Helping families in remote Alaska locations improve respiratory health
When AJ Salkoski ’04 ’07 graduated from UIndy and said that he wanted to move far away from Indiana, he meant it. Far away ended up being in Anchorage, Alaska, where the history and international relations scholar took a job with Americorps Vista, working on community planning in rural tribal villages. It wasn’t long before he was working on other environmental projects around the state and ended up meeting his future boss, who happens to be from Bedford, Ind.
In August 2011, after spending four years leading indoor air quality improvement, energy efficiency, and solid waste management projects in dozens of Alaska villages, AJ became a project manager at the Alaska Native Tribal Health Consortium, part of the Division of Environmental Health & Engineering. His new project had a noble goal: to improve the respiratory health of chronically ill Alaskan native children. Several years ago, a pediatric pulmonologist in Anchorage was noticing that many children from rural areas were being treated for respiratory illnesses at the hospital, then sent back home—but were returning just months later for more treatments. In parts of Alaska, one in four Native Alaskan children is hospitalized each year withan acute respiratory infection. The pulmonologist and the Environmental Health Consultation group looked into the problem and wanted to see if there was a connection between the indoor air quality in their homes and the condition of the childrens’ health.
The Alaska Native Tribal Health Consortium found the funding to design a project that would work to improve the indoor air quality in rural homes in southwest Alaska and provide home-based education free of charge to the families. AJ and his coworkers, with permission from the Alaska Area Institutional Review Board, began to examine health records to find out which villages and communities had the highest number of sick kids, especially those who visited a hospital or local clinic four or more times during the previous year. AJ then contacts the tribe to ask for permission to speak with family members in their community. At that point, the journey for AJ begins.
Many of the villages are so remote that no roads are nearby. AJ must fly into a small airport hub, then take a bush plane to the village, which can be anywhere from a 15-minute hop to a two-hour flight. “Sometimes we can travel on the ice road, or sometimes we can access the village by boat,” he explains. “But we travel with a lot of gear, so a bush plane is often best.”
When they reach the village, it’s not as simple as showing up, doing the work, and heading out. “There is a lot of respect that’s involved in a tribal village,” AJ says. “You have to understand the culture and respect the traditions of how you act in a village. Time moves differently for them, and each village is different. You have to be willing to learn and be open to new experiences.” Sometimes working with a translator (many of the Native Alaskans speak English, though there are about 10 native languages that AJ may encounter), AJ will evaluate the home and take measurements for indoor air contaminants. Many of the problems stem from the home being shut up too tight. The cost of heating oil in southwest Alaska can range between $6 and $10 per gallon, and families often go through two 55-gallon drums in the coldest months. They hate to see their heat leaving the house through the ventilation system, so they close off the vents or turn off the exhaust system, leaving the pollutants to collect in the home.
“The bad part is that they are paying for that decision through their health or their kids’ health,” says AJ. Another issue in the homes often is a lack of running water or proper sewage systems. Of the six communities that AJ has visited so far, four of them have been without running water in the homes, which also can limit the family’s healthy water use practices. Once AJ has gathered his data and has some air quality test results, he begins to work with the family on the education component. The local housing authority comes and makes any physical modifications to the home in order to reduce the level of pollutants. One year later, AJ returns to check on the family and home and to test the air quality one more time.
So far, the results have been good. “I’ve been extremely happy with the efforts of the residents in changing their indoor environments,” he says. “Having people fly 500 or more miles to your home in a remote community because you have a sick child is a pretty compelling reason for parents to work with us to improve the indoor air quality.” AJ and his coworkers have given presentations about their Healthy Homes research study across the United States and also in Canada and Mexico, where similar indoor air quality issues exist. The study is set to conclude in January 2016, and at that point, AJ and his coworkers will have worked in eight communities and served 60 homes within a five-year period. “Our goal is to work on behavior change,” he explains. “We’ve known for thousands of years that we need clean air to breathe, but now we’re trying to prove it.” —Jen Huber ’07
See more photos by AJ and alumnus Levi Hannah ’05 at http://ajandviti.com/.