The town of King Cove, Alaska is crowded onto a narrow spit of land, surrounded by ocean and volcanic mountains. It’s an Aleut Native community of about 1,000 people, and for roughly a third of the year, weather closes its gravel air strip. When that happens, the only way residents can get to the nearest town, Cold Bay, is by boat -- two hours on choppy seas.
So when an emergency call wakes up Bonita Babcock in the middle of the night, she first wants to know how bad the wind is blowing. Babcock is a community health aide and a lifelong resident of King Cove. Her job is to stabilize patients and get them to Cold Bay, where there is a year-round air strip and patients can get to the nearest hospital -- in Anchorage, 600 miles away.
King Cove is only 30 miles away from Cold Bay, but there's no road connecting the two towns.
“We're looking and most of the time, it's going to have to be a Medevac. And we're wondering, ‘What are we looking at here, are they going to be able to get them out?’" Babcock says.
King Cove has been asking for a road to Cold Bay for these types of situations for more than two decades. The U.S. Fish and Wildlife Service has denied the request twice. Alaska Senator Lisa Murkowski threatened to hold up the confirmation hearing for Interior Secretary Sally Jewell until Jewell agreed to visit.
So Jewell made the trip to King Cove, where Babcock gave her a tour around the King Cove Clinic.
Jewell heard stories of medical close calls, like a baby who was having trouble breathing and had to be rescued by a Coast Guard helicopter. And she heard about unreliable transportation out of or into the community. Babcock told Jewell the clinic sometimes has to make do without essential medication.
“Last week, six days it sat in Cold Bay . . . one of our patient’s meds,” Babcock explains to Jewell.
The problem King Cove faces is that the 11-mile one-lane gravel road that could make life safer there would slice through the center of Izembek National Wildlife Refuge. It’s 300,000 acres, and the community and the state are offering to add 60,000 more in exchange for the road. But environmental groups say the deal would set a precedent that could make it easier to build roads through other wilderness areas. Nicole Whittington-Evans, with The Wilderness Society, says Izembek is important for bird species like black brant and tundra swan.
"When you are in Izembek and you look around at the breathtaking coastal mountains and this incredibly vibrant and ecology rich area, you know this is a global resource we should be protecting," she says.
Whittington-Evans doesn’t think the road is worth it. It would take more than two hours to drive the full 30 miles between the towns, and she's skeptical it would be the fastest way to evacuate people with medical emergencies.
King Cove residents acknowledge they want the road for more than health and safety reasons. It would make it cheaper to fly to Anchorage, and high school sports teams could more reliably compete against other villages.
The decision ultimately rests with Interior Secretary Jewell, and she says it’s a tough choice.
"I think that there have been efforts to talk about a tradeoff between human safety and wildlife, and the reality is I think we want both, so I understand the interests on both sides. It's difficult, and I don't think that's a reasonable tradeoff,” says Jewell.
Jewell hasn't said when she'll decide. But Etta Kuzakin, with the Agdaagux Tribal Council in King Cove hopes Jewell’s visit persuaded her to approve it.
"It's easy to say no when you see it on writing on paper,” says Kuzakin. “But it's not easy to say no when you see and you know and you look at the eyes of the people who have been through these tragic situations."
Five months ago, Kuzakin went into premature labor in King Cove when the winds were howling. She made it out of the community later that day on a Coast Guard helicopter. She has a healthy daughter now named Sunny Ray, but she worries about future emergencies that may not have a similarly happy ending.
This story is part of a partnership that includes NPR, Alaska Public Radio Network, and Kaiser Health News.