Saturday, October 25, 2014

Remote Area Medical ~ Hospital under the Big Top

07/16/2008
RAM eye exam

The Remote Area Medical clinic, providing free eye and dental care, set up at the fairgrounds in Wise, Virginia, last July
Photo: Getty Images

Cars began lining up outside Chilhowee Park in Knoxville, TN, at midnight. It was early January. But despite 27 degree temperatures, the passengers had come to wait for seven hours -- to see a dentist or optometrist they could afford.

Relief corps and ventures to provide health care to those who lack basic assistance are no longer limited to Third World countries. Massive aid centers, volunteer medical staffs, and lists of people waiting for help are not just found at foreign aid stations. Working Americans are finding themselves lining up for free medical aid, revealing the growing gap between the wealthy and poor in the United States. Remote Area Medical is helping to serve Americans who cannot afford health care.

Remote Area Medical Volunteer Corps (RAM) was founded in 1985 to provide medical care to some of the poorest and most remote areas of the world. RAM is a non-profit, volunteer relief corps that provides free dental, eye and veterinary care to the underserved of the world. Volunteers collect supplies, medicine, facilities, and more. They travel as far as the Amazon jungles to assist those in need. RAM operates solely on the generosity of the American people and has no corporate sponsors. In fact, last year the organization survived on only $250,000 but treated 70,000 people.

RAM volunteers now find themselves in Appalachia helping working class Americans who cannot afford health care. Today 60% of expeditions serve rural America. The shift is evident in their program Rural AMerica- a program to provide dental and eye care to rural, mainly Appalachian, communities. RAM's website stresses "Poor dental health is a frequently seen problem in the hills of the southern Appalachians, and RAM's services are desperately needed."

The majority of those who come to the clinics have jobs; they simply cannot afford health care. Many Appalachian residents work hard but rising medical costs and limited local dental and eye care force them to look to services such as RAM.

ram headquarters in Wise, VARAM health care workers saw a steady stream of patients at the Wise County Fairground, July 2007
Photo: Josh Nash

On a typical RAM expedition, health care specialists make a weekend trip to a specified area- usually setting up in a high school or other local venue. Upon arriving, the RAM team sets up dental care stations and eye exam stations, and sometimes provides routine medical tests such as pap smears and mammograms.

The clinics open early in the morning; patients each take a ticket and are seen on a first-come, first-served basis. Those tickets are the only hope some people have of seeing a health clinician. Some have suffered multiple heart attacks but cannot afford follow-up visits to a doctor. Breast cancer survivors come to RAM clinics for mammograms that they can't pay for. Some people arrive barely able to see until they receive a new pair of glasses, free thanks to RAM.

When RAM came to Knoxville, Tennessee, in January, people started arriving at midnight, even though the doors did not open until seven -- and temperatures dropped below freezing that night. Asked why they'd come to early, people said they "just wanted to be seen" by a medical professional.

Long lines of people waited to see the doctors, nurses, and dentists at RAM's 2007 clinic in Wise, Virginia
Photo: Getty Images

In fact, RAM usually cannot attend to everyone who comes to their mobile clinics. When Stan Brock, the founder and leader of RAM, called the last number in Knoxville, four hundred people were left standing at the gate - unable to receive medical attention. "That's the lousy part of this job," he told CBS reporters.

Even so, Remote Area Medical has delivered astounding results. As of June 16th, 2008:

Total Patient Encounters 357,368
Total Value of Free Care Donated via RAM to the underserved $33,079,038
Total Number of RAM Volunteers 36,675
Total Glasses Given 70,704
Total Teeth Extracted 109,555

Brock notes that numbers of patients are rising at RAM clinics. Is this increase because of RAM's growing notoriety or is it the rising cost of health insurance? Either way, Remote Area Medical is becoming the last hope for many Appalachian Americans who work hard but still cannot provide health care for themselves or their families.

Here is the RAM schedule for 2008. The next expedition will be July 25-26 in Wise, Virginia.

Comments

Medical Care in Appalachia

I really appreciate this story -- as painful as it is to read. I've followed the health care debate for a long time, even devoted several months in 2002 to writing about the politics of unversal health care but RAM's existence somehow had escaped me. While I'm really grateful to know they exist and grateful for what they do, it highlights for me the shameful state of our health insurance system in this country. The wealthiest country in the world shouldn't have to take an economic triage approach to delivering health care. Every other industrialized country has figured out how to provide universal coverage while spending less than we do per capita while our political leaders spend their time trying to to figure out how companies can make a profit from illness. Thank you for bringing this effort to our attention.