Wise, Virginia is not a place that’s easy to get to. It’s 50 miles from the nearest interstate and almost 70 miles from the nearest commercial airport. And regardless of where you start from on your way to Wise—a town of 3,000 people in the Southern Appalachians—you’ll have to negotiate a winding mountain road.
Yet over a long weekend in late July, thousands of people make a pilgrimage to the Wise County Fairgrounds to get medical, vision and dental care they can’t afford closer to home—dental care especially.
Remote Area Medical, a nonprofit organization that operates free clinics around the world, has been coming to Wise County for 19 years. As word of mouth has spread, the Wise County “expedition,” as RAM calls it, has become one of the largest clinics it stages every year. And every year without fail, more people travel to Wise more for dental care than for any other medical need.
Stan Brock, who founded RAM in 1985 to fly American doctors and dentists to treat people in some of the world’s poorest and most remote areas, told me during an interview under one of the many M.A.S.H.-like tents on the fairgrounds site that the urgent need for dental care is not specific to Wise. Regardless of the location of RAM’s U.S. clinics—most of the organization’s expeditions are now held on U.S. soil because of this country’s large and growing number of uninsured and underinsured people—60 percent or more come first and foremost for dental care.
This year’s Wise clinic, held July 20-22, was no exception. Volunteer dentists, some traveling from as far away as Buffalo, New York, treated 454 patients, with extractions being the most common service provided. Although the dentists also perform cleanings and fillings, by the time most patients get there, their teeth have become too diseased to save.
People needing dental care often travel the farthest to get to Wise. RAM staff told me that this year, patients traveled from as far north as Michigan and New Jersey and as far south as Florida for care. Many of them arrived days before the start of the clinic and camped out in the fairgrounds parking lot—or slept in their cars—to increase the odds of being treated. Often the need is so great that some patients are turned away.
Many dental patients go to great lengths to get to a RAM clinic. One young woman told RAM staff earlier this year that she had ridden a bus from Columbus, Ohio, to Knoxville, Tennessee, where RAM holds an annual five-day clinic in late January and early February. She said she stayed in a homeless shelter when she got to Knoxville and walked four miles from the shelter to the clinic site—in 20-degree weather.
During this year’s Wise clinic, RAM posted a story on its Facebook page about a man named Larry who walked 30 miles to get to the clinic:
He began walking yesterday (July 20) to ensure he received a ticket for dental services today. Unable to find a job for almost two years, Larry can’t afford to get the dental services he needs. “I’ve been in pain for a while,” says Larry. “I’ve had abscessed teeth, and an extraction costs at least $100 per tooth.”
The high cost of dental care—and the lack of insurance to cover even a part of it—is often not the only reason so many people come to Wise County for care. Many live in the more than 5,000 “dental deserts” in the United States, areas, both rural and urban, where few if any dentists practice.
As noted earlier, the lack of access to dental care is such a critical and growing problem in the United States that the demand often is greater than RAM’s volunteer dental professionals can meet. At the end of my interview with Brock, an experience at Wise County from a few years ago came to mind. His voice cracked with emotion as he told it.
On the last day of the clinic, a Sunday, after all the dentists had packed up and left for home, a couple with two young children drove up to the fairgrounds parking lot. They would have gotten there earlier, the father told Brock, but “church ran late.”
Brock said the little girls—”probably about eight and seven maybe“—where hanging on to their parents’ legs. “We’ve come to see the dentist,” he said the father told him.
“’I’m very sorry, everything’s packed up,’” Brock said he told him. “And they turned around and got into the pickup truck and drove off.”
Brock paused, and I could see tears welling up in his eyes.
“What I should have said is, ‘Where do you live, man? We’ll do a house call.’ But I didn’t.”
Those were among the last words that one of the most compassionate people I’ve ever known, a man who has brought health care to millions of people around the world, said to me. With all he had done, he regretted that he had not done even more.
“And so you can’t see everybody,” he told me. “That’s unfortunately the reality.”
Editor’s note: Stan Brock died yesterday, August 29. He was 82.