This transcript is auto-generated and may contain inaccuracies.

GARLIE ST-CYR:
My name is Garlie. I’ll be serving as the moderator for today’s session.

And now that it’s 2 o’clock Eastern, I think that we can get started. So, I would like to happily announce the first presentation that is coming up with Berta Hernandez and Vincente Cordero. Just to provide a brief description, Berta has been working as a started her career as a promotora in San Francisco during the AIDS epidemic.

Over the decades, she has worked at various organizations in San Francisco and across the Bay Area, combining her passions for health education, storytelling, and traditional healing.

Berta now serves as the People’s Development Manager at San Francisco’s Health Department, and Vincente also works at the Office of HealthEquity and Community Engagement at the San Francisco Department of Public Health as a health program coordinator.

And they will be talking today about how they are centering these resources related to cultural connection and promotores. So if you would like to check out their full bio, you can on the event platform, but otherwise, I think we can get started, and I’ll hand it over to them.

BERTA HERNANDEZ:
Hello everyone. I’m Berta. I’m going to be speaking about this, which is the title of our presentation, then, during the legacy of an evolving impact of promotores in San Francisco from community tradition to public health.

So, I will be talking about a little bit of the history of how we came to be here as promotores in the Bay Area in San Francisco. And it’s a long history.

First, I want to talk about what a promoter is, a health promoter is a community health worker is a person from the community that is able to distribute information and education and prevention messages to their own community.

So, if we can see this as peer work, and we have seen community health work with peers, and how it is better for you to teach your own community. And so, because in that particular situation, we are we share common language, culture and life experience with the communities that we serve and we have built trust with them.

So, Promotores here in San Francisco, they have a long history of decades and already working with different health issues. So today I’m going to be speaking about where the promotores tradition comes from. And it has a very long-standing tradition in the history of the Americas.

We can look at this as a tradition that has survived through centuries. It survived colonization. That is how we see health in traditional communities, or how health was seen in the pre-Hispanic times in the Americas.

Way before the arrival of the Spaniards on the continent, there were great civilizations. We can mention the Aztecs in the center of Mexico, in Arabic city, they got the Grand Tenochtitlan or the Great Tenochtitlan. And there is also another civilization to the south, like the Incas and other groups of people.

And they have a very, they have those civilizations were very, they have together many things and aspects of their culture together, like their political practices, the cultural practices, their art, the way they relate to each other and the public life, etcetera.

But medicine was also part of this tapestry of different aspects of their life. They were not that separated and existed a health system in those times. We never talk about the health systems that we had in the pre-Hispanic times.

And we always talk about the artifacts, and sometimes even the literature, but it was the language that has survived. Also from those civilizations, we talk about the power structure, the different gods, and the different forces that they were using in terms of the natural forces like the rain, the fire, things like that.

But in those civilizations, all of these were more succinct, more organic relationships with each other, and also the health that was provided to the individuals in this place.

So we’re talking about a health that is not separate from superstition, we can say in belief in other forces and in belief in the spirit, but also it was rooted in the relationship that they have with each other in terms of a collective group.

So we see in this civilization that we have seen already empirical observation and experimentation of different aspects of medicine, of how to treat some of the things that were happening to them.

And, but they were all, they also have like surgical practices that have been documented by historians, anthropologists, and archaeologists, but at the same time with spiritual and rationalistic practices that were more aligned in terms of attending to mental health issues and emotions.

So the different problems that any human, any person can have in relationship with himself or with others in their surroundings.

So we have in those times, in those pre-Hispanic times, we already had a community-based healthcare, holistic approach to health that was done by trusted community members.

They had extensive herbal knowledge. This empirical observation and experimentation. I was talking about surgical practices and these spiritual and ritualistic practices. It’s important to notice that there was a very healthy society.

They have a very important infrastructure in terms of managing water, for example. So they had a very impressive sewage system. It was a very advanced relationship with Europe at that particular moment, prior to the arrival of the Spaniards. And that conduces to a very healthy environment.

You have never seen in that society big massive problems of health until the arrival of Spaniards, who, as you know, brought some diseases that the natives were not ready to take because they did not have immunity to them. And it was devastating to many in the population because the Spaniards came with those diseases, but they didn’t have the knowledge of how to contain the infections.

And so that the people who were in the Americas also didn’t know how to treatthose things. So it was a disruption. Not only that, but these practices that they had at the moment. They were seen as the Spaniards, as something bad.

And everything that they encounter here. They encountered all of these practices or the rituals or their religions that they thought were evil or something like that, like very bad. So that’s why they build their churches, the Catholic churches on top of their temples in the city of Mexico City, for example.

So they also tried to get away from all of these practices. They always consider the sorcery of things that needed to be eradicated. They continue to exist even with that intention and with the conqueror. They continue to be practiced.

And one very important that I want to name is the question of child of the I don’t know how to say that the parteras. The parteras are the women who help other women to get there. That was a very a practice that they was on at that time.

And it persisted or continued to exist through the whole colonial times in the Americas. It was a practice and knowledge that was passed from generation to generation, even Spaniards or Creoleos. The Spaniards that were born now in the Americas were seen by these women when they needed to have their children.

And so that was the colonization from the worst of independence. All these practices were seen as something that needed to be eradicated, but they didn’t disappear. The communities could keep their practices. And one of the practices is what the community health work.

And it is mostly women who will bring information and assistance to members of the community. And that was not at those times like medical services in Latin America. And when they started to be in medical services, they were just for the privileged classes of society.

It was not until the Mexican Revolution in 1910 that there was more dissemination of medical care with a more scientific understanding across all the different countries in Latin America, from Mexico to South America, where they started to see more clinics and medical care.

Nevertheless, these traditional practices continue to exist because these new medical systems were not able to reach to the whole population. So they continue to exist.

And then we have something that is very important, and this in the 50s that the Cuban Revolution, which was very important in Latin America in terms of extending public health systems to the population, and we also get to the 60s.

It’s not only these practices of extending the medical care through the countryside and different places of the continent and the cities, but also in terms of health education and literacy campaigns that were also rooted in later on into the Nicaraguan revolution and Friday in Brazil.

It was very important in as an educator in terms of popularizing knowledge, popularizing education. And it was together with this popularization of health also and the real visiting of the role of promotores or traditional healers. They were already distributing information and attending to their community.

From the 60s and beyond, they started these new systems of care, where they started to incorporate promotores into the clinics as something very important.

Even the pateras, the women who help other women to have their children, but they go to the United States because of all these things that you know as immigrants across the border to the United States from Latin America, mostly from Mexico. They bring their culture, or we bring the cultural language of our history, including these traditional healing practices and this way of relating to each other as a collective, with community health workers supporting their own community. Even if they are not paid, community health workers are just members of this community.

But they were identified also in United States in some clinics that were serving agricultural workers at the border that start that they saw this, how these people were able to communicate with the workers to prevent diseases or to take care of other thing when they were sick, able to translate, translate scientific information or very sophisticated medical information into the language that these workers could understand.

So, this since the 50s in United States, it was also a development of promotores working with different health providers to the country in the clinics that they were attending at this immigrant community from the South. And they started to have more roles.

In terms of community health work that also happened in San Francisco in the 50s, several organizations started to choose promotores and started to conduct many campaigns of health and education with promotores.

And that goes to the AIDS epidemic. When the AIDS epidemic happened in San Francisco, the Latino community was at 8% of the population. However, of the cases of AIDS in the community, we were 15% of the 8 cases in the population. So it was seen as a very difficult situation, a lot of disadvantage for this community.

And the different organizations at the time were starting with the San Francisco 8 Foundation, which was one of the first, maybe the 1st aid service organization in the city, started to have peers to work with other peers with people who were suffering the AIDS epidemic, not only the disease itself, but the impact in the community.

And they also recognized that promotores were very important in order to work with this particular community. So that’s when I started to work in public health.

I was a promotora. I gave a lot of condoms. I teach how to clean needles to people who were using injection drugs at the moment. And I also was able to participate in many community meetings and family meetings because I was a big mental health crisis, and people had a very difficult time processing the fact that you have and your family, somebody who had AIDS or he was gay. That was very difficult at that time.

Since the epidemic, the promoters continue to work in different aspects and these different areas of the city in public health and relating with the health department at many occasions.

But it’s not until COVID that again, another epidemic hit the city in a way that if we thought that HIV was disproportionately affecting that in a community, COVID was immensely more affecting the city. But in 2020, we were already 15% of the population. However, we accounted for 50% of COVID cases. So the infections were extremely high in this community.

And the health department was able to partner with other community organizations that had promotores that supported the effort and the attention to the epidemic from giving food to the people who were not able to get out of their houses to provide clear information.

Also, a cleaning kit that we had for distributing the mask, the jail, all of those things that were distributed by promotores on the street. And also, they were the first ones to staff the testing sites outside.

Many people went into shelter in place, and promotoras were on the streets, not only doing community service to people in need, but also staffing the testing sites and very soon the vaccination sites.

So we have this promotional working as contact tracing people, as case investigators, and they were able to provide a culturally responsive health promotion to the population, and it was very successful.

We were able to reach very high levels of vaccination in the city beyond 90%, and a lot of stuff has to do with the ability of the health department to work with the community organizations, but also to work with these promoters that work with this organization that has this tradition.

It’s not only that they have been taught in school or that they have a certificate from City College in how to do community health work.

They have it in tradition through the years, through generations, through history, how to work with their community, how to provide information and support in this collective way of seeing in public health.

And now from that, we have also continued our work with promotores, and Vincente is going to speak more about how we have conducted that work since COVID. Thank you very much.

VINCENTE CORDERO:

Thank you, Berta.

So that brings us to where we are now with the community of practice work we’ve done. As Berta had mentioned, the promotores work has a rich pre-colonial, pre- Columbian, pre-Hispanic history rooted in thousands and thousands of years of community engagement and different understandings of medicine and health and community engagement.

And fortunately enough, the Department of Public Health was a recipient of a PHIG grant, and said PHIG grant has allowed us to really bridge a lot of that traditional public health, community health history with our contemporary public health system to create greater connections between communities and the Department of Public Health.

So, I’m going to talk a little more about the community of practice we currently have running, which includes promoters from various community-based organizations, including those that are unaffiliated and just community members.

I really want to take a moment to just highlight that, as Berta spent a lot of her time saying, there are really ingrained, really strong cemented roots of this work that have existed before the PHIG, before the San Francisco Department of Public Health. This is work that, in some capacity, would have existed without us.

It is really with support from this funding and because of, you know, our capacity and in leadership’s recognition of the value of promotores that we have been able to sort of elevate this work and enhance it in a way that maybe had not been done previously.

So really what we’ve been trying to do is enhance the professional capacity of the promotores, recognizing them as community health leaders who have really strong connections in the communities that they serve. I’ll talk about that a little bit more in a few slides. And also enhancing our professional capacity as a department to engage the promotores in this way and enhance their capacity to engage us as a public health department.

So I’m going to talk a little bit about some of the pillars, some of the components of our community practice to highlight basically what we, what we have operationalized, what we’re working on right now.

We have a number of Wellness and trauma-informed care groups. We just completed a popular education seminar group. We’re planning on starting that again.

We have ongoing informational sessions, and then there are also ongoing meetings with promotores coordinators who are sort of leaders within the organizations that have promotores that they support and work under.

So a reason that promoters are a particularly important group when it comes to addressing health disparity in San Francisco is that they are, you know, a tile in the larger mosaic of Latino communities in the city.

They are very much representative of the data that is here on the slide. Many of them are members of the undocumented community. Many of them are first-generation immigrants.

Many of them have children in the city, you know, working community based organizations have friends and family. Members of these communities are very well placed to be the connector between community members who may have existing distrust of healthcare systems, city agencies, and other sorts of larger historical systems because of historical slights.

So in that way, they are very keenly positioned to support us at the Department of Public Health and create linkages and access to care where they may not exist otherwise.

As we’ve noted, the work of the promotores has evolved over time, and even their definition and the sort of roles that they perform have, and so has our community of practice in terms of the work that we’re doing.

I would be remiss if I didn’t sort of highlight the current political landscape here in San Francisco and around our country and the impact that it has had on our Latino and immigrant communities. And by extension the promotores, who again are very much members of those communities.

So you’ll see a lot of the work we are doing aligns with what the promotores have identified as important mental health considerations to help them support and continue their work in the community.

So, something that we continue to talk about is that the promotores really recognize that the current political landscape as being worse than COVID. So think about what Berta was saying with regard to how bad the pandemic was for Latino communities, and imagine that the fear and anxiety that people are experiencing now is notably worse.

And that’s what they’ve been telling us. The current context and all of this information is directly pulled from meetings and engagement opportunities that have happened with promotores, fear of public charge, you know, risk of increased substance use and overdose, and reduced access to knowledge of resources.

And they’ve noted that some of the needs and challenges that they’ve been facing are navigating vicarious trauma and emotional burden, lack of organizational administrative support, greater need for mental health first aid, as well as desire for safe spaces and peer support.

What you’ll see on the following slides has really been our attempt through the PHIG and through our collaborations with different groups within the city Department of Public Health, as well as other city agencies, to address some of these needs and challenges.

GARLIE ST-CYR:

I don’t mean to interrupt; I just want to give you a warning that you have about 3 minutes left.

VINCENTE CORDERO:

All right, thank you very much, Garlie. I’ll be quick about this.

A lot of the work really kicked off in 2024 with our Promo Torres leadership conference. And that was the first of its kind. And that was really a space where all of the Promotores, we had about 100 in total, came together to be in community and strategically plan for what our community of practice would look like in the coming years.

From that, we were able to develop a lot of really great programming, including informational sessions, which we have on the 1st Friday of every month. And this is a space to train up promotores and connect them directly with public health professionals, clinicians, and other city agency staff who have meaningful and important information to share.

So of course, we are trying to break down existing silos and barriers to make sure that there is a bidirectional flow of communication and engagement. And we have very good attendance at those. The Promotores really appreciate much of the space we’ve been able to create there.

As I mentioned, we have Wellness groups and Wellness activities. Again, this was really much the result of the Promotoris recognizing that they need safe spaces and opportunities to connect and just be around each other, and recognize that there is burnout and foster self-care. So that has been another space where we’ve been able to collaborate with city agencies.

These have been held in the community and recognize safe spaces and have been an integration of some of that traditional practice that Berta mentioned with our contemporary public health style. You’ll see that there is kind of an emphasis on culturally and linguistically congruent care in the work that we do with Promotores in the Wellness space.

Berta has also done a number of really incredible popular education seminars centering on the work of Paulo Freddis, Pedagogy of the Oppressed, and really serving to build up the capacity of a number of promotores to engage more impactfully in group facilitation, community engagements, and sort of recognizing and utilizing frameworks for liberation.

A lot of the work they do has felt like a really valuable opportunity, and we’re hoping to continue that, probably sometime next year, as PHIG funding continues.

I want to highlight our most recent success, our Wellness event that happened this past October. Reencuentro Y Bienestar, also known as Reunion and Wellness. A full day of Wellness activities and connection and community between a number of DPH staff, the promotores. Our health officer, Doctor Susan Phillip, came out and gave opening remarks.

And here are some quotes to highlight the impact. I’ll just share one really quickly. “Being able to share feelings and hear nourishing words was a great gift for my well-being.”

And our final slide before the thank you, and closing is that we do believe here at the Department of Public Health, at our promotores community of practice, is really an important model for sustainable community engagement and Health Equity.

And we think that our success thus far really highlights the importance of valuing and recognizing Promotores and the larger community health worker networks that exist in our city as something that is worth investing in in terms of capacity and well-being.

And that it is important to build genuine partnerships and relationships between us as a city agency and those in the community to establish long-term sustainable approaches to community health engagement.

Thank you all very much for your time. Thank you for attending our session.

And I’ll just end with this quote by Paula Freddy. “Education is an act of love and thus an act of courage.”

GARLIE ST-CYR:

You did perfect. Thank you, to you both so much. This is the second time I’ve been listening to you all speak about the work that you’ve been doing in San Francisco, and it’s really great to see.

Continue to drop questions in the Q&A. We love to hear your thoughts, and thank you so much for your reactions. You can also try to jot down any thoughts in the chat.

So now I’d like to pass it to Laura Sawney. Laura is a proud Cherokee woman who has founded the consulting firm, Rising Resilience, focused on various resources and services, deeply rooted in Indigenous works, such as evaluation and cultural revitalization.

I’m happy to say that I work closely with Laura on a particular project. So it’s really going to be great for you all to hear what we’ve been working on. I will pass it to you, Laura, for the session on braiding relationships.

LAURA SAWNEY:

All right, so welcome to our session about the Tribal Workforce Cultivation Center.

So they talked a lot about relationships, and that’s exactly what we’re trying to do too. While we’re growing Indigenous knowledge, we are also growing and strengthening relationships.

And you know, these relationships, of course, through this lens of PHIG. So it’s tribal practitioners and non-tribal practitioners working together. And so we’ll get started with looking at the agenda now.

Over the next 25 minutes or so, I’ll be introducing myself through my positionality statement, so you have a clearer sense of who I am, the land and the people who have shaped me, and the responsibilities I carry in this work we do in Indigenous public health.

Who we are is not, you know, separate from what we do. It’s our lived experiences, our kinship ties, and our histories that guide how we move, teach, and serve. So positionality statements are very important. There is a hyperlink on this agenda. So I believe you guys are going to be getting these presentations.

So, if you’re not familiar with positionality statements, I encourage you to take a look at that guide, which offers step-by-step instructions as well as a template. And I encourage you to do that. So, when you go out into the communities, you are able to share your positionality statement. And so I will go on to share mine.

So, like Garlie had mentioned, I’m a Cherokee Chalagi woman. I’m a daughter, a sister, and a relative to many. I also like to mention that I hold the Yuchi tribe in the Muscogee Nation near and dear to my heart.

And I actually considered the Yuchi ceremonial grounds of polka as my ceremonial grounds because mostly the role that’s most near and dear to my heart is I’m a mother of four amazing kids aged 26, 23, 21, and then a nine-year-old and then I’m also a Gigi to an amazing and energetic 4-year-old grandson.

And I can’t forget, I’m a dog mom to my 2-year-old Henri Boxer dog. I’m also a passionate native public health practitioner, and I’ve been doing that for almost 20 years now, a dedicated lifelong native scholar.

I have brown skin, black eyes, and long black hair, which I could never hide my indigenous phenotype if I needed to, though I would never want to do that. I’m just lucky to live in a time that doesn’t require me to do so. Unlike my ancestors, who had to face and endure, so, you know, that’s always there.

And I remember that my lived experiences, like losing my father to cancer at 16, watching my resilient mom raise four young children in poverty on our beautiful yet very rural Cherokee lands, and navigating the way of intergenerational trauma, all deeply shaped my positionality.

In my early years, these experiences instilled both pain and perseverance, teaching me what it means to survive systems not built for us.

And just a few years later, unfortunately, as a young mom to my three older children, I endured another unimaginable loss when the father of my three older children was violently murdered.

And so that tragedy marks not only my life, but also the positionality of my children, whose own journeys are now interwoven with the same cycles of loss and grief, but also the resilience that I once myself faced growing up.

So my heart, you know, aches, and it carries that sorrow of not being able to protect and shield them from that pain. So I carry that with me in my work and then my approaches to my work, my relationships, and my responsibility as a scholar, a teacher, and a practitioner out in the community.

Yet through all of that, all of the sorrow, I always keep moving forward, even then driven by an inner knowing that education could be both my medicine and my resistance.

I became a first-generation college graduate, earned a Master’s in Public Health, and am now a third-year doctoral student in Indigenous Health at the University of North Dakota.

My positionality is now forever shaped by walking between 2 worlds, one of academia and data systems, and the other grounded in community knowledge, ceremony, and lived experiences.

It’s balancing these worlds that I find a purpose to bridge them, not for personal achievement, but to honor my ancestors, my children who sacrificed so much so I can do what I do, and for the future generations whose healing depends on this work.

When I get opportunities like this, I, take the opportunity to share. So with my positionality, I hope you get a better understanding of me as a Cherokee woman, a scholar practitioner, and so that you understand when, when I talk about this work that I’m about to talk with how that has, you know, come about.

We like to share stories. And so you know that the tribal workforce cultivation center is a labor of love. And so, everything the process is about. We try to make it very indigenized. And so it’s befitting for me to tell this story if you’re not familiar with the story of the three sisters.

But again, we try to integrate every aspect with that indigenous indigeneity, and of course, I’ll get into the components of the Tribal Workforce Cultivating Center, which is a mouthful, so I’ll say TWCC.

But as far as the story of the three sisters, long ago, in a time when the land was still young, the Creator gifted the people with three sacred sisters to nourish the body, spirit, and community.

These sisters were Corn, Bean, and Squash. They were very different in appearance and personality, but they grew to live together in harmony and cooperation. Corn, the eldest sister, stood tall and proud and protective of her sisters. As older sisters often do, she provided strength and structure for Beans and Squash.

Corn understood that her sister Beans needed a little extra support, so Corn humbly offered Beans that needed support. While corn could grow high, her roots were shallow, and she struggled to stand firm in strong winds.

Bean, the middle sister, was lean and flexible. She lacked the strength that her sister Corn had, so Bean could not stand alone. But as Bean grew through the tangles of Squash’s vines, she gratefully received Corn’s extra support as Bean climbed and wound her way up and around Corn’s sturdy stock into the beaming, bright sunlight, resulting in Bean lovingly holding and keeping her sisters ever so closely together.

Bean as the middle sister was also the giving sister as she pulled nitrogen from the air, bringing and fixing the nitrogen into the soil, ensuring her sisters, along with herself, are nourished.

Squash, the youngest, was wild and bold. She looked up to her sisters, dearly loving both of them, and was fiercely protective of them. Squash used its wide, broad leaves to sprawl across the ground, protecting all three sisters by creating a living mulch to shade the soil, keeping it cool and moist while also preventing weeds from infiltrating their area.

In addition to Squash’s leaves being large and sprawling, her leaves were also very prickly, allowing her to keep pests away. Together, the sisters thrived.

Each sister brought their own gift: Corn’s with strength and structure, Bean’s nourishment, and Squash’s protection, but it was only when they grew together, intertwined, that they reached their full potential. This is why the three sisters are always planted together, not in rows, but in community.

And so nex,t we’ll touch on the TWCC. And so there’s a little story that will go with this one as well, but it’s a little twist on the three sisters. And again, to hopefully get you to, you know, give you some insight and kind of that a little different way of storytelling.

This is just a little twist on it, and it’s woven into the life cycle of the blooming flower, representing TWCC. So the TWCC is represented here as a thriving flower nourished through relationships. There are the word relationships again, reciprocity, and shared responsibility.

Just as corn, bean, and squash grow strongest together, TWCC blooms when tribal knowledge, partnerships, and community values grow in connection with the roots in the soil.

These roots reflect the role of corn in the Three Sisters traditional story. It’s our ancestral knowledge, cultural teachings, and tribal sovereignty. They anchor the work firmly in Indigenous history, responsibility and land-based wisdom. This grounding gives TWCC its stability and its direction, and then you have your seeds, which are the inputs.

The seeds parallel the way squash spreads across the ground. Community care, relational accountability, and indigenous values that protect the work. It’s that reciprocity as far as having both tribal and non-tribal community workers, practitioners, professionals coming, coming together in a safe, culturally safe environment.

These inputs safeguard TWCC from burnout, harm, and colonial mindsets, keeping the soil healthy for growth. Then you have the stems and leaves, the activities and outputs.

Here is where the bean, a metaphor, comes alive. Beans intertwine and climb, symbolizing collaborators, learners, and allies, tribal and non-tribal, who wrap their efforts around indigenous leadership with humility and respect. And their partnership enriches the soil through reciprocal knowledge exchange.

And so non-tribal and tribal coming together and making that new knowledge that is going to help now in future generations.

And so that’s fueling TWCC’s activities, trainings, and shared learning pathways. And then the bed and flowers is the outcomes, the short and intermediate. The bloom represents the emergence of new strength and healing and shared vision, the collective achievements of the tribal and non-tribal public health workforce. These outcomes reflect how the three sisters nourish one another, producing more together than they ever could alone.

And so that’s you know, both the tribal and non tribal can come together and help one another out. Pollination and long-term impact is the Hummingbird medicine, and the Hummingbird carries the pollen for the long-term impact of this work. It represents movement, connection, and renewal across tribal public health spaces.

The impact spreads outward and strengthen partnerships, a more culturally grounded public health workforce overall, and pathways that sustain future knowledge growers.

So together, these parts create a living, breathing garden of collaboration. So it’s not just a, you know, a single plant or single flower. Just like the three sisters, TWCC thrives because each element supports the others. And differences aren’t obstacles; they’re actually nutrients.

And so again, just for a different way to kind of understand that, but I’ll get into some more visuals of how the overview of the tribal workforce cultivating center.

And so this initiative is part of the National Coordinating Center for Public Health Training at the NNPHI (National Network of Public Health Institutes). And the TWCC is committed to strengthening the public health ecosystem by focusing on four key areas.

First, again, relationship-building is key to creating genuine, meaningful connections between tribal and non-tribal health departments.

 Second, the reciprocal exchange of knowledge I mentioned is a two-way street. We learn from you know, we can learn from the non-tribal public health departments and workforce. And then the tribal health workforce has, you know, teachings and education and knowledge, cultural that again, the non-tribal public health workforce can learn and gain.

Third, facilitate that collaborative infrastructure development between local, state, and other health departments that cross jurisdictional working together, because sometimes that does get complex, but again, coming together, communication, dialogue, discourse on that, figuring out together.

Finally, supporting both emerging and experienced public health practitioners who serve native communities and recognizing the invaluable contribution of all of the professionals in this field.

Together, these efforts ensure that we not only enhance the public health infrastructure, but do so in a way that honors and incorporates the rich culture and heritage of indigenous communities. Next, we will discuss how this work is being funded and some of the core components of it.

And so, of course, just always like to give credit where credit is due and acknowledge that, you know, the activities that we’re doing here is funded by the public health infrastructure grant. It’s such a needed, you know, effort. You know, we are grateful that we’re able to do that through this funding.

The purpose, I kind of mentioned it before, but again, just to kind of break it down. The TTCW is more than just an initiative, but it really is putting the effort, time, and priority into that relationship building.

And in order to produce something that can be beneficial to both non-tribal public health departments and create that safe space where they might say, “we want to work with some of the tribal communities or tribal people, but you know, they don’t know where to start”.

And sometimes that’s, you know, uncomfortable if you don’t know. And so again, we’re hoping to be that first step in providing some resources to be able to make it a little bit easier, like, who do we connect to? And what are some of the content that my public health department needs to use, and you can look and see what, what your department needs.

In that quest is epistemic repair of Indigenous knowledge and narrative, and addressing and reversing the historical silencing of native narratives. Again, creating that space to teach and look at history and why we’re here now. That’s saying you have to know history and where you’ve been in order to know where you’re at now and where you want to go in the future.

Doing that in a culturally safe environment where it’s okay to ask the questions that you need to ask, and to share that information in a culturally safe environment.

Imagine a centralized hub that restores and strengthens relationships, but also includes indigenous epistemologies within that curriculum. That is done by native scholars and native practitioners.

So what we’re trying to do here is just collect that and put that in a platform where it’s accessible and known. Not wanting to take over some of the great work that’s already being done, but just another outlet for the public health workforce to go. Sometimes it may be a link to some of the great, you know, like some of the tribal epicenters, some of the hubs.

Because I’m from the University of North Dakota’s Indigenous Health, they’ve got some great resources giving credit where credit’s due. But again, just making it easier for someone to access it who’s doing public health work.

If it’s a, you know, state or local public health department making it easy for you to know where can I get this content or access these people, so that we can partner.

GARLIE ST-CYR:

Laura, just to interrupt, you do have about 3 minutes left.

LAURA SAWNEY:

I want to say cool things that we’re trying to do is again, that online resource hub, and you know, this will be that centralized digital platform.

So right now we’re kind of curating. We have a great group of tribal and non-tribal experts, community members, people who have worked in it for, for years together and we call them our collectors team.

But we have our group that’s advising and helping us curate and collect all kinds of different resources. That will go in a centralized hub where we’ll work on developing a user-friendly website that’s interactive and curate some of the pathways. But again, we’re using our partners, whether that’s in health departments, academia, community itself, so be on the lookout for that.

I mentioned the learning pathways, and the National Network of Public Health already has some learning pathways. We’re wanting to curate some additional ones that may not be there, but are needed.

And finally, we’ll hopefully have an interactive map, kind of like this one you see here, where you can scroll through. And if you’re in a particular region, and I need to, you know, do some work here, but I don’t know anybody there. You’ll be able to find your indigenous tribal experts, your tribal liaisons who are working there. So, it’s just a one-stop shop for being able to locate that.

But as well as, you know, like consultants and businesses that are doing that, so that if you’re wanting to integrate not only, consultants, but if you’re wanting to integrate somebody like a native business that does IT or you know, anything like that, that will be a one stop shop to be able to hopefully locate them. So that’s our lofty goal is to do that.

And since I just want to kind of scroll through some of these, so you guys can see them, you know, our timeline if you’re interested in that.

There’s some great information in here about how we’re integrating Indigenous frameworks, the Two-Eyed Seeing, and we’re looking at Indigenous social determinants of health. This actually is from 7 directions, which is one of NNPHI’s, Indigenous Tribal Public Health Institutes. So again, we’re really trying to indigenize it.

We use our 10 Rs of Indigenous research and practice, and hopefully, you can see that image there. As I stated before, we try to really integrate that and set that as a foundation, always honoring tribal sovereignty and teaching about that history because we can’t just assume that everybody knows that history.

We integrate tribal and indigenous status sovereignty. Educating on that, making sure that’s the foundation of it too. And the next steps, we’re always trying to get surveys. We’re public health, right? But please scan this. What this survey does is help us know what you need.

So we’re doing the work now and having our collectors, the cultivating collecting team, bring resources that they know from their networks. But again, if you would be so kind as to take this survey, it will help us know what you guys need and where you might go.

So that, of course, we just want to get some more information for the people that it’s supposed to be serving, which is you guys. So I have to say it one more time, scan that and take that survey. And then the last slide is just our wonderful team, including Garlie. So if you ever need to get a hold of us with any questions, please do so, so much, Laura, right on time.

GARLIE ST-CYR:

Thank you so much to all of our session speakers today. I did drop the resource collection and survey in the chat just so that if you weren’t able to scan it through your QR code, you can click there. Now we are happy to open up these next few minutes for questions.

We see, I have one question here already in the Q&A, but feel free to drop them, and we’ll be sure to try to get to as many as we can.

So, I think this question came through during the first presentation. So for Berta and Vincente, it says how does promotores differ from community health workers or are they similar?

BERTA HERNANDEZ:

They are very similar. We can say they are the same, just that community health workers are mostly all of them. I will say many of the promotores are from the Latino Spanish-speaking community and many of them cannot get jobs.

So, they do their work on a volunteer basis, or they get compensated in different ways, like gift cards or things like that. That’s the difference because the majority of them are undocumented and they don’t have the right to work in the United States. That’s it.

GARLIE ST-CYR:

Thank you so much for answering. We just marked that the question has been answered, so feel free to keep dropping questions in the chat or in the Q&A. So here’s another question for Berta and Vincente.

What would your advice be for other local health departments who are wanting to get started with working closely with Promotores communities? What would an essential first step look like? So, asking for advice on how to engage with that community, and where to start.

BERTA HERNANDEZ:

Do you want to answer Vicente?

VINCENTE CORDERO:

I’ll let you go first, Berta, and then I’ll add afterwards.

BERTA HERNANDEZ:

OK. I think that if they start the relationship in whatever place they are at, they should reach out to community organizations that serve the Latin immigrant community. I think for sure they are already in communication with promotores within their client base.

There are people who have those skills or those who are interested or who already function as promotores even in an unofficial way. They may have promoters programs, but they may also have clients that are leaders within the clients base and those are prospective promoters. So I think that will be my, the first step reach out to those organizations.

VINCENTE CORDERO:

Something that I’ll, I’ll add to is something that I’ve recognized through our work is that, you know, working for a health department, there are lots of different skill sets that people have depending on which branch or which division or which office or which group you’re a part of.

And I think it’s worth considering what internal readiness looks like at your organization in terms of staff’s capacity to engage community members who are not monolingual or primarily English-speaking, because that’s something we’ve sort of contended with and navigated in our space.

All of our programming is done exclusively in Spanish for the promotores, and that inherently sort of limits what engagement can look like. And something that we recognize is that not everybody who is a staff person at the Department of Public Health is necessarily comfortable engaging communities where they aren’t able to understand the conversation that’s happening.

So a recommendation that I would have is to look internally and see what offerings there are, what sort of training or opportunities exist to begin to integrate staff into community spaces and make them more comfortable engaging community members and promotores directly.

GARLIE ST-CYR:

Thank you both for providing some insightful answers. I think we have time for one more question, which I see in the Q&A box, and I think this one can go to Laura based on the question that I’m seeing. And if you can try to answer within like 30 seconds, that would be great.

But the question is, are there resources or opportunities to bridge the knowledge gap around tribal health and public health university or public health college programs?

LAURA SAWNEY:

Yeah, so actually we have several. We have AHEC direct members, we have some NIHB, but definitely that’s one of the things that we’re looking at.

That’s one of the things that we’re looking at is not only curriculum or making pathways for learning, but pathways for public health, you know, to get people in there for public health. So we’re kind of doing that simultaneously. But yes, that’s definitely on our radar and we have people who are actively working in that now, which is why we kind of nudged them in the first place.

GARLIE ST-CYR:

I’ll add a little bit to this just because I work with the program a little bit.

So it’s great to have, you know, a lot of folks who are from health departments and non-profits. But at the Cultivators Collective, we do have a few people who are either working at a university through a center or our students themselves through those programs. So providing that insight as well.

All right, well, thank you so much for all your questions. I’m sorry we don’t have any time for additional questions at this time, but we really hope that you enjoyed today’s session.

Thank you for listening in and asking your questions today. So that concludes this session at least. There are plenty more sessions to be seen in the next few hours, but for now we just thank you and have a good rest of your day, everyone.