KAREN:  I'm interested in what you were talking about, about the traditional Native healers and then the transition into the health aide.  And how were health aides selected to participate in the program? 

ROY:  As I recall, they were selected in a combination of ways, whether or not they all -- already had been practitioners; and secondly, there were discussions with the village councils about who would they most -- find most favorably -- who would be most favorably disposed to being a health aide, a deliverer of health services.  By interviews, volunteers would volunteer or ask to be interviewed, and express interest, express interest. 
So there were a number of ways the selection could be made.  But -- but a lot of deference was given to people who had already been involved in delivering health care or dental care or who had, you know, worked with -- been noted by the Public Health nurse as she went through the village to -- as a person very interested in health care. 

Incidentally, the State of Alaska, at the time, had a Public Health nurse program.  They had a series of itinerant nurses that went throughout village Alaska, they had a -- a cadre of nurses. 

And they traveled virtually all the time, administering primarily preventative health measures.  Immunizations, well-baby clinics, Public Health lectures, and the things that Public Health nurses do.  Examinations of families, women, others in the villages as they went through.  And they also became involved in the health aide program.  They -- they participated in some of the training. 

KAREN:  Oh, okay. 

ROY:  At first, it was -- it was a hard -- it was a hard relationship.  It was -- the State, you know, often didn't get along with the Indian Health Service, the Federal. 

State and Federal didn't -- didn't get along too well.  And there were a lot of jealousies and petty ego fights over whose jurisdiction what was in, and of course, Federal people, Federal guys are pretty much preeminent.  And they have complete -- they have complete authority over Alaska Natives' health. 

And the State had long ago conceded that, but still, village Alaska was of concern to them and they did have this public itinerant health -- Public Health nurse itinerant service, and eventually, the nurses themselves just, you know, came together with the health aides and recognized them as a resource and -- and began utilizing them and didn't pay much attention, I think, to the policy -- the policy guys down in Juneau and what they wanted to do or not do.  Health care was important, they were going to deliver it. 

KAREN:  Right. 

ROY:  And they did, you know. 

So I thought it worked very well.  And after a while, everybody got -- started getting along and it all worked out.  I don't know if the State still has a Public Health nurse program. 

KAREN:  Yeah.  I didn't realize --

ROY:  Yeah. 

KAREN:  -- that the Public Health nurses were State.  I always thought that was Federal.  I thought PHS was Federal. 

ROY:  No.  No, they were -- as I understand it, they were State hired and -- and -- and they represented the State Public Health.

KAREN:  Hmm.  That's news to me.  And I don't know if they still exist.

ROY:  Check it out and see. 

KAREN:  Yes. 

ROY:  I'm almost certain that they were paid and employed by the State. 
But they were some tough ladies.  They could travel for days and days and days and live off their backpacks and -- and do the job, you know. 

I had great admiration for those people.  I thought they were very -- very -- very important health care deliverers.  And later interfaces with the -- with the health aides.  And mentors, you know. 

So they need some credit there, too, when you do this historical because they did get involved and they were a very productive -- a very productive element in this whole village health -- on the whole village health scene.