Thursday, August 07, 2008

Health And Human Services Secretary Mike Leavitt Visits Kwethluk In Southwest Alaska, Declares "Honeybucket Lake" Unacceptable

On Wednesday July 30th, 2008, the U.S. Secretary of Health and Human Services Mike Leavitt visited Southwest Alaska, and his stop in the Yup'ik village of Kwethluk as part of a three-day tour of the area conferred a better understanding of the problems which frequently contribute to health problems among the Alaska Native community. Full story published July 31st, 2008 in the Tundra Drums, a weekly paper serving the residents of the Lower Yukon-Kuskokwim Delta in Southwest Alaska. This story did not show up in the bigger Alaska media.

Leavitt's most vivid memory will be a feature called "Honeybucket Lake", a festering sewage lagoon on the edge of the village of 750 people. And he wasted no time in pronouncing it "unacceptable". Frothy, olive-colored “Honeybucket Lake,” as residents call it, is where the village dumps its feces because, like dozens of rural Alaska communities, it lacks flush toilets and running water.

Diapers, toilet paper and plastic trash bags sat in the muck and ringed the muddy banks. A wide trail of trash rose up a far bank. “When it floods, it seeps out, mixing with floodwaters that reach town and turn dirt roads into a soupy mess", said tribal administrator Herman Evan.

He and other village leaders suggested that may be one reason children often miss school with diarrhea, fevers and other illnesses. Also, the lack of tap water makes it difficult to wash hands – most villagers draw their drinking water from the Kwethluk River. Other health problems discussed include the fact that Native women have the highest per capita rates of cancer mortality in the nation, and that Natives suffer the nation’s highest per capita rates of dental disease and are plagued by diabetes, suicide, respiratory illnesses, obesity and accidental deaths often caused by alcohol.

Leavitt's hosts offered reasons for the illnesses, such as limited access to hospitals and a lack of flush toilets and easily available drinking water. Other reasons mentioned include dust clouds that fill villages during windy summers and a changing diet with more processed foods and less wild meat. Many Natives also make poor personal choices, using drugs, drinking liquor or eating too much junk food, they said.

Leavitt's host also explained what they've been doing to combat the problems. Health care improvements have been made in recent years. The Yukon-Kuskokwim Health Corporation (YKHC) has built dozens of clinics and employs health aides who provide basic care in 50 communities. It's also capitalizing on telemedicine, even providing patients with psychiatrists through videoconferences at the Bethel hospital. And it recently launched a program to put dental health aides in villages. The aides are a step below dentists and can extract and fill cavities. But the officials told Leavitt the system needed more money to hire health care professionals, study illnesses and to build facilities such as a regional nursing home in Bethel so dying elders are no longer sent 400 miles to Anchorage.

Leavitt said he requested the Southwest Alaska tour to understand the unique challenges facing Bush health care and to see solutions offered by the tribal-run hospital that provides services across the Yukon-Kuskokwim Delta. He said he was impressed with the high “degree of ingenuity” and passion employed by health aides, administrators and others who are trying to fix the problems. Leavitt also said the trip gave him an eye-opening view of village life that will lead to better-informed decisions as he reviews budgets totaling in the hundreds of millions of dollars.

Commentary: The small population and large area make it difficult to develop a modern economy in the area. Most residents live a subsistence lifestyle to augment their relatively small incomes. The sudden spike in fuel prices, the impact of which is described HERE, has strained their ability to cope economically. When local residents must pay up to 40 percent of their income for fuel, it inhibits the ability to upgrade amenities such as water and sewage. I hate to think what Kwethluk smells like when that "Honeybucket Lake" seeps out into the village.

The cultural divide between Native Bush Alaska and urban Alaska is also a limiting factor. This cultural divide recently re-surfaced in Point Hope when a number of caribou were found massacred and left to rot. There is dispute over how many; while news reports stated 60-120, there are now unsubstantiated reports that Point Hope Village President Jack Shaefer claims that there were considerably less. The report was passed on by KFQD's conservative shock jock Dan Fagan on Wednesday August 6th, but has not been substantiated by any media outlet.

Mike Leavitt has served as HHS Secretary since 2005. Before that, he served as EPA Administrator from 2003-2005, after serving as Governor of Utah from 1992-2003.

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