Medical community works for trust, equity in care
The Navajo Nation is bearing the brunt of pandemic
History will likely tell a different story than what the majority of New Mexicans can see in front of them. I feel imbued by New Mexico’s overwhelming cohesive cooperation; ranging from the aid of our national labs to small local businesses, extraordinary health care workers, and government spearheading direct decisions in our low-resource state. However, I’m standing at the crossroads of a major historical moment, watching the Navajo Nation suffer impetuously at the hands of this pandemic while flight crews bring patients to the ICU from their tight-knit communities hundreds of miles away to an enclosed medical center where communication is now more difficult than ever.
Prior to the pandemic, families would regularly accompany loved ones to the intensive care unit and aid in their advocacy and language barriers at times. As it is now, the Navajo Nation is experiencing per capita infection rates that mirror those of the epicenter of the United States. What has been brought to the forefront during this pandemic is the lack of trust and most apparent, lack of equity. As I mentioned, families would oftentimes travel from the Navajo Nation to be with their loved ones during their medical stay. This pandemic has not only made travel and being bedside impossible, but has also devastated families with multiple deaths and made communication ever more challenging. Providers are now giving updates almost solely over a phone. We are having discussions about discontinuation of life support virtually, and believe me, death, as hard as it is, is even more difficult when you take away compassionate touch. Code-status discussions in the time of this pandemic are important and a worthwhile conversation, hard as it is, before you get sick.
It is a well-known phenomenon that minorities lack trust in the medical community, especially if a provider is of a different ethnicity than your own. I think many New Mexicans can share a similar sentiment, and in my experience members of the Navajo Nation have been reluctant when speaking to providers in the Intensive Care Unit, more so when it’s not in Navajo. Oftentimes, we see this when trying to enroll patients in drug trials or discuss goals of care. I believe that, in part, a reason for the incredible spread of this virus and death seen in the Four Corners is a lack of trust.
As I see flight crews bringing patients daily to our ICU, which now spreads multiple floors of our hospital, from the overburdened medical centers in the Four Corners region of our state I say this: We love you. This sentiment is shared by all of our medical staff.
Our state is bleeding, but we don’t back down; New Mexico is pride. As the Navajo Nation endures the brunt of this pandemic in a colossal way, we stand with you. I hope that one day, regardless of your ethnicity or cultural background, we come to trust each other. I hope that politics cease to divide our diverse state. I hope that one day the sovereign nation will gain trust in the state and that health equity will be possible.
Until then, we stand together — 6 feet apart — to help each other from Anthony to Shiprock, from Deming to Raton, and every ranch, farm, dirt road and community in between.