Aid in Appalachia

Using GA to deliver health care to the needy

March 1, 2000

The Johnson County Airport in Mountain City, Tennessee, is an oasis in the rugged mountains that surround it. A long runway, nice facilities, and friendly people are there to serve you. No instrument approaches serve the airport, and if you fly there in the daytime you’ll see why. But on this September day, as I circled overhead to enter the traffic pattern, the ordinarily friendly airport looked like a makeshift military base.

Several large camouflaged tents and a handful of airplanes had transformed this remote airport into a bustling corner of Appalachia. A Douglas C–47 (the military version of the DC–3) and several general aviation airplanes were surrounded by tents that were pitched in the grass. After landing, I was greeted by a friendly linewoman who assumed that I was a doctor (it must have been the Beech Bonanza I was flying) and directed me toward a hangar that was serving as a makeshift hospital. After shutdown, I explained that I was only a writer and that I was here to see Stan Brock.

"You can’t miss him," said the linewoman. "He’s the only guy in the hangar wearing a khaki jumpsuit." Sure enough, when I strolled over to the hangar I quickly found him. With his rugged-adventurer looks neatly intact, Brock has aged quite well since his days as Marlin Perkins’ sidekick on Mutual of Omaha’s Wild Kingdom. Brock, who answered the question of his age by telling me that he does 600 push-ups a day, has committed the past 15 years of his life to Remote Area Medical (RAM), an organization of volunteers who travel around the world bringing medical care to places where no one else can or will. It is an entirely volunteer operation and Brock, who receives no salary or remuneration for his work, has brought free health care to thousands of patients. Although some 44 million Americans (16 percent) lack health insurance, organizations such as RAM are pushing to make health care a reality for some. We’ve all read about similar services being performed internationally, but RAM saw the need for this type of aid right here in the United States. RAM also travels to Central and South America. The best part is that RAM makes judicious use of general aviation to accomplish this noble goal.

At the Johnson County Airport from September 8 through 12, 1999, RAM held its 164th mission. Newspapers, word of mouth, and posted flyers got the word out to area residents that free medical care was coming. Helping Brock are several volunteers; among them are doctors, nurses, oral hygienists, optometrists, veterinarians, and medical students who will provide care to the hundreds of patients (pets included) who will come each day. And do they come. By 5 a.m. on September 8, cars were lining up to get into the airport—the word was out.

Dr. Edmond Reed, an oral surgeon from Brentwood, Tennessee, flew his Cessna 206 to the Johnson County Airport and pitched a tent under its wing to be a part of what would be his first volunteer mission for RAM. Flying doctors make optimal candidates for RAM because they love to fly, and GA allows them to reach remote sites in a matter of hours instead of the days it can take to reach sites by car. "Many doctors have busy schedules and can’t take more than a few days out of the office," said Brock. "With an airplane they can be here within hours, serve the patients, and still get back for their Monday appointments."

Reed’s oral surgery background made him the prime candidate to perform the majority of tooth extractions during this mission. "From talking to the patients, it was obvious that lots of them had teeth that should’ve been pulled 10 years ago," said Reed. "I’d ask them which teeth hurt, and they’d say, ‘All of them, just pull them all.’ I ended up pulling 25 teeth from one patient under local anesthesia. On the whole, they didn’t care—this was their one chance to get it done for nothing. It would’ve cost more than $1,000 to get an oral surgeon to do similar work." According to Reed, some patients waited an entire day to get teeth pulled, only to reappear the next day, wait in line, and get more pulled.

Instead of mostly extractions, another volunteer, dentist Dr. Mark Glovis, performed mostly fillings. Glovis was forced to drive to the event, thanks to unfavorable weather conditions between his home base in Grosse Ile, Michigan, and Tennessee. Glovis spent three days on site working seven to eight hours a day. He estimated that he filled 100 teeth per day and extracted 10. The 370-hour private pilot owns a Mooney M20F and hopes to use it to attend future RAM missions. "It’s a great program," said Glovis. "And I think there is a legitimate need for this kind of thing."

Besides dental work, RAM performs eye exams, mammograms, PSA (prostate) tests, pap smears, and veterinary services such as spaying and neutering. Over that weekend in September, more than 1,700 patients were treated. More than 600 people received an eye test and a new pair of glasses. All 22 children who received eye tests went home with new glasses. Both Glovis and Reed felt very satisfied with their volunteer efforts and plan to attend future RAM events.

All told, the dental staff extracted 1,106 teeth, filled 385, and cleaned teeth for 183 patients. When asked whether they thought people were taking advantage of this free service, Glovis and Reed both agreed that on the whole, the people who attended had a legitimate need for medical care.

"We treat everybody," said Brock. "We don’t want to embarrass people by asking, ‘How much do you make?’ or ‘Do you have insurance?’" RAM also doesn’t go where there isn’t a real problem. In the case of the Mountain City mission, the regional office of the Tennessee Department of Health asked that they come perform the service. The literature advertising the event explains that the service is for the unemployed, uninsured, and those who cannot afford to pay. People who take advantage of the service have never been a problem, said Brock.

"If we served 100 people and maybe there were five or six people in there that shouldn’t have been, the fact that we were able to see the other 96 people that really needed care is better than going through the bureaucracy of ‘Fill out this form, and bring a copy of your 1040,’" said Brock. "This is not a government operation and we don’t use, nor are we looking for, any taxpayer funds." Brock would like to see RAM receive some corporate support, however.

Brock uses the C–47 to bring in personnel and supplies. He holds airline transport pilot and flight instructor certificates and has flown nearly 7,000 hours. "Airplanes are very important to what we do," he said. "We would like to have a turbine-powered airplane that has the sort of capability that this airplane does. But, unfortunately, RAM—which relies on donations from the public as a tax-exempt charity—can’t afford that class of an airplane." Brock’s dream airplane for RAM is a Lockheed C–130 Hercules, which would have the room and heavy-lift capability to be a mobile operating room. It would also have far more reliable engines than the C–47’s radials.

Brock was inspired to create RAM when he lived among the Wapishanas tribe in the jungles of what used to be British Guiana (now Guyana) in South America. "We were 26 days on foot to the nearest town where a doctor was. These people were hunters and gatherers and seminomadic tribal people, so health care wasn’t a thing that they worried about. If they got sick and it was something that the jungle remedies wouldn’t cure, they died."

Brock learned to fly in a Piper Tri-Pacer with a tailwheel conversion in Georgetown, and with only about 30 hours of flying in two weeks, Brock bought the Tri-Pacer and dead-reckoned his way home to an 800-foot airstrip he created before he left.

"I made about a dozen airstrips in my part of the country, so what used to be a week on horseback then became just a few minutes in an airplane. And then I thought, ‘Why not bring back some medicine and vaccines in the airplane the next time I go to Georgetown?’" When he came to the United States to shoot Wild Kingdom, he saw the need for that kind of thing in the many places that they visited for the show. Now RAM has become Brock’s sole purpose.

"I don’t look at what I do as being a passion; I perceive it more like a lifelong necessity. I’ve been in that position of lying there thinking I was going to die, feeling ill from malaria and not having any medicine. Airplanes were the catalyst for what was an obvious need for people who lived in these very isolated areas.

"There’s a lot of satisfaction in what we do," said Brock. One of his fondest memories was of a woman on another mission in Appalachia who, after receiving her new pair of glasses, was in tears of gratitude. She asked the RAM volunteers to call the supervisor at a local plant where she had applied for a job. Apparently, the woman was unable to get a job because she couldn’t meet the eyesight requirement for the job, which involved the ability to thread needles. After she got the glasses, a RAM volunteer called the supervisor and said that she could now meet the sight requirement, and she was going to come over and interview for the job. "Long story short, she got the job," said Brock. "For that woman, the most important thing in her life was to get her sight back to a point where she could get the job." So it appears that Brock’s vision of free health care in the jungles of South America has made the dreams of the needy come true in the United States and other countries in the world.


For more information or to volunteer for Remote Area Medical, call 423/579-1530, or visit the Web site ( www.ramusa.org). E-mail the author at pete.bedell@aopa.org.