Delivering health care and hope to rural Appalachia
ON ROTATION
Mary Margaret Maddox is a final-year PharmD candidate at the William Carey University School of Pharmacy.
As the time to schedule APPE rotations approached, I eagerly sought experiences to challenge myself clinically and culturally. Discussions with clinical faculty led me to The Health Wagon in the rural Appalachian town of Wise, VA.
The Health Wagon was founded in 1980 by Sister Bernadette “Bernie” Kenny with the Catholic Order of Medical Missionaries of Mary. The program began out of her Volkswagen Beetle as she traveled through the Appalachian Mountains providing health care. Now, the organization has expanded to a mobile health unit and 3 stationary clinics that are operated by native Southwestern Virginians Teresa Tyson, DNP, (President and CEO) and Paula Hill-Collins, DNP (Clinical Director). The Health Wagon’s mission is to provide free, accessible, quality health care to the medically underserved in Appalachia.
Expanded my clinical and cultural scope
Once I arrived in Wise, 708 miles away and 2,400 feet higher, I knew it was the unique challenge I had been seeking. Thehealth care inequities Appalachians confront daily are inescapably evident to any outsider. The financial struggles these rural communities endure result in numerous hospital closures, the absence of urgent care, and neglect of behavioral health services. Illuminating the efforts of advocates like The Health Wagon is crucial to overcoming these adversities. The geographic landscape is a prevailing obstacle to accessing medical care. Well before COVID-19, The Health Wagon implemented telehealth services to help mitigate this issue.
I had the opportunity to witness the coordination of telehealth with an OB-GYN—who was 295 miles away—for a pap smear appointment needed to obtain cervical biopsies from a high-risk HPV patient. This is just one example of The Health Wagon’s steadfast efforts to provide vital medical care to the most vulnerable. Additionally, many in this coal-mining region are affected by black lung disease, making COVID-19 a heightened concern for health care providers.
As the Delta variant rampantly spread, The Health Wagon was one of the nation’s first outpatient clinics providing monoclonal antibody infusion therapy to high-risk COVID-positive patients. I was fortunate to participate in their COVID-19 education campaigns. This endeavor sought to inform the unvaccinated, increase vaccination rates, improve accessibility to COVID-19 testing, and explain the purpose of monoclonal antibody therapy.
I will forever cherish my time at The Health Wagon because it expanded my clinical and cultural scope. The beauty and resilience of the vastly misunderstood Appalachian region will continue to impact my actions and outlook as a future pharmacist. For more information, go to www.thehealthwagon.org