Providing brain health support to the Navajo Nation

Northern Navajo Medical Center with Shiprock in the background.

Last month, McCance Center Brain Health Clinic Director Dr. Zeina Chemali. MD, MPH, volunteered with the Mass Communication Program with the Indian Health Service to provide specialized expertise to the neurology and psychiatry departments at the Northern Navajo Medical Center (NNMC) in Shiprock, New Mexico. Dr. Chemali’s trip is the result of a growing collaboration with the Indian Health Service and is the first of many volunteer endeavors as the McCance Center seeks to increase its outreach to underserved communities.

With the Navajo community still reeling from the impact of COVID-19, the need for more specialized support in the region has never been greater. According to Ellen Bell, MBA, MPH, director, Mass General Brigham Community Health Outreach and Education Programs and primary liaison for this initiative, “There was a lot of death and illness and in their small tight-knit community they were caring for and looking after friends, family and staff. They have come a long way in their recovery and healing, and the presence of our faculty has provided them with invaluable support.”

For Dr. Chemali, this was an opportunity she had been waiting for for quite some time. “I have always been so intrigued and inspired by the Native American people and their complex history. If we can support this vibrant and sustainable community through partnership, we should do everything we can to make it happen.”

Learn more about this experience in the Q&A with Dr. Chemali below.

Q: What prompted this collaboration?

Left to right: Dr. Garrett Riggs, Dr. Zeina Chemali and Dr. David Durham.

A: Even before I moved to the United States, I was always very intrigued by Native American history. I remember when my own children were in school learning about its complex nature; you look at these rich and beautiful tribes and to see where the communities are today is frankly quite painful. I came into medicine to help those who have not been helped. Initially, the Outreach volunteer opportunity was only available through Brigham and Women’s, but when it opened up to Mass General providers in 2022, I knew we had to find a way to get involved.

Q: What was the main purpose of this first trip?

A: I consider this past trip to be the initial beginning of what I hope will become a long-term relationship. The purpose of this visit was primarily a needs assessment. My initial focus was as a neurologist, working with Dr. Garrett Riggs in neurology, but as the trip took shape, I connected with the psychiatrist, Dr. David Durham, and was able to find time to help with his cases as well and learn from his experience in serving this community for a long time.

Q:What were some of your biggest takeaways?

A: NNMC has very strong support services – truly extraordinary. Professional services, internal medicine, public health nurses, and extremely well-trained and insightful pharmacists really do a tremendous job for this community and often handle the management of stable neurological cases that they would not normally see elsewhere.

Beyond that, what became clear is how deep the level of generational trauma in this community runs. It is pervasive in ways that are almost unfathomable. Helping these patients overcome this and building their confidence in the process is paramount in any care. It will also help overtime work build trust in the medical system as it meets the patients it serves where they are. It will take time and a lot of listening and learning from the people on the ground about what works best for them.

Q: A unique or special experience you would like to share?

Sculpture in the atrium of the NNMK.

A: Shiprock is truly a majestic place, spirituality is all around it. You see that even in people, despite this deep trauma, there is a sense of community and support for each other. Individuals try to be healthy for the sake of the community, not for themselves, as evident in their ‘Walking for a Stronger Nation’ emblem of exercise effort. We can all learn from this. Meeting Ms. Ida Bradley really stands out for me. I came as a student and she was a teacher about the Navajo Nation and how we as providers can help and meet them where they are. The providers at NNMC are true visionaries in many ways and it is simply inspiring to be around them.

Q: What’s next in this collaboration?

A: More cooperation! We plan to come back again and hope to find a regular rhythm. In addition, the Outreach program has many opportunities beyond site visits. There is a robust distance learning program that we hope to use, this may include case sharing, grand rounds or patient consultations. In addition, to further develop and nurture these longitudinal relationships, there are opportunities for MGB providers to host and mentor Navajo IHS physicians in Boston for shared training. These week-long visits are powerful ways to teach us about their unique challenges and treatment methods, and also for them to receive more targeted training and education in their area of ​​interest. In every way we can, we are committed to working together with these extraordinary providers—in person and through technology—to develop meaningful professional relationships and a community of Mass General Brigham volunteers to help build capacity and support programs.

Leave a Comment

Your email address will not be published. Required fields are marked *