800 medical professionals. 1,800 volunteers. 2,700 patients. 1 weekend of free health care.
by Sierra Bellows. Photographs by David Deal
Founded in 1985, Remote Area Medical is an all-volunteer charitable organization. Volunteer doctors, nurses, pilots, veterinarians and support workers participate in expeditions (at their own expense) in the United States and around the world. Medical supplies, medicines, facilities and vehicles are donated.
When dawn comes to the Wise County Fairgrounds, color seeps back into the red cliffs, the air is cool and dew is thick on a field that serves as a makeshift parking lot. People begin emerging from cars in which they’ve spent the night, sleeping or not, awaiting the opening of the Remote Area Medical (RAM) clinic. Beige tents serve as temporary examination rooms, and trailers hold diagnostic equipment and laboratories, where patients can get an ultrasound or a blood test or dentures. The fairgrounds look like a cross between a carnival and a military installation. Patients wearing brightly colored wristbands that read “medical” or “extraction” wait in long lines. Dentist chairs fill an open-air tent the size of a gymnasium, and generators drown out the sounds of the drills they power. Volunteers pass out bottles of water, bagged lunches and pamphlets about cancer. A nurse circulates through the crowd testing blood sugar with a quick finger prick.
More than 240 medical professionals from the University of Virginia Health System are among RAM’s volunteer staff; they are easy to spot in their orange T-shirts, their stethoscopes and walkie-talkies. Among them are cardiologists, nurse practitioners, endocrinologists, neurologists, social workers and emergency room physicians. “There are areas of the country, and certainly Wise County is one of them, where there just aren’t [enough] physicians,” Dr. Susan Kirk, an endocrinologist from UVA, tells NPR.
UVA’s association with the clinic began in RAM’s first year in Virginia when Audrey Snyder (Nurs ’89, Grad ’07), a Ph.D. emergency department clinician and nursing professor, brought several members of the Nursing Students Without Borders along with her to Wise. The University’s first clinic participant remains one of its most devoted: Snyder received the UVA Health System’s 2009 Community Service Award, largely in recognition of her dedicated support for RAM.
“The [UVA] Health System supports health services in this part of the state all year long,” says Dr. Scott Syverud, an emergency physician who coordinates the efforts of the UVA volunteers. “This event is just the most visible part of a much larger effort.” At RAM, doctors see many of the same diseases they see at the UVA Health System, most commonly diabetes, high blood pressure and high cholesterol. “Sometimes local medical providers will refer patients to the RAM clinic to get testing that would otherwise be unavailable or too expensive,” says Syverud. “We do lots of mammograms, ultrasounds and lab work here.”
In the medical tents, drapes partition off each examination room and sound travels easily from one area to another, soft voices asking questions, giving medical histories. A sanitized poultry barn has been fitted with optometry equipment. A converted 18-wheeler opens to reveal a mobile X-ray room.
The RAM clinic has been held in Wise for 10 years now and has treated more than 25,000 people. This weekend alone, the clinic will provide 2,671 medical exams for patients from 16 states: 51 percent of them have no insurance, and 40 percent are on Medicaid or Medicare. The RAM organizers paid about $250,000 out of pocket to run the event, while providing an estimated $1.5 million worth of care.
By noon, the sun beats down on the fairgrounds, patients and doctors alike seek shade inside the tents. Volunteers handing out bottled water from a golf cart encourage everyone to drink. “I saw a woman faint last year,” a woman waiting in line says, holding her still-cool water bottle against her neck. “I guess if it’s going to happen, though, it’s best that it happens here, where there’s a doctor in the house.”