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

2

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: messenger@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. © 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

4

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 messenger@ykhc.org 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