LINDA:  And this program is unique in the United States but it's also being looked at very carefully by a variety of folks.  And one of them, the U.S.
Government itself, we're looking at if the Indian Health Care Improvement Act is some of the original legislation that created the Health Aide Program, and they are trying to -- there's an interest in rewriting that so the -- the Community Health Aide Program would actually be replicated in the Lower 48.  Not only on the tribal reservations, but in other situations, as well. 

The model could work in Rural America, but easily in Urban.  Look at the urban city situation.  I worked at Hopkins and we certainly had problems of access of health care intercity Baltimore, Maryland. 

And you know, can you imagine if you had a -- well, a village is about 4- to 500 folks, average, and think of the tall buildings in New York City, 4- to 500 folks, and what if you trained a couple of people to be your access point to health care.  Because that's what it is, it's about access. 

And they are data collectors.  They are trained data collectors who can then contact the medical care system, whether it's by radio or telephone into Bethel, and the patient can be in the village or brought into Bethel, or then brought into Anchorage.  But it's the same concept. 

And the Lower 48 desperately needs some new models for health care.  The emergency rooms are overwhelmed.  Well, they are being seen for somebody needing their blood pressure checked to whether they have an earache. 

KAREN:  Right. 

LINDA:  You know.  And then the other arena is the world stage.  And there's interest in looking at the model.  Both folks from India have been here recently, China.  The government has been talking about a program like this in Afghanistan. 

And I have -- did some work in the mid '90s in Saudi Arabia with this model, and there's a lot of elements that could work anywhere in the world.  But my caution to folks is that you would need to adapt them.  It is not -- you don't just pick up and dump it in a place. 

It has been almost 40 years since it was Federally funded, which is 1968, and certainly since its beginning in the early '60s were going on a long time and an evolution and a development of materials, curriculum, expectations. 

In the early days, the medical -- you know, it was about medication for tuberculosis.  We saw the years of infectious diseases.  We certainly -- you know, the years of meningitis now, we give vaccine, we don't see that as much, we are seeing actually now more life-style issues, whether it be tobacco -- cancer is now the number one cause of death of Alaska Natives.  Well, many of those elements are life-style. 

So another course that we developed for distance with Melanie Quaver (phonetic) involves the docs over at the hospital is in cancer.  And looking at cancer.  I'm looking forward when this is finished to sort of the next -- next course and the next students.