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The Health Wagon
in the Appalachian Mountains

Appalachians take care of their own

An Interview with Sister Bernie Kenny
Dickinson County, Virginia


Sister Bernie Kenny
Deep in the Appalachian Mountains of western Virginia, generations of miners and their families live in narrow hollers between beautiful tree-covered hills and mountains. Towns are often only four or five blocks long, and one block wide. Between the steep sides of the valleys flow rivers, winding roads, and train tracks travelled by load after load of coal.

Healthcare is hard to come by in these remote areas and many people's health is seriously damaged by a combination of work in the mines, coal dust in the air, one of the highest cigarette-smoking rates in the country, poor nutrition, close-by nuclear reactors, and poverty.

In these surroundings, a threesome team of women are considered by many in the area to be healthcare providing angels. The leader of the team is
Sister Bernie Kenny (of the Medical Missionaries of Mary), a certified nurse practitioner who has been promoting preventive medicine and caring for the sick for 18 years. Her assistants are Tracy Gilmore (studying to be a registered nurse) and Teresa Gardner (a registered nurse studying to be a nurse practioner) -- both lifelong residents of the Appalachians.

Because people are so dispersed and healthcare facilities so remote Sister Bernie, Teresa Gardner, and Tracy Gilmore travel from community to community in a converted healthcare bus.

The following interview with Sister Bernie (conducted by Nic Paget-Clarke) took place at a community meeting in Dickinson County. The meeting was called by Sister Bernie as part of a national networked press conference to announce the 20th anniversary and update of the Pastoral Message on Sustainable Communities in Appalachia. To contact Sister Bernie to learn more of the Health Wagon program and/or to make donations, write to: Sister Bernie Kenny, Route 1, Box 329, Clinchco, Virginia, 24226.

In Motion Magazine: How would you describe your approach to healthcare?

Sister Bernie: It empowers people to understand their health problems better, to take better care of themselves. By going to the communities, we go to seven sites, now, we know how to deal with environmental problems that contribute to health problems. It's a whole different way when you see people in their own homes and how they deal with different problems. You see different generations at the same time in an informal atmosphere.

It very much empowers people to take better care of themselves, to understand their symptoms, to observe nutrition. Life style changes are the hardest.

In Motion Magazine: By empowerment, do you mean people are taking control of their lives?

Sister Bernie driving the Health Wagon. Clinchco. Virginia. Photo by Nic Paget-Clarke
Sister Bernie: That's right. And while we're not a high-tech thing, we're the entrance into the health care system. By appropriate referral we save people money, instead of people going from one doctor to the next. And by providing the medication they don't get the complications of the illness. We have a very good pharmacy access program. We get drug companies to donate to the indigent program. We do all the paperwork and we give out about $600,000 worth of medicine -- to 6,000 people this year so far.In Motion Magazine: Is that more than before?

Sister Bernie: Yes, it's a 35% increase. Anyway, for example, if you keep taking your insulin, you won't end up with your leg off like that man over there. His diet just wasn't controlled. That's why we have him in the group. Socializing is so important.

In Motion Magazine: Is diabetes a big problem in Appalachia?

Sister Bernie: Yes, because we use a lot of bread and starches in the low-income diet of this area

In Motion Magazine: How many years has the healthcare preventive program program been in effect?

Sister Bernie: Since 1985. We've had the best success rate with our smoking cessation.

In Motion Magazine: I've noticed people do smoke a lot around here.

Sister Bernie: It's boredom, it's Virginia, it's the in thing to do now. But we get patches (editor:anti-nicotene addiction patches) from the company (pharmaceutical) and we work with them in stopping smoking. That really helps. When I say diabetes, that man used to smoke also and that makes the diabetes worse.

Another example of preventive care is our efforts against infant mortality. By us offering free pregnancy testing, we get into care earlier, provide better nutrition and a healthier baby. The infant mortality rate has come down two points in the last four years which is really considerable.

In Motion Magazine: How are you funded?

Sister Bernie: We write grants. We get funding from the church by personal appeals.
In Motion Magazine: You don't get grants from the church?Sister Bernie: No. Grants from health care corporations, for example St. Joseph's Hospital in Orange, California.

In Motion Magazine: It must be difficult to never really know when or if the next grant is coming.

Sister Bernie: We just keep scrambling. One grant that's Teresa was on finished in June, but we received word of another two-year grant, so we're sure for two years.

In Motion Magazine: So at least you're not at the whim of Mr. Gingrich.

Sister Bernie: No, it's totally private. We get enough from the donations of the people -- we don't charge anybody and we don't do any third-party billing. People make donations and that's enough to pay gas and repairs on the bus.

In Motion Magazine: What would happen if you weren't here?

Sister Bernie: A lot of things wouldn't happen.

In Motion Magazine: There's just no health care?

Sister Bernie: There's no care.

In Motion Magazine: There's other parts of the Appalachians that don't have care? Are there others like you? -- Or do people just not have anything?

Sister Bernie: A lot of people, they don't have anything.

Published in In Motion Magazine November 16, 1997

  • To read about Appalachian videomaker Anne Lewis - click here.
  • To read about Appalachian videomaker Herb E. Smith - click here.
  • To see a photo of Virgina miners going into the coal mines - click here.
  • To read the Pastoral Message on Sustainable Communites in Appalachia - click here.