A map of Alaska with the Southeast region highlighted.
Organization: Healing Hand Foundation , Southeast Alaska Regional Health Consortium
City: Juneau
Region: Southeast
Program Area: Health \ Regional health
Grants Received:
2000: $2,835  2004: $23,809
2002: $18,009  2005: $750,000
2003: $500,000

"Gumboot Determination: the little old ladies from the villages"

Mission Statement
Southeast Alaska
Regional Health Consortium

To provide the highest quality health services in partnership with Native people. To improve the health status of Native people in Southeast Alaska and other partners to the highest possible level.
Committees get no respect, least of all a committee composed of grandmotherly Alaska Native women from villages who appear to be preoccupied with their knitting. But it was a committee like this — 16 members, all women but one, and most from small Native communities — that in 1975 founded the Southeast Alaska Regional Health Consortium (SEARHC, pronounced "search"). Their mission was to improve health care for Alaska Natives living in the region.

Ten years and a few months later, at a ceremony on a blustery January day in front of the Mt. Edgecumbe Hospital in Sitka, a crowd of dignitaries, hospital employees, and SEARHC directors watched respectfully as the Indian Health Service flag came down, then burst into applause as the SEARHC flag was raised. At that time the Mt. Edgecumbe Service Unit, which provided
health care for Native people living in Southeast Alaska, operated on an annual budget of approximately $10 million and employed about 250 people. When SEARHC took over, the I.H.S. facilities were substandard, few, and woefully inadequate. Today, just over twenty years after the transfer ceremony, the budget is more than $85 million and SEARHC employs close to 1,000 people. Its facilities are modern, widespread, and equipped with some of the best medical and dental equipment in the region.

A photo of SEARHC chair Viola Burgess, left in background, Ethel Lund, center, and SEARHC CEO Niles Cesar watching Robert Singyke of the Indian Health Service sign the historic agreement that transferred management of the Mt.
Edgecumbe Service Unit to the organization founded by “the little old ladies from the villages.”Spacer Image During the three years it took me to research and write the history of SEARHC, I interviewed well over 100 individuals, starting with the person who asked me to write the book, Ethel Lund, the remarkable woman who led the Native health organization for a quarter century and remains actively involved as president emeritus. Those most deserving of credit for SEARHC 's success, Ethel insisted, were the "little old ladies from the villages," a description of SEARHC's directors she frequently overheard and one she now uses with pride when speaking about the organization.

Two men who pled guilty to underestimating the board were Bruce Denton, a Juneau contractor and his partner Larry Spencer, a real estate developer. In the mid-1980s, SEARHC needed a new clinic in Juneau and the financially well-connected partners were invited to brief the board on the proposed construction project.

A photo of generations of SEARHC leaders: Evelyn Hotch of Klukwan; Viola Burgess of Hydaburg; Lincoln Bean of Kake; Liv Gray of Hoonah; Ken Brewer, SEARHC CEO; Ethel Lund, SEARHC President Emeritus; and Lance Twitchell of Skagway.
Spacer Image "When you think of a board meeting, you expect to walk in and see a bunch of suits," Denton told me during an interview. "We walk into this board room and here are 15 ladies, average age of 60 or more, looking like they should be doing needlepoint, tea or something."

"And they are asking incredibly tough questions," Spencer added, still amused with the experience.

In the estimation of Denton and Spencer, the board's resolve was courageous at a time when Alaska was in an economic tailspin that derailed many construction projects and nearly ruined the two developers. "SEARHC was the financial gorilla that pulled us back into the project," Spencer said. "The roles had totally reversed."

Dr. Tom Bornstein, a dentist who has worked for SEARHC since 1984, described for me a board presentation he once made to explain why SEARHC could not afford to provide orthodontics. The board members listened politely, then talked among themselves about the importance of self-image for teenage girls in the villages who, when smiling, often put hand to mouth to hide crooked or missing teeth, and how self-image played into the rising incidence of suicide and alcoholism. Tom sat there patiently until, finally, the board chair, Viola Burgess of Hydaburg, looked at him and said: "You will have an orthodontic program. Figure out how to do it."

The Alaska Native women — and a few men — who set SEARHC's policies knew what it was like to get medical care in substandard facilities, and were not easily deflected from their plans to build and own a clinic to serve Juneau's Native population — the largest in Southeast. Nor were they dissuaded by Bornstein's budget problems, intuitively understanding the true cost benefit ratio of straightening teenagers' teeth.

What this group had in spades was the determination to stick-to-it, to hang in there like gumboots, the humble mollusk found along the stormy shores of Alaska's coast. "Gumboot Determination" became the unofficial motto of SEARHC's "little old ladies from the villages."

Peter Metcalfe is a Juneau writer, photographer and publisher who has produced many publications for Alaska Native organizations including "Earning a Place in History: Shee Atiká, the Sitka Native Claims Corporation" (2000), and "Gumboot Determination: the Story of the Southeast Alaska Regional Health Consortium" (2005), both full-color illustrated books.