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Guest column: Three docs explain the shame and glory of the Wise free medical clinic

By Ike Koziol, Kenneth Olshansky and David F. Gardner – Ricmond Times-Dispatch

The annual Remote Area Medical Clinic was held in Wise County in Southwest Virginia from July 21-24. This clinic treated more than 2,000 individuals who have no health insurance.

It is an event that stirred up emotions of pride and anger in all three of us. Pride, because we came away feeling good that we helped people in need. Anger, because this clinic should not have to happen in the richest country in the world.

Remote Area Medical is a national nonprofit organization that provides free health care where it is not available or many residents have no health insurance coverage. Wise County is one of those areas. The four-day event is the largest free medical clinic in the United States.

A year ago, one of us — Dr. Koziol — wrote a letter to the editor at The Times-Dispatch regarding the tragic medical situation in Southwest Virginia. Coal mines have closed and poverty abounds. Tens of thousands of people have no health insurance and limited access to health care.

Many of these proud folks worked in or had family members in the mines. Now, they work in fast food and small businesses and have no health insurance. They make too much for Medicaid eligibility and too little to pay for coverage through the Affordable Care Act.

In their local communities, they have to rely on an overworked medical system known as the Health Wagon. The Health Wagon does wonderful work, but it can only do so much. There is limited access to x-rays, lab tests, medications, and specialists.

For surgery, people in the area often go to local hospitals and accumulate enormous debts. The wonderful staff of the Health Wagon covers a multi-county area with free clinics. They rely on donations and grants to maintain their operations.


How proud we were to be a part of this incredible event. Once a year, patients come from near and far — Virginia, Kentucky, Tennessee, and West Virginia. They arrive and line up the night before at the Wise County Fairgrounds, sleeping in their cars and tents, and at dawn they start the process.

Volunteers register and escort them to the numerous health-care venues. They receive dental, vision, and hearing evaluations. They get their lungs checked for coal-related problems. Women get Pap smears and mammograms, and patients can even get dentures, hearing aids, and eye glasses.

They see doctors in multiple specialties (e.g., orthopedics, dermatology, internal medicine, gynecology, dentistry, oral surgery, and many others), as well as get advice on nutrition, diabetes management, stress management and general wellness.

All of this care is provided by hundreds of selfless, dedicated and compassionate volunteers who come from Florida to Maine, as well as from surrounding states. The volunteers come from all walks of life and spend four days in the hot sun doing for these people what our society has not done.

Each patient is treated with dignity, as if they were in a private health-care setting. The problem is the four-day event is held only once a year, and the Health Wagon can only serve a small percentage of those in need for the rest of the year. There are an estimated 40,000 people in this area who need basic services. They suffer through no fault of their own.


For a new volunteer, the weekend was an eye-opener. We all know there is poverty, and people do not get needed medications or do not see dentists, get glasses and hearing aids, etc. We all know that in many Third World countries easily treated illnesses can kill in the absence of basic medical care. But do we know that areas in our country like Wise County are just as bad when it comes to health care?

One of the volunteer oral surgeons shared that in his morning clinic he had to do a full mouth extraction on a 26-year-old man who never had dental care in his entire life. It will probably be another year for him to return for dentures unless he can find some type of charitable organization to pay for this service.

Do we all know that much of this suffering can be prevented? Do we even appreciate how much suffering there is in areas like Wise? Life, liberty, and the pursuit of happiness is all well and good, but without good health care a person can lose life early and not be free enough to pursue any semblance of happiness. We are all equal under God and that should include access to health care.

This is the reason we feel angry. Our state delegates and senators know this exists and they choose to ignore it. Good leaders should be interested in the welfare of all of their citizens. Our Republican legislators have blocked Medicaid expansion for many years. This expansion would cover an estimated 40,000 citizens in southwest Virginia and some 400,000 statewide.

The fact that Medicaid expansion has not happened has cost all of us billions of dollars in lost revenue from the federal government that should have come back to Virginia. That is the financial toll. What is much more devastating is the human toll.

People die early. Diabetics cannot get insulin. Teeth rot. On top of all that, people cannot see or hear and that just adds to the suffering. Those that block Medicaid expansion are hurting our fellow citizens. They are not physically assaulting them but by their actions and inactions, they are nonetheless injuring them. Neglecting the problems is shameful.

President Jimmy Carter said it best: “The measure of a society is found in how they treat their weakest and most helpless citizens.” We implore all of our legislators to attend and volunteer at one of these clinics to see first-hand the human suffering. We appeal to our leaders to do the right thing: Expand Medicaid.

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