Health Care in the Bush

I received so many questions about life in the bush that I will be breaking the answers into several posts. For today I decided to start with questions about health care.

I had a lot of questions about health care in the bush. Particularly prenatal care.  When a woman gets pregnant in the village, she generally seeks prenatal care in Bethel, a thirty minute plane ride away, although some may choose to go all the way to Anchorage (an additional hour-long flight from Bethel).

After the initial visit, I believe they go to the doctor every six weeks, then every four weeks, then every two weeks up to 36 weeks.  At 36 weeks it is required by health insurance that expectant mothers fly out (again, to Bethel or Anchorage) and stay at a home while they wait for their babies to be born.  The women have roommates and cannot bring their husbands or children.  Once the baby is born, they are able to fly home, usually within a few days of birth.

There are no home births.  There is no midwife.  The risk is too great.

If you are required to leave the village for medical care (for any reason, not just pregnancy) the insurance reimburses the cost of the flight at 90%.  

Occasionally a medical doctor will come to the village and see patients.  I have never seen a doctor out here personally.  We have been to the clinic multiple times for ear infections, one case of scabies (!!!) and some other illnesses.

The staff is medically trained, but are not doctors or nurses.  They take all our vitals, ask questions and then correspond with doctors in Bethel to decide which treatment is best.  They carry most necessary prescriptions (i.e. Albuterol for inhalers, Amoxicillin for ear infections...).

In addition to minor urgent care, the workers at the clinic are on call 24/7 in case of emergency.  They are the ones who call Medivac (similar to life flight) if necessary and have saved many lives here in the village.  Medivac is emergency medical transportation via airplane or helicopter, depending on weather, and Medivac insurance can be purchased for $100 a year for the entire family.

The clinic also coordinates the dentists, eye doctors and nurses who give well-child check ups and necessary shots for everyone.  We have opted to use our doctors at home in Washington for well child check ups and shots.  So every summer we catch the boys up, seeing the dentist, the eye doctor and their pediatrician.  But if we wanted, they could be seen out here.

When our doctors send in a Rx for us, we use a mail order pharmacy that ships directly to our PO box.  The only inconvenience there is that we have to make sure we give the Rx enough time to get to us.  Luckily we've had no issues.  

I would say the only major change to my health since arriving in Alaska is dry skin and chapped lips.  I use lotion and chapstick like they are going out of style.  I also drink a lot of water, and we use humidifiers in both our room and the boys' room to keep the air moisturized.

The bonus to dry air is that our cups never sweat, so I have no need for cup holders.

Silver lining?

:)

Some people may be surprised that I don't list anxiety as a change to my health since arriving here, but the truth is I have had anxiety for about five years, it had just never gotten quite so severe.  I believe that my wisdom teeth removal recovery (which was slow and agonizing) this summer, coupled with the powerful antibiotics I was on and the lack of medical care once we arrived in Marshall this fall was the perfect storm for my health-related anxiety.  

Then in December I actually became ill with pneumonia, followed by bronchitis, and that took everything out of me.

Thankfully I found a counselor willing to do phone counseling with me, which has been a tremendous help, and finding a doctor (+ corresponding prescription) in Anchorage when I visited in January was also a big help.

The last question I was asked was if there are any villagers who've never left the village.  All the people I know personally have left the village at some point.  At the very least they have been out to see a doctor, but many go to Anchorage for vacation, to shop and to see family they have there.

The natives also do a lot of traveling amongst villages (either by plane, by boat or by snow machine, depending on the weather and the season), because many families are spread out across the many villages.  

~