Module VII: American Period - Society

Essential Question: 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?

A.J. Dimond High School
courtesy classmates.com

Education as it has developed in Alaska has been a reflection of socio-cultural norms in the dominant culture in many areas. Structurally school buildings were often built according to plans that had worked well in the warmer climates of the 48 contiguous states. One example of this is the structure of A.J. Dimond High School, the third high school in Anchorage. It was constructed in 1967 and demolished in 2004 after a new building had been constructed at an alternate site. The original building was constructed with outdoor courtyards and "breezeways" between wings of the school. It also had 160 exit doors to the exterior! This type of school building may have worked well in southern California, but it was soon realized that the building was inefficient to heat and the outdoor courtyards filled with snow and ice in the winter. The courtyards and breezeways were thus difficult to maintain, let alone feasible for use during sub-zero temperatures.


Another socio-cultural norm in early Alaskan education systems was assimilation of Native youth to speak the language of the dominate culture of the U.S. in school. This has led to the near extinction of some Native languages, such as the Eyak language which has only one remaining Native speaker. Subsequently, a lack of cultural identity has been a topic of great concern across Alaska in recent years and a renewed interest in and exposure to Alaska Native heritage has ensued.


In healthcare, socio-cultural norms that have been adhered to include the norm of the first half of the 20th century that led to the institutionalization of those with mental health conditions within the state. Alaskans with mental health concerns and especially those judged "insane" were placed in Morningside, an institution in Oregon, because there were no such facilities in Alaska at the time.


Healthcare system development has occurred in response to the challenges of providing services as evidenced by the development of the Community Health Aide Program which I referenced in my last blog post. CHAP is a program that bridges the gap in village healthcare needs and limits of transportation and accessibility while providing an educational opportunity for Natives to provide healthcare for their own people.

The Sisters of Providence
courtesy alaska.providence.org

Further challenges that helped in the development of healthcare can be observed in studying the Sisters of Providence role in establishing health care in Alaska. It was their goal to face obstacles and overcome barriers in healthcare for the far reaches of society. If the Sisters of Providence had not come to Alaska, healthcare in this state would have taken much longer to take shape. 


Challenges included that of financing their healthcare delivery and hospitals. This was done by selling "tickets" to miners in Nome at the turn of the 20th century that would provide for their care if they should become sick. Providence Alaska still operates as a non-profit and is able to forgive payments for services in some cases due to the philanthropy of others. More recently a challenge that has been overcome is providing housing for families of inpatients at Providence Alaska Medical Center in Anchorage when they have to fly in from villages for loved ones to receive care. This challenge has been met by the building of Providence House which sits adjacent to the hospital itself so families can be near their children and other family members who are hospitalized.




Examine Question:What have been the major healthcare challenges in Alaska during the American period?
Three main healthcare challenges in Alaska during the American period include the physical geography and how it affected healthcare delivery, the rampant spread of diseases such as tuberculosis, and the contrast between Native versus Western views on health.


The shear size of Alaska and isolation of many of it's communities during the American period made healthcare delivery a costly and difficult venture. In the early American period transportation was very limited and most communities could only be reached by boat or by foot. I venture to say that only those with genuine compassion for the Alaskan people made it, let alone lasted.


Diseases that Native people had never encountered could quickly overtake the immune systems of a once healthy village. Dr. Curtis Welch knew this well when he first identified diphtheria in a 6 year old boy in Nome. His quick realization of the need for a mass quantity of antidote lead to the Serum Run of 1925 which made front-page news across the United States. The delivery of the antitoxin was a major challenge because of the 674 miles that had to be covered in 30 to 50 degree below zero temperatures as quickly as possible. Because of this need and the inability to access Nome from any other route at the time other than dogsled, 20 mushers came forth to create a relay line in order to get the serum to Nome as fast as possible, saving many lives in the process. Click on this link to see a 6 minute History Channel documentary on the Serum Run.


Another major disease that took hold during the American period was Tuberculosis. This is an airborne infection so the simple act of sneezing, coughing, or simply breathing in close quarters can transmit the mycobacterium. The TB epidemic was a major health challenge because TB had nearly been eradicated in the contiguous United States and principles of TB treatment were no longer even taught in many medical schools. In addition, Native people were highly susceptible and treatment took 6-12 months of daily medication, often using 3 types of drugs. If medication was missed the course of drug therapy had to start over, which lead to quarantines and sanatorium hospitals to insure treatment was received daily and the disease did not spread. The history of TB in Alaska shaped much of Alaska's healthcare such as the establishment of the first Native hospital in Anchorage, Alaska standards for TB screening in public schools, and the realization for the need for health aides in each village - a precursor to the Community Health Aide Program of today.


A final challenge, although there are many more, is that of the clash of two cultural viewpoints on health. This was discussed somewhat in module II. Shamans were very influential among Native people and some were seen as healers while others were seen as evil. Disease was viewed as a spirit's anger coming upon a person so the western principles of medicinal healing were seen as a threat to the status of the Shaman and disease prevention and hygiene measures were foreign concepts to Native people. This created a huge challenge in regards to the Native people accepting rather than resisting the healthcare that was being provided.


Evaluate
The content of this module was a wealth of information and I appreciated the link to Morningside and the history therein. I would have liked to see links to the modern Psychiatric health facilities now present in Alaska, although room was left for course participants to delve into this in their blog responses. There were some typos in Chapter 4:21 Health and Medicine in the 2nd and 5th paragraph as well as further down in the article, especially in regards to dates being printed as 1667 instead of 1867. I don't know that this is something that the professors of this course have the ability to edit.


Colleague Review
Claire presents a concise and informative listing of the 10 Alaskan Highways which is useful for understanding the uniqueness of Alaska's highway transportation routes.


Christy brings up a valid point in her discussion on how the dangers of the waters off Alaska's coastline effect transportation, even today.


Kelley discussed the value of air transportation within the state and emphasized its value in the medical realm.