What Life Without Medical Services Is Like For Residents In Rural Towns

A scene from REMOTE AREA MEDICAL, directed by Jeff Reichert & Farihah Zaman. CREDIT: REMOTE AREA MEDICAL
A scene from REMOTE AREA MEDICAL, directed by Jeff Reichert & Farihah Zaman. CREDIT: REMOTE AREA MEDICAL

Stan Brock has journeyed through parts of Africa, the Amazon forest, and Guyana. His experiences during those excursions — particularly a long wait for a doctor after an accident in Guyana — inspired him to create Remote Area Medical (RAM), a nonprofit that delivers medical care to people living in places often characterized as “the middle of nowhere.”

Less than 10 years after the group’s inception, however, Brock’s attention turned to the United States — where he saw that access to consistent, affordable medical care posed a challenge for millions of people living in the Appalachia, along the Southern poverty belt, and other low-income pockets of the country.

“The United States has to find a way to help those who can’t afford health care,” Brock told ThinkProgress, pointing out that teeth and eyes are often the first to go among people who lack regular access to doctors. “Seventy percent of the people who come to RAM’s events come to get their teeth and eyes fixed.”

Later this month, Americans can get an inside look into one of those RAM events when the documentary Remote Area Medical hits movie theaters. The film focuses on a three-day pop-up clinic the nonprofit hosted in the rural community of Bristol, Tennessee in 2012. While the region is best known as the “birthplace of country music,” the documentary doesn’t focus on the town’s contribution to the genre.


Instead, viewers will get to meet some Bristol residents as they endure long waits in the cold to receive the eye care, dental care, medical exams, vaccinations, and follow-up care they desperately need but can’t afford through conventional means.

“We want to inspire people to volunteer for RAM but we also want people to see what it’s like to live without health care,” Farihah Zaman, Remote Area Medical’s co-director, told ThinkProgress. “Statistics are often divorced from reality because they don’t show the faces of who it affects and why it happens. What’s heartbreaking about this story is that the resources exist but they’re not available to everyone.”

In the film, more than 1,000 community members converge on the grounds of the Bristol Motor Speedway and Dragway and anxiously wait as a RAM volunteer passes out pink numbered slips that will grant them admission into the facility. For many of the residents featured, this visit would count as their first doctors’ appointment in decades.

That makes the clinic’s visit especially critical for Bristol residents, like one woman who’s in a fight against time as her teeth degenerate. Another woman yelps in joy after receiving a pair of prescription glasses. An elderly man also schedules follow-up care for his newly discovered blood pressure problems. Later in the film, in what illustrates the public health issues at hand, a woman lights up a cigarette moments after learning that she could have lung cancer.

“Even if this was a culture where people don’t do the healthiest things, people should still feel the empathy that we felt,” “Remote Area Medical” co-director Jeff Reichert told ThinkProgress. Reichert and Zaman worked on the film after Reichert’s aunt told them of her experiences as a volunteer at a RAM pop-up clinic in Tennessee. “It’s about putting yourself in these people’s shoes because it’s not right that they can’t get this care, even if it’s self-inflicted. If you were a member of Congress, how would you know about what the people in these communities are going through?”


Since shooting for the film wrapped up in 2012, the national health care landscape has changed drastically, thanks to the Affordable Care Act, also known as Obamacare. A recent New York Times analysis of enrollment data showed that the health care law has lowered the uninsured rate among those previously without coverage — including people of color, women, people living in low-income communities, and those with preexisting conditions. Today, many of those people can afford their health care costs, thanks in part to federal subsidies to purchase private insurance or federal assistance to enroll in public insurance. But not much has changed for many people living in the Appalachia and parts of the Southern poverty belt. More than four years after President Barack Obama signed the landmark legislation into law, about four million people still don’t have coverage due to state governors’ reluctance to expand Medicaid to additional low-income people whose income falls between the current eligibility level and the state poverty line.

The states that have refused expansion had higher uninsurance rates to begin with, and are home to people who tend to be poorer and sicker than the residents in other states. To make matters worse, they’re missing out on the federal funding designated for states that expand Medicaid, which has caused clinics and emergency rooms to close throughout rural areas of the United States. In turn, that has created more “medical deserts,” or places where medical services aren’t in close proximity.

That’s why Brock has wasted little time in getting Congress’ attention. During three different trips to the Capitol, he has recounted his experiences with RAM and railed against laws that prevent licensed health care professionals from working across state lines, which often worsens the doctor shortage in rural areas. The philanthropist’s efforts played a part in 11 states changing their laws governing where doctors could practice. Earlier this year, Brock and other activists petitioned lawmakers to enact an “Open Border for Doctors” law in Florida.

Since Brock appeared before Congress, more than a dozen lawmakers have also made visits to RAM pop-up clinics. He said two visitors in particular — Sens. Bob Corker (R-TN) and Harry Reid (D-NV) — expressed shock at what they saw and the stories they heard. Reid documented some of his experiences there in the congressional record.

“In the May 22 congressional record, there’s a whole page about RAM,” Brock told ThinkProgress. “Sen. Corker was also easily taken aback by what he saw in the Appalachian and he has pledged to get something done. Sen. Barbara Boxer (D-CA) has also been interested for years so I’m becoming optimistic that [health care coverage for all Americans] might happen.”

Even if expanded Medicaid coverage were to reach every state, however, reducing the prevalence of chronic illnesses also depends on people’s lifestyle choices. Throughout the Remote Area Medical film, Bristol community members can be seen enjoying cigarettes, fast food, and high-sugar drinks — the key causes of obesity, heart disease, and diabetes.

So Brock has a surprise for those who visit future RAM pop-up clinics: short films about shopping and eating healthy.

“We have a captive audience — more than 1,000 people waiting hours for a dentist appointment,” Brock told ThinkProgress. “Starting in 2015, we will show a series of movies about health, nutrition, and exercise. They’ll be both informative and amusing. We want people to see that they have to take the time to shop smart if they want to be healthy.”

Remote Area Medical hits theaters in New York City on Nov. 28 and in Washington, D.C. on Dec. 5th.