Dent Blog

Water in the Village

2015-01-21T07:33:00.003-08:00

1/21/2015, Chefornak, Alaska: I recently learned how much effort is involved in getting drinking water to the clinic. Chefornak does not have piped in water - which means water fluoridation is not feasible. Running water is a luxury, requiring large holding tanks that need to be filled manually (usually once every few days). In the clinic, the sewage and water system are linked. When the sewage holding tank fills up, the water turns off to prevent overflows. This system encourages users to conserve water, particularly since the holding tanks fill up without any notification system. The local store sells commercially bottled drinking water, which costs about $8-$10 per gallon. To save money, locals will drink rainwater, which is collected through rooftop systems on top of homes during the year and stored in outdoor ponds. In the clinic, there is a water distiller that makes the rainwater safe to drink.

Last June, the water distiller was up and running. There was a slightly brown color to the water even after being distilled, but the water tasted just fine. This trip, the distiller is broken. When I arrived in Chefornak about 10 days ago, there was a large plastic container filled with drinking water.

Like over the summer, I assumed during the winter that water was simply brought to the clinic. Not so simple in sub-zero degree terrain. Where would water be stored in the village? Outside?

After running out of water over the MLK day weekend, I learned about the drinking water procurement process during winters in the YK. Drinking water starts off looking like this, which is hand-chipped from an outside pond.

9:43AM

It's quite the process to melt the ice into water, one pot at a time.

The most recent update on the clinic's drinking water status.

10:28PM

Chefornak 2015

2015-01-19T20:21:00.001-08:00

01/19/2015, Chefornak, Alaska: I'm heading to Chefornak, Alaska - a small Yukon Kuskokwim community (population 418 according to the 2010 U.S. Census) - for my first winter clinic trip to a village. I was in Chefornak in June 2014. This time I had to pack winter gear in preparation for the cold weather, including my -40 degree coat. I left the Bunny Boots at home. I also packed 2 weeks of food, clothing, and entertainment (i.e., laptop and external hard drive full of data to process and analyze, one book, a couple of dental journals, dozens of hours of archived Dan Savage podcasts). Amazingly, I only had to check one bag at the airport.

On the flight from Seattle to Anchorage, I met a cute service dog named Teddy. She was sitting on the floor next to me. By the time we hit 10,000 feet, Teddy's head was resting on my right foot. An hour later, she had taken up most of my leg room. She was a very friendly, well-behaved dog.

The rest of the flight to Anchorage and the flight to Bethel was uneventful. Woke up early the next morning and arrived at the Era Terminal in Bethel, where I had at least 8 cups of complimentary Folgers coffee with instant powdered cream. The airport was pretty quiet when I first arrived, but it got pretty busy close to boarding time. This is one of the only places I know of in Bethel (besides the Bethel library) that has free wifi. This was the last time I'd be able to check email on my iPhone, access episodes of Glee and Downton Abbey through Amazon Prime, and check Facebook status updates.

It's January, which means it stays dark until pretty late in the morning and starts to get dark early in the evening. The winter solstice has passed and the length of daylight is increasing each day, but it's hard to tell. I complain a lot about how dark it is in Seattle during the winter. But we have it pretty good in comparison.

9:09 AM (liftoff)

9:21AM (midflight)

9:46AM (landing)

It takes about 35 minutes to complete the direct flight from Bethel to Chefornak. It was still pretty dark when we landed. It wasn't as cold as I thought it would be, which was a good thing given that I had not packed snow pants. The ride to the clinic was chilly but unseasonable warm (20s). The left side of my face got pretty cold. Thankfully, I didn't develop Bell's Palsy.

During the first few days in Chefornak, we spent our time at the Head Start Center and K-12 Chefornak School (Amaqigciq/Caputnguaq) screening children for dental disease. At the Head Start Center, it was nice to see a toothbrushing operation set up near the sink. Most importantly, the kids were brushing with fluoridated toothpaste.

It was nice to see the Yupik word for mouth, teeth, or smile near the toothbrushing sink (right up there with hair and ear).

It's been a great trip so far. We were able to meet with the Chefornak Village Council earlier in the week to share findings from our sugar sweetened beverage study. Our hope is to include Chefornak as a partner community for our next NIH grant. Over the week, the temperature has dropped and there's been a bit of snowfall. Today it's -7. The sunset is absolutely stunning. Just a few more days and I'll be heading back to the land of the 12th Man.

5:07PM (sunset)

Sugar Sweetened Beverages and Tooth Decay in the YK Delta

2014-09-10T22:28:00.000-07:00

09/09/14, Bethel, Alaska: Sugar sweetened beverage consumption in the YK is implicated as the driving force in the Alaska Native childhood tooth decay epidemic. Sugar sweetened beverages include instant Tang, Kool Aid, Sunny Delight, energy drinks, and soda. Tap water is either unavailable or tastes bad in the YK.

Sugar sweetened beverages are relatively inexpensive and abundantly available in village grocery stores. In addition, while it is well known that soda pop contains high concentrations of sugar, many parents are unaware of the amount of hidden sugars present in juices and other sugared beverages.

Our research team, consisting of collaborators from UW, UAF, and YKHC, received pilot funding from the UW Royalty Research Fund. Our goal was to use a novel biomarker to measure sugar sweetened beverage (added sugar) consumption in childrens' diets and to develop a community-based intervention aimed at reducing added sugar intake by targeting sugar sweetened beverage intake.

In January 2014, we traveled to Bethel and spent about 2 weeks enrolling study participants. We enrolled 54 children and adolescents ages 6 to 17 into our study. We spent the next few months processing and analyzing data. Our findings indicate that YK children consume the equivalent of 5 cans of Coke each day. This is over 16 times the maximum amount of added sugars recommended for children. Parents and community members were stunned.

During our 2-day stay in Bethel, we presented study findings to parents of participants, disseminated study findings to YKHC health providers and community stakeholders, recruited members of a Community Planning Group (CPG), and convened our first CPG meeting to generate a series of community-based interventions.

The trip was very successful and we generated a preliminary intervention. In the next few months, we will work with our CPG and YKHC partners to fine tune our intervention and apply for NIH research funding.

Sour dock and tundra

2014-06-29T13:59:00.003-07:00

06/10/14, Chefornak, Alaska: After a productive day in clinic, I met the Dental Assistant and her two sisters, niece, nephew, and Golden Retriever puppy (Zola) near the local store so we could take a walk on the Alaksa tundra. Our goal was to look for and pick sour dock – a redish-greenish leaf that grows wild near ponds in the summer. When we got close to one of the many large ponds, I saw sour dock growing in small patches. As I picked the leaves, I tried a few and found that it is sour (thus the name) and really tasty. It would a great addition to a leafy summer salad. We picked two large bags of sour dock and quickly began walking back to town – it was extremely wind and about 42 degrees.

Sour dock is chopped into small pieces and boiled for a few minutes.It is then frozen and used in sour dock agudak, an Alaska Native dessert that consists of instant potato flakes (a binder), hot water, Crisco (or seal oil), and sugar. The Dental Assistant’s mother made a special batch of sour dock agudak and brought it to the clinic. I was only able to take a few bites before heading to the airport. It was a super interesting treat. Two nights ago, when I went over to the Assistant's home for dinner, I had a large serving of homemade blackberry agudak. It was awesome.

As we walked back, I quickly learned that it’s easy to lose your footing. The tundra is soft and soggy. There were berry blossoms all over and a rich moss that looked like wood shavings.

Half-way point - fish, fish, fish

2014-06-08T08:49:00.000-07:00

06/07/14, Chefornak, Alaska: It’s the start of day 6 of 12. During the long summer days, Alaskan villagers are busy catching and preparing fish, picking berries, and hunting – all in preparation for the nose-hair-freezing winter. Subsistence fishing/farming/hunting help Alaska Natives survive the long winter. Currently, it’s the height of the fishing season. Later in the summer will be berry picking and hunting. Of course, the specific harvested goods vary from community to community.

I walked to the local grocery store on day 3 to explore Chefornak and get some exercise. Throughout Chefornak, you can see fish hanging on outdoor wooden structures and drying on boards matressing the Alaskan tundra. From the village boardwalk, you can smell fish, which reminded me of my childhood and early 20s – wonderfully familiar scents that wafted through mom's kitchen on weekend mornings and during trips I’d take to old villages in Korea. Each household has a slightly different wooden structure constructed for drying fish in the Alaskan summer heat. Though it was cold when we first arrived, it’s been warm the past few days and the sunshine has been intense.

One afternoon, I was chatting with the Chefornak health clinic receptionist, who mentioned that she was keeping busy outside of clinic hours preparing fish for the winter. Mothers of children I’d been treating in clinic talked about similarly busy summer schedules. In the village, men and boys take their boats and fish on the river, bringing back gunny sacks filled with halibut, salmon, anchovies, herring, white fish, and other river delicacies. Women and girls clean, prepare, and hang the fish to be dried. It’s a time sensitive process (to prevent spoiling of fish and to take optimal advantage of weather conditions to dry the fish properly).

There are apparently dozens of ways to prepare fish. Some fish are dried and then frozen – and eaten like jerky except that it is dipped into seal oil, which helps villagers keep warm in the winter. Other preparations include fermentation and drying, salt curing, and drying then soaking fish in seal oil. I asked the receptionist if we could stop by after work to watch her prepare fish and she warmly welcomed us to her home on the river. I was able to watch her and her three daughters prepare semi-dried fish to be soaked in seal oil. It was an amazing experience.

We also got to see families braid anchovies onto beautifully crafted ropes made of dried tundra grass.

Most of the fish will be ready to consume in the late fall and early winter. The food preparation activities require intense family effort. I’m not sure how many families involve children in these activities, but from an outsider’s perspective, it seems like most do - and what a great way for children to contribute to the household and stay busy during the long summer days.

The little things in life

2014-06-08T07:58:00.003-07:00

06/02/14, Chefornak, Alaska: Day 1. This is my third clinic trip to a Yukon Kuskokwim village (first trip was to Kipuk in August 2013 and second was to Chevak in October 2013). I arrived into Bethel on June 1 at 8:30PM. The first thing I noticed after landing was how bright it was outside – and then it struck me that I had entered the land of the Midnight Sun. It wasn’t sunny but it was super bright most of the evening. I woke up early to pick up my travel bag from the YKHC dental clinic and arrived the next morning at the Era Airlines counter in Bethel at 8:00 AM, about an hour before my flight to Chefornak. I met the super friendly Dental Assistant who had been assigned to this village trip along with 3 or 4 YKHC social workers who were getting ready to travel out to different villages in the YK. I had 3 requisite cups of very strong Folgers coffee (compliments of the airport). We walked onto the tarmac about 30 minutes after our scheduled departure time to allow for some time for the morning clouds to lift.

Riding aboard a 7-passenger place Cessna is a really cool experience. It's small enough where you have you crouch to get to your seat. You can hear everything - the engines, the propellers, all of the other machinery. Earplugs are a must - I forgot to grab a pair during check in at the Era Airlines counter.

We flew for about an hour and landed in Kipnuk to drop off a few passengers and then continued onto Chefornak, which took about 20 minutes from the Kipnuk airport. When we landed in Chefornak, we were greeted by a Primary Dental Health Aide (PDHA) with whom I had worked during my first village trip to Kipnuk. PDHAs are an integral member of the dental care delivery system in rural Alaska and provide preventive dental care services to villagers. The PDHA met us on her sparkling red 4x4 (all terrain vehicle). After loading our personal belongings onto a second 4x4 with a wooden trailer in tote, we hopped onto the back of the red ATV and rode to the dental clinic.

Once we arrived to the Denali clinic (the name of pre-fabricated structures that serve as health care centers in the YK Delta), we unpacked our dental supplies and started setting up the clinic. Denali clinics are really nice – they contain primary care medical care examination room, an emergency room, and a dental clinic. There is also a room set aside for itinerant health care providers that contains 2 bunk beds and a kitchen with a sink, a small fridge, and microwave. There is also water treatment equipment used to produce drinking water.

After setting up the clinic, I unpacked my large “immigrant suitcase” I had stored in Bethel with one of the dentists. I bought this abnormally large suitcase back in the early 2000s when world travelers were allowed to pack bags that weighed 75 pounds (and sometimes, in my case of jetsetting between Seattle and Seoul, 100+ pounds) unlike today where the strict limit is 50 pounds. The bag contained a portable air mattress, sleeping bag, a small stash of non-perishable snacks, and other random items needed for village trips.

Which brings me to the reason I titled this blog post (the little things in life). First, all of my food for the 2 weeks fit into the small fridge. The dental assistant and I had to play a little bit of “fridge puzzle” but it all fit. SCORE! I can’t believe what a relief it is to know that your perishable foods will stay cold the whole 2 week trip. During past village trips, I’d spend the first few days nervously and voraciously consuming food that wouldn’t fit into the fridge, which is really stressful. Second, when I opened up the front zipper of the immigrant suitcase, I found 2 items that were icing on this wonderful day: a stash of Tazo teabags and a set of Krogers toenail clippers. It felt like Christmas. I can’t describe how unbelievably happy I was to rediscover these precious items I had left in Alaska after my last village trip.

In terms of clinic, it was wonderful to keep busy. We saw 15 patients on day 1 for exams and cleanings and have a full day of patients scheduled for day 2. It helps tremendously to work with a local PDHA who knows the families and is able to call households for same day dental appointments. It’s summer in the YK and the school kids have been on vacation since May 15, which can make it hard to schedule children.

After work, I reheated a bowl of Basmati rice along with General Tso’s Fish and Kung Pao Tofu from my favorite Chinese restaurant in Seattle – a place called Sichuanese Cuisine Restaurant. I took a lukewarm shower, which was wonderful. There have been times in the past when an-end-of-clinic-day shower wasn’t possible (e.g., sewer was backed up, water was turned off, water was ice cold, gym lockers were locked). Also, this trip I brought with me a cordless 1.7L hot water kettle - one the best ways to ensure easy access to cuppa. The planned kettle coupled with a fistful of surprise Tazo teabags are the perfect pairing.

Lesson reinforced on day 1: enjoy the little things in life. Teabags, toenail clippers, and the ability to shower – I feel like the luckiest itinerant village dentist in the world!

Rest in Peace, Lyle

2014-04-15T00:22:00.004-07:00

I met Lyle during third year of dental school at UW in 2004. At our first appointment, we learned that we had both studied government as college students and hit it off immediately. Over the next year, we spent many hours together in clinic - sometimes working on his teeth - mostly talking about politics, the state of the country, single payer health care systems, his work as an advocate for the vulnerable and disenfranchised, and public health.

We kept in touch throughout dental school. I'd go over to his house for dinner (he and his wife Bobby lived down the street from me) and I went to my first peace march with the Mercers at the Seattle Center during fourth year. As a dental school graduation gift, he and Bobby took me to the Pink Door in the Pike Place Market. We had an awesome dinner - I remember Lyle and I sharing an enormous tray of raw oysters.

After I moved to Iowa for residency training, Lyle kept in touch and sent me postcards, letters, and health-related newspaper clippings. When I moved back to Seattle in 2009, we reconnected. Life got super busy and I didn't get to see Lyle and Bobby as often as I should have. Two weeks ago, after giving a lecture in which I had recalled working with Lyle in dental school, I called Lyle and Bobby to make dinner plans. This is when I learned of Lyle's death.

Lyle led an amazingly rich life and fought tirelessly for progressive political causes as an upstanding U.S. citizen. He helped keep me on track during a professionally vulnerable time in my career. I started off as his student dentist and we quickly became friends. Rest in peace, Lyle.

Food Glorious Food

2014-03-12T22:42:00.000-07:00

Peruvian food is AMAZING. The last time I was in Arequipa and Lima (November 2013), I gained 5kg in 6 days. Even as a devout pescatarian, I will admit that there are lots of wonderful land proteins served in Peru. There is no shortage of wonderful food options in Peru. The seafood (especially ceviche), fruit, pasteries, chifa (Chinese food), Inca Kola – I love it all. One of my favorite things to do in Peru is to visit the local market and look around at the food stalls.

The fruit stalls are my favorite – so much fruit I’d never seen, heard of, or tasted before visiting Peru. Most of the fruit is trucked in from nearby farms.

Within hours of arriving into Arequipa, we drove to the market and brought back a ton of fruit (and carrots) to our hotel.

During my last trip to Arequipa, I tried 5 new fruits. This time, I’ve added a few more to the list. I can never remember names. One of my favorites is granadilla, which looks and feels like a hollowed out orange. Cut it in half and there are tons of edible seeds swimming in a mass of gooey and sweet fruit.

Gigantic Peruvian corn with kernels 5 or 6 times as large as kernels of U.S. corn. Peruvian corn isn't sweet like American corn.

Avocado and cheese sandwiches made with Pan de Tres Puntas (or Three Points Bread), a puffy pita-like bread that originated in Arequipa. Bought a few of these from a very nice woman at a sandwich stand for 1.2 soles (<$0.50 apiece).

Inca Kola, the best-selling carbonated beverage in Peru. It's everywhere. This is the famous stuff that looks like a yellow-hued Mt. Dew and tastes like bubble gum. I’ve been told that Inca Kola had historically outstripped Coke and Pepsi in terms of sales and popularity. Coke had tried to compete, but it gave up and ended up buying Inca Kola. After toying around with the formula, which resulted in massive consumer protests, Coke reverted to the original Inca Kola formula and hasn’t touched it since. Not sure if the popularity of Inca Kola is generational. Most of the young children I've seen in Peru seem to prefer other types of carbonated drinks. I'll ask around and report back later.

Speaking of Inca Kola. I agree with my Peruvian friends that it is the perfect accoutrement to chifa, the Peruvian version of Chinese food. Haven’t seen General Tso’s Fish yet, but I’m on the prowl.

I’ve managed to walk over 10,000 steps each day (tracked using my handy FuelBand), which has helped me to keep my weight down this trip. So far, my belt notch suggests that I haven’t gained any weight. In fact, I think I’ve dropped a couple pounds. Last trip, I was walking less than 2,000 steps per day, which in conjunction with heavy, non-stop eating might explain the flash weight gain. I have an embarrassingly large collection of food photos. I will continue posting new AMAZING food photos throughout the week.

Hello, Arequipa!

2014-03-09T22:53:00.000-07:00

The last three months, I have been busy running around town preparing for a clinical trial funded by the International Association of Dental Research. We are working with our long-time friends and colleagues in Peru to test whether adding xylitol to milk prevents tooth decay in Peruvian school children. Xylitol is a natural sweetener found in birch trees and other agricultural byproducts that has been shown to prevent tooth decay. There is an interesting story that led to the development of our study. All low-income children in Peru are given a glass of milk each day as part of Peru's Programa del Vaso de Leche, a national nutrition program designed to improve the health of vulnerable populations. Peruvian children, like most children worldwide, don’t like the taste of milk. To enhance uptake by children, local schools add sucrose (table sugar) to milk. Adding sweeteners like table sugar or honey to milk is common practice by milk manufacturers in Latin America. Notice the honey bees on the Gloria milk can label. The rest of the world isn't innocent. We do this in the U.S. with chocolate and strawberry milk and in Korea with banana milk. The public health problem is that exposing low-income children to fermentable carbohydrates via sweetened milk can increase tooth decay risk among these already vulnerable children.

Before we left Seattle, I visited the Peruvian Consulate in North Seattle to seek approval to transport our microbiological supplies to Peru. The Consul, Miguel Angel Velasquez, was very friendly and helped moved the process along quickly. The Consulate is located in a neighborhood off Bothell Way.

We flew to Atlanta and arrived in Lima at 1:00 AM. After a few hours of sleep, we were back at the Lima airport to catch our morning flight to Arequipa, the second largest city in Peru (after Lima, the capitol).

After nearly 22 hours of non-continuous travel that started at SeaTac Airport, we made it to Arequipa, Peru. We were greeted by at least 100 parents and family members of local high school students who were returning from studying abroad in Europe. Each family member was holding balloons and screaming as each passenger entered the airport. I felt like a K-pop star.

Our team will be in Arequipa for the next 11 days. The weather today was sunny, dry, and warm. Rain is in the forecast, which is an obvious feature of the rainy season that typically lasts from January to March.

12th Man in Alaska

2014-02-02T21:05:00.001-08:00

Had a great time supporting the Seahawks from Bethel. Went to a house party hosted by a YKHC optometrist and her husband. Ten of the twelve people in attendance were Seattle fans, including Emily, a very fashionable and mild mannered Chihuahua. Go Seahawks!

Weekending in Bethel

2014-02-02T14:45:00.000-08:00

When I left Seatac Airport last Monday morning, it was colder in Seattle than Bethel.

In the past few couple days, things reversed.

Temperatures in Alaska are dropping, though it is still much warmer than it normally is this time of year. On Saturday there was about an inch of snow on the ground. Today it has been extremely windy.The Bethel forecast indicates that temperatures will continue to drop, but no below-zero temperatures are anticipated this coming week.

On Saturday morning, we recruited additional participants for our study. We decided it would be a good idea to make some coffee for ourselves and the childrens' parents. After filling the clinic Brita with tap water, we noticed the water had an interesting color. The coffee tasted fine, but it is easy to understand why parents might be hesitant about giving their children tap water. In fact, some parents have talked to us about the concerns they have with Bethel tap water. Bethel's community water supply is fluoridated, but it would be interesting to know what percentage of the population drinks the water.

Before work on Saturday, we stopped by the Bethel Farmer's Market, located in a one-room building near large greenhouses in which Tim Meyers (the farmer) grows food all year round.

The market sells produce that is flown in as well as locally grown fruits and vegetables. Currently, Tim sells root vegetables grown in his winter greenhouses.

Before coming up to the YK Delta, I packed most of my food into a large cooler. This is the norm for visitors before heading out to villages for dental trips. There are no restaurants in the villages. I did go to the local grocery store in Bethel a couple times, one of which is called the AC.

Prices at the AC are high because all the food sold is flown in from Anchorage. I took a photo of a circular advertisement, which provides insight as to how much food costs in the YK Delta.

Since I've been taking cabs to most places within Bethel, there is a constant need to have a wallet full of cash. I came to town with a little over $100 in cash. There is a Wells Fargo in town located next to the AC.

This was what I encountered during my failed attempt to access the Wells Fargo ATM on a Sunday afternoon. So close yet so far. I'll have to try again during business hours.

A Beautiful Dentist Visits the White House

2014-02-01T01:35:00.001-08:00

A gift from a patient. The heading says it all. Is my hair really that long?

My UAF Co-Investigator is staying at the White House Bed and Breakfast, a typical Alaskan structure constructed of logs that were floated down the Yukon or Kuskokwim River in the 1970s. Fran, the owner, is a long-time resident of Bethel. The inside of the B&B is charming, clean, and comfortable. It's what comes to mind when I think of Alaska.

Yurts and Rudabaga

2014-01-30T23:39:00.002-08:00

After work, one of the dentists in Bethel hosted a party in her very cool yurt-like structure, located next to the White House Bed and Breakfast. It's a very cool structure with a living room and kitchen on the ground floor and a bedroom in the loft.

The YKHC dentists and our study team enjoyed a gourmet potluck consisting of salmon (cooked two ways), two colorful salads, homemade baked bread and butter, and an amazing coconut rice (the last of which I somehow managed not to get a photo of…you can see part of the red bowl in which it was served). What a beautiful spread of amazing food. YUM!

I met and socialized with Baga (short for Rutabaga), a vivacious and affectionate female Husky from the YK Delta. She French kissed me three seconds after I walked into the house. You can't tell from the photo but Baga has a long juicy tongue.

The YKHC dentists have built a strong sense of community, which I really enjoy being part of each time I visit Bethel. They warmly welcome all visitors into their homes and lives. The gatherings remind me of what college was like – frequent social events that happen spontaneously without an ounce of planning stress. I've had lots of really interesting conversations with authentic, genuine people. They call it the Bethel Family and I certainly feel like an honorary member. See if you can spot Baga. There she is!

We had another great enrollment day - 7 children - bringing our total enrollment to 18 participants. I’m getting used to my operatory in the YKHC dental clinic, which is spacious and set up nicely for participant examinations and data collection.

Stabilicers and Gasoline

2014-01-29T22:14:00.001-08:00

I’ve been exposed to something new this trip: Stabilicers. What a product!

The unseasonably warm weather in the YK Delta has been nice. Once consequence is melting ice on the roads and walkways (and very few paved sidewalks). The melted ice freezes overnight, leading to many square miles of natural ice skating pathways in the morning. Stabilicers have metal screws implanted into the soles. I borrowed a pair from the UAF CANHR stash and strap them over my boots or shoes. I’ll be purchasing my own pair before I leave Bethel from the YKHC gift store for $35. I never leave my Bethel home without them.

I learned today that gas is super expensive in the YK, which is counterintuitive given the amount of oil that is extracted from Alaska territory. This may explain why cab rides in Bethel cost as much as they do.

Today we enrolled 6 participants, bringing our total enrollment to 11 children. We are one participant ahead of our daily recruitment goals. The YKHC dental clinic is a beautiful facility located across the street from the YK Hospital and the movie theatre/shopping mall currently under construction. There are a number of specialty health clinics in our building including optometry and behavioral health.

Alaska Native Sugar Sweetened Beverage (SSB) Study

2014-01-29T00:02:00.000-08:00

We are thrilled to kick off our research funded by the University of Washington Royalty Research Fund (RRF). Tooth decay is a major public health problem in Alaska Native communities. Our work will examine the association between sugar sweetened beverage (SSB) intake and dental caries (tooth decay) in Alaska Native children. One really cool thing about this project is the use of carbon and nitrogen isotopes found in hair to measure SSB intake. We have a fantastic team consisting of Co-Investigators from the UW and the University of Alaska Fairbanks (UAF) Center for Alaska Native Health Research (CANHR). CANHR investigators have been in the Yukon Kuskokwim (YK) Delta for over a decade conducting NIH-funded studies in various YK communities.

Our initial grant application was submitted to the RRF in September 2012. We were not funded the first time. In March 2013, we resubmitted the grant and were notified in June 2013 that we had received a $40,000 grant.

Our project is taking place at the Yukon Kuskokwim Health Corporation (YKHC) dental clinic in Bethel. The YKHC dental staff has been amazing. We spent the early part of the day figuring out ways to identify potential participants, organize study forms, manage flow of study participants, document incentives, etc. The YKHC dental staff has been very accommodating and helpful. We worked out of two dental operatories (#13 and #14). In one of the operatories, my UAF collaborators consented parents and collected survey, height, and weight data as well as hair samples from the children. In the second operatory, I collected dental caries data.

After the YKHC dental clinic closed for the day, we were able to continue collecting data at the CANHR clinical research facilities at the Kuskokwim Campus (KuC), which is located next to the Bethel library.

We transported some of our examination materials to KuC around 6:00 PM. After we arrived and got settled into KuC, I realized I had left the mouth mirrors in the YKHC clinic. So I called a cab and went over to YKHC to pick up the mirrors. Speaking of cabs…

The cab system in Bethel is really interesting. Unless you own a car, cabs are one of the only ways to get around town. Word on the street (unconfirmed) is that there are more cabs per capita in Bethel than there are in Manhattan. I will try to find published data to support this claim. Based on personal experiences, I can attest that there are TONS of cabs in Bethel – TONS. You call the taxi dispatcher and a cab is usually at your door within minutes. The cab payment system in Bethel is flat rate - $7 one way from the airport to anywhere in Bethel and $5 one way to travel anywhere within Bethel. These rates are per person, which means that you end up sharing cabs with others, including strangers. If you want to stop someplace (e.g., the AC grocery store), you get charged an extra $2 per stop and $1 for every minute of waiting beyond three minutes. My cab ride from KuC to YKHC cost $10. I avoided the $2 stop fee, which the nice Macedonian cab driver waived. He and his family (wife, child, mother, and father) have all lived in Bethel for 3 years. His brother used to live in Bethel but moved back to Macedonia.

This morning, the temperature in Bethel was in the 30s, which is much warmer than usual. There are sheets of slippery ice covering most of the town. There are also reports that parts of the Yukon and Kuskokwim Rivers have started to thaw (usually this happens in April), which has led to major transportation problems for families that rely on a frozen river to get from one place to another using snow machines (=snow mobiles).

Our goal is to enroll 50 children. We saw 5 children today. Since we have a total of 10 enrollment days available, which includes working on the Saturday before the Super Bowl, we are currently on target. As clinic flow improves and word gets out into the community that we are in town, I am hoping to meet our enrollment goals ahead of time.

faculty website v1 almost complete

2013-12-29T16:32:00.003-08:00

After working on website design and implementation over the long winter holiday, v1 is nearly ready to go live. This site is a work-in-progress project. I hope to update the site regularly with research musings, photos, tweets and blog posts.