03 March 2008

Remote Area Medical: on the Homefront

Remember the guy from Mutual of Omaha's Wild Kingdom? Not Marlon Perkins, I mean the guy who actually did all the work, the guy down in the trenches with the alligators and water buffalo, before Steve Irwin even knew what a croc was. That man is Stan Brock. I saw him on 60 Minutes tonight, but he wasn't sporting his trademark khakis.

Mr. Brock heads up a different kind of wild kingdom these days. He founded Remote Area Medical (RAM), a volunteer organization that brings needed medicine and medical care to remote locations around the planet. He takes no salary, and lives at the headquarters in Tennessee, a former elementary school. He pilots the planes himself. The medical personnel, all volunteers, parachute to their destinations, and serve without benefit of showers, electricity, or other modern conveniences. Medical supplies are donated. RAM expeditions go to the Dominican Republic, Haiti, Honduras, Guatemala, East Africa, India, Nepal, Guyana, and Tanzania.

Now here's the shocking part: currently, 60% of RAM's expeditions are right here, in the good old US of A. New Orleans, yes, but also Tennessee, Kentucky and Virginia. That's right, instead of deploying its resources to "remote areas", as per the original intent, turns out RAM's services are needed right here, in the richest country in the world.

60 Minutes covered Brock and his team setting up a two day no-cost clinic in Tennessee. The people waiting to be seen were from six states. People slept in their cars, or stood in below-freezing weather, not wanting to chance their shot at medical treatment. They were issued numbered tickets, in order of arrival. The RAM team treated over 900 people.

They turned away 400 more.

Some of the stories were just heart breaking. Like the guy who slept in the parking lot all night, hoping to be one of the lucky ones to make it in. He'd had a heart attack a couple of years before, and had had treatment at that time, but he couldn't afford the follow up care. He'd also been living with an infected tooth for weeks. Yes, actually, he does have health insurance, through his job as a truck driver, but the deductible is $500. He couldn't afford it. He noted that he was fortunate in that he had a vehicle for the two hour drive and all night wait.

There was an elderly woman, in tears because her ticket number was too high to make the cutoff. She was on social security and needed glasses. The interviewer asked what she'd do now, and she hesitated, finally saying she had friends and a church, "... but I hate to ask," she said, breaking into tears. "I've worked all my life ... I hate to ask." (RAM volunteers did end up seeing her, and issued her glasses)

A 28-year-old mother of three had been treated for cervical cancer two years prior. She was supposed to be getting Pap smears every six months, and follow-up care. With three kids and her husband's job loss last year, they couldn't afford it. She got her first Pap smear since the surgery.
Another woman confided it had been 25 years since her last breast exam.

The interviewer asked one of the volunteer doctors who these folks were, this crowd of people so desperate for medical care.
They're the working poor, middle of their lives, most with families, most not substance abusers, and most employed without adequate insurance ...

These folks are people just like you and me. Most of the people seen during those two days are working hard, paying (or have long paid) into a system that is not taking care of them or their families. American families have a right to expect health care from a system we're contributing to. Given the current expeditions of Remote Area Medical, it doesn't look like that's the case.

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