NOORVIK CLINIC, ALASKA
Community Facilities Guaranteed Loan - $290,000
Community Facilities Direct Loan - $290,000
Noorvik is a small Inupiaq Eskimo community located above the Arctic
Circle on the Kobuk River 45 miles east of Kotzebue, Alaska. The village numbers 598 and is 98.3% native, most
of whom are Inupiat Eskimo. The village is
not on a road or rail system and is accessible by plane or shallow draft vessels only. Local transportation is by All Terrain Vehicles,
snow machines or boats. Noorvik endures
extreme cold temperatures in the winter. Permafrost
is prevalent in the area. The lifestyle
here is “subsistence”, meaning most of the villagers’ food and even some of
their clothing is derived from caribou, fish, moose, waterfowl and berries.
Until this
year, Noorvik’s clinic was a 400 square foot building that barely accommodated a
small supply room, small computer and office room, a tiny waiting area and one set of bunk
beds for critical care patients. The bunk
beds were located in the computer area and medical care was performed in the office area. A stretcher laid in that area had only 1 foot
clearance on either side for personnel to operate. Noorvik
desperately needed a new clinic.
A 2400
square foot clinic on driven pile foundation was constructed. It provides space for examination rooms, storage
and office space, a waiting area, critical care beds and accommodations for itinerant
medical and dental personnel (there are no resident doctors or dentists). Maniilaq, a Native Regional Health Corporation,
contributed $250,000.00 towards the project, Indian Health Services provided $40,000.00
for water and sewer hookup, the Native Community of Noorvik is providing $125,000.00 and
Rural Development provided a $290,000.00 Guaranteed and a $290,000.00 Direct Loan to
complete the project. The total cost of the
project was $1,000,000.00.
Telemedicine
equipment and connection was incorporated into the facility. It is the first such facility within the region. According to Noorvik sources, telemedicine
is not only helping to provide better medical services but has the added benefit of
helping to educate and increase the skills level of their staff. Since the opening of the clinic which now offers
essential equipment and facilities needed by itinerant medical and dental staff, Noorvik has been able to attract more qualified medical
and dental professionals to their area.
There were
two distinct challenges in bringing this project to fruition: (1) Noorvik is a subsistence based economy with
little cash flow. No taxes are levied in
Noorvik. Debt service for the loans could not
conceivably come from user fees so other means of repayment had to be examined. Maniilaq had agreed to subsidize the clinic’s
operational costs at $25,000.00 per year and Indian Health Services will lease the
completed clinic for an estimated $50,000.00 per year.
Both Maniilaq and Indian Health Services were amenable to portions of their
monies being used for debt service on the loan. The
Native Community of Noorvik will assign these income streams. (2) The second challenge we faced was the actual
construction of the building. It is located
on permafrost. An engineered foundation on
pilings driven 40 feet into the permafrost with an open airspace of approximately 5 feet
under the building was constructed. The
purpose of the airspace is to keep the permafrost frozen and stabilized. A heavily reinforced webbing underlies the
first floor to further stabilize the building should it ever be subject to permafrost
thawing or movement. The construction season
is very short in the Arctic, materials have to be ordered and brought in on one of about 4
barges that will travel up the Kobuk when it is ice-free.
If the barges are missed, the only alternative is to airlift which is much
too expensive.
A large
amount of “force-account” labor was
used, providing employment for residents of the village.
A Native Engineering firm, Nana/Dowl was employed.
The clinic
formally opened this January. We and the
residents of Noorvik are very proud of this project.
It has been typical for many facilities built in the Arctic to fail within
10 years because of foundations improperly constructed for use on permafrost. We believe the Noorvik clinic is superior
construction on one of the best foundations that can be constructed on permafrost and
should serve the community well for many many years.
By Merlaine
Kruse, Community Facilities Programs, Alaska State Office, Housing and Community Facilities Programs, USDA |
