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AUDIE CORNISH, HOST:

The small town of King Cove, Alaska, is in a fight with the U.S. Fish and Wildlife Service. Residents there want a road to the nearest town 11 miles away. But the road would cut through the Izembek National Wildlife Refuge, and environmental groups are opposing it. So it's up to Secretary of the Interior Sally Jewell to decide whether or not it gets constructed.

Alaska Public Radio Network's Annie Feidt traveled with Secretary Jewell when she recently toured the town.

ANNIE FEIDT, BYLINE: When an emergency call wakes up Bonita Babcock in the middle of the night, she immediately checks the weather.

BONITA BABCOCK: How bad is it blowing?

FEIDT: Babcock is a community health aide and a lifelong resident of King Cove, Alaska. The Aleut Native community of about a thousand people is crowded on to a narrow spit, surrounded by ocean and volcanic mountains. Babcock helps stabilize patients and then gets them ready to fly to the nearest hospital in Anchorage, 600 miles away.

BABCOCK: We're looking and it's like, OK, most of the time, it 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?

FEIDT: About a third of the time, the answer is no. High winds frequently shut down King Cove's small, gravel air strip. 30 miles away, the town of Cold Bay has an all-weather airport, but there's no road between the communities. So King Cove residents have to take a two-hour boat ride in choppy seas to reach Cold Bay when flying isn't an option. King Cove has been asking for a road for more than two decades. And the U.S. Fish and Wildlife Service has denied the request twice. Alaska Senator Lisa Murkowski threatened to hold up Interior Secretary Sally Jewell's confirmation until she agreed to a visit.

SECRETARY SALLY JEWELL: Hello.

MAYOR STANLEY MACK: Secretary Sally Jewell, welcome to King Cove.

JEWELL: Yeah.

MACK: Mayor of King Cove. Glad you're here.

JEWELL: Mayor, very nice to meet you.

MACK: Glad you're here.

FEIDT: With the mayor following along, Babcock gave Jewell a tour of the King Cove Clinic.

UNIDENTIFIED MAN: Follow Bonita.

JEWELL: OK.

FEIDT: 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.

BABCOCK: Last week, six days it sat in Cold Bay, one of our patient's meds, you know, and...

JEWELL: And there's no boats running back and forth?

BABCOCK: Well...

MACK: The postmaster would have to go over by boat.

JEWELL: I see.

MACK: They've only done that maybe once, and it was a mess. So...

FEIDT: But the 11 mile one-lane gravel road that could make life safer in King Cove 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.

NICOLE WHITTINGTON-EVANS: When you are in Izembek and you look around at the breathtaking coastal mountains and this incredibly vibrant and ecologically rich area, you know it is a global resource we should be protecting.

FEIDT: Wittington-Evans says the road isn't worth it. It would take more than two hours to drive the full 30 miles, 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. Secretary Jewell says it will be a tough decision.

JEWELL: 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. And so, you know, I understand the interests on both sides, difficult, and I don't think that that's a reasonable tradeoff.

FEIDT: Jewell hasn't said when she'll make a decision. But Etta Kuzakin, with the Agdaagux Tribal Council in King Cove, is hopeful Jewell will come out in favor of the road.

ETTA KUZAKIN: It's easy to say no when you see it in writing on paper. But it's not easy to say no when you look at the eyes of the people that have been through these tragic situations.

FEIDT: 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. For NPR news, I'm Annie Feidt.

CORNISH: This piece is part of a collaboration with NPR, Alaska Public Radio Network, and Kaiser Health News.

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