Elaine Allison is one of two First Nations health directors in Nova Scotia who is also a registered nurse. She’s been with Wagmatcook First Nation for 21 years.

By Brendan Elliott

Early in the pandemic a formal request was made of Nova Scotia Health by Mi’kmaq First Nations communities in the province.

First Nations chiefs wanted their own health care professionals engaged in the battle against COVID-19. But they needed help.

“The idea was that if they were able to deploy their own staff to do the testing then it might allay some of the concerns and fears by community members,” said Nova Scotia Health vice president of operations, Madonna MacDonald.

The collaboration efforts were instant.

Nova Scotia Health would provide First Nation health care teams with the professional support, education, training and access to swabs and test kits.

First Nations front line workers would in turn gain the confidence and ability to provide customized in-house programs to test their community members for COVID-19.

“I was really pleased to see how quickly it happened,” said Wagmatcook First Nation health director Elaine Allison. “I was thinking we’d be lucky to get this done by September. But we talked about it, made the guiding principles and pathways, and we had everything operational in a matter of weeks. It was just amazing how quick it was.”

Allison is one of two First Nations health directors in Nova Scotia who is also a registered nurse. She’s been with Wagmatcook for 21 years, but she was still a rookie when it came to dealing with COVID-19.

“This is my first time ever being part of a real pandemic, so I felt just like everyone else. We were all scared and nervous to begin with,” Allison said. “So, what we did every day, the nurses would meet and we’d go over scenarios, just trying to think about what we would do if this household got (COVID-19), or what if this happens or that happens.”

Thankfully, no cases were identified in Wagmatcook during the first wave. But Allison said her team is ready for a second wave, and she has Nova Scotia Health to thank. “We talk to Public Health all the time.”

Of the 13 First Nations communities in Nova Scotia, 11 expressed an interest in collaborating with Nova Scotia Health. Eight communities participated in the training, and three now have on-reserve COVID-19 assessment programs.

Cindy MacQuarrie is senior director of interprofessional practice and learning with Nova Scotia Health. Her job was to bring all the right people together to ensure everyone’s needs were met. “COVID has taught us a lot of great lessons,” MacQuarrie said, pointing out the value that comes from collaboration. “The ask comes in, and people just really rally around the ask, and they roll up their sleeves and we collectively strategize on how best to approach the particular piece of work.”

From the health organization’s perspective, MacQuarrie said everyone had a can-do attitude toward assisting the First Nations front-line health care providers.

“My sense is that people just really wanted to ensure members of First Nations communities had access to testing as close to home as they desired. The whole idea of desire is really important because it is up to the members of the community, and how it is that they want to be tested.

“Having the people that have the closest relationships within their communities, and ensuring they have the competencies to be able to do it, and ensuring they have the connections with our public health system, our lab team, 811 team, our education and our resources within Nova Scotia Health.”

Jennifer MacDonald has been director of health and wellness for Waycobah First Nation for the past 11 years. She says community leaders and elders recognized early on that their citizens were at higher risk for the potential spread of COVID-19.

“In other Nova Scotia communities, you may live in one geographic area and travel an hour to go to work,” she said. “For the most part, it’s not that way here.”

MacDonald said residents in Waycobah tend to stay close to home and socialize at common centres within the community. With that in mind, health care providers decided to provide only in-home COVID-19 testing.

“People live together, people work together, and there are multi-generational homes, so it was important for us to try and put in place what we could, to keep people at home … because there is so much interaction on all levels,” MacDonald said.

MacDonald couldn’t say enough good things about the partnership with Nova Scotia Health. “It’s been an excellent, positive experience. And seamless. We have Nova Scotia Health employees within our communities as well, so it’s a win-win situation for the community members to stay in the comfort of their own environment.

“But also, the more people stay home and out of primary assessment centres and hospitals, the better it is for everyone.”