On Navajo Nation, Community Health Representatives Provide Essential Support Amid COVID-19

Marlene Nez won't let anything get in the way of helping her community, including COVID-19—despite challenges including exposure and needing to quarantine.

As a Community Health Representative (CHR) on Navajo Nation, it is Marlene’s job to ensure individuals and families have the resources—clean drinking water, food, medication—and assistance they need. Though she’s been a CHR for 3 years, her daily home visits look much different these days due to the pandemic.

“We are not able to go into homes. And if we do have to deliver food, then it’s really hard to just stand in the doorway and say that we are just here to drop off these items,” says Marlene. Her elders really want to be able to spend time with her, but she has to let them know she can’t because of the pandemic.

As much as Marlene would like to spend time with those in her tight-knit community in Greasewood Springs, Arizona—a small, rural area west of Gallup, N.M.—she knows that it’s in everyone’s best interest to keep their distance from each other.

“She is always very careful in her work and is very compassionate,” says Olivia Muskett, Community Outreach Specialist at Community Outreach and Patient Empowerment Program (COPE), Partners In Health’s (PIH) sister organization on Navajo Nation. “You can really see how much she cares for her community and how she’s always thinking about others before herself.”

Marlene has always sought ways to help others, long before becoming a CHR. She previously worked in the health field, and most recently has worked helping support many patients. With a desire to give back to the community where she grew up, she applied for a CHR role, which involves robust training including being a Certified Nurse Assistant.

She is one of about 100 CHR program staff on Navajo Nation, who work under the Navajo Nation Department of Health, and form the community foundation of Navajo Nation’s health system. COPE was established in 2009 as a collaboration with the CHR Program, but CHRs have been working with community members since 1968.

Because of the pandemic, CHRs’ role has become even more essential across Navajo Nation, which experienced the highest rate of COVID-19 infection in early months—outpacing even New York City’s. Most recently in the second surge, Navajo Nation is again experiencing one of the highest incidence rates in the country. Marlene and her colleagues have consistently connected families in quarantine or isolation with the essentials they need to remain healthy or overcome illness.

Deliveries, Decisions, and Delegating

When Marlene isn't on the road delivering essentials, she is busy working to find out what individuals need and how to get it to them. Usually, she’s able to offer direct support, but oftentimes it has involved bringing in other key groups, such as St. Mary’s Church, the Navajo-Hopi COVID-19 Relief Fund, and World Central Kitchen.

Marlene explained additional challenges that affected her community this summer, “I ran into one of my clients at the grocery store and asked how she was doing, and she informed me that they were really struggling with water because the well dried up, so I had to go back to my chapter and let them know that community members may be in need of water.”

In came the Water Warriors United team, who were able to distribute water and water barrels. The efforts didn’t stop there though. Marlene also took it upon herself to notify the chapter manager of how the Navajo Incident Command System (ICS) could assist community members. While ICS worked to fill the chapter’s request, the chapter used their own funds to purchase about 100 cases of water.

“It was a real surprise and blessing for our community members,” says Marlene. “I’m glad that I was able to work with the chapter manager on this and that I have a good working relationship with the chapter.”

Marlene remains optimistic and hopeful. Even though the pandemic has had a disproportionate impact on Navajo Nation, she has seen that families are so dedicated to caring for each other and that has been incredibly meaningful during this difficult time.