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Remote Area Medical Treats America’s Other World

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 photo 140720WiseRAM_2_zpse6420519.jpgIt is been called a field hospital, but really isn’t. There is some minor surgery, mostly dental, but most care falls into more clinical than surgical. An impressive endeavor in any case and outclasses any medical or dental activity the U.S. military routinely provides overseas. That was striking.

Odd what catches one’s attention. The nice tents and orderly processes were expected. What caught my eye was the condition of the Wise County Fairgrounds as the Remote Area Medical (RAM) effort came to an end. The clients left the grounds far tidier than I would have ever expected. In fact, quite clean. A sign of respect? Or just the nature of people in this part of Virginia. Everywhere you go people are friendlier and more open to strangers than in more urban areas.

At the close of this RAM I was told that the last count at mid-morning had been 2,700 and that the total was likely near last year’s 3,000 treated. The numbers are misleading. At every RAM, people are turned away and there is no accurate count of those. If the capacity supported more, the numbers would have some meaning. What is clear is that demand is growing either from awareness or economic conditions.

What I didn’t know is that Wise is just one of three clinics that RAM has organized in far Southwest Virginia this year. Next: Jonesville, Virginia; 13 – 14 September. Then: Grundy, Virginia; 4 – 5 October. What I didn’t expect was the efficiency of the breakdown of the camp. I now want to take part in and watch the arrival and assembly. For those who want to volunteer, information is available at the RAM website. Note that you should register early as registration can close; it closed a month before the clinic in Wise.

Another thing I didn’t realize: the State Fairgrounds at the center of Oklahoma City, The Seattle Center in, of course, Seattle, and the Manhattan Convention Center in New York City now qualify as “remote.” New York City! Clinics will be held at those locations in August, October, and November respectively. What does this say about health care in the United States? I am not really sure other than something is amiss.  

RAM tents photo 140720WiseRAM_1_zps0ccc7c15.jpgBut back to the field hospitals and clinics. One of the things the military considers when it does what are capability demonstrations overseas is ensure we do nothing to disrupt indigenous services. We try to enhance but never replace. Otherwise our efforts would be counter-productive by displacing, maybe permanently, a portion of the economy. Another thing we consider is the fact there very likely will be no follow-up unless it is domestic.

So here is one of my concerns. There are people in Southwest Virginia who now count on this clinic for service and at the same time say they don’t want expanded Medicaid because they want to be independent of the government. Does RAM actually work against developing more permanent and reliable local medical services? This is not to argue against RAM in any way at all. It is clearly needed and appreciated. But does this maintain Americans in eternal health limbo? An other world? I just wonder.

And having said that, I wonder if efforts like these would not be appropriate exercises for military field hospital units during their summer drills. Even if the only thing provided were the mobile infrastructure in cooperation with the RAM’s civilian organization of the medical staff and personnel, it seems RAM’s efforts could be leveraged. Obviously this isn’t just a rural thing. I just wonder.

  • Jim B

    Those that don’t want a so called government handout have bought the republican line including the hook and sinker. If these people have payed one cent in taxes they are just getting back something in return for their taxes.

    These free clinics are not totally free since the people involved have probably used some involvement by the government.

  • Jim B

    What I mean by govt involvement is does anyone think that all those that participate in the clinic are not going to take a charitable tax deduction like mileage to and from the event or donations of materials?  

  • Elaine in Roanoke

    The folks served by such RAM efforts have had so little health care in their lives, I’m betting, that to them going to such venues and getting assistance for their very severe problems is normative. It would be quite instructive to survey those people (survey done by people they trust completely) to find out what are their objections to expanded Medicaid that would benefit them. If I were to venture a guess, some results would be:

    1. “Medicaid is a welfare program. The only people who accept welfare like that are lazy people  who have no initiative.” (This from some people who are taking advantage of government programs themselves.)

    2. “Obama and Obamacare are bad because Obama is a ‘socialist’ ” (I won’t t translate why they really mean to say about President Obama and what they think   he is.), and Obamacare is “socialized medicine” like Britain has.” (How do they know? Rush Limbaugh and Fox News said so.)

    3. “Democrats should be called ‘Demoncrats.’ ” (After all, every election they hear at church how they should vote.)

    I guess I’m letting my disdain for the propagandists who have poisoned the very air out in SV Virginia show. Sadly, the part of Virginia that is whitest, oldest, and least educated votes against its own interest constantly.

  • kindler

    …that getting a taste of normal healthcare would leave people wanting more of the same, rather than filling the need.  

    I guess rural folks are so brainwashed at this point, with all their fears channeled by Fox News and company into hatred of Obama that they’re even blind to their own basic needs at this point.

  • teacherken

    written for Daily Kos titled A sacred obligation.

    I arrived at Wise for the first time in 2009.

    I have been back every year since except last when my wife was recovering from cancer.

    I volunteer in triage for dental. As Stan Brock noted in remarks on Thursday at orientation/welcoming for the volunteers, 70% of those who come to Wise do so for dental.

    Anyhow, there are a lot of picture in my piece, as well as some reflections.

    Let me offer two more links  – to pieces I wrote in 2009

    A different perspective on the health care debate written after my first day of volunteering

    Now that the Wise health fair is over . . ., written after I got back to Arlington, and with a lot of reflection on the long (6+ hours) drive back.

    Dan, sorry we did not know we were both there – would have enjoyed catching up with you.

    Peace