- The Washington Times - Monday, July 21, 2008

Thousands of uninsured or underinsured Virginians are expected to line up this weekend for free medical, dental and vision care when the Remote Area Medical (RAM) Volunteer Corps stops off in Wise County in the mountainous southwestern part of the state.

RAM is a nonprofit, volunteer-based relief organization that travels across the impoverished Appalachian regions of Tennessee, Kentucky and Virginia providing free eye exams and glasses, dental checkups and teeth pulling, medical services, veterinary care and technical and educational assistance.

Wise County residents nine years ago requested that RAM come to the county, and it has visited every year since. This year’s event, at the county fairgrounds from July 25 through July 27, is expected to be the largest yet. Last year, 1,377 volunteers gave away more than $1.6 million worth of care to 2,506 patients. Most patients saw more than one doctor, elevating the numbers of patient encounters to 5,616.

“I don’t know if more people come because the need is getting bigger or if this is a public service people can’t afford anymore,” said founder Stan Brock. “For some people, it’s the only doctors they’ll see all year.”

The Health Wagon in Southwestern Virginia coordinates the RAM excursions in Wise County. More than 1 million people in the state are without health insurance, and the number rises as insurance copays and deductibles increase.

Skyrocketing gas and food prices have also pushed some to drop their health insurance, and they now depend on the free medical services.

Despite constant requests for a RAM visit to the District, local laws - similar to laws in many states - prevent Mr. Brock and his mobile team of licensed doctors from setting up shop. Yet large numbers of city residents need free medical services, he said.

“We’re reaching the point where we can’t do much more, and we keep saying that year after year,” said Teresa Gardner, nurse practitioner and executive director of the Health Wagon. Mrs. Gardner predicts even more patients and volunteers will show up this year.

Mr. Brock started RAM in 1985 after living in the Amazon, where outdated care was provided and doctors were 26 days away by foot. His plan was to develop the program in the United States and take it back to the Amazon, but he then realized there was a great need for health services here at home. About 60 percent of his work is in the rural United States, nearly all of it in Tennessee, Kentucky and Virginia, while the rest is overseas.

RAM treated 17,000 patients last year, operating on a $250,000 budget provided entirely by donations. Its mobile optical lab turns out 200 pairs of new, custom-made glasses per day. Eyeglass frames are all donated, and lenses are a combination of new and used. RAM’s 12 portable dental stations are equipped with a drill and suction setup as well as hand tools.

Strict laws preventing doctors from traveling between states limit RAM’s ability to serve those in need. But Tennessee laws adopted in 1995 let doctors all over the U.S. volunteer in the state, and as a result, Tennessee is getting 11 of the 14 RAM events this year. The three in Kentucky and Virginia are performed by physicians within each state, or out-of-state doctors willing to fill out dozens of pages of paperwork, apply for a temporary license and subject themselves to thorough background screening.

“It’s easier to bring doctors in from out of state, because there’s something about going to help someone somewhere else,” Mr. Brock said. “But it’s harder to get them to do something in their own back yard.”

Dr. Tom Kim, a Korean immigrant and director of medicine at the Free Medical Clinic of America in Knoxville, Tenn., was disappointed by the number of local doctors volunteering at a January RAM event in Knoxville. Unlike Mr. Brock, he advocates helping those in one city and not moving around.

Dr. Kim closed his private practice of 28 years and has treated uninsured workers for almost three years, yet was shocked by what he saw at the RAM event.

“It was terrible,” he said. “It was like a third world country’s emergency room.”

RAM volunteers begin seeing patients at 6 a.m., but those eager for help usually line up the night before. At last year’s Wise County event, 150 cars were parked on the fairgrounds the day before, and by 9 a.m. the next day, no spots were available. Mrs. Gardner said that the hardest part of the event is turning away people at the end of the day.

“It’s so sad that our success is the failure of the health care system,” Mrs. Gardner added.

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