Poor Americans depend on free healthcare

For one weekend in September, a tiny private airport in Lee County, rural Virginia, has been transformed into a health clinic. Outside the building, hundreds of people are waiting in the dark morning, joining a growing queue to see a doctor or dentist - many of them for the first time in years. Some have been waiting nearly 24 hours, camping out in their cars overnight in order to be among the first in line.

Around 5 a.m. the rain subsides and people begin emerging into the still dark, damp dawn, lighting the first cigarette of day, sipping on the last can of cola before they see the dentist. These are patients whose teeth and lungs are rotting more quickly than they can pull in the dollars to fix them. In the US, without health insurance, getting medical treatment is a problem - one that affects around one in 10 Americans.

Struggling to get by

"If I don't have insurance to pay and I have to go to the emergency room or into the hospital, they can wind up with everything I have," says Aaron Stapleton. "Everything I've worked for, it's gone," he tells DW. The 62-year old, well turned out in a jacket and hat, has not been able to afford health insurance since he retired. Recently he almost cut off his finger in an accident. "We went to the emergency room and they had to call three doctors before one would sew his finger up because he didn't have insurance," says his wife Judy. "That's how bad it is."

Aaron and Judy were fairly well off before the coal mines in the area were closed. "Now we're down to nothing," says Judy. She has health insurance through her job, but the tall, grey-haired woman is now the only breadwinner for the couple, and approaching 60, she worries about the future. "At this point in our lives, my parents were comfortable. We struggle from one month to the next," she says. "It's depressing, because we've worked all our lives. But that's the way it is."

Denture at 22

During the night, the mayor of Lee County handed out numbered tickets to the patients in the queue. Treatment here is first come, first served. After a medical check up, patients have to choose between seeing the dentist and the eye doctor. While many here do have some form of health insurance, basic coverage rarely includes dental and eye care.

"I think for people having trouble paying bills, dental care is one of the first things that gets cut from their thought process," says dentist Gregory Caldwell. He is among the dozens of volunteer dentists in pastel colored scrubs, wedged in between the 20 horizontal treatment chairs while numerous student volunteers flit back and forth with trays of equipment and buckets of water. The 47-year old has travelled nearly 900 miles at his own expense to help out for the first time. "I just saw a 22-year-old kid who's going to have all his remaining upper teeth removed and get a denture. That's something where I practice that I don't even see at 72."

No safety net

The clinic is being run by Remote Area Medical, or RAM, an organization which travels around the US setting up mobile healthcare clinics like this one. Its 80-year-old founder and president, Stan Brock, has flown in to oversee the clinic himself, ensuring that the streams of patients flow smoothly through the highly organized network of volunteers.

Originally from Britain, Stan started the organization whilst living in the Amazon, where the closest doctor was 26 days away - on foot. But when he arrived in the US, he saw that even here many people simply could not afford healthcare. "There is no safety net for these people," he told DW, adamant that healthcare should, like the police force and education system, be a public service. "From a political standpoint it seems to be a very difficult hurdle for them to overcome," he says of the US attitude to public healthcare. "People are concerned that it's socialism."

New smiles, for free

For the volunteers, however, it is obvious that something needs to be done. "Somebody will get out of the dental chair, they've been in pain for weeks or months, sometimes years, and they'll hug the doctor, the dentist, the assistant," says Stan. "Or a little kid will put on a pair of glasses for the first time and just be absolutely amazed that he can see the leaves on the trees." That's what keeps the hundreds of volunteer practitioners and helpers coming back. Over the past 30 years, RAM has organized almost 800 free health clinics.

Lum Abner Deary, a chatty 24-year-old wearing trainers and a black baseball cap, is one of the 500 patients who visit the RAM clinic over the weekend. He was one of the first in the dentist's chair, having waited all day and all night in his car. Like almost 60 percent of the population in Lee County, Lum Abner is currently unemployed. When he came to the clinic, his two front teeth were visibly rotten. Now they're a shiny white. "I feel fabulous. It's a lot better, it gives me my confidence back," he says, admiring his new smile in his sister's sunglasses. "It's given me back to me, that's what I like about it."

An American problem

Over two days in Lee County, Remote Area Medical provides medical care to the poor to a value of around $229,000. Although the organization has some big name sponsors, it is primarily funded by small, private donations.

It's a lifeline for the millions of Americans too poor to afford healthcare. But for patients like Aaron Stapleton, the need for sick citizens to turn to charity is a symptom of bigger problems. "We may have to pinch pennies so to speak but still, we'll get by," he says. "But for America - she's in trouble. She's already in trouble."