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The Magazine o f the C H R IS T IA N A P P A L A C H IA N P R O JE C T AUGUST
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VOL.
NO.
primary elections featured many
by Katie Newsome
pledges from candidates to “fix
Welfare: Health Care in Transition
health care” on a legislative level. In the eastern part of the state, the
by Margaret Gabriel
problems in health have been much the same for many years: a shortage
The Health o f A Community
Page 4, Meeting The Challenge
welfare reform allows for a year of Medicaid benefits for former cash recipients who enter the work force, it seems that people without insurance will become more numerous rather than less. This issue of The Mountain Spirit looks at the effect of welfare reform on
by Beth Dotson
Page 24, The Many Hats o f the Public Health Dept.
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R an d o m T h o u g h ts
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Page 16, The Health o f a Community Published by the Christian Appalachian Project E d ito r M a rg a r e t G a b r ie l
G raphic D e s ig n K a r e n F r a n c e s S p iv e y
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A round the Project
of primary care physicians, and many people without health care insurance of any kind. Although
The Many Hats o f the Public Health Department
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The state of health care is in transition for most Americans, not just those who have low incomes. In Kentucky, the recently completed
M eeting The Challenge
by Margaret Gabriel
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XVII,
Health Care
C irculation
Letters to the Editor
L in d a G r id e r E a s t
T he C A P C lo seu p
F a th e r R a lp h W . B e itin g , M ik e San d ers, B ill B egley, Ik e A dam s
A d v iso r y Board:
The Mountain Spirit is published six times a year. The annual subscription price is $8.00. Subscriptions and other correspondence should be sent to The Mountain Spirit, Christian Appalachian Project, 322 Crab Orchard Street, Lancaster, KY 40446. Copyright, 1997, The Christian Appalachian Project, Inc. All rights reserved. Member, Catholic Press Association. The Christian Appalachian Project is a non-profit Christian service organization operating throughout Appalachia. The project operates on the philosophy that helping people help themselves is the best approach to Appalachian poverty.
health care and introduces readers to some new concepts, and to some long-time providers. On page four, you’ll learn about Appalachian Regional Healthcare and how they involve local communities in health care options and services. On page sixteen, read about the work of the Christian Appalachian Project’s Community Health Advocates Program which promotes good nutrition and healthy relationships in Magoffin, Floyd, Knott and Johnson counties. On the cover, nurse Eva Stone and a satisfied patient at the Garrard County Health Department.
A summary of the registration and financial documents filed by this organization can be obtained by contacting: in Maryland, for the cost o f copies and postage, the Secretary o f State, State House, Annapolis, MD 21401; in Virginia, State Division o f Consumer Affairs, P.O. Box 1163, Richmond, VA 23209; in Washington, residents can call the Secretary o f State toll-free within the state at 800-3324483; IN NEW YORK, OFFICE OF THE ATTORNEY GENERAL, CHARITIES BUREAU, 120 BROADWAY, NEW YORK, NY 10271; IN NEW JERSEY, THE ATTORNEY GENERAL BY CALLING 201-504-6215; IN PENNSYLVANIA, DEPARTMENT OF STATE BY CALLING TOLL-FREE WITHIN THE STATE, 800-732-0999; IN WEST VIRGINIA, SECRETARY OF STATE STATE CAPITOL, CHARLESTON, W V 25305; IN FLORIDA, THE DIVISION OF CONSUMER SERVICES BY CALL TOLL-FREE WITHIN THE STATE AT 800-435-7352- IN NORTH CAROLINA, FINANCIAL INFORMATION AND A COPY OF THE LICENSE ARE AVAILABLE FROM THE STATE SOLICITATION LICENSING BRANCH AT 919-733-4510; or by writing to Christian Appalachian Project, 322 Crab Orchard Street, Lancaster, KY 40446. Our license number in Michigan is MICS 9933. Registration with any o f the above government agencies does not imply endorsement by the state.
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friend of mine recently graduated summa cum laude from the Univer sity of Tennessee. This lady has been through two marriages; one lasted two years and one ended after 12 years. During her second marriage, she and her husband worked hard to build a beautiful log house but then she lost it in the divorce settlement. After her divorce she had to move several times, but has managed to keep two young children in school and other recreational activities. Her children are now 16 and 13 years old. I find it amazing that this young woman just turned 45 in January! We have all known people like my friend. These are people who, in spite of many trials and obstacles that enter their lives, seem to be able to cope with what ever happens to them. These people have good mental health — they are focused and centered. But, just what is good mental health? Many professionals define good mental health as the absence of mental illness. But just as light is so much more than just the absence of darkness, mental health can be described as something that is, not something that isn’t. Good mental health is the ability to balance, in a positive manner, family relationships, social relation ships, work and community life. If one is able to balance positive aspects of family relationships such as weddings, births and graduations, against such negative aspects as death, divorce, or unfulfilled expectations of self or others, one would certainly have good mental health. This same balancing ability carries over to social relationships, work and commu nity life. A person who has a good acceptance of himself or herself, being able to evaluate both faults and at tributes, has good mental health. A person who sets goals and has a purpose in life — one who has control over life, seems to have good mental health. Good mental health suggests normal, positive functioning, while on the other hand, mental illness suggests dysfunction. The mentally healthy person has made healthy life choices and is content with those choices. If given lemons, a mentally healthy person makes lemonade. The mentally healthy person has a positive attitude. JULY
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Brenda Wireman
For example, the loss of a job becomes a challenge to explore new opportunities, to relocate in a new exciting place, and to meet new people. The mentally healthy person has acceptance of self and of others. And, I believe, a deep trust and faith in God. He or she has learned “to change the things that can be changed, accept the things that cannot be changed,” and has wisdom from God to know the difference. A mentally healthy person strives to maintain a balance of emotions, striking a median range between extreme happiness and extreme sadness. A psychologist once said to me, “If people would simply trust the Lord in all aspects of their lives, there would be no need for my services.” I truly believe that to be true. If you believe and trust the Lord to provide for all of your needs, your mental health, which links your mind, body, and social life in an arena of acceptance will be ideal. A mentally healthy person is involved in life — always learning, looking forward to new challenge and opportunities, experiencing life to the fullest, and always standing firm in a belief and trust in God to provide and care for His own. •
Brenda Wireman is the manager of CAP's Community Health Advocates, which operates out of Salyersville.
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Eula Elall, Founder o f the M ud Creek Clinic in Floyd County, Ky., that serves over 15,000 patients yearly.
Meeting The Challenge:
Health Care in Appalachia by Katie Newsome Providing adequate health care to people in Appalachia has always been a challenge. This task has been addressed by many highspirited groups and individuals who assure that the health care system is not only ad equate, but in a constant state of evolution to meet the needs of the communities. 4
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An ambulance siren vibrates from the hillsides along the Left Beaver section of Floyd County. Every person that hears this ominous sound starts a prayer: “Lord, please, let them be all right.” Local people are sure to know the person, a family member or a neighbor of the passenger in the ambulance. This is rural, small town Appalachia. This piercing sound of an EMS vehicle is much like the wailing siren from the coal mine of long
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ago when there was a slate fall or an accident with men trapped in the mine. At that time in Appala chian history, coal mining was the major industry of the region. Injuries to miners were many, benefits were few, and reliable health care was practically non existent. In 1956 members of the United Mine Workers of America (UMWA), its president, John L. Lewis, and thousands of citizens dedicated the Miners Memorial hospitals in Harlan, Hazard, McDowell, Middlesboro, Whitesburg, Pikeville and South Williamson, Kentucky; Man and Beckley, West Virginia; and Wise, Virginia. The goals was to provide miners and their families with the best possible health care. By the early 1960s Miners Memorial Hospitals were declin ing rapidly as the number of mining jobs had been cut in half. Declining royalties by the coal company and fewer miner contri butions to the fund were depleting the resources of the hospitals. UMWA decided to sell the facilities. Rev. Samuel McMaster Kerr, then pastor of the First Presbyterian Church in Harlan, Ky., realized the consequences of MMHS’s decision. He asked the Board of National Mission of the Presbyterian Church to investigate. Church leaders vowed to find a solution.
ARM Formed In 1963, the Board of National Missions formed a new and independent not-for-profit corporation — Appalachian Regional Hospitals (ARH). ARH purchased the first hospitals with a $3.9 million grant from the Area Redevelopment Administration, established by President John F. Kennedy. Governor Bert T. Combs JULY
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called a special session of the Kentucky legislature to approve $700,000 to support indigent care during ARH’s first year. From the beginning ARH has responded to the changing demands of rural health care. The corporation changed its name to Appalachian Regional Healthcare to more accurately reflect its farranging activities. The Home Health Services, first initiated at McDowell ARH in Floyd County, is now one of its largest services and celebrates 26 years of care in 1998. Elderly people and those with disabilities benefit greatly from the home health agency. Patients are under doctors’ care, but recovery and care is at home instead of the hospital. Home visits by a nurse monitor a patient’s condition, and nurses are in direct contact with doctors, if need be. It is common for a nurse to become an adopted member of a patient’s family; many friendships continue to grow long after a patient has recovered and no longer needs services. Extensive renovation at McDowell ARH in 1995 resulted in a new emergency room with five examining rooms with all new equipment. A teleconference link to larger urban hospitals will be added soon. The link will be most helpful when a patient is referred to a hospital that is two or three hours away by ambulance or requires airlift by helicopter. By the 1990s the impact of a dying coal industry, a sinking economic base and people going outside Appalachia for health care was threatening the very existence of rural health care services. Again, the challenge is being met. The management team of ARH, with its president and CEO, Forrest Calico, M.D., (a member of the Christian Appalachian
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Project board of directors), contracted with the University of Kentucky Center for Rural Health to begin a Community-Initiated Decision Making (CIDM) process. This project involves communities in determining the changes that need to be made in their local health care system.
Community Involvement In 1994, the Harlan ARH was chosen as the pilot site to begin the community involvement process. The UK Center for Rural Health hired Harlan native Annie Fox as a Community Encourager. The UK Center for Rural Health became the sponsor of the project to eliminate bias on the part of the hospital and encourage honest input from people in the commu nity without fear of reprisal from local health care providers. This allowed for honest input — sometimes painfully honest — of the community’s perceptions regarding local health care. Extensive in-depth interviews were conducted throughout the area with local residents who represented all areas of rural life: low-income people, business owners, educators, government officials, young parents, elderly people, unemployed people, health care workers, doctors, and people in the religious community. From these interviews, Fox appointed a local Community Health Council. With information gleaned from the interviews, the council made their recommendations. Positive changes occurred in the Harlan community, including increased use of local health services, collaboration between competitors and increased access to health care for people who formerly “fell through the cracks.” There was an
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increase in community education and knowledge of what was available in the community. The improvement led to enhanced recruitment and retention of needed doctors and other health care professionals. McDowell ARH is one of seven hospitals in the group that have participated in the community involvement process since the pilot project in Harlan. McDowell has experienced similar improve ments and task forces are now working to complete a resource book of local health care providers and to establish a youth/teen center to offset the high incidence of teen pregnancies and substance abuse. Nearby, Our Lady of the Way Hospital at Martin, Ky., was a co sponsor with McDowell ARH on the community involvement process. A part of the Catholic Health Initiatives, this not-forprofit hospital recently marked 50 years of service to the community. The Community Health Education Department of Our Lady of the Way makes a positive impact in the community with programs such as smoking cessation, CPR classes and diabetes care.
Teens Learn to Respect Selves The “Respect” program is being taught in four county schools and a fifth will be added in the fall of 1998. Funded by a grant from Catholic Health Initiatives and the March of Dimes, the program was developed by the Community Health Education Department of Our Lady of the Way Hospital for girls in sixth and seventh grade girls to build self-confidence, self esteem and motivation — and to understand the importance of postponing sexual involvement 6
and the consequences if abstinence Department works closely with “Respect” in a program called is not practiced. “Postponing Sexual Involvement” Responding to the community’s for grade school students. The concern and the high incidence of teen pregnancies, “Respect” is a department continues the theme of series of ten abstinence into sessions, each high schools with a “One person can “Reducing the with a different topic, but Risk” program related to and make a difference.” geared toward all first year high overlapping the others. Discus school students, Eula said. “It's a sion on career again with parental permission. choices and miracle, in many budgeting and Local county health departments guest speakers ways, how far are frequently the are integral first rung on the parts of the we’ve come here at program. Young ladder of local health care. mothers in the the clinic. Realizing transpor area bring their babies and Whatever the need tation is sometimes difficult for people speak to living in outlying students about is, we meet it. The their experi areas of the county, the department in ences in caring good Lord is with Floyd County for a new child. “Baby Think established two us,” she says. It Over” dolls fully staffed give the satellite branches Eula Hall students first in Wheelwright and Mud Creek Clinic Betsy Layne, Ky. hand experience in caring for a Both towns are nearly twenty miles from the newborn in a simulated, but realistic, situation. The computer in county seat. A combined effort of ARH and the doll allows it to cry at any and all hours. When the girls take them local health departments in 30 eastern Kentucky counties, the home for a day or two, the whole Care Van brings a mobile family gets to see what it is like to have a newborn infant in the home. mammography unit to women at health departments, clinics, The student must take care of the “baby,” check its diaper, change its schools, churches and places of employment. The van provides clothes, bathe, feed, hold and rock it until it stops crying. If the student mammograms to women who otherwise might not receive them wants to go out she must take the because of lack of access or a lack “baby” or get a reliable “baby” sitter. This program is approved by of money. The van was supported by funds from several sources each school’s decision-making including the Susan G. Commune body and the girls must have Breast Cancer Foundation and the written parental permission to Appalachian Regional Commis participate in the program. sion. The Floyd County Health T
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There are several clinics throughout the region; some are branches of the local hospitals, others are privately owned. The Big Sandy Health Care, Inc. is a federally funded program with primary care facilities in Pike, Floyd and Magoffin counties. These clinics were established to offer health care to persons who had no health insurance or limited means of paying for their medical needs. The clinics serve over 32,000 patients each year. Mud Creek Clinic in Floyd County sees approximately 15,000 of these patients. Mud Creek Clinic and its founder, seventy-year-old Eula Hall, have a combined history. Eula still works at the clinic full time as their social worker/patient advocate. “I like to work,” Eula says. “I live alone and I would much rather be here helping people than sitting around. I don’t care much for some people who think just because you’re older that you are helpless. I know better! I have some arthritis and I’m diabetic, but I take my medicine and go on. I believe in living and I mean that in an active way, until you die. Don’t accept anything less,” Eula says. Eula is a local and regional legend. In the 1960s she helped lead community protest over the lack of health care in the Mud Creek area of Floyd County. The Mud Creek Health Project, Inc. was formed in 1973 with the help of volunteers, support from local health care providers, and the determination of Eula Hall that the project wouldn’t fall by the wayside. “I’m not a registered anything.” she says. She dropped out of school in the eighth grade, married when she was 17 and gave birth to five children at home. She is a living example that one can overcome strife and live a happy, JULY
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productive life. “One person can make a difference.” Eula said. “It’s a miracle, in many ways, how far we’ve come here at the clinic. Whatever the need is, we meet it. The good Lord is with us,” she says. Forrest Calico,M.D., president o f Appalachian Regional In 1977 Mud Healthcare and Dena Ellis Curry Sparkman, administrator o f Creek Clinic M cDowell ARH. Dena is a native o f the area and a graduate o f became a part of Alice Lloyd College and the University o f Kentucky. the Big Sandy overflowing, with long waits for Health Care, Inc. Eula has been honored by appointments. Recruitment and retention of dozens of organizations and has many physicians to the area is an been written about in many ongoing task. Several programs publications and appeared on several TV talk shows, always encourage both local and interna telling of the needs of the people tional doctors to locate and make and Mud Creek Clinic. contributions in the area. “I always dreamed of being The McDowell ARH Hospital somebody like I am. Somebody in has taken a step further and gone a position to help people,” Eula to local high schools and colleges to encourage students interested in says. “I never say no. I always let people know I’ll do what I can for health care professions to volun teer at the hospital in order to them.” The last five years have seen experience the atmosphere of much expansion of health care in health care. Several pre-med the region. There is a new cancer students spend their summers center in Pikeville, Ky., also host working at the hospital to add to to eastern Kentucky’s first school their medical background. of osteopathic medicine, which There is an unending list of began accepting students in the fall changes in the field of health care. Health care will present a chal of 1997. The Pikeville Methodist lenge in Appalachia for many Hospital has made major changes years to come, but it seems that and is currently training and those challenges will be met by staffing an open heart surgery groups and people with vision who program, the first of its kind for will bring new and innovative eastern Kentucky. solutions to the problems. As has been the case for many years, eastern Kentucky is Katie Newsome thanks Annie Fox, the considered to have a shortage of Community Consultant fo r A R H in physicians. The local physicians Harlan, Ky., fo r her assistance with and specialists native to the area, this article. have practices that are usually
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WELFARE... _jn r
by Margaret Gabriel
C u e in T o * '8* " '* B e A LTB Wanda made her choice, rolled the dice and took a part-tim e, low-paying job, hoping that it would lead to an opportunity fo r full-tim e employment. The decision also m eant that Wanda w ould lose M edicaid benefits fo r h erself and her daughter. Then she learned that she was pregnant with her second child. “It took me six years to p a y o ff those bills, ” she recalls. The Personal Responsibility and Work Opportunity Reconciliation Act, more readily known as welfare reform, makes a scenario like Wanda’s less likely to happen. Under the Kentucky Transitional Assistance
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Program (K-TAP), a family at 185 percent of the federal poverty level is eligible to continue receiving Medicaid for one year after joining the work force. Nearly 15,000 fewer families are receiving cash assistance in 1998 than 1997 and for many, this has been possible T
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because the family still has access to health insurance. Because people often have to take low-paying jobs with no benefits, it remains to be seen exactly what the early drop in the number of people receiving assistance indicates. Are people not only entering the work force, but leaving chronic poverty? “The long answer is more problematic,” said Dr. Tim Jackson, deputy commissioner for the Kentucky Cabinet for Families and Children at a CAP seminar recently. He said that although early data is encouraging, the effects of welfare reform will be far more evident in 2001, when we can determine whether people are out of poverty or just falling between bigger cracks. “It’s encouraging, but the victory is by no means won,” Dr. Jackson said. “We must know more about families who have gotten off the welfare rolls.” The victory will be closer at hand if more attention is paid to preventive measures, as is being done by CAP and other programs. Bill Belcher, manager of the Christian Appalachian Project Family Life Counseling Service reports that Medicaid is making counseling services available to severely troubled children, which will save public dollars in the long run. “It’s good from a preventive standpoint, if we can deal with a child’s needs early on,” Bill said. “That will prevent another generation of problems.” n
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care is going Services are to be twice as available to help important.” the child’s family Sister and to consult with Loretta schools and other Spotila, professionals, as director of well. “That allows the Interfaith us to do more Wellness intensive work,” Ministry in Bill said, since Estill County, they are able to Ky., worked work with many for 30 years aspects of the as a child’s family and registered school contacts. nurse in While extension Cleveland, of Medicaid will Ohio. She help people make visited the the transition to the Appalachian work force, there region during are still problems an to be tackled. It is “immersion” not known how with the many of the Appalachian 15,000 people who Ministries have joined the Educational work force are Resource working at jobs Center in CAP Community Health Advocates that provide health Berea (see benefits and how The many of them will Mountain Spirit, Novemberno longer be eligible for Medicaid December 1987), and was after one year of work. Although “astounded to see that the War on benefits will still be available to Poverty is not over,” Sr. Loretta pregnant women and children said. “I saw terrible need here. By whose families are below 185 the end of the week I found that percent of the federal poverty God was calling me to work here.” level, it seems evident that before Through several churches in long a larger segment of the Estill County, Sr. Loretta works to working poor will be without create healthy families, healthy medical insurance. churches and then healthy Brenda Wireman, manager of communities by integrating faith CAP’s Community Health and health, she said. Advocates says that they are “If God is in your life, God beginning to feel more of an urgency to promote wellness. “But wants you, body, mind and spirit. we’ve never focused on preventive Having those things in balance health care in this county,” Brenda puts you in good health.” Sister Loretta points out that 80 said. “We’ve always want to fix a percent of the billions of dollars problem after it happens, especially people in this area. With spent on health care in this country is devoted to high tech hospital the cut of Medicaid, preventive
“We’ve always want to fix a
problem after it happens,
especially people In this area. With the cut of
Medicaid,
preventive care is going to be twice as important.” BrendaWireman
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care. She said that by emphasizing the importance of a healthy diet, moderate exercise and good sleeping habits, all relatively low cost preventive measures, the need for expensive medical care will be far less. A 1995 report by the Good Samaritan Foundation identified wellness education as a top priority for the area, she said. Health care will be impacted by welfare reform because of a lack of primary care providers in the area and because people will not have the means to access health care, Sr. Loretta believes. “There are people who have [private] insurance and others qualify for state assistance, but there will still be those people in the middle,” she said. “But even if people are able to go [to a doctor], if they do these things, they won’t get sick later. Prevention gives a better life and prevents problems down the road.” Brenda Wireman, too, expresses concern for people who fall outside the boundary of those receiving assistance, “And most of them are men,” she said. She fears that the mortality rate will increase because people will not be able to access the medical treatment that they need. The federal regulations concerning benefits for health care have been designed to “increase flexibility to research care delivery alternatives while controlling program costs.” An increase in the support of people and programs teaching families how to stay well instead of finding ways to pay for illness could very well be a way of controlling those program costs. •
The Mountain Spirit is examining different aspects o f welfare reform this year. The Septem ber issue will focus on economic development
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CAP Sponsors Partnership Seminar at Hazard Community College 43 Agencies Send Representatives To Network with Others in Region Nearly 80 people representing 43 grassroots service agencies participated in the Community Partners Seminar, sponsored by the Christian Appalachian Project at Hazard Community College. The workshop was planned by Sheila Helton, manager of CAP’s human development grants, and Tom Conner, director of human development. “We wanted to share some of CAP’s success in the area of grant writing and give people an opportunity for networking,” Sheila said. Breakout meetings included sessions on grantwriting conducted by CAP grantwriters Kathleen Leavell and Ike Adams, training for volunteers and other staff, and ways to create partnerships in the region. Dr. Tim Jackson, deputy commissioner for the Kentucky Cabinet for Families and Children, updated the group on the Personal Responsibility and Work Opportu nity Reconciliation Act, informally known as welfare reform, address ing the questions “where have we been, where are we now and where are we going?” Early data indicates success with the reform, Dr. Jackson said, but in the years to come, the questions will be answered more successfully when the state and service providers can assess the number of people who have not only entered, but stayed, in the
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CAP assistant director o f human development Brenda Riddle (seated) greets Dr. Tim Jackson at C A P ’s Community Partnership Seminar.
workforce and are no longer considered poor. “For some Kentuckians it’s not as easy as just going out and getting a job,” Dr. Jackson said. Especially in eastern Kentucky, he said, people who have been receiving cash assistance have as many as seven barriers to success that include a lack of education, child care or transportation and problems with self-esteem, domestic violence and substance abuse. Dr. Jackson said that welfare reform, a work program, is designed to move people from assistance to the work force, but it is important to realize that just because a person has made that transition, he or she hasn’t neces sarily escaped poverty. “Frankfort doesn’t have all the T
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answers,” he said. “In fact, sometimes, we don’t even know the questions. We’ve learned that sometimes the best way to support the local community is to get the heck out of the way.” Saying that networking is critically important as the welfare to-work process continues, Dr. Jackson commended the assembly for working together to solve common problems. Angie Strunk, with the McCreary County Adult Literacy program, said “I enjoyed every thing, but I really like the informa tion about grantwriting.” Strunk said that although she has little experience in the skill, she now knows of more potential funding sources. CAP plans to hold the event annually, Sheila said.
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Outreach Program Collaborates On Seed Distribution The Christian Appalachian Project outreach program collaborated with the Jackson County Extension Service and Future Farmers of America at Jackson County High School to distribute seed vouchers to 200 Jackson County families. The vouchers were filled by FFA students. With help from teachers Steve Whitaker and Doug Wilson, they ordered and separated seeds into packages, grew plants and loaded seed potatoes into vehicles for the recipients. They also called people to let them know when to pick up seed. The Jackson County Extension Service helped to find families
interested in growing vegetables and will help them take care of their gardens. Cathy Howell with the Expanded Food and Nutrition Education Project worked with Peggy Hancock, program manager of CAP outreach services, to put together the cooperative effort. The extension service commended the teamwork for the success of “Project Green Thumb.’’ “What a great day this was!” the extension service told the local newspaper. “This kind of success and overall cooperation proves what teamwork is all about, and what can be accomplished if people in a community come together.”
Moving ? Please notify us of any change of address to make sure you receive every issue of The Mountain Spirit. Please print
O ld A ddress
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Mail to: The Mountain Spirit 322 Crab Orchard Road Lancaster, Kentucky 40446
M any people who participate in the CAP garden programs also participate in the elderly services program.
What Can I Do to Help CAP? Not long ago, the Christian Appalachian Project received an email from a supporter who asked about the availability of CAP volunteer opportunities for a family. We replied that because of housing limitations, different opportunities are open for families than are available for single JULY
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people. There are other ways for families to volunteer however. For instance, they might volunteer to tell church and school groups about the problems in Appalachia and that they have learned about through The Mountain Spirit and other CAP publications. We are
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happy to make additional copies of those publications available for distribution. For more information about the various ways of contributing to CAP through volunteer assistance in various forms, please contact The Mountain Spirit, 322 Crab Orchard Street, Lancaster, KY 40446. Our most powerful form of assistance, however, is prayer. No matter where they are or what they’re doing, volunteers, and supporters of all descriptions, can have a mighty influence by praying at least one minute a day for poor people in Appalachia and throughout the world.
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Rainbow Respite Men Enjoy a Week at Camp The Rainbow Respite Care Center will sponsor three weeks of camping during the summer of ’98, one for men, one for women, and one for people with PraderWilli Syndrome. The men spent the week of May 25 communing with nature, and with each other. The center in Renfro Valley provides in-center and at-home respite for families with members with disabilities Over 20 men gathered at Camp Andrew Jackson, the Christian Appalachian Project’s camp in Jackson County, and enjoyed swimming, hiking, canoeing and crafts, said program manager Carolyn Butt.
“All of them participate in our program, but since the house only holds eight people, they don’t get to see other much through the year,” Carolyn said. “A week at camp gave them the chance to renew friendships.” The men seldom have the opportunity to be involved in water sports, so the favorite activity of the week was canoeing
and fishing, “When they caught a fish. When they didn’t, they hated fishing,” Carolyn said. The group was accompanied by ten staff members, who also enjoyed the unstructured week at camp. “I look forward to it every year, almost like a vacation,” Carolyn said. “It gives us an opportunity to get together and relax.”
DOUBLE Your Dollars! If you are a CAP donor, or are considering becoming one, you may be eligible to double your gift through your employer’s matching gift program. Many companies today match monetary support to non-profit community service org zations that are supported by their employees. Many of these companies match the gifts that are made by their retirees as well. Please write for your brochure “Double Your Dollars,” which lists participating companies and instructions. Send correspondence to:
Teresa McAnly, CAP 322 Crab Orchard Road Lancaster, KY 40446 Respecting the wishes of deceased loved ones, or in honor of them, families often request that memorials be sent to us. Memorial gifts live on to benefit others. Many also specify memorial gifts in their wills. Any size gift is welcome. Contact us for more information.
Upon completion, B o o n e‘s Landing will make recreation and retreat facilities available to fam ilies.
Camp to Receive Help from Lawrence County Students The newest of the Christian Before the end of the ’97-’98 Appalachian Project camps, school year the shop students, in Boone’s Landing in Lawrence conjuction with several math County, is benefitting this summer classes, constructed 40 picnic from collaboration with several tables for use at Boone’s Landing. projects at Lawrence County High In the coming school year, the School, according to camp students will work on benches for manager Albert Bloomfield. the tables as well as other projects The Lawrence County Family for the camp. “They’re really Resource Center, which is affili excited about working on an ated with the county middle and ongoing project,” Albert said. high schools, received a grant CAP has also collaborated with from the Points of Light Founda the county directors of the Job tion to involve young people in Training and Partnership Act, applied learning and service Albert said, for help at Boone’s projects. CAP is one of four Landing throughout the summer. organzations that is receiving a CAP workers will provide training portion of the students’ efforts. and supervision. T h e
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Community-Based Housing Agency Reaches Milestone The Federation of Appalachian Housing Enterprises (FAHE) accomplished a major milestone in May when it completed its 1500th new home, in Neon, Kentucky. FAHE is an association of 27 community-based, non-profit housing organizations that build decent, affordable homes for low income families in the Appala chian counties of Kentucky, Tennessee, Virginia and the entire state of West Virginia. CAP has provided some funding to FAHE and its individual member groups over the years and has maintained close ties to the organization since its inception.
The 1500th home, sponsored by HOMES, Inc in Letcher County, Ky. was “blitz built” in just ten days by volunteers from the community, other FAHE groups and 40 volunteers from AmeriCorps who contributed two full days of labor. HOMES, Inc. has been building and rehabilitat ing low income housing in southeastern Kentucky counties for more than 25 years. State Representative Paul Mason presented the house keys to proud new home owner Mary Lou Weber at a celebration held on site on May 8,1998.
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Carol Peterson, Senior Vice President and Director o f H ousing and Community Investment, Federal Home Loan Bank o f Cincinnati, speaks at the 1500th House Kentucky Build Blitz.
CAP Participates in The Human Race The Christian Appalachian Project was well represented at the “Human Race,” a fund raising event that is sponsored by the Volunteer Center of the Bluegrass in Lexington, Ky. The annual race benefits the volunteers of many non-profit organizations in central JULY
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and eastern Kentucky. Nearly 20 employees, volunteers and friends ran and walked for CAP, and in doing so raised over $1100 in pledges for the organization. Volunteer Steve Kneipp was the first place finisher among CAP’s participants.
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What You Don't Know About Wills Can Hurt Your Heirs... Find Out Why. Request j Your Free Copy.
Much of what you know about wills may be misinformation that has been floating around for years. If you think, for example, that wills are primarily for rich people, or elderly people, you may be the victim of a common misconception. The helpful book let offered here will explain how your will can save your heirs from costly delays and confu sion. Send for your copy today. Clip and Mail
Christian Appalachian Project 322 Crab Orchard Street Lancaster, Kentucky 40446 Please send without obligation your booklet, “37 Things People ‘Know’ About Wills That Aren't Really So.” Nam e______________________ Address_ City____ State,ZIP
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CAP Builds Dream Houses in Berea and Louisa Since its earliest days, the Christian Appalachian Project has worked to provide safe, affordable housing for people living in substandard conditions. Repairing family homes has been, for the most part, the way CAP has achieved those goals. Lately, though, housing initiatives have expanded beyond just repair. The Appalachian Development Company, Inc., a for-profit subsidiary of CAP, has constructed neighborhoods in Louisa and Berea designed to provide lowcost housing to low-income working families who dream of owning their own home. Larry Cranfill, president of
ADC, is working on a proposal that will establish partnerships between ADC and area banks to enable families to secure lowinterest mortgages. “Families that have an income of $ 19,000 to $20,000 and a decent credit history may be able to reach these payments, which should be under $450,” Larry said, “Two minimum wage earners per household can support this payment, assuming they don’t have other large debts.” Larry envisions the houses in both Louisa and Berea being bought by “families with a couple of kids who are barely getting by.” Often these are people who
wouldn’t be eligible for housing subsidies, but don’t have the means to cover closing costs and the other requirements of a conventional mortgage. “We anticipate that mortgage payments will be about the same as the rent they’re paying and a better deal because they can start building some equity,” Larry said. “CAP will take a special interest in the families in the houses,” Larry said, “helping them to overcome problems that they might have as new homeowners. “CAP can step in and help with budgeting or emergencies, and should, as far as I’m concerned,” Larry said.
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uring this time of year workers in CAP’s outreach program begin the D work necessary to provide Christmas baskets of toys, gifts and food to the folks we serve. If you would like to take part: NAME__________________________________________ ADDRESS_________________ ________________ _______ CITY, STATE, ZIP___________________________________ PHONE (please include area code)________
• Let us know the size family you would like to sponsor (Gifts for each person in the family should cost between $15 and $25). W e’ll send you information about your family, including ages, sizes and a few gift suggestions;
I would like to sponsor:____small family (1-2 children), ____ medium family (3-4 children),____ large family (5-6 children), ____ extra large family (8 or more children) and parents. TOTAL NUMBER OF FAMILIES SPONSORED___ _____ / am not able to shop for a needy family, but I have included a contribution that will enable you to provide gifts fo ra family.($75.00 provides gifts fo ra family o f five. $20.00 will provide a Christmas food voucher for a three member family.) Any amount you choose will help us share the jo y o f Christ’s birth in Appalachia. Please return to: Brenda Watts • 1333 Slate Lick Road • Berea, K Y 40403
• W e’ll also include family code stickers and a guideline letter with the correct address of where to send your gift box. • Wrap and label your gifts with the name of each person;
• Mail your boxes to CAP by or before November 21,1998. Please adhere to our deadlines, so we can ensure timely distribution of all gifts. T hat’s all there is to it! Your Appalachian fa m ily will have a Christmas they ’ll never fo rg et and you ’ll know that you ’ve contributed to the real meaning o f the birth o f Christ. We look -* fo rw a rd to hearing fro m you! ____________________________
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Families, Staff, Volunteers Gather for Reunion at Family Life Services Family Life Services, the Christian Appalachian Project residential program for people and families in transition, celebrated 10 years of service with a reunion of staff, volunteers and residents at the Family Life Center in Renfro Valley in early May. Over 70 people came from as nearby as Mount Vernon, and former volunteers Sandy Murphy Farrell and Shannon Hodge traveled from Atlanta for the party which included lunch, games and lots of visiting and laughter, according to program manager Liz Phelps. Volunteers Valerie Balling and Sally Stubbs provided carnival games for the children while their parents played bingo, and talked over old times at the “Remember When?” poster, which invited people to write their memories of their days at Family Life Services.
“All day, we noticed people at the poster, sharing stories and remembering,” Liz said. “It helped us to celebrate and say thanks. Most FLS residents are single women with their children, Liz said, although services are also offered to single men and couples. “Women are more frequently involved in the health care and justice systems,” Liz said. “They’re usually more likely to reach out for help.” Mary McNamara, who volunteered for two years at FLS, said that the reunion had the feel of a big family reunion. Mary was attracted to Family Life Services as a volunteer because the residents set their own goals, and the staff and volunteers support them in reaching those goals. “I saw that support come to fruition at the reunion. When they were coming together, they couldn’t
Form er residents o f Family Life Services gathered at the “M emory Wall” and enjoyed pictures and stories o f their days in Renfro Valley.
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wait to tell each other they good news, just like a family.” Liz was happy to see that many of the families were more settled than they seemed to be during their days at FLS. Several of the former residents have married, others have finished the high school equivalency diplomas that they began when they were involved in the program. For many of the families, their days at FLS were tough times, but “they came back to say thanks, and to let the staff know how much they’d done for them,” Liz said. Liz estimates that nearly 1000 people have been helped through the work of Family Life Services. She points out, though, that much of the good work that is done is through the determination of families who want to make substantial changes in their lives and work hard to see that those changes come about.
Are you looking for information about a CAP program that you don’t see in this issue of The Mountain Spirit? CAP’s web site has information about all of CAP’s human development programs, planned giving and major gifts and the volunteer program. Please visit the site at www.chrisapp.org and be sure to sign our guest book!
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b y Margaret Mi by Gabriel
^~me J-Ceatth o fa ommunity f t smatthut dedicatedrgroup gathered in the TaCcon area o f Magoffin County one sunny morning in fate March. They tromped across the wet grass, cdm6edon a red schooC6us that has 6een remodeCedinto a cCassroom/meeting space, and tafhed a6out adopting vaCues that wifimahe their Civesfitter and richer. T h e
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The group leader asked the women to “list five things that you want to do with your life from this point on,” and stressed that part of the exercise might require that they free themselves from mistakes they might have made in the past. With some nervousness, they reflected on things they would do if they only had three months to live (“Let’s assume that our closets are already clean!”), then determined ways to turn their dreams to reality. The key to the discussion was the focus on choice. The group talked about the choices they can make to simplify their lives in order to concentrate on the things they value. The health of a community can be measured in a number of ways, but if people are strong in mind and spirit, healthy bodies are certain to follow. With support groups, nutrition classes and presentations on health and safety topics, the Christian Appalachian Project’s Community Health Advocates Program (CHAP) helps people in Magoffin, Floyd, Johnson and Knott counties acquire the tools for good health. W omen’s groups empower Women’s groups have been central to CHAP for the nearly ten years the program has been in existance, according to program manager Brenda Wireman. Currently, groups that meet in a half-dozen areas in Magoffin and Floyd counties give women an opportunity to gather and talk about issues that affect them and their families. CHAP staffworker Trish Joseph meets with five of the six groups which include women of various ages. The meeting on the school bus in Falcon was fairly typical, Trish said. The women talked about values and goals, JULY
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machine or power tool gives an then crafted decorative cloth bags unaccustomed feeling of success. to hold grocery store sacks using Brenda considers opportunities sewing machines, which Trish and that have grown out of the the group packed from her van to women’s the school bus. groups to be The group among the listened to biggest impact Trish’s that CHAP has instructions had on its then set to participants. work on the “Women in craft. The more smaller experienced communities seamstresses have come helped the less Trish Joseph together to experienced to c h m share ideas and thread their they’ve become a positive machines and gave tips on how to influence in their own homes,” she sew a straight line. said. “These will make good gifts for Women’s groups led to an Christmas,” Trish said. “Or you annual leadership conference, the can make some extra money by sixth of which was held at Camp selling them at yard sales or at Shawnee in Floyd County the Founders’ Day.” While the groups customarily discuss important health issues like breast cancer and domestic violence, and support women who are increasing their education levels and job skills, the crafts that the groups make are often the element that attract women to the groups.’’They enjoy being able to say ‘I did this,’” Trish said. “I’ve had people come into a group and say they can’t paint or they can’t sew, but by the time they leave they see they can do something.” For some women, making something pretty for
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Angie Slone, CHAP staff, with a participant o f the Life Skills Programs.
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Mora a n d her mother, M inerva, w ho w as aCso recognized f o r perfect attendance, 6egan attending a CdlJUIP w o m en ’s group a fter the death o f their 6rother a n d son. “W e were grieving, ” M inerva said. “I f it hadn I 6 een fo r this group, I d o n ’t hnow i f I ’d 6e here now. ” N ora VanderpooC CNJPP “W om en’s (Jroup (participant
been for this group, I don’t know if I’d be here now.” Minerva and Nora met another woman who was grieving the loss of her son. They said that she helped them work through several problems, including depression. “It’s really helped me, and I’d advise it for anybody who’s going through a trying time,” Minerva said. Michelle Collins is one of several younger women who leave their children in the care of husbands and take a week to learn about health issues, both physical and mental. “More than anything else, I enjoy the fellowship,” she
defense, AIDS, and home repair. On Thursday, the women were still talking about a presentation they had heard on Wednesday about welfare reform. Presenter Jim Rechtenwald told the group to be sure to make their voices count by voting, and by making sure that they raise their sons to give women, including mothers, the respect they deserve. Staffer Angie Slone believes that of all of the programs CHAP operates, the leadership conference has had the greatest effect on the area. “The conference covers a wide variety of topics and gives women an opportunity to get together one-on-one. They get ideas from each other and that boosts self-esteem,” said Angie. Life shifts training and jo6 readiness Angie meets with a women’s group in Floyd County, but spends most of her time working with women in life skills training, which she says is her favorite part
said. week of May 4. On a rainy The 1998 conference included Thursday afternoon that week, the CHAP staff recognized ten women presentations on nutrition, self who have participated in the conference every year. Nora Vanderpool, of Magoffin County, calls the conference the “best times of my life.” Nora and her mother, Minerva, who was also recognized for perfect attendance, began attending a CHAP women’s group after the death of their brother and son. “We were grieving,” Minerva Nora Vanderpool says that Women’s Leadership Conferences are the best times o f her life. said. “If it hadn’t 18
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George Webb, CAP Home Repair, serenades with the saxophone, treating his audience to both rock and roll and big band sounds.
tt(We hehped them pich^out new outfits, a n d tooh^ them to the 6eauty parCor — f o r one o f them, it w as the f i r s t time she h a d ever been, a n d she ’s 33 years oCd ” Jdngie Stone CWV of working with CHAP (“I get the feeling that I’m really helping somebody.”). Recently, Angie JULY
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helped two students prepare for mock interviews that will let them know what to expect when they enter the job market. “We helped them pick out new outfits, and took them to the beauty parlor — for one of them, it was the first time she had ever been, and she’s 33 years old,” Angie said. A colleague at a local mental health agency filled the role of interviewer, and Angie told him “to be tough — I want them to be ready and on their toes, but he couldn’t stump them. He said they had a real feel for what they were doing, they were really prepared.” Should they decide to move away from the area — which they might find that they have to do — they’re prepared to work anywhere. “Unfortunately, there are few jobs outside of fast food available in the Magoffin County area,” Brenda said. Brenda and Angie hope to get more referrals from the state department of employment
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services, and to begin a Job Start program similar to the ones that CAP is operating in Jackson and Garrard counties. The mission of health advocacy and that of job readiness easily fit together, Brenda said. “We try to address physical health, mental health, emotional health, spiritual health and through life skills and job readiness training, we incorporate all of that into our teaching. We deal with hygiene issues in life skills, we talk about attitude, behaviors. All of this goes into making people ready psychologically, physically, emotionally to get out there in the work force.” Sc to o t presentations sow the seeds In addition to her work with women’s groups, Trish also makes about 100 school presentations each year to over 3,000 children. With input from teachers and
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A t the Women’s Leadership Conference a part o f every day was devoted to crafts. Here, women are making appliqued t-shirts.
school administrators, Trish determines the topics that she will address in presentations each year. Currently she has presentations prepared on nutrition, personal and dental hygiene and “Home Alone,” a presentation Trish makes to children in upper grades. “She felt this was necessary because it talks about the safety that children need to be aware of, since more parents are going to be out of the home more, with the new regulations around welfare reform,” Brenda said. “Kids get home around 3 or 3:30 and parents don’t usually get home until 5:00. So she’s got a video and a check sheet that she goes over. They list neighbors’ home phone numbers or their granny’s home phone number — whoever is closest to them in the neighborhood, so that if an emergency came up, they would know who to call.” Trish said that the teachers have found the “Home Alone” presentation very helpful in 20
encouraging responsibility in children, and to make them more aware of the need for safety in their own homes. The manners presentation is also in great demand, Trish said, although she finds that most of her students know what’s right, “They just don’t always practice it,” she said. She tells the children that manners are for use all the time, not just when someone is looking, or when they have company. Since its earliest days in the late 1980s, Community Health Advocates has used volunteers in its program, and their expertise has enabled the program to expand in new and different directions. Brenda points out that the women’s leadership conference was conceived and planned the first year by former volunteer Natalie Vasquez and tells of current volunteer Christen Schiffer’s work in developing a presentation on AIDS and HIV, T
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“th ir ty percent o f eightto ten-year-oCcfs are dieting or have 6een on a diet, ”pointing out that even at that young age, chihdren, especiady girCs, are becoming obsessed w ith unrealistic body images. Christen Schiffer CAP Vofunteer which is a personal interest. While she is working to develop her AIDS presentation, Christen is
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giving presentations on eating disorders, a topic that was suggested by teachers. “Thirty percent of eight- to tenyear-olds are dieting or have been on a diet,” Christen said, pointing out that even at that young age, children, especially girls, are becoming obsessed with unrealistic body images. “I start by asking them to list three things about themselves that they don’t like. That’s pretty easy for them,” she said. “When I ask them to list three things that they do like, that’s a lot harder. We talk about how they feel about themselves, and I tell them about their inner qualities that are the most important.” Christen makes laminated cards that say “I Am Special” to give to each of her students.
that Trish brings to her groups, to make them aware of issues that they wouldn’t necessarily know about,” she said. Awareness education and screenings are important components of CHAP because of the high incidence of several types of disease in the region. Angie has performed blood pressure screenings at local department stores and feels certain, she said, that high readings for several people encouraged them to seek
the homes, when we do home visits. For example, one of Trish’s participants is diabetic, so she tries to give her recipes that will help her to cook better.” Brenda says that the incidence of obesity in such a small community makes obvious the need to educate people about improvements in eating, exercising and cooking habits. For women whose time-honored family recipes often call for lard or sugar or both, a switch to healthier
Awareness o f the issues By virtue of training she has taken in Hazard and Martin, Christen is certified by the Kentucky Cabinet of Health Services to give AIDS training. “The statistics say that if you have one case of AIDS in any area, multiply that by twenty, and that will give you a more accurate picture of the number of cases within your county,” Brenda said. “We like to think that as small as this community is, we’ve had no instances, but we have. Christen wants to take her presentation into the churches and into the schools. She’s doing the presentation at the leadership conference.” In the past Dr. Mary Fox, a retired public health physician, has given presentations about AIDS and HIV at the conference. Brenda believes her talks have heightened the awareness of women in the area concerning the disease and the virus. “There are lots of issues JULY
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CHAP w om en’s groups are made up o f women o f a variety o f ages. The older women say they like the vitality o f the younger women, and the younger women appreciate the wisdom o f the older group members.
treatment from a physician. “I hope I kept them from stroking out,” she said. Presentations on nutrition are included in all of CHAP’s programs, and Brenda believes that by giving children and their mothers the same message about food and nutrition, CHAP can have the greatest impact on the health of the family. “It’s part of everything. We do it in the school, we do it in women’s groups, we do it in life skills. We try to do it in
cooking means changing tradition and culture. “Don’t buy that fivepound bucket of lard,” Brenda said she encourages. “Use canola oil, if you have to, or spray with [cooking spray], or something like that. Try to substitute applesauce for sugar. That’s what we’re teaching across the board. In schools we talk about healthy snacks — juice, crackers and peanut butter instead of pop and chips.” Teaching children about the
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from the health department. The kids love it, and it gets better and better every year. It gets people in the community involved with the school.” The career day, like other Community Health Advocates programs, concentrates on making people Delinda Huff, a m ember o f the CHAP staff, helps a participant during the Women’s Leadership aware of Conference. opportunities and issues. “I an active role in planning and advantages of good nutrition is the think awareness is going to make implementation of “Career Day” at most effective way, Brenda said. the difference,” Brenda said. “We Magoffin County High School. “By starting with the first graders have to let people know what’s out Brenda tells of a seminar she and kindergarteners and building there in the world. You hear about attended in 1994 which introduced healthy attitudes and self-esteem, television, and think people know the idea of acquainting children we might not see it in five years, what’s going on if they watch with careers that they might but twenty years down the road, television, but if that were true, explore. “When I came back, I we’re going to see a difference. every house in this county would went to the postmaster, some local Even in our women’s groups, be cleaned up and everybody businesses and the bank and got we’re making a difference in how would speak perfect English — about six people to participate. they perceive themselves. They’re because that’s what we hear on They talked about their careers to taking that home and standing up television, right? But as educators the study hall students. That’s how more, in a positive way. I don’t in the community, as parents, in it got started, then the next year mean they’re going home and our church, whatever role we play, the resource director called me to kicking their husbands out the we need to make young people ask how we could do it together.” door, but they’re learning new aware that there are other things CHAP staffers continue to ask ways to talk, to communicate with besides what you see around you local businesses and professionals their husbands and with their here.” to participate, “and we participate children.” If, in fact, the health of a by having a table there,” Brenda community can be measured in a said. “The child development cls a partner number of ways, then one of the center and counseling service have most important ways is to look at also participated, and we’re listed The CHAP offices in the things that people value. A on the brochure as a sponsor. Salyers ville receive a large community that values good health That’s one way we let the assortment of written material on through simple living is certainly a community know what we’re nutrition and other health issues community that will be a strong doing. This year we had nearly 60 which they share with groups, and leader in the next century. booths, with everything from in school presentations, and are • dentists to a modeling agency often in alliance with local health M argaret Gabriel is the editor o f the from Lexington. We’ve had The Mountain Spirit. departments for additional veterinarians, car salesmen, people information. CHAP has also taken
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L etters to the E d itor Being from Kentucky and having lived the country life, I am very fortunate to have accomplished my goals in life. Give the people a chance to prove themselves and the world will be a better place. Keep up the good work and tell them to never give up. Howard B. Dillon Indianapolis, Ind.
It is truly wonderful how everyone works together, helping to repair homes, comforting the elders, teaching better education to go further in life. Bless you Father Beiting. Everyone loves you for all you do and say. Ms. H. Joanna Sode Honolulu, Hawaii
The Mountain Spirit is interesting, concise, comprehensive, and inspiring, while making us aware of problems. I come from mountains in Virginia and have seen much misery firsthand. God bless you as you continue your greatly needed ministry to further God’s work. Mary E. Hylton Lynchburg, Va.
It is a pleasure to read about the work that is being done through Though I don’t live in Appalachia, my heart and prayers your programs. My husband and I are happy that our donations are are still there. I was born in Pike going to help so many needy County and raised in Floyd people. I was bom and raised in County, at Wheelwright. I enjoy Somerset, Kentucky, and did not The Mountain Spirit and read it realize that the need was so great in to my mother who is 98 years our region. I was blessed with a old, and in good health. good home and parents who Mary E. Malnar Las Vegas, Nev. worked hard to give their children a good education as well as a good Christian upbringing. I would like so much to come and work for you for awhile, but my health is not Sorry I missed seeing you good for the time being. May God when you came to Greensburg. It’s only a little more than an hour continue to bless you. Our prayers will be going out for you. or so. Maybe next time I will be Freeman M. Agnor lucky. God bless you and keep Powhatan, Va. you well. P.S. Enjoy the magazine. Mary Tierno Pittsburgh, Pa.
The Mountain Spirit is such great reading! I don’t want to miss a copy of it. Thanks. Selma Diller Pandora, Ohio
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The Mountain Spirit shows a people who are independent and willing to work to make a better life for themselves and family. Marion L. Hagadone Hobart, Ind.
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I would hate to ever have to be without The Mountain Spirit to keep me informed on what wonderful things are being done in Appalachia by CAP and others. There are dozens of books and magazines out there, but all I want to read about is God’s work. The Mountain Spirit answers that to perfection. I feel such a blessing when I read of your work putting people back on the road to constructive lives. To all of you full-time, part-time employees and volunteers, God bless you all, and to Father Beiting —thank you and God bless and keep you for many more years. Mr. and Mrs. Myrl Scheetz Squaw Valley, Calif. Letters to the editor are welcome. They should not exceed 150 words in length, and we reserve the right to edit them for space. Address letters to: The Mountain Spirit Christian Appalachian Project 322 Crab Orchard Street Lancaster, K Y 40446
The Many Hats Of
The Public Health Department t . by Beth Dotson ¡though many people think of health care as going to the doctor when someone is sick, the people who work in Kentucky’s health departments will tell you it is much more. Charged with looking after the health of an entire community, employees in county health departments do everything from giving vaccinations and counseling teen mothers to inspecting restaurants to ensure they are cooking in safe kitchens. T he
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ol Holbrook, Public Health have traditionally offered pre-natal irector at the Floyd County care, well-child checkups, immuni Health Department, explains the zations, physicals for school and work of her office by saying, “Our other basic services for children. whole emphasis is on education Women who are pregnant can and prevention.” apply through the health depart As good as that sounds, it’s not ment for the Women, Infants and always easy to carry out that Children (WIC) program, a special mission in a nation where most supplemental food program that people don’t see a doctor until they are sick and in a region where poverty can make people fearful of finding out why they don’t feel well. Carol said that many times, Diane Blackburn, she has worked Johnson County Health Department with people who said they would rather not know what is wrong works to ensure proper nutrition with them because they don’t have and health care during pregnancy the money to pay for the treatment. and early childhood. After Diane Blackburn works as a submitting an application and community health educator for the having a health exam, those Johnson County Health Depart eligible for the service receive ment. She has also experienced checks for the purchase of specific some of what Carol described. foods at the grocery store, such as “It’s hard to say to a lady ‘you milk and cheese, iron-fortified need to go have a mammogram’ when she can’t put food on the table,” Diane said. Knowing the difficulties that face them in their work, the nurses, educators, environmen talists and clerks who run health departments look at their individual communities to determine in what areas they should be working and they set out to create an atmosphere that welcomes people into their care.
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infant formula and vitamin Cfortified natural juice. Participants also receive monthly nutrition education and assistance with receiving regular health care. Many people are not aware that the program is available even for families that do not live below the poverty line. For example, in Kentucky a family of four with an annual income of $30,433 is eligible. Health departments emphasize that they exist to serve the entire community. Health departments also offer peri-natal programs that send home visitors out to talk with women before their babies ______ are born. These workers develop a one-on-one relationship with the new mother so she has someone to confer with about nutrition concerns, as well as the changes in her body. “It helps to have another woman who has been through that to tell you about what is going to happen,” Carol Holbrook said. Some women, especially teens,
"It's hard to say to a lady 'you need to go have a mammogram' when she can't put food on the table.
Addressing Family Heaitti Often, it is children who prompt their parents to have a first encounter with the health department. Health departments
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Nurse Shirley Woods (right) and the Garrard County Health Departm ent are an integral p a rt o f health care in the county.
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Lucy Atkerson provides treatment to a Garrard County boy.
Reaching people in need, Robert they have been able to pass on to have problems with transportation said, makes his days rewarding. teen mothers. For example, they to doctor appointments or The births of healthy babies are might receive baby clothes, bags unsupportive families. Carol gratifying for the people who work explained that in Floyd County, the and toys. “CAP has been a real with expectant mothers. Diane blessing for us,” she said. health department has a close explained that after the baby is Robert Duncan, who directs working relationship with doctors. born, the visitor continues If a woman doesn’t show up meet with the teen for a pre-natal appointment, At the health department in to mother. There are times the doctor will call the when the recognition in the department to see if they Garrard County, nurse young mother’s eyes says know why or if they can send Shirley Woods recently met that she understands the someone to her house to importance of something the check on her. with a 13-year-old who is visitor is sharing with her, The Resource Mother pregnant. "You don't go such as being sure her infant Program is similar, but is has a proper diet or is specifically for teen mothers home and forget that . " secured in car seat when who likely need even more riding in an automobile. support to have a healthy Shirley Woods, “It’s rewarding when you pregnancy. Some aren’t sure Garrard County Health Department can see that we’re helping,” where they will live during Diane said. their pregnancy or after the baby is CAP’SOperation Sharing program Once the parents come into a born. Diane Blackburn said that in for the Hagerhill office, said that health department with their approximately ten health depart Johnson County, the health children, the staff learns about the department has received numerous ments regularly pick up material entire family and, therefore, can donations. These go beyond baby material donations from the also address their other needs. supplies to items like vitamins, Christian Appalachian Project’s Nurses at health departments are wheelchairs and toothbrushes. Operation Sharing program that T
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specially trained in procedures such as diabetes counseling, testing for sexually transmitted diseases, testing for tuberculosis, performing pap smears and breast exams, and offering counseling for high blood pressure, cholesterol and other health concerns. They can tell families about other resources available through the health department or in the community.
again and again and the work can get frustrating, but it is also satisfying. Especially if you have experienced your own hard times, she said, you relate to people as they share their problems, healthrelated or not. At the Garrard County Health Department, health worker Trava Murphy volunteers with the local food pantry and has gotten the department involved in giving out vouchers for food when they see someone who needs them. When the department becomes familiar with a family through any of its programs, it is likely that they will be able to draw a broad portrait of what the family needs. “This is a place where people come for other needs and we find out they also need food,” Shirley said. During a visit to the health department, it might also become obvious that a woman is in an abusive relationship or a parent is worried about being able to find a job as required by welfare reform. Diane Blackburn said, “I know the clients we serve are really con-
"This is a place where people come for other needs and we find out they also need food." Shirley Woods, R.N. Garrard County Health Department
cerned because there are no job opportunities in this area.” As a result, the department is seeing more anxiety and stress in their patients. Carol Holbrook said the staff in Floyd County is trying to help its patients who receive government assistance to understand that the clock is ticking and they need to find job training and a job. Because they are well-connected in the community, the health department can refer patients elsewhere to get that kind of assistance. It’s that kind of networking that helps health departments point people to other resources in the community they might be able to use in order to get a better handle on their overall health. It’s also a job for each department to get the word out about the variety of services they offer. Shirley Woods recalls that in Garrard County, they have used billboards, advertisements and even trayliners at the local Dairy Queen to tell people about initiatives such as a month of free mammograms or WIC. She has found that a lot of people learn about their Health departments in Kentucky provide prim ary care to children. In many o f the counties services through word of the services o f a pediatrician are as much as an h o u r’s drive away. Health Departments Network At the health department in Garrard County, nurse Shirley Woods recently met with a 13year-old who is pregnant. “You don’t go home and forget that,” she said, explaining how deeply many public health workers feel for the people they serve. “All of us are caring people and all of us have dug in our own pockets or asked our churches for help,” Shirley said about the personal way many health workers respond to the people they meet. Shirley said there are times when you hear the same story
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departments charge nominal fees for their services, and don’t press the issue when a person cannot pay, they don’t always have the resources to pay for all the necessary treatment that might be required after they refer a patient on to a doctor. Some times, they are Health departments examine the safety o f playgrounds, as able to negotiate well as the soundness o f sewage systems. lower fees for the clients, but the mouth. lack of insurance is a big worry. Some also learn about the health As people who have relied on department through their education government assistance move into outreach projects. In her work in the workplace, they often find Johnson County, Diane Blackburn themselves in jobs that do not often goes into schools to talk provide medical insurance. about topics ranging from self Health departments also plan esteem to hygiene. She can special clinics for which they bring address community groups with doctors on site. Days have been information on how to modify high devoted to clinics such as physi fat recipes to be low fat or what cals for school sports teams, women need to know about breast infectious diseases and family and cervical planning. cancer. She has For Carol "I love it and I think learned that Holbrook, some there are some it's b e c a u s e .. .w e're of her best days things she can have been when change and not pushed to make a mother who some she can’t, a profit, but to help used the but when department’s something she people," she said. services told says registers, her that her she feels Carol Holbrook child received fulfilled. Public Health Director the best exam Diane and Floyd County Health he or she had Department Carol both ever gotten. expressed That is one of concern about the growing number the reasons that Carol likes her of people they see who lack work. “I love it and I think it’s medical coverage. Although health because . . . we’re not pushed to
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make a profit, but to help people,” she said.
Environmental Health Some of a health department’s most valuable work doesn’t happen inside its building, but rather in the community. Health departments also look into the community at health issues such as rabies, rodents, playground safety, food safety and sewage disposal. Departments have environmental ists on staff to work in these areas. One large problem in eastern Kentucky that the Floyd County Health Department has been addressing is lack of proper sewage disposal. Many families do not have a sewage system and get rid of waste by installing a straight pipe that empties into a nearby creek or river, thus polluting the waterway. When homes are built on small parcels of land, and often that land is rocky, there is no space to install a septic tank. Carol Holbrook said that in Floyd County, an ordinance passed last year to require sewage inspections before someone could get a permit to turn their electricity on. The department has been trying to educate mobile home salesmen about this ordinance so that they won’t move a trailer to a site until the inspections have been done. Since the ordinance was passed, Carol said, the office has had three times the number of requests for inspections as before. Monitoring this sort of environ mental safety fits in with the department’s emphasis on preven tive medicine. “If people use preventive health services, you can live a happier and healthier life,” Carol said. Beth Dotson, a writer and editor, is a former CAP volunteer.
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“It’s rewarding to be able to help people, to listen to them, pray with them. ” Trish Joseph
As Trish Joseph guided Tabitha, Lesia and Orville through the exercise, one could sense that along with the three members of the Falcon Women’s Group, she too was considering ways to bring her life into greater harmony. Everyone agreed that the “Univer sal Shopping List” that she shared was a good way to separate needs from wants. The group is one of the five Community Health Advocates women’s groups that Trish attends. As a CHAP staffer, Trish’s position is a combination of ♦ JULY
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mentor, teacher, coach, and — most important — friend to the women who have gathered. “Is the cost of the item worth the time it takes to earn the money to buy it?” was one of the questions. The question led to a discussion of the at-home work that is available, and Trish said that she had a budgeting presentation she would bring to their next meeting. A native of the Royalton area of Magoffin County, Trish speaks of the advantage she has of knowing people in the area and having them know that she’s a hometown girl.
by Margaret Gabriel
“I know a lot of my people and I have them invite other people. I know where they live, and I know where they’re coming from. “But I’ve also seen volunteers come in, especially Jan Bruns, and really make a difference. They got to know her, and even though she was different, they related to her as much as they did me,” Trish said. As one of a family of eleven children, Trish said “Growing up, I was poor. We didn’t have much, but we were happy. We had fun together, and didn’t have to spend
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a whole lot of money to do it. Everybody in the neighbor hood was always at our house — we had the most kids!” After high school gradua tion, Trish followed her older sister to Cumberland College in Williamsburg, Ky., got her degree in education and moved back home after she met, fell in love and married her husband, Bobby. She began working for the Christian Appalachian Project after being encouraged to apply for a job opening in CHAP by program manager Brenda Wireman, with whom Trish Trish and two members o f the Falcon Women’s Group discuss ways that they can unclutter their lives and concentrate on values. had worked as a substitute teacher. long-range outlook of a home that duces them to the superintendent Working with CAP and with she loves. “It’s rewarding to be and principals with whom they women’s groups has made Trish able to help people, to listen to will come in contact. In the seven more sensitive to the needs of them, pray with them.” years that Trish has been visiting people in the area. “Before I came Before becoming involved with classrooms, she has met thousands to work for CAP, I didn’t realize CHAP’s women’s groups, Trish of children who often speak to her there were people in this county had never considered herself to be in the grocery or drug store. who didn’t have electricity.” Trish a particularly “crafty” person, but “They’ll say hello and ask if I believes she is not only assisting that has certainly changed. remember them.” Trish said she people who have needs, but Although determining which crafts remembers faces more often than encouraging others to help, too. to feature during meetings is names, and has been introduced to Trish is sensitive to the stereo usually a decision of the group, mothers as “The lady who said we types that people hold about Trish keeps her eyes open for have to brush our teeth.” Appalachia, and carefully sets the project she thinks people will like. Bobby Keith came home one record straight whenever she can. Crafts have been termed “the day, and told his mother that a “We have volunteers that say heart of women’s groups” and “different lady” had been to his they’re from such-and-such a women say that the opportunity to classroom, Sister Rose, a CAP place, ‘have you ever heard of learn the skills involved in making volunteer, who told the group to that?’ We know where those crafts attracts them to the groups. brush their teeth six times. “I had places are.” “Brenda had started these told him three, and he said, ‘I just As the mother of nine-year-old wanted to see if you make me do it projects and told me she was going Bobby Keith, Trish enjoys making to turn them over to me. I didn’t six!”’ Trish said. nearly 100 presentations in know where I’d get ideas for She especially enjoys going to Magoffin County schools each things or how much money I’d be Bobby Keith’s classroom once or year. Because of the days she able to spend. We still don’t spend twice a year. “He wants to answer spent working as a substitute much money — we use a lot of all my questions, but he’s proud to teacher, Trish is comfortable Tide boxes,” Trish said. have me there,” Trish said. working in classrooms, and knows The experience of learning from Her work making school many of the teachers and adminis scratch has been important to presentations and sponsoring trators in the school system. Trish’s ability, now, to assure women’s groups makes Trish feel Trish also takes the lead in women that they can do whatever that she is making a positive scheduling presentations that are they set minds to do. contribution to her community, made by volunteers, and intro one that serves to improve the 30
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A Violent Beginning That Became A Victory The Christian Appalachian Project Big Sandy Abuse Shelter recently received an essay from a former resident. It started / came from an abusive family with 12 children: eight girls and four boys. My father was an alcoholic who beat my mother and us children whenever he felt like it.
The essay chronicled memories of a childhood shaped by poverty and abuse, which led to marriage at the age of 16 to another teenager who abused drugs, and also abused his wife. The abuse continued for years until, after three children, she finally summoned the courage to divorce her husband. She wrote . . . the last time he hit me was the worst. He beat me in the head until I was knocked down and then he kicked me in the face so bad that it left tread marks on my face . . . The police told me that he loved me and I should give him another chance.
A month after remarrying, she learned that she had married another abuser who drank as much as two cases of beer a day. After months of violence she found safety for herself and her children at the Big Sandy Family Abuse Shelter. They took my picture. I had two black eyes, busted vessels in my eyes, a concussion. I couldn’t balance m yself or focus my eyes. I couldn’t think straight. I felt so ashamed for how I looked and for what I had been putting up with. They gave me clothes, a place to sleep, took me to the d o c to r. . . made me feel like I was worth the effort and trouble I felt I was putting her through.
Donna Turner and the staff of the Big Sandy Abuse Shelter are justifiably proud of this woman. It took years of work and an incredible amount of determination, but her story ends, saying / will be graduated with my Bachelor’s o f University Studies with a minor in Social Work on May 16, 1998. I did my field experience at the shelter these past few months. This was like a dream come true to me. The shelter was where I got the strength to get my education and the courage to fight for what I wanted. It has been a very long and hard road, but I am about to reach the end.
She did her internship at the Big Sandy Family Abuse Shelter and looks forward to continuing to help other women find the strength and courage that she found. The support of CAP donors was an important ingredient to success. Your donation of $20, $50, $75 or more for use at a CAP abuse shelter — or where it is needed most — can be an integral part of more success stories. JULY
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H n ft^n fe iw f • In one county served by CAP over 75 percent of the children received free or ' reduced lunches in 1997. • Hungry children are two to three times more likely to suffer from health problems, such as frequent colds, headaches and fatigue. • Ten eastern Kentucky counties have poverty rates that average 42 percent. Only about half of those living below the poverty level in this counties receive public assistance. • The number of Kentucky children living in poverty increased over 12 percent between 1990 and 1997.
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