Black and Indigenous communities are amongst the most vulnerable to contracting COVID-19 in Canada. Initial data from Region of Waterloo Public Health showed the hardest hit were Black neighbourhoods. The most recent data found cases were two to three times higher amongst Black and other visible minorities. Public Health formed the Community Engagement Committee earlier this year. They were a part of the vaccine task force leading the rollout, but their job was specifically directed at outreach in racialized communities and vaccine hesitation.
Maedith Radlein is a retired school principal leading the charge on this initiative. She is also a member of the region’s Anti-Racism Advisory Working Group and helped organize a briefing on the vaccine rollout back in February. During that brief, she explained that the police involvement in the vaccine rollout would sow distrust in Indigenous and Black communities.
While deputy police chief Shirley Hilton still heads the vaccine rollout, she has largely let Radlein do her work unheeded. While plans still needed to be approved by police, there “is not direct police involvement in the distribution,” according to Radlein.
Ismail Mohamed was also brought onto the Community Engagement Committee. Between the two of them, they realized early on the region wasn’t prepared to engage Black communities.
“The region was unprepared because it lacked awareness of the issue that needs to be addressed,” Mohamed said. “And this is a result of them not having a diverse staff that represent the communities the region serves. Not having a diverse staff means you’re disconnected from the issues that are important to the communities.”
“Public Health treats the region as a homogeneous group, and has a one size fits all approach to distribution,” Radlein said. “I think the past year with Black Lives Matter and other indigenous protests, it has been made clear to regional government that this approach does not work.”
For the Indigenous community, it meant requiring their own clinic to go for vaccinations. The pop-up clinic was a partnership between The Healing of the Seven Generations, the KW Urban Native Wigwam Project, the Southwest Ontario Aboriginal Health Access Centre, Ontario Health West and the Region of Waterloo.
Meanwhile, Radlein and Mohammed have been busy spreading the word in various Black communities. Information sessions were held for specific communities in their native language, along with flyers translated into six African languages. They had organized a virtual town hall with Black doctors to help field various questions about the vaccine. There has also been a strong focus on getting pop-up vaccination clinics in harder hit neighbourhoods to ensure traditional clinics can be a hassle to get to.
“If community feels comfortable to connect, the community feels comfortable to get the vaccination,” Mohamed said.
Distrust in the healthcare system and vaccine hesitancy among the Black community has historical roots. The most infamous example was the “Tuskegee Study of Untreated Syphilis in the Negro Male,” conducted by the United States Public Health Service between 1932-1972. Black men were promised free medical care, but never received any and never informed of their disease. Men who had been diagnosed with syphilis, or later developed it, were given placebos or ineffective treatments.
From racist unethical experiments on Black bodies years ago to the biases on display now in treating Black patients. A more recent example was a CTV report in 2019 about Toronto-area rapper John River after he received a spinal tap operation to test for meningitis.
Due to complications following that operation, he spent the two years searching for a doctor that would believe him when he said he felt a crushing feeling in the back of his head. River’s spinal canal had been leaking. When his family brought attention to it through social media, he was able to find a doctor willing to look into his case.
Aside from bridging that trust gap, Mohamed said there were a lot of myths they had to address along with cultural issues and faith. Muslims have had concerns around Ramadan and whether the vaccine was considered halal. This led to the Canadian Muslim COVID-19 Taskforce to come with specific messaging explaining that the shot would not invalidate anyone’s fast.
It became very apparent how needed this group was when comparing other regions. Both Ottawa and Toronto had conceived of their own task forces led by Black community leaders, doctors and experts.
“They’ve done it way before the vaccination. They’ve done outreach in those communities, they hired nurses that look like the people that they’re serving,” Mohamed said. “We haven’t seen that here. We’re hoping that that changes the future.”
Atop of that, they had to work with less than accurate data to inform their work, according to him.
The data was using old neighbourhood maps that didn’t properly reflect current demographics, and it ended up combining communities. Poor neighbourhoods have been hit hard, but when combined with middle- and upper-class areas, you wouldn’t know it at first glance, as Radlein noted with Columbia/Lakeshore in Waterloo. Another example was Alpine/Laurentian in Kitchener, which was around 80 per cent middle class according to Mohamed.
“You don’t know where the most affected numbers of COVID are from. Maybe all the numbers are from specific neighbourhoods. Maybe it’s not the whole area,” he said. Regardless, both areas are considered high-priority by Public Health, and it’s been setting up pop-up clinics in municipal facilities in the areas.
And the province recently announced that people 18 years and older in COVID hotspots were now eligible for bookings. That’s due to a stable supply of vaccines coming in this week, according to a media release.
That’s not to say their experience working with Public Health has been negative. The two of them are simply acknowledging issues that have plagued the healthcare system for decades.
“I think the fact that they reached out is commendable and also the fact that they have accepted our input, and for the most part acted on it,” Radlein said. For them this work was going to be a “learning process” for regional Public Health. That it will hopefully take this community engagement approach and use it in the future for other healthcare issues in the region.