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Good Medicine
U.Va. volunteers make a difference in Southwest Virginia
Adults and children receive free food and drink
Photographs by Donnie Sorah / The Coalfield Progress
Adults and children receive free food and drink as they wait their turn to see health care professionals at the RAM clinic. The grandstand of the Wise County Fairgrounds horse ring serves as a waiting room.

By John Mongle

WISE, VA. — Karen Maxton described to a middle-aged woman a series of tests that a doctor had just ordered for her. There was to be a blood count, a urine test and others. For Maxton, a phlebotomist supervisor at the U.Va. Medical Center, it was work as usual — except for where she was and the patients she was seeing.

Maxton’s lab on that sweltering late-July afternoon was in a tent built with white tarpaulins. Her desk was a folding table; climate control was an oscillating fan. The ground was soaked from recent rains.

“We are walking around on a tarp with mud underneath it,” said Jessica Monroe, with the University’s Neo-Natal Intensive Care Unit. “It’s like walking on a water bed, but we are having fun.”

Maxton and Monroe were among two of more than 100 volunteers from the University at the Wise County Fairgrounds — a more than five-hour drive from their air-conditioned offices and state-of–the-art labs — who helped out in the fifth annual Remote Area Medical, or RAM, Clinic, held July 23-25.

Preliminary results showed more than 6,000 patient “encounters” (one patient could have more than one encounter). The U.Va. team, which was joined by other volunteers from around the state and the U.S., accounted for well more than half of the medical staff there.

Dental instruments laid out and ready for use.
Dental instruments laid out and ready for use.

Maxton’s patient was tired and worried. She arrived early in the morning and was talking to Maxton late in the afternoon. She waited for months for a chance to see a doctor and find out why she hasn’t been feeling well. The wait at the fairgrounds was long as well.

“We would like to have two or three more phlebotomists and a couple of more tables,” said Maxton. “These girls haven’t sat down. They’re drinking hot bottled water, but they are hanging in there.”

Couriers ferried specimens in coolers, packed in dry ice, to local hospitals and back to the University, but that was only part of the logistics battle. Before she left Charlottesville, Maxton, who supervises 30 people, had to make sure all of the shifts were covered for the staff members she brought with her.

“That is a major deal,” she said.

Virginia’s coalfields are plagued by low wages, high unemployment and no health insurance. For many, this was their only opportunity this year to see a doctor, a dentist or to have an eye exam.

“ You expect this kind of need in another country, not in this state,” said U.Va. pharmacist Michelle Hobbs, who is making her third visit to Wise County as a volunteer. ”People down here are wonderful, and they are very receptive to our help.”

Preparation for her three days in the field started in January as she began to collect medicine to load into a rental truck for the long journey. She rounded up drugs from pharmaceutical company representatives, including antibiotics and hypertension, diabetes and cholesterol medicines.

Generic drugs were supplied through the University Hospital budget and by Remote Area Medical, a nonprofit, volunteer organization providing care to the uninsured, underinsured and the unemployed. The program started in Virginia’s coalfields after Sister Bernadette Kenny of Bon Secours St. Mary’s Hospital in Norton helped out in a similar clinic in rural northeastern Tennessee.

Currell Tiffany, with his back to the camera, of Leesburg Lion’s Club, administers a hearing test
Currell Tiffany, with his back to the camera, of Leesburg Lion’s Club, administers a hearing test to Charlotte Gruber of Lebanon, Va.

Hobbs managed to solicit and bring over $200,000 in prescription drugs to Wise County, with the total worth of medical supplies on hand for the weekend topping $1 million.

“She is the unsung hero in this group,” said Dr. Claudette Dalton, who led the U.Va. group. “She worked with the dental folks to get a voucher system going for pain medications, since we do not bring narcotics.”
Dalton’s commitment to the project is stalwart, as is the commitment of those whom she brought along.

“People down here are tough, and all they want is a little help,” Dalton said. “We try to look at these people as members of our family who’ve fallen on hard times.”

More than 1 million Virginians are underserved when it comes to healthcare, so Southwest Virginia is not unique, but the problem is focused there because it affects so many in the population.

“In the United States, 18 percent of the population has hypertension; here it is 50 percent,” said Dr. Ross Isaacs, a U.Va. nephrologist making his fourth trip to the RAM clinic. “Eight percent have diabetes nationally; here it is one in three. The problem is, these are preventable diseases.”

Isaacs voices the adamant commitment of the entire U.Va. group: “I will be back as long as the problem is here.”

“It is a sad statement that the main way these people get health care is when people have to come from all over to provide it,” said Dr. Moe Nagjarni, a University internist. “The success of our mission is an indictment on the health care system.”

Carl Hale, 14, of Cleveland, Va., is anesthetized by dentist Ben Campbell
Carl Hale, 14, of Cleveland, Va., is anesthetized by dentist Ben Campbell. Hale received five
fillings at the Remote Area Medical Clinic, held July 23-25 and supported by U.Va. volunteers.

Volunteers came from U.Va., local Wise County hospitals, medical practices and clinics, Virginia Commonwealth University’s School of Dentistry, the Lions Club eyeglasses program and from around the country to help out.

“I think this is absolutely one of the most meaningful efforts that takes place anywhere in Virginia,” said state Secretary of Health and Human Services Jane Woods, who volunteered and helped raise money for RAM this year. “The blessing is there are so many talented people willing to pitch in. And the tragedy is that the need is here, but blessings overcome tragedies.” Medical personnel take contact information and follow up with patients on their test results, and make local referrals or arrangements for transportation to Charlottesville should a patient need a specialty not found locally.

The three days in late July produced over 3,000 medical exams, over 1,200 dental visits and over 1,000 eye exams, with glasses provided to the patients.

“In terms of the big picture, this is a Band-Aid that is repeated every year,” said Nagjarni. “We are not addressing the underlying problem.”
But, for Edna Banks of Coeburn it was a chance to get needed glasses and blood work.

“I love it,” she said. “The people of Wise County need this. I hardly have enough money for groceries – to me this was a Godsend.”


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