How this health centre is providing culturally appropriate care during COVID-19

Meditation by phone. Traditional healing via video chat. In the midst of a pandemic, the Noojmowin Teg Health Centre is adapting to meet the needs of its clients
By Shelby Lisk - Published on Jul 28, 2020
The Noojmowin Teg Health Centre supports the distribution of the Northern Fruit and Vegetable Program to more than a dozen different community partners across the island. (Courtesy of Cody Leeson)



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The first thing David Pitawanakwat does when he arrives at work is find his smudge bowl. He begins his morning by smudging — that is, cleansing his own mind, body, and spirit with the sacred smoke of medicinal plants — before smudging the Noojmowin Teg Health Centre’s healing lodge, where he spends most of the day. Soon the lodge will be filled with the crackling sounds of a cedar fire, the low hum of the overhead fan, and the smells of harvested medicines mixed with steaming water in cups of blueberry-leaf or dandelion-root tea — but, lately, there have been no clients.  “We used to play music when clients were in, some nice flute music,” says Pitawanakwat. “But since there aren’t clients anymore, I skip the music part and just listen to the fire crackling.”

Pitawanakwat is the fire keeper and harvester at the Indigenous health centre on Manitoulin Island, where he has kept a sacred fire burning in the healing lodge since COVID-19 started shutting down communities on the island in March. Before the pandemic, clients who visited the facility, which serves the Anishhinabek population on Manitoulin island and from the surrounding area, might have stopped to see Pitawanakwat after an appointment with a nurse, dietitian, traditional healer, or mental-health and addictions counsellor. They’d perhaps sit by the fire, offer their own prayers, and share tea. Although such physical interaction isn’t possible amid a pandemic, Pitawanakwat says it’s important for the community to know that the sacred fire is burning and that prayers are being offered, even if they can’t be there to see it.

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David Pitawanakwat tilling the earth
David Pitawanakwat tilling the earth before planting and transplanting seeds. (Courtesy of David Pitawanakwat)

The sacred fire is just one way the Noojmowin Teg Health Centre has adapted during the COVID-19 pandemic to meet the needs of the seven First Nations and two off-reserve communities it serves within the district of Manitoulin Island and surrounding area, located on Lake Huron off Georgian Bay. Providing a daily meditation group by phone and making traditional healers available via Zoom video chat are also measures that have helped keep services running, but Danielle Wilson, the centre’s new executive director, says losing the social connection has been hard for many in their community. That’s why Wilson and Pamela Williamson, the outgoing director, asked staff to focus on check-in calls to help clients combat isolation. “That's one of the things that we've done here is make sure that the staff continue to engage with our clients to let them know that they're not alone — that our services are still here — and even just [offer] a friendly voice,” says Wilson.

Cody Leeson, the child-nutrition coordinator, has seen his role quickly change from running programming in schools and daycares to supporting the distribution of the Northern Fruit and Vegetable Program to more than a dozen different community partners across the island. The program, which provides free fruit and vegetables to elementary-school students every week, needed a new means of distribution when the schools closed. Public Health Sudbury asked Leeson and his team whether they would oversee the distribution and continue to get healthy food into the homes of children and families in the area. “We have different arrangements in different communities,” says Leeson, noting, for example, that one community uses the program for Ontario Works recipients, while others have setups that resemble farmers’ markets.

Leeson says the centre receives an average of six to 11 pallets of food every Thursday morning. A team of six sorts the food based on each community’s requests that week and begins delivering to community partners that afternoon. In doing so, the health centre reaches people — such as Elders and families — who wouldn’t normally access the program. While the communities have been really appreciative, Leeson says, he misses the social connection with students: "It's weird not being in the daycares, going and hanging out and making snacks with four-year-olds and the after-school programs, doing fun stuff like making snacks and teaching kids about sustainable foods, and being out in the community.”

Noojmowin Teg Health Centre is one of the original 10 Aboriginal Health Access Centres created following the 1994 introduction of the Aboriginal Health Policy in Ontario. First Nation, Métis, and Inuit communities identified “Aboriginal community-led primary health care centres” as a key pillar to health care, and the centres were established to provide clients with access to doctors, nurse practitioners, traditional healers, dietitians, and social workers, as well as mental-health, addiction, and diabetes support — all designed to meet the specific needs of Indigenous people.

David Pitawanakwat gives a thumbs-up while Courtney Kurek transplant tobaccos plants.
David Pitawanakwat and Courtney Kurek transplant
tobaccos plants and plant tobacco seeds.
(Courtesy of David Pitawanakwat)

On top of the primary-care and mental-health services, Noojmowin Teg offers health-promotion programs, such as children’s recreation, community gardens, and Indigenous-food sovereignty, which connects community members with the traditional food practices of foraging, freshwater fishing, and harvesting wild game.  Williamson, who retired as executive director at the beginning of July after 15 years with the organization, says one way to understand its services is to think of the holistic approach represented by the medicine wheel. “The guiding principle is looking at the individual as a whole, not just as a fragment of their physical well-being. It's providing the cultural, spiritual, and mental wellness through a person’s entire journey through life,” says Williamson. “When there's an imbalance in one of the quadrants, that impacts all four quadrants of health and wellness, so that’s part of the services that are delivered here, and it's a belief that we live through every day with our team.”

The centre’s community-based approach is reflected in its connections with local partners, including Aundeck Omni Kaning First Nation, M’Chigeeng First Nation, Sheguiandah First Nation, Sheshegwaning First Nation, Whitefish River First Nation, Wiikwemkoong Unceded Territory, Zhiibaahaasing First Nation, and two areas where they serve off-reserve Anishinabek populations. These partnerships have allowed the centre’s practitioners to travel to provide services directly, although that changed with the arrival of COVID-19, as many of the First Nations closed borders to minimize the virus’s spread.

Mary Ann Auger, Noojmowin Teg’s diabetes-wellness foot nurse, says she has still had to make trips for emergency care during the pandemic but that there have been protocols in place. “I had a letter from the organization. Plus, the community that I was going to would know I was coming, because I'd have to get an okay from the chief, too,” says Auger, adding that, ideally, her patients should get check-ups every two months. Due to COVID-19, some have gone more than three months without care. Now that the province has begun reopening, Auger is starting to see more patients in person again: they’re asked screening questions when they book their appointments and before they enter the centre on appointment day.

Both Leeson and Auger say that they may continue to use technology to stay connected to clients post-pandemic. Auger notes that video conferencing could help her meet with clients in the wintertime if she can’t travel due to inclement weather, and Leeson says that online programs can be more accessible. However, for the most part, they both want to get back to their in-person programming and connecting with their communities. “I think part of who we are as Indigenous people is to gather,” says Wilson. “We definitely want to get back to doing group programming.”

This is one of a series of stories about Indigenous issues brought to you in partnership with Carleton University’s School of Journalism and Communication.

Ontario Hubs are made possible by the Barry and Laurie Green Family Charitable Trust & Goldie Feldman.

David Pitawanakwat gives a thumbs-up while Courtney Kurek transplant tobaccos plants. image widget
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