This interview is part of a series that highlights the work of Community Health Centres (CHCs) across Canada through the Community Vaccination Promotion (CVP)-National project and discusses the realities of COVID-19. Visit CACHC’s Addressing COVID-19 webpage and listen to CVP-National related episodes of our Community Matters podcast to learn more about the frontline response of CHCs across Canada to COVID-19.

Briefly tell us about your organization, where it is located, the services and programs provided, and the communities/population you serve?  

Central Interior Native Health Society (CINHS) is a Community Health Centre located on the unceded, ancestral and stolen territory of the Lheidli T’enneh people, in downtown Prince George, BC. We are a street level clinic with a primary goal of meeting the needs of clients in our community with as few barriers to care as possible. Our clinic can be thought of as a one stop shop, we have physicians, Nurse practitioners, nurses, social work, physio, counselling, and outreach services. We also have a cultural space in the basement of our clinic which hosts a variety of workshops and groups. As the majority of our clients are Indigenous we have a strong cultural influence to our services and are guided by Indigenous elders both on our staff and on our Board of Directors.

Over the last 3 years the COVID-19 pandemic presented unforeseen challenges in all sectors, and the vulnerable population has been one of the hardest hit groups. What has been the impact of the COVID-19 pandemic in your community, how have you been able to address it and how is your organization navigating providing care and services to your clients during this time?

When the COVID-19 pandemic started, it seemed to amplify the difficulties that our clients already face day to day. Suddenly there were fewer and fewer places to exist, to go to the bathroom even. Access to care and supports became more and more sparce as organizations adjusted their hours or closed completely. Our clients, who already hear the word ‘No’ all too often were suddenly hearing it even more. When infections began appearing in our community and in shelters, solutions had to be found for where people can isolate, how will we get their medications to them etc. The realities of just how important it is to have a home became even more clear. For CINHS, the COVID-19 Pandemic required a well thought out but rapid response. Luckily, we were able to be nimble and adjusted quickly to the situation. We determined very early on that we would be staying open and would begin covid testing as testing was otherwise largely inaccessible to our clients. We worked with other community partners to establish a system of providing clients with isolation space in a local motel that had been repurposed. Team members took on medication and food delivery for clients, and when vaccines began to be available, we worked hard to ensure our client had access to them and to accurate information about the vaccines.

Your CHC is one of the recipients of the CVP National (PHAC funded project). Could you tell us about your project and its goal? Include any activities and programs carried out and resources created.

Provide Trauma Informed, Culturally Safe and non-stigmatizing COVID-19 and Flu vaccine clinics to our clientele, who are primarily Indigenous, living on or near the street, may have or be at risk for HIV or HCV, may be receiving OAT and/or experiencing complex illness or substance use disorders who may not be able to or feel safe accessing traditional Western influenced services.

Clients who are already connected to the clinic, feel safe accessing services and would benefit from a drop-in style service would benefit from receiving Covid vaccine information and then, if they choose, receive the vaccination with traditional wellness and healing supports.

What milestones or achievements (including uptake of the vaccine) have you achieved, and lessons learned during the project so far? 

Clients identified that the provincial booking system in BC is a barrier, or they do not know how to book or where to go. We held our clinics in an Indigenous cultural space, respondents identified this as very important to them.  Clients identified the drop in nature of our clinic was the primary factor in their overall ability to be vaccinated this season and that having the clinics in our cultural center was important to them.

As a Nursing team, we are now up to date on all of the Province’s current Covid 19 vaccination processes and we have evidenced our gained competencies through these clinics.  We also felt a sense of satisfaction know that we supported some of our most vulnerable clients to get their COVID-19 vaccines in a way that felt supportive to the more people were interested in getting their annual flu vaccine then in getting a Covid booster.  If we had been able to offer the COVID-19 primary series, I believe we would have had an uptake on that.

Have you and your team experienced any challenges or barriers to vaccine promotion and uptake in your community? How have you managed these challenges?

Ordering the COVID-19 vaccine under BCCDC guidelines at the time was not possible for our clinic, finding a health service partner who would support us by ordering vaccine was not possible. We were able to partner with a local pharmacy which was excellent. Doing the clinics under a pharmacy in BC though meant we could only provide COVID-19 vaccine to 12+ and boosters only, per BCCDC guidelines.  This limited our reach and scope immensely. We believe we would have had more reach if we could have provided the full spectrum of covid vaccines (under 12 and primary series).

One of the major challenges to vaccine promotion in the community seems to be a general distrust of the government or health care overall. Many clients have referred to the legacy of colonization in Canada and the subsequent trauma that has come from medical experimentation in residential schools or forced medical procedures as reasons they are very wary of being given priority access based on their ancestry.

Did your project involve any partnerships or collaborations? If yes, please describe. What relationships if any did you leverage to ensure the delivery of your project.

One of our local pharmacies, who is our client’s pharmacy provider and we know them well, stepped up, provided training, ordered vaccines, and stood up the clinics with us. A team member from First Nations Health Authority advocated for us with our partners and Northern Health provided an LPN for both of our clinics which was very appreciated!

How has the funding through the CVP National Project helped your centre and the community it serves?

We would not have been able to provide these clinics without the funding.