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Applauding the state of Alaska

Over the past several months, I have been reading some very disturbing articles in Indian Country Today on sexual violence in Indian country in the lower 48. After reading these, I have to applaud the state of Alaska in its efforts in dealing with sexual and domestic violence.

I am an itinerant public health nurse and also a sexual assault nurse examiner in Fairbanks. My public health job is in Athabascan villages and my SANE position is on call in Fairbanks.

We have SANEs; two work full-time and the other five are on call. We work out of the emergency room at Fairbanks Memorial Hospital and have the full support of the staff. We are even getting our own department in 2008 and have expanded our services to domestic violence as wel1.

There are sexual assault nurse examiners in Anchorage, Homer, Sitka, Bethel, Nome, Kotzebue and Dillingham. Most of these programs are hospital-based.

I have even had to do sexual assault exams in the remote villages, although most of those victims are flown, by state troopers, to the nearest facility that has a sexual assault program.

Alaska has women's shelters in Homer, Bethel, Unalaska, Kodiak, Dillingham, Sitka, Emmonak, Fairbanks, Juneau, Kenai, Ketchikan, Anchorage, Nome and Barrow.

The largest problem in regard to sexual assault and domestic violence in Alaska, especially in the Native villages, is lack of reporting. There is so much violence in the villages that I serve, but women don't want to - or are afraid to - talk; and a lot of the elders don't want them to talk. We desperately need to provide more education in this area.

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I was taken back with David Melmer's article [''Violence against women may go unpunished,'' Vol. 27, Iss. 2], stating that according to some advocates, short-term IHS doctors do not perform rape testing because they don't want to return to attend a possible court hearing.

My job requires me to be out of town a lot, but I testify for grand jury over the phone. The doctors could do the same. Not doing evidence collection for sexual assault cases, in my opinion, is denying care to patients.

We work very closely with the Alaska State Troopers, rural safety officers and local police departments incorporating sexual assault training into their new officer training schedule. The Forensic Nurses Association of Alaska puts on quarterly SANE trainings throughout the state and we have participants from the troopers, district attorney offices, shelters, military and local police departments.

If all BIA officers are required to be trained in Albuquerque, N.M., can pressure not be put on the training facility to use some of the resources of the sexual assault nurse examiner programs located in Albuquerque?

In looking at the International Association of Forensic Nurses Web site, the entire state of South Dakota does not even have one Sexual Assault Nurse/Sexual Assault Response Team program. It takes a lot of work to set up programs such as ours in Alaska, but in the end is it not worth the effort?

- Paula Ciniero RN, BSN

Fairbanks, Alaska