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Community Story: Cowichan Tribes

September 27, 2022

Meet Cowichan Tribes, a First Nations community that is using Jane to meet the needs of its members.

Story by Jack Murphy

Cowichan Tribes is a Jane Bursary recipient that is helping to bring mental health, vaccinations, dental services and so much more to their community members.

Tell us a little about Cowichan Tribes

Cowichan Tribes is the largest single First Nation Band in British Columbia. The Community is currently made up of nearly 5,500 members in the Cowichan Valley, with about half living on Reserve lands. We have seven traditional villages: Kw’amutsun, Qwum’yiqun’, Hwulqwselu, S’amuna’, L’uml’umuluts, Hinupsum, Tl’ulpalus, governed by a Chief and 12 Councillors, within the framework of the Indian Act.

We provide numerous services to our community from children and family services, to education, health, housing, memberships, and social development. We are also one of the single largest employers in the region.

Tell us a little about yourselves and what you do at Cowichan Tribes.

I’m Fairlie Mendoza, and I’m a community health nurse working for Cowichan Tribes. I’ve been working here at our independent health center since 1995. I am the manger of a team composed of nurses, harm reduction and outreach workers, maternal child health, infant development, speech therapy, as well as research workers, cooks, and child minders.

I’m Tisha Efford, the medical office assistant for the Cowichan Tribes. I also coordinate logistics for many of our team’s activities, including things like vaccine clinics and health fairs. I’ve worked here now for nine years. I initially started in the dental department six years ago, however, when COVID hit I began helping out the nurses, and that’s when I began working health center full-time.

You provide immunizations to so many Cowichan Tribe members, how were you handling that task before Jane?

We serve hundreds of children under the age of five or whom we offer routine immunizations; that is one of our main objectives here as a team.

Before Jane, we were observing declining rates of vaccination in our community, especially in the last ten years. We were spending so many staff hours and ancillary staff hours, printing lists of eligible children and phoning families trying to encourage vaccinations and extend invitations to our walk-in vaccine clinic. So we would invite, invite, invite. It was a very intensive activity that often didn’t result in bettering our rates of immunization. Before Jane, everything was pen and paper, leaflets going out; it was a very manual process.

So a couple of years ago, before 2020 and COVID, we were thinking we need an app or software so that people could make their own appointments. Then when COVID came, we had to restrict our vaccine services to appointments only, and we really needed a system in place.

So Tisha and I talked with our IT department about options, but ultimately it was Tisha who found Jane and said that you would be a good fit for us.

We definitely want to say thank you to Jane App, and Tisha as well, because she is really in the details of it all helping to get people in here and to use Jane. It’s still early days, but we like to think we have a new tool with Jane that will change things for the better.

Tell us what you are using Jane for now.

We use Jane’s Online Booking for our immunization programs. That’s for children two months and up, as well as for booking folks in for COVID vaccines.

We also use it to book our nurse visits, for STI testing, sexual health, TB tests, pap smears, baby weights, really anything that somebody would want to come in for. We’ll be starting to use it now for flu shots as we move into the fall season too.

Fairlie, can you tell us why you chose to work here with Cowichan Tribes, and what you find is the most satisfying part of working here?

Once I left my job as a nurse working in a hospital, I became interested in community health jobs and projects that were promoting access, diversity, and social justice. I initially worked in a free clinic in Montreal, and from there I worked as a street nurse in Vancouver before coming to Cowichan Tribes.

Primarily, I came to work here because it is an independent organization. We do not work for the government, we’re employed by the Chief and Council, so we have a degree of agency and the ability to be creative that doesn’t exist in the public health or hospital sector. There are many more benefits to working for an indigenous nation, but I’d say that is what brought me here in the first place.

Since I’ve been here for such a long time, the most satisfying part of the work for me is that I’ve been able to build relationships and acquaintances with so many people in the community. I’ve been here for over three generations of family members, so I really enjoy that; it feels kind of like the old-style country doctor.

What about yourself, Tisha?

In my journey, I kind of fell into working with Cowichan tribes. It wasn’t necessarily planned. I had worked in many dental clinics in Calgary doing lots of surgeries and different things like that. I was initially just applying for a job here and ended up starting with a term position, which led to full-time. I think the biggest reason I stay here and do the work that I do every day is because of the people. It comes down to the community here and the support network we’ve created.

Tisha, can you tell us about some of the successes you’ve been a part of over the past few years with Cowichan Tribes?

I think my biggest impact has been in the last few years where I have been able to take on more responsibility and being able to do more things to help the community. Whether it’s dental or it’s immunizations, it’s getting people to either show up or make their health more of a priority for themselves. I think that with Jane app giving them automatic reminders, it’s a little less invasive than us calling them, especially for the newer generation.

What about yourself Fairlie, can you tell us about any successes or hardships you’ve seen over the past few years?

I think for me there have been episodic successes, but in terms of a shift that may be more sustaining for the organization is we now have an in-house community-based research project. That has always been something we wished and hoped for, and now it is happening. We have some really wonderful people, community members, and researchers running that and working hand in hand with us and it’s really good to see.

I think some of the challenges I’ve seen have been the advent and adoption of mobile phones and social media and how that has changed people’s dynamics with each other as well as with the health centers. It’s so much harder to attract people for things like community dinners and events because they socialize with each other online and in different ways now. We’ve seen that also play into vaccine hesitancy and medical treatment, and we’ve seen that discourse on social media impacting our ability to vaccinate our communities.

Can you tell us a little about the research your project has been working on?

They’re engaged in a research project looking into the rate of premature births that we have in this community, which is at least double that of other indigenous communities. They’re looking into the risk factors for health and development. We’re hopeful that because it’s community-based research, we’re going to be able to develop some strategies to decrease this rate.

Last year, the Government of Canada named September 30th as National Day for Truth and Reconciliation. How have you viewed that day now as a national holiday?

You know, it might be seen as something akin to Martin Luther King’s birthday or Black History Month. It should be seen as a day to focus and bring to the attention of other Canadians.

Some Canadians remain unaware about that branch of history with indigenous people in this country and the effects colonialism has had on them. They really don’t know, it hasn’t been shared in the school curriculum, it’s almost as if there is a denial of it. Which certainly contributes to discriminatory attitudes.

We hope that this is a type of beginning to bring this into the public consciousness and discourse and hopefully into school systems. And ultimately, we’ll see some better progress and understanding of where we have all come from.

I choose to be an optimist and hope that it at least makes people think, what does that orange shirt mean, what is that all about?

Before we say goodbye, I’d love to know what advice you would give to someone working in similar environments where the emotional work can sometimes be just as demanding as the job itself.

I think creating a fellowship with your coworkers is key, and being able to enjoy the people around you and have a laugh while you’re at work is really important. I know each and every one of us go through difficult things, but all we can do is acknowledge that and be there for each other and our coworkers. You spend most of your time with them, right?

So share. We share quite a bit of our personal journeys with each other and support each other. Yes, you can go home and do self-care, and be with your family. But you’re sleeping, and refuelling half of the time that you’re back home. So share that emotional load, and be there for those around you. Bring your humour, and create those connections with each other.

A big thanks to Tisha and Fairlie for taking the time to chat with the Jane Community today. I hope people take this as an opportunity to learn more about both our land and its peoples’ history. And acknowledge both the successes and struggles that First Nation’s people are facing today.

To learn more about Cowichan Tribes and the work they are doing you can visit their website and Facebook page here.

If you’re not already part of the Jane community, welcome! We’re so glad you found us. If you’re in search of Practice Management software to help run your clinic, we’d love for you to meet Jane. Take a virtual tour, book a demo with one of our lovely support staff, or sign up here ! Or, check out what our customers are saying about us in the jane.app Community Forum. We can’t wait to chat!

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