Conference The Crooked Creek Clinic. The staff received ...Story on page 8 The Crooked Creek Clinic. The staff received the “Clinic of the Year” award at the 18th Annual Health

INSIDE: Diabetes types, p. 4 • RUC in Chevak, p. 6 • Breastfeed!, p. 11 • Krevans, p. 15

Health Aides hone skills at Annual Conference

Story on page 8

The Crooked Creek Clinic. The staff received the “Clinic of the Year” award at the 18th Annual Health Aide Conference in St. Mary’s. Sally Whitman of Mekoryuk—Health Aide of the Year.

Health Aides got together with Board members, instructors, administrators and guests for a group photo.

Volume X No. 8 • August 15, 2005

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 99680907-256-2798

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: 558-4711Moses J. TulimP.O. Box 130Chevak, Alaska 99563907-858-7366

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

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

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


The Messenger is a monthly publication pro-duced by the Yukon-Kuskokwim Health Corporation as a report to Tribal Members. For questions, comments, sub-mission of articles, or subscription information, write to Messenger Editor, Media Services, Yukon-Kuskokwim Health Corporation, P.O. Box 528, Bethel, Alaska 99559. E-mail: [email protected]. Deadline is the last day of the month preceding publication. Publication is on the 15th of every month. Anchorage Office: 4700 Business Park Blvd. Suite E25, Anchorage, Alaska 99503. 907-677-2232. Please ask permission to reprint articles or pictures. © 2005, Yu-kon-Kuskokwim Health Corporation.

YKHC Board & Committee Meetings

2005

August 16Finance Committee

August 17–18Executive Board

September 20Finance Committee

September 21–22Governing Body

October 18Finance Committee

October 19 – 21Alaska Federation of Natives, in Fairbanks.

November 15Finance Committee

November 16–18Full Board of Directors Meeting

December 13Finance Committee

December 14–15Executive Board

Call The YKHC Learning Center: 907-543-6758

Dalarie Peters, Dental Assistant Supervisor

Dalarie is the daughter of Carol Ann Peters, who is originally from Tanana, and Charles LoneWolf, originally from Columbus, Ohio. She is Athabaskan Indian

and Yupik Eskimo and is a shareholder of Doyon Corporation.“I was born and raised in Bethel, but in 1999 when I was seventeen I went to Job

Corps in Sedro Woolley, Washington, for vocational training as a dental assistant and to complete high school. I received my high school equivalency at Skagit Valley Col-lege in Mt. Vernon, Washington.”

Dalarie returned to Bethel in 2003 and completed her training in a dental assistant apprentice position at YKHC. “I went through three weeks of on-the-job training and after a year as an apprentice I became a dental assistant. I was a chairside assistant, which involved traveling to numerous villages and training out-of-town. I worked very hard helping out my supervisors and after a year and a half I became Dental Assistant Supervisor.

“I am responsible for supervising 11 dental assis-tants. I make sure that all policies are followed and that we always have enough assistants here at the Clinic. I am also in charge of inventory of all clinic supplies and ensure that everyone has what they need for village trips. Although I rarely get to assist anymore, I still love doing it. I love working with the patients and helping new assistants. I encour-age them to stick around, because dental assisting is more than just a job. There are so many opportuni-ties in this field. I truly believe it is a great career.

“Stay on track. Always, always have goals, whether they are big or small. Goals give you moti-vation to achieve things.

Dental Assistant Supervisor Basic Requirements:• Two years experi-

ence as a dental assistant and work experience with the YKHC Dental Pro-gram

• Certified Dental Assistant with one year work experi-ence in a multi-chair clinic.

• Starting wage: $19.97 hr.

“We make a living by what we get; we make a life by what we give.”

—Winston Churchill

4YKHC Diabetes Prevention & Control

Send your kids off to school with a HEALTHY BREAKFAST

1/2 cup oatmeal (quick or old fashioned)

2 tablespoons powdered dry milk

1/2 cup berries

1/2 cup water

1/8 teaspoon cinnamon (optional)

Place in bowl, cover and microwave for 1 to 2 minutes. Use a larger bowl to keep from boiling over in the microwave. The cinnamon sweetens it so you might not need to add sugar or other sweetener. Add additional milk if desired.

The kinds of Diabetes What is the difference?PRE-DIABETES used to be called borderline diabetes. Blood glucose levels are higher than normal but not yet high enough to be considered diabetic. There is more risk for developing type 2 diabetes. A healthy diet, weight loss, and exercise can still delay or even prevent type 2 diabetes. It is important to have blood sugar checked at least annually to make sure it hasnʼt turned into type 2 diabetes.TYPE 2 DIABETES is a form of diabetes that usually occurs in people over 40 years of age who frequently are overweight. Because of over-weight and not enough physical activity it is becoming more common in younger people and even teenagers. Most people with type 2 diabetes are insulin resistant. However, some people simply cannot produce enough insulin to meet their bodies ̓needs. Others have a combination of these problems. Some people can control the disease through diet and exercise but most will eventually need pills and/or insulin.TYPE 1 DIABETES usually develops before age 30. It is caused by an immune system attack on the pancreas. The beta cells canʼt produce insu-lin when the cells are destroyed. People with Type 1 diabetes must take insulin to live.GESTATIONAL DIABETES develops during pregnancy. The momʼs blood glucose rises because of the hormones secreted during pregnancy and she cannot produce enough insulin to take care of the extra glucose levels. This type of diabetes almost always goes away after the baby is born. Women who have had gestational diabetes should ask for a blood test at their 6 week check up to make sure their blood sugar has returned to normal. 60% of women who have had gestational diabetes will develop type 2 diabetes. This could be prevented or delayed if the mom loses a little weight, exercises and eats healthy.

WIN A PRIZEHow many words in B R E A K F A S T?

If you have diabetes, you know how important breakfast is. But how many words of 3 letters or more can you make from the letters in breakfast?

Count a word twice if you add an s on the end, but don’t use a letter more times than it appears in “breakfast.”

There are at least 98 words. If you find 90 or more, mail your list by August 25th to:

Diabetes Prevention and Control attn: Lorraine Gill

Box 528 Bethel, AK 99559.

Or fax it to 907-543-6143.

Be sure to send your name, address and phone number so

we can send you your prize!

Mary Naieda enjoys berry picking. It’s two-for-one—great excer-cise, and you get a bunch of berries for healthy, vitamin-rich eating.


FIT seeks to screen all young childrenYKHCʼs Family Infant Toddler program (FIT) hopes to perform developmental screening on all children in the Delta under age 3.As babies grow, many changes take place. One way in which babies change ais the physical growth we notice in the first few years of life. While changes in a babyʼs size and shape are dramatic, the changes in the way the child plays, learns, speaks and behaves are even more exciting. Just as we measure a babyʼs physical growth in pounds or inches, it is also important to measure developmental growth.

If you are a parent or plan on becoming one, you may have already heard about developmental screening. It is a way in which a health care provider can measure developmental growth. The person performing the test will interact with the child and parent to assess “developmental milestones.” These milestones could be things like smiling, laughing, or even picking up a Cheerio!

Developmental screenings take about 20 minutes, require no blood draw and are generally enjoyable for children and parents. Not only are developmental screenings easy to do, they are very beneficial for children and their families. When a developmental delay is detected early, more can be done to address it. Develop-mental screening can lead to services like speech therapy, physical therapy or audiology. This can help to prepare a child for school and family life before problems occur. Even small delays that are not detected or addressed can lead to serious difficulties when the child starts school.

Unfortunately the CDC reports that less than half of developmen-tal delays are detected before the child starts school. With this in mind, FIT, partnering with other local agencies, is working towards the screening of all children under three years of age. If you, or someone you know, would like to take advantage of this free and beneficial service, please contact FIT at 1-800-478-3690. This can help insure that when it is time for school, your child will be ready and able to learn.

Sixth Grade students tour Nicotine Control ProgramOn June 15, the KuC Talent Search students enjoyed a day of

touring specific departments at YKHC. Nicotine Control & Research Program was chosen to host many of the student groups.

The Talent Search program enables students all across the Delta the opportunity to come to Bethel and be educated by different careers in the health care field. During the visits the Nicotine staff educated students on the hazards of tobacco use, what type of work a Nicotine Counselor does thus providing an excellent opportunity to discuss youth prevention and cessation. The stu-dents enjoyed this informal education in addition to the comple-mentary t-shirts provided after each visit.

Today, more than 2,300 clients have entered in our program, and 783 clients are active in the program. Our average quit rate is 25 percent which is higher than the National quit rate.

If you are interested in stopping tobacco or want more information, please call us at

1-800-478-3321 or 543-6312.

Governor appoints new DHSS Commissioner(Anchorage) – On Tuesday, August 9, Governor Frank H.

Murkowski announced his appointment of Karleen Jackson to the position of Health and Social Services Commissioner, effective October 1.

Jackson has served as DHSS Deputy Commissioner since Febru-ary 2003.

Murkowski said Jackson has played an integral part in the leader-ship of the department during his administration. “I am pleased that Karleen will continue to carry out the health and social services ini-tiatives my administration has put in place,” he said.

“She has been in Alaska for almost 40 years, has a strong back-ground in the field of social services, and possesses the skill and talent to serve the people of this state well,” Murkowski added.

Prior to working for DHSS, Jackson served as executive direc-tor of Catholic Social Services in Anchorage for five years and had worked for the organization since 1991 in various social services positions.

Jackson earned a Ph.D in Human Services and a Master of Arts in Human Development from the Fielding Institute, as well as a Bach-elor of Arts degree from Alaska Pacific University.

A group of Delta 6th graders looks at Nicotine Education tools.

6

YKHC RUC prepares to help ChevakA western Alaska village dogged by financial woes is stepping forward to try to alleviate

its fiscal challenges. As a first step, the village is moving in the direction to become a member of the YKHC Rural Utilities Cooperative (RUC).

In July, Chevakʼs city council con-tacted YKHC and gave an indication of their desire to join its RUC Program.

“We are working with Chevak on a management plan as we speak,” said Seth Smith, YKHCʼs RUC Manager.

According to Smith, Chevakʼs mem-bership should become effective some-time this fall. “RUCʼs first step will be to start billing and collections for Chevakʼs water and sewer utilities in August,” he said. “RUC would then assume overall management of the utilities by October 1.”

Toward that end, RUC staff traveled to Chevak and started collecting copies of the cityʼs water and sewer records needed to make management of the villageʼs sanitation system more successful.

“Our first order of business will be to determine how much it costs to run the Chevak water and sewer system,” said Smith. “We also want to make sure the monthly billings are current. The rates residents will pay after October 1 will be the same as the rest of the cooperative.”

When building a utility in a village, residents need to know what the cost is going to be for the community before and after itʼs built, said Smith. “The residents ultimately end up paying for it. If you donʼt collect enough revenue, the utility will go into debt or go under.”

Chevakʼs municipality has been in the news regularly, especially for its delinquent debts to the Alaska Village Electrical Cooperative. Recently, the village had been warned to pay up its electricity debts soon, or else face a power shutdown to municipal-owned buildings, there-fore its many local services, including the water and sewer utility.

According to the Tundra Drums, the village was a model village that kept current with its obligations until four years ago, when the cityʼs administration changed. Then things went downhill. Last fall, after learning just how far downhill they went, its residents took action by voting in new members for its city council.

The new council then decided to seek help from YKHC. “But before RUC can assume management, Chevak will need to satisfy AVECʼs demands for all of its debt obligations—not just for its water and sewer services,” Smith said.

To that end, the State Dept. of Economic and Community Development staff has also been working with Chevak to assist in the development a payment plan for those debts. Once an agreement between the village and AVEC is accomplished, RUC can then begin management of Chevakʼs sanitation system.

But joining RUC will not alleviate the villageʼs debts, said Smith. “Chevak will still need to continue working with AVEC to resolve its debt issues.”

RUC is a water and sewer utilities cooperative that was created in 2002 by a partnership of YKHC, ANTHC, Denali Commission, Environmental Protection Agency, and the Rasmussen Foundation.

RUCʼs intent is to lower the high costs of maintenance of water and sewer systems in vil-lages who join the cooperative and/or prevent their shutdown for one reason or another.

The first village joined RUC in the summer of 2003. Currently, RUC manages the utilities for six villages: Toksook Bay, Holy Cross, Grayling, Upper Kalskag, Alakanuk, and Russian Mission.

The village of Chevak, on the Bering Sea coast, is becoming a member of the Rural Utility Coopera-tive. (YKHC file photo)

Care Management starts with you —

We, the Care Managers of YKHC, want you to take good care of your-self.

Please bring all your medicines with you to see the doctor.

When you see the doctor here or in Anchorage, ask questions:

• What is this medicine for? How does it work?

• What problems should I call about or come back for?

• How soon should I see results?

• Is there anything I should not eat or drink while taking this medicine?

• If I feel better, can I quit taking this medicine?

• To make sure I’m getting the right amount of medicine are there any lab tests I need to do? How often should I have those tests done?

• When should make another appointment for this? Do I really need to come back if I feel OK?

If there are any changes in the way you feel or how much work you can do, make an appointment to talk about this.

There are some exams that need to be done every year. Ask your Doctor what kind of exams you need this coming year.

• HINT—the easiest way to remember things to be done each year is to try to do them in the month you were born.

• Other tests may be more often. Monthly ones can be done on the day of your birth each month.

Write down your questions and answers. Ask someone else to take notes for you if necessary.

Remember YOU are your own best care manager!


Bike Helmet Festival brings in St Mary’s subregion youth

On July 21, kids of all ages flocked to the

small parking lot near the St. Maryʼs Subregional Clinic for the first ever St. Maryʼs Helmet Fest.The event was planned by St. Mary s̓ Subregional Clinic and YKHC Injury Prevention staff in response to concerns brought up by community and staff members that there seemed to be a lot of bike inju-ries in the area this summer.After working out dates and times, YKHC Injury Prevention staff mem-bers Jonica Thomas and Debra Olick flew out from Bethel especially for the event to help fit the more than 90 local kids who showed up for the event.Kids from St. Mary s̓ and Pitka s̓ Point took part and there were even a few from Pilot Station and Mountain Village. Local St. Mary s̓ YKHC staff were also on hand to assist with the event: Andy Evan, Health Aide from Pitkas Point; Paul Lamont, St. Mary s̓ Maintenance Technician; and Gail Alstrom, St. Mary s̓ Operation s̓ Manager.Special thanks also goes out to the Yupiit of Andreafski Tribe for the assistance they offered through their ICWA Program for donations (Lucy Mochin, ICWA Director), and event support from Serena Alstrom, EPA/IGAP Program Director, and Earl Alstrom, Summer Youth Employ-ment Program.Quyana also to Pitka s̓ Point Tradi-tional Council for their generosity in donating prizes for the kids, and to Ivy Lamont, Tribal Administrator, for helping to organize rides for Pit-ka s̓ Point children and to Josephine Tinker for driving all the kids back and forth to attend the event. Once all of the kids were fitted with sporty new bike helmets, door prize drawings were held for different age groups and lots of pic-tures were taken by YKHC staff and proud parents. Goody bags with crayons, pens and coloring books were distributed to the kids

along with information on bike safety.Thank you to all of the parents who came to this fun event with their kids. We hope that you will encourage your children to wear their bike helmets when bicycling and to always practice safe riding. Have a safe and fun summer from the staff at the St. Mary s̓ Subre-gional Clinic!

Shannon Hart plays it safe with a new bike helmet. Joey Beans got a door prize.

Debi Olick helps Tatiana Wasky get her helmet fitted just right. (Photos by Lisa Aguda)

8

Celebrating many successes and accom-plishments, Health Aides throughout the YK Delta gathered in St. Maryʼs for the

18th Annual Health Aide Conference Aug. 1-5.

The conference enables Health Aides to maintain their certification with a week of courses that refresh and improve their skills. Certification allows YKHC to bill Medicaid for their services. The conference is also an opportunity to share time with peers in one of the most demanding professions in rural Alaska.

“It is good to meet with other Health Aides to be able to talk with each other,” said Sally Whitman, Mekoryuk Health Aide. “It is a good stress reliever.”

This year, courses ranged from the new updated telemedicine capabilities that will be soon arriving at the villages, to advanced childcare practices, such as emergency newborn delivery and stabi-lization.

“These detailed trainings in areas such as newborn care help to give Health Aides confidence in some of the most stressful situ-ations they may experience,” said Dana Hall, Village Operations Administrator.

What’s New

Two new exciting advancements at YKHC were also presented at the conference: Advanced Access and Napartet.

Advanced Access refers to a new system of patient care the Yukon-Kuskokwim Health Corporation is implementing in Bethel-based outpatient clinics. This model of healthcare is patient-focused, and allows patients to make appointments with their con-tinuity provider or their team members at times that are convenient to the patient. It also enables care providers to work in extended care teams to provide a full range of coordinated care and services that include and extend to our subregional clinics and the villages.

Napartet is YKHCʼs quality improvement initiative. Focusing on five areas, or “pillars,” that drive YKHCʼs success, Napartet is now being rolled out to employees throughout the corporation. The St.

Lynette Collins, PA, and Lon Putnam, PA, act out a skit at the YKHC Napartet training.

Health Aides from all over the Delta take part in course refreshers to maintain their certification at the conference. It is also an opportunity to see old friends and make new acquaintances.

Bringing it all together...


Maryʼs Health Aide Conference marked the first employee Napartet training. Health Aides and other YKHC employees at the confer-ence got an overview of the benefits of using Napartet to guide the corporation in achieving its mission of “working together to achieve excellent health.”

Recognitions

Awards were given for Health Aide of the Year and Clinic of the year. Sally Whitman from Mekoryuk was named

Health Aide of the Year for her outstanding service to her community. Crooked Creek was named Clinic of the Year for their excellence in service to their community and custom-ers, with all of their monthly quality assurance reports filed on time and their high rate of immunizations in their village.

This year, 88 percent of the Health Aides in the YK Delta are certified, an increase of 21 percent over September 2004.

“Our improved extended session training schedule makes it possible,” said Community Health Aide Training Director, Anna Simon. “In addition, we have a very dedicated staff. Credentialing Coordinator Melinda Flemings has really kept on top of our Health Aideʼs training needs, and CHAP Instructors like Lon Putnam and Cynthia Chan are constantly in the field, allowing Health Aides to maintain their certifica-tion.”

Health Aides watch a Napartet training skit as part of a customer satisfaction exercise.

NAPARTET PILLARSPatient-Centered ExcellenceEmployee FocusNative Staff DevelopmentCommunity and Partner SatisfactionFinancial Viability

This year, 88 percent of the Health Aides in the YK Delta are certified, an increase of 21 percent over September 2004.

Health Aides Maxine Rivers of Napakiak and Ida Lynn Henry of Scammon Bay discuss training evaluation.

10

by John Dickens

Logrolling

It is one of the most basic and important EMS skills…

Logrolling is the primary technique used to move a patient onto a long backboard. It can be easy to

accomplish, but it requires teamwork between respond-ers for safety and effectiveness. Remember, this is a serious event played for keeps!

You need at least 3-5 people to do it right and this is a great way a layperson can be a huge help in an emer-gency. Because logrolling requires sufficient space to be done right it cannot always be done perfectly. That is why the principles of the movement rather than the spe-cific rules are stressed here.

In any patient movement technique, and especially if spinal injury is suspected, everyone must understand who is directing the maneuver. The responder at the head is the boss, and should always give the commands so that all rescuers can better coordinate their actions. The specific wording is not as important as the need for everyone to understand what is the command is. Each member of the team must understand what is being done so they can do their part correctly and as one.

All patient movement commands should have two parts, a question and the order for movement. The person at the head might ask loudly, “Is everyone ready?” and they must make sure that everyone really is ready, and then they will give the order. Sometimes it is helpful to everyone to do a count, for instance, “OK. On a count of three we will roll the patient on his left side. Ready? One, two, three ROLL.” While the patient is up on their side, a trained responder can position the back-board and check out the patientʼs posterior for injury.

In any logrolling technique, you must move the patient as a unit. Keep the patientʼs head in a neutral position at all times. Do not allow the head to rotate, move backward (extend), or move forward (flex). The old saying goes, “Keep the nose in line with the belly button at all times.”

Back to School Safety Tips

Itʼs that time of year! As your kids prepare

to return to school, there are some very important safety tips you should know.These tips should help reduce the number of days your child spends outside of the class-room.

Keep your child healthy. Make sure they are up-to-date with all their immu-nizations. Children in school are exposed to many germs throughout the day. By being properly immunized, your child will have a reduced risk of catching many illnesses. Check with your provider to see what immunizations your child may need. Also teach your child proper hand washing techniques and the importance of washing your hands many times throughout the day. Proper hand washing consists of 15 seconds of scrubbing with soap and water (have them sing happy birthday) before rinsing. After rinsing, be sure their hands are dried completely. This will eliminate many harmful germs.

Keep your child safe. Although playgrounds are supposed to be fun, and generally are, they can also be dangerous. Many accidents happen on school grounds. Be sure your child knows the dangers associated with playground equipment and that there is proper supervision during recess times. Backpack safety is also very important for each child. A backpack should weigh no more than 15 percent of the childʼs total body weight. Also make sure the child is using both shoulder straps because this helps distribute the weight to both shoulders.

Help your child eat right. Check the school lunch menu to be sure your child likes the food provided. Educate them on healthy food choices that will help their body grow. If your child does not like the food choices provided, help pack a healthy lunch they will enjoy. Also be sure your child knows the impor-tance of staying hydrated. Kids often use a lot of energy during recess and they need to re-supply their bodies with fluids. Every child looks forward to after school snacks, so help them choose snacks that are healthy and do not contain high amounts of fat or sugar.

Keep you child energized. Ensuring that your child is getting the proper amount of sleep can increase their performance during school hours. Follow a bedtime routine that includes more relaxing activities at night.

Going back to school is a very exciting time for many children. Following a few safety tips will help make your childʼs learning experience easier and healthier.

If you have any questions about back to school health tips, talk with your provider or pharmacist.

For more information visit www.mayoclinic.com


Subscribe to—

The Messenger will for the time being be available to Delta box-holders by subscription only.

You won’t be receiving it in your mailbox every month whether you want to or not.

The subscription is FREE!All you have to do is call, fax, email or write

to us and we’ll put you on the mailing list.

Copies of the Messener will be available at

your local health clinic, Tribal office and other

YKHC locations in the villages and Bethel.

You can also find the Messenger ONLINE at www.ykhc.org/messenger every

month and either read it in your web

browser or download the Acrobat file

and print your own hard copy.

SUBSCRIBE! CALL: 1-800-478-3321 ext. 6030 or 907-677-2232

FAX: 907-677-7502

EMAIL: [email protected]

Write: Messenger Editor, Public Relations Dept. P.O. Box 528 Bethel, Alaska 99559

WIC encourages you to breastfeed your baby!

Why do we encourage breastfeeding? There are many reasons why formula isnʼt as good as breastmilk:

• Breastmilk contains ingredients that formula canʼt copy. It is a remarkable, complicated mixture of nutrients and other ingredi-ents that protect your baby and help him/her grow well.

• Breastfed babies are smarter.• Breastfed babies get sick less often.• Breastmilk has ingredients (hormones) that soothe baby and help

baby feel full.

Breastfeeding is good for mom too• Moms who breastfeed have lower risk for ovarian and breast

cancer.• Breastfeeding helps moms lose pregnancy weight.• Breastfeeding releases hormones that soothe mom and make her

feel calm and close to baby.• Formula feeding is more expensive than breastfeeding.• mom can make milk without much extra food• formula cost about $20 a can (or more)

Breastfeeding is best, but isn’t it ok to give formula too?• Baby can start to prefer bottle and refuse breastfeeding.• Giving formula interferes with milk supply.• Giving formula introduces ingredients that baby might be allergic

to it.• Babies who get formula are more likely to have stomach prob-

lems, constipation and diarrhea.• Babies who get formula are more likely to overfeed (risk of obe-

sity in later childhood)

Put baby to breast as soon after birth as possible, within the first hour.• Baby might breastfeed often or not at all the first 24 hours• You will make small amounts of colostrum (the tiny bit of first

milk) the first hour after birth. Your baby will get tiny amounts of rich colostrums from you until your milk comes in. This is all your baby needs unless a doctor says otherwise.

• It is normal for babies to lose weight after birth. They are losing extra water and fat that they were born with. They will regain birth weight in 7-10 days. After 3-4 days, your milk will come in.

Remember, the more you nurse, the more milk you produce or create and the less you nurse, the less milk you produce. You

can express your milk by hand expression, using a manual pump or an electric breast pump. Expressed milk is the best supplement .

Breastfeeding is mother natureʼs way of making sure baby gets exactly the right nutrients and immunities.

12

Senator Murkowski advocates for Dental Health Aides Says program can help meet vital health needs in rural Alaska (Washington, D.C.) – On July 14, 2005, during the Indian Affairs Committee hearing on the reauthorization of the Indian Health Care Improvement Act, Sen. Lisa Murkowski advocated for the continua-tion of the Dental Health Aide Therapist Program in rural Alaska.

The program, which has received support from the Indian Health Service and the Alaska Department of Health and Social Services, supplements dental care in rural Alaska with the use of trained dental therapists in areas where there are not full time dentists.

“The Dental Health Aide Therapist Program has been imple-mented to deliver high quality health care in very innovative ways throughout Alaska,” Murkowski said. “We have a dentist shortage and a dental health crisis throughout rural Alaska.

“We also have the greatest state on earth and when we canʼt get the professionals into the villages, we need to be creative and do what we can to solve this problem. This program is very well thought-out and deserves an opportunity to prove itself.”

The American Dental Association (ADA) opposes the use of Dental Health Aide Therapists to the full extent of their training and maintains that the trained therapist aides are not capable of provid-ing adequate care. During the hearing, ADA President elect, Dr. Robert Branjord, said the program is an “unfair experiment” on, and a “second-class service” for, Native Alaskans.

“I do know in terms of health care issues, we are so lacking in the area of dental health care in rural Alaska,” Murkowski said during the hearing. “And Iʼve got a real problem when people say that we are experimenting on Alaskans by providing them with the first steps in the dental care that is so badly needed.”

Dr. Mary Willard, a dentist with the Yukon Kuskokwim Health Corporation Dental Clinic, testified to the success of the therapist program in providing care to rural Alaska. “I believe what we are doing is a good thing and it is well thought out, and I know the people in the area are very supportive of us,” she said.

Willard, who oversees the program in Bethel, noted that the thera-pists are as equally trained and skilled as the dental school students that have come to work in the area.

Willard also registered her opposition to the ADA campaign against the program. “I learned this morning that the ADA, in our local newspapers, is describing the dental therapists as experiment-ing on people of the villages and providing substandard care. I very strongly and clearly state that that is not true.”

Murkowski noted that there is a severe shortage of trained dentists

in rural Alaska, and an equally large problem attracting dentists to rural areas across the state. “If we can put together a program that works, then we need put it into place,” she said.

Murkowski said that rather than see if the therapist program can truly have the positive impact on rural Alaska that we believe it is having, the ADA would have us solve our dental backlog with the sole use of dentist volunteers. “While the work of any volunteer is appreciated, it is hard for them to give more than two weeks a year and thatʼs part of our biggest problem,” she said.

“Without the full-time presence of health education and health service, something these trained dental therapists can provide, we will not make progress in addressing rural Alaskaʼs severe dental needs. I strongly support this program and the benefit it can provide to Alaskans.”Source: Sen. Murkowski press release

Dental Health Aide Kristy Tulik (left) and Trainer Kathy Belasko practice teeth cleaning techniques. Phyllis Rivers observes. (YKHC file photo)


Dangers of Sharing Medications

With todayʼs increasing prescription prices, many people are beginning to share medications

with family and friends. Although it may seem like a money saver at the time, sharing medications can have very costly effects; not to mention, itʼs illegal.

If a person is taking medications without consult-ing a provider, they could be doing great harm to their body. A highly trained provider will be able to select the best medication to fit the specific needs of a patient and this is often based on characteristics such as age, weight, race, medical history, and other dis-eases. Even though two patients sharing medications could have the same disease, the drug may be safe for one, but cause a potentially dangerous event for the other.

Women should also keep in mind that many drugs can cause serious birth defects. Whether or not a woman is planning on becoming pregnant, it is always a possibility; therefore, it is necessary that the provider know what medications are being taken.

Children often believe that if a medication is okay for one person to take, then it is okay for them to take, no matter what the condition being treated. Explain to children the dangers of sharing medica-tions with their friends and also the dangers of taking another personʼs medication. Check school policies to ensure that medications brought on school grounds are properly stored.

All medications have the potential for side effects. Medications can interact with certain foods, other medications, or cause allergic reactions. Only a pro-vider is capable of prescribing the appropriate drug therapy for any given condition. By talking with a pharmacist, a person can learn about the potential dangerous effects of taking certain medications, but feel confident that the medications prescribed are helpful for their disease state.

With the increasing prescription advertisements on television that claim to be a “cure all”, it is easy to forget how dangerous medications can be if not taken properly and for the correct condition. No matter what the circumstance, never take another personʼs prescription medications, and donʼt forget, itʼs illegal!

Albertson named new YE Executive DirectorLaMont Albertson of Aniak

has recently been named as the new Executive Director of Yuut Elitnaurviat—The Peopleʼs Learning Center (YE). He will replace Carlton Kuhns, who will be the new principal of Mikelnguut Elitnaurviat School in Bethel.

Out-going Executive Director Kuhns said that heʼs very enthusiastic about his replacement as well as for the future of the organization. “I am very pleased with the selection of LaMont Albertson as the Executive Director for Yuut Elitnaur-viat.”

The job-training program under YE is one of the most important projects underway in our region, said Kuhns, who will serve as Interim Director until Albertsonʼs arrival. “LaMont brings a unique combination of expertise, talents, and knowledge of the region that will continue to move this important project for-ward.”

Albertson has lived in the YK Delta for more than 38 years and was involved with numerous educational and community endeavors before retiring. In the course of his career he was a teacher, principal, and director of Kuspuk School Districtʼs Vocational Education and UAFʼs Kuskokwim Campus.

Albertson received a B.A. from Oklahoma Baptist University and a M.Ed. from the University of Florida and Florida Atlantic University.

But according to Albertson, the most important job heʼs ever had was being a parent and a grandparent. “I came out of retirement because I want to be here and be involved with this project,” he said. “I want to be sure my kids and grandkids can get good jobs.”

Albertson is also a guide and owner of Wilderness Experiences, a fishing and naturalist guide service on the Aniak River and also served as charter member of the Kuskokwim River Fisheries User Group. He will complete personal commit-ments before assuming the Executive Directorʼs position in September.

YE is a regional partnership consisting of nine local agencies with the mission of creating vocational training opportunities for the YK Delta Region. To date, two construction phases of the YE Career Learning Center have been completed—the Yuut Construction Trades Shop and Early Childhood Education Center.

The remaining campus components—dormitories and the Technical Education and Support Services building—are currently under construction. YE is scheduled for full completion in August, 2007.Source: Yuut Elitnaurviat—People s̓ Learning Center.

For more information, contact Tiffany Longan, YE Training Manager, at 907-543-6920

LaMont Albertson will take over as director of Yuut Elitnaurviat in September.

A leader knows what to do; a manager knows merely how to do it.

—Ken Adelman

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EARTH study comes to Kotlik in August, Alakanuk in Sept.The EARTH study will be arriving in the community of Kotlik

this month and will be there until August 31. EARTH stands for Education and Research Towards Health and seeks to answer ques-tions about how traditional diet and lifestyle may prevent chronic diseases.

Any Alaska Native over the age of 18 is eligible to participate. Along with answering questions about diet and lifestyle, all partici-pants have blood pressure, blood sugar and cholesterol checks, along with height, weight and other medical measurements.

After finishing the project, each person receives a four-page health summary outlining healthy aspects of their individual diet

and lifestyle. The EARTH study feedback also provides information about changes that can be made to lead a healthier life. All partici-pants receive an EARTH t-shirt and $20 cash and are automatically enrolled in weekly raffles upon completion of the project.

After Kotlik, the EARTH study will be moving on to Alakanuk from September 19 until mid-October.

The YKHC EARTH study is run by Katie Rose Hulett, from the ANTHC Office of Alaska Native Health Research.

For more information about the EARTH study, please contact Aggie Varney at the Bethel EARTH office at 543-3961. While in Kotlik, interested participants can call Stella Unok or 899-4790.


Dr. Krevans says goodbye for now After two decades in the YK Delta, Julius Krevans, Jr., MD,

and Mary, his wife, and three children are leaving Bethel to be nearer to relatives in the lower ʼ48. The Krevanses have been in Alaska since the mid-80s.

Krevans attended the University of California Davis Medical School and completed his Internal Medicine Resi-dency training at the University of California San Francisco, becoming board certified in internal medi-cine in 1984 (he was recertified again in 1997).

Krevans first moved to Bethel and joined the staff of Y-K Delta Regional Hospital as a General Medical Officer for the US Public Health Service in 1984.

In the following long years of service to YKDRH, he delivered babies and cared in clinics, inpatient unit and ER; he also consulted on on-site internal medicine and was an active participant in medical staff leader-ship.

In addition, he was involved in quality of care and services in his roles as Lab Director, TB and Infection Control officer, and participated in corporate redesign projects to increase and improve medical staff services and patient access to care.

Krevans also assisted in the development of statewide pneumonia care guidelines and was active in training medical staff in documen-tation and charge methods to help improve billing and revenue cap-ture for the corporation.

Krevans finally retired from the PHS in August of 2004 and was hired by YKHC as a physician and he continued working at the hospitalʼs Kusko Clinic.

During an employee recognition luncheon last month, Krevans said it was an incredible experience to work with people in Bethel and the Y-K Delta in those 21 years. “Weʼve met so many people and made so many great friends.”

Krevans will continue to work as a locums (TDY) through December 2005. “He is a teacher, a patient advocate and a role model for many,” said Gene Peltola, President and CEO, during the

luncheon. “He is loved and respected by many and has become an integral part of both this corporation and the community.”

As for Mary, she initially came to western Alaska as a Jesuit Vol-unteer for the St. Maryʼs Mission School from 1982 to 1985, and moved to Bethel in 1986 to work as a state Public Health Nurse.

Krevans said he met Mary at a fiddle dance in 1988. “We had a wonderful time dancing together,” he said. “Later that week, I became sick with pneu-monia and Mary came by the house bringing fresh bread and checking up on me.”

And the rest is history. The eventual marriage of Krevans and Mary produced three children – Solo-mon, Sophia and Aaron. “Mary became the chief PHN for our region before taking a few years off to raise our children,” Krevans said.

Prior to leaving, Mary worked with Dr. Joe Klejka, YKHCʼs Medical Director, coordinating a variety of research projects, mostly for the Centers of Disease Control. She also worked part-time for the Bethel Alternative Boarding School in the past

few years. Krevans said the reason they are leaving is because their parents

are getting old and theyʼd like to be closer to them. Krevans ̓father and mother live in Bar Harbor, Maine, while Maryʼs dad, who lives in Milwaukee, WI, is 90. “But it will also give our children a chance for new experiences,” he said.

Krevans said he will be leaving August 17, but Mary and the chil-dren already left on July 31. Their immediate plans are to travel to Maine first, then travel around the United States “for a year home-schooling our kids, teaching them about our nation, and visiting with our family and friends scattered across the country,” he said.

Although excited about traveling and being closer to their fami-lies, Krevans said they are sad about leaving. “We have many friends here and love the town, but right now is a time for us to be elsewhere, at least for a while,” he said.

Kids learn about poison prevention at library presentationOn Wednesday, August 3, two pharmacy students working at the hospital gave a Poison

Prevention presentation at the Bethel City Library during children s̓ story hour.The pharmacy students are Jamie Keller and Lori Sorensen. They are going to be entering

their fifth year of pharmacy school at South Dakota State University (SDSU). They led a dis-cussion about poisons with the kids at the library that addressed the different forms of poisons (solids, liquids, gases), ways of being poisoned (touching, tasting, inhaling, splashing in eyes), and how not all poisons are “bad” (medicine, perfume, and gasoline can all be good when used in the proper way).

Jamie and Lori showed a short video, and then presented an activity that compared differ-ent medicines to candy to see if the children could “guess the poison.” After that, they handed out a worksheet, taught the kids the song “Whereʼs the Poison,” and then passed out coloring sheets and candy for the children to take home.

The participants were also given poison control center telephone number magnets and stick-ers (courtesy of YKHC injury prevention).

The presentation is put on by one of the SDSU student pharmacy organizations. They decided that it would be good to present to kids anywhere, so they brought it to Bethel. Jamie

and Lori arrived in Bethel in May, and will be leaving in August.

Pharmacy student Lori Sorensen helped pres-ent poison prevention information to children at the Bethel library recently.

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


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Conference The Crooked Creek Clinic. The staff received ...Story on page 8 The Crooked Creek Clinic. The staff received the “Clinic of the Year” award at the 18th Annual Health