Voters in one Alabama Congressional district will make history in November. They’ll cast their first ever votes for a newly redrawn seat in the U.S. House of Representatives. The U.S. Supreme Court ordered deep red Alabama to redraw its political map to better represent African Americans. The APR news team spent the better part of the year investigating issues impacting voters in the new District 2. One hits many close to home.
“My with my little girl, she broke her arm back in 2021, I think it was,” recalled Caila Savage, who lives in rural Mobile County in Alabama.
“It was a freak accident. She was rolling down the hill and her arm snapped in half,” she said.
Savage’s story has to do with rural heath.
“I think about an hour, maybe two hours, we had to wait on the ambulance to get to the hospital,” said Savage. “Then it was an hour ambulance ride to get her, I mean, and this is my five year old who has her arm snapped in half, having to wait all this, you know, oh, it was, it was crazy.”
Savage’s home town is Citronelle—population about four thousand. That may sound small, but maybe not to everybody.
“I live in Tibbie (Alabama.) A very, very, very small community with population on the census of 32,” said Meagan Carpenter. “We don't have a gas station, we don't have a store, we do have a postal office.”
To put everything into perspective, Meagan Carpenter is a doctor and Caila Savage is one of her patients. Both live in Alabama’s new U.S. House District two. But, that’s not where we are today. Carpenter explains why…
“For a bit of backstory, I still currently live in Alabama, but drive to Mississippi, currently to work. I currently work at Wayne General Hospital,” Carpenter explained.
We’re in Waynesboro Mississippi, just over the border from Alabama. Caila Savage has a blended family with five children. She also runs her own bakery. Here’s how today went…
”Well, like today, I had to get up at four o'clock today and get about four or five dozen cookies done, and then we had to get us ready, and then drive an hour to come to this appointment, and then however long this takes, and then I have to drive an hour back,” she said.
Savage travels to Mississippi because she can’t get the care she needs in rural Alabama. One issue is lack of doctors and hospitals. Another is the poverty rate. In rural Alabama, that runs about twenty percent,
“I even have some patients who it's like they storehouse medication because they're not sure when the next time they're going to be able to come see me,” said Carpenter. And, by “store housing” medicine, she means the patient only takes a pill when they feel sick…
“That does not mean that they're not having based on blood pressure issues. That just means they're not having a headache that day,”
And that’s not everything considered wrong with rural health in Alabama.
Obesity is, you know, a problem throughout the southern states,” said Doctor David Bramm. We met him at the annual conference of the Alabama Rural Health Association. He studies that subject at the University of Alabama in Birmingham. That includes all the ailments that go along with it…
“It (obesity) contributes to diabetes and heart disease and high blood pressure, which produce kidney failure, obesity and inactivity produce bad obstetrical outcomes, so that the quality of our children is diminished. So I think those are tobacco. Smoking is still a huge thing, tobacco use of any kind, but smoking is the worst.”
Talking about rural health is one thing. Fixing it is the other. More doctors may just be part of the answer. Bramm says there are also out of the box ideas like putting clinics in rural churches. He says even bribery has worked…
“The only way they got people to come in and be tested, because there was so much distrust in the black community, was to offer them $20,” recalled Bramm.
Bramm is referring to a tuberculosis outbreak in rural Alabama back in 2016.
“They offered the patients $20 to come in and be tested for TB, and that that worked. So maybe there's an incentive for a financial incentive for patients that might be entertained as well,” he said.
Back In Waynesboro, Mississippi, Caila Savage is getting ready for a check up. Promises of money from Washington are fine, but she and her neighbors are dealing with rural health challenges right now.
“We need specialists,” she said.
Savage has one medical specialty in mind. And the reason is her eighteen month old Allie Ray who’s along for a medical check of her own.
“Well, see, actually, when I was pregnant with my with my last one, that was a challenge, because my OB was also an hour away, and any type of paranoia that I was having judge to which we wait to a doctor appointment,” said Savage. “Or do we need to go and go to the ER because if something is happening, you don't want to wait till late, or, you know, too late and then be on the road for an hour to go get it checked out. So it was a constant paranoia on, should I go now, or should I wait?”
And for expectant mothers in Savage’s neck of the woods, life is getting more complicated with the recent closure of labor and delivery units in Monroe County and in the town of Grove Hill, not far from Savage’s home in Citronelle.
“I am from Clark County originally, so I do know a lot of people that were that were going there that um, did depend on that facility for their treatment, and had to, I mean, they were, like, seven and eight months pregnant. They were having to find a new doctor last minute. And, I mean, it was scary for them.”
And all of these patients need solutions, possibly from whoever gets elected to the new redrawn U.S. House Seat in district two.
The subject of rural health did come up at a mid October debate between Democrat Shomari Figures and Republican Caroleene Dobson. Figures took aim at GOP lawmakers who up to now have refused to expand Medicaid.
"If the state refuses to do that<' he said. "Then we have to look at ways to to get funding directly to the county level to at least provide some of the preventative care services that they would otherwise be able to receive if they have had the state expanded Medicaid."
Dobson took a different view, one that doesn’t involve money specifically to buck up rural health care in District two.
“Medicaid reimbursements, Medicare reimbursements, are not enough alone to continue to support our hospitals at the level that they need, that we have got to ensure that we have good paying jobs, that we have folks with private insurance that can reimburse at a higher level, and that we have an economic base," said Dobson.
“I don't, I don't, I don't see it," said Caila Savage on the subject of rural healthcare. She says having a hard time finding details online to go with the rhetoric….
“I'm having to, I have to, typically go search and see like, Okay, well, what are they wanting to do? What are they talking about? What? What change are they wanting to make?”
People tend to not care what poor rural people need or, I mean, they're just not a big voting block.
And Savage isn’t the only person you met in this story that’s less than optimistic. Doctor David Bramm at the University of Alabama at Birmingham doesn’t see much hope no matter which party wins…
“You know, certainly if the Democrats are elected, they're they're probably not going to do anything for Alabama. And if the Republicans elected, they probably won't do anything either. I hate to be cynical about that, but I just don't think that there's enough clout among those people to make material changes.
And, until change comes from Washington on rural health, Caila Savage will be getting up at 4 am, baking cookies, and making the two hour round trip to get the health care and her family needs. For APR news, I’m Pat Duggins in Waynesboro, Mississippi.
