Thursday, March 31, 2011

Just Special

Tracy Nolan is just one of those special people you know for their intellligence and extraordinary compassion. As Director of Community Services, she oversaw a wide array of social services, wrote grants, shared vision, and always shared her enthusiasm for providing the best of care. Her passion and vision influenced our decision to move to the mountains.

The three of us worked closely together: Dr. Sharon Fogleman, center, (medical director) and Winna Wagers (business office manager). Both were very skilled at what they do; both worked hard, but laughed a lot too; both taught me a lot about the Clinic and about the unique community in which we lived; both made my job easy.

My Biggest Fan

When Taylor Collins, PhD, arrived at Red Bird to take over as Executive Director, he was very clear: he did not like what I was doing at the Clinic. He had no intention of ceding any space or service to anybody besides Red Bird staff. Health care, as part of Methodist mission in southeast Kentucky, had "been in these mountains" for almost 90 years; he had no intention of letting it go.

Taylor was a graduate of Red Bird School and part of a large local family down on Jack's Creek. He went on to receive multiple degrees and worked as teacher, principal, and superintendent of schools near and far. He moved home to The Valley from Texas, and took over Red Bird Mission as its first Director to have grown up in the community. His local roots made him a favorite of locals; he seemed rather suspicious of those of us who had come from the outside.

It took time, but he listened to my well-reasoned reasons for divesting healthcare. Document after document, study after study, projection after projection...and finally he listened. Taylor Collins went from being my biggest critic to "being my biggest fan" (his words). His support helped persuade a sceptical board of directors and meant that healthcare was secured in the Red Bird Valley for the future. On January 1, 2011 health services at Red Bird Mission were turned over to the Adventist Health System; the partnership provided jobs for almost all of the staff, provided monies for the Mission, and continued quality care in the region. I worked myself out of a job and quietly slipped back to our home in Indiana.

Benny and I

Benny Nolen, of Adventist Health Systems, and I worked many hours creating the opportunity for Red Bird Health Services to be contracted out to their Clay County hospital Manchester Memorial. We worked through personnel, facilities, profitability and other issues to create a proposal for Red Bird's leadership board. Benny took seriously the Adventist motto to "continue the healing ministry of Christ" by service to the people of the Red Bird Valley. It was a good match with United Methodist values and so we were successful in our efforts.

King Coal

The bumper sticker says it all: “Coal keeps the lights on.” And so it does. Coal keeps the lights on for millions of homes and businesses around America. What would utility companies do without the relatively cheap fuel that keeps their fires burning brightly? And what would these people of the Cumberland Plateau do without one sure way out of poverty? For all of its controversy, coal remains king in the mountains and will remain so for the unforeseeable future.

The present controversy around coal is the practice of mountaintop removal. Once blasted off and the coal scooped out, a mountaintop can never be replaced. And so many, some mountain folks included, protest this form of mining. It would be easy to jump on the anti-coal bandwagon, except that I know we have allowed many acres of farmland to be turned into shopping malls and housing, and the green earth of my Minnesota home to give way to a deep gash of red iron ore. Most seem to be content that companies “reclaim” the land (whatever that means), planting trees on what remains and making the best of earthly wounds.

We hope for a day when fossil fuels can be replaced by renewable sources of energy and made available at affordable costs. We also hope that in the meantime new industries and jobs can emerge in the beautiful mountains, jobs that will allow the mountains to remain intact and the people to find good work. For now, we say thank you to those who go into earth’s black belly to keep our lights on.

Tuesday, March 15, 2011

Rural Poverty

We hadn’t lived in southeast Kentucky long when it struck us that we were living in a place and with a people that reminded us of our experiences in the Developing World. It was more than the depth of poverty, lack of jobs, even environmental degradation. It was a basic life orientation focused either on the past or the present. Perhaps driven by simple survival, we met few whose outlook was toward the future--but many whose thoughts, conversations, and actions were rooted in the present. That meant that many decisions were made for immediate gratification, with little thought to the long-term consequences of those actions. For example, it was common for people to get a loan in anticipation of a tax refund and then spend the money immediately; for little connection of success in school leading to success in life. It was not uncommon for families living in squalor to spend hundreds, even thousands, of dollars on guns, ATVs, electronics and other non-necessities. I knew parents who spent an amount totally out of proportion to their salary on birthday and Christmas gifts. Even the terrible scourge of selling and/or using drugs pointed to this kind of thinking. This short-term orientation made it difficult for people to think about the future and about the effect of their behaviors on their own future.
It seemed that this inability or unwillingness to think about the future meant that dreams were in short supply. And when dreams die, the future (and the present) become even bleaker. So few young people seemed able to envision their own success. This lack of drive, ambition, dreams, visions (especially in youth) were especially hard to understand. It also meant that we found much pleasure in meeting those people who had lives filled with optimism and possibilities. However, almost no one we met seemed able to envision theirs to be a healthy, thriving community.
We discovered, too, that rural poverty is much more complex and difficult to address than urban poverty. In the mountains, the poor were scattered in invisible hollers, far away from anybody’s line of sight, and out of the mind of even their own county services. There were few jobs, no universities, no mass of people from which to draw human or monetary resources, no collection of health providers, no public transportation, no institutions, no grocery or hardware stores on corners, no churches large enough to address the needs. In southeast Kentucky land issues also fuel poverty, with huge swaths of land owned by the government, making it unavailable for private ownership and thus taxation (Daniel Boone National Forest & Cumberland Gap National Park) or held in some tension between private and corporate ownership (local mineral rights owned by coal companies). Lack of jobs, educational attainment, a culture of poverty, tight family units given to suspicion and squabbling, isolation, a population too dependent on government largesse, attitudes of entitlement—all magnified the poverty of the region’s very soul.
We never found answers. We only joined in the struggle for the short time we lived and worked in the mountains. We were fortunate in that my work of finding a sustainable health system had a solution; and Alan’s work on infrastructure also had a tangible focus. We believe that many of the resources, gifts, and talents needed to make a good life are resident within a community—not imposed from outside. We loved living among and working with the best of the Red Bird Valley. We hope that dreamers rise up from the community and cast a vision that brings enough people, energy, determination, and hope to transform community. It will be difficult, success is not ensured, & so far the soul of poverty has been winning the war.

Mountain Women

Public Health nurses Angela (l) and Marilyn drove many miles in the "Blue Goose" (a temperamental old Jeep) providing care for elderly patients in scattered hollers. Their predecessors rode horses to provide care in the region.

One of the best things about mountain life was getting to meet & know awesome women. They are the best kept secret of the mountains. I heard stories of women shooing mountain lions off their porch with nothing more than an aerosol spray can, warding off intruders with a machete used for clearing brush, riding horseback or driving Jeeps to provide medicine and care in isolated hollers. One thing is certain: they are the backbone of family and culture in the hills.
It was not uncommon to find women working hard to support their families. We had many at Red Bird who were extremely dedicated, hardworking, and juggled the demands of life with grace. They follow in a long line of women who more than survived the hardship of the hills; they thrived in harsh circumstances. Some, however, lived lives I could neither understand nor accept: willing to support a husband who would not work, nor care for the affairs of home and children while she worked, or perhaps even engaged in illegal activity. There seemed to be no end to some women’s devotion to their men. Many endured a lifetime of isolation, violence and domestic abuse, alcoholism, or at the very least a life of being second-place. Mountain women are survivors.
I was often puzzled by the contradictory messages about the place of women that I heard from church and culture. The messages from mountain churches were that men are to be the head of households and heads in the church. One little congregation had no Sunday School for children because the men wouldn’t let the women teach, yet none of them would either. Women heard a lifetime of “submission” sermons. Women preachers were certainly not accepted in the indigenous churches. And yet for all the preaching about their proper place, women ruled home and community life.
I knew of a married man whose mother called him each morning to wake him for work; of another mother who called her daughter incessantly at work; of another who, even more obsessively, insisted on going to work with her daughter every day. Several of our married staff even told me they’d move back with their Mommy (the favored maternal term) “in a heartbeat”—with or without husbands. In disbelief I asked how their mothers felt about that. “They’d love it,” I was told. This seems to me the weakness of a strength taken to extreme. I found many relationships with mothers to be loving, close, and respectful. I also found those that were parasitical, manipulative, & intrusive. But I am not a mountain woman & knew I never would or could be. For better or worse, women rule the mountains. And don’t let any of the mountain men tell you otherwise.

Gap Cave

A tiny subterranean salamander was a bright flash--invisible beauty except for those lucky enough to see one down under. (Photo taken w/o camera flash & w/ permission of Guide)

Cumberland Gap-Gap Cave
Ranger Matt lead our group of ‘spelunkers’ one hot July afternoon into the depths of Gap Cave. The coolness was a welcome change from the humidity and heat of a Southern summer day. We learned about the diverse history of the miles of subterranean caves in the area, including their use by Native Americans of the area, their shelter for Civil War soldiers, and their exploitation as tourist attractions decades ago—including one of its chambers being used as a popular dance hall. Our walk was surprisingly strenuous, with no amenities for handicap accessibility and rather rough wooden stairways to access some of the chambers. But there were enough stalagmites and glistening flowstone cascades, large and small chambers, and subterranean wildlife to capture all of our imagination. Our walk to the caves included a mile along the historic Wilderness Road.

Hensley Settlement

Split-rail fences at Hensley Settlement
Original buildings of the Settlement remain intact. One loses any sense of being on a mountain top in the sweeping meadows of the site.

Cumberland Gap-Hensley Settlement

Exploring the now vacant Hensley Settlement is like taking a step back in time. Located on the large flat top of Brush Mountain, one can experience the quiet solitude and isolation of the Hensley families who made their homes there in the early to mid-20th Century. One can still walk down fence-lined lanes, step into the blacksmith's shop, look into the springhouse and sit in the one-room schoolhouse. A family cemetery occupies a corner of the large meadow; its many children’s graves a testament, perhaps, to the practice of intermarriage on the isolated mountaintop. The Hensley Settlement was established in 1904 by Sherman Hensley and was occupied until 1951. A Hensley family member still lives on the mountaintop as a guest of the National Park Service; his job is to provide security and a human presence to discourage vandalism at the site. The Park Service continued to manage a working farm at the Settlement until recent years; now it is only accessible on Park tours.