Its not a town. Its a village.

Preamble: This is attempt two at this post. This time with functioning pictures?

The week that was, was the week that was.

Difficult.

Professionally.

Personally.

Psychologically.

Physically.

The best way to explain these difficulties is to simply tell you our week. Our week in rural Alaska.

But before we discuss our week in the villages I should go back and post some long promised pictures from our first week in Nome.

This is the entrance we use every morning we are in Nome to get to our offices:


Swell meets a friend named Velvet. (What’s with us seeing animals in the backs of cars?)


One of our views. (Ignore the shadow on the right corner. Somehow I jacked my camera up. I’ll need to get that fixed when we’re in Washington).


Our gourmet kitchen.



Eskimo Dancing



Sunset over the Bering Sea





The most beautiful girl in the world




Late last week we received our travel itinerary for village week. We were to leave via Bering Air on Monday around 10 in the morning and return on Friday February 29 in the late afternoon. Being the ignorant Southern 48ers we are we packed according to this itinerary.

When we flew up here from Atlanta we packed in two large suitcases and a duffel bag. I didn’t think that the large suitcases would make for appropriate village travel luggage so we squeezed our weeks worth of clothes into the duffel bag and Swell’s small backpack. My backpack is suitable only for my camera and a computer so all of our belongings were relegated to the aforementioned duffel and backpack. We were also required to bring our sleeping bags and most importantly food and water for a week.

We were graciously lent the clinic’s cooler for our food.

In case you didn’t realize – it was extremely difficult to accomplish this packing feat.

We were able to shove and squeeze everything into our allotted luggage but were forced to cut some clothes and shove some food into the duffel.

We were set.

But not prepared.

In the midst of our packing we were asked to go to one of the hospital’s big-wigs home for pizza.

A nice late welcome?

Nah, we were going to the “lets-convince-a-yet-to-be-graduated-OD-to-move-to-Nome” meet the staff dinner.

Funny enough only one of three staff members made it to the dinner but both Swell and I made it.

We actually left Nome and headed to the bustling Nome suburb of Icy View.

While I was packing a thought popped into my head, I thought; “Self the name of this optometrist they’re trying to convince to come here seems so familiar. Where do I know that name from?”

And then it dawned on me.

A number of years ago I wrote this person an unsolicited email.

Why would I do that?

Because I’m an ass.

This person wrote a plea on the internet for connections to plan a trip to Belize for an optometric mission. I had just done a case study on eye care in Belize in Public Health school so I wrote this person what I thought about eye care missions and that they should contact one of two groups – the Ministry of Health or a non-governmental organization working on eye care in Belize – if they decided to go forward with an inappropriate mission. (My email was worded nicely and there is good reason to discourage foreign eye care in Belize – the good reason is that optometry is developing along a very public health path in Belize and should be aided before foreigners run in and throw glasses at the people).

Surprisingly I never heard back from this person but learned later via other sources that they did contact and work with the NGO I suggested.

The pizza party was good. We visited with the potential OD and encouraged them to seriously consider coming up here all the while wondering why we were never given the sales pitch they were giving this person.

I suppose we weren’t given the sales pitch because we never expressed any interest in staying here more full time. On Monday and Tuesday while we were slaving away in the villages the potential employee was being interviewed, given tours, and told about the potential for loan forgiveness through Indian Health Services.

I could sure use some loan forgiveness.

Monday morning eventually rolled around and we were soon ready to head to the airport.

In order to save space in our luggage we both got dressed with long underwear, jeans, ski pants, boots, undershirts, thermal shirts, jackets, toques, gloves and anything else we could think of.

I called for a cab thinking that it would give us another 15 minutes or so to finish getting dressed. Upon calling the cab company I was told “We’re on the way.”

No lie 1 minute later the cab pulled up to our door.

We threw our boots on ran out and were soon on our way to the Nome “airport”.

“Airport” because it’s actually one runway and every airline has its own little terminal building.

The cab drivers act as their own dispatchers. We heard a funny exchange between the cabbie and a potential passenger.

Cabbie Checker Cab
Woman’s voice Can you come and get me at X hotel?
Cabbie Where to?
Woman’s voice The hospital
Cabbie Ok. I’ll be there soon.

Two minutes later
Cabbie Checker Cab
Woman’s voice Are you coming to get me from X hotel?
Cabbie I’m on my way. (by this time we were fully loaded with passengers – the cab is a van and it picks up multiple fares and makes up the most efficient route to pick up/drop off fares – and on our way to the airport which is a little way out of town).
Woman’s voice I’m having some chest pains and I need to get to the hospital
Cabbie I’m on my way to the airport so you should call the hospital and ask them to send the ambulance
Man’s voice – apparently another cabbie listening in Call 911
Woman’s voice I’ll be waiting outside
Cabbie – shaking head Ok. We’re on the way.

We arrived a little early and had to sit and wait to check-in. I suppose we didn’t have to wait but Swell wanted to wait until our optician/assistant arrived at the “airport” and all check in together.

We waited. And waited. And waited.

Eventually the front desk people told us we needed to check-in. As our concern grew that we were being stood up and wouldn’t be able to function on our own the optician/assistant arrived.
As part of the check in process you are required to give your weight and weigh every item that will be carried onto the plane.

That should tell you something about the size of the plane we flew on.




Soon some kid who looked about 12 years old with some five o’clock shadow walked into the waiting area and said “Brevig/Wales”. We followed him out the door onto the tarmac and onto the plane.



We were flying in a plane called a caravan. It seems to be a true bush plane. Being able to be transformed to carry people or goods or some combination of both.

Once on the plane both Swell and I were very grateful that our small luggage forced us to dress in all of our warm clothes. Soon after putting on my seatbelt I realized that not only was it chilly on the plane but I could see my breath.

I was slightly shocked when the 12 year old guy who walked us out to the plane got in the pilot’s seat and strapped in.

It was going to be a long plane ride.

We flew to Wales via another small village where we dropped some people and goods off. Soon we were approaching “windy Wales”.

Upon arrival we hopped off the plane and started the long walk to the village school where we would spend the next two days and nights. I carried my backpack, a sleeping bag, and Swell’s pillow while she carried her backpack and a sleeping bag.

It was cold and I’ve been cold before. I mean cold, cold not just regular cold. We walked, and walked, and walked. At one point the “snow machine” (aka snowmobile) that was our luggage cart came by with the second half of our luggage and picked up the optician. Swell and I continued to walk and walk. Eventually the snow machine picked us up. Swell sat behind the driver and I sat on the sled behind it hanging on for dear life with my backpack weighing me down and the sleeping bag slipping from my grasp.

Fun?

Ummmm…no.

We got to the school and immediately started to unpack and set up. The optician/assistant also began to man the phones phoning those who had signed up for an exam to set up an appointment for them.
We were a little shocked by the room we were given to work in. It was basically a large storage room. We did our best to set up in a way that would be at least somewhat functional while being clinically appropriate.

Our exam room




View through phoropter (prescription checker)


We began seeing patients at around 11:30 and finished for the night around 8pm.

We saw a lot of kids but also many adults. Everyone was very grateful that we were there and were very friendly. It had been a couple of years since a Norton Sound Health Corporation eye team had been to Wales but there are a couple of private outfits that fly to villages to do eye exam and sell glasses. The bad thing is that they don’t do follow up care or report to Norton sound. While it’s not necessary to share findings Norton sound provides the rest of these patient’s healthcare so it would be nice to have complete charts.

Just another little problem in the provision of care to those in rural areas.

Toward the end of the day I was met with the best of all news.

Every evening the school gym was open for people to play basketball.

For much of the evening a little store was also open that sold soda and candy.

Much to my excitement not only did they sell Dr. Pepper it was actually quite cheap – only 75 cents per can.

I was ecstatic.

The work was difficult. We were busy. Our equipment left much to be desired. Many of the folks had difficult problems that we were unable to completely deal with. We were not sure how to refer, where to refer, or when to refer.

Again, a manual – policies and procedures – would have come in handy.

The big excitement in town was that there was a Polar Bear spotted in town recently. We were told not to venture outside – not that we had time to – and the children were told to walk on the town side of the school rather than the water side.

Wales is a very small village with less than 200 inhabitants. The post office was closed while we were there as the post master was at a conference.

The school has five or six classes which are not grades per se; rather the children are grouped according to “level”. If you reach one level you’re geared for general life. If you want to go to college or trade school you have to reach the final level.

From the papers posted on various bulletin boards it seems that the kids are quite bright and well taught.

We met one teacher who is originally from Oklahoma and has been teaching in this little village for 10 years now. She mentioned that most of the staff had been at the school for years now.

Very impressive if you ask me. Important for the kids’ education as well. Continuity is important.

We met one girl who wants to go to optometry school – or not. It said in her chart under occupation “future optometrist” so we talked to her about it. Like most people she didn’t realize that it was a post-grad degree so we’re not sure if she’s in it for the long haul. We gave her Swell’s email address and have already communicated via email about optometry school.

As we prepared for bed we realized two things:
1) We would be sleeping in a classroom – the younger kindergarten age kids’ room and
2) There were others sleeping in other classrooms.

We’re not entirely sure how many people were spending the night in the school but I think there were three groups in total – us, some folks working on the schools plumbing issues (?? – An interesting plumbing side note in both villages we stayed in they had indoor washrooms for us but both contained signs bearing the clever albeit off colour saying If its yellow let it mellow. If its brown flush it down. In Wales the bathrooms also bore signs indicating that they were only to be used during school hours due to “freezing pipes”. That made for some long nights. Nah, we ignored that sign and some ignored the latter part of the first…if you get my drift.) The third group was a couple of young guys – Glaciologists – from the University of Alaska doing some research on the sea ice. I’m sure their conclusions will not bode well for humankind. They were nice although a little disappointed by our presence. Apparently the storage room/eye exam room is also the Glaciologist’s equipment cleaning room and we were in their space all day.

Our beds were grand.



But our sleep was not sound.

The next day started with a wonderful breakfast of water and a granola bar. We were both tired and my back was sore (and still is). Despite that we worked.

From 8:30 am until 9:00 pm.

Four patients an hour (with two ~45 minute breaks for lunch and dinner).

We each shared the patients and a routine that would carry through the week was developed. Swell would start the patients and I would finish with them. I think Swell had it harder, she thinks I had it harder. I guess that means we found a good balance.

Looking out the unfortunately placed (for an eye exam lane) window one could see why the village is called “Windy Wales”. It looked absolutely miserable out.


We were glad to be indoors in the too light exam room during the day and too dark exam room during the early morning and night. Swell was struck with the realization (and I’ll avoid using this opportunity to say I told you so) that she in fact did not need the heavy sweaters and pants that she packed as – surprise, surprise – they actually had good heat in the school. She was sweating like a pig. Ha!

The day was uneventful, although our last patient before dinner spent quite a bit of time talking to us about the changes he has seen in Wales. Mentioning that usually by this time of the year they have seen 8 or 9 Polar Bears but this year just one. He mentioned that the weather has changed drastically in the past number of years. He didn’t say why he thought these things have happened. Perhaps global warming we pondered, perhaps just a regular weather cycle. He didn’t know. We couldn’t offer an explanation but it was an interesting ten minutes learning about life in Wales.

Yet another life experience I couldn’t ever have imagined having: standing in a school hallway talking to an Eskimo about life in a tiny village in rural Alaska.

We went to bed that night knowing that this was our last night in Wales. We would wake up the next morning and work for a few hours and then pack up and fly out to Shishmaref.

That night Swell was shown the shower.

There was a shower (limited to a total of 2 minutes).

She states that it was so powerful that one couldn’t stay more than two minutes even if one wanted to.

I turned down the shower.

I’m a man’s man.

Stinky.

The next morning we woke up and started working again.

We worked.

We ate our PB and J for lunch.

I packed up the equipment while Swell walked to the only open store. It turned out to only be a grocery store. She was hoping for a hand made goods store.

We had opportunity to buy things made locally.

The first things one of the patients brought was beautiful. It was an Ivory carving of little Eskimo guys dancing.

It was $750.

We said no.

We also said no to the $150 crafts and the $85 ones. Well, we said no to everything.

Far too rich for our blood.

We decided that it would be fun to walk to the "airport" to take some pictures.

It was sooooo cold. Colder than the first day. The coldest I've ever been.

Some pictures of our walk to the airport as taken by two frozen cameras.









Yes I'm stupid. Yes its on upside down. My excuse - I didn't put it on until outside and my fingers were freezing.



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