On March 26, 2020, in the remote village of Takotna, Alaska, a fire started in a multi-use building that included the village medical clinic. It was an old wooden building and the fire quickly destroyed the structure. Fortunately, no one was hurt, and no other buildings were damaged. While the fire was still burning, village leadership began contacting those who might be able to assist with recovery.
Texts and phone calls offering personal support and encouragement, and promises of rapidly activated teams of support, occurred. In response to this loss what has become apparent is the many personal connections, friendships, and trust that surround the clinic. We are grateful for the outpouring of support that has already occurred and the level of professionalism exhibited by those responding to the unfortunate event.
Losing the clinic in the midst of the coronavirus crisis meant that all medications, testing supplies, on site testing capability, and video connectivity equipment were lost – including the most basic things needed to do a physical exam. As solutions to this loss are explored an additional challenge being faced is the fact that the village is in full isolation protocol. In an attempt to avoid the spread of the virus, no planes or snow machines from anywhere else are being permitted. Takotna is hundreds of miles from any road or city.
By 9:30 a.m. on March 27, many things were in place including:
- A full set of basic clinic equipment, supplies, and medications.
- Arrangements for these to be flown in and left on the side of the gravel/snow runway.
- Transition plans to open a temporary clinic in another facility.
- A team put in place to help manage the transition.
- A team put in place to accelerate a previously planned replacement clinic.
- Scheduled discussion with Indian Health Service director for emergency response funding.
- Communications from local leaders, regional leaders, CEO’s, and VP’s of corporations were complete.
All of this was possible because of a highly developed and capable health care system across every village and town in Alaska – owned and designed and led by Alaska Native people. It is built on an amazingly capable layered system of training, skills, networking, support, communication, and trust. It is a system of highly capable virtual connectivity and locally recruited workforce connected and supported all the way to highly sophisticated medical centers and experts.
If you stop and think about it —this is how health care should be for everyone, everywhere. It should be always present, largely virtual and woven into lives, locally controlled with considerable local autonomy, and backed up by great communication, expertise, trust, and friendship.