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How the Seattle Indian Health Board became a model for pandemic response

When the pandemic was still in its early days, the Seattle Indian Health Board asked for PPE. Instead, they received boxes of body bags. The incident made national headlines. 

The mistake stood out not just because PPE was in short supply and desperately needed. But the fact that an organization dedicated to serving the Urban Indian population was given supplies used to deal with dead bodies struck a chord that reflected hundreds of years of efforts to erase their community.

Despite the early setback, Seattle Indian Health Board (SIHB) has gone on to prove itself as a model for how to respond to a pandemic. How they did it was a combination of several things, but at its heart was a community-based approach.

Esther Lucero, the CEO of SIHB, explained that when it came to vaccine distribution, this meant prioritizing not just health care workers and elders but those providing services that were essential to the community. 

“We reached out to Chief Seattle Club and we vaccinated their staff,” Lucero said in an interview with The Evergrey. “We reached out to Mother Nation, which is an organization that is a shelter for women experiencing domestic violence, the United Indians of All Tribes because they serve families and pregnant women and they also operate a daycare. We vaccinated their staff and then also the Urban Native Education Alliance because they serve our youth and families”

Meanwhile, they were also vaccinating marginalized folks like those experiencing homelessness, along with culture keepers and traditional healers. They’ve been able to vaccinate all patients 50 or over since February 1 and have worked with Seattle Public Schools Superintendent, Denise Juneau, to vaccinate their Special Education department. 

SIHB was able to execute this community-based approach thanks to the state’s tribes fighting for urban Indian health programs’ inclusion in the state’s commitment to upholding tribal sovereignty, Lucero explained.

The start of the pandemic

After the body bag incident, SIHB leveraged the media attention to their advantage. Besides getting the supplies they asked for from government entities, they received donations from the local community.

“When the pandemic hit, people started to realize community health centers were the epicenters of where things were either going really well or really poorly,” Ryan Gilbert, the COO of SIHB explained. 

The company Eighth Generation acquired PPE through their manufacturer to give to SIHB while UW medical students donated scrubs that staff could change in and out of before they went home to their families. People made masks to donate, restaurants provided meals, and cash donations streamed in. 

“I feel like the community sees us, they want us to be successful, and they also want to value our contributions to the broader system,” Lucero said. 

SIHB managed to not lay off or furlough any of its 200 employees. Their ability to pivot to the challenges that arose because of the pandemic proved to be highly effective. Gilbert explained how they were able to turn a part of the building into an isolation wing to quarantine patients with symptoms. They also ramped up their telehealth program doing 35% of their visits through the virtual platform. 

“Everything was so challenging,” Lucero said. One of the many challenges SIHB had to face was how to care for the marginalized members of their community, like those experiencing homelessness. “Our elders, for example, 40% of them are homeless and the Governor was saying, ‘Oh, tell them to stay at home’ — well they don’t have a home.”

Working with the Chief Seattle Club, SIHB made sure elders had access to food, hygiene stations, and a warm place to go. They also established a pop-up testing site at Chief Seattle Club so houseless folks could walk right up. 

“We have been defined as a model program as to how to address a pandemic from a community-based approach,” Lucero said.

Using Indigenous knowledge

SIHB is close to opening up vaccinations to all American Indian and Alaskan Native adults over the age of 18, but they’re making phone calls to ensure they’ve serviced their entire patient population first. Lucero and Gilbert credit a part of the organization’s success in vaccinating their community to a non-Western perspective. Patients of SIHB are called “relatives,” Gilbert explains, “because they care about them like family.”

“It’s really interesting that despite historical atrocities that have been inflicted on us, our people are still going to get the vaccine,” Lucero said. “Not to protect themselves — we hear that from a Western perspective, non-Native perspective — but for our community, people are willing to get the vaccine for others.”

At the start of the pandemic, SIHB’s traditional medicine team started to smudge the building twice a day using sage and sometimes cedar. Doing those sorts of things she said, helped center and ground them. 

“When you ask what we’ve done from the beginning of COVID to now, we’ve done everything. Everything King County has done and more, specifically for our Native communities.”

Sponsored by Civic Commons at The Seattle Foundation