When she started working as a community health aide in Angoon 35 years ago, Jessie Jim worked from her own house. There was no clinic. She stuffed equipment and medicine in a small traveling bag and did everything from delivering babies to treating accident trauma.
After 35 years of service, Jim, 65, decided to hang up her old medical bag. Her last day was Thursday. She might be the last community health aide in Southeast Alaska that was trained in the 1960s, when Walter Johnson founded the Alaska Community Health Aide Program.
"In the early days, the community health aide might be the only person that had any medical knowledge in the whole village," said Barbra Hollian, spokeswoman for SouthEast Alaska Regional Health Consortium.
Johnson's program was inspired by an Emmonak couple he stayed with between 1954 and 1956. The couple, both native to the village, provided medical service to their fellow villagers with minimum radio communication with doctors in Bethel.
"They were school teachers. They were not medically trained," said Johnson, 82. "And there was a real need to have someone of medical knowledge to communicate with doctors on the radio. I was thinking instead of training someone from outside who didn't speak the language, why not train someone who was from the village and would permanently stay there?"
Congress began funding the program in 1968. When it started, Johnson trained 200 health aides from 150 villages. Now more than 500 health aides serve 200 villages throughout Alaska.
"They are the extra eyes, ears and hands for doctors," said Johnson, who lives in Homer.
Jim graduated from the first training. She became a health aide before there was a manual on how to be one.
"Jessie has taken care of everything from birth to death," said Kari Lundgren, an assistant medical doctor in Sitka that supervised Jim since 1992. "She is always calm. There isn't anything she hasn't seen as a health aide during the past 35 years."
Jim remembers the first two babies she delivered. She's lost count of how many deaths she's seen, but she said it is always hard.
"If someone died while you were taking care of them, you wanted to talk about it but you couldn't because of confidentiality issue," Jim said. "Now we have a de-grieving team to work with us on that."
For almost 20 years, Jim was one of two permanent health aides in Angoon, a village of 500 people on Admiralty Island. The other health aide, Barbara Johnson, moved back to Yakutat in 1988. Being a health aide was tough, said Johnson, 68. She still works as a health aide in Yakutat.
"You have to deal with politics, deal with people and deal with rumors," Johnson said. "One of the ladies said Jessie and I were always laughing because we took the drugs we were supposed to give out. That just made us laugh more. What can you do? You either laugh or get really upset. You may as well laugh."
When they started working, Johnson and Jim didn't have much except some bandages, a blood pressure cuff and a stethoscope. Before the days of computers and fax machines, they used citizen band radio to talk to doctors in Sitka or recruit residents to help them transport patients to the airport.
"We had to be very careful when we discussed patients' conditions with doctors on the radio," Johnson said. "The whole village could hear us. So we kept changing channels."
Much has changed since then.
Health providers now have a permanent clinic in Angoon, although Jim only worked there for three months. Her farewell party demonstrated how much things have evolved. Seven regional offices of SouthEast Alaska Health Consortium held a video-conference to honor her.
By video, Jim reunited with retired health aides Alicia Roberts from Klawock, Alma Cook from Hydaburg and their teacher, Walter Johnson from Anchorage. She also talked to her sisters, Ella Bennett and Sophie Frank, from Juneau.
Participants could adjust the video to send a close-up shot of themselves. Images from all seven offices were displayed simultaneously on monitors. But the technology wasn't without glitches. The images were disconnected several times.
"You almost wish you could use an old-fashioned phone and dial," one participant said.
On video, Jim wore a white sweater and was surrounded by coworkers and family members. She didn't say much but smiled a lot.
"There were many times I wanted to quit but my stubbornness kept me going," she said in a later interview. "This is a thankless job. There are times people give you a bad time. They think we don't respond fast enough or don't give them the right kind of care. They don't know what we have been through. We do what we can with what we have."
Jim said she would miss her coworkers, but she wouldn't miss being awakened in the middle of the night to check a sick patient.