Resilience in Indigenous health research during COVID-19

Allen et al. highlight many ways that Indigenous-led partnerships can promote health [1]. At the time of their pre-pandemic publication, facilitating health research consultations with Indigenous Elders or Knowledge Keepers by videoconference would have been inconceivable. But COVID-19 has forced a shift to online formats, and Indigenous communities across North America have exemplified resilience by adapting cultural protocols to ensure that critical collaborations are not stalled.

In Canada, Elders’ gatherings have taken on new forms. At the Turtle Lodge discussed by Allen and colleagues, Elders have been conducting Full Moon Ceremonies from their homes guided by flexible instructions from one of the Lodge’s Grandmothers [2]. In the USA, the National Native Health Research Training Initiative operationalized adaptive protocols for the recording of ceremonies. Each session in their webinar series began with a prayer by a Knowledge Keeper or Elder that, with their consent, became part of the publicly available recordings [3].

Tobacco protocols have also been modified in both countries so that a giver can lay down a tobacco offering in front of a camera to be accepted virtually; a wire transfer is made in lieu of an honorarium and handshake.

Approaches differ across communities and contexts. Consistent among them is flexibility paired with a commitment to recover lost in-person time when it is safe to do so again. It is important for the medical community to witness how protocols evolve as our country moves through and beyond the pandemic, and to bring this spirit of adaptability to clinical and research work.