As the vaccine eligibility scope widens throughout the province, tangible measures to provide access to Indigenous people living in the greater Montreal area are gaining traction, as the city opens three COVID-19 vaccination sites specifically adapted for the population.
The initiative is the result of a collaboration between various Indigenous community organizations and Montreal’s public health team.
“Our role in public health is really to make sure that the importance of providing access to vaccination for Indigenous people who live in Montreal was brought to the forefront,” said Dr. David Kaiser, the chief physician for environmental health with the Montreal public health department. “We want to make sure that communities and individuals that are in Montreal aren’t penalized for being here and not travelling home.”
Although Indigenous people and communities are being prioritized as part of the national vaccine rollout, the responsibility of providing the vaccine to individuals living in urban areas has been left in the hands of provincial health authorities. Until today, efforts by city officials to provide Onkwehón:we residing in Montreal with the right they have been accorded nationally, has gone unseen.
The first phase of the project, which targets Indigenous adults aged 18 and over, began on Friday and is expected to run until mid-May. According to Kaiser, approximately 1,800 doses are anticipated to be administered throughout this period.
“There’s a question of equity that arises when campaigns in communities like Kanesatake and Kahnawake are already over, while in the meantime, Indigenous people in urban areas aren’t even targeted,” said Kanehsata’kehró:non Philippe Tsaronséré Meilleur, the general
manager of Native Montreal, one of the organizations that clamoured for the project. “My community is right next to Montreal, so if I can get vaccinated there, I don’t see a reason why our members (at Native Montreal) wouldn’t also be granted this access.”
As of April 20, Indigenous Services Canada reported a total of 654 vaccination campaigns within communities across the country, either in progress or already having been completed.
While the initial phase requires individuals to book an appointment, Meilleur and other actors involved in the initiative are questioning the efficacy of this system. They say this has already proven ineffective when unhoused and precariously housed communities were targeted following outbreaks in shelters and services centres throughout the winter.
“The method that is used by our health system right now is simply not adapted for the majority of vulnerable populations living here,” Meilleur said. “The future phases will probably be something more flexible and better adapted to the reality of those who don’t have phones, emails or fixed homes.”
Leilani Shaw, deputy executive director at Montreal Indigenous Community NETWORK, another organization spearheading the project, reiterated the importance of offering flexible vaccination options for the populations, which she explains require services adapted to their needs. “We’re fortunate to be able to have the vaccination sites, not only within organizations that the Indigenous urban communities are familiar with, but that they have also used their services perhaps one time or another,” said Shaw. “It brings a lot of comfort to community members when they see a familiar face or go to a location they’ve seen before.”
The features that were established to be instrumental in the success of the campaign also include language accessibility for members who are not French-speakers. As such, Native Montreal will have staff on the ground at both the sites overseen by the organization to offer English translation. Inuktitut and Cree translation will also be available at the site operating at the Native Friendship Centre of Montreal situated downtown.
The third vaccination site for Indigenous people is an Inuit-specific clinic launched in conjunction with the Nunavik Regional Board of Health and Social Services, which will offer service in Inuktitut, English and French. The clinic is operating inside the Douglas Hall Pavilion of the Douglas Mental Health University Institute.
In order to remove the structural barriers that limit accessibility to services for the Indigenous urban population, the organizations are allowing staffers to register members for their vaccination appointment. Meilleur said that every step of the campaign seeks to be as inclusive as possible.
“Many of the participants no longer have any identification methods, so we didn’t want to start asking for those when it’s time for booking,” he explained. “The campaign’s approach is really aimed towards accessibility rather than trying to be restrictive.”
In addition to avoiding the transmission of COVID-19 by limiting regional travel, Kaiser explained that the campaign also strives to make do on promises regarding equality for
Indigenous people. “The project has to be placed in a context of reconciliation, that’s the first thing,” said the chief physician. “The second is that we are really wanting to address inequalities that we know are historical, structural, and ever present.”
For the community organizations involved, the objective of the vaccine strategy is not only to provide vaccination to vulnerable populations, but also to set a precedent for how the public health agents and the healthcare system can operate within a culturally-safe framework.
“In order for public health to address this in a way that is actually impactful, they need to listen to Indigenous organizations who have been advocating for adapted services for over two decades,” said Shaw. “To actually be heard and have our recommendations be responded to, it’s a groundbreaking process that we want to continue seeing in the future.”