Closing out his three-day tour of Alaska, Obama set off first for the fishing village of Dillingham in Western Alaska. He was to become the first sitting president to travel north of the Arctic Circle later in the day with a visit to the town of Kotzebue, a regional hub with a population of barely more than 3,000.

Obama’s trip will put on rare display the ways of life and daily challenges in Alaska’s more than 200 far-flung rural villages. Outside of Kotzebue, 1 in 5 in the Alaska Arctic doesn’t have a proper kitchen, according to the U.S. Census Bureau. And even more lack complete plumbing. Instead, many use the “honey bucket” system — five-gallon drums that serve as makeshift toilets are emptied into nearby sewage lagoons.

Obama’s goal was to showcase the havoc he says human-influenced climate change is wreaking on Alaska’s delicate landscape: entire rural villages sinking into the ground as permafrost thaws, protective sea ice melts and temperatures climb.

Alaska Natives have joined the president in sounding the alarm on climate change. Yet the obstacles they confront daily in rural Alaska extend far deeper, raising questions about whether the federal government has done enough to help some of the country’s most destitute citizens.

This is a life of subsistence hunting for bowhead whales, walruses and seals, a proud tradition of dependence on the land that poses immense logistical challenges.

“The vast majority of Americans have no idea there are dozens of communities in Alaska that live like this,” Sen. Dan Sullivan, R-Alaska, said in an interview. “It’s unacceptable, and we need to do more to fix it.”

Even as Obama’s travels brought him near the Bering Sea, there were five Chinese PLA Navy ships in the sea that the U.S. military has been tracking for a number of days.

White House press secretary Josh Earnest said U.S. officials don’t view the Chinese vessels to be a threat but he added that the reason for their presence “is still unclear.”

The ships were participating in a military exercise with Russia in previous days and then broke off to head into the Bering Sea, according to a U.S. defense official who was not authorized to discuss the matter publicly so spoke on condition of anonymity.

According to Navy Cdr. Bill Urban, the U.S. respects the right of all navies to operate in international waters, under international law.

With no roads to their villages, residents in rural Alaska are dependent on boats, snowmobiles and bush planes — weather permitting — to ferry them to rare doctor visits or other business. Among Alaska Natives, cancer is the leading killer, with incidence rates about 16 percent higher than for white men and women in the U.S., according to the Centers for Disease Control and Prevention.

At the same time, temperatures in the Arctic are rising twice as fast as anywhere else on earth, the National Oceanic and Atmospheric Administration has said, bringing with it profound changes to Alaska’s cherished landscape. Amid dire poverty and few resources, many rural villages have had their foundations literally pulled out from under them as the planet gets warmer.

Permafrost, the layer of frozen ice under the surface, is thawing and causing homes, pipes and roads to sink as the soil quickly erodes. Some 100,000 Alaskans live in areas vulnerable to melting permafrost, the Environmental Protection Agency estimates.

And in coastal Alaska, sea ice that once offered critical protection is melting, exposing coastlines, causing more extreme ocean storm surges and risking mass emergency evacuations.

It’s enough that the 400 or so residents of Kivalina, an Arctic town on a skinny barrier island along the Chukchi Sea, have decided they have no choice but to pick up and move. Kivalina is one of about a dozen other rural villages have voted to relocate to more stable terrain inland despite the hurdles it presents in maintaining their traditions, such as hunting marine mammals.

Alaska scholars say the struggles in Kivalina and other rural villages have been compounded by disputes among local, state and federal agencies and a lack of money for large-scale resiliency projects — the relocation of an entire village, for example. One recommendation from an Obama-commissioned task force was for Washington to take the lead in coordinating relocation.

But Brian Deese, Obama’s senior adviser, said the administration was looking for ways to be more nimble in helping communities relocate — not to make the decision for them.

“It should be easier and more effective for the federal government to come in and support that decision,” Deese said.

Alaska officials say well over $2 billion in federal and state funds have been spent over the last 50 years to bring indoor plumbing to rural Alaska, but the challenge is finding money to build water and sewer systems in nearly three dozen village that still lack them to one degree or another.