Better Health in Bethel

AGC Winter 2018 Better Health in Bethel


Distance doesn't deter mission to link modern, traditional care.

Structural steel erection began on Bethel’s three-story health clinic upon arrival of the season’s first barge in June. Now the focus turns to enclosing the 185,000-square-foot building with enough roofing and insulation to accommodate interior work during the long winter months ahead.

The Paul John Calricaraq Clinic and Hospital, named after visionary elder Dr. Paul John, incorporates new construction of a primary care clinic and renovation of the region’s 1970s-era flagship hospital. The two structures will be connected by a wide, curved single story building.

A 54-unit employee housing complex will also be built on Yukon Kuskokwim Health Corp.’s 23-acre site by general contractor Bethel Services. YKHC is the principal healthcare organization responsible for the health and wellbeing of some 30,000 Alaska Natives from 58 tribes residing in the Yukon-Kuskokwim Delta’s 50 villages.

Construction progress

Construction began in fall 2016 with site work, installing thermosiphons and pile driving. James Murrell, project manager for ASKW-Davis LLC, said it could be one of, if not the largest vertical construction project not supported by a road system that has ever been undertaken in North America.

General contractor Davis Constructors and Engineers joined forces with Arctic Slope Regional Corp. subsidiary SKW Eskimos Inc. to form a limited liability corporation for completion of the PJCP project. Murrell said the LLC leverages the expertise of both companies in delivering the large remote project.

And this project is not without its unique challenges.

“Managing remote logistics on this construction project is probably the biggest challenge” said Kent Crandall, program manager for consulting firm Arcadis.

“Since the project is completely off the road system, all construction materials and tools have to be sent to Bethel by barge during the summertime months,” he added. “You can’t go to the local hardware store to buy additional building panels or replacement windows.”

Six barges a season dock in the village located 400 miles west of Anchorage beginning in early June through late September. That means all major procurement items anticipated to be required through the winter must be onsite by early fall, explained Davis’ Murrell.

However, money is budgeted for last-minute needs that must be flown in by plane.

Another challenge comes into play when the work shifts from new construction of the clinic to the existing hospital remodel — how to accomplish the work without negatively affecting patient care.

“All work will be done while existing hospital functions are maintained 24/7,” Murrell said. “There will be instances of full demolition and rebuild ongoing one stud-width away from care providers seeing patients. Ensuring construction activities do not negatively impact the surrounding environment of care is probably the single greatest challenge of the project.”

Project schedule

The $330 million-plus project is scheduled for completion in 2021; however, some phases will open earlier.

The first and third floors of the new clinic will be turned over complete in July 2019, Murrell said. The second floor will follow a few months later at the end of November. Interior renovations of the existing hospital are scheduled to begin in May 2018 and continue as occupancy levels and staff relocations permit, he added.

The first floor will house the pharmacy, laboratory and primary care outpatient clinics with 76 exam rooms, Crandall said. The second floor includes a dental clinic with 33 chairs, imaging, behavioral health, and a physical therapy and wellness center. A 26-bed acute care unit will occupy the third floor, along with labor and delivery, an infusion center for patients undergoing cancer treatment and audiology and eye care clinics.

Funding was procured through the Alaska Municipal Bond Bank Authority, U.S. Department of Agriculture Rural Development, Indian Health Service, and the Alaska Industrial Development and Export Authority.

But the Paul John Calricaraq complex will be more than just a building.

Calricaraq is a Yup’ik word meaning “you be well” or “you do not be sick,” said Mitchell Forbes, YKHC’s public information officer.

The project merges Dr. John’s inspirational teachings and stories of traditional ways of healthy living with national best practice models to treat the whole person, Forbes added.

The second floor wellness center will have an educational facilities kitchen where people can learn to prepare Native foods and study traditional wellness approaches to health care.

“Patients will have a choice to use modern or traditional medical approaches for their treatment,” Crandall said.

Crandall noted another unique feature of the hospital is that it’s not only a treatment center but also a social center for the community.

“Design of the tribally-run health facility is intended to evoke both the natural world and the Alaska Native heritage, such as a lobby that will function like a gathering area and feature elements of an old-style qasgiq or men’s house,” Crandall said.


One of ASKW-Davis, LLC’s main focuses on the project is ensuring local hire and developing the local workforce to the greatest extent practical, Murrell said.

“There are currently seven subcontractors working as we’re moving through the core/shell construction,” Murrell said. “By the time all work is completed, 25 to 30 subcontractors will have lent their expertise to the project.”

Murrell directed those looking for employment to go to the company’s website at

Nancy Erickson is a freelance writer who lives in Moose Pass.