WEEK IN THE WAINWRIGHT CLINIC

Wainwright is located approximately 90 miles southwest of Barrow on the Chukchi Sea and is the third largest community on the North Slope with a population of 563 (2011 census).  Over 90% of the people in Wainwright are Alaska Natives, calling themselves Tagiumiut or “People of the Sea”.  In doing a little research about Wainwright, I learned that James Michener spent quite a bit of time there and in his book “Alaska”, he recreated a fictionalized village based on what he learned while in the community. 

I would be spending Monday through early Friday there, accompanying one of the experienced public health nurses, Bertrand, for my first clinic training outside of Barrow.  Bertrand packed the insulated bag with vaccines and the paperwork we would be taking with us and we met at the airport for an 8:30 a.m. take off.  While waiting, I met a woman who was flying to Wainwright to do some training of the City clerks.  She worked in Anchorage and had been to quite a few villages in Alaska, but not as far north as Barrow or Wainwright.  She sounded happy to be making the journey to both of them this week.  So many of the people I’ve met so far have had a long history of working in many different areas of Alaska and it’s always interesting hearing about their work and lives.

Every airplane that lands in any community on the North Slope is soon closely circled by a number of vehicles.  Commodities for the local store are loaded into the back of pickups and people, their boxes, totes and bags are hustled off to their warm destinations within the community.  A police officer was kind enough to offer Bertrand and me a ride to the clinic.  While they visited in the front seat, I peered ahead through the thick black cage behind them and tried to get comfortable in the very hard plastic seat that was about as wide as my oldest granddaughter’s little hips.  It must be a method to deter repeat offenders…it’s definitely not comfortable back there.  I discovered that there was no way to let myself out when we pulled up to the clinic so I was happy when Bertrand opened my door, even if he was laughing = ). 

The clinic is a large building with offices and rooms for medical exams, dental visits, physical therapy, and teleconferencing.  The emergency room has a door large enough for an ambulance to back up to transfer patients into the building.

The upstairs living quarters, where Bertrand and I stayed and where all visiting medical staff, as well as other service people on a space available basis, stay, is large and comfortable with a full-sized kitchen opening into a dining and living room area.  Two bedrooms with two twin beds each are down the hall just beyond the bathroom and the stacked washer and dryer.  Bertrand and I each chose a room, unpacked and began our first day at the clinic.

It was an honor meeting the Community Health Aides, Bummie, Sophia and Stella.  Their work is vital to the daily health of the community and to see them in action was awe-inspiring.  They saw clients in the clinic, communicated with doctors from Barrow and Anchorage, treated people in the emergency room during the day as well as during the night and arranged a medevac while we were there.  In listening to them, I had the sense that although they are there to care for community members, they also attempt to empower people.  I overheard phrases like, “it’s your responsibility…”, “you need to take responsibility for…” a number of times related to different situations. 

Before leaving Barrow, Bertrand had a “due list” and a health summary for each person listed on it printed out for our reference while in Wainwright.  The due list shows which children are due for which immunizations and is organized by birth date.  I was given children from 11 to 18 years old, so spent my mornings calling their parents, inviting them to make appointments to come in and have them immunized.  Bertrand did the same with his list so our schedules for the days we would be there filled up quickly.  The VHF, a public address system that is picked up in every home in the village, allowed Bertrand to announce our arrival and that we would be holding an open flu vaccination clinic on Thursday afternoon. 

Many of the numbers I called had been disconnected, so I enlisted the help of Bummie, Sophia and Stella in finding correct ones.  I sat with Bummie while she called out the names of each child or parent if she didn’t know their telephone numbers and Sophia or Stella called back, “he works at the school…the number is XXXX” or “her number is XXXX”.  I learned that several of the families had moved to Anchorage or to another village but in a very short time, ended up with working numbers for all of the other families on my list, thanks to Bummie, Sophia and Stella’s great memories.  I tried calling one woman quite a few times, but there was never any answer, so was about to give up when I heard an announcement over the VHF system, “would the person who is trying to reach me at XXXX, please call back…I’ll answer the phone.”  It was the woman I’d been trying to reach = ). 

I loved my appointments with the adolescents and their fathers or mothers who came in with them.  Several appointments were for two or three family members at a time.  The visits were all delightful with some teasing between siblings and good natured chiding by parents.  I weighed and measured each child, and asked them about school, their favorite sport, etc. while immunizing them against HPV and the flu.  My only challenge was keeping up with the paperwork related to each client as well as preparing post cards to remind their parents about their next visit.  The HPV immunization requires subsequent shots in two and in six months.  I stayed late each night with my stack of charts and documentation, but enjoying it, thinking of how rewarding each appointment had been.   

Along with meeting the Community Health Aides, I also met Ward, the Fire Chief and Willie and Kitty, the two first responders on duty that week.  The fire station was being remodeled, so the crew was temporarily housed at the clinic.  Stella is also on the volunteer fire team, so on one of the days when someone reported black smoke coming from a house, all four of them jumped into their fire gear and boots and raced out the door of the clinic, returning an hour later, thankfully with news that things were under control and that no damage was done and no one was hurt. 

Because they had time on their hands, Ward and Willie commenced to clean the clinic, making it sparkle as much as any fire station.  The only problem was that with the floors being mopped so often, I was afraid that one of my clients or I would slip when walking back to the exam room I was using.  My observations about this possibility didn’t affect a change, but fortunately everyone stayed on their feet.

I enjoyed talking with Willie when we both and Bertrand had down time.  He shared with us that he had purchased a jeep in Anchorage and had driven it to Fairbanks.  From there, he drove it up the Haul Road, 498 challenging miles to Prudhoe Bay (the Haul Road or Dalton Highway begins at Mile 73 on the Elliott Highway, 84 miles north of Fairbanks).  In the winter, there is a rough ice trail between Prudhoe Bay and Barrow.  Willie navigated it with his jeep and then with the help of two other men, drove it up onto two sleds, roped them to the back of two snow machines and finished the 90 mile journey over the frozen tundra from Barrow to Wainwright.  He said that it took around four days and that it beat waiting for the barge to arrive in the spring.  He’d saved over $3,000 in bringing it up himself, just paying for the cost of gas.  Where there’s a will (or in this case a Willie), there’s a way = ).

Bertrand did the well-child checks, assessing one for a developmental disability and giving the ones younger than 11 their immunizations.  I enjoy watching him…he loves children and it clearly shows by how he interacts with them.  I’m taking notes and will go to well-child training in the spring, eventually doing them on my own.  I’m hoping that I’ll be as good as Bertrand and the other public health nurses.  Blowing bubbles after giving a shot is a key strategy to maintaining a good relationship with these little ones.

The temperature held at a fairly constant -22 degrees with a wind, so walking in the mornings necessitated wearing warm layers and my new Baffin boots rated for -40 below zero. Staying oriented to my route to prevent becoming lost didn't allow for day dreaming on those cold and dark, but pleasant outings.

We finished our clinical work late Thursday, having accomplished most of what we had come to do.  We rose early on Friday in order to wash and dry our towels and sheets and clean the quarters before leaving.  We said good bye to the health aides and fire department staff and received a ride to the airport from Isabel in the senior van (more my style than the police car).  We joined the circle of vehicles around the just-landed plane, waiting for it to unload before Bertrand and I climbed the stairs for the 40 minute flight back to Barrow.  I loved the week in Wainwright, having experienced a rewarding time in the clinic as well as in the community. 

I’ll post a second page related to the celebrations we were fortunate enough to be able to attend most evenings.