As the rate of COVID-19 vaccinations slows down across the U.S., state governments are using various tactics to entice more adults to get their shots, but effective public health strategies to address this pandemic need to be as diverse as the populations they serve. In an emergency, when every vaccine shot counts, an array of nonprofits are stepping up to connect every Mainer to the healthcare they need.

“I want to promote vaccinations, but I also want to have empathy and understanding before I start designing my approach,” said Lisa Sockabasin, MS, RN and leader at Wabanaki Public Health & Wellness (WPHW). WPHW supports Maine’s Tribal Public Health District, a division of Maine’s Department of Health and Human Services. This unique cooperative governing structure is one of only a few in the nation, serving Indigenous people from the four bordering tribal communities of the state—Passamaquoddy, Penobscot, Maliseet and Micmac.

In healthcare, cultural competence is defined as the ability of providers and organizations to deliver services that meet the social, cultural and linguistic needs of patients. People from all backgrounds might have some level of mistrust in medical science or systems, but existing and persistent historical trauma continues to influence how communities of color view the medical establishment.

“The best tool to have in public health is patience,” said Sockabasin. “We have to acknowledge past harm done by the very government we are asking Black, Brown and Indigenous people to trust.”

WPHW was one of six Maine nonprofits to receive grants this past February from the Harvard Pilgrim Health Care Foundation and Tufts Health Plan Foundation to support vaccine education in communities of color. The others were Maine Immigrants’ Rights Coalition, Portland Minority Health Department, Presente! Maine and the Somali Bantu Community Association in Lewiston.

Compared to the general population, Sockabasin said that Indigenous people “get sicker and die more frequently in a pandemic because we don’t have the resources to address the issues. So, our team watched this from the beginning, and we planned for a crisis while looking at the future.”

Now Sockabasin says they are focusing on reaching out to young people about getting their COVID vaccination shots, as it’s a demographic that is hesitant about the vaccine, regardless of your ethnicity. Sockabasin says WPHW’s strategy to get more youths vaccinated is led by youth themselves because “we believe that young people listen to young people.”

Sockabasin is proud of the tribes innovations to make vaccines low barrier and accessible, but with their success, she also worried about immigrant and refugee neighbors who were experiencing a crisis, asking “How do we recreate the success that Wabanaki communities have had for other communities where they are struggling?”

Around this time last year, Black Mainers accounted for over 27% of the week’s active COVID-19 cases. Only 1.4% of Maine’s population is Black and many are new or first-generation immigrants. The racial disparity of infections made national news and “opened people’s eyes,” recalled Muhidin Libah, the Executive Director of the Somali Bantu Community Association (SBCA). “People in the larger Lewiston community, were like, ‘Okay, what can we do about this? We need to fight as one.’ Everybody was so ready to fight with information, with medical expertise, with funds, with everything they can.”

SBCA had an existing Medical Reconciliation Program, where staff or volunteers would help community members get to the pharmacy or healthcare appointments and translate for Somali or Lingala speakers. Previously, SBCA had been working with local healthcare systems, teaching Somali Bantu cultural competence to healthcare professionals and ensuring appointments provided ample time for thorough translation.

“The money that came in allowed us to get more hands on deck,” Libah said, as they were able to create more pop-up vaccination sites with free PPE and increase outreach. That said, Libah is still seeing COVID-19 vaccine hesitancy amongst young people within the Somali American community.

Libah’s mindful of people’s religious beliefs and practices so we “are making signs, chatting on WhatsApp, meeting them at the mosques, or any place we know people are gathering,” Libah said. “We can also investigate where there are unvaccinated people and what kinds of misinformation or rumors are out there.”

For Libah, the community’s losses are interwoven with the creation of Liberation Farms, a more than 100-acre farm that SBCA acquired last year. More than 200 Somali Bantu families have plots on the land. Libah hopes the farm will provide a place of healing to “create different ways to commemorate and go forward.”

The effectiveness of community-led public health policy is clear. Libah said he thinks around 80% of the Somali Bantu population in the Lewiston area (about 2,000 people) is vaccinated now. That will help SBCA focus on long-term community health around diet and lifestyle, which are goals that Lisa Sockabasin at Wabanaki Public Health & Wellness shares.

In Sockabasin’s three years at WPHW, the organization has grown from seven employees to over 100. It is growth that she hopes is part of an overall philanthropic and policy shift toward “trusting communities to know what they need in times of crisis and peace,” because of how it can strengthen and heal cross-cultural relationships.

“Our insights and experiences can help people’s health everywhere and that’s the conversation I’m having with immigrant and refugee groups—that we can do this with them too,” said Sockabasin. “There is enough for everyone. There is abundance everywhere.”

 

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