Module VII - Health and Medicine

No matter where you are, we're glad you're here! 

AK Dept. of Health M/V Hygiene 
(one of the shot ships)
ca. 1950's  VILDA ASL-P143-

Essential Questions

• How have the settlement patterns of Alaska been a reflection of the natural landscape, distance, resources, and the economy?

• How have the ways Alaskans have devised education and health care systems been both a reflection of socio-cultural norms of the dominant culture as well as a response to the challenges of providing services in a vast geographic area?

Nurse on M/V Hygiene Discusses Tuberculosis
ca. 1940's   VILDA ASL-P143-0283

• To what degree is there distinctiveness in the art, literature, science, recreation, and cultural institutions of Alaska?  In what way do these contribute to, or reflect, a unique Alaska identity?

ENGAGE

Giving Cod Liver Oil, Pt. Hope Classroom 
1942 - VILDA ASL-P306-0595

Healthcare History
Like the story of education in Alaska, the story of health care from 1867 to the present is complex.  
It is the story of diseases that decimated entire communities and a high rate of accidents related to occupations and lifestyle.  

It is the story of actions and reactions to the health care challenges, which taxed the efforts of governments, churches, educators, businesses, and health care providers. 

It is the story of pain and heartache, as well as successes in the control  and eradication of certain diseases.

It is also the story of the Western medical system sometimes in conflict with, and more currently, working in conjunction with traditional providers.

Brushing Teeth, Mission School,
Yakutat ca. 1920's
VILDA ASL-P56-395

The individual characters involved in this health care story include intrepid community health care providers/first responders and itinerant public health nurses and doctors who endured challenging work and travel conditions to serve far-flung communities.

In a larger context, the story of health care is also the story of migrants to Alaska,  culture exchange and change, population and settlement, resource development, the physical landscape, and the transportation/communication infrastructure.  That is, it is part of everything you have studied in this course so far.

What were the major diseases?  During the Russian-America period smallpox and measles were the killers of Alaska Natives who did not have immunity to these diseases.

Hudson Stuck Memorial Hospital, 
Fort Yukon ca. 1950's
VILDA AMRC-b85-27-1200

The late 1800's saw sporadic outbreaks of typhoid, small pox, diphtheria, respiratory distress, and measles transmitted by the many miners, trappers, traders, whalers, and others chasing adventure and profits from Alaska's natural resources.  Such transmission continued in  the early 1900's with devastating influenza and measles epidemics.   

After WW I, the Spanish Influenza further decimated the Seward Peninsula and spread to other regions of Alaska.   While these diseases impacted all ethnic groups in Alaska, the Native communities were hit particularly hard.

Sisters of Providence  Anchorage 1956
VILDA  AMRC-wwc-2268

Church missions, in the late 1800's, were among the first to respond to the health care needs in Alaska. They were joined by doctors on the ships of the Revenue Service (forerunner of the Coast Guard) and those employed by mining, trading, and transportation companies. 

While church denominations expanded their service to include the establishment of hospitals in larger communities like Anchorage, Fairbanks, and Juneau, the federal government began to take more responsibility for health care in rural Alaska.

Mt. Edgecumbe Orthopedic Unit Staff

Examine X-Ray ca. 1950's  

VILDA ASL-P143-0212

In the 20th century the Bureau of Education, then the Bureau of Indian Affairs, and later the U.S. Public Health Service/Indian Health Service provided for traveling medical professionals, local clinics, health care education, and immunizations.

TB

TB Boys' Ward, U.S. Indian Health Service
Hospital, Juneau  1938
VILDA AMRC-b75-175-523

Tuberculosis became the scourge from the early 1900's through the 1950's. Both the federal government and the AK territorial government tackled this through the building of sanatoriums to isolate the infected, surgical and chemical treatment, and early identification through X-rays and skin tests. By the late 1950's TB was finally under control.
 

A Dose of Medicine, Jesse Lee Home,
Seward late 1940's - VILDA SCL-7-9

All of these health care challenges severely impacted rural/Native populations. The loss of family labor caused by death, illness, disability, or long-term absence threatened the survival of those living a subsistence lifestyle. 

Missions added orphanages for children who had lost one or both parents.  In some areas,  entire communities were abandoned or relocated.  Rural Alaska would never be the same.

Patients and Personnel- Mobile Health Unit,
AK Native Service + AK TB Assoc.
 ca. late 1940's
VILDA UAA-hmc-0375-partl-series1c-10-9

Today, the Alaska Department of Health and Social Services provides public health clinics throughout the state; it also conducts research and collects public health statistics.

The federal government subsidizes health care for Native Alaskans, primarily through tribal health consortia or non-profit Native organizations, as part of the historic compact between the U.S. government and Native Americans.  

Itinerant Nurse, Nome ca. 1940's
VILDA  ASL-P143-1010

Many hub communities in Alaska have small regional hospitals, while the major cities have an array of medical options, with a fully developed network of providers linked to larger urban medical centers in the lower 48.

The challenges for health care in Alaska today are both similar to other areas of the U.S. (obesity, diabetes, smoking, healthy lifestyles, aging population) and unique to Alaska (higher rates of accidents, suicide, alcoholism and providing high quality care in remote areas)

U.S. Coast Guard Helicopter and Cutter Provide
Medevac Service for Injured Fisherman
Dutch Harbor  Dec. 2010

Sophisticated long-distance medical care utilizing advanced communication technologies have proven particularly suitable to Alaska. Emergency medical evacuation by air transport is available throughout much of Alaska.  

And, as more Alaskans are choosing to retire and stay in the state, health care services for seniors is a growing field. 

EXAMINE

• 

  AK Railroad Hospital, Anchorage ca. 1930's
  VILDA UAA-hmc-0370-series 15b-33-1 

  What have been the major health care challenges in Alaska during the American period?
• What are the links between health care issues and the growth and development of Alaska since the 1870's?
• How have the health care issues impacted Alaska's Native population?
• What are Alaskans responding to current health care issues?

EXPLORE

 

Providence Hospital Campus Anchorage

From Alaska's Heritage, read:

• Chapter 4-21: Health and Medicine

Please also choose two of these websites to learn more about current health care systems in Alaska.

• Alaska Department of Health and Social Services
• Providence Hospital - Anchorage
• Alaska Community Health Aide Program (CHAP)
• Alaska Native Tribal Health Consortium
• Southcentral Foundation

EXTEND 

So much need to know!  So much nice to know! Are you picking up pieces of the puzzle?  How are they fitting together?


Mental Health 
The Alaska Psychiatric Institute is a state-run facility providing mental health services.  The story of mental health services in Alaska is difficult and often painful. The story is about lack of services, exportation of patients to Morningside Hospital in Portland, Oregon, the creation of a land trust with which to fund services in Alaska, and lawsuits to enforce the appropriate collection and use of land trust funds.  

"In Territorial Days, Alaskans could be in one of three places...Inside (in Alaska), Outside (anywhere else), or Morningside (Morningside Hospital). (Quote taken from Morningside website.)

For more information on this history, here are two helpful websites:

• Morningside Hospital   (website started by medical professionals to document this little known and often shocking history)

• Alaska Mental Health Trust Authority

Airlift of 15 TB Patients on Reeve Aleutian
Airways C-47A Cargo Plane  Anchorage 1954
VILDA  ASL-P143-0095

Questions for Consideration

• What are the health care services available in your community?  
• Are there particular challenges faced by those in your community related to health care? Feel free to share those.

Just a Few More Resources
These sources are not available online, but must be mentioned as being among the premier sources on disease, health care, and the historic impacts on Alaskans.  All are excellent reads, so add these to your summer reading list!

By Robert Fortuine, Alaska Public Health Physician: 

• Chills and Fever: Health and Disease in the Early History of Alaska 
• 'Must We All  Die'? Alaska's Enduring Struggle with Tuberculosis 
• A Century of Adventure in Northern Health: The Public Health Service Commissioned Corps in Alaska 1879-1978

Alaska's first full-time health commissioner and legendary physician, serving 1935-late 1970's: C. Earl Albrecht - Moravian.

• Frontier Physician:The Life and Legacy of C. Earl Albrecht, by Nancy Jordan

Dr. Joseph H. Romig - Moravian, served in Bethel, Nushagak (for a fish processor), Fairbanks, Nenana and Anchorage (for AK Railroad)      

• Dog Team Doctor by Eva G. Anderson

What's Next?

You've read some of the best, now for all the rest - Potpourri