This month's cover features a photograph by Suzy Allman, whose work won an Honorable Mention and two Judges' Choice awards in AJN 's 2005 photo-journalism contest, the Faces of Caring: Nurses at Work. Allman, after returning to New York from college in Sydney, Australia, has focused much of her career on sports photography for the New York Times and other publications (http://www.suzyallman.com).
In seeking to capture images of nursing in unusual settings, Allman, a photographer based in Rye, New York, came across the Yukon-Kuskokwim Health Corporation, which manages 58 federally recognized native tribes over an area of Alaska that is roughly the size of Oregon.
Last February she followed two nurses (one in Bethel, Alaska, and the other in Aniak, Alaska) on home visits to rural communities. She is planning future projects on this theme, which include returning to the Yukon Delta to visit even more remote areas than her previous trip, as well as attending the seventh annual Remote Area Medical Volunteer Corps event in Wise, Virginia, where more than a thousand doctors and nurses provide services for more than 6,000 patients.
The cover photo features Christine Pekar, RN, case manager for the home health care program of the Yukon--Kuskokwim Delta Regional Hospital, walking into the home of one of her patients in Kwethluk, Alaska, a Yup'ik (Alaska native) village on the Kuskokwim River. Kwethluk has no running water or sewer system. Most of Pekar's patients in these remote areas live in single-room homes, haul their water from two communal wells or collect rainwater and melt ice from the river in the winter, and use buckets for sewage disposal. Pekar takes vital signs and checks medications but it is her companionship that often matters the most to her patients. The nurses often travel by bush plane, snowmobile, all-terrain vehicles, and sometimes dogsled to reach these remote villages. Many of the nurses she met were not native Alaskans, but came to the region for temporary employment and stayed. Some nurses were raising their children in the Yup'ik villages. Allman says that the nurses discuss their home visits in terms of "the challenges of the weather and lack of roads, the summer thaw and the breaking up of the river, and the family life" of the Yup'ik people.
The photos on this page are of Lena Morris (seated in her kitchen), a Yup'ik living in the Yukon Delta village of Aniak, with Sue Hoeldt, her home care nurse, and Antone Anvil (sitting up in bed) and Pekar. There are no records of Lena Morris's birth, but she believes she's 90. She stays indoors, but longs to go outside and hopes the end of a long winter will make this possible. It is a hope shared by Hoeldt, who regularly visits Ms. Morris. They talk about the fiddle dance, a traditional, all-night Yup'ik celebration.
Mr. Anvil, one of Pekar's patients, has Parkinson disease and his hospital bed is set up in his living room. Pekar often uses humor during her visits. She asks Mr. Anvil, the Yup'ik tribal chief in Bethel, Alaska, if he's still the chief. He responds in a slow and halted Yup'ik: "I am still the chief, but I can't go to where they need