How decolonizing public health has helped Indigenous communities control COVID-19

On the Siksika First Nation, east of Calgary, about 4,000 on-reserve nation members have been adjusting to a new normal under COVID-19.  There are screening stations at the entrance of all public buildings and a drive-thru testing is open daily between 10 a.m. and 1 p.m.

“We’re a higher risk population,” said Sisksika Chief Ouray Crowfoot.

“Because of our demographic, we knew we had to test and contact trace a lot more extensively.”

The nation had an outbreak over the summer, but thanks to fast action and the use of 19 trailers renovated to host those who needed to isolate, the outbreak was limited to just 31 cases.

“Sometimes there’s two or three generations in one home, so if family members needed to isolate, we used those trailers,” said Siksika Nation Emergency Management Director Stacy Doore.

“As a First Nations community, we needed our own plan to suit our own needs.”

Dr. Lisa Richardson, an internal medicine specialist and of self-identified mixed-blood Anishinaabe descent, believes the quick and decisive action by local Indigenous leaders have helped many Indigenous communities come through Canada’s first wave of COVID-19 relatively unscathed.

“Recognizing the ongoing housing overcrowding and higher burden of chronic illness that exist, Indigenous leaders have had to be stringent and hardcore because leaders know that once that virus gets in (to communities), the effects could be very profound.”

In 2009, Indigenous communities were impacted more severely by the H1N1 pandemic.  Indigenous Canadians were more than six times more likely to require ICU care, but 11 years later, Richardson says many communities are better prepared and had emergency response plans ready when COVID-19 hit.

“The impact of H1N1 was traumatizing. We had communities in northern Manitoba — they did not have supplies sent. They were having body bags sent .”

In a commentary published in the Canadian Medical Association Journal, Richardson and co-author Allison Crawford credit the decolonization of public health policies for the low number of COVID-19 on reserve during the pandemic’s first wave.

They write, “Indigenous self-determination, leadership and knowledge have been successful in protecting Indigenous communities in Canada during the COVID-19 pandemic.”

“Indigenous communities don’t needs to be taken care of,” said Crawford.

“They need space for leadership, they need resources and they need some of the social inequities taken care of,

but they have the skills and the leadership to protect their people.”


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