fritz George P.O. Box 62Akiachak, Alaska 99551907-825-4626Moses Peter P.O. Box 57 Tuluksak, Alaska 99679907- 695-6420

Unit 5Bill Kristovich P.O. Box 1037 Bethel, Alaska 99559907-543-4151/2212Henry Hunter, Sr.P.O. Box 632Bethel, Alaska 99559907-543-5130Gloria SimeonP.O. Box 308 Bethel, Alaska 99559907-543-5676Joseph C. BavillaP.O. Box 6011Napaskiak, Alaska 99559907-737-7062

Unit 6Chuck Chaliak P.O. Box 169 Nunapitchuk, Alaska907- 527-5045

Unit 7Robert Enoch P.O. Box 8054 Tuntutuliak, Alaska 99680907-256-2529

Unit 8James R. Charlie, Sr. P.O. Box 37012Toksook Bay, Alaska 99637907-427-7114James SiparyP.O. Box 37134 Toksook Bay, Alaska 99637907- 427-7816

Unit 9Reuben HillP.O. Box 210Hooper Bay, Alaska 99604H: 907-558-4096 - W: 558-4711William NanengP.O. Box 114Hooper Bay, Alaska 99604907-758-4015

Unit 10Sam W. AlexieP.O. Box 57 Eek, Alaska 99578907-536-5428

Unit 11Kathy W. ChaseP.O. Box 41Holy Cross, Alaska 99602H: 907-476-7162W: 907-663-6318

Honorary Board MemberPaul JohnP.O. Box 37067 Toksook Bay, Alaska 99637907-427-74l4

Numbers to CallYKHC......................................................................... 543-6000Public Relations Dept. ................................................ 543-6030Media Services ............................................................ 543-6038Office of Environmental Health & Engineering ......... 543-6420Technology Help Desk ................................................ 543-6070Human Resources ....................................................... 543-6060 Job Line ................................................................... 543-6443Learning Center .......................................................... 543-6980Administration ............................................................ 543-6020Hospital ....................................................................... 543-6300Emergency Room ........................................................ 543-6395Hospital Community Relations ................................... 543-6350Social Services ............................................................ 543-6225Clinic Appointments ................................................. 543-6442 1-800-478-3321Dental Appointments ................................................ 543-6229Optometry Appointments ......................................... 543-6336Audiology Appointments .......................................... 543-6466

Subregional Clinic Appointments Aniak ....................................................................... 675-4556 Emmonak ................................................................ 949-3500 St. Maryʼs ................................................................ 438-3500Public Health Nurses ....................................................543-2110Pharmacy ..................................................................... 543-6382Travel Management Center ......................................... 543-6360WIC Program .............................................................. 543-6459Health Services .......................................................... 543-6024Village Operations ...................................................... 543-6160 CHAP ...................................................................... 543-6160 Injury Prevention/EMS ........................................... 543-6080 Community Health & Wellness ............................... 543-6190Behavioral Health Services ...................................... 543-6100 Phillips Ayagnirvik .................................................. 543-6700 Village Services ....................................................... 543-6740Home Care Services .................................................... 543-6170

Volume IX No. 11 • November 15, 20043

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 Corpo-ration, P.O. Box 528, Bethel, Alaska 99559. E-mail: 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 99503. 907-677-2232. Please ask permission to reprint articles or pictures. © 2004, Yukon-Kuskokwim Health Corporation.

YKHC Board & Committee Meetings

2004

November 16YKHC Finance Committee

November 17 – 19YKHC Full Board of Directors

December 10YKHC Holiday, Traditional Chief’s Day

December 21YKHC Finance Committee

December 22 – 23YKHC Executive Board

For questions / comments or additional listings, please contact YKHC Administration 907-543-6020

Call The YKHC Learning Center: 907-543-6758

Health Aides

Faced with unforeseen circumstances, Health Aides go way beyond their known limits and their stamina is

tested again and again.Oftentimes they are not aware that anyone is paying attention and arenʼt sure even if what they are doing is known to others outside the small circle of family and friends.

Health Aides are committed and dedicated to the health of the people in their vil-lages.

In 2003, health aides had 103,663 patient visits in their clinics. This is the same amount that is seen at the hospital each year. Not only do they take care of people who are acutely sick, they also care for people who are chronically ill with diseases like heart disease, diabetes, cancer, and other serious illness.

In addition, health aides do preventive care, such as giving babies immunizations and do well-child exams. In the near future there will be health aides who special-ize in preventive dental care.

Becoming a Health Aide takes many years of training. Health Aides who complete all the training are called Community Health Practitio-ners (CHPs). Health Aides are also trained in Emergency Medicine. Many are trained to level EMT I. Some are trained even higher.

There are 209 CHA/P positions in 48 village clinics in YKHC. Starting salary is $15/hr, and training occurs on the job.

Community Health Aide (CHA)• Lives and works in remote areas

• Communicates with physicians by phone, radio or computer

• Takes patients’ medical history, per-forms examinations and plans care

• Has the ability to work independently

• CHA is employed while in training

• Average starting wage: $15 per hour

Health Aides from throughout the YK Delta gathered in St. Mary’s in August for their annual conference.

4

Meet your Health Educator

My name is Julia Brown,

Health Educator with YKHCʼs Health Edu-cation Department. My office is located in my hometown of Kongi-ganak. My service area includes the villages listed here. I will soon be traveling to your village to personally introduce myself.

As a Health Educator, I present material and information on certain health promotion and prevention topics in schools, groups, and the community at large. The Health Edu-cation Department is focusing on six topics gathered from the survey of community issues at the annual Tribal Gathering—alcohol; cancer; sexuality education; talking about touch (sexual abuse prevention); tobacco; nutrition and physical activity.

Health Educators may also make referrals to other departments if we are not knowledgeable in a specific topic.

If you have identified someone in your group or com-munity who can call me, she/he can be the person that I can contact before visiting your village. I look forward to meeting you and your community.

If you have any questions, please call me at 907-557-5613, or email Julia_brown@ykhc.org. I look forward to working with you.

Spotlight on Health Education

Chefornak

Eek

Kipnuk

Kongiganak

Kwigillingok

Mekoryuk

Newtok

Nightmute

Quinhagak

Toksook Bay

Tununak

Julia Brown

Please welcome new staff

The Health Education Department (HE) is pleased to announce the expan-sion of services with the addition of four new staff members: Bethel-

based Health Education Coordinator Lisa Aguda, and Health Educator Alma Kanrilak; and village-based Community Health Representatives (CHRs), Stella Lake from Chevak and Wayne Morgan from Aniak. They are highly motivated and we are excited to have them join our program. Learn more about each through interviews in future articles.

Wayne Morgan receives education award

Congratulations to Wayne Morgan of the Health Education Department, proud recipient of the

MacKinnon Educational Excellence and Human Recog-nition Award!

In addition to his work as a community health rep-resentative in Aniak, Wayne is a dedicated and active member of the local school board, located within the Kuspuk School District. The Alaska Association of School Administrators officially recognized Wayneʼs efforts by selecting him to receive this annual award.

The MacKinnon Educational Excellence and Human Recognition Award was established in 1985 and bestowed on “school board members who have provided meritorious service to their school districts and communities.”

In consideration of the financially burdened school board, Wayne decided to forego attending the awards ceremony. He has sent an acceptance speech with a fellow attendee.

Recognition continues for Wayne in the form of an invitation to represent rural schools of Alaska at the Public Education Networkʼs 2004 Annual Conference. This conference will explore “the relationship between public schools and their communities through four lenses: public schools as models of community, public schools as centers of community, public schools as community builders, and public schools as model public institutions.”

Health Educators meet Head Start parents

Kudos to Debi Olick and Alma Kanrilak for their fine presentations at the Well Child/Head Start Health Fair! Over the course of the three-day

event the health educators spoke to 104 parents and 117 children. The pre-sentations were well received and several parents requested contact informa-tion from the educators to learn more about other health and nutrition topics.

Debi and Alma discussed various adverse health effects of the consump-tion of large amounts of sugar found in soda pop. They encouraged partici-pants to use the healthy alternative of drinking milk.

The number of participants and their responses were encouraging and Debi and Alma are excited to continue bringing this and other messages to the public.

The Health Education Department offers disease prevention and health promotion activities including:

• Health presentations in schools and in communities

• Community health fairs

• Community wellness team development for health promotion planning

• Resource library with videos and lesson plans

• Monthly radio program on health issues and concerns

If you would like more information about our services or the Community Health Representative for your community, please call toll-free 1-800-478-4471

Wayne Morgan

Volume IX No. 11 • November 15, 20045

Nurses spend a day refreshing competenciesNurse managers, staff nurses, and RN

nursing students worked together Octo-ber 13 and 14 to have a MUDD (Mandatory Update and Development Day) for Regis-tered Nurses, Licensed Practical Nurses, Certified Medical Assistants, and Certified Nurses ̓Aides.

The mandatory updates included BLS refresher, color blindness test, pharmacy test, license verification, and N-95 mask fitting, among other things. Staff members who have state certifications or licensure are required to update annually in competen-cies. Having a two-day update organizes the competencies and allows additional discus-sion along with a sense of fun and camara-derie.

“It went very well with a lot of participation,” said Carol Garrison, Infection Control Nurse.

The MUDD was a success, with 65 percent of the staff required to provide the certifi-cations participating. The staff that could not attend the two-day offering will make up the competencies at another time.

Carol Garrison, RN; Interim Womenʼs Health Program Man-ager Sandi Cook, RN; and Lead Clinician for Ambulatory Clinics Monica Martin, RN, worked together developing the program

and hope to continue the project annually. The nurse managers, case managers, and staff assisted in giving the competencies.

From left: Lela Andrew, RN (NW), Rhonda Griffith, Lab; Doug Kelly, Cardiopulmonary Dept. ; Heather Hamblin, RN, ER; Carol Garrison, RN, Infection Control; Brenda Fox, CNA, NW; Colleen Hearn, RN, Kusko Case Management.

Quitting – It isn’t easy, but you’ll be glad you didStopping tobacco use can be one of the hardest things to do

because of the physical and psychological withdrawal symp-toms. But quitting will improve the health and emotional well-being of someone who has been addicted to tobacco.

Physical symptoms of nicotine withdrawal vary from person to person, but may include any of the following:

Remember that the health benefits of ending tobacco use far exceed any negative symptoms that may follow quitting.

Health Benefits include:• Improved sense of smell and taste• Clothes, home, and car smell better • Lowered blood pressure• Lowered heart rate• Improved circulation in the hands and feet• Less carbon monoxide levels in the blood• More oxygen to your brain and body• Generally feel better than when you used tobacco products• Reduced risk for cancer• Reduced risk for heart disease

New Staff at Nicotine Control

The Nicotine Control and Research Pro-gram would like to welcome Samantha

Epchook, Nicotine Cessation Counselor, to the YKHC Bethel based Tobacco Pro-gram. Samantha is pursuing her Bachelors Degree in Social Work and will be working part-time in the YKDRH Tobacco Program Clinic.

CELEBRATE GREAT AMERICAN SMOKEOUT ON NOVEMBER 18th—Call In Show on KYUK!!

If you want information on Tobacco and Health, or are interested in quitting tobacco contact the

Nicotine Control Department at 543-6312 or 1-800-478-3321

• Craving for something, especially for carbohydrates (bread, pasta, potatoes) and sweets (candy, soda pop)

• Coughing more, with more sputum production

• Feeling tired

• Muscle aches and cramps• Constipation or diarrhea• Headache• Very sensitive to touch• Trouble sleeping• Weight gain• Feeling sick to stomach

Physical withdrawal will begin to go away after about one week. Nicotine is flushed out from the bloodstream and body tissues via the kidneys, so people who have quit may find drinking plenty of liquids such as water and fruit juices helpful. Beverages often asso-ciated with smoking, such as coffee and alcohol should be reduced or avoided.

Most people will experience the worst withdrawal symptoms during the first several days following the quit date. Withdrawal symptoms will lessen slowly after that, but urges to smoke and increased appetite may be long-term effects of ending tobacco use. Some ex-tobacco users say that occasional urges occur years after stopping tobacco use, so itʼs good to have a plan for what to do when you get a craving.

Exercise, even light exercise such as walking, can help those who have chosen to break the habit to remain tobacco-free and avoid or minimize weight gain.

Nearly 80 percent of those who quit smoking gain weight, but so do 56 percent of those who continue smoking. The average weight gain after quitting is 5 to 10 pounds, and only 3.5 percent of quitters gain more than 20 pounds.

Samantha Epchook

6

Kusko ClinicJudith Arrington, RN

Judith Arrington initially came to Kusko Clinic as a travel nurse in October, 2003. She trans-ferred into the Case Management Department in February of this year. Judith came to Bethel from Texas, where she worked for several years as a case manager, primarily in the area of Home Health, which encompasses a large seg-ment of health care in the South. She has three children and five grandchildren.

“Bethel was my first travel assignment, and I loved it here. The people, the climate, the tundra, the “eclecticness” of it all – I love it! I look forward to working with the people of this region for a long time.”

Judith s̓ villages: Akiachak, Akiak, Aniak, Anvik, Chuathbaluk, Crooked Creek, Grayling, Holy Cross, Kwethluk, Lower Kalskag, Red Devil, Russian Mission, Shageluk, Sleetmute, Stony River, Tuluksak, and Upper Kalskag. She also works with a number of Bethel patients who are seen by providers in Kusko Clinic.

Colleen HearnColleen Hearn has been a Kusko Care Manager for one year and has been a YKHC employee for three years. Colleen is a Forensic Nurse and is the Director of the Jabez Soup Kitchen, a mis-sionary project that she began three years ago here in the Delta. Colleen also likes to entertain and coordinates many of the social events at YKHC.

In 1993, Colleen Graduated from Oklahoma City University with a Bachelors of Science in Nursing. She then moved with her three children and dog to Nome to begin her nursing career. Her desire has always been to make a difference and improve the healthcare of Alaskan Natives.

Colleen is an avid traveler and has been all over Alaska, the lower 48 states, Mexico, South America and Europe.

Colleen s̓ villages: Alakanuk, Chevak, Emmonak, Hooper Bay, Kotlik, Nunam Iqua, and Scammon Bay. She also works with many Bethel patients.

Learn more about YKHC Care Management

We would like to introduce you to the Care Management Team. By asking for your

Care manager directly, you may get quicker answers to your questions and spend less time being forwarded to people who are not familiar with your needs.

Yukon ClinicSherri Rock RN, BSN

Sherri Rock has been in Alaska since she was nine years old and has lived in Kodiak, Anchor-age and Wasilla. Sherri graduated from Bartlett High School in Anchorage and then went to Nursing School in Oklahoma. In 1993 she received her Bachelorʼs Degree in Nursing and returned to Alaska.

Sherri Rock has worked in mental health facilities, schools, doctorʼs offices, cardiology

clinics, pediatrics and inpatient nursing. Sherri came to YKHC last year through a local travel nursing agency from Anchorage. She thoroughly enjoyed working with the people in Bethel and so she returned in April, 2004, to stay.

Sherri s̓ villages: Napaskiak, Newtok, Nightmute, Nunapitchuk, Oscarville, Pilot Station, Pitka s̓ Point, Quinhagak, St.Mary s̓, Tok-sook Bay, Tuntutuliak, Tununak and a portion of Bethel.

Katy Skillman, RNKaty Skillman has been a Registered Nurse for more than 35 years. She has worked on Medical and Surgical floors, Intensive Care and Emer-gency Departments prior to coming to Ambula-tory Services. She has a Bachelor of Science in Nursing and is Certified in College Health. Katy has been at YKHC for six years. She and her husband, Jon, have been married for 35 years. Jon manages KYKD FM, the Christian radio

station in Bethel. Katy s̓ villages: Atmautluak, Chefornak, Eek, Kasigluk, Kipnuk,

Kongiganak, Kwigillingok, Marshall, Mekoryuk, Mt. Village, and Napakiak, along with Bethel people who use the Yukon Clinic.

Anna Nicolai“Iʼm the department secretary for the Care Man-agement Ambulatory Department at the Yukon Clinic here at YKHC. Iʼm originally from Kwethluk and have lived in Bethel for more than 20 years. Among other duties, I coordinate arrangments and referrals for patients who are going to ANMC for their scheduled appoint-ments with the specialists.”

OncologyDawn Hackney RN, BSN

Dawn Hackney RN, BSN, is the Oncology Care Manager for YKHC. She came to Bethel in August, 2002. Dawn is the oldest of nine chil-dren, and was raised on a large ranch in a small town in Northern Idaho.

Before Bethel, Dawn worked on an inpatient chemotherapy unit in Coeur d ̓Alene, Idaho. While in Coeur d ̓Alene she administered che-motherapy agents involved in clinical trials.

Volume IX No. 11 • November 15, 20047

Women’s HealthJackie Owen, LPN

“I Have been a nurse for approx 35 yrs. I worked in a nursing home for 21 years; I was a manufactur-ing nurse, and also worked with mentally disabled women. I have been at YKHC for eight years, work-ing in Kusko Clinic before transferring to Womenʼs Health as a Care Mananger for the Kusko Clinic villages.

“I follow up the abnormal pap smears and mam-mograms primarily for Kusko Clinic patients.”

Heidi O’Leary, LPNHeidi is Care Manager-Educator for Womenʼs Health Grant Breast and Cervical Cancer Early Detection Program.

“I have been a nurse for seven years. I worked in OB and Rehab/Med-Surg in Montana before relocat-ing to Bethel. After working in the Yukon Clinic for two years, I transferred to Womenʼs Health. I am the care manager for the women of the Yukon Clinic villages. I am also enrolled in the Registered Nurse

program here in Bethel thru UAA-Anchorage. I am married to Mike and we have three children. I have been in Bethel for more than three years.”

Dawn DaviesDawn Davies is a Data Manager for the National Breast and Cervical Cancer Early Detection Program and the Department Secretary for Womenʼs Health.

“I track test results and send out letters. I also manage the reports for the Centers for Disease Con-trol. My husband and I have been living in Bethel for the past eight years. I am currently enrolled in the University of Alaskaʼs Registered Nurse program being offered for the first time in Bethel and will be

graduating in December, 2005.”

Prenatal CareVenissa Berlin and Ann Glasheen

These two are the Prenatal Care Management team that follows approximately 650 pregnant women a year. Venissa was born in Bethel; she is the daughter of Bessie and Kenneth Berlin. Venissa has been in this position for almost two years. She manages all the data entry and many more duties to keep the Prenatal Care Manage-ment running smoothly.

Ann Glasheen has been a nurse for 28 years. She is married to Brian. They have four sons and they have been in Bethel for 13 years. She first worked on OB for seven and a half years and then moved to Care Management. Ann has

just completed a Womenʼs Health Nurse Practitioner program and, once licensed, will be working in the clinic two days a week.

Update name changes at hospital Registration

This month we would like to encourage everyone to update their names and family members ̓names, if

applicable, with the Registration Department at the hospital.Your medical record is a confidential and legal record

maintained by the hospital. If your name has changed from what is currently in the hospital system, we recommend that you bring in the required legal documents to have your information updated so that the hospital can maintain accu-rate records of your visits and the pharmacy can maintain an accurate medication profile for each patient.

When patients have a status change regarding their names, they usually remember to change their driverʼs licenses, bank records, and monthly bills. Unfortunately, often times the health or medical records are not updated.

This also happens with health and prescription insurance coverage. Sometimes, the insurance card does not reflect the name that the hospital has recorded in their system. This can cause errors in billing as well as medical records.

We suggest that you also update your name and con-tact information with the Registration Department. Appropriate documentation may include a marriage cer-tificate, social security card, adoption papers, or a driverʼs license just to name a few.

If you have any questions regarding name changes, the Registration Department at 543-6315.

Thank you for assisting us in maintaining appropriate and accurate records for you and your family. This effort on your part will help alleviate preventable and time-consum-ing errors and make some of our processes and, ultimately, your visits here with us more efficient.

When visiting the pharmacy, please remember to bring in your prescription cards and have them ready to present at the front window with your medication requests. As always, if you have any questions about your medications, ask for a pharmacist. It is our privilege to serve you.

8

Fetal Alcohol Spectrum Disorder – Program Update

Imitating: Teaching Your Child to Make Sounds

Whittaker takes reins of Diagnostic Team

Longtime Bethel resident Mary Whitaker is the new Fetal Alco-hol Spectrum Disorder (FASD) Diagnostic Team Coordinator.

The FASD Diagnostic Team provides Screening, assessment, diag-nosis, and referral for children suspected of having been exposed to prenatal alcohol. Adults may also be accepted for screening on a case-by-case basis. The team is composed of members from various clinical disciplines including a coordinator, pediatricians, pediatric nurse practitioners, social workers, speech pathologist, occupational therapist, clinical psychologist, school psychologist and a FASD school specialist.

FASD/SED Grant

Children affected by serious emotional challenges may benefit from a new grant-funded project. This “Promising Practice”

program will provide individualized wraparound services for chil-dren and adolescents with FASD utilizing a multisystem, multidisci-

plinary, community-based collaborative intervention model. Identi-fying FASD as a primary physical disability and providing appropri-ate accommodations in all settings—home, school, mental health, and social services—could prevent secondary behavioral problems and a potential placement to a residential facility. This program is scheduled to begin services at the end of this year.

Presentation well-attended

On October 15, Dan Dubovsky with the SAMHSA FASD Center for Excellence in Washington, D.C. presented “The Impact of

FASD on Every Day Life,” a one-day workshop on working with children with Fetal Alcohol Spectrum Disorders and mental health issues. The presentation included discussions on their transitions into adolescence and adulthood, prevention of secondary disabilities, and use of medications. At this training we had More than 130 people attended including parents and providers from all over the YK Delta.

Your child first learns to speak by imitat-ing (copying or repeating) what you

say and do. Imitation skills learned early on help children develop speech and language.

Here are some suggestions of how to teach your childʼs imitation skills while encouraging speech and language.

Some imitation games:• Playing with toys. Banging blocks, stack-

ing them and knocking them down. Shak-ing rattles, rolling cars.

• Play Pat-a-cake, Peek-a-boo, or sing the Eensy Weensy Spider with your child. Teach your child to imitate your hand ges-tures during these activities, to clap along, and to attempt to sing along.

• Make sounds for your child to imitate. For example, while playing with a toy car make “raspberry” sounds as the car moves. When you pretend to eat food say “mmmm.” When you pretend to give a toy animal a kiss, make kissing sounds. Then stop and wait. See if you child attempts to imitate you.

Make Puppets:Here is a fun language activity you can do

with your child. This activity will encour-age imitation skills, build vocabulary, teach turn-taking, and provide you and your child with some time together! All you need are some old socks and a marker.

Activity• Make a puppet out of an old sock by

drawing eyes, nose, and mouth on it.• Some words or sounds you can have the

puppet say:∆ Hugging (“love”, “ah”)∆ Kissing (lip smacks)∆ Tickling (t-t-t-tickle!)∆ Rubbing tummy (“m-m-m”)∆ Pretend crying (wae-wae)∆ Waving good-bye (“bye-bye”)

Activities were adapted from Early Communica-tion Games by Deborah G. Casey-Harvey, Com-munication Skill Builders, 1995

HIV is in the DeltaDecember 1is World AIDS Day, an international day of action on HIV and

AIDS which takes place every year on this date. The focus this year is on the tremendous impact that this preventable disease is having on women and children worldwide.

Bethel AIDS Task Force (BATF) wants to remind everyone that the HIV virus does not discriminate and that we are all affected when someone has HIV or puts themselves or others at risk for HIV/AIDS. BATF will be having a candlelight vigil at Watsonʼs corner on Wednesday December 1 at 4:30 p.m.

Please join us in remembering the 925 Alaskans who have been diagnosed with HIV/AIDS and the 328 people who have died.

BATF would like your thoughts and suggestions about confronting HIV/AIDS in the Delta. Please call Carl Evans at 543-6486 if you would like to get involved or would like more information.

World AIDS Day, 2003, at Watsons Corner in Bethel, Alaska.

Volume IX No. 11 • November 15, 20049

New services will soon be avail-able in several villages as the

Dental Health Aide program takes off, according to YKHCʼs Deputy Dental Director Mary Williard.

“We hope to eventually get a Dental Health Aide in every village,” Williard said.

Several different levels of Dental Health Aides (DHAs) provide a range of services, depending on their qualifications and their location. Primary DHAs provide dental education, dental assisting, and preventive den-tistry services. DHA hygienists provide dental hygiene services in regional dental clinics and villages, and DHA Therapists will provide oral exams, preventive dental services, restorations, stainless steel crowns, extractions, and take x-rays. Expanded function dental assis-tant DHAs will place restorations in hub clinics.

The first six DHA Therapists in the Alaska DHA program have been in training for the last two years at Otago University in Dune-din, New Zealand. Otago is an internationally recognized school of dentistry that has more than 85 years of experience with this model. The students, three of whom were sent from YKHC, graduate in December and will soon be back in the YK Delta.

In Bethel, the new DHA Therapists will work with YKHC Dentists for at least three months, and then move out to the villages to prac-tice independently under individually structured standing orders.

Primary DHAs were recently in Bethel working with YKHCʼs Dental Staff and educators from the University of Kentucky on the services they will provide in the villages. These services include dental hygine education, evaluating plaque deposits, fluoride treat-ments, and preventative dentistry services.

Eleven PDHAs are already working in the villages of Akiachak, Aniak, Chefornak, Hooper Bay, Kongiganak, Kotlik, Kwigillingok, Marshall, Nunapitchuk, Scammon Bay, and Toksook Bay.

“A large part of the Primary DHA̓ s job is education,” said Wil-liard. People can come to the Health Clinic, or the DHA can come to a personʼs home if needed. They will also visit schools and teach

Dental Health Aide program promises improved dental care in villages

kids about good oral health and good dental habits.The DHA program was created to develop a local capacity to

address the oral health needs of rural residents, especially children, who suffer from cavities at two times the national rate.

The lack of year-round dental care in the Y-K Delta villages as well as the expense and hardships of rural travel often makes it tough for people to obtain dental check-ups on a regular basis. The new Dental Health Aides, who are village-based, are able to provide basic oral health services, disease prevention education, and continu-ity of care never before possible in rural Alaska.

The concept of developing needed dental services in rural Alaska adapts and expands on the existing Community Health Aide (CHA) Program. Federal statute authorizes Tribal health organizations to operate the CHA Program to provide primary health care throughout Alaska, and through 35 years of experience, the CHA program has developed administrative controls to ensure quality of care which the DHA program continues.

Operating in partnership with the Alaska Native Tribal Health Consortium (ANTHC), the Alaska DHA program plans to fully establish a statewide program of Dental Health Aides within the existing Tribal health care system.

For more information about the program, or information about becoming a Dental Health

Aide, contact Mary Williard at 543-6212 or Mary_Williard@ykhc.org.

At Otaga University in New Zealand Dental Health Aide trainee Lillian McGilton of Methlakatla masters xray techniques.

VISIT OUR WEBSITE!www.ykhc.org

Employment Opportunities • Latest NewsUpcoming Events • Messenger Back Issues

www.ykhc.org/tobaccoprogramDownload anti-tobacco hand-outs to post in your community—

10

by John Dickens

Assessing Responsiveness

You need to do it fast…

By being alert and observant you can learn much about your patient. Develop a general impression as you approach a patient.

The general impression should be kept simple. Base your general impression on:• The immediate environment in which the patient is found.• Whether the patient is ill (medical) or injured (trauma)• How the patient presents (appears).• What the bystanders or patient tell you (e.g. “ He fell off the back of

the snow machine” or “I woke up and canʼt breathe!”).• What the patientʼs chief complaint is.

A fast general impression made as you approach the patient will help guide your care.

The first priority is to assess responsiveness when making initial patient contact. As you approach the patient, introduce yourself. You may already know the personʼs name; if you do, use it. If the patient is talking, even if he or she is disoriented, the airway is open and the patient is breathing.

If the patient appears unconscious, tap the patientʼs shoulder and shout, “Are you OK?” If there is no response, the patient is unrespon-sive. This is a very big deal. You need to get help coming A.S.A.P.

An easy way to determine the level of responsiveness is the acronym A.V.P.U. It stands for:

ALERT—Awake and normally responsive.VERBAL—Responds only when spoken to, may be disoriented.PAIN—Responds only to a painful stimulus (pinching of earlobe or a

sternum rub)UNRESPONSIVE—Does not respond.Another good acronym is A+O X 4—Alert and Oriented times four.

This means your patient is oriented to person, place, time and event. This is a good way to describe level of consciousness to other rescuers or health professionals.

It is important to remember that infants and young children cannot respond like adults. Children can be assessed by observing their aware-ness of their surroundings, interactions with parents, and the level of activity. A lethargic child who is not interested in his/her surroundings and does not interact with the parents is very sick.

Adults Need Immunizations, Too! by Deborah Burnard, RN, YKHC Immunization Program

Most people know that babies and school-age children need immunizations to protect against diseases like

measles and whooping cough. But many of those people donʼt realize that adults need shots, too!

Each year in the United States, more than 30,000 adults die from vaccine-preventable diseases or their complications. Pneumonia and influenza together, for example, are the 5th leading cause of death among older adults.

But itʼs not just elders who are at risk...adults with certain health conditions, including diabetes and heart, lung and kidney conditions need these vaccines, too. Also, more than half the people living in the U.S. over the age of 50 are not fully immunized against tetanus and diphtheria. Remember, being immunized against these diseases helps protect you and those around you!

Adult Immunization Facts Did you know that…?• As you get older, your immune system becomes less active.

Immunizations can help your body fight off infections. • Tetanus can live for months and years in soil, dust and

animal feces, even in a very cold climate, so you need a tetanus-diphtheria (Td) booster every 10 years throughout your life.

• Varicella (chicken pox) is a common childhood disease. It is usually mild, but it can be serious in adults. 100 people a year in the United States die from complications of the chicken pox. If you have not had chicken pox, you should get vaccinated.

• Hepatitis A and B can cause serious liver disease. People living in the YK Delta, health workers, family members of Hepatitis B carriers, and infants of mothers who carry Hep-atitis B are especially at risk. If you have never completed the basic 3-dose Hepatitis B series, or a 2-dose Hepatitis A series, talk to your doctor, nurse or Health Aide about get-ting caught up.

• According to the American Society of Internal Medicine, “the flu and pneumonia kill thousands of people in this country every year even though there are safe and effective vaccines for both diseases.” You can protect yourself by getting an Influenza vaccine every year and a booster for Pneumococcal disease every 6 years, starting at age 55.

• If you are pregnant during the flu season (usually Novem-ber to May) you should talk to your provider about getting a flu shot to protect your health during pregnancy.

• If you have a chronic disease, such as diabetes, heart dis-ease or asthma, you are at higher risk of complications from

see IMMUNIZATION, P. 12

Volume IX No. 11 • November 15, 200411

Baby Your Baby…Before It’s Born

by Cami Weeks, UAA Dietetic Intern

Pregnancy is a time when taking a little extra care can bring some very valuable

benefits. There are many aspects involved in a healthy pregnancy, but here are a few tips that can help mothers-to-be take good care of themselves and their baby thatʼs on the way! 1. Eat a well-rounded, nutritious diet. Eating well before pregnancy will help build good nutrient stores, and proper nutrition during pregnancy will increase the health of both mother and baby. The food guide pyramid should be used to help women choose a variety of foods from all of the major food groups, though the number of servings usu-ally consumed may need to be increased as the pregnancy progresses.

Many nutrients work together to keep the human body healthy and to allow for fetal growth. Consuming a variety of foods will assist a woman in achieving adequate nutri-ent intake during pregnancy. Some nutrients of special importance during pregnancy are folate, calcium, and iron.

It is essential that women consume folate before and during pregnancy to prevent neural tube defects in their babies. Every woman who is pregnant or considering preg-nancy should be consuming four milligrams of folate every day. This nutrient is found in foods such as breakfast cereal, flour, green leafy vegetables, and orange juice. One cup of fortified cereal or one cup of orange juice contains about 1 milligram of folate.

Calcium serves several purposes in the body, including building strong bones and teeth. If women do not consume adequate amounts of calcium during pregnancy, the growing baby will pull calcium from the stores in the motherʼs bones for his/her needs. This could lead to problems such as poor dental health and osteoporosis (weak, porous bones) later in the motherʼs life.

Calcium is found most abundantly in dairy products. For the proper calcium intake, women should consume about three one-cup servings from the dairy group each day.

Iron is a nutrient that is needed to manu-facture hemoglobin, the part of blood that delivers oxygen to the body. During preg-

nancy, a womanʼs blood volume is rapidly expanding to support the growing fetus, thus the need for iron in the diet increases. To help ensure proper intake, women should eat three servings from the meat group each day, including such foods as beef, chicken, beans, and eggs.

Taking a prenatal vitamin is recom-mended, and doctors will sometimes pre-scribe additional supplements to comple-ment the diet and ensure adequate intake.2. See a doctor to begin prenatal care as soon as possible after becoming pregnant. The doctor will do regular check-ups to make sure the baby is developing properly and that the woman is gaining the proper amount of weight for a healthy pregnancy. Normal weight gain is between 15-40 pounds, depending on the motherʼs pre-pregnancy weight and age. Good prenatal care can help prevent future complications and greatly increases the likelihood of a healthy pregnancy. 3. Avoid taking any drugs, medications, or herbal products while pregnant, without the advice of a health care provider. Even some common medications may be harm-ful to developing babies. Women should not smoke or use other tobacco products

or drink alcohol during pregnancy, as this greatly increases the risk of birth defects and low birth weight babies.4. Make time for regular physical activity. Women who were physically active before becoming pregnant can usually continue their physical activity through most of the pregnancy. Women who are not used to exercise should consult their doctor before beginning a new exercise program. Pregnant women should choose forms of exercise that donʼt jar the body or cause excessive strain. Activities such as walking, swimming or low impact aerobics are some good choices. Regular exercise has great benefits for preg-nant women; it helps regulate weight gain, relieves stress, and strengthens the muscles. Being in good physical condition will help women to have easier deliveries and quicker recoveries.

Following these simple suggestions will help give women a great start toward a healthy pregnancy and a healthy beginning for baby! More information can be obtained by visiting with a doctor or a registered dietitian.Information obtained from the American Dietetic Association www.eatright.org and the Idaho WIC Program.

Sharing the Art — Keeping Traditions Alive

Upcoming Classes and Events at Yupiit Piciryarait Cultural Center

Kuspuk-Making ClassNovember 15, 22, 29; December 6 at the Youth Center. 6–9 p.m.Lucy Kuhns, Instructor.Can be taken for 1 credit, or for non-credit. Register with Ali Graham at KuC.

Ivory Jewelry Making ClassDecember 7, 9, (7–9 p.m.) 11 (2 – 5 p.m.)December 14, 16, (7–9 p.m.) 18 (2–5 p.m.)Ben Pungowiyi, Instructor, cultural center classroom.Can be taken for 1 credit, or for non-credit. Register with Ali Graham at KuC.

Drum Making ClassJanuary 4, 6, (7–9 p.m.) 8 (2–5 p.m.)January 11, 13, (7–9 p.m.) 15 (2–5 p.m.)Jerry Lieb instructor, at the cultural centerCan be taken for 1 credit, or for non-credit Register with Ali Graham at KuC

Community Dance Nights (tentative dates)

January 27, 7–9 p.m.March 28, 7–9 p.m.Dance Groups Performing:KuC Traditional Dancers Bethel Traditional Dancers UpallretThese are fundraising events for all three groups and a $5 admission will be asked.

Questions? Call Dan 543-4547

Non -Profit Org.US Postage

PAIDAnchorage, AK

Permit # 537

Yukon-Kuskokwim Health CorporationP.O. Box 528Bethel, Alaska 99559907-543-6000

Volume IX No. 11 • November 15, 2004

vaccine-preventable disease, and you should make sure you are up to date on your immunizations.

• If you are planning on international travel, ask your health care provider to suggest any special vaccines you may need to protect you.Please call your village health clinic and make an appointment to get any immuniza-

tions you need. In Bethel, you can make an appointment by calling 543-6442. For questions and/or concerns, or if you have a hard time making an appointment at the

clinic, please call the Immunization Program at 907- 543-6437 or 1-800-478-3321.Information adapted with permission from Community Health Improvements Partners. http://www.sdchip.org/pdfs/adultmessage2002.pdf

IMMUNIZATION, from p. 10

The YE group presented Sen. Murkowski with a placque of appreciation for her role in funding the YE project. Pictured here with Sen. Murkowski include (L to R): YKHC Support Services VP Hugh Short, YKHC President/CEO Gene Peltola, AVCP Housing Executive Director Ron Hoff-man, Bethel City Manager Bob Herron, Coastal Venture Region Fund’s Joe Hall, AVCP President Myron Naneng and YE Director Carlton Kuhns.

Senator promises support for Yuut ElitaurviatSenator Lisa Murkowski met with Yuut

Elitnaurviat (YE) partner organization representatives during the AFN Convention in Anchorage Oct. 29, promising to help secure an additional $5 million needed to complete construction of the Bethel-based training facil-ity.

Unlike many capital projects undertaken in the state, operation and maintaince money for the YE project is already being taken care of by the partners involved: YKHC, AVCP Inc, AVCP Housing Authority, City of Bethel (and a host of others).

Carlton Kuhns, YE Director, thanked Murkowski for her support of the project so far and, with other partner representatives, presented a plaque commemorating her partici-pation in the groundbreaking ceremonies last year.

“This is an incredible project,” Murkowski said, recognizing it as an example of how enti-ties can work in cooperation with each other to make good things happen.

Murkowski said she will work to put YE graduates into jobs on the gas pipeline when that project eventually gets underway.