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February 20, 2012 | Volume 87, Number 8






– Necrology


photo: SStanding with the Health Wagon are left, Paula Hill, clinical director, and Teresa Gardner, executive director of St. Mary’s Health Wagon.Health Wagon is primary care provider for many in southwest Virginia

You can’t miss the Health Wagon when it makes its weekly visit to Binns Counts Community Center in Stratton, Virginia — literally a wide spot in the road (Highway 63).

The spot is barely wide enough for the huge, white converted recreational vehicle to open its doors without stopping traffic.

But the local people don’t want to miss it. Whether it’s in Stratton, Clinchco, Pound or any of the other five stops on its regular rounds through the poor Appalachian mountain communities, the non-profit St. Mary’s Health Wagon mobile clinic is their life line to health care.

“It’s my primary care provider,” said Tina White, 38, a mother of three in McClure. “I don’t know what I’d do without the Health Wagon. I probably wouldn’t ever go to a doctor.”

Ms. White receives treatment and medicines for stomach ailments, blood pressure problems and depression.

photo: Tina Smith, right, receives her medicine from nurse JoElla Dales.“We struggle to get by,” Ms. White said with a friendly smile.

She and her husband, a construction laborer, are typical Health Wagon clients. They work hard to care for their young family in a beautiful but economically depressed region where diabetes, high blood pressure and pulmonary disease — especially Black Lung — are rampant. They have no health insurance.

Another patient, Forester Mullins, a disabled, unemployed truck driver from Haysi, explained that the clinic is the only place that will give him an appointment.

“It’s hard to get seen if you don’t have insurance,” he said.

Last year St. Mary’s Health Wagon provided comprehensive health care services to more than 2,600 indigent patients throughout the four counties it serves: Dickenson, Russell, Buchanan and Wise.

photo: From left LPNs Crystal Clark and JoElla Dales in the Health Wagon’s nurse station with Teresa Gardner. The two nurses have been on the staff for 2 and 13 years respectively.The mobile clinic’s origin in Catholic social ministry is well known in the region, and its founder, Sister Bernadette Kenny, is well-loved and admired by those who have reaped the benefits of the Health Wagon’s mission for at least two generations.

A nurse practitioner when that field was new, Sister Bernie “was ahead of her time, doing 30 years ago what we in health care are now pushing,” noted Teresa Gardner, the current Health Wagon executive director.

Sister Bernie started the mobile health service in 1980 in a donated Volkswagen van, traveling to scattered homes in the region to treat people suffering with chronic disease.

A member of the Medical Missionaries of Mary, she had initial help from several other women religious in the area, notably Sister Ann Christine whose order, the Poor Servants of the Mother of God, then staffed and owned St. Mary’s Hospital in Norton.

photo: Sister Bernadette KennySt. Mary’s sponsored the fledgling Health Wagon, but Sister Bernie operated on a shoestring for years while growing the clinic’s outreach through donated operations and medications, recycled equipment and ecumenical community support.

“Sister Bernie captured the heart of the people,” said Paula Hill, Health Wagon clinical director. “For an outsider (originally from Massachusetts), she fit right in,” noted Ms. Hill who is a native of Coeburn. “The people love her.”

The feeling is mutual. Sister Bernie pointed out that the success and development of the Health Wagon “is due to the generosity of the volunteers, both the medical professionals and the mechanics, electricians and so many local people willing to give to the effort.”

Now retired, Sister Bernie lives in Clintwood and continues to serve on the Health Wagon board of directors.

Today, St. Mary’s Health Wagon has a 12-member professional staff, supported by a number of area physicians and other medical volunteers, including Dr. Joseph Smiddy, a Kingsport, Tenn. pulmonologist who serves as medical director.

With its mission to serve “the health care needs of the uninsured, underinsured and disenfranchised in the mountains of Appalachia in Southwest Virginia,” the clinic is funded through a variety of grants — including an endowment from the Diocese of Richmond — and private donations.

photo: Sister Bernadette Kenny joyfully raises her hands with three clergy during a presentation of an award to her from AMERC (Appalachian Ministries Educational Resource Center) at St. Joseph’s Church in Clintwood in 2004. With her, from left, are Glenmary Father John Rausch, Rev. Ben Poage, a Methodist minister, and Glenmary Father Robert Rademacher. The raised hands symbolize energy healing. Sister Bernie, as she is best known, started the Health Wagon in 1980 in her Volkswagen Beetle.A new clinic in Wise is currently under construction with financial assistance from the diocese. It will expand the Health Wagon’s operations, providing specialty care services, particularly chronic disease treatment, and further its working relationship with the University of Virginia.

“We’re getting so many requests wanting us to come to Lee and Scott counties,” Ms. Gardner said. “We want to expand more because there’s so much need.”

The opening of the Wise facility already has increased the Health Wagon’s profile with medical providers calling to volunteer their services.

“The response has been incredible. We think Wise is going to be a new calling card for us, opening the doors to more volunteers,” she said.

Ms. Gardner, also from Coeburn and now a family nurse practitioner, was a nursing student when she began working with Sister Bernie at the Health Wagon 19 years ago. She became executive director in 2005.

Her lifelong friend and fellow nurse practitioner Ms. Hill joined her on the staff in 2009. Together the two women embody the clinic’s commitment to the community.

Heading the Health Wagon operations means regularly working 14-hour days treating patients and writing grants on the weekends. Both women know their native community well.

“There are so many low income people here,” Ms. Gardner noted in her gentle local twang. “They are faced with electric bills and expensive medicines, and many of them come to us in desperation.

“For instance, we had a World War II veteran who came to us because he didn’t have transportation to the VA (hospital) in Kingsport.

“This man had no heat in his house,” she said softly. “We kept him alive for many years when he was out of insulin.”

Their professional expertise and enthusiasm are palpable as Ms. Gardner and Ms. Hill describe the daily care the Health Wagon offers to address the dire conditions of their patients.

photo:Teresa Gardner, right, examines patient Wanda Simerly. Ms. Gardner noted that they see more women than men and Ms. Simerly is like many others, middle age, worked hard all her life in the home caring for her family and when they are older they have no resources—no possibility for insurance—for health care.The staff, including nurses, a health educator and social worker, provides basic care, lab services, prescription medicines and health education such as nutrition and smoking cessation classes.

A “big push” toward addressing diabetes and high blood pressure has resulted in a substantial drop in those diseases in the community, Ms. Gardner said.

“We are removing the barriers to care by providing medicines, education, blood sugar monitors and self-management,” she explained. “This comprehensive focus is having an impact and saving lives.”

That’s what keeps her with the Health Wagon, Ms. Gardner said.

“Oh, I could never do anything else,” she said. “It’s a mission for us. We see miracles on a daily basis.”

Of the volunteer physicians, specialists and financial gifts, she added, “We take an interest in our community and God has blessed us. It’s like the loaves and fishes — he has multiplied our efforts phenomenally.”

Ms. Hill agrees.

“This is missionary work in our own backyard. When people come to us, they are hurting so bad. A lot of our patients are train wrecks when they come with multiple disease problems.”

The Health Wagon team constantly searches for additional resources.

“We don’t live in a metropolitan area with big donors, so in addressing the needs of our community, while we worry about how we can deliver care and alleviate the suffering, we also are faced with financial needs,” Ms. Gardner said.

Each year in April and May, the clinic organizes regional health fairs where people can come for screenings, lab work, immunizations and chest x-rays. The fairs are supported and staffed by area medical and pharmacy schools.

The Health Wagon’s annual Remote Area Medical (RAM) event brings in volunteer medical professionals to Wise County for three days to provide free eye, dental and medical care to thousands of underserved people.

The RAM organization holds such weekend events at various rural sites nationwide, but the event in Wise — now in its 14th year — is the largest in the country. Last year there were nearly 7,000 patient encounters which provided more than $2 million in free health care.

“It makes me cry every time,” Ms. Hill said, reflecting on the huge crowds which come out on Friday night to wait their turn for health care which begins on Saturday.

“I look at the crowd and I think why are we not giving to the poor, why are we not doing what Jesus does? But by Sunday, I see that we did.”

There remains more to be done.

Ms. Gardner also recalled that by Friday night registrations were complete and all the slots were filled.

“We were at capacity and we had to begin turning people away,” she said. “I watched all those people leaving and I couldn’t help thinking, ‘Who are they? What are they going to do?’”

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