WALTER:  Regarding the health aide training, one of the challenges, of course, was to -- to maintain some uniformity and to avoid a lot of repetition of effort by maintaining a rather uniform curriculum throughout the state. 
And here's where the Robert Wood Johnson grant and the CHAP liaison position funded by Robert Wood Johnson based at the university came into play. 

This person, or the individual in this position, had responsibility to -- to provide leadership to what they called the academic review committee. 
This was composed of the directors of all of the health aide training programs, which had expanded from the original three or -- in the state.  And they would meet and help the -- and advise the -- the CHAP liaison in publishing a uniform curriculum. 

KAREN:  The academic review committee --

WALTER:  Yes.

KAREN:  -- revised the curriculum development? 

WALTER:  They revised the CHAP liaison whose job it was to -- to maintain a uniform curriculum, which was accepted by the university as a basis of awarding university credit. 

KAREN:  Okay.  And what kind of people were on that committee? 

WALTER:  It was the -- the directors of the various training programs, which is people like Rosaire Kennedy from Nome, Winnie Reeves from Kotzebue, Linda Curda originally from Bethel, and later held the liaison position.  And a number of others.  But they were essentially the people who were out in the field. 

And under them were mid-level practitioners usually who would actually make the trips into the villages, spend time with the health aides, and observing their practice and checking off their skills list and reporting back on the health aide's progress so that there was actual validation that what was listed in the curriculum was being accomplished. 

KAREN:  What kind of -- back to the training program, how that was set up, you had mentioned they did two weeks or -- and then they came back.  And what kinds of things -- how was the training organized and what were they taught?
 
WALTER:  Well, when they first came in, as I recall, it was -- there were three sessions, two weeks, two weeks, and three weeks. 

And during the first sessions, a lot of emphasis on -- on patient encounter, the taking of a history and how to report it.  And then how to carry out the most common directions, such as giving a penicillin shot, suturing a wound and -- or dressing it.  And/or maybe prenatal care and that sort of thing. 

Then this clinical training continued all the way through, but later there was a lot more emphasis on well-child development and nutrition, and the usual preventative and health maintenance activities. 

And then, of course, there were added return visits for special periods of training to culminate in enough hours of training and supervised experience to -- to fulfill this university requirement.
 
KAREN:  And then what was your role with the training?
 
WALTER:  Well, my role initially, beginning in ‘68, was to do some -- do some of the clinical teaching on the wards at the Alaska Native Medical Center. 
Then in 1976, I moved over, I left the hospital in the position of medical director of the hospital, and became the medical director of the health aide program at Anchorage, working with and under Roy Huhndorf and Jim Sosoff.  And there I did a lot of -- a lot of the lectures and -- and also the ward round. 

In 1980, I retired from the U.S. Public Health Service and assumed the position of CHAP liaison at the university just as a part-time job or part-year job, 10 months, I think.  And then later part time.  And that I did until ‘87.  And we have already mentioned that the academic review committee and the curriculum. 

One of the physicians at Bethel, Marilyn Chahaney and I, we did a -- we did a curriculum which was published in about -- in the early 1980s, which was one of the early uniform curriculum. 

So anyway, then, my relationship with -- formal relationship with the health aide program ended in 1987, and since then I've just gone back as a visitor.