National health officials praise the benefits of traditional food

The importance of traditional Inupiaq food and the danger of environmental changes to health were among the topics national and local health professionals in Northwest Alaska discussed last week.

Several health officials — including Assistant Secretary for Health for the U.S. Department of Health and Human Services Admiral Rachel Levine and, for a part of the trip, Director of the Indian Health Service Roselyn Tso — visited Nome, Savoonga, Kotzebue, Kiana and Utqiagvik last week.

“It was comforting that they came all the way out here to see how our rural health system operates and are interested in the climate change and how our telemedicine works and how we communicate with our providers,” said Kiana Clinic Supervisor Ryan Morris.

The goal of the trip was to learn about the challenges of providing care in rural Alaska and to look at some of the issues that affect health equity, Levine said. Tso agreed.

“The true essence of the unique health-related needs and concerns can only be grasped when you witness and listen to the voices of these communities firsthand,” Tso told Sounder in an email. “The leaders, staff and residents we encountered offered invaluable insights into the possibilities and obstacles encountered by Alaska Native communities.”

Importance of telehealth and safety

Receiving healthcare in remote villages like Kiana often means using telehealth technology, Morris said.

“One of the aspects of our clinic — and it’s one of the few in our region — we can have VTC (video teleconference), kind of like Zoom meetings, with doctors over the phone, whether it’s for chronic or whether it’s for emergencies,” Morris said. “It’s one of the big highlights that we wanted to emphasize that it should be all of the villages have this option so that we can better care for our patients. It just makes it a lot more smoother.”

To better represent the process, Levine said the visitors had a telehealth visit with a Fairbanks-based physician who demonstrated how the technology helps health professionals conduct nose and throat exams.

Still, the intermittent connection can make telehealth services less reliable, Levine said.

The main issue Morris shared with the visitors was ensuring the safety of village health professionals. When someone in Kiana is in crisis, she explained, health professionals are the ones responding to the situation, with the goal to de-escalate it, provide health care and “enforce a stable environment for everyone.”

“One of the challenging things for our village, I’m sure it’s in all of them, is safety. Healthcare providers are responding to calls that are unsafe, but we’re the only first responders in our village, we kind of have the obligation to care for these patients.”

To address the safety situation, Morris said Maniilaq is working to secure funding to fill security positions for a few villages.

“Public health safety is a very important issue throughout rural Alaska,” Levine said. “We are pleased to discuss this with our public health colleagues in rural Alaska and in Washington DC.”

Food is medicine

In Kotzebue, the health professionals visited the Maniilaq Health Center; Utuqqanaat Inaat, or Kotzebue’s senior housing center; and a traditional food donation center and food storage facility called the Siġḷauq. They also toured the town and participated in fishing activities.

“It was really special: they had thrown out some nets and actually caught salmon, and we got to pull in the salmon,” Levine said. “I’ve never experienced anything like that.”

In Kiana, accompanied by the mayor, health officials went to the Kiana Community Health Center, as well as to the Kobuk River.

“They talked a lot about, of course, their subsistence lifestyle, and the importance of food and salmon and freshwater fish and moose and caribou, waterfowl,” Levine said.

The visit majorly focused on nutrition, the benefits of serving traditional Inupiaq food and programs such as Food Is Medicine — especially in long-term care facilities, Levine said.

“You can see that here, the impact of nutrition on the patients that they serve, and also particularly the Elders that they serve in the senior living facility,” Levine said. “They’re able to serve traditional foods, which they find has really helped them both nutritionally and medically as well as in terms of their mental health.”

In fact, the visiting group had a chance to see and taste the traditional Inupiaq food at the end of their visit to Kotzebue, in the Utuqqanaat Inaat, the senior housing center.

“We had salmon, both some smoked salmon and kind of a salmon cake. There was seal oil and there were two different forms of serving of whale. And then Eskimo ice cream,” Levine said. “It was just a unique experience to get the flavor of real Alaska and rural Alaska.”

Climate change

In terms of challenges, health professionals discussed the effects of climate change on health, subsistence hunting in the villages and the availability of nutritious traditional food, Levine said.

In Kotzebue, Cyrus Harris, who is in charge of Maniilaq’s hunter support program, and other local experts spoke to national guests about the changes in caribou migration, the delays in the formation of sea ice and an increase in invasive species of fish such as pollock and Pacific cod, Levine said.

“The range of the caribou and then when the caribou come down from the north seems to be different,” Levine said. “They talked about changes in the sea ice in terms of the timing so that it starts later and ends earlier. And of course. that really impacts traditional hunters who go out to hunt on the sea ice, to hunt, seal, walrus and whale.”

Local providers pointed out that recruiting healthcare and behavioral health professionals to the area is also hard. Levine said that HHS could try and help recruit more officers “to come particularly to Alaska.”

Overall, the goal of the trip was to listen and learn more about the existing challenges and opportunities in rural Alaska so that in the future the HHS staff can work with the local communities to find solutions together, Levine said.

“Everything has to be viewed with the lens of the local people, you know, of the Alaska Native people, and each tribe is different and their challenges are you unique,” she said. “When we come, we have to have humility, that we don’t have all the answers, and we don’t really know the circumstances in the villages. It has to be a partnership and a collaboration.”