# North to Alaska: ACOG committee provides consultation to 

**American Indian/Alaska Native hospitals**

In May ACOG's Committee on American Indian Affairs traveled to Alaska,
where committee members split into teams and visited four Native
American medical centers---in Anchorage, Bethel, Barrow, and Sitka. Each
year the committee makes a site visit to several Indian Health Service
or tribal facilities in a region and provides recommendations on
staffing, equipment, and quality of maternal and child care.

In addition to the review of services, at each site a team member
provided an hour of continuing education on a topic chosen by the local
hospital staff. "These sessions were very well attended, no doubt
because of the paucity of opportunities for professional education and
CME credits in these remote areas," comments J. Chris Carey, MD,
committee chair.

## Hospitals vary widely

The number of deliveries a year in the four hospitals visited by the
committee varies from around two dozen in Barrow to more than 1,200 at
the Anchorage hospital, according to Dr. Carey. "The level of staffing
also varies greatly. For example, the delivery service in Anchorage is
well staffed with ob-gyns, including a perinatologist, and
nurse-midwives and family physicians, while Sitka, with about 60
deliveries a year, has only one ob-gyn, along with five family
physicians who do obstetrics."

In the rural areas, because of the uncertainty of weather and lack of
roads, at 36 weeks' gestation women from villages are expected to come
to towns with hospitals and stay in prematernal homes. Women requiring
surgical or other special care must go to Anchorage to await delivery.

## 

## Rugged terrain, vast distances call for unique delivery system

"We were very impressed with the unique and innovative program they have
to provide care in the remote areas," Dr. Carey said, speaking of the
statewide Community Health Aide System.

This program, which grew from efforts in the 1950s to distribute
antibiotics for a tuberculosis epidemic, now has 178 clinics statewide,
in villages with names like Chuathbaluk, Unalakleet, and Takotna. At
these rural clinics more than 500 trained health aides provide emergency
and primary health services to the local residents. The aides are the
patients' first contact with the network of health professionals in the
Alaska Native Health Care System.

"This is a model of regionalized health care that could be used in many
other areas for care for a remote population," Dr. Carey noted.

![](media/image1.jpeg){width="2.625in" height="2.125in"}

ACOG team members tour the Anchorage Native Medical Center in Anchorage,
AK.

![](media/image2.jpeg){width="3.125in" height="2.0729166666666665in"}

ACOG committee member Frank J. Anderson, MD (left), meets with staff of
the Yukon-Kuskokwim Delta Regional Hospital in Bethel, AK.

## SIDEBAR

# ACOG's Indian Health Service program

In addition to the annual site visit to a Native American health
facility by the Committee on American Indian Affairs, the College has
two other Indian Health Service programs:

## 

## Ob-gyns cover temporary vacancies 

## In the "Fellows in Service" program, ACOG Fellows and Junior Fellows volunteer to provide ob-gyn services for at least three weeks at Indian Health Service or tribal hospitals in Arizona, Montana, New Mexico, Oklahoma, or South Dakota.

Usually the volunteer provides essential coverage for a full-time
physician who needs to take time off. Recently, for example, an ACOG
Fellow filled a vacancy in Montana after military call-up of the Indian
Health Service physician.

"Volunteers almost universally regard the experience as personally
invaluable, because of both the service they perform and the cultural
experience to which they are exposed," notes Yvonne Malloy, manager of
ACOG's Indian Health Service programs.

## Postgraduate course helps non--ob-gyns

ACOG also conducts an annual four-day postgraduate course in Denver.
ACOG members participate on a multidisciplinary faculty for the course.
Among the topics presented are abnormal cervical cytology, adolescent
health, diabetes in pregnancy, hypertension in pregnancy, obstetric
emergencies, and pediatric gynecology.

Attending the course are about 100 family physicians, nurse
practitioners, nurses, and other health professionals who provide care
to women in Indian health programs, but who are not specially trained in
these areas.

**info**

♦ Yvonne Malloy at 800-673-8444 or 202-863-2580; email ymalloy@acog.org

♦ www.acog.org/departments and click on Indian Health Service (member
password required)