Imagine for a moment that you lived somewhere remote. Your small town is surrounded by mountains — the nearest major hospital is hours away, and the only jobs that exist are retail jobs that pay little and offer few, if any, benefits. Now, imagine you had to pay out of pocket for all your medical visits and medications. Your access to basic infrastructure and income are limited, and your community is often overlooked. How high on your list of priorities would routine medical care be?

Probably not very high.

Unique Challenges to Healthcare in Appalachia

That’s just a snapshot of what life can be like in rural Appalachia — where the cultural roots run deep, but the economy and infrastructure have been struggling for decades — where the residents must choose between their diabetes medication or groceries for their family. It’s a simple choice for many people in these circumstances.

You buy the groceries.

These are some of the patient-care scenarios that Goodwin University Nursing students encounter when they travel to Wise County, Virginia, each summer to provide medical care to residents at a weekend-long pop-up medical clinic. In previous years, this medical clinic was run by Remote Area Mission (RAM), and last year, the Navy Reserve joined for an Innovation Readiness Training. After years of involvement, RAM has stepped aside as the local medical clinic in Wise County has taken over the organization and implementation of this much-needed public health initiative.

When Culture Impacts Healthcare

Poverty exists in many areas. One doesn’t have to leave CT to see poverty’s impact on human health — we have underserved and uninsured populations that need care and compassion right in our own cities and towns.

What students encounter in Appalachia is unique, however.

“This medical mission to Appalachia is very exciting. Even though I expect to see some people living in unbearable situations, I look forward to providing the best medical care and support while connecting with humanity in this way. This experience will help shape how I provide care to others, despite their economic situations, using a holistic approach. With this opportunity, I will not only empathize and care for these underserved individuals, but it also will shape my mindset about changes and approaches that my peers and I can implement in the future of healthcare.”

– Sashin Hanson, Nursing Student

In Appalachia, many factors that influence healthcare intersect in significant ways. Culture, poverty, geography, lack of resources, and distrust have all resulted in a community of people feeling left behind. These circumstances pose a unique challenge to community service volunteers, like Goodwin’s Nursing students, who arrive to volunteer their time providing medical assistance.

When GU Nursing students arrive and set up, they encounter the surprising and often devastating medical conditions that arise when routine and treatable medical issues go untreated for too long. They see what happens when a patient with diabetes doesn’t receive insulin regularly, or someone with gum disease goes untreated. Nursing students encounter patients with heart conditions that aren’t monitored by medical professionals. Methamphetamine usage is also a significant problem in the region but access to Narcan — an emergency medication used to treat overdoses — requires special training.

“There are so many values taken from the RAM trip that I needed reminding of. I need to remember never to take what I have for granted. After witnessing people sleep in tents and in their cars overnight to seek medical care, the next time I have to wait an hour for my doctor, I will not complain. It was an incredible trip – one that I will never forget. All the skills I took away from attending RAM from both a personal and professional aspect will assist me in my future career as a registered nurse. Most of all, I learned that showing compassion and caring for someone is the most important thing— all the rest will follow.”

-Barbara Stebbins, Nursing Graduate

For many patients arriving at the medical clinic, this is the only medical care they will receive for the entire year — until next year’s clinic. Decades worth of much-needed medical intervention is condensed into one weekend. Locals arrive early and camp out overnight, waiting to see the doctors, nurses, and other volunteers ready to provide attention and medical care.

“One of the most important reasons we go on this mission is because I want students to see how culture impacts healthcare — to show how factors like culture, religion, and geography can impact a community’s access to adequate healthcare,” says Sue Grabowski, Nursing faculty member, and trip facilitator.

Move Mountains Medical Mission

This year’s clinic is different from years past.

2023 is the 5th year that Goodwin University Nursing students have gone to Wise County, Virginia, to volunteer.

We’re now three years into the Covid-19 pandemic, the impacts of which were exacerbated by pre-existing conditions such as obesity, diabetes, and other autoimmune disorders; the types of ongoing medical issues faced by the residents of Wise County at a higher rate than in other parts of the country.

The pop-up clinic has changed over the last few years. The organization that started the clinic, Remote Area Medical, has stepped aside to allow a local medical clinic to take over. Now called the Move Mountains Medical Mission, this weekend-long clinic is organized by the one medical clinic in the area that offers year-round services to the people willing to travel to the clinic and pay out of pocket for their treatment.

Last year’s clinic was aided by the U.S. Navy — which offered services as part of a two-week-long Innovation Readiness Training mission. Last year’s clinic being two weeks long meant that residents had more time to come to the fairgrounds and seek medical care. This year the clinic is back to three days over a weekend. Volunteers arrive days before and begin setting up at a local fairground.

Because of the length of the clinic last year, volunteers had some relief in the numbers. Fewer patients seen per day meant more time to meet with individuals, provide care plans, and get them through the various medical stations at the clinic. This year, nurse volunteers will face much higher numbers of patients per day while providing the same caliber of care.

These Nursing students will see more patients and more medical conditions in this one weekend than they could throughout the first few years of their nursing careers. It’s a rigorous and immersive hands-on experience in providing patient care. Students are set to take part in this mission from July 25 to August 1 of this year.

“I have always believed that we were each created to change the world for someone and make it a better place by helping and serving them with kindness and complete care. This is what this mission trip is about. I am so excited about contributing my time and skills as a student nurse in providing life-changing care for people in serious need of medical attention.”

– Silvana Alushi, Nursing Student

Choosing the Right Nursing Students for the Mission Trip

Knowing how challenging this nursing mission trip is, Goodwin’s Nursing faculty must be selective in who they choose to join professor Sue Grabowski on the mission trip. Each year, students must apply for the mission trip through a comprehensive selection process that involves writing personal statements and meeting certain academic criteria to qualify for the medical mission.

“This nursing mission trip to Appalachia will be a transformative experience that will help shape my nursing career. It will provide me with a deeper understanding of healthcare disparities, enhance my clinical skills, and foster a strong sense of empathy and commitment to my patients. I’m excited about this invaluable opportunity and look forward to the growth and knowledge it will bring.”

-Leah Chung, ABSN student, and 2023 Nursing mission participant

This year, four Goodwin students from the AS Nursing and ABSN programs are going on the upcoming trip.

“I was honored and thrilled to be allowed to attend the nursing mission trip to Appalachia. My decision to become a nurse is motivated by my desire to help as many people as possible and make a difference in the lives of those I care for. This trip was the perfect place to do just that. I also wanted to broaden my understanding of how geographic location, economic status, as well as religious, cultural, and social beliefs contribute to one’s perceptions of healthcare. I gained invaluable knowledge from this experience that will enhance the patient-centered and culturally competent care I provide throughout my career.”

– Kristen, DellaCorte

This year’s mission cohort, along with trip facilitator Sue Grabowski, MSN, RN, will be documenting their travels this summer through their medical mission blog. Be sure to follow along as they share photos and write about their experiences.

The support for Goodwin students to have this professional enrichment experience is provided by the Stanley D. and Hinda N. Fisher Fund at the Hartford Foundation that has supported past medical mission trips. The University is incredibly grateful for this support, which benefits not only the current students but the many individuals who will be entrusted to their care in the future as well.