paula ayunerak


Paula Ayunerak


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Paula Ayunerak was interviewed at Bentley's Bed and Breakfast in Bethel, Alaska, although she lives in the village of Alakanuk near the mouth of the Yukon River. She traveled to Bethel for the interview. Paula was a health aide for twenty-seven years, and a supervisor/instructor for seventeen years.  She grew up out on the land near Scammon Bay and did not go to school until she was fifteen. She graduated from high school and attended nursing school in Seattle. She married John Ayunerak in 1966, and they have two children and seven grandchildren. Paula retired in 2000, but writes a column about health issues in the regional newspaper, The Delta Discovery. In this interview, Paula talks about the early days of being a health aide before there was much equipment, communication, or medicine, what she enjoys about doing health related work, funny situations she found herself in, the hardships of being a health provider in your own community, difficult cases she faced, her work as a supervisor/instructor, and the teaching she did.
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Paula Ayunerak talks with Karen Brewster on April 1, 2006 at Bentley's Bed and Breakfast in Bethel, Alaska about...

1) Some background on where she and her family are from and about her education.
Fox Village\ Black River\ Scammon Bay\ father\ mother\ family -- move\ Nunakok -- ? Mountain\ St. Mary's -- school\ school -- beginning\ school -- age at\ grade level\ hospital -- tuberculosis (TB)\ high school -- Tacoma, WA\ hospital -- friends\ residence\ training -- nurse\ health aide\ teacher -- health aide\ volunteerism\ job -- wages\ training -- health aide\ college -- courses\ degree -- Associate of Science, Health\ job -- supervisor instructor\ teaching -- teleconference\ research\ body -- sickness\ column -- Delta Discovery\ school -- childhood\ education -- quality of\ culture -- parents\ strength\ culture -- western\ bilingualism\ parents -- teaching|

2) More about her parents, and how she was drawn to a career in health.
parents -- names\ Augustine, Maria\ Augustine, Charlie\ children -- number of\ brother\ work -- Yukon-Kuskokwim Health Corporation (YKHC)\ education -- Yupik\ brother -- age\ elder -- advice\ elders -- work with\ knowledge\ support\ school -- nursing\ father -- ill\ nurses\ doctors\ illness -- terminal\ care -- mother\ brother -- helping\ illness -- duration\ hips\ elbows\ skin -- open\ grease\ dressing\ father -- death of\ St. Mary's -- “future nurses club”\ interest -- health care\ retirement -- research\ learning\ parents -- religion\ God -- creation\ microscopes\ bacteria\ blood cells\ neurotransmitters\ study -- desire for|

3) How her religious upbringing has affected her life. 
upbringing -- religious\ work -- influence on\ lifestyle\ work -- method\ food -- natural\ greens\ fish\ animals\ berries\ land -- respect for\ parents\ animals\ food -- pure\ medicine\ animals -- sickness\ rabbit\ fox\ hunting\ brother -- teacher\ shooting\ upbringing -- influence\ parents\ Fox Village\ neighbors\ dog team\ puppies\ stores -- lack of\ dolls -- lack of\ God -- awareness of\ angels\ food -- preparation|

4) How she learned to hunt, where her name comes from, getting married, and finally getting paid for her work.
brother -- hunting\ name -- uncle\ ?, Paul\ Eskimo Name -- ?\ childhood -- tom-boy\ marriage\ Ayunerak, John\  husband -- meeting\ hospital\ TB\ training\ high school\ training -- nurses\ Ayunerak, John -- school\ Seattle, Washington\ California -- relocation to\ family -- move\ Alakanuk -- school\ marriage\ engagement -- duration\ house -- construction\ logs\ job -- social worker\ Cushman Hospital -- Tacoma, Washington\ ladies -- introduction\ work -- English\ math\ health aide -- pay\ work -- volunteer\ Association of Village Council Presidents (AVCP) -- formation of\ headquarters -- St. Mary's\ health aides -- pay\ pay -- request\ pay -- rate\ YKHC -- beginning of\ pay -- increase\ health aides -- move\ teaching\ health care -- advanced\ classes -- evening\ math\ English\ speech\ course -- duration\ weekends\ hospital -- shifts\ doctors -- help\ babies -- delivery\ emergencies|

5) Changes in health aide training and in communication over the years.
health aide -- selection\ training -- licensed practical nurse (LPN)\ health aide -- training\ training -- lack of\ Damian, Francis\ tuberculosis (TB)\ TB -- care\ TB -- medicine\ vitamins\ school\ teacher\ work\ education -- level of\ training -- difficulties\ family -- demands\ patients -- reports\ communication -- Bureau of Indian Affairs (BIA) radio\ radio call -- conditions\ doctor\ villages -- quantity\ patient -- name\ illness\ villages -- listening\ confidentiality\ telephones -- satellite\ telephones\ fax machines\ communication -- changes in\ health aide -- equipment\ black bag\ stethoscope\ blood pressure -- monitor\ mother -- assistance from\ doctors -- advice from\ shots -- penicillin\ shots -- duration\ shots -- effectiveness|

6) Different treatments for illnesses, including some traditional remedies.
babies -- delivery\ baby -- care\ blood -- loss\ fainting\ remedies -- home\ medicines\ Triple Sulfa\ Tetracycline\ Aspirin\ infection -- urinary tract\ salt -- Epsom\ cuts -- infected\ medicine -- traditional\ chaithluk\ ayuk -- tundra tea\ fever\ berries -- picking\ throat -- sore\ Labrador tea\ stinkweed -- use of\ berries -- salmonberries\ berries -- cranberries\ flu -- treatment of\ animal oil -- uses\ fat -- swan\ oil -- seal\ hands -- eczema\ seal -- skinning\ eczema -- cure\ spring\ birds -- migration\ Center for Disease Control -- Anchorage\ research -- health\ psoriasis -- treatment of\ Delta Discovery|

7) Traditional uses of animal fats and fish fat for home remedies.
medicine -- traditional\ animal fat -- use of\ sore throat -- treatment of\ fat -- swan\ dosage -- size of\ Mountain Village\ brother\ tonsils -- removal\ medicine -- cod liver oil\ vitamins\ seal oil\ YKHC -- Native food research\ fish oil -- benefits of\ dry fish\ mother\ fish fat -- use of\ skins -- tanning\ urine -- aged\ skins -- rinse\ ammonia\ cleanser\ skins -- oil\ skins -- bleached|

8) Balancing traditional and western medicines, and the suicide crisis that occurred in her village.
medicine -- western\ medicine -- traditional\ preference\ medicine -- harm\ body -- parts\ husband -- heart\ heart -- fluttering\ Nyquil\ Yukon-Kuskokwim Delta\ medicine -- abuse of\ training -- Bethel\ body -- systems\ illnesses\ cuts -- suturing\ village -- return to\ casts -- application of\ doctors -- permission\ treatment -- alternatives\ cuts -- tape\ head wounds -- knotted hair\ training -- schedule\ schedule -- busy\ family -- concerns\ son\ mother -- babysitter\ husband -- work\ Alakanuk\ work -- stress\ career -- change\ jobs -- difficulties\ individuals -- gifts\ emergencies\ hospital\ relief\ airplane -- charter\ travel\ career -- end of\ suicides -- cope with\ job -- stressful\ youth\ well-child clinic\ husband -- support from\ support groups\ village response team\ crisis\ healing -- talking circles\ YKHC\ travel\ suicides -- chain reaction\ suicides -- rate of\ St. Mary's\ student -- suicide\ suicide -- hanging\ shooting\ coping|

9) The challenges and satisfactions of her job as supervisor instructor.
job -- supervisor instructor\ job -- stresses\ health aides\ problems -- alcohol\ job -- duties\ supervision\ villages -- number of\ health aides -- number of\ work -- overload\ villages -- size of\ contact -- daily\ work -- schedules\ work -- on-call\ schedule -- changes in\ advantages\ disadvantages\ stress -- decrease\ schedule -- current\ schedule -- understanding of\ emergencies\ vacation time\ community -- demands from\ vacation -- camp\ patients -- treatment of\ patients -- chronic\ health aides -- complaint\ complaints -- prevalence of\ job -- quitting\ job -- challenge|

10) Radio traffic and issues of confidentiality.
radio -- location\ Bureau of Indian Affairs (BIA)-- schools\ schools -- radios\ communication -- radio\ teachers -- BIA\ school district -- Mountain Village\ hospital\ doctor -- reports\ confidentiality\ villages -- number of\ villages -- listening\ patient -- report on\ patient -- name\ patient -- age\ patient -- health problem\ radio traffic\ training -- LPN\ work -- hospitals\ temperatures\ blood pressure\ bed pans\ head nurse\ doctor\ self-reliance\ Bethel -- training\ training -- phases\ training -- sessions\ Anchorage -- travel\ Native Corporations\ Yukon-Kuskokwim Delta\ Annabo, Dr. ? -- teacher\ self-confidence\ training -- improvement in\ notes -- writing\ learning -- hands-on\ babies -- delivery|

11) Delivering and caring for babies.
baby -- delivery\ delivery -- difficulty\ cervix -- size of\ scissors\ suffering\ talk\ tearing\ clean-up\ travel -- Bethel\ delivery -- breech\ mother -- advice\ auntie -- advice\ baby -- repositioning\ options\ Native people -- custom\ baby -- sleep with\ emergency\ baby -- breathing\ heart -- stopping\ heart -- massage\ treatment -- mouth-to-mouth\ airplane -- call for\ equipment -- stethoscope\ airplane -- arrival\ mother\ public health nurse\ patient -- escort\ nurse -- relief\ hospital -- arrival\ Bethel\ oxygen\ baby -- recovery\ survival -- reasons for\ well-child clinic\ school\ marriage\ children|

12) Dealing with emergencies and deaths, and overcoming fainting at the sight of blood.
emergencies\ trauma\ blood -- reaction to\ reaction -- fainting\ wood -- cutting\ accident\ axe\ head wound\ bleeding -- heavy\ treatment -- pressure\ mother -- help from\  fainting\ embarrassment\ self-cure\ concentration\ suicide\ gunshot wound -- head\ blood -- pooling\ blood -- coagulation\ victim -- bloody\ breath\ heart -- weak\ tissue -- gauze\ face\ wound -- forehead\ exit wound -- size of\ brain -- damage to\ parents\ wound -- fatal\ fainting\ patient -- life\ elder -- fall\ head -- wound\ concentration\ weakness\ tragedies\ snow machine -- collision\ patient -- unconscious\ pupils -- responsiveness\ doctors -- help from\ brain -- damage to\ wound -- shotgun\ job -- supervisor instructor\ knowledge -- subconscious|

13) Finding humor in strange situations.
wound -- stab\ wound -- bubbles\ bandage -- tinfoil\ Easter Sunday\ family\ Stebbins\ airplane -- charter\ pilot\ job -- day-off\ steam bath\ hair -- towel\ health aide\ patient -- transport\ medics\ paper\ parka -- pocket\ embarrassment\ Emmonak\ telephone\ doctor -- scolding\ house call\ miscarriage\ alcohol -- influence of\ patient -- position\ floor\ legs -- level\ patient -- relocation\ bed\ patient -- check-up\ patient -- transport\ Bethel\ clinic\ doctor -- communication with\ people -- function|

14) A meeting where health aides from all over the state got together and laughed about their job, plus a funny story about a patient.
mistakes\ situations -- life-threatening\ health aides -- meeting\ health aides -- statewide\ discussion -- mistakes\ research\ system -- reproductive\ play\ egg -- princess\ sperm -- prince\ health aides -- actors\ skits\ narrator\ laughter\ Ashenfelter, Willa\ White Mountain\ doctor -- Nome\ patient -- reporting on\ communication -- confusion\ patient -- elder\ fever -- treatment of\ medicine -- Tylenol\ doctor -- communication\ patient -- talk with\ medicine -- use of\ patient -- understanding\ speech\ suppositories -- vaginal\ hearing -- difficulty\ usage -- directions\ explanation -- misunderstanding|

15) Stories about caring for patients from the village and from outside, and technological changes in the care she offered.
Bingo\ lady -- collapse\ non-drinker\ helper -- alcoholic\ taxi\ patient -- transportation\ knee -- care for\ pillow -- use of\ patient -- unconscious\ breathing -- shallow\ finger -- pressure\ hospital -- emergency room\ gurney\ doctor\ nurse\ patient -- chart\ medicine -- dosage\ medicine -- overdose\ patient -- recovery\ community members -- help from\ victim -- family\ patients -- survival\ successes\ baby -- survival\ crib death\ appendicitis\ seizures\ meningitis\ pneumonia\ treatment\ prevention\ Nunamiqua\ population -- growth\ clinic -- visits\ visits -- rate of\ fishermen\ visitors\ sexually transmitted disease (STD) -- check for\ gonorrhea -- treatment\ travel -- Anchorage\ drinkers\ placenta -- stuck\ baby -- birth\ bleeding\ mother\ doctors\ treatment\ patient -- fainting\ blood -- loss of\ hydration\ water\ broth\ airplane\ happy endings -- majority\ experiences -- rewarding\ self-reliance\ skills -- IV\ oxygen -- use of\ nausea -- vomiting\ dehydration -- prevention|

16) Dealing with a hypothermic patient.
boating -- accident\  fall -- overboard\ buoy\ patient -- transport\ camp\ patient -- stiff\ sleeping bag\ clothes\ temperature -- core\ water\ milk\ temperature -- low\ vital signs\ health aide -- Alakanuk\ doctor -- advice from\ towels -- warm\ tarp\ transport\ clinic\ house\ doctor -- communication with\ telephone\ airplane -- charter\ Emmonak\ seizure\ potassium -- imbalance\ salt water\ hypothermia\ arthritis -- severe\ Bering Sea\ pattern|

17) The importance of preventative care and how running water has improved health in the villages.
training -- initial\ training -- subsequent\ sessions\ preceptorship\ Anchorage\ Center for Disease Control (CDC)\ sexually transmitted disease (STD)\ gonorrhea\ syphilis\ liver disease -- Hepatitis\ AIDS -- prevention\ people -- understanding\ AIDS -- education\ families -- acceptance\ diabetes -- incidence of\ junk food\ soda pop\ sugar\ soda -- diet\ drinks -- ingredients\ water\ juice -- fruit\ elders\ asthma -- incidence of\ diseases -- increase in\ children\ disease -- Impetigo\ ears -- draining\ boils\ health aides\ communication -- meetings\ priorities\ water system\ sewer system\ cleanliness\ water -- access\ water -- packing\ water -- heating\ Alakanuk -- houses\ water -- running\ letters -- environmental health\ Washington, DC\ honey buckets -- dumping\ spills -- danger of\ children -- playing\ contamination -- danger of|

18) Balancing her career and her family during training and travel, and the story of her trip to New York for a national health conference.
health aide -- work\ water -- running\ water -- packing\ water -- boiling\ babies -- birth\ cuts -- soaking\ birth control\ nature\ health care system\ children -- number of\ birth control pills -- side-effects\ pregnancy -- rate\ pregnancy -- increase in\ check-up -- maternity\ delivery -- hospital\ delivery -- home\ heath care -- women\ prevention\ pregnancies -- healthy\ children -- number of\ grandchildren -- number of\ career -- balance\ family -- balance\ mother -- babysitter\ training\ work\ son\ daughter\ babysitter\ Headstart\ husband -- job\ job -- airline agent\ training -- duration\ family -- support from\ travel -- San Diego\ children -- care of\ health conference -- national\ trip -- New York\ pictures\ VanDoorn, Myrtle -- story\ subway\ Quick, Dr. ?\ Twin Towers\ top floor -- restaurant\ window\ cars -- size of\ view -- clouds\ boss\ health aides\ booths\ bags -- collections\ pens\ pencils\ condoms\ Anaruk, Mary\ Moses, Greg -- diaphragms\ sizes\ colors\ picture| 

19) A picture from the trip to New York, and what she did on her job as a supervisor instructor.
picture\ boat\ dock\ Manhattan Island\ people -- identification\ Kinegak, Pahnem\ Anaruk, Mary\ Friday, Henry\ Hooper Bay\ Moses, Greg\ VanDoorn, Myrtle\ Aniak\ presentations -- planning\ article -- Aniak newspaper\ roads -- narrow\ buildings -- height\ sky\ watches -- sale\ police\ fear\ Bethel\ drunks\ Bethel -- stores\ job -- supervisor instructor\ villages -- number of\ health aides -- number of\ contact -- daily\ teaching -- teleconference\ topic -- selection of\ schedules -- tentative\ work -- schedule\ training\ distance\ travel\ city councils -- meeting\ health aides\ janitor\ secretaries\ villages -- size of\ travel -- duration\ clinic -- inventory\ supplies -- dry\ medicine\ supplies -- cleaning\ workshops\ AIDS\ women's health care|

20) Her job as a supervisor instructor and the research and teaching she did.
teaching -- teleconference\ job\ work -- assigned\ Curda, Linda\ Morgan, Clara\ facilitator\ research\ presentations\ Jasper, Sarah\ Akiak\ supervisor\ retirement\ teaching -- interest in\ topics -- body parts\ brain -- neurotransmitters\ body systems\ classes -- purpose of\ illness-- symptoms\ illness -- treatment\ gas -- sniffing\ alcohol\ drug abuse\ death and dying\ suicide\ villages -- division\ groups\ teleconferences\ crying\ minutes -- typing\ work -- jobs\ college -- courses\ college degree\ family -- care of\ retirement -- busy\ relaxation\ guilt\ parkas -- sewing\ fish camp|

21) More about her job as a supervisor instructor, including changes in the types of treatment she provided.
classes -- teleconference\ training -- sessions\ training -- differences\ basics -- vital signs\ heart\ lungs\ kidneys\ health care\ babies -- delivery\ continuing medical education (CME)\ attendance -- credit\ health aides -- education\ work -- difficulties\ work -- night\ suicides -- increase in\ accidents -- increase in\ outboard motors -- power\ snowmachines -- speed\ alcohol\ driving\ child -- fever\ Aspirin\ sleep -- difficulty\ conscious\ job -- satisfaction\ healing\ medicine\ patient -- elderly\ clinic\ rash -- genital\ shame\ care\ tub -- soaking\ rash -- spreading\ face -- covering\ recovery -- relief\ women -- pregnant\ urination\ baby -- pressure\ pain\ catheter -- sterilization\ equipment\ boiling|

22) Getting a clinic in Alakanuk and a little bit about her continued research interests.
clinic -- building\ clinic -- Bureau of Indian Affairs building\ room -- unused\ storage -- medicine\ cabinet\ clinic -- construction of\ patients -- attendance\ doctor -- support\ nurse -- support\ house calls -- fewer\ shots -- penicillin\ patients -- fear\ tears\ bed -- hiding\ medicine\ Aspirin\ Triple Sulfa\ Tetracycline\ penicillin\ refrigerator\ retirement\ research\ topics -- medical\ interest\ enjoyment\ teaching\ knowledge -- sharing\ learning\ workshop\ Morgan, Clara\ review\ reading\ maternal language -- Yupik\ second language -- English\ dictionary\ research -- organization\ language -- bush\ understanding\ language -- college\ information -- distribution\ draft -- typing\ teaching -- teleconference\ topic -- teeth\ topic -- hair\ hair -- damage\ dye\ permanent wave\ rubber bands\ hair -- effects\ book -- manuscript\ house -- fire\ topic -- Native stories\ life experiences\ Tacoma, Washington\ cultures -- difference\ loneliness\ race -- division\ discrimination\ prejudice|

23) Learning English and other aspects of dealing with “western” culture, and what she does now that she is retired.
health aide -- Yupik\ discrimination\ system -- western\ nurses -- itinerant\ job -- threatened\ discouragement\ health care\ teaching\ St. Mary's\ nuns\ priests\ Yupik way -- superstition\ superior -- speech\ school -- beginning\ English\ Yupik -- use of\ black marks\ Sunday -- movies\ talking -- punishment\ conversation\ communication\ seperation\ speech -- damaged\ speech -- fluent\ teaching -- language choice\ Grayling -- Indians\ retirement\  counseling\ mentoring\ translating\ family -- dysfunction\ problems -- behavior\ children\ winter\ arson\ Alaska State Trooper\ parents\ grandparents\ elders\ house -- break-in\ instigator\ understanding\ healing\ property\ children -- traumas\ parents -- alcohol|

24) Interacting with doctors and public health nurses at a distance and in the villages.
doctors -- interaction with\ doctors -- relationship with\ health aides\ patients -- daily reports\ emergencies\ doctors -- kindness\ help\ advice\ village -- work\ doctor visits -- frequency\ public health nurse -- visits\ doctor -- contact with\ job -- supervisor instructor\ doctors -- support from\ questions\ information\ clinic -- appointments|

25) Discussion of several photos.
photos -- identification\ health aide -- annual conference\ Qwethluk\ children's home\ people\ cars\ phones\ health aides -- Yukon- Kuskokwim Health Corporation\ Alexie, Sam \ Eek\ Morgan, Clara\ Demientieff, Theresa\ Phillips, Mary\ Moses, Frederick\ photo -- date of\ Lake, Lena\ Hooper Bay\ health aides -- first\ Stefana, Abbie\ Russian Mission\ training -- Bethel\ Boyscout, Agnes\ Chevak\ supervisor instructors\ coordinators\ program -- management\ Yukon-Kuskokwim Health Corporation\ Caldera, Deborah\ McNamara, Catherine\ health aides -- function of\ knowledge\ learning\ supervisor instructors -- local\ Rothschild, Elena\ Waskie, Georgiana -- deceased\ cancer\ Morgan, Clara\ Quick, Dr.?\ travel -- New York\ McNamara, Catherine\ ?, Martha\ Native food -- research \ ?, Janet\ ?, Penny\ photo -- date of\ St. Mary's\ health aide -- conference\ people\ Addy, Martha\ Morgan, Clara\ Himshutt, Bonnie\ Rothschild, Elena\ Evan, Ruth\ Street, Julia\  Clakas, Dr.? -- Bethel\ Larson, Belassa\ review -- complete\ shots -- administration\ oranges -- practice\ health aide -- trainer\ Alakanuk -- interview\ Yukon-Kuskokwim Health Corporation\ ?, Sue\ parka\ truck\ office\ place -- unique\ house\ film\ nutrition\ high school -- graduation\ Tacoma, Washington\ graduation -- age at\ graduation -- portrait\ degree -- AA\ college degree -- date of\ distance education\ laboratory -- work\ training -- audio\ students -- meeting\ University of Alaska Fairbanks\ treasures -- New York|

26) Final reflections on her career as a health aide and the health column she writes for the The Delta Discovery newspaper.
work -- memory\ gratification\ health aides -- teaching\ sharing\ Delta Discovery -- article\ health aides -- correspondence\ thanks|