NC Native American tribes make headway in bringing vaccine to oft-neglected members

Dozens of tribal elders lined up outside the community building on Haliwa-Saponi land in Halifax County early Saturday morning to wait for the opening of the first COVID-19 vaccine clinic they could get to in this rural part of northeastern North Carolina.

Jamie K. Oxendine, tribal administrator for the Haliwa-Saponi, pushed to bring a one-day vaccine clinic to the tribal grounds in tiny Hollister.

About 70 miles of tiny towns, farm fields, scattered farm houses, and churches separate the community from Wake County. Rocky Mount is the closest city of any size and it is 40 minutes away. Too little effort is focused on getting vaccines to Indigenous communities, which have been hit particularly hard by the pandemic, he said.

“It has been devastating to Native American populations all over the country,” Oxendine said.

For many, securing an appointment for a COVID-19 vaccination was a welcome end to weeks of frustrating and fruitless calls to health departments.

Friends and acquaintances who found one another in line shared stories of people they knew who had become sick and died from COVID-19 complications.

Anthony Richardson, a member of the tribe, took advantage of the convenience. “This is the first time that we had a chance to get one without going to other counties,” said Richardson, 66, who lives less than a mile from the vaccination site. A friend of his who lived in the community died recently of COVID-19, he said.

Over the last several months, Gov. Roy Cooper and Dr. Mandy Cohen, the state’s top health official, have had to balance enthusiasm about COVID-19 vaccines while managing expectations about when most adults will be able to get shots. Demand is much greater than the state’s weekly allotments.

Health care staff and people 65 and older are eligible for the vaccines that the state distributes.

The state Department of Health and Human Services is making mind-bending calculations to get vaccines into eligible people quickly, while at the same time making shots available to people who tend to lose out when there’s a frenzied scramble for a scarce resource.

Many tribal lands in North Carolina are in rural areas, where elders must contend with spotty internet service or frustrating waits on the telephone as they try to make appointments. Then, they have to find their way to a vaccination site.

Scheduling the Haliwa-Saponi clinic “was a logistical nightmare,” Oxendine said. The 650 available slots filled in about a day. Oxendine said he had fielded a lot of calls from people who didn’t make it on the schedule and expected some to show up at the end of the day in hopes of getting a chance at any leftover vaccine.

The Rural Health Group administered the vaccines and will return to give second doses, he said.

The Waccamaw Siouan Tribe has tried to work through the NC Commission on Indian Affairs to set up a vaccination event that would be easy for members to get to, but it hasn’t worked out so far, said Chief Michael Jacobs.

The Waccamaw Siouan tribal homeland is near the Green Swamp and about seven miles from Lake Waccamaw in Columbus County.

“A lot of elders can’t sit on the internet and wait,” Jacobs said.

The toll of the pandemic is not only personal for Native Americans, but results in a cultural loss. “When our elders are gone, our oral history is gone,” he said.

“A lot of people overlook the situation and what it’s doing to Native communities,” Jacobs said. “The Native Americans have always been put on the back burner.”

In Robeson County, a doctor, who’s also a Lumbee tribal member, gets the word out

The Lumbee Tribe, the largest of the eight state-recognized tribes, has an advantage most others don’t enjoy – a hospital as a close neighbor. Both the Lumbee and UNC Health Southeastern, based in Robeson County, have sponsored active COVID-19 information campaigns.

Dr. Joseph E. Roberts said he’s shy, but is willing to push himself outside his comfort zone for good causes.

So there he was — one of the top administrators at a UNC hospital in Lumberton — featured in a video wearing a white suit and platform shoes, dancing to a parody of the Bee Gees disco hit “Staying Alive.” The video features a lot of hand washing, face masks, and people dancing for joy when Roberts touches their arms with a handmade and comically large fake syringe.

The video from UNC Health Southeastern in Robeson County, where more than 40% of residents are Native American, about 23% are Black and 27% are white, puts a light-hearted shine on the deadly serious business of public health communication and vaccine distribution.

“We’re a small community hospital,” Roberts said in an interview.  “I think we’ve done very well in setting up our processes and getting the word out.”

UNC Health Southeastern has worked with Lumbee leaders on ways to make it easier for members to access vaccination sites.

Of the health system’s three Robeson vaccination clinics, one is in Pembroke, near the tribe’s headquarters.

“It is very well-used and very well-received,” said Jason Cox, UNC Health Southeastern’s chief operating officer.

The tribe posted a YouTube video of Tribal Chairman Harvey Godwin Jr. receiving the vaccine.

“As I am speaking to you today many of our well-known elders are in the hospital and very sick with COVID-19,” Godwin said in the video. “For us to bring our tribe back to wellness and back to wholeness spiritually, physically, mentally, we have to get vaccinated.”

Roberts, who plays the John Travolta role in the hospital video, is Lumbee and grew up around Pembroke. He is now Southeastern’s vice president and chief medical officer.

The health system’s outreach isn’t aimed at one racial or ethnic group, Roberts said. UNC Health has a strong interest in ensuring members of marginalized groups have a chance to get shots, he said.

UNC Health Southeastern has on its YouTube page a video of the first four people it vaccinated when the supply was limited to health care workers. They represented Robeson’s racial diversity.

Cox said the health system is working with the NAACP to help Black residents overcome transportation obstacles; for example, they have discussed possibilities for bringing a mobile vaccine clinic to Black communities in South Lumberton.

Though white residents are the minority in Robeson County, they still account for the greatest share of people vaccinated: nearly 46% of all shots so far. Native American residents have gotten about 30.4% of vaccine shots, and Black residents, 20.6%.

Roberts has been vaccinated and recommends it to others.

UNC Health Southeastern was giving distributing badges to people who were vaccinated, with space for them to write in why they got it. Roberts said he wrote, “to live again.”

Eastern Band of Cherokee has autonomy over its vaccine rollout

The Eastern Band of Cherokee Indians, the only federally recognized tribe in the state, receives its supplies of vaccine from the federal Indian Health Service and established its own roll-out plan. The tribe’s first vaccination phase includes people from a dozen categories, such as front-line health care workers, public safety workers, staff and residents of its skilled nursing facility, and Cherokee speakers.

The tribe publishes its own coronavirus infection and vaccination data. The latest information from its website reports that 13.4% of the population has gotten at least one dose.

The tribe also has its own hospital and health care system and its land, known as the Qualla Boundary, includes several counties in western North Carolina.

An information committee, which included Tribal Public Health and hospital staff, worked on communications about limiting viral spread. That message then switched to information about vaccines, Dr. Richard Bunio said in an email.

Bunio is executive clinical director of the Cherokee Indian Hospital, medical director for Tribal Public Health and Human Services and leader of the COVID incident Command Planning group.

The information committee has used a combination of PSAs, social media posts, newspaper articles, and livestream events to get the message out, he wrote.

“There is some vaccine hesitancy and this was expected,” Bunio wrote. “Tribal Public Health had surveyed the community to gauge the level of hesitancy in each age group months before the vaccine was available. This allowed us to tailor our messaging to those most resistant to vaccination and predict when each phase was close to being completed. We spent hours answering vaccine questions from the community and posting this to social media. We also highlighted respected Tribal members receiving the vaccine.”

In an interview posted to YouTube, Bunio mentioned that health workers had called elders to tell them it was their turn to get vaccinated.

Native Americans in remote areas try to find meager state vaccine supplies 

Back in Hollister, in Halifax County, tribal staff worked with some elders to get them registered for vaccination appointments.

Oxendine, the tribal administrator, said one of the realities of living in rural northeast North Carolina is horrible internet service. The vaccine signups were online, which presented an obstacle for elders who don’t have internet access.

Mary Evans, a 65-year-old Haliwa-Saponi member, and her 70-year-old husband, Phillip, waited outside for their shots.

Mary Evans had trouble catching her breath as she spoke. “I have right many ailments” she said, including bronchitis, rheumatoid arthritis, and lupus. Evans tried calling local health department “for a solid week” for an appointment and didn’t get an answer.

Evans said it’s important to make it more convenient for older Native Americans to get vaccinated.

“A lot of us do have extra problems,” she said.

Though the clinic was arranged to make it convenient for tribal members, it was open to anyone 65 and older.

One woman, Sheila Coffey, who is not a member of the tribe, drove in from Rocky Mount after failing to get appointments at several other locations. She wanted to get vaccinated before her upcoming lung surgery.

“This is the most efficient event I’ve seen in years,” said 70-year-old Coffey.

Her 94-year-old mother-in-law got a dose of vaccine, too.

Harvey Evans, 76, who said he has COPD, rolled his oxygen tank into the community center. Doretha Evans, 65, had called three or four places trying to find vaccine appointments before they were able to get on the schedule in Hollister.

She heard about the event in her prayer group.

“God always works things out,” she said.

The Evanses live about 10 miles from Hollister and are not Haliwa-Saponi. They were thrilled to find convenient vaccination appointments.

“A lot of people don’t want to take it,” said Harvey Evans. “I’ve got to take it. I want to live a little bit longer.”