These facilities are currently adequately equipped but there's no long-term capital replacement program in place, according to Nell Vrolyk, director of health and social services for the Dogrib Community Services Board.

"If a piece of equipment we bought five years ago breaks down, either you wait for capital allocation and try to fight for some money if it's over $5,000," Vrolyk said. "Or you take it from within. You just go out and do it because you need it. But it comes out of your operating budget."

Despite a growing population, the number of funded nursing positions in the Northwest Territories has not changed since the transfer to the GNWT in 1988, Vrolyk noted.

"So workloads have increased," she said, adding that holds true for aboriginal staff such as community health representatives and interpreters, as well as social workers.

"Everyone's workload has gotten immensely larger."

Vrolyk, who has been staffing nurses since 1995 when she worked in Baffin, said it's becoming increasingly difficult to recruit nurses to the North. The factors, in her opinion, are the high cost of housing, the absence of vacation travel assistance (there used to be one paid trip per year) and the lack of funding for continuing education. She added that most nurses now dictate their terms and chose short sojourns.

"We basically have to hire them because we have no other alternative," she said.

Hay River

Hay River has a staff of three doctors -- two full time and one part time. They work on a fee-for-service basis.

A fourth physician has been sought since last May. Hay River also serves the community of Enterprise as well as patients admitted to the hospital from Fort Resolution and Fort Providence.

Dr. Dennis Atoe has been working in Hay River for

16 months. He works close to 80 hours each week, but said he has worked as many as 96 elsewhere.

Facilities and equipment in Hay River are generally adequate, according to David Matthews, Hay River Health Board CEO. Basic emergency services are available.

Matthews described the situation as "fairly stable." Although, he adds the nursing staff is being stretched thin.

"It's getting a little more difficult but, again, we're not in a stage where we have an acute shortage," Matthews said.

Fort Smith

Fort Smith has three physicians on staff. Their work is based on a 37.5 hour week and they're on call every third day.

"Things are good here right now," said doctor Garry Benson, who is on a one-year contract. "I've worked in the North for some time and I think Fort Smith is reasonable at the moment."

Benson noted that the Fort Smith Health Centre is relatively new and in good shape.

As with most small communities, severe emergency patients are stabilized and medevaced to Yellowknife.

Lutselk'e

In Lutselk'e there are two nurses on staff and a doctor who flies in once per month for a one-day clinic and referrals to specialists.

Diane Bullock, a nurse, said she and her colleague work, on average, 37.5 hours each week plus overtime and callbacks.

"We have a fairly good setup," Bullock said. "We have been lucky. When we don't have a specific doctor and we're getting different ones every other month, that's where you run into big problems because you don't have any continuity."

Bullock said she would consider staying in Lutselk'e long term if things remain the same. However, she added that a mental health specialist is needed in the community.

Medevac emergency response time to Lutselk'e is one-and-a-half hours, according to Bullock.