St. Olaf College | News

Alumna cares for rural patients in the Arctic

Katrine Bengaard ’02 keeping warm in Alaska.

As a Doctor of Osteopathy, Katrine Bengaard ‘02 is able to treat and diagnose patients with all the same confidence and training of a traditional Medical Doctor. But as a DO, she also has specialized training in manual manipulation, which means her hands are an important medical instrument unto themselves.

“We are able to trust our hands a little bit more than our MD colleagues because we learn what different disease processes feel like through our fingers,” Bengaard says. “It’s a unique way of practicing medicine that really enhances the way that we treat patients.”

Ambulance in rural Alaska, photographed by Katrine Bengaard ’02.

Healthcare systems worldwide have been strained by the pandemic, a fact that has been widely publicized. But within the rural Arctic communities that Bengaard serves from her home base in Kotzebue, Alaska, the pandemic has changed routine medical care completely. Physicians are removing the potential for infection by delivering remote care almost exclusively.

“It has been extremely frustrating,” Bengaard says. “And of course, we understand why.

“We are still doing telemedicine. We are calling the patients. But there’s something about — especially for osteopaths — there’s something about seeing and putting a hand on someone’s shoulder and just reassuring them about, you know, whatever process is going on with them.”

With just 20 percent of Alaska’s untamed wilderness being accessible by road, it’s actually normal for Bengaard to reach her patients by plane and dog sled. Or by boat, if the weather’s good.

Kotzebue, Alaska, population 4,000. Illustrated photo of Kotzebue Sound, provided by Katrine Bengaard ’02.

“That’s only a couple of months up in the Arctic Sea,” Bengaard says. “Because otherwise the sea is frozen, so we’re really pretty isolated where we are.”

When Bengaard visits her patients under normal circumstances, she’s already dealing with limitations. She arrives alone and without any other medical specialists or high-end equipment. No X-Ray machine. No IV drips. No pharmacy. Her hands are important for this work and essential for guiding her to assess and diagnose problems, and provide the answers that her patients need.

Air travel is an integral part of delivering medical care to rural Alaskan communities. Photo provided by Katrine Bengaard ’02.

Her appointments at the clinic sites she visits are coordinated by a local Community Health Aide. Someone who lives in that community who can also take vital signs and draw labs. Labs which are not processed on site, of course, but sent out elsewhere for evaluation.

Bengaard partly moved to Alaska for the adventure. But even by domestic rural medicine standards, the circumstances she faces in the Alaskan Arctic off-road system are unique.

“The biggest difference, I would say, with rural medicine is that you really have to trust your own gut feeling about what’s going on and your diagnostic skills,” Bengaard says. “Because you don’t always have the right imaging or the right specialist around to ask questions to confirm what’s going on. So you really have to trust your experience and gut.”

Life progresses for us all, we’ve learned, even in a pandemic. And patients from these areas who need specialized care will still have to be flown into Anchorage, Alaska, for treatment.

Considering these medical trips, and those made for personal reasons, it’s easy to understand why medical professionals are taking such great care with these communities by staying remote.

Just one COVID-positive person coming back to a village of, let’s say, 150 people could be really devastating because we don’t have the same medical infrastructure there to treat them.Katrine Bengaard ’02

“Just one COVID-positive person coming back to a village of, let’s say, 150 people could be really devastating because we don’t have the same medical infrastructure there to treat them,” Bengaard says.

Most of the people living in these areas are also Native Alaskan, and generations from these villages still remember the 1918 pandemic which disproportionately affected Alaska Natives and swiftly gutted their community. Language and culture was lost with the people, and some villages were even abandoned — too devastated by the loss of life to continue.

It is reported that from 1918 to 1919, one out of every 20 people in Alaska died. Half of those deaths were from the influenza and about 80 percent of those who died were Alaska Natives.

It is reported that from 1918 to 1919, one out of every 20 people in Alaska died. Half of those deaths were from the influenza and about 80 percent of those who died were Alaska Natives.

Bengaard says that many of the village members today live in multigenerational homes and they have experienced firsthand how even a minor illness can spread quickly in their small households. At least one of her patient families took the pandemic as a sign to begin writing down stories from their loved ones before they’re gone. Just in case.

“The words of the elders are really held in high esteem in these communities, and they don’t want to lose it so they’re starting to recognize that they need to write this down and they need to try to keep it as a legacy for future generations,” Bengaard says. “These communities, even though they’re still pretty traditional, the Western world is creeping in more and more with technology and some of those types of things. So it’s really neat to see how much they value words and the stories of their elders.”

Katrine Bengaard ’02 sits at the front of a sled that brought her medical team into remote Alaskan villages to deliver the earliest COVID-19 vaccines available in December 2020.

When Bengaard was finally able to return to her village patients in-person in December 2020 (after not seeing them since January 2020) it was under a remarkable circumstance: Alaska had some of the first vaccines available in the United States. Enough to be distributed quickly to elders in the high-need rural areas.

A huge coordinated effort sent teams of healthcare workers across the state and into their assigned rural communities to begin dispensing the vaccine.

One of Bengaard’s teams, which included two nurses, a doctor, and a pharmacist, was even featured on Good Morning America. The pharmacist prepared the vaccine, the nurses kept records and administered the doses, and Doctor Bengaard was able to intervene in case there was a reaction. Additionally, and most importantly for Bengaard, returning to these communities in-person meant she was able to see her patients face-to-face for the first time in a very long time.

Katrine Bengaard ’02 takes a selfie of her team while delivering COVID-19 vaccines to rural Alaskans.

Bengaard says receiving this vaccine has meant the world to these communities. And it has been especially uplifting for those who grew up hearing stories about the 1918 pandemic.

“The biggest thing to keep in mind is that this is bigger than yourself, and so even if you don’t feel at risk personally, those around you might be at risk,” Bengaard says. “I think that we all have a role to play. I have a very direct role just because of what I do for a living. But that doesn’t mean everyone can’t play a role and do their part.

“One of the things I loved about being at St. Olaf is all of the global opportunities to travel abroad and those types of things. And I’m sure that that’s been affected by this pandemic. And if we want to get back to what we love, we need to get this virus under better control so that we can get back out there and experience life to the fullest.”