Episode 6 – The Effects of COVID-19 & the COVID Vaccination of the Indigenous People of Canada

COVID19 The Answers

Dr Evan Adams MD - Deputy Chief Medical Officer, Indigenous Services Canada talks about the experiences of the First Nations, Inuit and Metis people of Canada during the COVID-19 pandemic and the COVID vaccination of these communities.

Watch the full interview here: https://youtu.be/SekNL1-5CHQ

Learn more at: https://kojalamedical.com/covid19theanswers/

https://www.rcaanc-cirnac.gc.ca/eng/1100100013785/1529102490303

https://www.sac-isc.gc.ca/eng/1606941379837/1606941507767

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TRANSCRIPT:

Kojala Medical presents COVID 19 The Answers. The show that delivers the scientific evidence-based knowledge that can safely return us all to our pre-COVID lives. My name is Dr. Funmi Okunola and I'll be hosting the show. Every week you can listen to me interview a highly respected professional about the science that can reduce your risk of becoming infected with the coronavirus.

Welcome to episode 6 of COVID 19: The Answers, titled 'The vaccination of the Indigenous People of Canada and the effects of COVID 19 on the Indigenous People of Canada I'd like to introduce you all to Dr Evan Adams, Dr Adams is from the Tla'amin First Nation near Powell river in British Columbia Canada. Dr Adams completed his doctor of medicine degree at the University of Calgary and his aboriginal family practice residency at Saint Paul's hospital UBC in Vancouver Canada as chief resident. He then went on to acquire a Masters of Public Health degree from John Hopkins University in Baltimore in the USA. He was the first ever aboriginal health physician advisor in the office of the Provincial Health Officer and became the deputy Provincial Health Officer in the province of British Columbia Canada in 2014 he became the first Chief Medical Officer for the newly formed First Nations Health Authority in BC.

Dr Adams is currently the Deputy Chief Medical Officer for Indigenous Services Canada Dr Adams is a multi-award-winning actor, most famously starring as Thomas Builds-The-Fire in the movie, 'Smoke Signals' and has over 30 years experience as a motivational speaker. Dr Evan Adams is one of the most famous, honored and much-loved persons amongst the Indigenous People of Canada. Welcome! Ah thank you, what a very generous introduction. Oh it's very true.

I've spoken to many Indigenous People and I hear nothing but high praise. Ah, that's a that's a nice feeling, thank you. So, I've been dying to ask, how a medical physician came to be a famous actor and did you have to choose between the two professions? Yeah, it actually happened the other way around. I was uh, you know, I was a fairly good student and and as a you know as a high school student was told 'oh we we so need you to get an education and return home and help with all of those all of those issues' and I think as a as a young person, that's pretty daunting and so when I was in University I was studying Biochemistry in my second year, a woman came up to me on the street and she said are you an actor and I just lied. Why did I say yes?

She said come and read for me tomorrow and I did, and I was cast in the second lead in a, in a film and it was actually quite wonderful. I thought oh this is really fun, it's much better than the drudgery and the burden of training and going home and serving. It's just really light fun, but of course I did it with all my heart and I was uh, I think 18. I looked 16 I thought I was you know akin to an English major or a performance artist and I just uh, I just kept working, but by the time I hit 30 I thought oh I better go back to my original dream before I age out and see if I see if I can do it so here I am. I've done them both and it's been really quite a journey. That is fantastic and a real inspiration to lots of other students. I mean I often tell people now you can have more than one career. And that's, that's just a great story. Thank you. Oh,

you're welcome and I hope it does encourage people to at the very least recognize that we all play many roles right like we're not just we don't just want to be good at our one profession, we also have you know we want to be a good person, we want to be a good partner, we want to be a good parent, we want to be clear honest authentic. Right there, there are lots of goals and I feel like sometimes we're raised up, just for excellence and work and that's just not enough. Yes, and, and I think when you've had those sorts of experience,

it gives you breadth and depth of character too. It helps you to relate to people better. Yes and it's also humbling, which is very important. I think it's important for people to not position themselves as subject matter experts, or as de facto experts right? As physicians we can be, we can think of ourselves as as God-like. I always joke. Doctors, they're just like people. And I really want to avoid that, especially of course with my people

you know, who I was seeing as patients, but now take care of as a public health doctor. I needed to be seen as really quite approachable and not as you know, some fancy doctor coming from a far away city, who, who was you know, going to institute, you know, things that were not helpful are meaningful to them. Indeed.

um

We have an international as well as a national audience, so I thought I'd start the program with a definition of Indigenous People and communities pulled from the Canadian government website Indigenous Peoples is a collective name for the Original Peoples of North America and their descendants often Aboriginal Peoples is also used the Canadian constitution recognizes three groups of aboriginal peoples Indians more commonly referred to as First Nations, Inuit and Metis. These are three distinct peoples with unique histories, languages, cultural practices and spiritual beliefs. More than 1.6 million people in Canada identify themselves as an aboriginal person according to the 2016 census. Aboriginal Peoples are the fastest growing population in Canada they grew by 42.5 percent between 2006 and 2016 and the youngest population in Canada about 44 were under the age of 25 in 2016. There are more than 630 first nation communities in Canada which represent more than 50 nations and 50 indigenous languages. Evan is there anything that you'd like to add to that statement? Yeah I think you know, the the United Nations and the World Health Organization

speaks of at least 80 countries that have Original Peoples and Indigenous populations who are affected by waves of migration and migration is not a bad word. We have feet, we're not barnacles people go to different places and set up their homes, but sometimes for Indigenous Peoples the commonalities between us you know we're not DNA cousins but we're cousins by our colonial experience. And so definitely, in Canada Indigenous Peoples, you know, their health was going in one direction health interrupted and now it's going in another direction and we actually have the worst health of any ethnic group in the country in our in our own territories. All right that's so great. So, I'm moving on to the questions.

I think it's important for our International audience to understand some of the nefarious history between the Canadian Government and the Indigenous People of Canada, although this was well known for decades within Indigenous communities the recent discoveries of mass graves at past residential school sites across Canada, has cast a spotlight on the treatment of Indigenous People here across generations,

which frankly, a significant proportion of the general public were ignorant of. In order to try to understand the mindset and lack of trust within the indigenous community for Canadian governmental systems, can you please provide some of the background of the racist and genocidal practices perpetrated by the colonial system to the Indigenous People of Canada?

Thank you, thanks, and I think of colonization in many other countries that are kind of illustrative of you know, what was happening here. There were Indigenous Peoples all over the Americas including of course Central and South America. And I think of places like Hawaii, Tahiti and, and of course there are many other places. I mean you could even you could even say the experiences of of Indians or of Africans you know,

their quite violent histories where people were subjugated and their lands and wealth went from them to other hands, and that was really essentially the case here. Indigenous Peoples in Canada had to live under what was called the Indian Act and there was no other Act for any other ethnic group. Just for us and let's not be naïve, part of it was to separate us from our lands and to contain us. Put us on reserves or reservations and part of that was an attempt by the Canadian Government in allyship with many churches to take children from their indigenous families to institutionalize them and to try and get them to forget where they were from, and to accept a different way of being and knowing, and those those places residential schools and they weren't really schools they were really much more like like prisons had a very high fatality rates and many many children died. So, so now Canada has gone through a process of trying to reconcile what has happened. Lest we forget. And we are finding all kinds of unmarked graves with thousands of children's bodies and we as a nation have to deal with, and ask what happened who, who are we. That this could occur in this country because I think Canadians are are proud of themselves on the International stage they Canadians like to think of themselves as being a fair people but you know this is definitely a stain in there in their history and for us my parents went to extension school for us it is definitely a reckoning as well like what does this what does this mean for us in our own lands?

Evan you were the first Chief Medical Officer for the First Nations Health Authority in Canada based in British Columbia. The only health organization in Canada set up to directly provide health services to first nation people by first nation people can you please tell the audience why this was set up? Sure, the health system or health setup for Canadian citizens is delivered by our provinces, however for Indigenous People their healthcare system was created separately and was seen as a Federal system. So around all other Canadians, except for maybe the armed forces, around all other Canadians oh, and prisoners too, they're considered Federal subjects they would have hospitals and physicians employed by their provinces but we would have the separate system or we did have this separate system, run by the federal government and it was exceedingly inefficient to have healthcare delivered from the capital city, Ottawa several ,

that's not several, a few thousand miles away, or from the provincial capital hundreds of miles away, or kilometers away, and so we

enacted in our province and amongst the the Indigenous Peoples NBC a system that was run by by us essentially so for a large First Nations health service organization created to help Indigenous Peoples particularly First Nations peoples to to be better and it really has been quite an important step in self-determination in improving outcomes achieving equity in service and I think as well having people be less subjugated and participate more in in their own wellness but also in in society as well. Thank you.

Could you tell us about your two-year secondment at Indigenous Services Canada and your role as Deputy Chief Medical Officer. Were you invited to take up this role? Uh, when I was at the First Nations Health Authority and serving the First Nations people of British Columbia and working as a really a Public Health Official as a a physician with authority to to vocalize and direct care and attention to specific areas like mental health or exploitation of women, or substance use, that was really a lovely piece. I did that for many many years, but I did feel like there was more work to be done in other areas and I feel like the pandemic gave me an opportunity to say well let me go Federally, let me work Nationally and work on all things code. Because actually, like everywhere, many healthcare workers and other workers were being redeployed to deal with COVID issues so really in in a way, and I asked for this, I was, I was, redeployed and sent to a National position in our National Capital in Ottawa.

All right, so moving on to the COVID vaccination of the Indigenous People of Canada the reason why I

wanted to do this interview amongst others, is to highlight the marvelous achievement that you were part of with regards to the scale-up and execution of the national COVID vaccination program for the Indigenous People of Canada. You achieved an eighty percent two-shot vaccination rate on reserves up to a year before this was achieved nationally. The vaccination program involved a brand new vaccine formulated from mRNA technology. Indigenous People have injured significant human rights abuses from the Canadian medical system as a result of historical colonial practices and continue to suffer racism in the health system prior to the arrival of the COVID vaccines what medical psychological and social impacts did COVID 19 have on indigenous communities?

Yes, the pandemic was absolutely frightening for all of us. Particularly for our small communities. We have many small communities. About 650 different First Nations communities in Canada many of them are quite remote and because of their remoteness and their size they don't have tertiary care. So they were identified quite early on as being vulnerable just on, on just on a geographic basis if they got COVID they would have very few means to help anyone there to stop up to stop an outbreak, or to care for those who were, who were sick.

Of course there were other risk factors that we brought forward a number of us and my team included where we said Indigenous People have the poorest health of anyone, so you know, they, they do have elevated risk compared to the average Canadian and we have a special relationship with the crown with the country of Canada. So we're we're actually different from other marginalized groups and chiefs, or our leaders were clear that in their relationship the health of our Peoples was important and this happened in many countries. This happened in Hawaii in the United states. In New Zealand, in Australia.

Those countries named their Indigenous Peoples as having special risk and so they were given more of a priority than the the average citizen in those countries, so we did that here. We got the word out that we would have you know, some availability of the vaccine eventually. Our people did really well at the beginning because we were so remote and in part because we protected our borders. We protected our communities from importation. We actually literally set up roadblocks and asked people's business going in and out of our tiny communities, but eventually our infection rate and our mortality rate and our complication rate were worse than other Canadians around. So now about two and a half times worse, roughly from the data that we have so we did push hard in communities and we said please let's look after each other we we can't afford to do badly at this time we've had a long history of communicable diseases that were very bad for us including smallpox and tuberculosis and even even modern scourges like HIV and and also we had been already giving health messages to our people so anyway we we talked it up we encourage people to be vaccinated and yeah we did fairly well even though in my mind I would like to do better! No, you did remarkably well. So I think you've answered question three, so Indigenous Communities in Canada have specific experiences via Provincial territorial and local Public Health systems concerning the management of their health and access to vaccines and past pandemics. Could you please tell the audience about their experiences of the H1N1 pandemic back in 2009 and the lessons learned?

Thanks, yes I was in charge of the indigenous response to H1N1 in 2009 in my province. I was working provincially then remember my previous job was with First Nations NBC but my job before that was with the province of BC looking after Indigenous Peoples so H1N1 happened and again we were nervous about what would happen to us we knew that our communities were not prepared much less prepared than they were this time around in that for instance they didn't have communicable disease and pandemic plans at a community level but almost no one knew them they were on a shelf collecting dust large pandemics was was not really front of mind for those little tiny communities that were having struggles in lots of other ways. So we we knew that they needed help and so I was part of a team provincially remember our services are delivered provincially including Public Health services so we would work with those largely those Public Health teams to make sure that communities were ready. My gosh that was we were so we were so lucky. We did everything we could,

but we were so lucky that ultimately H1N1

wasn't that bad, I guess you could say it yeah it could have been a lot worse.

So, what did you learn from that experience that helped channel your sort of management of COVID 19 well in DC? We learned that we needed to cooperate with the province that First Nations needed to cooperate with the province we knew that public health centers those local public health centers needed to take us into consideration they didn't even know for instance sometimes that they needed to vaccinate us that that was their job that you know they thought they thought they were vaccinating everyone else but when it came to us they thought oh well really we we have to do that we we have to speak to those people or go to those communities and and vaccinate we didn't we didn't know that so we'd have to we'd have to like literally go and tell them and explain well here's why we you need to go over there

so that was part of it but also we needed to make sure that communities understood their pandemic plans so that it was quite a lot of work to engage those health workers and those indigenous leaders that another pandemic could happen and we needed to be ready and we spent a lot of time there and lo and behold my gosh, COVID happened 11 years after H1N1 and the the indigenous communities in BC I think were pretty pretty ready, yes gosh that's astonishing what you said about how public health didn't realize their their responsibilities now let's contrast the previous pandemic experiences of the indigenous community to the current COVID pandemic several working groups were set up by the government of Canada to facilitate the success of the COVID 19 vaccine program for indigenous communities. Evan could you please describe the work of the indigenous services Canada or ISC led COVID 19 vaccine planning working group sure indigenous...