Day 1 in Point Lay

Well it's been quite a hectic day! I got to the airport early this morning and checked in for the flight to Point Lay. It was still on time even though weather was slightly increment. When the pilots finally took us outside at 9 I didn't really know what to expect but what I saw made me laugh. I was about to step onto the TINIEST plane I've ever seen in my life! SIX SEATS! I mean, this thing was about the size of a bathroom in my house. I was slightly worried. There was a pilot and co-pilot who were dressed in what looked like construction clothes--not like the pilots for big airlines who wear suits and carry briefcases, etc. Anyways, we climbed this crooked ladder which was swaying because it was so windy. I took my seat on the right side next to a tiny window. It was freezing on the plane. We boarded up the cargo and everything and then we were off! No safety introductions, anything. It was dark, and I hate flying in the dark because I need to see what's happening. We got off to a wobbly start and all I could do was close my eyes because I was so nervous. About an hour later things got choppy and we went down swaying like a teacup on the runway--we didn't even touch the ground with both wheels. The "runway" was a squat little road in the middle of nowhere. The health aid van was waiting for us. We drove to the clinic a few minutes away, dropped off our luggage in the itinerant quarters, took a quick tour, and then gathered the PPD's to do Mantoux tests at the school. I gave about 40 PPD's, which was fun, new experience for me. After those were completed we heard there was a death in the village so only one of the expected afternoon appointments came to the clinic for her immunization. It was tragic to see how the death affected the entire community, even in the schools. Most of the children (about 70) grades K-10 are related somehow, so the death is likely someone very important or well-known in the community. The rest of the afternoon went by pretty slow as we waited to hear news on shipping the body to Anchorage for an autopsy. Life in the village is even more remote than in Barrow. There is a certain process when things happen, but things don't and can't always happen like they should because the resources just aren't there. It's been an exhausting, eye-opening experience today, that's for sure. The rest of this week we'll be placing the remainder of PPD's, reading them, and doing Tdap immunizations and flu shots.

Whose Are You?

This morning Pastor Morrow preached a great sermon on John 8:31-36. If we obey the LORD's commands, then we are His disciples. The TRUTH SETS US FREE! Conversely, if we continue to live in sin, we become slaves to sin. Many people say, if the truth sets you free, how can you be free if you're "bound" to Jesus? We cannot overemphasize the importance of truth. It is the difference between honestly and dishonesty, right and wrong, and often the difference between success and failure, or life and death. We are not satisfied with anything less than the truth in science, finance, or in that which we are told by our friends. If we learn that some business house has dealt with us dishonestly even to a small degree we will shun that place in the future. Truth is even more important where the welfare of our souls is involved. Only the truth of God can make us free. The truth leads to our sanctification, that is, the setting our ourselves apart to God and His service. Jesus came and died for humanity to make it clear that it does make a difference what we believe. The very fact that God has given us the Bible is evidence that He wants us to study it, learn its truth, and abide in it. Jesus has promised that those who follow Him, walking in His word, shall know the truth and thereby be made free from sin.

³¹ To the Jews who had believed him, Jesus said, “If you hold to my teaching, you are really my disciples. ³² Then you will know the truth, and the truth will set you free.”
³³ They answered him, “We are Abraham’s descendants and have never been slaves of anyone. How can you say that we shall be set free?”
³⁴ Jesus replied, “Very truly I tell you, everyone who sins is a slave to sin. ³⁵ Now a slave has no permanent place in the family, but a son belongs to it forever. ³⁶ So if the Son sets you free, you will be free indeed.

Views from the Dorm

I can’t believe it’s almost Halloween. This will be the first time I haven’t been home for it in a long, long time! I will miss seeing all the cute little kids in their costumes…slash eating the leftover candy. Hopefully Mom will save me a basket J I did ask if the kids here trick or treat and they DO! I don’t really know what that looks like but I’m slightly interested in finding out! Today we didn’t really have plans so I took advantage and slept in until 1:30 (granted I hardly slept a wink during the night) and then studied.

 I interviewed a student here completing the electrician program. He has a wide history of construction and electrical work, along with a strong resume. He is a Native shareholder and has confidence in finding a job. He was born and raised in Fairbanks and moved to Barrow when he was fourteen, after a knife attack. He graduates in the spring and is very anxious to leave Barrow and get back to Fairbanks where there is a stronger network of community and civilization. He worked in the hospital for a year before starting classes at Ilisagvik, and is excited to see work on the new hospital being done. They are hoping to use the old hospital for housing. He stated the housing situation in Barrow is terrible and no new building takes place because it is so expensive and time consuming to ship supplies in. They obviously cannot build during the winter. He stated the motivational level of students here is very low. The apathy rubbed off on him for awhile and he was in and out of depression. He is, however, very social and enjoys meeting new people so it was easy to see he would do well in a community with more people. He thinks the future of the young people would be strong if they had more motivation. Sometimes that means moving away from Barrow and finding a new start.

 Overall I see the apathy level to be pretty high. While there are students in the college going to class, there is not much motivation to complete the work. Most people just don’t want to do much and that is very sad to me. Not having a lot of structure this week, I was able to hang out in the lounge and get to know more of the students and staff. Hopefully next week we will dive in with the visit to Point Lay.

Tomorrow there is a haunted house at the rec center from 7-10 pm. Cristian and I went over to investigate and do a run-through of tomorrow night. They will meet at 4pm tomorrow to start makeup and costumes. I, however, am NOT participating because I am a complete chicken and the last time I went through a haunted house (only 6 years ago) I came crawling out on my hands and knees, bawling. So it ain’t happening. 

This week we participated in the assessment portion of the core functions of public health. Upon arrival in Barrow, we conducted a windshield survey of the entire "village" of Barrow, which allowed us to visually assess resources in Barrow. It was difficult to tell which things were functional, nonfunctional, residential, or industrial within the village because A) residential areas and industrial areas are equally combined and B) there are many abandoned areas of the village. We were able to verbally discuss some of the elements of town to discover that there really is one of very few things within Barrow, if any: one post office, one fire station, one library, one assisted living home, one grocery store, etc., but no doctor's offices, no real "semblance" of the many resources a full community like this elsewhere would need. There are many services within the community that are very inadequate. We also conducted interviews with community members like the Presbyterian pastor and his wife who are two essentially "hot spots" in town. They hold status and community ties and events occur through the church. This week gave us a good glimpse in Barrow to get answers about the history of the community, some of the pertinent cultural issues, and the needs. There are SO many needs in Barrow that are not accessible and it's frustrating to see that need right in front of you. I think we will have no problem prioritizing three issues in the community.

Adjusting to Barrow

Monday October 22, 2012 
This morning we were dropped off at the college and checked into the dorms. The student who is interested in applying to the nursing program at Gustavus is one of the student services workers so she helped us out. I am hoping to interview her sometime this week! She is very nice and welcoming. After we dropped our luggage off the pastor took us to the Public Health building where we met with Julie, the deputy director of community health. We also met with Doreen Leavitt, the PHN who traveled to Gustavus last year to talk to us about circumpolar health. She is now the director, so that is exciting! She booked us two free seats on the charter flights out to the village health fairs on November 5, 9, and 13. We are both very excited for that opportunity. We can add three more remote villages to our list of “places” we’ve visited in Alaska. Throughout the day we got an orientation and history of the PHN program, the services provided, etc. We also did a bunch of reading on immunization information, as that is primarily what the wellness clinic participates in during the day. It was a fairly slow day. Life in Barrow is definitely different! It just takes awhile to slow your system down and get used to the way of life here.

Utqiagvik Presbyterian Service

This morning we went to the 11:00 church service. It was pretty awesome! The church is beautiful with lots of open space. The sermon was titled “Got Food” and emphasized the blessing in that most of us are able to live on three meals a day and afford meals. Pastor Morrow discussed the number of people in Barrow and the North Slope Borough, as well as across the nation, who go hungry. It was amazing to sit there and listen in this new culture, to see the people singing traditional hymns, some of which was in the Inupiaq language. The church services are run very similar to ones I attend at home. There is lots of emphasis on prayer which is beautiful and really unites the people! After the service we met a lot of influential people in the town like the judge, some of the public health workers, the OB doctor, and an OB nurse. We talked a little bit about the public health agency here in Barrow. After that we came back and had really great vegetable soup, which was perfect since it’s a cold, dreary day! It’s not as dark here as I thought it would be. It’s overcast, yes, but at least it’s light out until about 6:15. So far I’ve loved staying with the pastor and his wife! The house is cozy, warm, and welcoming, just like the people have been. They just come up to you and welcome you to Barrow. I’m eager to start digging in to the public health side of things, since I keep hearing that the public health agency in Alaska is very strong. Time to dig into some of our big projects! Stay tuned!

Finally in Barrow!

We're finally here in Barrow! This is so surreal! Maybe more so because we got on and off the plane via manual stairway, like in the movies. It was pretty awesome. I love getting on and off a plane that way. Anyways, when we arrived in the tiny Alaskan airport, the Presbyterian pastor was waiting for us. We collected our bags from the one baggage carousel and then got in the car. He took us to his house where we unloaded luggage and met his wife, who works at the women's shelter. We spoke with her a little bit about their move to Barrow about a year ago; and what her experiences here have been so far. We drove to the ocean and took pictures at the "top of the world" famous entrance to the Arctic coast. We went out to lunch at one of the five restaurants in Barrow, called Brower's. Restaurants here do not undergo inspection so we were told to be very cautious when eating out. My pancakes and hashbrowns, however, were very good. After we ate lunch we took a driving tour, which allowed us time to conduct our windshield survey of the resources available in Barrow. We saw the library and cultural center, the expensive grocery store called AC (Alaska Commercial), the neighborhoods, the whaling boats, Ilisagvik College, the elementary and high schools, and out to the cemeteries and the satellite field out on the tundra. Barrow is very interesting. We've learned, as previously suspected, that some of the most disconcerting issues in the town deal with domestic abuse (or abuse of any kind), alcohol/drug use, and type 2 diabetes and obesity. Driving through the town was amazing. I've never experienced this way of life and I'm sure it will take some time to adjust to the differences. It's good to know we'll be here for a month, which will give us time to acclimate to the culture. Initially I had a sad feeling about Barrow. Poverty and the lack of availability to resources is astounding. There is no acute care. There are no clinics. The hospital doesn't do surgery because that requires anesthesia. For nearly everything, including severe domestic abuse consults, people are flown to Anchorage or Fairbanks. In town here there is a dental clinic and a wellness clinic. A can of soda costs $1 as compared to the exorbitant prices of anything else. Babies are given soda in their bottles because it's cheaper than formula. Their baby teeth completely rot out. I was shocked. This area of the North Slope Borough has the highest per capita of soda drunk per person (20 cans/day). Also astounding are the quirks of the culture, which we'll hear more stories about over the weekend. Tomorrow morning we will go to the 11:00 church service and meet some of the prominent people in town. I got to look through an Inupiaq language New Testament Bible and it was neat to look up the verses I know and then look at the Inupiaq language, which has only been incorporated as a written language for fifty-some years. It's very confusing! We are hoping to go to a class or learn some Inupiaq while we are here. The pastor is currently taking an Inupiaq course. It's been a pretty long day and I'll upload some pictures of what we've seen so far....stay tuned!

Hello, all!

Today Cristian and I ventured back to UAF to take our Public Health exam (WOOT!) and go in the bookstore. At 1:30 we're Skyping with our nursing instructor to discuss the updated itinerary for Barrow! I can't believe we leave tomorrow morning! We plan to have a cab pick us up at 5:45 (WHYYYYY?!) and our flight leaves for Prudhoe Bay at 7:40. Oy. Too early for me. When we get to Barrow we'll be picked up by the Presbyterian pastor at Utqiagvik Presbyterian Church. We'll do our windshield survey of Barrow and then stay with the pastor and his wife all weekend. I'm pretty excited to launch into another new culture and see what it's like! Stay tuned!

Goodbye, Denali

Thursday October 18, 2012

Today was my last day at Denali Center and I am going to miss the residents! I got used to sitting with the “Golden Girls” for breakfast and lunch each day. What a lively bunch! I could definitely assign each of them a role as a Golden Girl. On of the women was explaining to me the things that bother her about the staff at elder care facilities. She said old people are just like babies—in the way to start to revert back, and in what they need. If a baby was crying you would hold him/her and hush that everything was going to be okay. She said, in the same way, those are the loving gestures that older adults need but for some reason, there is some aversion to loving adults. She said it seems harder. She was a very intuitive gal. I got to sit and talk with another kind woman who used to be a missionary with her husband in the Amazon for many years. I found that fascinating! She had five children as well. There are just so many stories that are lying dormant in these residents’ minds that really need to be told to anyone who will listen. I can see how and why oral storytelling is so important to pass on—not just to grandchildren and immediate family but to people who they interact with at these types of facilities. I am excited to hear more amazing stories when we head up to Barrow on Saturday morning.

Today was a pretty relaxing day. I sat with a group of residents while they ate breakfast and we had some good laughs. Then I met with the registered dietitian on staff and she was awesome to talk with about nutritional assessments and some of the work I've done over the past few years with nutrition. After that I headed back to the cafeteria and had lunch with some more residents before attending two care conferences. I also sat down with the social worker and he told me a lot about Barrow. Tonight we're headed to a meeting with some staff members about efficient ways to communicate with Native American elders; this will be useful for our time in Barrow.

Denali Center

Today was day 1 at the Denali Center, which is connected to the Fairbanks Memorial Hospital and Chief Andrew Isaac Health Center, where I was last week. I spent today orienting to the Denali Center with one of the RN's. Denali Center is the only skilled nursing facility in interior Alaska. The next closest place would be in Anchorage. The Denali Center has four wings-- Tamarack and Birch are both long-term care wings; Willow Run is a dementia unit; and Aspen is the short-term care wing. I got a tour of each wing and I was also able to meet the RN's, LPN's, and the nurse practitioner, who I spent the later part of the afternoon talking to about Master's options and her role at Denali. It was a very different day for me; the flow was slower and I was allowed to kind of make myself useful any way I wanted to. I got to listen to some great stories of two women, one who grew up in a remote village and another who grew up in Fairbanks. It was amazing to sit back and listen to these elderly women recall memories of their families and of childhood, which seemed like a long time ago. I realized everyone can learn so much from these people. Their knowledge and wisdom is invaluable and can so easily heighten perceptions of nursing.

Day 9: Chena Hot Springs

Today was great! We went back to Fred Meyer to get some more food for this week and then we drove 60 miles northeast to the Chena Hot Springs Resort. We took the Monument Trail through the mountains and ended up back at the Activity Center. I'd say it was probably a four-mile trail, no elevation aside from the 1,800 ft we were already at. The land was absolutely stunning, with the freshest water you've ever seen in the streams. The mountains rose up in front and back and it made me miss being in beautiful Colorado so much! Here are a few shots from the afternoon!