In this episode, we talk to Lynne Innes, President and CEO of Weeneebayko Area Health Authority, Cynthia Yellowhead, Community Coordinator in Nibinamik, and Brian Crowe, Ornge PC12 Captain. We learn about the implementation of Operation Remote Immunity in various communities across northern Ontario, and discuss the importance of providing vaccines to Northern communities.

See episode transcript below:

… Various news clips

Rachel Scott:
If you live in Ontario, you've probably heard of Operation Remote Immunity, or as we call it, ORI. Launched on February 1, 2021, ORI offers residents in remote indigenous communities access to the Moderna vaccine. Recognizing the critical importance of engaging indigenous leadership and how vaccines are offered to their communities, ORI was co-developed through a partnership with Nishnawbe Aski Nation.
Vaccination teams under the direction of Ornge have traveled to 31 northern, remote NAN communities and Moosonee to administer the vaccine to residents who wish to receive it. As of April 6, 2021, more than 24,800 doses have been administered.
My name is Rachel Scott. Welcome to Ornge Pulse.
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During this episode, we wanted to learn about the importance of Operation Remote Immunity and how the implementation of vaccines to northern communities is a priority. To learn a bit more, I sat down with Lynn Innis.

Lynn Innis:
My name is Lynn Innis, and I'm the president and CEO of Winnebago Area health Authority. Winnebago Area Health Authority is our healthcare system along the James and Hudson Bay coast, providing services to all six remote communities, that being from pre-hospital care, emergency care, acute care, and primary care.

Rachel Scott:
Lynn is from Moose Factory, which helps give her even more insight into the needs of the community.

Lynn Innis:
I'm originally from Moose Factory, I was born in Moose Factory in the hospital that I work in, and raised in Moosonee. I left just for post-secondary education. So I am a nurse practitioner, so once I was done, my nurse practitioner program, I then came home to Moosonee to work as a practitioner in primary care and to raise my family. I have three small children all of which are very active and love Northern living.

Rachel Scott:
So, can you tell me a bit about the physical location sites that Winnebago supports?

Lynn Innis:
So our main site is located in Moose Factory Island, that's where our general hospital is, where we provide OR emergency care, all services. And then we have six nursing stations, six remote nursing stations, two of which are supported with nursing staff by Health Canada and the rest are primarily Winnebago.

Rachel Scott:
Can you tell me about some of the goals of your organization when it comes to care?

Lynn Innis:
Our goal is to provide care as close to home as possible, whether that be at the local level, regional level. And then of course our referral centers are tertiary care centers, so we like to try to keep as much of the care flow within the region that we can, and when we can't then we certainly have to refer out.

Rachel Scott:
So, when it comes to Operation Remote Immunity, can you tell me why it was so important for us to prioritize the communities you serve?

Lynn Innis:
So it's incredibly important for all of the communities in James and Hudson Bay Coast, as well as NAN west to receive the vaccines because: A. We are generally more vulnerable and more sick in comparison to our southern partners as well as we lack the health infrastructure that is in place and accessible again to our southern partners.
And the housing situation in all of our communities is very sparse, so we have multiple families living in one household so there's a lot of congregated living, as well as the issues with water in each community, not being able to drink the water...hygiene, so we knew that we had to buckle down and lock down quite quickly because we knew if COVID was ever to hit any of our remote communities, it would essentially spread like wildfire because we have so many people living in each household and not having access to healthcare in every community was a huge risk for us. We have very unique logistical challenges, such as the spring flood for the community of Kashechewan, the remoteness factor. And then again being fly-in only, which is why we wanted to ensure... we advocated to get the vaccines as soon as possible to make sure we could protect our people.

Rachel Scott:
When the pandemic was declared, how did it impact your organization, and what did your organization do to adapt to ensure you're able to effectively and safely serve your community?

Lynn Innis:
Once the pandemic was declared in March of last year, we worked with all of the First Nation communities and their pandemic groups to ensure that we were adhering to the wishes of each individual community as well as making sure we had guidelines in place to ensure that: A. We kept the hospital running and B, we were able to provide as much care as we could without interruption and also enhancing our virtual care capabilities along the James and Hudson Bay coast. We did have quite an enhanced virtual care program whether that be through OTN or other means, but we just had to bump it up quite significantly to ensure we were meeting the needs of everyone, especially with regards to primary care and follow up.

Rachel Scott:
What are some of the changes you made?

Lynn Innis:
So there was a lot of operational demands and changes that we had to make within the first couple weeks of initiating our Incident Command Center to ensure that we were meeting not only the ministry requirements, but the requirements of our community because we are unique. So what we did is we basically went into lockdown and shut services for three months except for what could be provided virtually. We went from having all kinds of entrances to the hospital, to just having the one entrance for all visitors, and one entrance for staff, as well as the screening protocols and extra screeners to ensure that anybody coming into the building was being screened and that only people working in the building or that were approved to come in as an escort to a patient under special circumstances were able to come into the building, but there were a lot of restrictions that we had to put in place in all of our sites to ensure that we were keeping the community safe and keeping all of our healthcare staff safe.

Rachel Scott:
So, when Operation Remote Immunity was initiated, how was Winnebago involved in the process?

Lynn Innis:
Initially, the callout or the meetings were with NAN and then we were looped in with Ornge and I know Dr. Tien very well, so it was an easy transition to move into that task team table to ensure that we were able to meet the needs of the community. And as far as the planning stages go, making sure that our rollout was tailored to each community to ensure we had: A. Good uptake and B. Were able to get into the community with the appropriate resources in a timely fashion.

Rachel Scott:
So, when it came to each community, what was the process to ensure members were aware of the initiative, as well as to ensure an increased uptake of the vaccine?

Lynn Innis:
So we had our communications team prepare multiple newsletters, as well as using Facebook, Twitter, LinkedIn, as well as the local community channels, the local radio stations. We had our community relations specialist on several times a week, and we had it replaying in both English and Cree to ensure that we were meeting the needs of everyone, especially our elders because they had a little bit of a decreased uptake initially, but once we were able to get all of the misinformation curbed and provide the appropriate information in a language they understood, we saw an increase in the uptake for the Moderna vaccine.

Rachel Scott:
So, talking about misinformation and hesitancy, how was that addressed?

Lynn Innis:
Initially, there was a lot of vaccine hesitancy along the James and Hudson Bay coast, and naturally our people felt that they didn't want to repeat history, they didn't want the colonial system and residential school, etc. So it was very important for them to have all of the information, and to ensure that they were, in fact, not guinea pigs. So Dr. Tien and I spent a lot of time with each community meeting with each respective Chief in Counsel, as well as their health directors to ensure we were answering all of the questions and we were translating that over into Cree to ensure that the elders that couldn't speak or read were able to at least listen to it. So we worked hand-in-hand with Ornge to ensure that the misinformation was curbed and we explained to the elders that it was safe and we weren't, in fact, the guinea pigs and that there was 30,000 people in the clinical trial who were the guinea pigs, so it was a lesson learned from our neighbors in the states to have a successful and safe rollout here in northern James and Hudson Bay.

Rachel Scott:
I also heard you were working with community leaders as well.

Lynn Innis:
Yeah, so what we did is we identified either leaders, or an elder, or somebody that was very passionate about getting the vaccine and that could spread the good word in each community. So every community we went to, we ensured that the Chief was there and we dialogued with the Chief and we recorded a message and then we replayed it on our website and on our Facebook so people had access to that all the time. I also went out as part of the vaccination team to provide some local support and familiarity along the James and Hudson Bay coast, and it was really important for us when working with Ornge to ensure that our local teams were just as much a part of the rollout as Ornge, because we felt that the uptake would be a lot better with local health care providers and local health human resources to be able to provide the vaccines to the people they serve.

Rachel Scott:
Can you tell me a bit about the resources? Specifically when it came to language or translation?

Lynn Innis:
We have a Community Relations Officer, a Community Relations Specialist who is an elder in our region, a well-respected elder that travels alongside myself and the ORI rollout to ensure that there was no gaps in communication. We also sent all of the information ahead of time in the appropriate dialect to ensure that the Chief in Counsel, the community members, the community health representatives, had that information well in advance before we actually arrived with the vaccines.

Rachel Scott:
And I understand there are different dialects for the communities you serve?

Lynn Innis:
There's two different dialects along the James and Hudson Bay coast. There's the L and the N dialect.

Rachel Scott:
So, I heard you traveled with each vaccination team to all the communities. How was that?

Lynn Innis:
Though I participated in every single mission for every single community, I didn't get to hit every community for dose number two, but I did for all dose number ones.

Rachel Scott:
Wow. So these were big missions? It sounds like a lot of work.

Lynn Innis:
It is. It's an incredible amount of work. So the first we started with was Peawanuck, because it was the furthest away, so that's along the Hudson Bay coast. Then we moved down Kashechewan, and then went over to Attawapiskat, and then Fort Albany, and then Moose Factory, and Moosonee.

Rachel Scott:
Was there anything you had to adjust or adapt when it came to offering vaccinations within each community?

Lynn Innis:
So, because we had multiple meetings, multiple virtual meeting, as well as recce flights to ensure a couple days in advance we were able to step foot into the communities and ensure that the clinics were set up appropriately, because all of that preparation went in far in advance, it was pretty much a seamless transition once we arrived in each community, and each community is very different. Some places we were in gyms, some places we were in community health centers, and sometimes because we kicked our rollout off the first week of January, we did all of our long-term care patients in our three hospital sites. So we were able to work out a few kinks and certainly have some lessons learned from each smaller rollout before we had the mass clinics.

Rachel Scott:
Can you tell me how your team ensured that everyone who wanted a vaccine was able to get it?

Lynn Innis:
Absolutely. So what we did is we had booked appointments, we had walk ins, we also had home visits, so we were very flexible, as well as, for people that weren't in the community, we made sure that there was plans A,B, and C for them to ensure that they were able to get their vaccines as well. We did about 10 home visits in each community, which was great because then we're minimizing the amount of exposure and travel for our elders and knowledge-keepers in each community.

Rachel Scott:
And is there anything that you think would be important to share about health equity, or about any insights of key learnings that happened throughout the mission?

Lynn Innis:
I think there's a few things. One, with regards to health equity, there was a lot of physicians on all of the teams and a lot of allied health support, that when they came to the community, they immediately fell in love with every community and they didn't actually realize that we existed and that there was disparities in northern remote Ontario that they didn't know existed. So a lot of them had said, "you know I do work in Africa, I do work overseas, and I didn't know this was happening in my own backyard." So there was a lot of room for learning, a lot of room for growth, and future opportunities for having some of these specialists in allied health to come and help support us as we move forward as a partnership on the local level and the regional level. We have developed a very strong relationship with universities, as well as, with Ornge and ensuring that from an acute care perspective from the vaccine rollout we're all working together and integrating into one system so we are able to meet the needs of the communities and the region.

Rachel Scott:
That's some really great insight, Lynn. I just want to thank you for taking the time to chat with me about how COVID as well as Operation Remote Immunity has impacted the community you serve.

Lynn Innis:
It was certainly an honor and a pleasure to be able to bring the Moderna vaccine to all of our communities and to a part of the vaccine team.

Rachel Scott:
If you'd like to learn more about the Winnebago Area Health Authority, feel free to visit their website at waha.ca, W-A-H-A dot C-A.

So, we were able to learn about ORI and how it was rolled out along the James Bay and Hudson Bay coast, which is northeastern Ontario. Up next, we're going to go to northwestern Ontario to Summerbeaver. We're going to talk about setting up vaccination clinics from the ground up with community coordinator Cynthia Yellowhead.
Hey Cynthia, thanks for talking to me. Do you mind introducing yourself and your role

Cynthia Yellowhead:
My name is Cynthia Yellowhead. I am from Nibinamik First Nation and I am the community vaccine coordinator for Nibinamik.

Rachel Scott:
So, during our conversation, Cynthia taught me the proper enunciation of Summerbeaver, which is Nibinamik

Cynthia Yellowhead:
Nibinamik. Nee-bin-uh-mik.

Rachel Scott:
Nibinamik

Cynthia Yellowhead:
The 'nibin' is 'summer'.

Rachel Scott:
Cynthia grew up in Nibinamik.

Cynthia Yellowhead:
I grew up in the community and we're actually taught a lot of traditional things as we're going through school as well. I speak all the Crees so I'm able to speak to the elders and the young people, either.

Rachel Scott:
Can you tell me a bit about Nibinamik, how I would be able to visit, and maybe a bit about the landscape and the people there?

Cynthia Yellowhead:
We live by a lake and are only accessible by plane half of the year and we have a winter route that's used around December and we're able to use that until March. We have about over 300 residents on reserve and about around 200, give or take.

Rachel Scott:
So, before you were asked to be a coordinator with Operation Remote Immunity, what was your role?

Cynthia Yellowhead:
Before all this, I worked in health as the family resource outreach worker and a crisis coordinator, and I moved on to Chief in Counsel executive and other jobs. The crisis coordinator part came in handy with this position and I was able to adapt quickly and plane accordingly to whatever came up with the vaccination rollout.

Rachel Scott:
Can you tell me a bit about the process of developing a vaccine clinic where Nibinamik community would receive their vaccine?

Cynthia Yellowhead:
In the beginning it was just a drawing that I took to the Chief in Counsel to review and to see if that was how they wanted it built, and the Canadian Rangers, they have all these skills that they bring to the team and we built a field hospital inside the gym. We built it within two days. We just took our time building it, make it work with how we saw our vision.

Rachel Scott:
So, how did that vision change and adapt over time?

Cynthia Yellowhead:
Every time somebody walked in, the vision just got bigger and bigger and we just added on. We custom-built our setup insider the gym. We made an office area and three stations and a first-aid area and an isolation are, so we had all the windows covered, and the private entrance. And how the people would walk in and sit down from each station to station, we had three stations set up. There was another entrance where you could go out of. We had two drivers to bring them in, then another driver to drive them home after the inoculations. We didn't really have anybody walk during that first rollout.

Rachel Scott:
What was the reason behind that?

Cynthia Yellowhead:
Just to keep up with the time and our scheduling.

Rachel Scott:
That makes sense. Can you tell me a bit about the team you worked with and their roles and their responsibilities?

Cynthia Yellowhead:
I had two translators and a scheduling coordinator, and the rangers did the transportation part of it, and there was three drivers in total and they took turns organizing themselves to drive people there and back.

Rachel Scott:
You mentioned a scheduling coordinator. Can you tell me a bit about the importance of their role?

Cynthia Yellowhead:
Kelma was my first hire to work with the vaccination rollout and she had a really good skillset as a scheduler and she went out there that first rollout a week before to sign up who were ready to be signed up and I am really thankful that she messaged me within the first half-hour that I posted that I needed somebody to help me with scheduling and appointments. She did a great job on the second rollout and she was constant and was really good at communicating with all the incoming people that were coming to get their second or their first dose.

Rachel Scott:
Okay cool. So, take me to the first day of vaccinations. How did that start?

Cynthia Yellowhead:
The first day, we met with the vaccination team that morning, then we had the Chief in Counsel come in and there was an opening prayer by the local reverend, and just a blessing ceremony of the vaccinations for the week.

Rachel Scott:
Can you tell me a bit more about that?

Cynthia Yellowhead:
That's mainly what we do in our community, we always have a blessing and a prayer done by either an elder or a church member. In this case, we had Reverend Georgina Neshinapaise do the blessing of the vaccines and to have a good vaccination rollout week.

Rachel Scott:
Okay, so what happened next?

Cynthia Yellowhead:
Then the first three counsel members were vaccinated, and then we opened it up to the essential workers, then the community members after that. Each day that's how it went, whoever was willing to be vaccinate, who was ready, it was everyone's choice.

Rachel Scott:
Okay, so I know everyone who was vaccinated signed up, they had registration forms, etc, but was there anything else you found helpful in ensuring that everyone was able to be communicated with or vaccinated?

Cynthia Yellowhead:
I used a map to cross off houses that came in as a household, and I was able to keep up with that throughout the four days that we did the vaccinations, just for my reference and the team leader's reference, like who we have vaccinated so far. That was a time-saver for us.

Rachel Scott:
Can you talk a bit about promoting awareness about the vaccine?

Cynthia Yellowhead:
We did a lot of black radio outreach program with the vaccinators, and one of the translators worked with the vaccination team and the local community doctor with home visits to bring awareness with the vaccination period if they had any questions or concerns. And I had one other translator that stayed with us in the gym and she was able to work with anyone that needed help with translating and filling out their registration forms.

Rachel Scott:
So can you tell me a bit about the second vaccine a month later? This one was different, right?

Cynthia Yellowhead:
The second we had to adjust a lot more. We were that COVID would be coming to our community at some point in the future, but we just didn't know when, or how soon that would be, and then suddenly we had positive cases in between the first and second vaccination. And it was imperative to have our vac stations done on the second rollout.

Rachel Scott:
Okay, so at that point, Nibinamik was under lockdown?

Cynthia Yellowhead:
We went on lockdown on March 2, and I tried to get the team ready and everyone was scared to do this.

Rachel Scott:
So what did you do next?

Cynthia Yellowhead:
To the positive cases? Just to minimize people having to go outside of their own bubble, we had them drive up to do a drive through vaccination, and either to walk over or drive their ski-doo to be vaccinated in a tent outside of the school gym.

Rachel Scott:
So how were you able to coordinate the curation of the new drive through clinic under lockdown?

Cynthia Yellowhead:
Paul and I, Paul Oskenigish, Paul is the sergeant for Summerbeaver. We communicated a lot over the phone and on Facebook Messenger and he showed me a picture of how the vac station would go and we spoke about having a drive through vaccination and having a tent set up and they did that on Sunday. He sent me a picture of how it would go, and I agreed that's how we should do it.

Rachel Scott:
You mentioned that your team was a bit scared. What did you do to mitigate this fear?

Cynthia Yellowhead:
We had really low numbers for staff within our community, then we had COVID rapid testing done, which was available for us from the Ornge team, they provided our testing that first morning before the vac stations began. We were able to bring up our trust levels within our team that were working with the vaccinations. It alleviated my trust with all the people that I would work with and was able to focus on the task at hand more.

Rachel Scott:
Aw, that's great. So I heard the second round went really well?

Cynthia Yellowhead:
We were able to do all the second dose people within three days instead of five, and we added almost 30 people for the first dose on the second rollout, which was surprising for me. I wasn't expecting that much new people.

Rachel Scott:
What was the overall total after the second round?

Cynthia Yellowhead:
In total, I counted 83 per cent for Nibinamik.

Rachel Scott:
So according to the community, approximately 83 per cent of eligible members received the Moderna vaccination. What a wonderful uptake.
Just wanted to give a special thanks to Cynthia for taking the time out to chat with me. If you'd like to learn more about Nibinamik, feel free to visit summerbeaver.com, that's s-u-m-m-e-r-b-e-a-v-e-r dot com.

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Up next, we move even more north Port Severn. We speak to Captain Brian Crow, who is not only a pilot with Ornge, but a community member form Fort Severn. We were able to catch up and discuss how he became a pilot with Ornge, as well as his role on the team for ORI in his hometown. So meet Brian Crow, PC12 Captain.
So Brian, what made you decide to become a pilot?

Brian Crow:
It was a childhood dream of mine to be a pilot. I was probably around six or seven years old, my dad took me to the airport, and we saw an old plane land, the cargo plane up in Port Severn. I remember to this day that that evening I made a plane out of the couch cushion.

Rachel Scott:
That's wonderful, knowing your calling from such a young age. What did it take for your dream to become a reality?

Brian Crow:
During high school, the counselor said that what I needed to have to continue on through college. So I took all my math courses and physics, one of them was physics, and all of my English courses and I went off to college after high school.

Rachel Scott:
So me and Brian chatted, he told me that he spent time working on float planes and gaining flight hours throughout various jobs, he even took some time off and lived in Fort Severn, where he was elected as deputy chief.

Brian Crow:
When coming back to the community, for those two years, I'm deputy chief. I'm happy to be back and to help doing stuff that I grew up doing, like hunting, fishing, and just more around family and friends again.

Rachel Scott:
So when did you start working with Ornge?

Brian Crow:
In 2009, that's when Ornge was starting up with their hike swing blades, and I really wanted to be a part the Ornge team. I applied and I got hired on in November 2009 and I enjoy it every day.

Rachel Scott:
Do you find that with your current role as a PC-12 Captain at Ornge that you get calls to go into Fort Severn.

Brian Crow:
I do. We do a lot of remote flying committees, and when I'm on shift I would get the Fort Severn call which I'm happy to do. And I get to see a bit of family and friends when I'm there for the short turnaround time. My dad usually comes up and says hey.

Rachel Scott:
And so you have the opportunity to work on Operation Remote Immunity, not as a pilot, but as an administration staff on the team. What did you think about the way it was organized?

Brian Crow:
I was very honored to be part of the team,the Ornge team, the vaccination to Fort Severn. The organizers of the Operation Remote Immunity did really well and Ornge brought together a really good time and it was well put together. When I joined the team there we did training the first day before flying up to the community. We flew in from Sioux Lookout and it took an hour and 45 minutes each way. During our week there, the plane stayed in Fort Severn and waited for us until we had done our vaccinations each day, and then we flew back Sioux Lookout. Then we flew back in, in the morning. It was five days of being up there, I enjoyed being there and very happy to be part of a team, a vaccination team.

Rachel Scott:
And what was your role as admin, what kind of duties did you have?

Brian Crow:
I was helping out with the handing out information that builds rapport in the community. There were rangers from the community there that helped the vaccination team and also the other community members that were there helping out with the screening and the admin work. We came together and we made a good team/

Rachel Scott:
Can you tell me how this role with Operation Remote Immunity was different from your day to day work with Ornge?

Brian Crow:
It was different from our regular routine when I'm on shift working, when I go to the community, as far as like going in there to medevac somebody who needs medical attention to bigger center. But this role with the vaccination, we go in there for something good, to help the community with the vaccination. Doing that is doing something good for the community. That's where I'm from and I'm giving back to the community it's where I grew up. I was very happy to be part of the team during that vaccination week.

Rachel Scott:
Awesome. Thanks for taking the time to speak with me, Brian. I really appreciate it.

Brian Crow:
Thank you. Very honored and happy to be back in my home community and to be able to be there helping out.

Rachel Scott:
So it was great to explore the vaccination efforts in northern Ontario, but I really enjoyed hearing from the people who worked hard to ensure that members from fly-in and remote, indigenous communities were able to receive the vaccines that they needed.

On Tuesday, March 23, Dr. Homer Tien, Ornge president and CEO attended the Nishnawbe Aski Nations virtual Chiefs assembly. Ornge joined seven other organizations in the signing of relationship accords to improve healthcare across NAN territory. The signing of this accord speaks to Ornge's commitment to health and our continued efforts to provide inclusive and culturally appropriate health care. We look forward to working with our partners at NAN and the ministry of health towards this goal. Feel free to read the full statement the NAN website, That's www.nan.ca

In our next episode, we'll be following one team, team six, and hear a bit about their specific journey and how they overcame a number of challenges to deliver the vaccine to the community of Kashechewan.

I'm Rachel Scott, and this is Ornge Pulse. This podcast could not have been completed without help from staff on Team Ornge, more importantly, Operation Remote Immunity was only possible due to the collaboration from a number of partners: The Winnebago Health Authority, the Sioux Lookout First Nations Health Authority, Indigenous Services Canada, The Northern Ontario School of Medicine, Queens University, The University of Toronto, Northern Paramedic Services, The Porcupine Health Unit, The Thunder Bay District Health Unit, The Northwestern Health Unit, The Ministry of Natural Resources and Forestry, The Canadian Red Cross, The Rangers, and many more.

 

     

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