By Staff Sgt. John Wilkes, 180th Fighter Wing, Ohio Air National Guard
/ Published August 10, 2017
HAYESVILLE, N.C. -- “The Appalachian people themselves are a strong and independent people,” said Matthew Lyvers, a public health educator with Clay County Health Department in Hayesville, North Carolina. “And that can pose a challenge.”
The Appalachian region is one of economic contrasts: some communities have diverse economies while others are still in need of basic infrastructure. Many roads remain unpaved and wells are a common sight across the region as city water and sewer access are not readily available.
“Many people came here because they wanted to be independent,” said Lyvers.
The way of life here can be rugged, more hands on. The terrain is unforgiving. Seeking medical, dental, vision or veterinary care may require a two hour drive. This is not an option for some.
“Because people are strong and independent, they do not want to be told what to do, how to live,” Lyvers said. “I was born and raised here. My family is here and I truly enjoy it here. When helping people, sometimes being from here and knowing the issues helps.”
There are many challenges in regards to providing and seeking out proper medical, dental, ophthalmologic and veterinary services in parts of Appalachia.
“Many people are self-employed or don’t have insurance,” said Lyvers. “There is a perception that things like this are for the lazy, which is not true. Many do not have the [benefits] of a large corporation.”
According to the Clay County Health Department, there are geographic barriers, specialists are not readily accessible and cost is an issue.
This is where Smoky Mountain Medical Innovative Readiness Training comes in. IRT missions provide a direct and lasting benefit to the local communities while service members and their units gain valuable readiness training.
Smoky Mountain Medical IRT took place Aug. 2-10, 2017, providing no-cost medical, dental, ophthalmologic and veterinary services to residents of North Carolina’s Clay County, Swain County and the surrounding areas.
More than 200 service members with the National Guard, Air Force Reserve, Army Reserve and Navy participated in or provided care during the mission. In addition, hundreds of people from surrounding communities volunteered their time to assist during Smoky Mountain Medical IRT.
“We don’t have a hospital in our county which is a tremendous barrier,” Lyvers said. “Our closest major trauma center is two hours away. There are very few low cost or no cost dental services. Many people drink well or spring water and even the county water does not have fluoride in it.”
Dental and ophthalmologic services are in very high demand in the region.
“It provides hope,” said Lyvers, who has lived in Clay County for most of his life. “Even relatively simple dental services provide hope for people.”
According to Lyvers, there was a woman who couldn’t afford to have teeth extracted at 200 or more dollars per tooth but she could afford to save for dentures. After receiving them it increased her nutrition because she could eat foods she may not have been able to eat.
“It boosts her pride and increases her quality of life,” he continued. “With poor oral health comes poor cardiac health.”
Public health plays a key role in Smoky Mountain Medical IRT. Public health professionals such as Lyvers overcome many challenges such as culture and lifestyle to educate the population and prevent people from getting sick or injured in the first place. They promote wellness by encouraging healthy behaviors and work to ensure conditions exist in which people in a community or population can be healthy.
“People who join the military or become medical professionals have the desire to serve and help people,” said Lyvers. “I have always been a service type person. I enjoy working with people in different capacities. That’s what I liked about nursing. In public health, I am able to be more humanistic and help people in other ways.”
The health department has a sliding fee scale based on income but that can present challenges too. Some may not be able to afford even greatly reduced fees, according to Janice Patterson, director of the Clay County Health Department. Many people are working and make too much for assistance but can’t afford all the care they need.
“There are multiple resources in the community for those are not able to afford care,” Patterson said. “There is a backlog in this area for those who need care. We have an association that holds clinics once or twice a month. Things like this help us free up those other resources and create space.”
Smoky Mountain Medical cared for more than 2,800 patients, performed more than 8,000 medical and dental procedures and more than 2,600 veterinary procedures in the first 7 days. These services totaled more than $600,000 in benefit to the community.
According to Senior Airman Delaney Preston, a medic assigned to the 180th Fighter Wing, Ohio Air National Guard, interacting with so many people from the community and being able to help them makes it all worth it.
“Many community leaders have stopped by and thanked us,” said Preston. “We can feel the support from the community.”
Despite all the support, challenges still exist.
“There are geographical barriers, specialists are not readily available,” said Patterson. “For example, there isn’t an endocrinologist in the area. There are not a lot of large businesses in the area. Usually larger businesses provide health insurance so that is missing for many people.”
To combat the challenges, providers made referrals for patients to follow up with the local health department. The health department is then aware of the needs of the patient and can assist in getting them the specialty care they need.
Many people drove from distant locations to seek care for themselves of their family. Patterson overheard a conversation between a lady and her husband – “They were waiting for the vet, they brought two dogs. I asked where they came from and she said ‘we drove from down in Georgia, over an hour and a half.’”
Anthony McCray, a resident of Andrews, North Carolina, came to Smoky Mountain Medical to receive dental and vision services.
“This is such a great event I wish they would do it once or twice a year,” he said. “We are in need of services like this.”
According to the U.S. Census Bureau, more than 20 percent of the population in the greater Swain and Clay County area fall below federal poverty guidelines. The national average is approximately 15 percent.
Despite these challenges, the people of Appalachia are strong, said Lyvers.
“It’s not just the physical care that means so much, it’s the ‘my country cares about me’, and they care about the service members,” said Patterson. “Our military is very much respected.”
The culture here promotes a sense of strength, patriotism and pride, according to Patterson. “People around here place morals and helping your neighbors higher than other areas do.”
The IRT is a civil-military program which builds mutually beneficial partnerships between U.S. communities and the Department of Defense to meet training and readiness requirements for active, reserve and National Guard service members and units while addressing public and society needs.
“Smoky Mountain Medical provided a great two weeks of training while assisting fellow Americans,” said Lt. Col. Gary M. Easterly, medical planner at the 180FW and officer in charge of Smoky Mountain Medical IRT. "Smoky Mountain Medical IRT is not only beneficial to the people that receive health care, but it fulfills necessary training requirements and increases readiness amongst our health professionals.”
IRT missions strengthen the bond between American citizens and the military.
"It is great to see our Airmen working side by side with other military personnel to help our own,” said Col. Kevin Doyle, commander of the 180FW. "Their efforts have helped those who are unable to afford health care for themselves and their children, greatly improving their quality of life.”
By providing care and connecting citizens to community resources, the IRT mission helps overcome the cultural, geographic and financial barriers associated with the Appalachia region to improve their lives for years to come.