Health care providers in New Jersey could learn a thing or two from their colleagues in Barrow, says Program Assistant Emily Bass. In this blog post, she shares her impressions of the 2014 Healthy Living Summit in Barrow and compares what she saw there with a real-life experience a few days later in New Jersey.
Where would you rather be if you lived alone, broke your leg and became unable to fend for yourself — in Barrow or in Spring Lake, New Jersey? That’s an easy call for me, based on my experiences the last couple of weeks. From what I saw, the care in Barrow would compare very favorably to the care in New Jersey.
I recently had the opportunity to attend the first ever 2014 Healthy Living Summit in Barrow sponsored by North Slope Borough Health and Social Services (NSB-DHSS) and Arctic Slope Native Association (ASNA). The summit theme was “Sharing Knowledge ~ Strengthening Communities,” to focus the group on the intent to “share only the best and most effective ideas from within the health care arena.”
Attendees included community members, high school students and health care providers. Although I was able to attend only the first of the three days, I came away with a budding understanding of the tribal health care system, the efforts of the North Slope Borough to make its region one of the healthiest, and the mindful attention to detail by ASNA when it comes to access and delivery of health care for their people.
I noticed a sense of pride from the speakers about their health care systems and I thought that was a bit curious. In my own experience with health care institutions, I had never seen anyone take personal pride or ownership of the system as each of these people did. Katherine Gottlieb spoke of the Southcentral Foundation’s Nuka System of Care and all they do for their “customer-owners” as well as their employees. Barrow Mayor Charlotte Brower spoke about focusing on her community and the importance and value of good care of all kinds for a person’s overall health. Looking around the audience I saw youth and community members of all ages taking part in the conversation – not just the providers talking about the problems and how hard they are to solve.
Dr. Daniel Dickerson, assistant research psychiatrist for the Integrated Substance Abuse Programs at the University of California in Los Angeles, spoke about his work with drumming assisted therapies and the benefit of it as a culturally inclusive substance abuse treatment program. Dr. Dickerson’s research shows how an activity that speaks to one’s heritage, something they can take with them and feel accomplished in, has long term healing effects for those who have experienced trauma.
Other topics covered throughout the summit included: Bullying Intervention for Young People, Suicide Prevention and Intervention Training, The Mental and Emotional Effects of Substance Abuse Among Youth, and A Comprehensive Look at Health Care on the North Slope.
The session on A Comprehensive Look at Health Care on the North Slope was eye opening. The session outlined how to navigate and access the tribal health care system — the innards of which are extremely complex to the outsider looking in for the first time. One speaker noted that it took her two years to grasp the system. I walked away with a greater understanding – enough to take a stab at explaining it myself.
The North Slope service relationships begin with DHSS of the North Slope Borough. These services overlap and are complemented by ASNA. ASNA overlaps and is complemented by the Alaska Native Tribal Health Consortium (ANTHC), and finally ANTHC overlaps and is complemented by contracted health care services such as non-tribal hospitals both in and outside the state. The way the system is integrated from community to region to state is impressive. There is clear oversight for each of the entities as well as joint contributions to the efforts for the whole system throughout the state.
Before I hopped on the plane back to Anchorage, Samuel Simmonds Memorial Hospital Administrator Jeff Prater took me on a tour along with a small group from ANTHC. It was very impressive. They seemed to have thought of everything possible to make their owner-users feel welcome and cared for. The setting radiates healing in a community and culturally fitting way – right down to the gender appropriate Eskimo silhouettes used to indicate male and female rest rooms. I wondered if anyone in my health care system took such pride in their place of health care.
The next day, I hopped on another plane to Spring Lake, New Jersey, to care for my 80-year-old aunt who lives alone and took a bad fall, breaking her leg. A family friend took her to the local community clinic where they took an x-ray, put a splint on it, told her not to put any weight on it and sent her home. No walker, no crutches, no assistance. She was swollen and black and blue, anxious and frightened. Her foot was facing 45 degrees off center. She has insurance and even the money to pay for rehab while she heals. But no one asked if she lived alone or how she would fare in this new situation. She didn’t think to tell them or to ask for help. She trusts her health care providers to know better than she does how the system works, what she is entitled to and what is best for her.
In my six days there, I never did get to speak directly to her doctor or even get her in to see him. I found her a wheel chair and a home care aide until she does get in. I found an advocate to speak for her at the doctor’s office and a medical transport to get her there because the person making the appointment, two weeks out, didn’t think to ask her how she would get there.
I couldn’t help thinking about the cozy hospital in Barrow and how my auntie would have been cared for there, how the system would have worked for her and fostered her healing, inside and out. They would have provided better care than even I, her jet-lagged niece, was able to muster as I struggled to navigate a system not designed to take its users into account. The most ironic part is that she lived there her entire life, volunteered in the hospital, and delivered meals on wheels. Yet the institution in her community couldn’t take care of her. The North Slope Borough and the entire tribal health care system can certainly be proud of themselves. The pride I witnessed no longer seemed curious, but well-deserved. And the source of that pride – that focus on care and consideration for the user – should be copied far and wide.