Going Above and Beyond During Crisis

“Our mission is to improve outcomes with quality health care by removing barriers to treatment” – these words are emblazoned on the wall of the Swinomish Indian Tribal Community’s didgwálič Wellness Center, greeting everyone who enters. Since the wellness center’s opening in 2018, didgʷálič has been immensely successful in fulfilling this mission. However, recent challenges – including a global pandemic, historic emergency flooding, and snowstorms – have deepened didgʷálič’s commitment to its mission.  

In November 2021, as torrential rain hit northwest Washington State, the Nooksack River began to flood. Soon, homes and then entire communities were underwater. Flooding and mudslides on the roads meant that many area residents were cut off from essential supplies.  Among those affected were residents of the Lummi Indian Reservation and the nearby city of Bellingham.

As floodwaters spread south and rivers jumped their banks, didgwálič staff realized that they too would soon face similar problems. didgwálič Wellness Center – owned and operated by the Swinomish Indian Tribal Community – provides community members experiencing substance use disorders with essential medical and social services. The floods threatened to cut patients off from access to vital medications and services to treat their substance use disorders and other health conditions. 

“When someone with an opioid use disorder is stabilized on medication, that dose needs to be consistently delivered,” said Dr. Matt Krumpak, didgwálič’s Pharmacy Services Manager. “Without consistent dosing, clients may begin the process of withdrawal. Once withdrawal begins, the risk of relapse increases significantly.”

With over one hundred clients living in areas affected by flooding, staff knew that the risks would be high if they couldn’t deliver care. That’s when an emergency response command center was formed, with didgʷálič’s Transportation Director, Huge Edwards, stepping forward to lead the effort. 

Huge, a Swinomish Tribal member, partnered with the Swinomish Police Department and Swinomish Fish & Game officers, to utilize a 35-foot boat owned by the Tribe. This boat could hold all the staff and equipment needed to safely transport a care team beyond the flooded areas. 

Then, together with staff from all departments, the emergency response team arranged for three clinics off the dock per week. Transportation, security, and nursing staff were responsible for calling clients to make sure that they were informed of the temporary clinic locations. 

During these crisis clinics, clients would meet with dosing nurses and counselors at points along the flood line. The boat trip itself was an hour each way, through choppy waters polluted with debris from the flooding. However, that didn’t seem to bother anyone. “Swinomish people are taught when we’re growing up,” said Huge “that we need to take care of our people. This is a lesson I learned from my grandfather.” 

Just one month later in December 2021, didgwálič staff faced a new natural hurdle – snowstorms. According to David Jefferson, didgwálič’s Chief Clinical Officer, “We’ve really been in an emergency event for over two years now with COVID-19. When the flooding and snowstorms came, staff were already hyper-focused on removing barriers to care for our clients. In a way, we were already prepared.”

During the pandemic, didgwálič was forced to adapt their services significantly. For example, maintaining safety protocols meant testing patients and staff weekly for COVID, providing curbside dosing, and social distancing for counseling sessions, among other efforts. 

All these adaptations have made didgwálič staff nimble and more resilient. In response to flooding, snowstorms, and COVID, they’ve built new policies and procedures that will formalize emergency response for years to come. Now, didgwálič has one staff person dedicated to monitoring potential weather challenges. Furthermore, there are now protocols in place for rapidly gathering Program Directors and Care Managers to coordinate prompt policy changes and emergency communication with patients when needed. All these measures were put in place to ensure that patients are taken care of – regardless of the barrier to care – just like didgwálič’s mission states.

To learn more about the didgwálič Wellness Center and their unique, comprehensive approach to care visit www.didgwalic.com.  

Want to learn about innovative approaches to care for people experiencing substance use disorders? Consider joining the Harm Reduction, Pharmacy SUD or Substance Use Disorder ECHO programs.