Health Care in the Bush

I published a very editted version of this on December 10, 2010. Now, you get to read the WHOLE story, unedited! ...

Pneumonia. This is the second time I’ve been down with it in the past 45 days. It’s worse this time, much worse. I took all the precautions – got the 7-year pneumonia shot last year (that covers 25% of the strains out there – apparently the other 75% are in Kwethluk), take a daily vitamin (when I remember), drink plenty of orange juice, take Echinacea and vitamin C supplements, get plenty of rest, and I even started exercising (remember Jillian?). However, there is one little bugger that I can’t seem to tame… stress. Beyond that, I’m not sure what else I can do. Anyway, here’s the story that led me to today…

Last Friday, I came home from school feeling like I was getting a cold – stuffy nose, drainage in the throat, the usual. I started dosing up on herbal tea and vitamin C. It just got worse. By Saturday night, I had a pretty bad cough and by Sunday, I knew it was at least Bronchitis – fever coming in around 99. I made an appointment at the clinic for 9am, found someone to cover my class, bundled up, and made the half-mile walk there in 20 below windchill temps. Once there, I sat in an empty seat closest to the door, at the edge of the waiting room, not wanting to spread my germs because of my horrible cough. There was a young mother there with two young children, both under the age of two and both sick with snotty noses and thick coughs. There was another woman there, about my age. At one point, the older woman coughed and then came over to the trash can that was six inches from my elbow and spit into it. As she walked back to her seat, I looked down at the trash can and noticed dried sunflower seed hulls stuck to the top of the trash bag. Obviously, the trash bag had not been replaced the last time the trash was emptied. My gag reflex let me know that it was at full attention.

At 9:30am, I was called back to an examining room and the 30-year-old female health aide assigned to me had just arrived, late. She was still in her snow pants as she quickly started examining me with her dirty hands and black-edged fingernails. She gave me a smile through her thickly yellowed, crooked teeth and asked, “Do you feel safe at home?” – standard question at the village clinic. Greasy hair sprinkled with dandruff gave away that she did not have running water at home. My fever was 100. After 30 minutes of her asking me questions, looking up information in a medical textbook, and writing down details on a sheet that she would soon fax to a doctor in Bethel, the exam was over. She told me that she heard crackling in my lungs and was sure it was pneumonia. I was sent back to school and told that she would call me later that afternoon with doctor recommendations.

At 3pm, I still had not heard from the clinic, so I called. My aide told me that the Bethel doctor said that my fever needed to be 102 before they’d prescribe antibiotics. That’s a new one! So, I called the Bethel doctor and she told me that without a chest x-ray (which can only be done if I spend an entire day flying back and forth to Bethel to have it done in the hospital there), my temperature has to be 102 for them to diagnose pneumonia. Where do they make up these rules?

By Tuesday morning, I was beginning to see stars from being lightheaded. In the classroom, I was useless as I only had a whisper of a voice. The soonest the clinic could see me was 2pm. I hauled myself there (remember that it’s a mile roundtrip) in the subzero temps, colder than Monday. They examined me (temp at 102), sent off the paperwork to Bethel, and I was given antibiotics. I barely remember my walk home. I know I was weaving as I walked down the road just concentrating on breathing, which was difficult, and keeping my eyes focused enough to put one foot in front of the other. Oh yeah, on my way out of the clinic, they demanded that I make a follow-up appointment for Wednesday (walk back there again? NOT!) which I did and promptly called to cancel Wednesday morning.

I spent the next several days in and out of bed, never leaving the house, doped up on as much medication as I could find. Thursday morning, I woke up with 9 cold sores lining my top lip and by Thursday night, I also had sores inside my nose. Miserable. Frustrated. Now, angry.

I’m angry at the poor medical care available. I’m angry at the unsanitary conditions at the school, at the clinic, at the Native Store.

I’m sure I’ll go back to school next week and someone will pose the question, “Why do you think you’ve been so sick here?” The only truthful answer is the unsanitary nature of this village. I have never seen a nastier teacher’s bathroom. I’m sure it has not been cleaned yet this school year and it was dirty when the year began.

Kids hack into trash cans and lie on dirty floors. Cleanliness is not revered – students are visibly dirty and often smelly. The school is not cleaned regularly – the floors, bathrooms, etc. A favorite snack of students is a pack of sunflower seeds. They spit the shells into their bare hands or stack them up on their desktops until they are ready to sweep them into the trash can, which has a bag in it that is regularly reused.