Health Workers Go Above and Beyond for Vulnerable Patients in Rural North Carolina

Nurse Gena Byrd, a clinician for local farmworkers at Greene County Health Care, at the home of an elderly patient outside Snow Hill, North Carolina. The home had recently flooded as a result of Hurricane Florence. Byrd and other staff and volunteers made repairs to make the home safer. (Lara Cooper/Direct Relief)

By Lara Cooper

September 23, 2018

House calls may be a thing of the past for most health providers these days, but not for Nurse Gena Byrd.

The nurse is so involved with her vulnerable patients that last week found her swinging a hammer in the kitchen of an elderly, home-bound patient whose home had been damaged by Hurricane Florence several days earlier.

Byrd’s patients are some of the most vulnerable in Greene County, a mostly rural area of eastern North Carolina, where she works in farm worker services for Greene County Health Care.

About half of the health center’s patients are farm workers, and 85 percent of the clinic’s patients are uninsured.

On Friday, Byrd and Imelda Moye, a case worker and health educator for Greene County Health Care, were working alongside a group of volunteers, ripping up soaked carpet and hauling away a damaged refrigerator from the patient’s home.

Nurse Gena Byrd (right), who does medical outreach for local farm workers for Greene County Health Care, coordinates with volunteers to move a new refrigerator into the home of an elderly patient outside Snow Hill, North Carolina. (Lara Cooper/Direct Relief)

As the pair worked to create room for the fridge, they found some unwelcome visitors.

“There are black widows in there,” Byrd called out to Moye, and they worked to dispose of the nest safely.

One could argue that ripping out boards and repairing flood damage is way beyond Byrd and Moye’s job descriptions.

But going above and beyond for patients has long been in encoded in the DNA of health centers in the United States.

Nurse Gena Byrd and case worker Imelda Moye, both of whom conduct medical outreach for local farm workers for Greene County Health Care, repair the flood-damaged home of an elderly patient. (Lara Cooper/Direct Relief)

Dr. Jack Geiger, who formed the model for community health centers in the American South in the 1960s, sought to not only address the health issues of patients living in extreme poverty, but account for the underlying causes of those illnesses, including unsafe living conditions.

Digging clean water wells and installing screens on windows to protect from insect-borne diseases were all done by Geiger and his health center staff, in the name of protecting their patients.

Echoes from that history came through loud and clear with every thud of Byrd’s hammer.

Because this patient’s home is heated by wood, Byrd and her husband will often bring by chopped wood to stack nearby.

“We always have patients that we check on,” the nurse said.

Medical care is still at the heart of her work, though, and Byrd has worked with the woman living in the home to manage her health. The patient, a farm worker for 18 years, is now relatively home-bound, managing chronic conditions like high blood pressure and struggling to afford medication.

Among the bag of medicines she takes daily were several medications donated by Direct Relief to Greene County Health Care, which receives ongoing support of donated medicines and supplies.

Byrd and Moye’s patient requires a number of daily medication to manage chronic conditions like high blood pressure. Some of that medication was donated to Greene County Health Care from Direct Relief, so that medicine was provided for free. (Lara Cooper/Direct Relief)

The system has sites in Greene, Pamlico and Pitt Counties, which were seriously impacted by recent flooding.

Though the health system’s facilities didn’t experience any damage, many patients were impacted.

Just before the storm struck, local farm workers were right in the middle of cultivating and harvesting crops for the season, said Doug Smith, CEO of Greene County Health Care.

Hurricane Florence blew through, leaving nothing but destroyed crops behind, which will no doubt prove economically devastating for those that count on the work. Many of those farm workers have already returned to Mexico, Texas, Florida or other places they live when not harvesting in North Carolina.

“The tobacco is ruined, the sweet potatoes ruined,” Smith said.

Flooding in Greene County from Hurricane Florence damaged infrastructure in the area and destroyed local crops.

Smith said that most of the center’s patients fall into the category of “working poor,” and that about half of those patients work as farm labor for the agricultural operations that quilt the county landscape with soybeans, sweet potatoes, tobacco and other cash crops.

The state has not expanded Medicaid, meaning that there is a significant population of people that can’t afford to buy private insurance but don’t qualify for safety-net programs.

This makes the health center’s work even more vital, since many who receive care there would be unable to afford it otherwise.

“We’re here for everybody,” Smith said.

Year round, Greene County Health Care provides everything from dental care to pre- and post-natal care, health screening and lab services.

But Hurricane Florence found their staff doing even more. “During disasters, health centers step up,” he said.

The home of an elderly patient outside of Snow Hill, North Carolina. Greene County Heath Care staff visited the patient on Sept. 21, 2018. The home had recently flooded from Hurricane Florence and volunteers were working to rip out carpet and make repairs. (Lara Cooper/Direct Relief)

Back in the yellow house, Byrd and Moye talked about why they do what they do.

“It’s the reward of helping others,” Byrd said, and Moye agreed.

The case worker has known this patient for 15 years. As she scrubbed down the kitchen with bleach, Moye said it’s rewarding to help patients in such a hands-on way.

“It makes me feel like I did something important,” she said.