Reinventing Primary Health Care in Appalachia & the Rural South
The principle at the heart of the work of the Student Health Coalition (SHC) held that quality health care required the voice of the people. Students operationalized this principle by helping small rural communities to organize around access to health care.
Stepping into these communities was facilitated by the fact that most residents lived in a vacuum of services, a complete absence of accessible health care, neither private nor public. Children were not immunized. Diabetes, high blood pressure, pulmonary disease were left undiagnosed and untreated. The nearest hospital might be hours away. Roads were subject to impassible disrepair. Clinics were no where to be seen, nor were public health officials. The proposal that students and community leaders working together might change all that was radical and thrilling.
Health Fairs were at the heart of the organizing. The fairs took place in a school or community center. Student nurses and physicians conducted comprehensive free exams for anyone who showed up. Funds to support the fairs were recruited from foundations. The Tennessee Valley Association (TVA) loaned a van for the first few summers, outfitted with lab equipment and exam rooms. The exams included hematocrits, urine screens, stool culture for parasites, throat cultures, and a full physical exam. People with abnormal results got a home visit from one of the students, with assistance on followup. Most children were anemic, from poor nutrition or parasites or both. Most miners had lung disease. Many adults were found to have untreated heart disease or diabetes.
The Health Fair team moved to a new community at the end of each week. At the end of the summer, most students returned to school. A handful stayed behind, digging into long term work. The Health Fairs and the clinics that were the “fruits” of our labors uncovered dirty secrets about the adequacy of health in Appalachia and the rural south. SHC challenged and angered local health departments, physicians, county judges, and the like.
Nonetheless, many of those clinics still stand. And in some cases, they grew into networks of clinics serving whole regions with community owned and operated primary care clinics.
A sampling of vignettes that illustrate activities and aspirations of the SHC in striving to reinvent primary health Care in Appalachia and the rural South. (For a complete catalogue of oral and written narratives on the website, go to “Stories.”)
Profiles of several individuals, among many, whose work with the Student Health Coalition was centered on reinventing primary health Care in Appalachia and the rural South. (A listing of all SHC profiles can be found under “People.”)
A selection of initiatives, organizations, and developments that grew from seeds planted or causes championed by the SHC. (A complete catalogue of materials related to various outcomes of the SHC experience can be found under “Legacy.”)