Suzy Allman Photography

Remote Area Medical

Remote Area Medical Volunteers Expedition to Wise, Virginia

During one weekend in July, volunteer doctors, nurses, dentists, pilots, and support workers set up a no-cost clinic at the Wise County fairgrounds in Wise, Virginia and, with the help of donated medical supplies, medicines, facilities and vehicles, brought much-needed health care and relief to an Appalachian community.

   
  
     
  
During one weekend in July, volunteer doctors, nurses, dentists, pilots, and support workers set up a no-cost clinic at the Wise County fairgrounds in Wise, Virginia and, with the help of donated medical supplies, medicines, facilities and vehicles, brought much-needed health care and relief to an Appalachian community.
   
Wise, Virginia, lies in the heart of Appalachia, in coal country. Its people are poor, hard-working, and find basic health care difficult to afford.
   
Stan Brock founded Remote Area Medical (RAM) clinics as a way to bring free medical, optical and dental care to poor, unemployed, uninsured families, children and adults in remote areas of the United States and the world.Brock flies a historic DC-3 carrying medical equipment and supplies to the remote areas where the clinics are held.
     
  
The RAM expedition to Wise, Virginia, begins early for its patients. At four a.m., two lines are already stretching behind the gateway to the Wise County Fairgrounds, where the health clinic will take place over the next three days.
   
Patients arrive as early as the night before to get in line for free medical treatment. Children play in their pajamas in the parking lot.
   
"They are poor, uneducated, disabled, unemployed; they are deathly afraid of needles. They have true dental pain. For them to show up, travel through the night, sleep in their cars, line up at 5:30 in the morning, wait in the sun and rain for long hours...they have true pain or they wouldn't show up." - Miles Wilhelm, oral surgeon
     
  
Joseph Mullings, with his wife Benita. Joseph has seven teeth removed for at the clinic, because private practice was not affordable for him."Now they charge five hundred dollars to put you to sleep, and one hundred dollars a tooth, so they would have charged thirteen-hundred dollars. He had the money to get four out, but then they started talking big money. Teeth is serious business." Benita Mullins
   
Cecil Hurley smiles at the end of a long dental procedure, where his remaining seven teeth were removed.
   
Rain falls on the clinic early in the second day. Garbage bags were distributed to keep patients dry as they waited in line.Chelsea Clark, 8, is getting glasses while her mother needs dental work.
     
  
Dr. Warren Huff puts a hand on the shoulder of a patient who is afraid to have her teeth removed. They are, in his words, 'blown out', and need to be extracted.
  
Vital signs are checked in Old Macdonald's Dairy Barn. The barn is the first staging area through which patients move on their way to medical, dental and optical care.
   
Dental procedures are a large part of RAMs services. The RAM dental program has grown from offering only emergency extractions in the early days to include restorations, cleanings and fluoride treatments today.
     
  
Patients arrive early to reduce their wait for routine procedures, like fillings.
   
Patricia Fleming tries on a new pair of eyeglasses in the rear-view mirror of a truck parked near the eyeglass station. Debbie Chafin, from the Park West Lions Club in Manassas, Virginia, helps her choose a pair.
   
A patient tries out a new set of false teeth. The process of obtaining new teeth begins a day before the official opening of the clinic, when patients make wax impressions of their mouths. Delivery of the final product takes several weeks.
     
  
Much of the volunteer service at the RAM expeditions comes from medical and dental schools. Patients get free service; students learn from the experience of pure, in-the-field medicine under less than optimal conditions. They learn, too, how to offer comfort and connect with their patients.Avery Burgess from the VCU dental school, with patient.
   
"My wife and I get here at about 5:30 am to have the first person in the chair by six o'clock. We'll work until 7, with about a fifteen minute break for lunch. Today - I can tell you exactly how many teeth I pulled - 125."
   
Virginia Commonwealth University dental student at the end of the day at the clinic. For most doctors and dentists, the day starts before the first patient at 5:30, and ends close to 7.
     
  
   
Tommy holds his girlfriend's hand as she has twenty-three teeth extracted. She is twenty-one years old. "Every night, I hear her crying", Tommy says of her chronic dental pain.
   
Sheets hung in a barn offer some privacy as Margaret Miller, an internist with the University of Virginia, carries out a patient interview.
     
  
   
  
A dental student pauses at the end of a long day of oral surgery. For most of the medical volunteers, the day begins well before the first patient is in the chair at 6:00 am, and ends close to 7 pm.
     
  
Patients wait in the 85-degree heat during the first day of the clinic; water, drinks, and sandwiches are handed out while they wait.
   
Cecil Hurley smiles a toothless smile at the end of a long dental procedure. He had seven lower teeth - the only ones left in his mouth - removed.
   
Dr. Miles Wilhelm writes a prescription for a patient who has had five teeth removed. Prescriptions are filled in a trailer on-site. "The biggest thing I get out of coming up here: it's pure dentistry. There's a minimal amount of burocracy, and a maximum amount of work." - Miles Wilhelm, oral surgeon
     
  
   
  
     
  
   
A cold drizzle falls on the second day of the clinic
  
     
  
A patient's first encounter with health volunteers begins in the Old MacDonald's Dairy Barn. Ruth Jacoby gets medical bracelets ready to put on the patients as they enter the clinic.
   
  
     
  
   
An order for dentures will take days to fill. Patients arrive before the official start of the clinic, on Thursday, to wait to have an imprint made. Dentures will be fitted at the clinic, but the final product won't be completed and delivered until later in the year.