OPINION: Alaska has its health care challenges, but its system works well at providing care

I read with interest the commentary, “Addressing maternity care deserts in Alaska,” by Madisyn Parker. Since I am a physician who specializes in maternity care and lives and works in Alaska, I thought I would share some thoughts based upon personal experience.

The dictionary defines a “desert” as an area devoid of water or life. I used to live in Arizona, and much of Arizona, to the casual observer, appears to be a desert. But when the sharp eye looks more carefully, the Arizona desert is actually teeming with life.

Geographically, Alaska is the largest state in the country. According to government data, there are some 162 communities in Alaska organized as a city or borough. In addition, there are at least 229 Alaska Native villages recognized by the federal government. Health care for anyone, especially for mothers and children, is not an easy thing to perform in Alaska. However, despite the vastness distances of Alaska, the sparse population and the tremendous challenges, I would not consider Alaska to be a maternity or child care desert. Like the Arizona desert, the maternal and child health care in Alaska is teeming with life.

Nearly every Alaska village, no matter how small or remote, has at least one health aide who serves a vital role to help monitor the health of pregnant women or young children. Many villages or remote communities also have a nurse practitioner or physician assistant available. When a patient is identified as pregnant, patients receive important teaching about nutrition and healthy lifestyles, are offered common medications such as prenatal vitamins and iron, and are aligned with a health care team to receive prenatal care. Significant efforts are expended to ensure that children receive routine well-child health care, dental care and standard immunizations.

There is a vast system of health care that funnels patients to larger and more complex hospitals and health care facilities in the state. For example, the Yukon-Kuskokwim Delta region is made up of 75,000 square miles, with a population of more than 23,000 people who live among 58 rural communities not connected by road. Bethel, the regional service and transportation hub, has a hospital and clinic staffed with excellent health care practitioners who also visit the villages to bring health care to the people. There are multiple larger communities throughout Alaska that serve as hubs for smaller and more remote villages. These hubs in turn, refer patients to Anchorage when the health care needs dictate.

Technology also plays an important role in health care in Alaska. Patients can connect by Internet or phone for medical care and teaching. We can and do monitor conditions such as diabetes or high blood pressure in pregnancy by use of Internet or phone. In addition, numerous and highly dedicated health care practitioners that includes OBGYN and family physicians, certified nurse midwives, nurse practitioners, physician assistants, nurses, and other more specialized physicians such as pediatric cardiologists, crisscross Alaska through outreach clinics to see patients and improve health care for pregnant women and children in rural and remote areas.

Alaska has the largest and most complex air transport system in the United States. Medical evacuations and transportation of patients is performed on a daily basis across Alaska. Patients can be transported from a remote village to a regional hub, or to Anchorage, or even beyond to highly specialized hospitals available in Seattle or Portland. These medical evacuation teams are superb and risk their lives to transport patients across Alaska when the need arises.

Several communities are equipped to have pregnant patients stay close to the hospital during the latter part of the pregnancy. Patients who live in the Y-K Delta can stay in Bethel, or they might travel to Anchorage. Patients in Southeast Alaska might stay in Sitka or Juneau, or come to Anchorage. Patients in the north might stay in Fairbanks. Alaska Medicaid and most private insurance companies are helpful in assisting with travel arrangements from their home village or community to a more robust health care facility. Most of the regional health care corporations also assist with funding for patients who need to stay in a large community for pregnancy or their child. In Anchorage, patients can stay in local hotels, the Ronald McDonald House, the Hickel House, or other places if necessary. Once a patient delivers her baby in Anchorage, she will receive assistance to return home with her baby and follow-up is arranged to check on the health of the mother and newborn baby. This includes lactation assistance for those mothers who choose to breastfeed their baby.

All in all, considering the unique challenges of patients and their families, Alaska is a wonderful place to live. Although the challenges of providing high-quality health care to pregnant women and children are immense, thanks to the dedication and commitment of many outstanding health care professionals and committed organizations across the state, Alaska is a national leader in health care outcomes.

Dr. Dana P. Damron is an Anchorage-based physician specializing in maternity care.

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