Hero to the poor

We have much that is wrong with our health care system here in Ireland. We suffer the inequities that a divided health care system brings, but however bad it is, I can’t help thinking that we are still so much better off than the situation that many in the United States, with no health insurance find themselves in. Through the many cancer blogs and twitter related tweets I read, I have become very aware of what the health care situation is like in the US. In 2008, there were approximately 48m Americans with no health insurance whatsoever and 25m-30m more who were under-insured, according to the National Coalition on Health Care in Washington, DC. Millions of Americans who are working still cannot afford the cost of healthcare. They are considered “working poor” because they are earning a modest income and unable to qualify for Medicaid or Medicare, the public-assistance programmes for those whose income and resources are insufficient to pay. And I know from my friends in the US, that health coverage is a complex labyrinth that is dizzyingly difficult to navigate.

And that’s where the story of Stan Brock comes in. This man has come to the rescue of nearly 200,000 poor Americans who can’t afford to see a doctor. So who is Stan Brock — and why has a penniless 72-year-old Brit devoted his life to solving the US healthcare crisis?

Stan Brock founded the Remote Area Medical Volunteer Corps, a non-profit-making organisation, in 1985, but he had the idea when he lived in the Amazon in the 1950s. He has carried out medical relief missions all over the world, but increasingly his focus has been on the poorest Americans.

Brock was born in Lancashire, England in 1936 and grew up mainly in South Wales and along the south coast of England. He had been given a scholarship to the Canford school in Dorset, but dropped out at 16 to join his mother and father, a civil servant who had been posted to British Guiana on the northern coast of South America — now known as Guyana.

His life story unfolds like an action-packed western where Brock is the hero. For the next 15 years he lived as a cowboy with the Wapishana Indians on Dadanawa ranch in the Amazon. It was during this time that he was inspired to start a volunteer medical-relief corps that would bring free healthcare to people who were poor and isolated.

In the US, Brock is remembered as the star of Wild Kingdom, a popular TV series about wildlife conservation that began in the late 1960s. Off the back of this, Brock starred in a few films in the 1970s that were low on plot but packed with animals. There are fading posters on the wall from Escape from Angola and Forgotten Wilderness. On this poster, Brock is pictured in a swamp wrestling a real anaconda. Also hanging on the wall is Brock’s tae-kwon-do black belt and several framed photographs — he looks more at ease in the ones with lion cubs than in those with humans. He was often referred to as “the original crocodile hunter”.

Forty years later, his adventurous spirit is still thriving. Part James Bond, part Gandhi, he moves with purposeful velocity. He seems incapable of wasting time. And because he has, as he says, “no dependants”, he is utterly, passionately committed to Ram. He needs very little. Brock sleeps on the floor on a mat, and his main companion is a stray dog, Rambeau, who is now blind. Until six months ago, the two of them showered outside in the courtyard with a hose, but when the temperatures dipped below freezing, ice cubes came out of the nozzle, so an indoor shower has been installed. There is no hot water? “No,” he says, recoiling. “Hot water is bad for you.” Brock does not take a salary and has no income. “I am here 365 days a year, all day, every year.” All of his money has gone into the organisation. He has no car, no house, no possessions, no bank account. He was sending in tax returns with “zero” under income for so long, the IRS (Internal Revenue Service) informed him it wasn’t necessary for him to file. “This is all I do. I do not need money. I had oatmeal to eat this morning and one of the volunteers brought the oatmeal.”

His family is his work — and the volunteers he surrounds himself with. Twelve years ago the operation became so large and complicated that Brock had to begin paying some of the volunteers. Jean Jolly will be 74 in August and has been with Ram for the past 15 years. Her salary is about $1,000 a month, and since she retired in 2004 from work at Talbots, a retail-clothing store, she is now the full-time volunteer co-ordinator; the engine that keeps everything running smoothly.

“We are the only nongovernmental charitable organisation in the United States that offers free dental, free visual, free medical, without any restrictions or questions asked,” she says proudly.

There are two separate entities. The Ram Foundation is the fundraising and administrative arm of the organisation, managing the private donations that underpin the work, with two full-time and five part-time employees. Then there is the Ram Volunteer Corps, which organises the expeditions and field operations, record-keeping and statistical information. Brock is chairman of both.

Last year, Ram was profiled on the American news programme 60 Minutes. Up until then, the annual budget had been about $250,000. And Ram had directed 94% to 96% of unrestricted funds to programme services, and spent between 4% and 6% on administration and overheads. But now, thanks to that exposure, the annual budget will be $1.9m. All donations and grants are from private donors and family foundations — no government money, no taxpayer money, no corporate funding. So what does that $1.9m cover? $595,000 of it was spent on an aeroplane, part of Ram’s mandate to take advanced surgical teams to communities that have never had a clinic before. It will fly a surgical team to Guyana a few times a year. There will also be a tractor-trailer rig outfitted as a self-contained mobile medical unit — to travel across America.

Twelve clinics are scheduled a year, but it usually ends up doing twice that. Some of those are one-day clinics offering one-day screenings, and so on. In the US it has expeditions scheduled in Kentucky, Virginia, Ohio and many more in Tennessee. Nobody gets paid. Everyone who has travelled has done so at his or her own cost. All volunteers cover their own food and lodging. There are no expenses.

Though Brock has adapted to living with the suffering of others, the rawness of it still hits him when he has to turn people away.

Teresa Gardner is a nurse practitioner and excecutive director of The Health Wagon, a mobile unit she drove up from Clinchco, Virginia, about four hours away. She is able to do smear tests and breast examinations, will screen-test for cervical cancer and will call the patients when the results come in and help refer them for follow-up care.

Though Brock has adapted to living with the suffering of others, the rawness of it still hits him when he has to turn people away.

“You try not to become immune. I review e-mails that come in by the hundreds.” He reads them all? “Oh yes,” he replies. “You can’t exit out and move on.” His current mission is to raise awareness about a key issue: that qualified, licensed medical professionals should be permitted to cross state lines to practise and provide free healthcare to indigent people. But owing to licensing laws, they are not, and that, he says, is the greatest impediment. The only place in the United States this can happen is in Tennessee, and this is because Brock had the laws changed. Most of the doctors who will show up over the weekend will be from out of state.

In April 2008, during the heart of the election campaign, Brock was asked to speak at a congressional hearing on healthcare in Washington, DC. He gave his views and asked: why can’t doctors cross state lines? He was given five minutes to say his piece and then was asked questions. And since then, what has transpired? Nothing. “It was a big disappointment,” he says.

Stan Brock is a hero and some have even called him a saint in his self-less devotion to those for whom paying for a basic human right to medical care, is beyond their reach. The volunteers who give of their free time for no cost are heroes too and the world is a better place for the work these people do.

Visit the Remote Area Medical website to learn more about the wonderful work of this organization: http://www.ramusa.org/

(This  post partially adapted from Ariel Leve’s Sunday Times feature article on Stan Brock )