by Donna Bach, YKHC Public Relations
Following the schedule of a Community Health Aide Practioner is busy. Wait, it’s more than busy. It’s complicated, intricate, detailed oriented, requires spreadsheets galore as well as comprehensive knowledge not just about the common cold, emergencies and what to do in crisis or emergency situations, it requires patience, comprehensive computer knowledge, charting, clear communication and an overall (and overwhelming) knowledge of not just YKHC’s RAVEN system, it goes beyond that. It requires comprehensive use of the Yup’ik language, inter-tribal and local community politics and understanding all other CHP’s certification levels, schedules, family dealings, deaths, subsistence leave and then some.
Welcome Anna Tinker, CHAP and Supervisor Instructor who is our featured provider profile for the May Messenger. Anna, born in an area near the tundra village of Kasigluk. She grew up and remembers “ellanaq” or “becoming aware” in a subsistence camp with her family. One of six surviving children out of ten, she attended and moved with her family to Kasigluk. She grew up in the village and attended Chemawa, a Native boarding school in Salem, Oregon for three years of high school from 1964 to 1967.
“It was different from Alaska. Everything –it was a city, different from a village there were stores and everything. I liked it there. The first night I almost didn’t sleep at night from loud trains passing our dorms that shook everything. By the second night maybe I was so tired and fell asleep better. From then on I never heard the trains passing. Our dorm was right near the railroad tracks.”
This formal education proved meaningful to Anna. In my brief interview before we boarded our flight to acknowledge the grand opening of the “miracle clinic” of Atmautluak, I learned so much about Anna. She mentioned, “I didn’t decide to become a Health Aide. While I was staying home I got a call from the tribal council requesting me to come in for an interview. I said ‘no, not me, my husband signed me up.’” She moved to Bethel in 1982, took the training and started up full time in 1983. In 1988 she was promoted to primary and became a Supervisor Instructor (SI) in 2001.
“My husband forwarded my name to be considered for the position. I was nominated, basically. I remember how much fun it was learning from Linda Curda and taking the ETT class from Alex Felker. It was really fun training and it reminded me of the coursework I took in biology lab. When I started working, I really loved it.”
Anna, now separated from her husband, has seven children and thirty grandchildren. “I have so many (grandchildren) and I love them all.” Most of her children still live in the village and the region.
In her role as SI, she loves working with her direct reporting Health Aides. She travels a lot and commends them for their hard work and thanks them for serving their communities, especially after experiencing challenging times such as emergencies. She oversees Health Aides who work in Holy Cross, Atmautluak, Chefornak, Toksook Bay, Kwigillingok and Nightmute. “When I have to do follow up on field work with Session I, II and III Health Aides, I check on them, observe and speak with their managers to make sure they are performing the proper follow-up according to the Community Health Aide Manual (CHAM).
“I remember when I was first in Session I, I was eager to learn about human anatomy and understand illness assessment and diagnosis. I really love and enjoyed working with the patients.”
Amidst working and raising her family and young children, she recalled enjoying her time because it was as if she was somewhere else. She understands the complex nature of illness and proper diagnosis, saying, “We never tell patients ‘you’ll be okay’ especially if there are underlying issues beyond the scope of our training. We always refer to our CHAM and stating that ‘I am here to help you and give information to the presiding physician or doctor to give you the right medicine to help whatever might be ailing them.’”
When asked about certain emergencies or situations she said, “There is always help, from other Health Aides who were serving in the village. I didn’t mind taking care of little emergencies. I never felt alone and the doctor is always there, one phone call away.”
Before the movement to encourage prenatal or “Be In Bethel” dates, Anna recounts helping with appropriate and urgent referral for early delivery and medevac of twins out of the village by helicopter to Bethel then onto Anchorage. “We never tried to show our fear. I helped with IV fluids before the chopper came to get her and I was so happy to provide an IV. When the chopper got her, they medevaced her successfully to Anchorage where she delivered two healthy babies.”
Anna finds her work very rewarding. When asked how tribes or communities could best support their local Health Aides she said, “show appreciation for them by hosting potlucks, thanking them. When they have a community potluck, give them some type of appreciation gift.” She hopes more community members are sensitive to the “on-call” nature of their job by not calling or bothering them frequently in the middle of the night for minor illnesses or questions that can wait “because our Health Aides may need their rest for the day, too.”