DILLINGHAM - Dillingham resident Joan Junge has delivered about 250 babies during her career as a nurse practitioner and midwife. Birthing is where the miracles are, she says.
In June, she participated in a birth of a different kind, opening the doors to her own practice.
The Wholistic Health Center was conceived earlier this year after a round of layoffs at the Bristol Bay Area Health Corporation's Kanakanak Hospital. The hospital let go about 18 employees, Junge said, and eliminated some programs including the maternal and child health program in which she worked.
The nurse practitioner, who has lived in Dillingham for 19 years, said she couldn't imagine leaving the community, and she wanted to continue doing what she'd been doing.
"I love the area, and I love the people," Junge said. "I've seen people here for almost 20 years. It was a big change. I've never been on unemployment in my life. It was a big shock, so I had to decide what I wanted to do."
It took her about a month before she came up with the idea for the clinic.
"I feel like I have a calling, and there's a need in this community for women's health care," Junge said.
She decided to open the practice with her focus on women's health care, prenatal and family planning.
Junge funded the clinic from her savings and found a downtown location. She chose to use a holistic approach which looks at body, soul and mind; whereas the medical model tends to deal with specific body parts, she said.
"Holistic means looking at all of it, there's a social structure, it's what kind of support people, women, have in their lives, how they're coping with their stresses, lifestyle choices such as cigarette smoking or alcohol use, what are they using to help cope with stress? Healthy lifestyles including healthy eating, keeping weight within a manageable, you know, about 10 pounds of what is comfortable for them. So those are some of the things we talk about when we're doing checkups," Junge said.
She encourages her patients to incorporate ways of increasing vitality by doing things such as yoga or some other exercise to increase endorphins.
The clinic is set up to be comfortable with big overstuffed chairs, a couch and a lobby area. Junge said there's an exam room with a bathroom off to the side. There's a kitchenette area for coffee, and she has snacks for the prenatal classes.
She has an area set up with a heated massage table that allows her patients to kick back for therapeutic massage, in which she draws from her nurse midwifery background as well as her nursing background to offer hands-on healing, hands-on massage.
Junge went through a "paper chase" and six weeks of waiting for approvals from Blue Cross Blue Shield which now recognizes the clinic as a preferred provider. And a similar process allows the clinic to accept Medicaid patients.
She has asked for privileges at the hospital and requested pharmacy, ultrasound, mammogram and lab privileges.
Among Junge's other challenges were figuring out the insurance and also advertising to get the word out that she's open for business. She's depending on word of mouth but has taken to bringing business cards along during errands to the store or post office.
People who were used to seeing her at the hospital will ask her where she's been and what she's doing now, so she lets them know that she's offering another option for women's health care.
"It's pretty much up to me to do my own advertising and it's a challenge, kind of tooting my own horn, kind of awkward, but that's the way to meet people," Junge says.
When people tell her their symptoms and ask her what to do she tells them to come see her.
Junge said her business is building with clients of various ages. She estimates that about half are premenopausal. She recently did a lot of sports physicals for teens and has seen women who need their well-woman exams.
Recently Junge was contracted by Bristol Bay Native Association to work with its TANF (Temporary Assistance for Needy Families) program specifically looking at teen pregnancy concerns. She'll be working with teens and offering young women information about choices for their life.
Junge said owning a business takes a lot of work, a lot of time and a lot of energy.
"I have a passion for this area. It's abundant with the harvest of our salmon and our moose and berries. The people are kind. The people are community-oriented. And I have a strong sense of commitment to people in our villages that they get the best health care possible," she said.
She said she wants to facilitate prenatal care of women all over including the 28 villages that she was overseeing in her previous job.
"They're just beautiful, the villages, I want to promote our villages to survive this economic time because there are certainly smaller families out there in the villages now because our cost of living out here in Western Alaska, it's really expensive, so if I can make families stronger, that's what it's all about for me. Help nurture moms so they can help nurture their babies," Junge said.
Prenatal patients from villages will fly in to see Junge their first visit, and a village health aide will see the patient in the village and transfer records to Junge via fax. At about 24 weeks, the patient will return for ultrasounds, labs, diabetes and anemia screens.
At that point, the patient will decide whether they want to deliver at Kanakanak, for low-risk clients. High-risk patients who may need Caesarean-section capabilities will have their health care transferred to Junge's colleagues at the Alaska Women's Health Center in Anchorage for delivery at Providence or Alaska Regional.