Where No Roads Lead_303.pm7 - Yukon

YKHC
YUKON-KUSKOKWIM HEALTH CORPORATION
Dear Prospective Employee:
Thank you for your interest in employment opportunities with the YukonKuskokwim Health Corporation in Bethel, Alaska.
We believe that working and living in Bethel provides a unique opportunity
to experience the Bush lifestyle in an area rich in native culture and traditional customs, yet with modern conveniences and amenities to ensure a
comfortable and safe community environment.
A new era of Tribal Unity began in 1995 under the Alaska Tribal Health
Compact. The 58 federally recognized tribes of the Yukon-Kuskokwim
Delta joined nearly 200 other Alaska tribes to identify and set priorities in
the advancement of the health of the Native people of the state. The
transition from government-operated health care to a managed-care delivery
system has already resulted in improved service and quality.
YKHC employs dedicated people ranging from village-based health aides to
the Bethel-based health care providers and administrative staff. These
positions require truly adventuresome, but concerned employees who are
looking for an Alaskan experience. All of our staff are committed to
improving both the quality and continuity of health care in the region and
are proud to be a part of the vision and mission of the Yukon-Kuskokwim
Health Corporation.
The information in this booklet was compiled to provide you with the
ability to make an informed decision regarding employment with YKHC.
We encourage you to study the information contained in this booklet, and
we invite your questions regarding any of the material presented.
"Fostering Native Self-determination in
Primary Care, Prevention and Health
Promotion..."
Where No Roads Lead
Where No Roads Lead
Making Your Way to Bush Alaska
© 1998, Yukon-Kuskokwim Health Corporation
YKHC
P.O. Box 528
Bethel, Alaska 99559
Contact YKHC Professional Recruiter: 800-478-8905
Third Edition Published 2/00 — Material is revised annually to reflect
continuing changes relevant to a progressive corporation and a growing
community.
Special thanks to Michael Faubion, Media Services Coordinator, and Rose
Henderson, Media Services Specialist, for editorial and technical assistance
in the production of this publication.
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Yukon-Kuskokwim Health Corporation
Where No Roads Lead
Making Your Way To Bush Alaska
Contents
The Mission ..................................................................................................... 4
The Corporation ............................................................................................... 5
Community Services & Tribal Support.. ............................................................ 7
The Hospital .................................................................................................... 9
Region Map ..................................................................................................... 14
The Yukon-Kuskokwim Delta ........................................................................... 15
Bethel .............................................................................................................. 18
Amenities... ..................................................................................................... 22
Transportation .................................................................................................
26
YKHC
Communication ............................................................................................... 28
Getting Started in Bethel .................................................................................. 29
Utilities and Deposits ....................................................................................... 31
Relocation Assistance ...................................................................................... 33
Further Reading ............................................................................................... 35
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Where No Roads Lead
The Mission
of the Yukon-Kuskokwim Health Corporation is to achieve the greatest
possible improvement in the health status of the people of the YukonKuskokwim Delta region of Alaska.
We are committed to the development of culturally relevant programs
for primary care, prevention, and health promotion in a setting that
fosters Native self-determination in the control and management of
health delivery.
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Yukon-Kuskokwim Health Corporation
The Corporation
The Yukon-Kuskokwim Health Corporation provides health care in the
Yukon-Kuskokwim Delta region of Alaska, an area the size of Oregon,
under the authority of 58 federally-recognized Tribes and pursuant to a Title
V Compact with the federal government under the Indian Self-Determination Act. Our four-tiered health care delivery system includes village clinics
in approximately 50 villages, subregional clinics located at rural hub
communities, a hospital in Bethel, and by referral for tertiary services
outside of the region in Anchorage.
Our services include primary health care (including community health aide)
services, dental, optometry, behavioral health (mental health and substance
abuse), air ambulance, home care, health promotion and disease prevention,
and environmental health services.
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Where No Roads Lead
Community Health Aide Program
Community Health Aides in village clinics are able to perform minimumdifficulty screening tests, make physical assessments and offer treatment
locally within the limits of their training.
Health Aides are trained and certified in
basic life support and emergency medical
services through YKHC’s own Health Aide
Training program and the EMS Department.
Health aides are in daily contact with
physicians to whom they describe their
patients’ symptoms. The physician may
suggest treatment or recommend that the
patient go to a subregional clinic or to the
regional hospital in Bethel.
Subregional Clinics
In 1995 the first Sub-Regional Clinic opened in Aniak, the Clara Morgan
Sub-Regional Clinic. Two more Sub-Regional Clinics opened in 2001 in St.
Mary’s and Emmonak. Sub-Regional Clinics are built in hub communities
in the Y-K Delta to serve smaller surrounding villages.
Sub-Regional Clinics provide medical care through midlevels and Community Health Aide staffing. Other services include radiology, laboratory,
dental, optometry, behavioral health, nicotine cessation and float coat sales
through the corporation’s Injury Prevention office. These clinics provide a
medical link closer to villages than Bethel, which decreases travel time and
expenses.
The next Sub-Regional clinic is scheduled to open in 2004 in Toksook Bay.
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Yukon-Kuskokwim Health Corporation
Health Services & Tribal Support
In addition to general medical care, YKHC offers—
• Substance abuse counseling at the village level and treatment at the
Phillips Ayagnirvik Center in Bethel;
• Crisis counseling, treatment, inhalent abuse programs, and residential
services through Behavioral Health Services;
• A health aide training program including a distance education center.
• A home care program that is expanding its services to all villages, and
adding skilled nursing services in Bethel and, when able, to surrounding
villages.
• An emergency medical services training and certification program;
• Health education and disease prevention outreach programs for nutrition,
family planning, FAS/FAE prevention,
oral health, hygiene, tobacco cessation,
inhalant abuse, public health, and more;
• Technical assistance and training for
communities and Tribal governments
for operation and maintenance of water
treatment facilities and for securing
funds to improve village water and
sewer systems;
• Some of YKHC’s administrative
services are extended to its Tribal
membership, including technical
assistance in grant writing, PL 93-638
contracting capability, clinic administration, technology and telecommunications expertise, access to information,
and graphic design.
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Where No Roads Lead
“Working in Bethel allows and
demands providers to use the whole
set of skills they have obtained...
Time spent here offers the
opportunity to help a population in
need while teaching and broadening
the provider and the person.”
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Yukon-Kuskokwim Health Corporation
The Hospital
The Hospital
The Yukon-Kuskokwim Delta Regional Hospital is a
JCAHO accredited facility, managed by the Yukon
Kuskokwim Health Corporation. The hospital is a
general acute care medical facility, well-equipped and
broadly staffed. Inpatient facilities include a 31-bed
combined medical-. In addition to five busy outpatient clinics and a full-service emergency room, the
hospital has a pharmacy, a lab, respiratory, physical
therapy services, social services, and diagnostic
imaging capability. Other outpatient services include
dental and eye clinics, residential and outpatient
behavioral helath services.
Village Based Services
Much of the basic care to the population is provided in home villages by
Community Health Aides—village residents with limited training in patient
evaluation/diagnosis who collectively see about 100,000 patients a year.
They obtain consults with the hospital medical staff by telephone or fax,
and have a limited formulary for Village based treatment. These unique
providers do an incredible job caring for a wide spectrum of problems, and
are a big part of what makes practicing medicine in Alaska special.
In addition to the village-based
health aides, each village
(populations of 60 to 1,000) has
an assigned physician in Bethel
who visits the village regularly
to see patients and work
alongside the health aides.
Public Health Nurses, dentists,
optometrists, and health
educators also regularly visit the
villages.
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Where No Roads Lead
Inpatient / Outpatient Services
The hospital averages well over 1,500 admissions a year to the adult/
pediatric unit, more than 115,000 outpatient encounters and approximately
18,000 emergency room visits. The obstetrics unit does about 500 deliveries
per year.
The hospital’s clinical model divides its team of physicians, pediatricians,
physician assistants, nurse practitioners and support staff into separate
teams, with each team responsible for a portion of the Delta’s population.
Each group includes a full range of
health care services—pediatrics,
women’s health and prenatal care,
family medicine, preventative care
and health education. Patients who
need further or more specialized
care than YKHC provides are sent
to Anchorage to the Alaska Native
Medical Center, Providence
Hospital, or another facility.
Patients may go to Seattle if the
care they need is not available in
Anchorage.
Dental Department
The YKHC Dental program has 11 dentists and 14 auxiliaries on staff who
handle about 40,000 cases year.
A large percentage of this care is given in the villages to children who suffer
from an unusually high incidence of dental disease. Poor diet and nutrition,
inadequate oral hygiene practices, and a lack of direct access to care are
contributing factors.
Baby Bottle Tooth Decay is of
particular concern in the YK
Delta. It has been found in 3050 percent of the Head Start
children in some villages.
In its severe form, it causes
acute pain, regional swelling,
and elevated temperatures.
Treatment of these cases
places a large demand on the
YKHC Dental staff and will continue to do so—studies have predicted a
huge population increase in the next 20-30 years.
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Yukon-Kuskokwim Health Corporation
Standard treatment of this
condition requires several
appointments for the child
where the teeth are
repaired with silver alloys,
composite resins, or
stainless steel crowns.
Multiple extractions are
also necessary. Frequently,
Native children are not
able to fully cooperate
emotionally with the
dental team to allow safe
or complete treatment
using routine methods.
These patients often must
travel to the Bethel hospital for emergency dental care. This usually consists
of restraint board, mouth prop, and exodontia. It is an unpleasant experience
for the child, the parents, and the dentist.
The difficulty in managing the special demands of the child with Baby
Bottle Tooth Decay at the YKHC Hospital has been a long term challenge
for the dental program. Many sedation patients have been referred into the
Bethel hospital by the village dentist only to find the sedation waiting list is
backlogged for many, many months. Very few families can afford to travel
into Anchorage for care by the Area Pedodontist. Therefore, many of these
children have had dental treatment needs which have gone unserviced.
In 1992 a program was begun to provide complete rehabilitation for
pediatric dental patients in the YKHC hospital operating room under
general anesthesia, thus returning their damaged dentition back to a healthy
functioning condition in one treatment appointment. Because there are risks
that may include life-threatening outcomes, and safety is the primary goal of
the program, general anesthesia is reserved for patients who cannot be
reasonably treated with other methods.
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Where No Roads Lead
Making a difference...
The spectrum of disease here is not only different than in the lower 48
states; it’s simply amazing in many ways. The following is the tip of the
iceberg:
• We manage severe hypothermia and frostbite regularly.
• We have the highest rate of adrenogenital syndrome in the world.
• We had the highest rate of invasive Haemophilus Influenza in the world
until about 1990 when as a demonstration site for the new generation H.
Flu vaccines we eradicated it as a problem.
• Invasive Pneumococcal disease occurs at 50 times the expected rate.
• About 1 in 10 patients are Hepatitis B carriers and Hepatitis A sweeps
through every 10 years or so infecting a couple thousand people (including medical staff)—we hope the new Hepatitis A vaccine does its job.
• We are one of the three sites in the U.S. where botulism úantitoxin is
stored—we average five cases a year.
• Tuberculosis never left our region. We have 40 to 120 new cases a year
and 95% of the population over age 40 is PPD positive.
• We have very high rates of bronchiectasis and TB induced COPD.
• Managing fetal alcohol syndrome, alcohol related trauma, and domestic
violence are sadly part of our regular work.
• Lung cancer from smoking is now the number one cause of death in
women and number three for men, although most other cancers also kill
at higher than U.S. reported rates.
• Our current epidemiologic study of severe RSV is producing numbers at
least 10 times higher than any previously reported in the world.
• Sero prevalence data for H. Pylori show that 50% of our kids are positive
by age 10, and that well over 90% are positive when adults.
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Yukon-Kuskokwim Health Corporation
Most clinical problems here are handled by the local medical staff—the vast
majority of our consults are by phone to our referral hospital in Anchorage.
Patients needing advanced care need to be stabilized for the one-hour air
ride to Anchorage. Our full staff consists of four pediatricians, and 16
doctors doing family practice (some of whom may be internists by training).
We also have a mix of mid-level practitioners—general PAs, family nurse
practitioners, and a certified nurse anesthetist. The staff is rounded out by
two radiologists, three optometrists, 12 dentists, two physical therapist, and
two nurse midwives. A few of the family practice doctors maintain/obtain
special skills so that they are capable of performing emergency C-sections,
ectopic pregnancy surgery, BTLs, treadmills, endoscopy, etc.
The nursing staff supports the providers in the care of this wide spectrum of
cases. It’s a challenge for them as well, but worthwhile for the same
reasons. Most of the nurses are already highly experienced in their area of
work, but soon become very skilled in all situations.
Working in Bethel allows and demands that providers use the whole set of
skills they have obtained. The practice of medicine here offers much to
those willing to meet the challenge. Although divided into three groups for
many aspects of the work (primarily clinics and village care), the job gets
done through team work; the knowledge and skill of the group is almost
always adequate to succeed.
Time spent here offers the opportunity to help a population in need while
teaching and broadening the provider and the person.
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Mekoryuk
Newtok
Scammon
Bay
Chevak
Kipnuk
Chefornak
R
IV
E
IM RIVER
Chuathbaluk
R
I
Lime Village
Stony River
Sleetmute
Georgetown
Red
Devil
R
Crooked
Creek
Napaimute
Aniak
Russian Mission
Kongiganak
Kwigillingok
Quinhagak
Eek
Tuntutuliak
O
Holy Cross
Anvik
Shageluk
Upper Kalskag
Lower Kalskag
Ohogomuit
Mountain Village
St. Mary’s
Andreafski
Pitka’s
Pilot Station
Point
Marshall
YUKON RIVER
Grayling
KUSKOKW
Nunapitchuk
Tuluksak
Akiak
Tununak
Kasigluk
Toksook Bay Atmautluak Bethel
Akiachak
Umkumuit
Napakiak
Nightmute
Kwethluk
Oscarville Napaskiak
Hooper
Bay
Paimute
Sheldon
Point
K
INNO
Kotlik
Billmore Slough
Hamilton
HO
A
N
LI
T
R
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VE
Emmonak
Alakanak
Where No Roads Lead
Yukon-Kuskokwim Delta Region
Yukon-Kuskokwim Health Corporation
The Yukon-Kuskokwim Delta
The Yukon-Kuskokwim Delta region of southwest Alaska is a complex
network of rivers, ocean tidelands, lakes, sloughs and ponds that have
shaped and reshaped a soft sand and silt landscape until it looks like an
abstract lace scarf at the throat of the state map.
The Delta is named for
the two great rivers that
run through it—the
The Yukon Kuskokwim DeltaYukon and Kuskokwim.
With the tons of sediArea: 75,000 square miles
ment these rivers bring
Population: 25,500
from deep in the interior
of Canada, the Alaska
Density: Less than one person
Range, and the
Kuskokwim Mountains,
for every 3.5 square miles!
they have created the
land they flow through.
Most of the Delta lies on a deep layer of arctic permafrost.
The melting and refreezing forces of the permafrost near the surface play
havoc with human attempts to tame the wilderness. Few roads have been
built; fewer still have been paved. Homes must be built on stilts so they can
be easily leveled when the ground they rest on heaves and sags. Pipes for
carrying water and sewer waste can’t be buried lest they bend, break, freeze
up, or thaw the ground itself.
The YK Delta is a vast arena where two great weather systems meet and
struggle. Wet blustery marine weather from the Gulf of Alaska and the
Bering Sea advances and retreats against cold dry icy weather from the
interior of the state. Sometimes deeply frigid arctic air sweeps around the
Arctic Ocean, over the Brooks Range and down into the Delta, driving
temperatures to minus 40. Temperatures in the winter can range from that
cold extreme to 30 or 40 degrees above zero—sometimes in the course of a
single day. For the most part, during the winter, the weather systems
grudgingly share the region—two weeks of cold clear minus 20-degree days
will be followed by a week or two of windy, snowy (or rainy) 20-to-30above weather. Snow begins falling in late October. There is often a thaw
around Christmas time, a hard cold spell in January and February, lengthening sunshine in March, and a general meltdown in April. All the rivers and
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Where No Roads Lead
ponds are frozen over
from the end of
November to the
beginning of May.
Break-up, when the
ice moves out to sea
(often accompanied
by floods), signals the
beginning of summer.
Temperatures seldom
climb above 70, but
the days of long
sunshine quickly turn the landscape green. Thousand of birds return to the
region to nest in the wetlands. Millions of mosquitoes come to life. King
salmon, red salmon, chums and cohos come up the river to spawn. Rain in
August announces autumn in September and soon it is winter again—the
season this northern place wears most comfortably.
The wide flat tundra, riverbank willow and scrubby spruce-covered Delta
takes up most of the Yukon-Kuskokwim Health Corporation service area.
Some villages, however, lie far enough upriver to be considered interior—
Aniak, Sleetmute, Stony River and Lime Village on the Kuskokwim and
Grayling, Anvik, Shageluk and Holy Cross on the Yukon. The mountain and
timber scenery here is more like the Alaska outsiders would recognize from
films and postcards.
The tundra landscape offers an unbroken vista to distant mountains. The
surface is rounded, molded by soft erosion—a velvety blanket of green in
summer, stern white in winter. Plant life includes low-bush blueberries,
crowberries, cranberries and salmon berries, with low-growing grasses and
shrubs rooted in a mat of lichens and mosses.
Wildlife
The region supports an abundance of fish and game. The Yukon Delta
National Wildlife Refuge, which covers most of the YK Delta, is a major
nesting grounds for thousands of waterfowl and shorebirds of the Pacific
Flyway and other parts of the world.
Besides waterfowl and small bird species, marine mammals, particularly
seals, walrus and whales migrate through the Bering Sea. Moose, bear, and
caribou roam the interior regions of the Delta.
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Yukon-Kuskokwim Health Corporation
Hunting, Fishing and Trapping
Dip netting for smelts (hooligan) in the spring along the Bethel seawall
begins the fishing season in the Kuskokwim River. Set-netting and drift
netting for salmon come next. There is excellent rod and reel fishing for
rainbow trout, grayling, northern pike, arctic char, dolly varden, sheefish,
and all species of salmon in the clearwater tributaries of the Kuskokwim.
Ice fishing for northern pike at the Johnson River below Bethel attracts and
brings together many people from different communities along the Kuskokwim River. Near Bethel, people jig for whitefish and lushfish (burbot) both
in summer and in winter. Many residents still practice the age-old method of
catching blackfish, a small and tasty foodfish, with a funnel-shaped trap
made of willow twigs.
Hunting for big game is done in spring, fall and winter. Many good locations can be reached by boat, snow machine or airplane. While moose and
caribou could be hunted near and far, wolf, wolverine, brown and black bear
can be found east of Bethel in the Kilbuck Mountains. Limited hunting for
muskox is allowed in the Nelson and Nunivak Island areas. Sometimes lynx
is caught, but hunting and trapping for fox, mink, otter and muskrat is
excellent. A popular annual event, the Mink Festival, encourages the
traditional and economic use of furs
and attracts hundreds of visitors to
Bethel from villages of the YukonKuskokwim Delta. Additionally,
snowshoe and Arctic hares, as well as
plentiful ptarmigans (a type of grouse)
can be found in close proximity to
Bethel.
With the numerous lakes, creeks and
sloughs surrounding the Bethel area,
waterfowl hunting is excellent and
locations can be reached by boat.
Canadian and white front geese,
cranes, swans, mallards, pintails,
shovelers, widgeons, blackduck
(scoters), green wing teal, scaups, and
goldeneyes inhabit the river waters and
marshy areas and provide good hunting
during open season.
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Where No Roads Lead
Bethel
History
Bethel was founded in 1888 by Moravian missionaries near the site of a
Kuskokwim River trading post called Mumtrekhlagamute Station. Yup’ik
Eskimos had lived in the area for thousands of years. The establishment of
the trading post began the village’s evolution into a trade and economic
center for the surrounding region. This identity and the resulting mixture of
cultures and life-styles has continued to the present.
Bethel’s early history continued to evolve around the Moravian mission and
the town’s role as a trading community. Bethel was also the upper limit for
ocean-going vessel navigation on the Kuskokwim River. The necessity to
transfer cargo bound for surrounding villages to smaller boats made Bethel
an early secondary transportation center as well.
Reindeer herding and fur farms were among the early industries in Bethel.
The first reindeer were introduced to Alaska in 1892 in an effort to revitalize the Alaska economy. In 1901, the Moravian Mission received 175
reindeer. By the 1930s, approximately 43,000 reindeer grazed along the
river. The population of reindeer gradually diminished and in 1946 only 600
remained. During the 1930s, several residents of Bethel owned fur farms
where mink and fox were raised.
During World War II, the military built a base and airfield near Bethel. With
the construction of an Indian Health Service regional hospital in the 1940s,
a river port facility, and a modern airport, Bethel’s importance as a regional
service center was secured. Today, the Yukon-Kuskokwim Health Corporation is the region’s largest employer, followed by the Lower Kuskokwim
School District and
state and federal
government agencies. Although
commercial fishing is
an important part of
Bethel’s cash
economy, the cultural
value of the annual
salmon run is far
more significant to
the Native subsistence way of life.
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Yukon-Kuskokwim Health Corporation
Bethel Today
Bethel is located on the Kuskokwim River
in Sourthwest Alaska, 400 miles west of
Anchorage, approximately 90 miles inland
from the Bering Sea. Population 5.500
Bethel is small in population compared to towns in
the Lower 48—5,500
people live here—but its
importance as a transportation and service hub for the
entire Yukon-Kuskokwim
Delta makes it a major
Alaska metropolis. Still, it
hasn’t outgrown its smalltown feel. Faces quickly
become familiar and soon
become friends. Neighbors
and co-workers help each
other out. The air is clean.
There are no traffic lights
and the traffic seldom jams
up for more than a few
minutes at the one major
intersection. It doesn’t take very long to get across town.
But Bethel is unlike most other American towns of its size—perhaps partly
because of the apparent contradictions, paradoxes: It is a commercial and
transportation hub, but is not situated on a highway. Cargo planes and air
taxis replace trains, trucks and cars. People come to Bethel from the villages
to shop, but there are no shopping malls or franchise super-stores. It’s in the
middle of a vast wetlands next to a huge river surrounded by ponds and
swamps; but delivering water to homes is expensive and complicated.
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Where No Roads Lead
Culture
Bethel’s population is about half Alaska Native—Yup’ik and Cup’ik
Eskimo and Athabascan Indian. Most villages are traditional Native
communities with 90 percent or higher Native populations, many of whom
speak their Native language exclusively. In addition to Native and nonNative, Bethel has a significant
population of mixed-blood families.
Missionaries, merchants and settlers
throughout Bethel’s history have met
and married Native partners, establishing families whose heritage
includes both the modern Western
and the ancient Native traditions.
The meeting of these two cultural
streams—the modern and the
ancient, the “kassaq” and the
Eskimo, (the Non-Native and Native)
is often described as a collision, with
the Native traditions faring the
worse—trampled and supplanted by modern ways. There is conflict and
confusion. It’s a challenge to Natives to hold on to their traditions and
values while at the same time being compelled by necessity to participate in
a culture of motors, computers, telephones, and cash.
While the conflict takes its toll, there is also a quiet and vital assimilation
going on. And it is two-way. In Bethel in particular, and throughout rural
Alaska, the Native traditions influence the Kassaq ways as well as viceversa. Native traditions have evolved over centuries in response to the
environment. Native language has evolved to describe it. With all its energy
and machines, western culture has not been able to change the arctic
environment; Native ways are still often the best for dealing with it.
There are also other cultural
streams pouring into the mix.
Greeks and Albanians, Koreans
and Filipinos have settled here,
vitalizing the community’s
cultural and economic fabric
and contributing international
specialties to the local restaurant menus.
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Yukon-Kuskokwim Health Corporation
Appearances
By most aesthetic standards, Bethel
is not a pretty town. Houses are
raised above the surface of the
ground on pilings, unarranged in
distinct subdivisions. Some are in
need of paint, with yards adorned
by upturned boats, rusty trucks, and stacks of building materials, palettes or
old tires. There is little in the way of landscaping and the gardens are few.
Most structures are utilitarian in design with the exception of a few public
buildings. The Yup’ik Cultural Center, the Bethel Fire Station, and the BNC
Office Complex are perhaps the most attractive buildings in town. The
hospital is probably the most striking and unusual.
Generally speaking, little attention is paid to appearances. The climate is
harsh, the environment extreme. It is more important that a building,
vehicle, road or piece of equipment serve its purpose well than look pretty.
People’s energy and time are more apt to be spent on activities that ensure
survival rather than those that enhance appearances.
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Where No Roads Lead
Amenities...
Activities and Recreation..
There are a number of all-community events during the year which bring
people together in a spirit of cooperation. The biggest ones are the Camai
Dance Festival and the Kuskokwim 300 Sled Dog Race. Camai attracts
Native dancers from all over Alaska, the Lower 48, and the world. The
country’s top dog mushers come to participate in the K-300. A big purse and
unpredictable race conditions make the K-300 an indispensable trial run for
the Iditarod. These and other
events need community
volunteers. After a while it
becomes difficult to not be
involved.
Bethel’s very active community theater group, the
Bethel Actors Guild,
produces four to six plays a
year, including musicals,
dramas, comedies and
children’s plays.
The Lion’s Club and the Veterans of Foreign Wars are two community
service organizations that raise money for scholorships and other worthwhile community causes.
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Yukon-Kuskokwim Health Corporation
The Bethel Council on the Arts sponsors the
Camai Dance Festival and other community
arts events, including the popular “Just
Desserts” concerts featuring local performers.
The annual Mink Festival is held each
December. Kuskokwim mink is famous as the
best wild mink in the world. It is a crafts fair
as well as a fur show where the best in Native
crafts, entertainment and home grown gifts
can be found.
Other groups, clubs and organizations abound,
offering opportunities to share interests and
get involved in the community—Boy Scouts
and Girl Scouts, a quilting club, a running
club and more.
There are plenty of both indoor and outdoor recreational opportunities:
boating, camping, cross-country skiing, snomobiling, walking and jogging,
ice-skating, volleyball, basketball, softball, weight-lifting, gymnastics, judo,
and more..
Schools
Bethel is the home of the Kuskokwim Campus of the University of Alaska,
Fairbanks. The college provides post-secondary and continuing education to
the residents of Southwest Alaska leading to certificates or associate
degrees, baccalaureate degrees and masters degrees. Continuing education
classes are offered in a variety of subjects, including Yup’ik language,
literature, art, stained glass, history, computer science, and other subjects of
general interest.
The Lower Kuskokwim School District, serving more than 20 villages, has
headquarters in Bethel.
In Bethel, there is the Bethel Regional High School (which includes juniorhigh grades), Kilbuck Elementary for second to sixth grade, and Mikelnguut
Elitnaurviat (ME) School for kindergarten and first graders only. Bethel
schools have an optional Yup’ik immersion program, in which classes are
taught entirely in the Yup’ik Native language.
Library
The Kuskokiwim Consortium Library serves the community’s needs and the
local college’s needs. Books, audiovisual equipment, records and cassettes
are available to the public. The library uses the State of Alaska film circuit
and State book depository and participates in the interlibrary loan service.
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Where No Roads Lead
Yup’ik Cultural Center
The Cultural Center was completed in 1994. It is the home of the Kuskokwim Consortium Library and the Yupiit Piciryarait Cultural Center
Museum. It has a large multi-purpose room where community events,
board meetings, Tribal gatherings, workshops and receptions are held.
Bethel Churches
Bethel Moravian Church
St. Sophia Russian Orthodox Church
Immaculate Conception Catholic Church
Church of Jesus Christ of Latter-Day Saints
Truth Missionary Baptist Church
Baha’i Faith
Bethel Community Assembly of God
Pentecostal Holiness Church
Bethel Covenant Church
Christian Science Church
Church of God of Prophecy
Seventh-Day Adventist Church
Bethel Korean Church
Bethel Independent Baptist Church
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Yukon-Kuskokwim Health Corporation
Shopping
There are three
“general stores” in
Bethel—Alaska
Commercial
Company,
Swanson’s, and
ANICA. In
addition to
groceries and produce, each store sells a variety of clothing, hardware,
appliances, furniture, dry goods and toys. Aside from the Alaska Commercial Company store, which is one of several throughout rural Alaska, a
NAPA Auto Parts store and a Radio Shack outlet, there are no franchise
stores in Bethel. No McDonalds, no Burger King, no K-Mart, no MinuteLube, no Holiday Inn, not even a Chevron Station.
There is a wide variety of locally-owned small businesses and specialty
shops offering goods and services such as video tape rental, pets and pet
supplies, auto parts and auto repair, beauty salon services, gifts, art and
Native art, crafts, marine services, travel services, insurance, home water
treatment, electrical and plumbing supplies, airline and air taxi services, car
rental, general contracting and much more.
For specialty items, bulk shopping and serious stockpiling, rural Alaskans
either shop by mail or make a periodic “trip to town” (Anchorage). Purchases can often be brought back on the plane as luggage, but if that is
impractical, the best deal is parcel post.
There is no dry cleaning facility in Bethel, but you can mail your cleaning
to Anchorage. These facilities are accustomed to handling requests from the
Bush.
Liquor
Alaska law allows individual communities to regulate alcohol locally.
Bethel is a “damp” town. Importation and possession of alcohol for personal consumption is allowed, but it cannot be sold in town. There is a limit
to how much an individual can bring in beyond which the law considers it
importation for sale. Arrangements must be made in person at one of the
bush-order liquor stores in Anchorage in order to import liquor into Bethel
for personal use.
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Where No Roads Lead
Transportation
Roads
The five-and-a-half mile road from the airport to the Brown Slough Bridge
is Bethel’s only paved highway. Ridgecrest Drive, which intersects the
highway at Watson’s Corner, is paved for about half a mile. There are
another 25 miles of unpaved road in Bethel. A few roads extend for a mile
or two beyond the edge of town.
During the winter,
the Kuskokwim
River is used as a
road and travel to
villages on the river
is possible by car
and snow machines.
During the summer,
these villages can be
reached by boat.
Trails
Where the roads end
the trails begin. A network of trails, originally sled dog routes, between
villages are now traveled mainly by snow machine. The snow machine is
the vehicle of choice for winter travel between villages in the Bush. Snow
machine trails are also handy for cross country skiing.
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Yukon-Kuskokwim Health Corporation
Airplanes
Bethel’s airport is one of the busiest
in the state. In addition to passenger
jet service to and from Anchorage,
there are many scheduled and
chartered small plane fights to and
from the villages of the region.
There are usually four passenger jet flights a day. The planes are configured
to haul more freight than people.
Cabs
There are almost as many taxi cabs in Bethel as there are in Anchorage. It
costs three to six dollars for a cab ride depending on how far you’re going.
Fares are not metered. Cabs are shared. A ride across town can result in a
tour of several neighborhoods and encounters with a variety of people.
Automobiles
Bethel has plenty of cars and trucks. The town is spread out just enough to
make places a little too far to walk to in the amount of time that is usually
available to get there. Four-wheel-drive sport utility vehicles (Broncos,
Blazers, Trackers, LandCruisers) are popular. There are a lot of pick-up
trucks and quite a few basic family sedans. Vehicles are brought to Bethel
by barge or cargo plane at a cost of about $2,500 to $3,500 depending on
the vehicle's size and weight.
The weather and road conditions are hard on cars. A vehicle with 50,000
Bethel miles has proved its worth. Used cars are usually very used and more
expensive than they should be for the condition they’re in. But buying a car
that’s already in Bethel is
probably still less expensive than
buying a car elsewhere and
transporting it in. There are no
new or used car dealerships in
Bethel.
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Where No Roads Lead
Communication
Alaska Rural Communications Service (ARCS) This statewide satellite
network shows network news, sports events, and selected dramatic and
comedy programs. Airs locally (in
Bethel) on Channel 4.
Alaska One—PBS “Superstation”
originating in Fairbanks and including local programming from public
TV stations in Bethel, Fairbanks, and
Juneau.
KYUK-AM is the local public radio
station carrying local news, music
and public affairs shows along with
National Public Radio and other
syndicated programming. KYUK is
part of the Alaska Public Radio
Network. Volunteers are appreciated.
The Tundra Drums and The Delta
Discovery are the two local newspapers. Both are published weekly and
distributed throughout the YK Delta
Local telephone service in Bethel is provided by Unicom Inc. Long
distance communications are through a satellite system. This is connected to
the Unicom Inc telephone system to provide long-distance service to Bethel
with your choice of long distance carriers, AT&T or GCI.
Cable TV: Bethel is served by a cable TV service that offers 46 channels.
The package containing premium channels and costs 86.90 per month.
Cable modems are also available and provided by GCI.
Internet: Local Internet access is available through two local internet
service providers. This service provides full Internet and World Wide Web
access. The cost ranges from $12.95 to $24.95 per month depending on
options. This could be purchased from Unicom Inc. or GCI.
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Yukon-Kuskokwim Health Corporation
Getting Started in Bethel
Housing
Housing in Bethel is likely to be very different from anywhere else you may
have lived. In accepting employment with YKHC, employees must understand that they bear the responsibility for securing their housing. To
facilitate an employee’s search for housing, YKHC will pay up to two
weeks temporary housing costs for the employee, employee’s spouse and
any dependent children. This time may be extended up to an additional 14
days. Approval and arrangements for obtaining temporary accommodations
are made with the employee’s department supervisor.
Because there are no real estate agencies in business in Bethel, a list of
Bethel landlords can be obtained from
the Housing Office by contacting (907)
543-6202 and from the Chamber of
Commerce (907) 543-2911.
If you would like to build your own
house, Lots are available for sale in the
Kasayuli Subdivision. If you are
interested in a lot, please call (907)
543-6029. This is available to YKHC
employees only.
Hospital Housing
Hospital housing is subject to limited availability on a first come/first serve
basis to hospital personnel only. Each of the 5 hospital divisions has an
allotted number of housing units, and units are assigned by the division
administrator. These
units are in constant
demand and may or
may not be available
during the period you
are employed by the
hospital.
Hospital housing is
governed by a Housing
Committee which
enforces rules and
regulations established
in the YKDRH Housing
Manual. One of these
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Where No Roads Lead
rules that applicants need to be aware of prior to accepting employment is
that pets are not allowed anywhere in the quarters or on the compound.
The hospital has 87 housing units — 47 efficiency and one-bedroom
apartments are located in an apartment building referred to as the “800
Building,” and 40 two- and three-bedroom apartments located in seven
“Townhouse” buildings. The 800 building does not accommodate children
over the age of 6 years old. Rent for housing is deducted from the
employee’s paycheck.
The 800 Building and Townhouse apartments contain most of the conveniences in the way of appliances, such as stoves, refrigerators, and dishwashers. There is access to several laundry rooms with washers and dryers
in the 800 Building, and a washer and dryer in each of the apartments in the
Townhouses. 800 Building rental rates are reviewed annually and adjusted
on October 1 of each year. Townhouse rates are established by the federal
government and, under present law, are adjusted March 1 of each year.
Monthly rental rates for the Townhouse apartments as of 3/1/99 are $521$570 for a two bedroom apartment which has 1100 square feet, and $615.00
for a three bedroom apartment which has 1220 square feet. Tenants are
responsible for the cost of electricity, telephone and cable TV; heating and
water are furnished.
Monthly rental rates for the 800 Building are $630 for an efficiency
apartment which has about 600 square feet, and $709 for a one-bedroom
apartment which has about 700 square feet. Rental rates include all utilities;
telephone and cable TV costs are the responsibility of the tenant.
If arrangements have been made for you to live in hospital housing by your
division administrator, you may contact the Hospital Housing Office at 907543-6202 to prepare for occupancy.
Corporate Housing
YKHC also has rentals located in Kasayuli Subdivision. These units are
Duplexes and are 3
bedroom units. The
rent price for these
duplexes is $1,500
per month and that
includes the fuel that
you use for heat.
Applications for
these rentals are
reviewed and
approved by the
housing committee.
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Yukon-Kuskokwim Health Corporation
Community Housing
Typically, houses in Bethel will have between 800 square feet (onebedroom) to 1500 square feet (two to three bedrooms) and will range in rent
from $1,100 to $1,800 per month. In addition to the monthly rent, tenants
will be responsible for some or all of the utilities. A deposit for first or last
month’s rent depends upon the landlord. We recommend that you be
prepared to put up $2,500 to $3,000 for out-of-pocket expenses for rent and
utility deposits.
If your current financial position requires, a new hire payroll advance may
be obtained when you report to work. NOTE: Payroll advances cannot
exceed one month’s salary and corporate policy requires repayment of
payroll advances through payroll deduction within a six month period.
Corporate policy is always subject to change.
Utilities and Deposits
Water and Sewer
Most of the homes in Bethel are not on a piped water system. These homes
receive water which is delivered by a truck once or twice a week, depending
upon the size of the water tank in the house. These homes also have their
own wastewater holding tanks which must be evacuated prior to the
delivery of additional water. Water in Bethel will be more expensive than
what you are presently accustomed to paying.
For instance, if you have a 1,000 gallon water storage tank (most tanks are
in the range of 500 to 1,000 gallons) and you have water delivered once per
week, you will be charged $94.06 per month (rate as of 9/1/96) for the water
delivery, and in addition you will be charged $80.00 per month for the
sewer tank evacuation.
If your house is on the piped water system, the monthly rates as of 9/1/96
are: water - $57.50; sewer - $18.00; garbage - $12.00; tax - $4.38; total $91.88. Fewer than 25% of the houses are on piped water.
Water/sewer/garbage utility service is provided by the City of Bethel. The
deposit will equal twice the average monthly bill for your place of residence. Contact the City of Bethel, Water/Sewer/Garbage Utility Services at
907-543-3150 to find out about the current rates.
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Where No Roads Lead
Electricity
Bethel Utilities Company (BUC) operates the electric plant in Bethel.
Depending upon where you live in town, the deposit can range from a low
in the summer of $175 - $450, to a high in the winter of $256 - $650. After
one year of good credit, the amount of the deposit will be applied to your
monthly electric bill. BUC will waive the deposit if you provide a letter of
reference from you previous electric company stating you have a good
credit standing with them. Contact BUC at (907) 543-2038.
Heating
Homes in Bethel are almost always heated by fuel oil. Each home has an
outside fuel tank, usually about
500 gallons. As of 3/12/03 the cost
per gallon for fuel oil is $2.15 plus
5% City sales tax. Most homes are
heated by a hot water boiler, which
is generally very efficient. A tank
of fuel can usually be expected to
last about two months in cold
weather, and much longer in warm
weather. There are two fuel
companies in town and deposits
average about $100 depending on
the amount of fuel your tank holds.
To arrange for fuel delivery, contact: Southwest Fuel Company (907) 5432632 or Hoffman Fuel Service (907) 543- 2430.
Propane
Some homes use propane fuel for cooking and clothes dryers which is more
cost effective than electricity. Contact North Star Gas (907) 543-4277; or
Hoffman Fuel Services (907) 543-2430.
Telephone
Deposits can range from $25 to $50 depending on what you estimate will be
your monthly long distance charges and whether you choose to have an
unlisted number. In addition, there is a basic installation fee of approximately $47.00 providing the company can connect your phone service from
its office. Contact Unicom Inc. (907) 543-2200.
Cable TV
GCI requires a deposit along with an installation charge. If you sign up for
the full cable package, your monthly fee will be approximately $86.90.
Contact GCI (907) 543-3226.
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Yukon-Kuskokwim Health Corporation
Relocation Assistance
YKHC provides relocation assistance to new employees and employees’
immediate families. To be eligible for this assistance, an employee must
enter into the Relocation Expense Contract with the Corporation. Relocation
assistance provides for airfare from the new employee’s current residence to
Bethel, plus the actual cost of transporting personal items from the current
residence to Bethel. If an employee elects to travel by other means, lodging,
gasoline and meals are reimbursable up to the cost of one-way coach
airfare.
As part of the Relocation Expense Contract, the employee agrees to repay
YKHC the monies expended for the actual costs of employee/family travel
and transporting personal items should the employee leave the employment
of YKHC prior to the completion of two years using the following repayment schedule:
Before one year anniversary date ................................. 100%
After one year, but before 18 month anniversary ........ 75%
After 18 months, but before second anniversary ......... 50%
After two years ................................................................ None
Should you accept employment with YKHC, arrangements for relocation
are governed by official corporate policy.
Mail Boxes
Mail is received through the U.S. Post Office; it is not delivered to a
person’s residence. Hospital employees can obtain a mail stop box at the
hospital where mail will be delivered. If you are an employee of another
corporate division and you wish to obtain a post office box before you
arrive, contact the Bethel Post Office at (907) 543-2525.
Shipping Goods to Bethel
Should you wish to send mailable items to Bethel, you can mail them to
YKHC (see how to below). Our Hospital Materials Management Department will pick the boxes up at the Post Office and place in a secured area.
YKHC, however, assumes no risk for lost or misplaced mail/boxes, and is
not responsible for tracing lost or misplaced packages. If you obtain a US
Post Office Box prior to arriving in Bethel, we do not recommend that you
send items to the post office as the post office does not hold mail or boxes
for pick up longer than 7 days.
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Where No Roads Lead
Some tips: US Parcel Post is economical, but can take 3-4 weeks for
delivery, and you mail at your own risk. There is no way to trace any
package that is lost or stolen. First Class, certified mail is faster (approximately one week delivery time), items can be insured and are traceable.
If boxes are shipped to YKHC, they must be addressed and labeled as
follows:
Your Name
Yukon Kuskokwim Health Corporation
P.O. Box 287, Suite 3000
Bethel, AK 99559
Each box should be labeled NEW EMPLOYEE and numbered (e.g., 1 of
5, 2 of 5, 3 of 5, etc.).
Once you arrive in Bethel, contact Hospital Materials Management Department, 543-6338 to make arrangements to pick up your boxes. YKHC is not
responsible for delivery or making arrangements to have boxes delivered to
your office or your home.
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Yukon-Kuskokwim Health Corporation
Further reading about Bethel and the Y-K Delta
Bethel: The First 100 Years
$18.00
Alaska Geographic: The Kuskokwim
$17.95
Always Getting Ready
$29.95
Harmonious to Dwell
$25.00
Boundaries and Passages
$17.95
Chills and Fever, by Dr. Robert Fortine
$18.95
The Frontier Physician by Dr.C. Earl Albrecht
a book about TB in the YK Delta
14.95
These titles and others are available at
The Bethel Moravian Bookstore
P.O. Box 327
Bethel, Alaska 99559
(907) 543-2474
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