The sight of a Winnebago is most profoundly associated with cross-country travel — sometimes invoking the dream of selling one’s possessions and heading off into the horizon, perhaps as Aaron Copeland’s “Appalachian Springs” blares on the stereo. But that’s a glossy, romantic version of mobile home travel, especially compared to what Teresa Gardner and Paula Meade are doing.
These two nurse practitioners, exasperated by the number of residents in Central Appalachia without access to basic healthcare, started a mobile medical clinic in a beat-up Winnebago and travel around, serving the most isolated and neediest patients.
The Health Wagon provides a wide range of healthcare services, including acute and chronic disease management, laboratory and diagnostic services, dental and eye care, immunization, diabetes management, and cancer screenings.
Established in 1980, the Health Wagon has been providing access to health care for most marginalized rural population of Central Appalachia (which does not enjoy similar living conditions and economic means as the rest of the nation) ever since. The region’s industries — including mining, manufacturing, textiles, and paper and wood products — are in significant decline to due to global outsourcing. Additionally, the area struggles with extreme poverty, unemployment, poor health, and acute educational inequalities. During periods of recession, it’s particularly vulnerable to both high rates of unemployment and structural economic changes.
According to a 2009 case study, 61 percent of the patients seen by the Health Wagon did not have healthcare, while an additional 10 percent did have health insurance but hadn’t sought treatment because they were unable to afford the co-payments required. Many residents who utilize services from the Health Wagon make too much income to qualify for Medicaid, but simply cannot afford to purchase insurance on health care exchanges.
However, it is not simply the treatment of the physical ailments that makes the duo of Gardner and Meade a powerful force of hopefulness for those not used to expecting much. 60 Minutes producer Henry Schuster attempted to describe their intangible goodwill: “There’s a feel when you’re in the Health Wagon that it took me a long time to put my finger on, and it’s the feel of a country doctor,” Schuster says. “They don’t just rush ’em in and out, they talk to them. It’s old-fashioned medicine in a lot of ways. You get a feel there that they’re treating the patient and not just the symptoms.”