WALTER:  A key time event in the evolution of the Community Health Aide Program, I would say, was the February 1964 meeting of the area service unit directors in Anchorage.  That is, those individuals, in this case, physicians, that would be responsible for the various service units in Alaska having a -- you had a meeting in Anchorage. 

The thrust of this meeting was how to get the community involved.  And I actually have the letter that was sent out by the area director, Dr. Holeman Warrick, to those of us who participated to talk about getting more community involvement. 

The idea of training local people came up at the meeting, and it was a very animated discussion. 

A number of the Public Health nurses who had carried this burden as itinerants, going to the villages, instructing people in midwifery and -- and giving immunizations and all the other things they did, always came back with a list of medical problems and would sit down with us physicians and try to resolve them.  These problems that they had encountered in the villages. 

So that the health aide would then be assuming some of the things they had done before.  And entering into the work at a much lower level of training and status than a Public Health nurse. 

John Hope from Southeast Alaska was there, Johnny Hope, and who was not primarily in health but was very active in promoting Native involvement, was, of course, a strong advocate. 

Airlie Bruce, who was the Deputy Director of the Public Health in Alaska, of the Public Health Nursing Program in Alaska, was a -- was a strong supporter. 

The upshot was that without any special budget, some of the -- several of the service unit directors would take it on themselves to call in for a two-week period villagers who had been doing some of this health aide work and give them some training, and return with a report on the consequences. 

Several of these people were James Justice in Sitka, Jay Keefer in Bethel, Gloria Park in Anchorage, and Tom Harrison in Kotzebue. 

Tom Harrison wrote his experience up, which was published in Alaska Medicine.  This experience was used for headquarters, which by that time, was very active in moving into more Native involvement in the health program under Dr. Emery Johnson to present the idea to Congress. 

Congress did then approve and budget, in 1968, funds to support 185 health aide positions in 157 villages.  That being the official beginning of the funded Community Health Aide Program. 

As a little sidelight, these folks were called -- were referred to as medical aides, usually, but because of all this emphasis on community was sort of the buzz word at the time, that's switched over. 

And also, it took -- in retrospect, that took a little of the sting out of the -- out of the threat to the -- the medical hierarchy, probably.  And because they were “health” rather than “medical” was less of a hot button.