RAM Clinic 2013: Volunteering with Rural Underserved Populations

(This photo was taken at the Remote Area Medical expedition in Wise, VA.)

My second year of medical school started in mid-July and it’s been a busy two weeks! We have already finished the pathogenesis course and we are now in the midst of pharmacology. Even with the intense workload and other school matters, I took the opportunity to travel outside of my comfort zone and volunteered at the Remote Area Medical (RAM) expedition in Wise, Virginia during my first weekend back at school.

RAM is an organization founded by Stan Brock that has coordinated mobile medical clinics in the US and abroad, providing free dental, vision, and medical services to thousands of uninsured or underinsured individuals since 1985. I have always had an interest in health care disparities and the medically underserved in urban areas, but college introduced me to the health care crisis of rural America. Through a course called “Healthy Appalachia,” I learned about life in Southwest Virginia, from the coal dependence and rich Appalachian culture to the health problems and the three-day long RAM clinics each year that provide critical health care to inhabitants of Virginia and other surrounding states.

Although I have lived in Virginia my entire life, I had never ventured to Southwest Virginia before my first RAM trip. The six and a half hour drive from Richmond, Virginia to Wise, Virginia took me deep into the countryside with the beautiful Appalachian Mountains along the horizon. It surprised that despite the mileage and proximity to Kentucky and Tennessee, we were still in Virginia.

Once we arrived at the Wise fairgrounds where the clinic was taking place, it was almost like stepping into an outdoor hospital. There were mobile units for ENT, audiology, women’s health, mammography, and x-rays. Large tents covered dental care and general medical services, while smaller tents housed dermatology and orthopedics. In the smaller makeshift barns, there was a full-service pharmacy and vision services with free eyeglasses being made on-site.

In my role as a volunteer, I was able to listen to patients’ stories and gain an understanding of their health problems in the context of the socioeconomic obstacles that they face on a daily basis. Each day of the clinic, I met patients who had been up at four o’clock that morning, so that they would be one of the first hundred in line for the opening of the clinic at six o’clock. I talked to patients about different chronic conditions, such as hypertension, diabetes, and obesity. Nevertheless, hearing some of the stories and seeing some of the medical conditions broke my heart at moments. With access to a primary care physician, the pain of a broken bone that did not heal correctly, the inability to read a book, the chronicity of arthritis in one’s joints, among other complaints, may have been resolved sooner so that these patients could return to having the best quality of life possible. Yet, by the end of the clinic, I realized that my efforts and the endeavors of all the RAM volunteers were worthwhile and at times, potentially life-saving. We were able to provide preventive care and other specialty services in over 3000 patient encounters, giving people health care they would have otherwise gone without. It was my first RAM expedition, but I do hope to return in the future. Most importantly, this clinic has helped me reaffirm my passion for helping the medically underserved, which is something that will enable me to persevere through the long year of challenging, but interesting, courses.