Shishmaref and beyond

I forgot to mention that when in Wales one can see mainland Russia off in the distance. The international date line is also very nearby.

After the long cold walk to the airport. We were soon on our way to the next village - Shishmaref.

This village was larger than Wales and we knew we were in for some busy times.

We flew on the same plane with the same pilot as took us to Wales.

The plane was still cold.

After a short flight we landed in Shishmaref and were soon on a much shorter walk to the clinic.

This time our clinic was located in the health center. It was a largish building with three exam rooms, a pharmacy, a front office and two - for lack of a better descriptor - storage rooms.

The health center is staffed solely by health aides. These are lay people trained to diagnose and treat basic conditions and refer up the chain for extra help. They basically follow algorithms to come up with diagnoses and treatment plans but have physicians, optometrists, pharmacists, dentists, audiologists, etc. available for consultation via fax, telephone, and tele-medicine.

The communities seem to love and trust their health aides.

Upon arrival we grabbed a quick bite to eat and were soon setting up.

The question was where could we set up? We had quite a bit of stuff and the clinic would still be seeing regular patients while we were there.

I asked where we could set up our main exam area and was told to set up in the room "to the left of the kitchen".

Now here is where Swell and I began to get a little angry.

Looking in the room "to the left of the kitchen" I soon realized that there was no way in the world that we could do anything in that room.

To put it bluntly I could barely fit in the room by myself let alone with equipment and a patient. This room was packed to the rafters with a combination of junk, dental equipment and supplies. (Dentists being who they are, are able to leave some of their big equipment in each village rather than lug it around - I'm talking patient chairs, exam chairs, lights, and the like). In addition to all of the stuff there were also file cabinets, a desk and a couple of book shelves.

No way, no how.

We decided forget it we'll set up wherever we like.

We set up in exam room 2, the main hall and a little hall off to the side.

It was not ideal.

Not ideal at all.

The optician set up in a little room to the right of the kitchen - and she wasn't happy about it.

We did the best we could to clear it out but she ended up using our big Tupperware boxes as tables and sitting in an office chair with a drug dispensing table as a desk. Not only was she cramped and uncomfortable she was way in the back of the building with no phone. This meant that patients we unsure of what to do and where to go and she was running back and forth between the office (where she was calling people to set up appointments) and the optical where she would help people with their glasses.

This really didn't work well so the next morning I, without asking, moved her to the front reception area of the building. It worked out much better and we didn't seem to be in the way of the clinic staff.

Swell and I had it tough. I did half of my part of the exam in a little hallway beside her room and the other half in the same room as her. She did her first bit in the main hallway and then the rest of it in the exam room.

It was crowded and unfortunate.

I was finding prescriptions in a way too short hallway with a chart that was a bit out of focus. It was not fun.

When we asked where they usually set up nobody really seemed to know or care. Eventually a patient indicated that they thought in the past that they eye exams occurred completely in the room Swell was in.

I really can't see how that worked but we made do.

And hopefully people's glasses work.

We dealt with a lot of minor disease issues and made a number of referrals both to Anchorage and to ourselves when we come back - we need to so some special testing on some kids and adults that we couldn't do while there.

Here are some pictures of our wonderful examination areas:

The Big E - for the optometrists out there, yes it was only 10 feet away. Yes it was out of focus. Yes I should be killed in my sleep.




New and improved glasses area:


We worked until 9:30 that night. We were happy that they had a TV in the clinic and we watched a little bit while having a midnight snack and unwinding then it was off to the least comfortable sleep ever.

Swell had an air mattress, the optician/assistant had a pull out bed, I had a little mat that they use for medi-vac patients. I was basically sleeping on the floor.

Ouch my back.

The next morning we were up and working by 8:30 and would end a little after 9 pm. It was on this day that we learned that the itineraries we were given were not, shall we say, accurate.

We would not be leaving Friday afternoon, rather we would be working a full day on Friday and leaving "sometime" on Saturday.

Great. Just great.

We were happy that there was a fairly big grocery store in the village although things were extremely expensive. Beyond expensive. We thought Nome was expensive this stuff was nearly twice as much as it is there. I guess thats what happens when you need to fly stuff in.



It was a neat village. Very hilly. Very snowy. Not terribly cold most days.




Beautiful sunrises.


Cute kids wearing wolverine jackets


Dogsleds




Antler Roofs


Rusty Gas Pumps (???)


We worked hard that day and all day Friday - from 8 am until 10 pm on Friday.

We were tired.


I think we did alright work. That will remain to be seen when others look at our charts though. It was hard. It was tiring. My back will never be the same both because of the sleeping arrangements and the awkward position I stood in for a week doing eye exams.

We eventually left not getting back to Nome until Saturday afternoon around 3 pm.

We flew to Nome via three other villages in the wind and ice. It was scary.

Icy Runways




Beautiful views


All in all a good trip.