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“We have some real overwhelming challenges in the Indian country,” said Stacy Bohlen, CEO of the National Indian Health Board. “We have a perfect storm for a pandemic like this to really knock us out. But we are also very, very resilient people.”
It is important to note that there are 574 federally recognized tribes, which makes it difficult to characterize overall how the vaccine rollout is going in the Indian country. Indigenous people receive their health care from a patchwork system of Indian health service facilities, tribal clinics, and Indian urban health centers, and vaccination efforts have varied from tribe to tribe and nation. state to state.
Yet the successes of some tribal healthcare providers offer lessons for communities struggling to effectively immunize their populations. Here are a few.
They adapted their message to build trust
It’s a strategy that the Cherokee Nation says has worked for them.
The Cherokee Nation has administered more than 17,000 vaccines as of Feb. 8, according to the tribe. Approximately 141,000 citizens of the Cherokee Nation live within the tribal reserve boundaries in northeast Oklahoma, suggesting an impressive pace so far.
The tribe’s “greatest confidence maker” in the vaccine has been their decision to put fluent Cherokee speakers at the forefront, said Senior Leader Chuck Hoskin Jr.
By vaccinating its most revered and valuable citizens first, the Cherokee Nation signaled to others who may be on the fence that they think the vaccine is safe.
“It has done something to create a sense of optimism among our people and also to build the confidence of fellow Cherokees who see these highly revered, in many cases fluent in many cases, Cherokee elders get vaccinated and celebrate it,” he said. he told CNN.
Navajo Nation President Jonathan Nez said people were reluctant to get the shot from the start, so he took the photo to help build their confidence. The tribe also answered questions from the Navajo on the radio and in town halls twice a week, sometimes calling in experts like Dr Anthony Fauci.
Navajo doctors and medical professionals are also essential to efforts to build the trust of the tribe, who are able to speak to citizens in their own language and alleviate any concerns about their safety.
“Using our way of life and teaching helps our Navajo feel like taking pictures is okay,” Nez said.
About three in four Navajo citizens are now interested in getting the vaccine, according to Nez. To respond to this interest, the tribe held mass vaccination events seven days a week.
They have the autonomy to decide who has priority
Tribes are sovereign nations with the autonomy to determine how to meet the health needs of their communities. For those managing their own health systems, this meant being able to decide who should have priority for the vaccine.
This autonomy allows tribes to respond adequately to the unique challenges they face, Bohlen said.
“Our life expectancy is so much lower than that of the general population that we have to be able to decide that a 55 year old man may in fact be an elder, if you are in a tribe where the life expectancy is is 58 years old, ”Bohlen said.
In Washington State, this self-determination also extends to Indian urban health centers.
The Seattle Indian Health Board, a community health center specializing in the care of American Indians and Alaska Natives, opened vaccines to American Indians and Alaskan Natives aged 55 and over as of start of their distribution plan. This allowed them to protect all the seniors served by their seniors program, many of whom are homeless, said CEO Esther Lucero.
“Sometimes it’s the only place they get a hot meal or have social interactions or don’t have to go out in really terrible weather,” she said, referring to where the program alumni congregate. . “So that was really important to us.”
Since February 1, the organization has opened appointments to all people aged 50 and over, indigenous or not.
This health system belongs to its inhabitants
After successfully vaccinating some of their most vulnerable populations, some tribal health care providers are now opening dates even for younger and relatively healthy Indigenous people – groups that would otherwise likely be months away. to get vaccinated.
The Southcentral Foundation, a regional health organization owned and operated by the local Indigenous community in south-central Alaska, offered its first vaccines to frontline healthcare workers and natives 85 and older. Once the organization acquired the staff to operate larger immunization clinics, it quickly expanded its distribution to offer the vaccine to successively younger age groups, said the Acting Chief Executive Officer, April Kyle.
He has been vaccinating natives aged 16 and over since January 22.
The Southcentral Foundation has administered more than 12,000 doses of the vaccine as of February 8, according to the health system. The organization serves approximately 65,000 Alaskan Indians and Native Americans in Anchorage, Matanuska-Susitna Borough and surrounding rural villages.
The success of the Southcentral Foundation does justice to its model of community health care, Kyle said.
Kyle credits the organization’s smooth vaccine rollout so far to the natives of south-central Alaska, who have developed a community-driven health care system that in turn has been able to plan how to get vaccines even for people in difficult terrain.
She sees similar results in tribal health systems across the country.
“I watch the news and I am really in awe of the passion and sophistication of tribal health care and how communities can know how in their community to get this vaccine out,” she said.
They made big investments in health care
The Chief Chief of the Cherokee Nation, Hoskin, has some advice on how the United States can replicate the success of the tribe. But this is not a quick fix.
“We are a country that does not make access to health care an element of citizenship,” he said. “Because of this, access to health care is uneven across the country. 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 strengthening its healthcare system, which is now the largest tribal-run healthcare system in the United States, Hoskin said.
“I hope the lesson people can learn from the success of Cherokee Nation is that you need to invest in health care during the good times, make it a priority for your nation and make it universally accessible to your citizens,” he said. Hoskin said.
Ultimately, success depends on the country’s vaccine supply
Tribal healthcare providers polled by CNN say they get vaccinated through the gate and in guns soon after receiving shipments, which either come from the Indian Health Service or their state governments.
But their ability to maintain their steady immunization rates ultimately depends on the ability of the United States to continue to deliver vaccines at the speed and volume they need – a challenge that has already slowed the efforts of counties and States.
If that turns out to be the case, tribal healthcare providers say they will be ready.
“Can the United States follow the Cherokee Nation?” Hoskin asked. “This is really the key question for us.”
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