BETHEL -- Poor salmon runs on the Kuskokwim River could spell the end of the Bethel Family Clinic, which has been crippled by the collapse in the fishery and the subsequently slow economy.
After 18 years as the only medical alternative to the Yukon-Kuskokwim Delta Regional Hospital, the clinic's door may close for the last time Oct. 15, when a one-year contract ends for the clinic's two nurse practitioners.
"If we can't get interim operating funds, we're done," said Diane Carpenter, co-chair of the clinic's board.
The clinic's last chance of survival may be a federal New Start grant, Carpenter said. Designed for rural clinics, the grant is almost a guarantee, but acquiring it could take several months, even with a costly grant writer. Until then, she hopes for everything from a windfall of state grants to community charity.
"If we can survive until then, we'll be on sound footing," she said.
Created for non-Natives when they weren't served by the hospital, the nonprofit clinic now provides an important alternative for all residents, said nurse practitioner Bill Danforth.
Most affected will be patients with chronic conditions, like diabetes, who rely on the clinic for quick but familiar providers eager to go the extra mile, Carpenter said.
"At the hospital, they will have to make an appointment way ahead and won't see the same doctor," Carpenter told The Tundra Drums.
One of those patients is Amy O'Brien, recently at the clinic for a sore throat and headache she caught after moving to town last month.
The California refugee said she's also visited the neurology clinic at the hospital for possible multiple sclerosis, but said she prefers the familiarity offered by the clinic. "It's horrible that they're closing," she said. "It makes me want to come in here and help."
Community involvement would be fine with Susie Athanas. The clinic's archaic boiler room gave out last year, freezing pipes and forcing providers to wash hands with bottled water.
"Our clinic has always been for the community, and it's come to the point where we have to get the community involved," Athanas said.
Thousands of people have walked through the clinic's familiar red door, though that number has dropped steadily since 1997.
In better years, the clinic offered a handful of visiting specialists. But with a debt load that exceeds $100,000 because of medicine and lab costs, the clinic now offers only a visiting cardiologist.