KAREN:  Okay.  Today is April 1st, 2006.  This is Karen Brewster, and I'm here with Paula Ayunerak.  We are in Bethel at the Bentley Bed and Breakfast.  Paula is from Alakanuk.  And very nicely agreed to come to Bethel to do this interview for the Community Health Aide Project.  Thank you, Paula, for coming all this way and agreeing to participate. 

PAULA:  You're welcome.  

KAREN:  Why don't we start out a little bit, tell us about yourself so that people know, you know, where you're from, where you were born, a little bit of your family background.  

PAULA:  Uh-hum (affirmative).  I was born in Fox Village.  It's between Black River and Scammon Bay.  And my father was from that area and my mother from Scammon Bay.  That was in 1938.  And I -- we lived there until I was about 11, 12 years old, then we moved to Nunaqaq (phonetic), it's close to Kwigigliak Mountain (phonetic)(Could this be Kochilagok Hill?).  And we lived there for, I don't know how many years.  And then in the summer of -- summer of 1953, my mother sent me to St. Mary's to go to school.  I was 15 then.  And so I finally went to school and went through -- started from third grade on until I was seventh grade.  And then I went to hospital for TB for 10 months, and then when I went back, I went back to St. Mary's and finished my eighth grade, and then I went to high school in Tacoma, Washington.  

Because when I was in hospital with TB, I got into some people there that were good friends of mine and so I start -- I lived with one of the ladies, lady friends there, and I went to school and -- for three years and one summer to complete high school.  

Then -- then I went to nurses training for one year and stayed for one -- maybe one more year, and then I went home and became a health aide.  
And there was people who were untrained, and especially one of the teachers was busy being teacher and being health aide in the village.  And this was on volunteer basis.  We didn't get paid.  

And then I had health aide trainings.  Then I continued on to college courses and got my Associate of Science Degree in Health in 1997.  
And I was health aide for 27 years.  And supervisor instructor for 16 years.  And I was teaching health aides for 16 years through teleconference, doing research in -- all about the body and the sicknesses that goes along with it.  So I still provide that with Delta Discovery little pieces about health.  

And I never went to school, like I said, from the time I can remember until I was 15 years old, but when I look back, that was the best teaching, education I ever got, in my own culture, and my parents taught me everything that I can use to be a -- to be a person that can be strong, profitable.  

And then when I finally went to school at the age of 15, I start learning about Western culture.  So it's -- it's good to be bilingual now.  

And all the teachings that my parents taught me was very useful during that elementary, seven years of elementary I had, and in the high school, and also in college courses I took and all the teaching I did, you know.  Everything they taught me, I -- I think it's because of, you know, teaching well done by my parents.

KAREN:  What were your parents' names? 

PAULA:  My mom's name was, excuse me, Maria, Maria Augustine, and my father Charlie Augustine.  

And there was eight of us children and four of us are living still.  Fred Augustine, my oldest brother, had also worked for YKHC.  Never have education all his life except in Yup'ik culture.
  
He's still living, he's 80.  And I'm the youngest one of the eight children, so he was an elder that I can look -- look up to.  And now I'm elder also, but I -- I still, you know, look up to him for good advice.  

There's always -- I worked with elders for maybe a good 20 years, and it's -- it's good that they give me a lot of support, lots of knowledge, and right way to approach everything that I have to go through. 

KAREN:  Uh-hum.  Now, you said you went to school in Seattle. 

PAULA:  That was in Tacoma, Washington.  

KAREN:  In Tacoma.  Okay.  And then why did you decide to go to nursing school?  

PAULA:  Well, when I was 14 -- well, from the time I can remember, my father was a very sickly person, and -- and he was sick for a long time.  And we had no nurses, doctors.  And he was terminally ill for a long time, and my mom was the only one that took care of him, and my oldest brother.  

And he was sick for a long time so that she had -- I forgot the medical names for, you know like your hips and your elbows, the skin opened and you know.  And my mom used to put grease from the animals and put dressing on those.  And I used to wish I could help him.  

So ever since that incident and he died, you know, I -- I used to think some day I'm going to have the health care as my career.  

So when I went to St. Mary's, there was Future Nurses Club, and I joined them.  And so I -- that was a long time ago, 1953.  I was very interested in learning how to care for sick people, how to help them.  And I was storing all my health aide career and supervisor instructor and teaching.  And I'm still -- I -- after I retire in 2000, I stopped for a while.  

And then after two -- about two years later, I got that itching to do research again.  And so I'm still doing the research and learning.  

You know, the one thing, my parents were very religious and -- and used to talk to me about God all the time and about Him having created us.  

And I think being religious and being a health care provider, it was a tremendous job, you know, the body, you know.  Everything, you know, that you can see and you cannot see and you have to use microscope to look, look at the, you know, bacteria or white blood cells, red blood cells.  Just amazing, somehow with like transmitter, neurotransmitters in our body.  

Just -- I guess that's why I keep on wanting to study and I'm elder now.  Just to benefit my -- the other health care providers.

KAREN:  So being raised so religious with your parents, do you think that affected the work or how did that influence your work?  

PAULA:  Well, I think it's the combination of how you live and how -- how you do your work and being religious, knowing that God had made me, God had provided everything on earth for all of us.  And to eat off land, we have all the greens, vegetables, all kinds, and all the fish and animals, berries, and we had a lot of -- my parents had a lot of respect for the land. 

And they used to say we came from land and -- and the animals, they not only teach me about our environment, but about the animals, too.  And all the food that we eat from -- from the land is pure.  

A lot of medicine, too.  And they used to say that the animals never get sick because they live off the land.  You know.  They eat -- you have -- you never see animals sick, they are always healthy all the time.  And they are healthy to eat.  

And then once in a great while there would be some rabbit, fox.  Especially recently, you know.  Maybe 30, 40 years ago.  Yeah. 

And I also used to hunt.  My -- my brother taught me how to hunt when I was -- when I was 10 years old, he taught me how to shoot.  So I used to hunt a lot.  

And so the way I grow up, I think, has lots of influence in me because the -- seems like my parents, like when I was little girl, in Fox, well, it's -- we had no neighbors around, so my brothers, two of my brothers had dog teams and -- and I used -- of course, we used to race dogs.  

And you know, the little pups, I play with little pups all the time.  And we had no stores, no dolls, and so I used to use little puppies for dolls.  

And knowing that God is around everywhere, my parents, they used to tell me that, don't ever think you're all alone because this -- you're alone, but God is everywhere.  And God is always with you and the angels, your guardian angel.  

So sometimes when I'm all alone, I used to play, pretend to play, you know, with God, you know, and angels.  And like making food for three of us.  
Things like that.

KAREN:  So you said your brother taught you to hunt and you would go out hunting.  Was that unusual for a girl to go out hunting? 

PAULA:  I don't know.  I was named after our cousin who was a man, both in English and -- my English -- his name was Paul, and his Eskimo name was Chigayuk (phonetic).  I don't know how it happened that they -- they named me Paula, not knowing his English name, but in Yup'ik, they call me Chigayuk, you know, same name.  So I was sort of like -- like a tomboy growing up.  

KAREN:  Now, you were married and had children?  

PAULA:  I got married in 1966.  It will be 40 years this summer.  And we have one and only boy, one and only daughter.  And we have seven children.  

KAREN:  And what's your husband's name?  

PAULA:  John Ayunerak.  

KAREN:  And how did you meet each other? 

PAULA:  Well, the very first time I met him was that we were in the hospital with TB.  He was 18 years old and I was 19.  And -- but we didn't have no attraction whatsoever towards each others.  And we never thought, you know, that some day we would be married.  

And then after -- I was -- while I was having training, going to high school and going to nurses training, he was in Seattle going to school.  And then later on, he relocated to California and worked there and -- and I continued with my training.  

And then in 1963, when I finally went home, we saw each other.  See, his family had moved to Alakanuk, and my family had moved to Alakanuk because the school was built in Alakanuk.  And when we saw each others, everything had changed, you know.  And so we started going around.  

And then one year later we got married.  Oh, so many years later, not one year.  But we were engaged for one year and then we got married in 1966. 
Built our own house out of log cabin, out of logs, you know.  And he was a social worker for 16 years.  And I was a health aide all the time, forever. 

KAREN:  So the place you were sent for TB, that was in Tacoma?  

PAULA:  Yeah.  Tacoma, Washington, in Cushman Hospital.  And that's when I met these ladies that they used to come to hospital and give us some work to do about English and math.  

And when I was a health aide, maybe I was health aide, I forgot, in '63, we never get paid, we were -- it was just on voluntary basis.  

Then in 1967, AVCP formed and the headquarters was in St. Mary's.  And they used to -- they said they were going to start paying the health aides.  
And for me, I have -- I had to ask for my pay.  Maybe send them letters, you know, they never -- you never pay me for this month and that month.  And the only money -- I mean, and the money that they pay -- pay for one whole month was something like $147 a month.  

And then in 1969, YKHC started, and that's when they start paying the health aides 600 a month.  

KAREN:  Wow.  

PAULA:  That's before taxes.  And boy, that was lots.  

KAREN:  And that was 1968?  

PAULA:  Yeah.  No, '69.  

KAREN:  '69?  

PAULA:  Yeah.  Also during that fall, September '69, eight of us health aides with their families moved here.  And all winter we teach about advanced health care, not only all day we'd be in class, but in the evening, two -- two evenings out of one week, we'd have math, and two evenings English, and one -- one evening of speech classes.  And we did that for eight months.
  
And every weekend two health aides use to stay up at the hospital, stay overnight, and help the doctors with emergency, or delivering babies. 

KAREN:  So that was part of the training?  

PAULA:  Yeah.  Part of the training.  And we -- we got to know each others, the eight of us.  So that was some good experience. 

KAREN:  Uh-hum.

KAREN: How did you get selected to be a health aide?  You said, you know, you had been -- you got nursing training and then you came home.  How did you then become the health aide?  

PAULA:  Well, the original health aide there, who is not trained, he was untrained person, actually, he was a person who would provide INH PAS, and vitamins to all the people who had TB.  

KAREN:  Oh.  

PAULA:  And so became -- had become somewhat like a health aide.  And there was a school teacher, people used to call all the time when they'd get sick, and she was a teacher in the school.  

So as soon as they find out I had some training, nurses training, LPN training, they just asked me and put me to work.  And I -- I just went to work.  
But when I went to work, and here I just came up from nurse -- LPN training, the health aide, untrained health aide was like a doctor and -- and I didn't know nothing, you know.  It's -- it's that different, you know.  It's -- health aide job is a unique thing.  And so I learned a lot from him who was an untrained person.  

KAREN:  You mentioned abbreviation that the untrained health aide gave, PHP -- what are those?  

PAULA:  It's the medicine for PAS, short for some kind of medicine to prevent -- get you well from TB.  

KAREN:  Oh, okay.  

PAULA:  And INH is another initial for that medicine --

KAREN:  Okay.  

PAULA:  -- that TB, people with TB took.  And all of them took vitamins, multiple vitamins to help them get well.  

KAREN:  Are you comfortable giving the name of who that health -- untrained TB aid was who taught you? 

PAULA:  Yeah.  That's Francis Damian.  And him and I worked together for a long time.  And he -- he had only fourth grade training, and even though he -- he would like to go -- go in for training, he -- his family, he was just married and bringing lots of children and he couldn't go on trainings.  
So as I get trained, he started -- I started helping him.  Like when -- when he's going to report patients, he used to let me go over his report that he's going to give to a doctor.  

And in those days, we had no telephones, no communication, only the BIA radio.  And it's -- it's really funny, compared to the reports we give nowadays.  And we would be listening at maybe 11:30 in the morning, and as soon as the doctor comes on, all 48 villages used to just, you know, go in, you know, just call back to doctor.  And -- and the person that he can hear first, he will call them. 

And that person will report a person, name, age, and what's wrong with that person, all 48 villages are listening in.  And what's wrong with that person.  And it went on and on and on for a long time like that. 

Then we got satellite phones finally, so people didn't listen to us any more while we report our -- even, you know, even in the village, people were able to hear that BIA radio. 

KAREN:  Oh, really?  

PAULA:  If they go on to a certain place, they can hear us talk, you know, talk to doctor about that person.  You know.  And that was really funny.  
And after satellite phones, we finally got phones.  

KAREN:  When was that?  Do you remember?  

PAULA:  Gee.  Probably in '70s or -- I can't remember when.  I should have thought about that.  It's not long ago that we -- we finally got phones.  
Now, we finally -- and then we finally got fax machines.  Now the health aides always see a person, and they don't have to report, they fax that -- fax all the information to the doctor, and then the doctor call back by phone to give them what to do for that person.  

KAREN:  Oh.  

PAULA:  Very easy.  

And when I first start being a health aide, all I had was black bag with stethoscope, thermometer, blood pressure cuff, something else.  We didn't have very much to start.  And -- 

KAREN:  So how did you give -- how do you give care to people when you have only those few tools?  

PAULA:  Just give them exam.  And a lot of times, too, my mother helped me in how to care for them and of course, the doctor's side of orders were to give them a shot.  Lots of penicillin shots in those days.  If somebody's got sickness, we just give them seven days of shots, you know.  And -- 

KAREN:  Did it work?  

PAULA:  Oh, yeah, in a lot of -- a lot of times, it worked.

PAULA: And uhm -- There was something I thought about that's really funny.  Well, anyway, my mom helped me, like I used to deliver babies, a lot of babies, and how to take care of them.  And -- and like if somebody is losing a lot of blood, how to take care of them.  

If they are big -- starting to faint, you know, she used to tell me, whenever somebody's fainting, you know, just squeeze their little finger and then they'll wake up.  And I've used that.  And it worked.  

There was lots of home remedies we used.  The only medicines were Triple Sulfa and like for UTI, people with UTI.  

KAREN:  Urinary tract infection?  

PAULA:  Triple Sulfa and Tetracycline and aspirins.  No Tylenol.  

So in those days, people still used, like, Epsom salt for soaking infected cuts on their hands.  And.  

KAREN:  Did you use traditional medicines?  

PAULA:  Yes.  You know, like Caiggluk, we used it for just about everything.  And we also used Tundra Tea, guyuk (phonetic).  We used that for a lot of things.  My mom used to let us, like if we have fever, as kids, you know, she used to boil some Iuke and let us drink.  

And then even recently, one time we were berry picking just recently, and I woke up with really bad sore throat.  And so I -- knowing that, my sister boiled some Iuke tea for me, and they went out berry picking, so I stayed home in the tent and keep drinking that, and it helped.  It helped.  And we didn't have no -- nothing else.  

KAREN:  So Iuke is Labrador Tea in English?  

PAULA:  Uh-hum.  Yeah.  

KAREN:  And what Caiggluk, what's that in English, do you know?  

PAULA:  Stinkweed.  Yeah.  

KAREN:  How do you use that? 

PAULA:  Well, as a child, I didn't use it, because it didn't grow in the area where I lived.  But now Caiggluk is all over.  Even in that area where I grow up, Caiggluk is all over.  Plenty of it.  So...  

And we used, like, a lot of berries like salmonberries and cranberries for, you know, like if you have flu or -- and you -- always use animal oil for sore throat, and like swan fat.  Of course, seal oil.  You use it for a lot of things.  
And recently I learned that if you use seal oil for -- see, ever since I became a health aide, I've seen these eczema of the hands.  And they never grow -- I mean, doctors say there's nothing we can do about those people, just have them.  There's no cure for them.  

Recently, I think accidentally we find out, somebody was even there -- even though they have this, a lot of eczema, nobody else had to take care of a seal skin, or seal, so she took care of it, and the oil felt good on their hands.  And kind of softened the skin.  

And so she, all day, you know, while she was taking care of the oil, she would kind of rub her hands with that oil.  And then next day, her hands, you know, felt good.  And since then, she never had, just went away. 

KAREN:  Just one time with that seal oil?  

PAULA:  Uh-hum (affirmative).  And three other people experiment that, and they don't have it anymore.  

KAREN:  Wow.  

PAULA:  And one other people who exper -- not experiment, just accidentally use in the springtime, when the birds and swans come in, they are fat.  She used swan fat while she was working on those swans, and now she don't have that eczema anymore.  

KAREN:  Wow.  

PAULA:  That's something new.  And I called CDC in Anchorage, I used to call CDC in Anchorage.  I used to call CDC in Anchorage for while I'm doing research on body parts or whatever.  Anything about health.  I called them and talked to them about that.  

And I think I'm going to try it on one more person, that seal oil, who have psoriasis.  I'm going to try it and see if it works.  

KAREN:  CDC is Center For Disease Control?  

PAULA:  Uh-hum.  Yeah.  And -- and then I would like to, like, put -- I always put anything on Delta Discovery forum, you know.  Then I can do that.  I could make a, you know -- put it there so people can know.  I also talked to CHAP program in Anchorage about it.

PAULA:  So... 

KAREN:  Were there other ways that people used to use animal fat, swan fat?  

PAULA:  Well, the only thing I know about that is they used -- like -- like I said, you know, they use it for sore throat.  And I don't know what else it was used for.  

KAREN:  So for -- swan fat for sore throat, do you make it liquid and drink it?  How do you use it?  

PAULA:  Just scrape it.  When you scrape it off the skin, it becomes more like -- more like a liquid.  It's not total liquid, it's, you know -- 

KAREN:  Kind of softens the fat?  

PAULA:  Uh-hum.  Yeah.  And you have a tablespoon of that.  
Like my brother, when -- there used to be a hospital in Mountain Village.  And when he went to Mountain Village, they took his tonsils out.  Excuse me.  And then they gave him cod liver oil for medicine, you know, to take two teaspoons of cod liver oil daily for vitamins, I guess.  

And he didn't like the cod liver oil, so my mom used to give him two teaspoons of seal oil, the liquid part.  Every day.  So I think seal oil has a lot of vitamins, vitamins in it.  

Exactly what, I don't know.  I probably -- there's YKHC group of people who find out about values of all the greens, the berries that we eat off land.  They should do that, too, on seal oil and see. 

KAREN:  Yeah.  

PAULA:  What the con -- what the contents are.  

KAREN:  Yeah.  I know in -- you know, Mainstream America, fish oil now is becoming a big thing with, you know, natural medicines. 

PAULA:  Uh-hum (affirmative).  

KAREN:  And everybody up here has been eating fish for a long -- 

PAULA:  Uh-hum (affirmative).  Long time.  Yeah.  

Ever since I find -- I heard that, that fish oil is good, you know, I -- I -- I try to have some.  You know, when you take that dried fish off the skin, there's fat.  I start eating that for it, you know, just for that. 

And my mother used to use the fish fat for when she'd tan skins, she used to put some fish fat and, you know, start.  And it makes the tan good, you know, very soft.  

And of course, your hands, too, like we used to have aged urine all the time, and my mom used to wash the fish skins, dried fish skins in there, soak them for a few days, and wash them in that urine in wintertime and hang them outside.  And -- and then they -- the winter, cold, sort of bleached them along with the aged urine is just like ammonia.  And it really cleaned that.  There's no more oil whatsoever on the skin.  And we used to use a lot of that -- excuse me.  So --

KAREN:  So what was that like, balancing Western medicines that you had learned in training and school with traditional medicines?  Is that common?
  
PAULA:  Yeah.  In fact, I would rather push traditional medicines for the people because sometimes the medicines that you take are or could be harmful to the parts of your body.  

Like I've heard medicines, some medicines, you -- they give you, like, for arthritis, I can't remember that medicine, it's a short name.  I took that for arthritis.  And then they removed it from the pharmacy because it affects your heart.  

Like one doctor had told me that for heart fibrillation -- I mean, my -- like my husband, my husband's heart will be, you know, fluttering.  And if you take Nyquil, that tends to make your heart, doesn't beat right.  

It's the chemical in it, it's very good, and Nyquil, I've tried it when I had really bad cold, you know, you always get -- your nose get clogged up.  And then if you take Nyquil, it just opens up.  It's really good.  But it affects your heart.  

So I'd rather have -- try the traditional medicines for the people, you know.  
And in YK -- YK Delta, some people abuse medicine, you know, which is not good for your body.  

KAREN:  Right.  

PAULA:  Yeah.  

KAREN:  When you first came into Bethel for training, that -- those eight months, how did that work?  What kind of training did you have?  

PAULA:  We covered the whole body, 10 body systems.  Just everything, all the sicknesses and everything about body.  

We even start suturing cuts.  But that was -- we learn how, like in the hospital here, we helped suturing somebody.  But when we went back to the village, doctors didn't allow us to do suturing.  

And other -- other things that we learned how to put cast on people with broken bones, the doctors did not didn't allow us to do that in the -- in the village.  

KAREN:  How did that feel?  

PAULA:  We didn't mind it.  It would have been very handy.  But I didn't mind it, you know.  It's something that you -- you have other alternatives, you know, like the tape, you could close the cut and, you know, tape it.  Or if it's on the head, you could even tie the -- alongside of the cut, you could even tie the hair to close it.  You know.  

KAREN:  It sounds like that schedule when you were here in training was very full.  How did you -- you had children at that time?  

PAULA:  I just had one boy that time.  He was one and two years old, and my mother was still living and took care of him because I let mom come here and -- well, he -- she used to tell me never to have baby-sitters.  And she'd rather watch -- watch him than having somebody else. 

KAREN:  And your husband stayed in Alakanuk?  

PAULA:  Yeah, he stayed in Alakanuk because he was working.  He's a -- he was a social worker and -- and he works with that for 16 years, and then got stressed out when there was some incest going, and changed jobs.  

KAREN:  Well, I think being a health aide would be hard work, and then mixing with the social worker in the family, both of you had hard jobs.  

PAULA:  Yeah.  Working with people all the time.  And -- but I think, you know, each person is gifted in something. 

So I always think that health care, being a health care provider was a good gift for me because I seem to just go -- go in it and just, you know, everything go smoothly.  

Like whenever I have emergencies, I took care of them, seemed to know how to take care of them.  And once they are gone, you know, once we get them to the hospital, that's a relief.  

Sometimes I used to leave in the middle of the night with a charter and come here and go home the same night and nobody knew I had left during the night and come back.  

And then towards the end of my career as a health aide, there was some suicides started.  And that was very stressful.  And because those -- those young people who commit suicide were the people I used to have well child clinic just about every week.  And I knew -- I know those people from the time they were little until they got big.  And I have delivered some of them.  So when they commit suicide, it was tough.  

And we didn't have support groups in those days.  So -- but my husband was the only one that I -- that I can go home and cry on his shoulder.  
But now the health aides have everything.  You know, they have support groups and that goes to the village.  

And we had Village Response Team at home and that helped a lot during the crisis, we would get together and plan on what to do about healing, talking circles.  And YKHC used to let us go to other villages and talk to people and, you know, give them support.  

KAREN:  At that time when there were all those suicides, was that a particular time period that that happened?  

PAULA:  Yeah.  They have, like -- I think in one year, Alakanuk had -- what you call that, oh, chain reaction.  In one year, we had at the very beginning, we had six young people in one year that killed themselves. 

It started out when one student was going to school at St. Mary's, when there was Catholic Mission there, and he hang himself.  And after that, some other boys, girls, either hanged themselves or shoot themselves.  And it was -- it was very hard.  But like I said, you have to be a tough person to continue on, you know.  

KAREN:  Yeah.  I was going to say, how did you get yourself through that hard time?  

PAULA:  And then one other stressful thing like after I became supervising instructor was the health aides, some -- a few health aides having alcohol problems.  And those were the stressful things to take care of.  Besides the emergencies and suicides.

KAREN:  So as a supervisor instructor, can you talk about what you do in that job?  

PAULA:  Well, I -- all the time I just had about 36 health aides to supervise, in six or nine villages.  I had more villages sometimes than what I should have.  And depending on the size of where I live around there, they are mostly bigger villages, or I had more health aides to supervise.  

And so I have daily -- almost daily contact with them, and make sure that they have schedules, every month they have schedules, who is going to be on call.  

And then YKHC started having that the health aides work three weeks on and one week off.  That worked.  There's good advantages and bad advantages to that.  Excuse me.  

Good advantages was that the health aides weren't as stressed out as, you know, as they used to be during that time.  Having one week off.  
Another -- well, the bad advantage was that the health aides want to be off all the time.  I mean, it kind of -- they liked it, you know, being off and still earn salary.  So that was kind of...  

But I see that after I retire, they didn't have no more one week off.  So... 

KAREN:  So what kind of schedule do they have now?  

PAULA:  I don't know.  I just -- I just really don't pay attention anymore.  

KAREN:  But when you started as the health aide, did you get a week off every month?  

PAULA:  No.  

KAREN:  What was your schedule?  

PAULA:  Just work day and night.  When we first started.  

It's when YKHC started, that's when we started having schedule.  We worked six -- six hours a day, five days a week, and are supposed to have a week off -- I mean, a day off on Saturday and Sunday, only for emergencies.  
But people, it took people a long time to finally understand, or you know, even it's not emergency on weekends, they used to.  You know.  

And then we're supposed to have one month -- earn one month vacation time, if you work all year.  And still, the community wouldn't see that.  They still call you.  They still like they were.  

So one year my husband and I made camp and -- camp in month of June away from Alakanuk to -- to have vacation. 

But now, the health aides have vacation.  People are used to it now.  It took us long time to convince the community that we work six hours a day and have not where -- only take care of emergencies on weekends.  

KAREN:  So when you were first starting, how did you deal with that schedule of you were there all the time and on call all the time?  

PAULA:  Well, people call you any time of the day or night.  And even we got schedule, six hour work time, they still call you.  

And there's -- in every village, there's one family where you have -- they want you to come to their house.  And no matter how many times we tell them that we have all the equipment in the clinic, they should come to the clinic, they still want us to go to their house.  

And in every village, there's a chronic person that comes to you, come to clinic all the time, all the time, and there's nothing really wrong with that person.  And we're supposed to treat -- once we go into the clinic, we treat people equally.  Even though some chronic people like that.  

And it was good that I know that when I was supervisor and stuff there because when the health aides complain about another village, complain about those kind of people, I always tell them that they have them in every village.  

And another thing that my experience that helped the other health aides was that people like to complain.  Negative things outweighs good things.  They like to complain.  

Like if the health aide is 10 minutes late, you hear that maybe for a week.  If the health aide stay up all night in the clinic taking care of emergency, nobody say anything about it.  

So -- and the complaints, I taught the health aides how to challenge that.  
Because when there was a complaint about me and all the complaints weren't true, I was going to, right off, I was going to quit.  

But I think about it for some time because one of the doctors told me that with so much training and experience, I shouldn't quit.  Just take maybe a month off.  

And I keep thinking about it and keep thinking about it.  Pretty soon I said, if -- if I quit right now, the person who complained about me is going to win.  And all 500 other people need my help to take care of them, you know, in the village.  I know I was working okay, but I said, I am going to even do better.  So I did that.  

So I challenged things like that, and I taught the other health aides to do the same thing, and they appreciate that.  A lot of them are still working up to this day.

KAREN:  I want to go back a little bit to you were talking about the radio, using the radio. 

PAULA:  Uh-hum.  

KAREN:  Where was that radio located?  

PAULA:  When the BIA, Bureau of Indian Affairs, started schools in all the village -- well, some villages, they provided those radios.  It's a big radio, they provided to all the teachers -- I mean, to each school so that the -- they can communicate -- what is that radio called.  

KAREN:  Is it one of those big, like -- 

PAULA:  The airlines use to communicate with each others.  

KAREN:  Yeah.  

PAULA:  I can't remember.  

KAREN:  That's okay.  

PAULA:  Anyway, those were for the BIA teachers to use to communicate to like district school and Mountain Village.  And they let us use them to report.  And the hospital had the same radio.  So that's why we used to report to the doctor like that.  

KAREN:  And confidentiality, how was that handled?  

PAULA:  Like I told you, all 48 villages, you know, whenever the doctor say this is KIK-732 Bethel hospital on the air for medical traffic, all the 48 villages would call in, and whoever the doctor hear clearly, he call that village.  And we have to wait and listen.  

And the health aide reports the person by name, age, and what's wrong with that person.  You know, all of us can hear what's wrong with that person.  

KAREN:  That's way different than nowadays when confidentiality is so important.  

PAULA:  Yeah.  Yeah, it is.  

KAREN:  Did you like doing that radio traffic?  

PAULA:  Not really.  Like when I was going to LPN training, we talked about confidentiality.  And when we -- after five -- five months of classroom work for -- for seven months we worked in the hospitals.  And things were confidential.  And we -- the only good things that we could do is taking temperatures, blood pressure, making beds, you know, help the patient with bed pan.  

Out in the field in the villages, that wasn't useful thing.  You have to depend on yourself instead of depending on the head nurse and the doctor, being a health aide you have to depend on yourself. 

KAREN:  What about the training you received in Bethel?  Did you find that helpful?  

PAULA:  Very helpful.  We used to have Phase 1, 2, 3 and 4, now you call it Session 1, 2 and 3, 4.  And we used to go to Anchorage with 12 health corporations, maybe two -- two from each corporation.  I don't know.  Quite a few from each corporation.  We used to go to Anchorage and have health aide training there.  That way we got to know each others.  

And around here, just the YK Delta health aides would come to Bethel and have training at the hospital.  And Dr. Annabo (phonetic) who was one of the first teachers we had for health aide training.  The health aide training make us more confident in ourselves.  

And it's very unique in that, you know, so that -- and each year it was better and better the way the health aides were taught. 

Now it's very easy.  In the past we used to do lots of notes and all kinds of writing, all the notes are provided to you nowadays with training.  But what we did, the way you learn the best is to actually doing something. 

Like when we had eight months training, at the hospital up there we did -- we actually see the patients.  We took care of the emergencies.  So it taught you self-confidence, and self-strength so that you can take care of things at home.  Like babies always come at night, so you get up and deliver babies at night.

KAREN:  Do you remember your first delivery that you did? 

PAULA:  Not really.  But the first difficult delivery I did, I've never forget that.  The lady was having baby, but the baby couldn't come out.  Her cervix, she was too small down there.  And we had hard time.  

She even told me -- she even give me scissors, she was suffering so much.  She even gave me scissors to cut it and make it bigger so the baby can go out.  

And I just keep on talking to her and helping her what to do, and giving her reassurance.  And the baby finally come out, but naturally, she had tore.  But I cleaned her up well and put padding and the next day she -- she went to Bethel so that no infection come.  

KAREN:  So you delivered that in the village?  

PAULA:  Uh-hum.  Yeah.  So that's what I did were babies in the village.  I don't know how many.  

Another -- another delivery that I did that was kind of difficult was baby coming out feet first.  

KAREN:  Breech. 

PAULA:  Yeah, breech.  

KAREN:  What did you do there?  

PAULA:  I don't know, but I did good.  My mom used to tell me, expect those things, you know.  And what to do about them.  

So I just tried to -- well, see, it's like my Auntie used to tell me the breech baby comes like that, push the baby back and sort of turn it around.  And I didn't do that.  I was -- if you cannot turn it, turn it at all, there was some options, you know, to guide -- to guide the baby out.  And that's what I did.  Yeah.  

And the baby survived.  And there's -- the Native people like to sleep with their babies, right beside them.  And one time in the morning at four o'clock, somebody came and got me and keep telling me that baby wants to stop breathing.  It was one week old baby.  

And I went over there and from 4:30 until 11:30 in the morning, I took care of that baby.  The heart would stop.  The baby was not sick.  The heart would stop and the breathing.  And I used two fingers to massage the heart, and little puffs to the mouth, from 4:30 in the morning until 11:30. 

KAREN:  Wow.  

PAULA:  And when we got into the plane, anyway, I was doing that and then -- then we -- when the plane was coming, the father took me to the airport, there was no plane there, and I had stethoscope on the baby's chest.  

And while we were coming down from the airport, the heart stopped.  So I told him to -- first I looked and there was a house, and I told him to stop there, and I run in there and I put the baby on the bed and start doing massage and puffs to the mouth.  

And when she got -- when he got good, I put blanket on and went out, and we went to the river and the plane was in the river.  It had landed in the river.  

And the mother and the Public Health nurse from -- it was a new Public Health nurse, went with me from there to here, escort the baby.  And I keep doing that and the -- the nurse would relieve me.  

Then one time she told me that even we -- we get to Bethel before -- while this baby is alive, it's going to be vegetables.  And I said, just keep helping me.  

And as soon as we got to emergency room at the hospital, and they put oxygen, that baby got just lively and turned pink.  And I always think that if the mother never sleep with that baby, it would have been a crib death.  But because she sleeps with -- with her baby, he's okay.  

And I -- I used to do well child clinic with that child.  And sometimes I used to go, when he start going to school, I used to go to school and ask the teacher how he's doing, and he was doing good.  He graduate from high school.  And he's a normal person, up to this day.  Married and have children.  

KAREN:  How do you feel about a little break?  

PAULA:  Oh, yeah.  

KAREN:  Okay.

KAREN:  Okay.  We're back from our little break.  And you were talking about delivering babies, which another thing I wanted to ask you about was emergencies and dealing with emergencies and trauma.  And do you remember the first one you had to go to?  

PAULA:  Well, one bad thing about me was in the sight of the blood, I used to faint.  

KAREN:  Oh.  

PAULA:  And that was a very bad advantage, you know, when you're a health care provider. 

So the first emergency, I did, that I had problem with that, some young man had gone out to get in wood, instead of cutting the tree first and then taking the limbs off, he was cutting the limbs first before he cut the tree down.  Accidentally the axe got stuck, but it fall down and hit him on the head.  Excuse me.  

And head wounds would really bleed, bleed lots.  Even if it's just a tiny little thing.  

And I tried to -- excuse me -- stop the bleeding with pressure, because we have nothing else.  I was so embarrassed, I keep getting light-headed and -- and then I would let the mother somehow have -- you know, take my hand from pressing that and somehow show that the pressure is not released, then she would be pressing it while I go out and put my head between my knees and tried to real -- that was awful embarrassing and -- but I managed to take care of that.  

So after traumatic things like head cuts, I would want to faint.  And so I told myself I have to get rid of this.  I can do it if I want to, I can do it, and I'll do it.  
So I told myself, next time I see a lot of flow of blood, I'm going to only concentrate on saving that life, never mind the blood.  And I did it, you know.  

I've gone into one of the suicides, a person who had shot himself on the head, and I went in early in the mornings when -- when I called -- when I was called, and when I went in the house, there was pool of blood on the floor, some coagulation have set in.  And this person was just covered with blood.  

And he -- he didn't seem to be breathing, so I was breathe for him and check the heart, but the heart was very weak.  

And when I took -- took tissue, gauze, and wiped -- wiped the face, I realized that there was gunshot wound on the forehead.  And right away I felt for the back, because the exit wound is bigger and there was some brain in it, too, on the hair.  

And so I told the parents that he wasn't going to live.  And so that was very hard thing.  One of the children I used to do -- take care of, I used to take care of.  So -- 

KAREN:  I don't know how you deal with that kind of a crisis. 

PAULA:  Yeah.  It's -- I did it anyway.  And for some reason, the blood didn't make me faint.  

Then I asked myself, was it because the person was dying that I didn't even get sick, because when I -- when I was going in, they didn't tell me what was going on.  If there's blood involved in this, I'm going to just concentrate on the life of that person.  And I didn't get sick.  

And then next time somebody fall -- one of the elders fall down and had a cut on their head.  I went in, because he couldn't get up right away, there was pool of blood when I came in.  And then I was only concentrating on the life of that person and not -- never mind the blood thing.  And that's how I overcome, you know.  

And there was other tragic things, like two machines, two snow machines collided to each others.  And one was unconscious.  And the other one was okay.  

And just from checking the peoples with flashlight and the peoples weren't, you know, responding to light, just stay kind of dilated and not getting smaller, never constrict, told me that person wasn't going to live because the doctor -- the doctors, you know, when they come to the town, they used to help us a lot, too, and teach us things like that, that the person is brain damaged, they are not going to live, their eyes are like that.  So I -- I knew from there.
  
And there was some other things, too.  Like one person had shot herself with a shotgun, and shotguns make lots of big, big holes.  She had shot herself on the side with shotgun, and she was probably still alive, so she repeated that, making it bigger.  And even touched the spine.
  
And blood just had already, when I -- this was after I became supervisor instructor.  People were still calling me for emergencies, so I went and know that she wasn't going to make it.  So all kinds of emergencies. Sometimes I wonder how I did it, how I took care of them.  Seems to be knowing -- I think subconsciously know, my arms and my hands just know what to do.  And if they live, you know, it's a reward, you know, something like a reward.  Makes you feel good.  But if they don't live, you know, it's different, too.

PAULA:  And there was some funny things, too, that happened, you know.  Like one time I was taking care of -- somebody's -- somebody's got stab wound.  I went there, another health aide was there, but she was just sitting there, not knowing what to do. And I look at the wound and it was bubbling with blood when the person inhale, then I know that the lung was involved.  So I just cover it with -- I think I used tin foil on her and taped three sides and keep one side open.  And she had been drunk so she was sleeping.  And I escorted him here -- her here.  And it was Easter, so it was going to be Easter Sunday tomorrow.  And my sister and her family from Stebbins were in our house, and my husband's sister and her family from Hooper Bay had come.  I wanted to go back, and this charter was from Emmonak, so I -- I asked that pilot, could I go home?  Could I go back home with you when -- when you are going back?  And he said, aren't you supposed to make statement for the troopers, how this happened?  And I never answer for a long time.  I had just come out from -- it was on my day off, I had just taken steam bath, and my hair was still in towel, you know.  And -- and I was thinking for a long time and I said, oh, the other health aide was there already when I went to see this lady.  She can -- she can make statement.  And he never answer me for a long time and finally he said, yeah, I guess you could go back with me.  And I was so happy that when we got there, the medics came and stopped there and I give them the patient, still passed out, I give them the patient, and I forgot to give them the paper.  And it was in my parka's pocket.  And oh, that was awful, you know, because they didn't know who that person was, where she came from, and what was wrong with that person.  KAREN:  Oh, no.  PAULA:  Oh, that was so embarrassing.  And that person happened to be from Emmonak, and the health aides in Emmonak called me the next day, on Monday, and they told me they got scolding from the doctor.  And I said, which doctor was that, so I could call him and talk to him and see.  They told me So-and-So.  So I called and asked for that doctor, and I told him that it was me that did it, not the health aides in Emmonak.  I was so embarrassed but I had to tell him everything, you know.  KAREN:  Yeah.  PAULA:  So yeah.  So...  KAREN:  Were there other funny things that you could think of?  PAULA:  Oh, yeah.  You know.  Some -- there's lots of funny things that -- they are not funny at the time at all.  KAREN:  No.  PAULA:  But later on, they are really funny.  Like one time I was called to a house and somebody had miscarried.  And everybody was under the influence.  And that person who was miscarried, you know, she was laying on the floor in just about the middle of the house.  And her legs were propped up on the -- higher than the head.  And that was really funny later on because every -- just about everybody was under the influence and I didn't know what to do, and everybody was acting as if nothing's wrong.  And even the person who miscarried on the floor was under the influence.  And it was just like going into a fairy tale story, you know, in person.  So I let some of the people go out and I moved the -- moved the person to a bed and checked, you know, checked everything.  And take care of it from there.  And then the next day she had to -- she had to go to Bethel.  So I stayed -- I must have stayed there for two or three hours because being under the influence, everybody was slow on getting whatever I need, you know.  And then I have to go to the clinic and talk to the doctor and come back and do this and that.  So that was kind of silly.  I mean, like I said, you know, just -- just like going into fairy tale and, you know, people not functioning the way they should do, you know.  So later on I laugh about it.

KAREN:  What about that -- you know, before you said you forgot to give that report and that was a mistake you made with that previous case.  Other times that you could think about that there were mistakes that you realized afterwards?  PAULA:  Well, I don't know.  That was the major mistake I did, you know.  If -- especially if it's life-threatening type of thing.  Other things, why I cannot remember them, I don't know.  KAREN:  Well, I was thinking, when you first started, were there things that happened that you didn't have the training for so you didn't know what to do, so it wasn't really a mistake, it was a -- you did what you did based on your training, but it turns out that maybe you didn't do the right thing because you didn't know?  PAULA:  Uh-hum.  Yeah.  One time all the health aides got together, we had a big gathering from all over the state of Alaska, we talked about those things.  That was really funny.  And when I did research on reproductive system, at the end of it, I had the little -- I had -- I made a play about the egg and sperm being -- the sperm being prince and the egg being a princess.  And just everything that went through it like the -- the train -- the train went through the tunnel and the sperm was in the -- as a passenger.  And when -- when they went through the tunnel, he went out, then he went to the castle.  And after castle he went to another tunnel to meet the prince -- princess.  And they met and decided to live and produce, you know.  So they went to the castle and in a big -- like a big bed, you know, that's placenta, settled there, and it's very funny.  I -- at that time, when we got together, I had two health aides, one man health aide and one lady health aide got together and act it out because every one of us were doing skit.  So they acted out and I was the talker.  And that was very funny.  Everybody just laugh and laugh and laugh.  But the funniest thing to me was Willa Ashenfelter and somebody did their skit and they were in White Mountain, the health aide was in White Mountain, and the doctor was in Nome, and Willa Ashenfelter was reporting that some -- last night somebody got shot.  And -- and the doctor said, where did he get shot?  And the health aide said, in his house.  And the doctor said, I know he got shot in his house, where did he get shot.  And Willa Ashenfelter answered, he got shot right here.  And she said later on that actually happened, you know.  Another health aide was doing that, just went up there and was talking.  One time elderly man came to clinic and she all examine, and she told that man, after I talk to the doctor, I'll get back to you.  And the man was going to go out and the health aide said, I'll give you a couple of Tylenol because you have fever.  And so she got two tablets of Tylenol and glass of water, but that elderly man keep talking and she keep talking and they talked back and forth for about 15, 20 minutes, and while they were talking, the health aide just caught herself taking the -- KAREN:  She took the Tylenol?  PAULA:  She took the Tylenol and drink the water.  And the patient said, I thought you were going to give me those.  So lots of funny things happening.  KAREN:  Any of those kinds of things happen to you?  Not that you took Tylenol, but -- PAULA:  No.  There's -- there's other things, you know.  But one time there was this lady, too, she was not very intelligent person.  And when you talk to them, she doesn't understand, you know, doesn't talk well either.  And she needed some vaginal depositories, and the doctor suggest, you know, we give them -- give her those.  And so I -- I talked to her, and she was also hard of hearing, not very intelligent, and I told her to come and let me know if those are helping her in three days.  Three days later she came back and these don't seem to help, she's still having lots of vaginal discharge.  And even though she's been taking them every evening just before going to bed, she's been taking one by mouth.  KAREN:  Well, yeah, I mean, people didn't have those experience with medicines.  PAULA:  I had to explain to her and even let the other health aide explain to her where she's supposed to put it. 

PAULA:  Things, you know, some of the funny things happened.  Even around here one time, my girlfriend and I went to bingo, and while we were at the bingo, I heard somebody -- somebody fall on the floor, and I looked back and I was thinking of maybe somebody's under the influence, I looked back and then turned around, and then I looked back again because that lady doesn't drink.  She was laying on the floor.  And of course, I just run -- run over to her naturally, you know.  And the only person that was helping me was a person who's an alcoholic that he's always going, you can say that he's always going.  So he got me taxi and we brought -- we brought the patient down to -- the taxi driver and him brought the patient out.  And I sit in the front with her laying down with my knee for -- for her pillow, she was out.  She was unconscious.  And while we were going up, she was -- her breathing was getting shallow, and when -- when I got scared, I -- I squeezed her little finger and she -- and she start moving and start breathing good.  When we got there at the hospital, I run into the -- I opened the door for them and I run into the hospital and go to the emergency room and get the gurney, and I put the gurney by the door.  And those taxi driver and the one that's -- who's still, you know, going, had taken the lady, one was holding her like this, the other one was holding her like that, you know, so they were holding the lady.  KAREN:  They were carrying her under her legs?  PAULA:  Well, their arms were like holding, one was on this side holding this leg, and his arm back there.  And the one that was on this side was holding this one and holding her on the back, you know, bringing her in, and they kind of raise her and they were going to put her on the gurney, but her butt hit the gurney -- and the gurney took off.  KAREN:  Wait.  You're attached.  PAULA:  Oh, yeah.  KAREN:  Oops.  Nope.  Now we're back.  So on that one, what happened after you said you found out later about that case?  PAULA:  Yeah.  The doctor came and the nurse came and went through her chart and find out that they had given too much of one kind of medicine, like sort of -- sort of overdosed because the bowels just went down, too, while she was out -- while she was out.  But she got better.  They take good care of her and she got good.  And she lived for a long time after that.  But that was funny.  But it was good that, you know, instead of there's lots of people at the bingo, even some health aides, but nobody stand up to help me except that alcoholic person who was playing bingo just -- that was nice.  Even the taxi driver was giving us help.  KAREN:  So when you were home in the village and something happened, emergency things, did you get help from other people in the community?   PAULA:  Usually the family of a person who is the victim usually give me a hand.  Yeah.  KAREN:  We -- we've been talking a lot about cases that were traumatic or stressful that didn't come out too well in the end.  What about some that had happy endings where you saved somebody, you were mentioning them as your rewards.  PAULA:  Yeah.  That -- that happy ending was about that boy that survived whom, I think, was -- you know, you see those, lots of crib deaths, you know.  It would have been a crib death if that -- if the Native people didn't sleep with their babies.  And a lot of things happened because somebody, like appendicitis, seizures due to meningitis, all those things, we take care of the pneumonias, and -- and prevention, too.  We practice lots of prevention.   So that in some villages, like -- like Nunam Iqua, when I -- when I first started working there, I think they had 125 people, the health aides did so much preventative work that even the -- the population sort of doubled.  These -- there's still -- their average patient daily is two people for the longest time because the health aides do a lot of preventative care.  So instead of getting more and more patients, you know, it's still something like average daily patient care, patient encounters still, too.  And the health aides also, one -- one other preventative thing we did was that when all the fishermen in summertime, we get lots of people coming to the village from -- even from outside, out states, we let them know that there's -- we can check for, if they want to be checked for gonorrhea, we have the -- you know, we have the things to check, you know.  And then treat them, you know, if they have gonorrhea.  Also we let everybody know who goes to Anchorage and get drunk and, you know, we know who the drinkers are, it's always available there, so instead of that one spreading, the health aides -- since the health aides let them know there's these, then they get treated right away when they get home, tested and treated.  So that's a good preventative care.  And some -- some things like placenta getting stuck in the person for a long time, and if the placenta is stuck after baby is born, there's -- there's lots of bleeding, you know, going on.  And from both my mother and from the doctors, we know we're not going to pull, you know, otherwise we might do more damage, you know.  We just let nature take care of that.  There was one lady that she was losing so much blood that she keep fainting.  But to make sure that the fluid didn't decrease, you did that, you know, to squeeze the little finger, and when she come to, you -- you let them have some liquids.  It could be water, it could be broth from the fish or from the meat, you know, just try to let them continue having some liquids.  And then whenever the plane came come, you know, you could, you know, let them go, and that is okay, that is good, you know.  There's more happy endings than sad, you know.  And I think this is majority of the health aides.  They hardly -- they have more rewarding experiences in sick people or accidents than having -- you know, than losing people.  So that is a good -- the health aides do good. And I think a lot of times it's, you know, out in the village, you know, where there's no doctors, nurses, that give us -- we have to know what to do and depend on ourselves, depend on our skills, everything what we learn, we have to depend on everything what we learn, like emergencies, the YKHC teach us, all about these emergencies, how to take care of them.  And nowadays, too, they have IVs.  They can put IV and oxygen.  We didn't have that before.  So in place of IV that they have right now, when I was starting or we just use liquid, a lot of liquid.  KAREN:  Just have them drink a lot of liquid?  PAULA:  Uh-hum.  Yeah.  And if you -- if they want to vomit, if they have nausea, then you just give them a spoon, a spoon of liquid every half hour or every hour, you know, every 15 minutes, to prevent them from getting dehydrated.

PAULA:  Well, one time, too, I took care of somebody that -- that accidentally fall overboard off -- I think it was in October or September or October, late -- maybe late part of September, he accidentally fall overboard from the boat.  But he happened to swim to -- the nearest thing was to swim to the buoy that made left the Yukon.  And somebody found him and when people took him up to the tent, along the nearest camp, they could carry him and he was stiff like a board.  And then put him in a down sleeping bag:  And they -- somebody came to get me because I was in Alakanuk on the other side of the Yukon.  So as soon as I got there, we wound up some -- the stove was on, half a drum stove was on, warmed some towels or any kind of clothing, warmed them up and wrapped them around his neck and put one between the legs and underarms to keep the core warm.  And we keep doing that and keep talking to him, and when he was able to, we let him have a little bit of warm water or milk.  And when I first checked his temperature, it was something like 96 or 94.  Anyway, it was very low.  And I check his temperature every 15, 20 minutes and -- and then when his temperature reached 96, the doctor -- I keep giving the vital signs to the other health aide in Alakanuk from that camp, and she keep telling the doctor by phone.  And when it reached 96, I think, then the doctor told me to warm up the -- those towels again and put -- put them in the, you know -- KAREN:  Those spots?  PAULA:  Yeah.  And then put them in the sleeping bag, which is already warming up, and, you know, warm.  And then wrap him in a tarp to keep the cold air from coming in.  Because it was kind of cold.  I think it was first part of October.   And we brought -- brought him back to Alakanuk and put him in the clinic and took care of him there.  And then -- no, instead of clinic, we brought him to his house, and I took care of him there and talking to the doctor myself on the phone.  And the doctor said to charter, put him in the first available charter from Emmonak.  In the meantime, he'd have something like seizure, and when he seizure he was standing on his head and his feet and just arched like this.  And he was really suffering because his like, potassium was out of order in his body.  That's what makes him arch.  That's what the doctor told me.  And so we sent him here.  They took care of him here.  And he went home okay.  And that's one of the other good -- good, rewarding, he's still living.  And he's okay.  KAREN:  Now, when you say that at the end, oh, he was still living, you get a big smile on your face.  PAULA:  Yeah.  I do that because I -- you know, that's good if -- if I hadn't probably properly take care of him, I don't know what would be wrong.  So.  Other -- other people who have gone in saltwater or go near hypothermia have come up with very bad arthritis later on.  Very.  I think it's -- I always think it's due to being near hypothermic and -- or being in water, that -- that's that cold.  Every single one of those people who have been underwater after freeze-up, couple of them, especially down in -- down in Bering Sea where it's saltwater, they always get very bad arthritis.  KAREN:  Hmm.  That's interesting.  PAULA:  Yeah.  Anybody can disagree with me, but it -- the pattern follows, you know. KAREN:  Uh-hum.

KAREN:  Well, you -- after those first eight months of training you had here in Bethel when you first started, did you get other training?  PAULA:  Well, I had so many trainings.  I had Session 1, 2, 3 and 4, preceptorship, and all kinds of other trainings.  Like I went to Anchorage one time and I -- I stayed -- for one week, I stayed in -- I had training in CDC.  And all -- it was all about sexually transmitted diseases.  Like gonorrhea, syphilis, maybe -- what do you call that liver disease -- I can't remember that name now.  Anyway, I -- anything, you know, about AIDS.  One thing -- one thing I've learned in the village that preventative, anything that you can prevent it from happening, and the people to understand it.  Like when they first start getting AIDS out in the states, YKHC was teaching about AIDS in the villages, and I did -- I taught that in the villages, too.  And understand it.  And I think that kind of prevent a lot of AIDS -- AIDS cases.  And also to under -- for the families to understand those kind of people instead of rejecting them, they -- you know, they know what the disease is and they work with them and accept them as they are instead of putting them down.  So that was good.  And people never used to have diabetes.  And I think all the junk food and especially pop, pop's got lots of sugar, like a can of pop will have something like 11 teaspoons of sugar.  KAREN:  Wow.  PAULA:  And diet pop, people drink it, but it's got something in it.  I used to know it.  Something sulfur in it.  So it's not good drinking.  The best drinking people can satisfy their thirst is with water or fruit juice instead of pop.  KAREN:  Yes.  PAULA:  All the junk food, I always blame it on -- even the elders just love to drink pop.  KAREN:  Besides diabetes, any other differences you've seen in disease and things you've had to deal with from when you started and when you retired?  PAULA:  We -- we never used to have asthma.  And then very, very, very few people start getting asthma.  And then nowadays, lots of people have asthma, even little kids have asthma.  In the past, we never used to have that.  Diabetes, we never used to have.  And when I first became a health aide, there was lots of impetigo and draining ears.  And we've overcome that.  And you hardly see draining ears anymore.  You hardly see impetigo anymore.  And when I became -- when I start traveling to the villages, in one village there was lots of boils.  So one time the health aides and myself start talking, every time I go to a village, we always have a meeting.  When we had meeting, we decided the boils are going to be their priorities.  So prioritize who always get and take care of that.  And, you know, eventually, boils went away.  But they are coming back here and there.  And having water and sewer system makes -- makes it better to -- I mean, got rid of those, like impetigo because people are cleaner.  And it's easy access to water, both warm water and cold water.  In the past, in the past, you -- you have to pack water and warm enough water to take a bath.  But now all you have to do is fill up the tub and you're there.  KAREN:  So.  PAULA:  So that has helped a lot of people. KAREN:  So houses in Alakanuk have running water?  PAULA:  Yes.  And -- but there's a few there still pack water. KAREN:  When did the village get running water?  PAULA:  Maybe six years ago.  KAREN:  Wow.  PAULA:  It could be more than that.  And then I used to write to environmental health or somewhere out in Washington, I used to write a letter to people about environmental health prevention like -- like places where they have, you know, just trying to let that village become -- have water and sewer because there's lots of -- they have places where they can empty their honey buckets, but they are still spilling on the, you know, ground.  And ground or sidewalks.  And the children don't see those as dangerous, something dangerous.  They just play, you know.  So -- and I'm so glad that those villages now have water.   KAREN:  Yes.

KAREN:  Well, how did you -- how did you do your work as a health aide without running water?  PAULA:  Well, we managed.  Because I grow up like that, you pack water.  You boil water for drinking.  You heat up water to wash babies when they are born.  Or have the people soak their cuts or sores.  And talking about birth control pills, before birth control pills, ladies still have babies, which is okay.  It's provided by nature and the way we were made.  And then people in health care system decided to use birth control pills on women so they wouldn't have babies so much.  You know.  People used to have babies until they stopped having babies.  And they are okay, they are healthy people, even though they have 12 to 15 children.  That's -- that's the way we were made.  So one time they introduced birth control pills that year.  And then some people start taking birth control pills.  And birth control pills, I find out later on, will make your body tend to have more children if you -- if you don't take it.  KAREN:  Oh.  PAULA:  So that year, the first year that they -- they got introduced, I had more pregnant women because once they forgot to take their pill, they get pregnant.  KAREN:  Yeah.  PAULA:  So that year I had 16 people pregnant, you know.  Because in every village, we used to have list of people who are pregnant so that we can do monthly or every -- monthly checkup on pregnant women until they are seven -- seven months, then from seven months on, you see them every two weeks.  KAREN:  And then did you have to send them here to Bethel?  PAULA:  Everybody -- the hospital wanted everybody to come here and have baby.  But we -- we -- a lot of people didn't have money to come here.  And we deliver a lot of babies at home.  But having women -- Women's Health Care prevented them from -- will make the women health -- having healthy pregnancies.  So...  KAREN:  So you said you have seven children?  PAULA:  No.  I never have -- I have two children and seven grandchildren.  KAREN:  Seven grandchildren.  Okay.  So how did you -- you know, being a health aide and then a supervisor instructor, you had a pretty busy schedule.  How did you mix that with having a family and raising your children?  PAULA:  Well, like I told you, when -- like when we were here, my mother came with us, she wanted to watch my boy.  So she watched my mom -- I mean, she watched my child when I'm training or when I'm working.  Same with my girl.  But towards -- my baby, maybe my mom watch her until maybe she was four years old.  Then I get baby-sitter later on after she was four years old.  But she was in head start, you know, from the time she was 13 -- three years old, both of my children.  And anyway, but my first grandchild, my -- John was working as an airline -- airline agent, so he practically grew up in a truck with his dad while I worked.  KAREN:  Yeah, well, then, when you had to go away for training. PAULA:  Yeah. KAREN:  You had to be away for a couple months at a time?  PAULA:  Well, a month at a time.  So I -- I have my mom bring my mom -- mother along and -- or my mother would take care of my child while I'm gone.  KAREN:  It seems like you were lucky you had family support. PAULA:  Oh, yeah, lots of support with -- from my family and from my husband, I had lots of support.  And then while I was a health aide, too, I made trips to, like, San Diego.  I went alone but my family took care of my kids.  When they had nationwide health conference in San Diego, I went there.  And -- and the furthest trip I make, another one while I was supervisor instructor, we went to New York, that was the furthest -- I have the pictures with me.  And also Myrtle VanDorn, who was with us as a health aide, when we made that trip, make a little story on.  But she missed some things like riding in subway with Dr. -- Dr. Quick.  He used to be here and then he was in New York when we went to New York.  So he took us right around with riding subway.  And then we went to -- one night we went to Twin -- one of the Twin Towers.  We went up to 107th floor to eat in a restaurant.  And I was just very curious to see how small the cars would be when -- when I look out the window.  So as soon as we settled down, I went to the window and I was going to look out there and see how small the cars would look, but it overcast was very low.  The ceiling was very low and I just see clouds in there when I look out the window.  So we had a wonderful time.  There was our boss there, some -- some of us -- some of the health aides, some -- some people from Women's Health Care, some of the -- well, anyway, we went -- we went to every booth in -- in one of the buildings and all day we were going from one booth to another.  And when we came back to our room, we -- we spilled our bags on our beds and see who collect what.  And I had lots of pencils.  Pens and pencils with my bag.  And Myrtle VanDorn had lots of -- lots of condoms, all colors.  And Mary Anaruk had -- I forgot what she had.  Lots of that.  And then when Moses somebody, and when he came in, anyway, instead of going to his room, he came to our room.  And we wanted to see what he got.  He spilled his bag on the bed and it had lots of diaphragms.  All sizes and all colors.  That was fun.  KAREN:  What -- what kind of a conference was that?  PAULA:  Nationwide health conference.  KAREN:  In New York?  PAULA:  New York.  KAREN:  Do you remember what year?  PAULA:  It was 1992, I think.  KAREN:  You said you had a picture.  PAULA:  Yeah.

PAULA:  These are the -- KAREN:  Let's see the pictures. PAULA:  -- all of us that went.  KAREN:  You're standing on a boat, you're on a boat dock?  PAULA:  We -- we ride around -- we were riding around Manhattan Island.  KAREN:  Oh, on the ferry?  PAULA:  For three hours.  KAREN:  On the ferry?  PAULA:  Yeah.  KAREN:  So who -- who all is in these pictures, starting on the left?  PAULA:  This was Pahnem Kinegak, who was working for Women's Health Care and became a health aide later on.  KAREN:  Okay.  PAULA:  And this is Mary Anaruk, our boss at the time.  Henry Friday, health aide from Hooper Bay.  And myself, I was supervisor instructor.  Oh, this is Greg -- Greg -- Greg Moses, and he had -- anyway, he's taking -- take care of AIDS or something like that.  KAREN:  Okay.  PAULA:  And it's written here.  And this is Myrtle VanDoorn, she's a health aide from Aniak.  KAREN:  Okay.  Do you remember how to spell people's names, like, or is that in -- PAULA:  Yeah, I've got them here.  KAREN:  Oh, good.  Okay.  It's in that article.  (Inaudible) sight-seeing crew.  PAULA:  And we each did presentation.  That was very good.  We -- we get together and plan our -- our presentations.  And oh, Moses Frederick was -- Greg Moses was working for AIDS department at that time, and he did his presentation on that.  And the rest of us, we had made -- Pahnem Kinegak did improving Alaska Native women's health care through IHS.  And Mary Anaruk and myself did the primary care providers in Alaska -- Bush Alaska.  So that was our -- KAREN:  Let me see this article.  This was an article in your -- PAULA:  This -- this is what Myrtle VanDoorn did with the school or -- KAREN:  It says the Aniak Paper?  PAULA:  Uh-hum (affirmative).  Aniak Paper. KAREN:  That's the local newspaper in Aniak?  PAULA:  Uh-hum (affirmative).  That's their local paper in Aniak.  KAREN:  Maybe I could try scanning this and see. PAULA:  Uh-hum.  Yeah.  KAREN:  To go with that photo.  PAULA:  Uh-hum (affirmative).  KAREN:  That would be good.  PAULA:  And that was fun.  And it was kind of scary, too, for me.  Narrow roads and narrow streets in New York, and the buildings, you know, just go up there.  You could only see the sky up there.  Like in the evening when I -- when we go out, I couldn't go out by myself, I have to have -- I would -- I would call Henry Friday and we would go out and -- and those people, some people would come trying to sell some watches and all that.  And once they see a police security, they vanish in there.  So I'd be scared to go out alone.  And around here, too, in Bethel I used to be scared of drunks outside of AC and outside of Swanson's.  So I told all these people the day before we went home, I told them that, oh, it's going to be so good to be in Anchorage -- or in Bethel.  Next time I see those drunks outside of Swanson's or AC, I'm just going to go over and give them a hug and I tell them I'm not scared of you. KAREN:  Well, that's good.  I know you have a lot of other pictures to -- for us to look at.  I just have a couple more questions while we're talking about this thing.  PAULA:  Uh-hum (affirmative).  KAREN:  Tell me a little bit -- tell me about that supervisor instructor job and what that is.  PAULA:  Well, each of us are given a certain amount of villages.  And we were supposed to have health aides, how many health aides, I forgot, maybe 26 health aides to each assigned.  But we probably had more than that.  Like I said, most I had was -- most of the time I had 36 health aides work with them.  And we have daily contact.  And we also -- well, I was teaching through teleconference, too, and I meant to bring one topic but I forgot.  And we have tentative -- nobody else did this, I think, but my tentative schedules for six months would be who's going to be working, who's going to be on -- on week off, who's going to be on week off, who's going to go training.  KAREN:  So you scheduled people in each village you were in charge of? PAULA:  Uh-hum (affirmative).  KAREN:  And you scheduled their work and then their trainings?  PAULA:  Uh-hum.  Yeah.  KAREN:  So you were everybody's supervisor?  PAULA:  Yeah.  KAREN:  Wow.  That's a lot of people. PAULA:  That's lots of people.  But it's doable.  It's -- you know, people are.  And it's long distance, you know.  And I'd go to each one of those villages two times a year.  And every time I go, I meet with the City Council, most of the health aides were under the City Council, and then I meet with all the health aides and the janitor or after they got secretaries, with their secretaries.  And you travel on Monday and stay three days, depending on how big it is.  And then you return on Friday.  But with small villages, you -- two days is good.  You travel out one day, one day travel, two days of travel, two days of work with the health aides.  And you make sure that you have inventory sheet, you inventory everything in the clinic there.  Supplies, dry supplies, their medicines, and other supplies for the health -- for the janitor.  Everything.  KAREN:  So when you're the supervisor instructor, you're no longer being a health aide and providing care?  PAULA:  No.  You're no longer health aide, but we have update every year, or every whatever.  The SI, supervisor instructors, will have update every year to keep up with the changes and, you know, that.  And they know what health aides are supposed to do. KAREN:  Uh-hum.  PAULA:  So you just still go on training, and then other things, workshops like AIDS workshop or Women's Health Care workshop.

KAREN:  Now, this teaching you were doing through teleconference, was that a different job position or that was part of your assigned work?  PAULA:  No, it was -- well, Linda Curda started that in 1980 -- '84 or '85.  And when I -- when Clara and I -- when I became an SI, supervisor instructor, I was asked if I could be facilitator for that.  So Clara Morgan and I became facilitators.  Each month we took turns like January, she'll do them -- she'll do the research in December and do a presentation on January; and in January, I'll do the research on one thing and do it in February.  Each month, we took turns.  And one time Sarah Jasper from Akiak, when she was a supervisor, she helped us.  So it kind of give us more time, Clara and I.  So three of us did research on one subject, one topic, and took turns, you know.  When I retire, nobody would take it.  So it just retire like me.  KAREN:  After you were gone nobody was interested in taking the class or nobody was interested in teaching?  PAULA:  Nobody was teaching.  I mean, nobody was interested in teaching besides Clara and myself.  So -- KAREN:  So what kind of things were those topics that you selected?   PAULA:  I went from the eyes, ears.  I did one on brain, I think.  Not quite.  What -- but I did some brain -- research on brain and that's how I know neurotransmitters and all that about the brain.  And then I did digestive system, respiratory system, reproductive system, urinary system, and then I did skeleton, muscle, and what's that other one, circulatory system, and that other, what's that other fluid that flows in our body.  I did that.  Lymph -- lymphatic system, I did that.  Yeah.  KAREN:  So what was the purpose of these classes?  PAULA:  So that the health aides will know all about the body systems and learn them so that when the sickness, then I went -- we went through the sicknesses, so that they know what to do.  Like if we're talking about pneumonia and symptoms, treatment, you know, things like that.  And other things that we did was sniffing gas and alcohol, drug -- alcohol and drug abuse.  Death and dying.  Death and dying, doctor said we should have it every year.  So we had death and dying every year.  And then we -- we did suicide.  And suicide and death and dying, we did it once a year.  And that's when all the health aides, everyone that talk about suicides or death and dying, that was a good way of unloading.  And I divide 4 to 8 villages into 12, 12 -- 12 villages, you know.  KAREN:  So 4 groups?  PAULA:  4 groups consisting of 12 villages each.  And so every Friday at ten o'clock in the morning, we have teleconference with Group 1, the next -- next Friday, Group 2, and so on.  And sometimes I used to -- when we first started the death and dying, every Friday I -- well, when I have teleconference, I'd be crying along with the health aides, you know, when they are unloading and crying.  And then I would think, now next Friday, I won't -- I won't be crying.  Come Friday, different health aides with different incidents, crying, and I cry all over again.  Then I used to take minutes.  And when I typed them, I cry all over again.  So that was a lot of work.  That's why I always wonder, how did I do it.  I was supervisor instructor, I was teaching with teleconference, researching just about every month, and I enjoyed, and I was taking college courses.   KAREN:  Wow.  PAULA:  Until I get my degree.  So -- and still keep my family in there good, provide them with good care.  I guess that's why when I retire for two years, I trained myself, I never settled for two years, I just keep on going, going, going, and sometimes I'd find myself doing two or three things at one time.  And one time I just sit down and I said, what am I hurrying for.  I'm not going to be working tomorrow.  So the third year I kind of relax, start relaxing.  On the fourth year, sometimes I could sit around doing nothing and not feel guilty at all about, you know, not doing anything.  KAREN:  Yeah.  PAULA:  And I've learned to -- but then I -- how did I do other things like making parkas -- KAREN:  Oh.  PAULA:  -- for my children.  KAREN:  Would you -- would you and your family go out to fish camp in the summers?  PAULA:  Uh-hum.  Yeah.  Until people learn that they are supposed to leave me alone when I'm on vacation.  Uh-hum.  KAREN:  So they would -- when you were out at camp, they'd call you to come in for things?  PAULA:  No.  I'd just stay out there.  KAREN:  That's good.  PAULA:  Yeah.  That's the only time that they would leave me alone. KAREN:  Yeah.  You need a break.  PAULA:  Uh-hum (affirmative).

PAULA:  Yeah.  KAREN:  So these classes you were teaching on teleconference how were they different from Session 1, 2, 3, 4 that the health aides got?  PAULA:  Very different because in Session 1, we're learning about basic, basic training.  The basic things that you're supposed to learn like temperature -- vital signs, how to listen to the heart, and how to listen to the lungs, and feel for kidneys.  I mean, you know.  Just -- and then from there, you go deeper into other things.  It just go -- go deeper into health care.  And like learning how to deliver is another.   KAREN:  So what is -- I've heard people use the abbreviation CME.  Continuing medical education. PAULA:  Education.  Yeah.  KAREN:  That's what these teleconference classes were?  PAULA:  Uh-hum (affirmative).  And the teleconference classes were -- were like CMEs, each person who attend will get one credit towards CME.  And which is good.  Because the -- you know, a lot of the health aides, I encourage them to have further education and even get a degree.  They are doing it more and more, which is good.  Yeah.  KAREN:  What would you say was the hardest or worst part about being a health aide?  PAULA:  Well, the hardest thing about it is being called at night.  Before people learned that you have to call them for emergencies.  Another hardest thing for me was that when suicides came, accidents came, people never used to have hardly any accidents.  That was before stronger outboard motors or snow machines.  They hardly have accidents.  But now you could -- snow machines, you get into accidents and people speeding around and -- or driving under the influence. KAREN:  Uh-hum.  PAULA:  We didn't have that in the past.  So if somebody call me during the night, especially if it's a child with fever, I would tell them to give them a couple of aspirin -- or you know, aspirins, baby aspirins, and but I won't go to sleep until I get up and go and see that baby myself.  So I always end up getting up.  And I find out later on, it wasn't only me, it was most of health aides that would just have to go out and check themselves.  Otherwise, it just constant bother them.  KAREN:  What was the best part about doing the job?   PAULA:  The -- the best part was take -- being able to help people healing -- heal.  Like, you know, if they have sickness, you know, help them to heal by giving them instructions on medicines.  Like one man I was taking care of, kind of elderly person, he finally came to clinic because he couldn't heal at home.  And he had rash.  He was old timer who have never -- modest person that, you know, he had rash in genital area.  And I was reassuring him that -- not to -- not to be ashamed, that to me, the whole body is just like one part of the body or not.  Even the genital area is no -- no different from, you know, other part of his body.  I have to take care of it.  So I start taking care of that.  He said even he's, you know, soak in the tub, and it seemed to be spreading, so I took care of him.   And each time he was really -- when I took care of him, he was really ashamed, you know, and would rather cover his face, you know.  But when he got good, he was so relieved, you know.  And so glad, you know, that was -- you know, that makes you feel good that they were able to help somebody.  Like those people, pregnant women who couldn't urinate anymore because of the pressure from the baby.  And it's painful.  And so when I -- you know, when I let them pee, you know, with that rubber thing, bring it into their -- KAREN:  Like a catheter?  PAULA:  Oh, catheter.  I couldn't remember.  But the catheter was just one.  I have to boil it over and over and over again.  Each time after use, I have to boil it.  That's the only way we could sterilize our equipment.  Yeah.

KAREN:  All the time you worked as a health aide, did you have a clinic in a building or did you have to do this from home?  PAULA:  When I started out, I had -- we had no clinics in the village.  The only little cubbyhole in -- in BIA building, excuse me, in BIA building, there was one little room that wasn't being used.  I was able to keep my -- keep little bit of medicine in there in the cabinet, and some -- something in there.  And no clinic.  And then in 1970, we finally got clinic, but it took about two, two, three years before people actually started coming.  The doctors and nurses really supported me when -- when they come to the village.  They tell me -- I mean, they will tell the people that come to the clinic.  He wasn't visiting from house to house anymore.  So that really helped.  Then I wasn't going around too much, you know.  KAREN:  So before you had the clinic, you would go make house calls?  PAULA:  Uh-hum.  Yeah.  Lots of house calls.  And there was one -- excuse me.  Anyway, there was -- I was giving shots to a couple of boys, and one family where there's lots of children.  And those two boys were really deathly scared of shots.  I was giving penicillin, and the first shots, you know, they were very crying and very fighting, maybe two days.  And then they got the idea.  Each time I'm -- I'm coming to that house to give them a shot, they'd go under the bed and hide.  And the parents had a hard time taking them out for me to give them shot.  That was very funny.  KAREN:  Because I do know that in other places before there were clinics, the health aide would have clinic at their houses.  PAULA:  Yeah.  Well, you have something in the house, that black bag, but we didn't have very much -- excuse me -- like I said, the only thing, medicines, there was aspirin and Triple Sulfa, and then later on Tetracycline.  All the rest are penicillin.  And penicillin, you have to keep in BIA refrigerator.  Because you can't keep them at home.  And I didn't have refrigerator.  Up to this date, I still don't have refrigerator.  KAREN:  Really?  PAULA:  Yeah.  But there's other ways to keep your things from being spoiled.  KAREN:  So you had men -- you mentioned that since you retired, you're continuing to do research on different medical topics.  Why do you think you have this interest in doing all this research?  PAULA:  Well, I enjoyed that research so much, and teaching it.  I always liked to share things that I know all the time.  And it's also -- it started when my -- when my parents told me, every knowledge, I have good knowledge, I always share it with other people.  And you'll get more knowledge that way.  But if you keep that knowledge to yourself, it will get old in there, you know.  So I'm always wanting to share things.  So I do research and share them with other people.  And I learned so much from them, it's good.  It gives you a lot of good knowledge.  Whenever they have any kind of workshop, I've gone -- Clara and I have gone through it all.  It's -- you know, it's just a review for us because we've done it already.  And then so I -- and I like to read.  Whether it's doing research or just for information, or reading a book, you learn a lot from reading book.  Because my original language is Yup'ik language.  And my second language is English, and if I don't understand a word, I use dictionary to find what it means.  In fact, during the research, I organize what I'm doing, the research, I write it down, organizing it, and also putting it into Bush language so that everybody can understand.  Most of the things I research is in college language.  So I use dictionary a lot to put it into Bush language and then give the information out.  All -- during all that doing that, I -- and then you type the -- from draft typing it, you learn a lot doing that.  So it's -- after two years -- two years after I retire, I had that itching to do, to -- to do something else and learn.  And most -- most of the thing I miss was researching, you know, start reading health book and organizing, and during that when I was teaching through teleconference, I missed doing the teeth.  So I -- I did that a couple years ago, I think, or last year.  And I've done some hair because I -- I didn't do the hair.  Now we have that, hair.   And there are other things besides just hair that I could -- I'm going to do some more like what the dyes and perm does to the hair, what the rubber band does to the hair.  I want people to know that.  KAREN:  And all of this you put in the Delta Discovery column there?  PAULA:  Uh-hum.  Yeah.  Send it to Delta Discovery and they'll put it on paper.  So I have that -- I -- one time in my life, too, I wrote a book.  And I had so many pages in it.  And -- and it -- when our house burned down in 1991, I think it was in '90 or '91, the -- all 7 chapters, 17 chapters burned.  And I never rewrite it.  And -- but... KAREN:  What was it about?  PAULA:  Oh, some experiences in life, some stories, like these stories that Native people have, they have stories, you know.  And all the experience I had, like when I went to Tacoma, Washington, you see people and you smile at them, you say hi to them.  And find out that they found me weird for doing that.  Just the difference of the different cultures.  I had to learn it the hard way.  There was lots of -- and it was very lonely and you feel this being alone.  And in that time, too, people were so -- the races were so different and excluded from each other.  Do you know what I mean?   KAREN:  Yeah.  Discrimination?  PAULA:  Yeah.  Race.  Nowadays I always say when the Blacks used to be pitch black, and when the Whites used to be pure white.  And when the Indians used to be totally red, you know, and us Natives being totally yellow, you know.  But nowadays, we mingle together and we -- it's okay to be without a people.  And there's no prejudice.

KAREN:  As a Yup'ik health aide, did you feel like you ever had -- were ever discriminated against in the Western system?  PAULA:  Well, when I first started, we used to have lots of itinerary nurses that goes to villages.  And the -- the public -- I mean, these nurses were kind of, what do you call that in English, afraid that they -- they going to lose their jobs, that the health aides are going to take over.  So I was discouraged from becoming a health aide by some nurses.  They felt -- the nurses felt threatened, that they might lose their jobs.  And -- and not only in health care this happened, now that we have more Yup'ik people going to college and becoming teachers, teachers are kind of threatened that they are not going to be having these jobs anymore.  So one -- one experience I had was when I went to St. Mary's, the nuns had -- the nuns and the priests told us that our Yup'ik way of living is superstition.  Our Yup'ik way of living is wrong.  And -- and before school started the -- the none -- the Superior talked to us and told us that tomorrow school starts, and starting tomorrow, you have to talk English.  And every time you caught talking Yup'ik, we're going to give you a black mark after your name.  And if you have three black marks, no movies for you on Sunday.  Naturally, we couldn't just learn to speaking English overnight.  And you become -- I became very quiet.  I try not to talk at all because if I -- I didn't know how to talk any other way, any other way than Yup'ik.  And I was 15.  The only language I know is in Yup'ik.  So it makes you feel kind of thirsty for conversation, thirsting for communication, all this feeling of separation.  And then it was my speech was kind of affected by that, trying to be quiet.  And so -- but now I'm -- I'm fluent no matter what -- what anybody say I can -- I can talk in fluently English and fluently in Yup'ik.  KAREN:  So those classes you taught by teleconference, were those in English or in Yup'ik?  PAULA:  They were both in English and Yup'ik.  And I know who speak what, so if I have totally Yup'ik people, I talk Yup'ik, and they ask questions in Yup'ik, so it was much more learning than just English if it was given in English.  If we have people, like people from Grayling who are Indians, then I speak English all the time.  You know.  During.  But I let them -- I give them -- they could talk to each others in -- in their language.  You know.  That's the way to learn, you know.  Understand things.  KAREN:  Did you end up doing a lot of Yup'ik translating?  PAULA:  Oh, yeah.  KAREN:  In bilingual?  PAULA:  Uh-hum (affirmative).  Today I'm translator.  I've been translating -- when I retire, I just retired from work, I'm still counseling, mentoring, and translating.  KAREN:  And who -- what are -- what's the mentoring?  PAULA:  Mentoring, if there's dysfunction in families, I mentor or if mis -- behavioral problems for little children.  Like this winter, little kids burned somebody's house, went in there.  And the elder told me that those four couldn't do it by themselves, they have to be an older person to force them.  But those little kids just told their parents and grandparents that there was just four of them.  And the -- the trooper came and talked to them and those little kids never -- just four of them tell that there was just four.  And their grandparents asked the elders if elders could talk to those four children.  And all the elders had excluded, so I saw them, four children, and sure enough somebody, some older person had done a -- you know, kind of forced them to break into the house and start the fire.  And so to make sure that they don't repeat what they did and to understand exactly what they did, I have to talk to them, you know, let them understand that because you did this, these people don't have home no more.  Because you burned the house, they have -- they no longer have clothes, no longer have food that they gathered into their house and put them in the freezer.  And let them understand what's right and wrong, and work towards healing and, you know.  And so those are the mentoring things I did, you know, like little kids breaking up into other people's property and I talk to them and they feel good about unloading, too, those little kids. And there's also little kids who have a lot of hurt from traumas or from alcohol, they -- their parents use.  There was 12 or 11, mostly 10 years old last year I talked to them, and that's mentoring and counseling, you know.  And I -- I had also a couple who are older than me.  My colleague mentoring because I guess both of them had grow up with dysfunctional families.  And they, in return, their married life was dysfunctional.  So we did some mentoring and they are doing good.  KAREN:  Yeah.

KAREN:  Back to the time of the health aides, how much interaction did you have with the doctors and what kind of relationships were established between you as a health aide and the doctors?  PAULA:  Well, we used to, like I said, we used to report our patients every day all the time.  And when I have emergency, I would call them and they would be so nice, even at night, and just help me just by phone giving me advice and tell me what to do.  And -- or when they are in the village, you know, we work together, same with the Public Health nurse.  KAREN:  And how often would they come to the -- would the doctors come to the village?  PAULA:  Usually once a year, I think, once a year the doctor comes.  The Public Health nurse comes to village maybe two or three times a year.  I don't know how long -- how often they are coming to the village now.  Seems like it's even maybe -- maybe the doctor comes to the village once a year now.  And as -- as supervisor instructor, I don't have very much contact with the doctor, but we used to go to our villages every two -- two times a year anyway.  KAREN:  What was that interaction like with the doctors?  Was it -- how were you treated by them?  PAULA:  They were -- they were very helpful and supportive, you know, towards me anyway, in the village, you know.  They -- I'd have lots of questions and they'd give me all the information.  And so like -- like while ago I said when we first got clinic when the doctor comes to village, he would be working out of clinic, and he was encouraging people, they have to come to clinic.  Same with the Public Health nurse.  They have to come to the clinic.  They have to start using the clinic, you know.  So people start going to clinic.  And then later on, we -- we schedule, we made schedules, so that we started appointment system in the clinic.  So people have to make appointment in order to be seen at the clinic now.  In the past, they just come when they -- come any time.

KAREN:  Do you want to look at some of those nice pictures you brought?   PAULA:  Yeah.  KAREN:  Before we run out of time.  PAULA:  These -- every year we used to have health aide conference at -- we had it one time in -- in Children's Home in Kwethluk, little ways from Kwethluk.  And each year -- this was in Kwethluk, Children's Home, we used that.  And it's good to have conference at Kwethluk because there's no people around there, there's no cars, there's no phones, so we had a wonderful.   KAREN:  So these are all the health aides from YKHC?  PAULA:  Yeah.  All of these here, Sam Alexie.  KAREN:  Second one from the top. PAULA:  And here's Clara.  Who else did you say?  And here's myself.   KAREN:  You're the front row?  PAULA:  Uh-hum (affirmative). KAREN:  Second from the right.  PAULA:  Yeah.  This is myself.   KAREN:  And Clara is in the little brown jacket. PAULA:  Clara.  Uh-hum.   KAREN:  Second row, third from the left. PAULA:  Theresa Demientieff from Holy Cross, is a good health aide.  KAREN:  Maroon jacket, second from the left, second row from the front. PAULA:  All of this I don't know.  I'm just telling you some of them.  KAREN:  Yeah.  PAULA:  Here's Mary Phillips.  KAREN:  Oh, with the sunglasses, and the brown jacket and the -- PAULA:  Yeah.  Yeah.  And one of the -- like Frederick Moses, I think this is him.  Or this one.  KAREN:  And about what year did you -- do you think this was?  Do you remember?  PAULA:  I don't know.  The real pictures here, these are -- I just put them on -- KAREN:  You scanned them?  PAULA:  Yeah.  I scanned these.   KAREN:  Okay.  PAULA:  And this is Lena.  I -- I was going to -- this is Lena Lake from Hooper Bay.  KAREN:  And who is she?   PAULA:  She was a health aide, Lena Lake.  KAREN:  Okay.  PAULA:  Those are -- these are the first health aides.  And Abby Stephana from Russian Mission, she was one of the people that had eight months training here.  She's one of the first health aides, she passed away.  KAREN:  So she's the older woman there on the left?  PAULA:  Yeah.  Uh-hum.  But Lena Lake is still living. KAREN:  Oh.  PAULA:  And this is Agnes Boyscout, one of the first health aides in Chevak.  And she's still living.  KAREN:  Wow.  PAULA:  Yeah.  KAREN:  Okay.  PAULA:  And this is Sam Alexie.  KAREN:  Alexie and -- PAULA:  Yes.  From Eek.  Still living.  I was going to make pictures like this, a little story and frame them and hang them at the YKHC, but nobody would help me.  And I didn't really know what to do about that.  And these are the supervisor instructors with coordinators.  KAREN:  What's a coordinator?  PAULA:  Coordinator is somebody based in Bethel who -- who -- and under the coordinator are supervisor instructors. KAREN:  Okay.  So the coordinator kind of manages the program?  PAULA:  Sort of.  If they know how.  KAREN:  And so that's with YKHC?  PAULA:  Uh-hum (affirmative).  When they first started supervisor instructors, the -- they brought some people from Outside, out in the states like Deborah Caldera.  KAREN:  So she's the one in the black shirt?  PAULA:  Uh-hum (affirmative).  But they didn't know anything about health aides.  There was four of them.  Catherine McNamara.  But they had to learn how the health aides function from me.  They didn't know anything about health aides.  So didn't work out really good.  So the YKHC then learned and got supervising instructors out of the people who were health aides before.  That makes sense.  Then we know -- we know everything about health aiding and we know what we need as a support. KAREN:  Uh-hum.  PAULA:  So I was -- I was a health aide and I became supervising instructor.  Elena -- and I've retired.  KAREN:  So let's say front row. PAULA:  Okay.  KAREN:  The first one in the black is Deborah.  PAULA:  Okay.  KAREN:  So right from -- from right to left. PAULA:  Yes.  KAREN:  And then that's you?  PAULA:  Yeah.  And myself.  KAREN:  Okay.  PAULA:  Elena Rothschild, she's still a supervising instructor but she would like to go back to her village and work as a health aide again.  KAREN:  And what village is she from?  PAULA:  I don't know.  I forgot.  She's from close by.  KAREN:  Okay.  And this next one?  PAULA:  And this is Georgianna Wasky, she was a health aide, a nurse and a health aide and a supervising instructor.  But she has passed away.  She had cancer.  And this is Clara Morgan.  KAREN:  With the glasses and the white shirt?  PAULA:  Uh-hum.  KAREN:  Okay.  PAULA:  I'm trying to find out who this is.   KAREN:  In the pink shirt.  PAULA:  Yeah.  I think one of the health aides.  And -- KAREN:  Okay.  PAULA:  Which way do you want to go?  KAREN:  Let's go the same way from the right to the left.  So the man.  PAULA:  The man is Dr. Quick, the one that used to come here and work as a physician here.  And then became something else, and when we went to New York, he is the one who took us around. KAREN:  How do you spell his name?  PAULA:  Just Quick, you know, like "quick." KAREN:  Q-U-I-C-K?  PAULA:  Uh-hum (affirmative). KAREN:  Quick.  Okay.  And the next one down?  PAULA:  I think this is Cathy McNamara, who was a coordinator.  KAREN:  Okay.  PAULA:  Supervisor.  And then this is Martha -- I forgot her last name.  And this one, too, I can't remember her name.  KAREN:  Okay.  PAULA:  And this is Janet.  Uh-hum.  Somebody.   KAREN:  Okay.  PAULA:  I don't know who this was.  Anyway, Martha did -- Martha was a health aide and then became supervisor instructor, and then became something else and study about the values of the food that we ate.  KAREN:  Oh, okay.  PAULA:  And this is Penny.  I forgot her name.  KAREN:  Okay.  Did we decide what year that was?  PAULA:  We'll see, I think. KAREN:  Is might be on the original picture?  PAULA:  This -- this one. KAREN:  Right.  In Kwethluk?  PAULA:  Yeah.  It was in -- KAREN:  Oh, 1988?  PAULA:  '88.  Yeah.  KAREN:  That's the Kwethluk.  Okay.  PAULA:  This one is different.  Another different health aide gathering, but this is not so good.  KAREN:  I'll put these in order quickly.  PAULA:  This is another time at St. Mary's, health aide conference.  KAREN:  Okay. PAULA:  Two different years, I guess.  No, this -- yeah, I guess -- yeah, this is two different years.  KAREN:  That looks the same -- no, it's the same.  PAULA:  Is it?  KAREN:  Yeah, I think it's just from a different angle.  Because it's the same people with the same clothes.  PAULA:  Oh, yeah, now I see.  KAREN:  I was looking at the clothes that people were wearing. PAULA:  Uh-hum.  Yeah.  KAREN:  So I think this one -- this one's a better one.  And this says -- oh, it doesn't have a date.  PAULA:  No.  I was looking for a date, but -- KAREN:  And you don't remember, huh?  PAULA:  Well, we had so many.  KAREN:  Yeah.  You have them every year?  PAULA:  Every single year. KAREN:  Okay.  So all the YKHC aides would come together every year?   PAULA:  Uh-hum (affirmative).  KAREN:  Okay.  PAULA:  This is another, what year, July of 1998, these were Martha Addy. KAREN:  Back row left.  Okay.  Martha Addy.  PAULA:  And this is Clara Morgan.  KAREN:  Okay.  PAULA:  And behind her, Bonnie Himshutt, our boss. KAREN:  Okay.  PAULA:  And what is her name now.  Belassa.  I don't know.  KAREN:  In the red?  PAULA:  Yeah.  I'll probably remember.  And myself.  KAREN:  Okay.  And then the front, left to right, or starting -- PAULA:  Oh, Elena Rothschild.  KAREN:  Okay.  PAULA:  Napakiak health aide, Ruth Evan, she was a health add and then supervisory instructor.  Julia Street was supervisor instructor, now she works in Dr. Claka's (phonetic) office.  KAREN:  Here in Bethel?  PAULA:  Uh-hum (affirmative).   KAREN:  Okay.  PAULA:  And this is Belassa Larson, supervisor instructor. KAREN:  So this was a supervisor instructor meeting?  PAULA:  Uh-hum.  Yeah.  KAREN:  Okay.  Here in Bethel?  PAULA:  Yeah.  Every month we used to get together and meet here in Bethel. This is another of our pictures, you know, but it's -- must be the same time that I have same shirt. KAREN:  You wore the same shirt in the St. Mary's one, or -- PAULA:  No.  This one.  I'm wearing the same shirt.  Yeah.  Same time.   KAREN:  This one's outside someplace.   PAULA:  Yeah.  Outside of St. Mary's.  KAREN:  Oh, that's at St. Mary's.  PAULA:  Uh-hum (affirmative).  KAREN:  Do you want to use this one?  PAULA:  I'll see if -- yeah.  I think that's good.  KAREN:  So that's Number 9.  So this is supervisor instructors again?  PAULA:  Uh-hum (affirmative).  And when we go to St. Mary's for health aide conference, everybody learns how to or review giving shots or doing something.  So just going through everything, you know.  During this time, when we were at St. Mary's, we learned about giving shots.  We review and we used the orange for giving shot properly. KAREN:  So that's what's happening in that picture Number 10?   PAULA:  Uh-hum (affirmative).  KAREN:  Who is this?  PAULA:  This is myself.  KAREN:  In the pink.  Okay.  PAULA:  Yeah.  I don't know which health aide was behind me.  Somebody from upriver I think.  And Janie Taluk (phonetic) from Kotlik.  KAREN:  Okay.  In this one back here, this Number 9, I'm numbering the pictures as we go, Number 9, do you recognize who the other people are in that picture?  It's just -- PAULA:  It's -- it's the same thing. KAREN:  Same group, so just pick one of those.  Yeah.  PAULA:  Yeah.  KAREN:  If you don't recognize them, that's okay.  I can just say -- PAULA:  Well, this is Clara.  KAREN:  Front row is Clara.  PAULA:  I think this is the same thing.  Yeah.  This is the same thing.  KAREN:  Yeah.  PAULA:  This is cute.  Look at the way Ruth Evan's mouth is trying to smile, just grin on one side.  KAREN:  So the first one on the left is Clara.  PAULA:  Clara Morgan.  Martha Addy.  Ruth Evan, Elena Rothschild, this is our boss, Bonnie Himshutt.  KAREN:  Okay.  Wait.  After Elena -- PAULA:  I don't remember.  KAREN:  You're -- you're not in that picture.  PAULA:  Yeah, I took the pictures.  KAREN:  Let's use the one -- this is a better picture.  PAULA:  But she's gone there.  Well, even she's gone there.  But I forgot -- I forgot these, you know.  I know their faces, but I forgot their -- KAREN:  Right.  Well, we'll see which -- do you want to use one with you and one without you, or -- PAULA:  Maybe this one would be better.  Yeah.  KAREN:  Okay.  So this one now it's Clara is the first?  PAULA:  Uh-hum (affirmative).  KAREN:  And then who is this one with the Alaska shirt?  PAULA:  I don't know.  KAREN:  Okay.  Question mark.  And then Ruth Evan?  PAULA:  Uh-hum (affirmative).  KAREN:  I recognize -- I'm getting it by the clothing.  PAULA:  Yeah.  And Bonnie Haines.  Oh, yeah, Elena Rothschild.   KAREN:  Elena Rothschild.  Then you?  PAULA:  Yeah.  KAREN:  And then this -- PAULA:  I don't know her.  KAREN:  Okay.  Okay.  Now, we do the back row.  Left to right.  Which is that first person.  PAULA:  I don't know her.  KAREN:  Okay.  Then your boss?  PAULA:  Yeah.  Bonnie Himshutt.  KAREN:  Okay.  PAULA:  This, I don't remember.  KAREN:  Okay.  And then there's that man.  PAULA:  He used to be our teacher.  One of the trainers, health aide trainers.  KAREN:  Okay.  PAULA:  I can't remember his name.  KAREN:  Okay.  And then we left out this one.  PAULA:  This lady used to be our coordinator.  KAREN:  Okay.  You don't remember her name?  PAULA:  No.  KAREN:  Okay.  All right.  PAULA:  And this Black lady, I forgot what -- she was something in the Health Aide Program.  KAREN:  Let me put that one in my pile.  Okay.   PAULA:  Let me see.  We've seen these.  Somebody went out to Alakanuk to interview me one time, I don't know for what, and he sent me those pictures.  KAREN:  They are kind of dark.  PAULA:  Yeah.  KAREN:  Well, we're going to take a new one of you today to go with this interview, so...  PAULA:  Yeah.  Another lady from YKHC, this is -- her name is Sue.  She came to interview me on -- on something at that time, so she's here and I'm here.  KAREN:  So is it a picture of you -- PAULA:  Me and Sue somebody.  KAREN:  Okay.  So that's Number 11 is you.  Do you know about what year that was?  Can you tell by looking at yourself or your -- your -- the parka you're wearing?  PAULA:  I wish I could see that date. KAREN:  This one you look like you're outside.  Oh, you're in the back of a truck in this one. PAULA:  Yeah.  And when we went into the -- into my office, this doesn't look like my office, though.  My office was a unique place.   KAREN:  Here, this one?  PAULA:  Yeah.  KAREN:  This is inside.  Is that in your house?  PAULA:  I don't know.  I don't think so.  It -- I don't think this was in my house.  Oh, they were interviewing a couple, and that was in their house.  KAREN:  Okay.  I don't see it too well.  PAULA:  And that was so -- and before she left, I took her picture and these two people.  They were doing a film.  KAREN:  So this is -- this is you in your parka -- PAULA:  No, this is Sue.  KAREN:  Oh, okay.  You're taking the picture. PAULA:  The lady -- yeah.  I took the picture.  Because she came to make that -- I think they were under nutrition, doing nutrition, and we visited somebody's house.  KAREN:  Those pictures of you, though, those are really good.  I don't know that we need those pictures of other people. PAULA:  Yeah.  Okay.  And when I graduate from high school in Tacoma, Washington, by the time I graduate, I was 21.  And this was my -- this was in 4/4/60 -- '63.  KAREN:  1963?  PAULA:  Well, I sent -- it was -- it happened before then.  But in 1963, I sent it to my cousin. KAREN:  So what year did you graduate?   PAULA:  I don't know.  How old would I be?  In 1961, I guess.  Yeah.  In 1961.  I graduated and somebody did portrait on my -- enlarge it and give me this.  KAREN:  That's pretty.  PAULA:  And that was before I got married.  1961.  Two years later, in '63, I became a health aide.  KAREN:  Well, you say here, this is my graduation picture.  I'm going to summer school and graduating in July.  So I guess we are graduating in the same year.  I won't be home until middle of July.  With all my love to you and -- maybe Lyle?  Paula.  Virgie, that's your cousin?  PAULA:  Yeah.  But this was done in '61. KAREN:  Okay.  PAULA:  My high school graduate.  And I -- this is when I got my AA degree -- KAREN:  Oh.  PAULA:  -- in health.   KAREN:  That's your graduation?  PAULA:  Yeah.  I couldn't find a single picture of that, so I -- I brought that one.  KAREN:  Do you remember what year that was?  PAULA:  '97.  Spring of '97.  I was going through all those years, I put science aside, and then when we did science, we came here and we stayed here for two weeks and work in the lab.  And it was the easiest one of all the, you know, classes I took.  KAREN:  So which one is you in that picture?  You're the first on the left?   PAULA:  This one.  Uh-hum. KAREN:  Do you remember the other people?  PAULA:  No.  Because we were -- we did our -- all our training through audio then.  KAREN:  Oh.  PAULA:  So on the last day before graduation was the first time we got to meet each others.  And when we had left for two weeks and became good friends.  KAREN:  So that was an AA degree from University of Alaska?  Or -- PAULA:  UAF. KAREN:  UAF.  Okay.  It looks like some of those other pictures -- this one, you said, is '97, and by looking at that number on the back, it looks like a '97.  So there was a couple other pictures where we were -- we didn't know the date.  PAULA:  Uh-hum (affirmative).  KAREN:  I was going to see maybe, they say '97, too.  So the St. Mary's conferences?  PAULA:  Uh-hum (affirmative).  KAREN:  So maybe those were 1997.  PAULA:  Yeah.  KAREN:  1997.  See that '97?  Yeah.  Looks like it's the same. PAULA:  Yeah.  KAREN:  And you know that from your graduation.  PAULA:  Uh-hum (affirmative). KAREN:  So we can guess that those other ones are '97 -- PAULA:  Yeah.  KAREN:  -- too.  All right.  Okay.  PAULA:  That's all the pictures I was able to find.  KAREN:  That's great.  That's great.  Yeah, you said that there had been one of you working as a health aide in your smock, but you couldn't find it.  PAULA:  No.  And I couldn't find that.  KAREN:  Well, if you find it, we can always add it later.  PAULA:  Yeah.  And these were the treasures I took from New York.  KAREN:  Your New York souvenirs?  PAULA:  Yeah.  KAREN:  Great.  Well, that's wonderful.  You've got a really good sense of your work that you've done and made you talk for a long time, so you're probably tired and ready to stop and unless there's anything else you want to talk about that -- I didn't ask about.  PAULA:  No.  You probably need to work on this. KAREN:  Yeah, I'm going to scan these in.  You probably may be hungry.  PAULA:  Not really.  KAREN:  So this won't -- this won't take me very long, but I want to stop and make sure I have time to do that.  PAULA:  Yeah. KAREN:  So I thought I'd end the interview unless you had anything else that you thought of that you wanted to talk about.

PAULA:  Right now, I can't think of anything else, so I think we can -- unless you have question.  KAREN:  Well, I just thought of one, I was going to put a nice way to maybe close it is thinking about what it's meant to you to have done this kind of work and have been a health aide.  PAULA:  Well, I -- I always call it, it was a -- it's a good memory, in spite of negative things in between, it was the most gratifying work I did.  And it gives me good memories to have taught all the health aides, there's 200 -- over 200 health aides, and share everything, and I'm still sharing it through that little article in Delta Discovery.  And I still love the health aides.  I used to write to them all the time and say greatest health aide -- health aides in YK Delta.  And I think they are doing wonderful job.  And so it's -- it's good.  Every time I'm talking about health aiding, it always perked me up.  KAREN:  Good.  Well, I very much enjoyed getting to know you a little bit and meeting you, and thank you very much for your time.   PAULA:  Uh-hum (affirmative).  You're welcome.  I enjoyed it, too.