MONTREAL -- Regional health authorities, community groups and places of worship in Montreal's most diverse neighbourhoods are working hard to adapt health instructions to the realities of their multiethnic populations.

Cote-des-Neiges, a densely populated area in the heart of the city where more than 50 per cent of residents are recent immigrants, has been one of the places most affected by COVID-19 in Quebec during both waves of the pandemic.

More than 40 cultures are represented in the area, said Valerie Lahaie, public health and partnerships coordinator at the regional health authority that covers west-central Montreal.

"It's enormous," she said, adding that there are many new arrivals and refugees in the neighbourhood.

Because residents speak a large number of languages and dialects -- more than 100 -- it was necessary to translate instructions from health authorities, as well as information about the lockdown and curfew into multiple languages.

An informational leaflet is now being distributed in the area in 18 languages. Another, explains isolation instructions with the help of pictograms.

There's also what workers in the neighbourhood have dubbed the "truck crier." Equipped with a loudspeaker, it roams the street of Cote-des-Neiges broadcasting instructions in 12 different languages.

The multiethnic character of Cote-des-Neiges isn't unique in Montreal, said Dr. David Kaiser, the doctor in charge of environmental health at Montreal's public health department. Other neighbourhoods, like Montreal-North and Parc-Extension have diverse populations and have been some of the most impacted by the pandemic.

"We have to adapt our communications" to ensure they're understood, he said. "It's an ongoing challenge to be able to reach the multitude of communities in Montreal."

Cote-des-Neiges also has more than 200 places of worship, which have been the sites of large gatherings. Health regulations have varied during the pandemic, at times restricting the number of people who can be in a mosque, church, temple or other place of worship at the same time.

To take this reality into account, the regional health authority looked to Alexis Jobin-Theberge, a senior advisor at the Regional Program for the Settlement of Asylum Seekers, who is now also a member of the health authority's "COVID brigade."

A calendar of religious festivals was created, he said, in order to contact places of worship before the beginning of celebrations to offer them advice and support.

For example, before Ramadan, workers at the regional heath authority called mosques. A similar approach was taken for holidays celebrated by people of southeast Asian origin.

"We also made them aware about high risk activities associated with certain religious practices," he said, giving the example of singing, which can project contaminated particles into the air. Health workers suggested, for example, that singing be done outside, he said.

Religious leaders also helped relay information to the community, he said.

"We created links with them."

Religious leaders helped keep health authorities updated on the needs of the community, he said, and helped them adjust their message.

On the ground, awareness workers in the Cote-des-Neiges area see the importance of these initiatives.

People understand the reasons for the health instructions but there's often a language barrier, Antonin Benoit said as he distributed kits containing a mask, gloves and information leaflets in front of the MultiCaf, a community organization that helps low income people access healthy food.

The community workers aren't all multilingual, though some have mastered Spanish, Arabic and Creole.

Reaching people in their own language makes them feel respected and has been a "miraculous solution" for getting people to follow prevention measures, said Jean-Sebastien Patrice, the director general of MultiCaf and the coordinator of a community initiative fighting COVID-19 that's supported by MultiCaf, the Greater Montreal Foundation and the Red Cross.

This report by The Canadian Press was first published Jan. 30, 2021.