“We have some huge crushing challenges in the Indian country,” said Stacy Bohlen, chief executive officer of the National Indian Health Board. “We have a perfect storm for a pandemic like this to really defeat us. But we are also very, very resilient people.”
It is important to note that there are 574 federally recognized strains, making it difficult to broadly characterize how the rollout of vaccines is going in Indian country. Indigenous people get their health care through a patchwork system of Indian health service facilities, tribal-run clinics and urban Indian health centers, and the vaccination effort has varied from tribe to tribe and state to state.
Yet the successes of some tribal providers offer lessons for communities struggling to vaccinate their populations effectively. Here are some of them.
They tweaked their messages to build trust
This is a strategy that has worked for them, according to the Cherokee Nation.
According to the tribe, from February 8, the Cherokee Nation administered more than 17,000 vaccines. About 141,000 Cherokee nationals live within the boundaries of the tribe’s reservation in northeastern Oklahoma, which so far represents an impressive pace.
The tribe’s “biggest confidence builder” in the vaccine was the decision to place fluent Cherokee speakers at the forefront of the queue, said principal Chuck Hoskin Jr.
The Cherokee nation first vaccinated its most revered and valued citizens and indicated to others who may have been on the fence that it believed the vaccine was safe.
“It has done something to create a sense of optimism among our people and also to increase the confidence of other Cherokees who see these very reverent Cherokee elders, in many cases who are fluent speakers, get the vaccinations and celebrate it, he told CNN.
Jonathan Nez, president of Navajo Nation, said people were reluctant to get the vaccine early, so he got the chance on camera to help build confidence in it. The tribe also answered questions that Navajo people had on the radio and twice a week in city halls, and sometimes experts like dr. Anthony Fauci brought in.
Navajo doctors and healthcare professionals, who are also able to speak to the citizens in their own language and alleviate their safety concerns, are also key to building the trust of the tribe.
“By utilizing our way of life and teaching, it helps our Navajo people feel that it’s okay to take the shots,” Nez said.
According to Nez, about three out of four Navajo citizens now want the vaccine. To satisfy this interest, the tribe held massive vaccinations seven days a week.
They have the autonomy to decide who gets preference
Tribes are sovereign countries with the autonomy to determine how the health care needs of their communities can be met. For those who operate their own health systems, this means you can decide who should get preference for the vaccine.
The autonomy allows tribes to respond adequately to the unique challenges they face, Bohlen said.
“Our life expectancy is so much lower than the general population that we need to be able to decide that a 55-year-old might be an older man, if you are in a tribe where the life expectancy is 58,” Bohlen said.
In the state of Washington, that self-determination also extends to urban Indian health centers.
The Seattle Indian Health Board, a community health center specializing in caring for Native Americans and Alaska natives, opened vaccinations for Native Americans and Alaska residents 55 and older early in their distribution plan. This has ensured that they can protect all the elders served by their parenting program, many of whom are homeless, said CEO Esther Lucero.
“It’s sometimes the only place where they get a hot meal or social interaction or not have to be in a terrible weather,” she said, referring to the place where elders gather in the program. “So it was very important to us.”
From 1 February, the organization has opened appointments for all persons aged 50 and over, Native or not.
This health system is owned by its people
After some of their most vulnerable populations were successfully vaccinated, some tribal health providers are now opening appointments for younger, relatively healthy indigenous people – groups who would otherwise be months away from getting a vaccine.
Southcentral Foundation, a local health organization owned and operated by the local indigenous community in southern Alaska, offered its first vaccines to frontline health workers and Indigenous people aged 85 and older. After the organization got the necessary staff to run larger vaccination clinics, the spread quickly increased to offer the shot to successive younger age groups, said April Kyle, interim president and CEO.
It has vaccinated indigenous people aged 16 and older since 22 January.
According to the health care system, the Southcentral Foundation administered more than 12,000 doses of vaccine as of February 8th. The organization serves approximately 65,000 Native Americans and Americans in Anchorage, the Matanuska-Susitna District, and surrounding rural villages.
The success of Southcentral Foundation is an honor to its community-owned healthcare model, Kyle said.
Kyle attributes the organization’s flexible vaccination so far to the indigenous people of southern Alaska, who have developed a community-oriented health care system that in turn could plan to get vaccinations even to people in challenging areas.
She sees similar results in tribal health systems across the country.
“I follow the news and am very impressed with the passion and refinement of tribal health care and the ways in which communities can know how to get the vaccine out of their community,” she said.
They have made huge investments in healthcare
The head of Cherokee Nation, Hoskin, has advice on how the US can replicate the success of the tribe. But this is not an instant solution.
“We are a country that does not have access to health care, but only be a part of a citizen,” he said. “That’s why there is unequal access to health care nationwide. It’s a problem during good times, and it’s definitely a problem during the pandemic.”
Meanwhile, the Cherokee Nation has spent the past decade sharpening its health care system, which is now the largest health care system in the United States, in the United States, Hoskin said.
“I hope the lesson that people can learn from Cherokee Nation’s success is that during the good times, you need to invest in healthcare, make it a priority for your country and make it universally accessible to your citizens,” Hoskin said. said.
Ultimately, success depends on the country’s vaccine supply
The tribal suppliers interviewed by CNN say they shoot the weapons shortly before the door and through after being sent, which comes from the Indian Health Service or their governments.
But whether they can sustain their steady vaccination rates ultimately depends on whether the US can continue to deliver vaccines at the speed and volume they need – a challenge that has already slowed the provinces and states.
If that turns out to be the case, tribal suppliers say they will be ready.
“Can the United States keep up with the Cherokee Nation?” Vra Hoskin. “That’s really the key question for us.”
CORRECTION: This piece has been corrected to say that the virus claimed the lives of an estimated 45 Cherokee speakers.