Region IV Reflections: Stronger than we think
Region IV Reflections: We are stronger than we think
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Meet Audrey Arona, MD, District Health Director
Audrey Arona, MD, graduated from the University of California, San Diego, with a degree in Cell Biology & Biochemistry and thereafter graduated from the University of Cincinnati, College of Medicine. She completed an OB/GYN Residency at the University of Southern California in Los Angeles, began private practice in San Jose, California, and later moved to Lawrenceville, Georgia where she owned and operated an OB/GYN private practice for 20 years. She currently serves as the Chief Executive Officer and District Health Director of the Gwinnett-Newton-Rockdale Health Department.
Our Health Department is a district in Georgia serving three Counties, including one of the most populous. We are charged with protecting and improving the health of 1.3 million residents. When the pandemic first hit we mobilized our incident command system so we could provide guidance and support to our community partners. We had to organize our response – logistics, planning, programs, and communications – to ensure a prompt response, to have accountability and responsibility divvied to the right location so we could work smoothly together. Our first major charge was to set up mass testing sites so we could help our community discern positive infections and institute quarantine isolation guidance. We conduct case investigations, contract tracing, and provide instructions and guidance based on CDC guidelines. Our focus is mostly on vaccinating right now, including the operation of two mass vaccination sites.
Reflecting on Challenges and Growth
Our focus is on vaccinating right now. An important part of that is equitable distribution among the diverse population in our community – seeing that everyone has equal access to the vaccine. We are trying to get in front of African American churches and Latino churches, the places where leaders of those diverse populations are, to use their voices to connect with those in the community. Those who have the deep relationships with diverse groups in the community are very influential. I’m trying to put my face in every church, in every organization asking ‘Can I please be part of your event and address your audience?’. To play a role in providing accurate and timely information, answering their questions, and sometimes just be a listening ear. Having a persistent message and being transparent will go a long way in developing trust in our community.
It takes a lot of work but I know the effort is worth it. We are seeing a larger uptake in more diverse communities being vaccinated. We are working on strategies with community partners, like View Point Health and others, to leverage those relationships and gain access to individuals who may be hesitant or lack access to the vaccine. It just takes time to get into these communities and build trust, build a relationship.
I am an optimist – I even look for the positives that come from the pandemic. One of the great things that everyone in public health can acknowledge is the fact that public health awareness and relevance in our communities was amplified dramatically. We have always had close community partners, but they have grown, become richer since the start of the pandemic. We really want to leverage the relationships and the public exposure we have gained this year.
It takes a lot of work but I know the effort is worth it. It just takes time to...build trust, build a relationship.
Reflecting on the Value of Partnerships
We are so thankful for the unbelievable partnership with View Point Health, a local community mental health clinic serving our district. Our partnership started years ago, and I would add, start building those relationships now -- do not wait for a crisis! Our team had the idea to incorporate mental health staff into our response team because of the mental health needs we encountered during past emergencies. When we looked at our work, our response efforts, we noticed gaps in mental health that our partners at View Point Health could easily fill. In a crisis situation you need mental health help. We saw that in our Hurricane responses and during the pandemic. When first tasked with setting up our community COVID testing sites, we knew View Point Health would be a huge asset. We built them into our process to do a check-in with individuals being tested because of the fear and unknown related to the virus. Having View Point Health staff be part of the response was comforting for the community. We knew this pandemic would take a toll on individuals; we never imagined the magnitude and our partnership has been a blessing.
We knew this pandemic would take a toll on individuals; we never imagined the magnitude and our partnership has been a blessing.
Supporting Staff Well-Being
We have public health staff who are committed to being here. We are short staffed. Our team works extremely long hours, and they face persistent day-to-day challenges. It has been a huge mental task when there seems to be no end in sight. They feel the call to show up every single day, and we love that about them.
Supporting our staff has been different this year. Generally, you devote a lot of resources up front and then you get back to normal relatively fast. But this has been a year-long crisis. We recognized the fatigue our staff was feeling. We encouraged our staff to take a day for mental health. As leaders, we took mental health days so the staff could see we were taking mental well-being seriously. We also had a dedicated scream room in our health department – a soundproof room we use for audio/video production – we changed it by adding a couch, dim lighting, and a fridge with snacks where people could get away for an hour.
Celebrating milestones also took on a new meaning. We are unable to do large, in-person staff appreciation events due to restrictions. We had to get creative in terms of how we show appreciation. We had drive-through lunches with gifts and notes from the supervisor or leadership thanking them for their great job. We held virtual bingo games, which was hugely popular. We also had our version of healthcare heroes – called health department heroes. We snapped a picture when the staff member was not aware and would post it to our weekly newsletter highlighting their important work and efforts.
Our partnership with View Point Health has also been instrumental in finding ways to support the well-being needs of our staff. I think our staff enjoyed the service dogs provided by View Point Health. It allowed our team just to take a mental break. The daily stress felt by our staff, day in and day out, in providing this service to the community, was really difficult. It was amazing to see the number of smiles and the tension relief that came with just an hour with the service dog.
They feel the call to show up every single day, and we love that about them.
Finding Balance Personally & Professionally
Finding that balance has been one of the hardest things this year. Things seem to change every single day. You can prepare for this today and things change the next day. Professionally, one important thing for me was our incident command structure, where leaders were in the room twice a day communicating. I think that communication during our leadership meetings was instrumental – not only in supporting our community but supporting our team, supporting each other, supporting me. I also think that because of our partnership with View Point Health, our staff is more cohesive. Witnessing my staff provide support for each other has been immensely helpful. The togetherness of our team seems to have gotten us through.
Personally, I have tried to do the things I would encourage my staff to do: cherish down time and family time, ensure plenty of rest, and make intentional prioritizations for time and a reset of my goals. On a more personal side, I practice daily prayer searching for wisdom, guidance, and the ability to extend grace and a sense of calm for my community that is very fearful.
Witnessing my staff provide support for each other has been immensely helpful. The togetherness of our team seems to have gotten us through.
This past year has been challenging for us all. I have learned a lot about myself, my team, and our organization’s role in the community. First, our organization is a lot stronger than we think. Second, the staff of our organization has hearts for service beyond what is expected. And third, we have identified some incredible leaders within our staff and going forward we will use them and their talents in larger roles.